86 research outputs found
Π€ΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΡΠΊΡΡΡΠ°ΠΌΠ°ΠΌΠΌΠ°ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΏΠ΅Π΄ΠΆΠ΅ΡΠ°
Extramammary Pagetβs disease (EMPD) is a rare tumor that predominantly affects the skin containing apocrine glands. Due to insufficient data on the effectiveness of different methods, there is no single therapeutic approach to the treatment of patients with EMPD and their subsequent management. The use of surgical methods, laser therapy and local cytotoxic drugs has a number of limitations. The advantages of using photodynamic therapy (PDT) in EMPD are the absence of systemic toxicity, non-invasiveness, selectivity of action, the absence of carcinogenic potential, the possibility of conducting several courses of treatment, and good cosmetic results. In our review, we analyzed those published in 2000-2022 data on the results of PDT treatment of 114 patients with EMPD. As a result of treatment, complete regression of tumor foci was achieved in 40% of patients. Most authors note that PDT is more effective for small areas (up to 4 cm2).ΠΠΊΡΡΡΠ°ΠΌΠ°ΠΌΠΌΠ°ΡΠ½ΡΠΉ ΡΠ°ΠΊ ΠΠ΅Π΄ΠΆΠ΅ΡΠ° (ΠΠΠ Π) β ΡΠ΅Π΄ΠΊΠΎ Π²ΡΡΡΠ΅ΡΠ°ΡΡΠ°ΡΡΡ ΠΎΠΏΡΡ
ΠΎΠ»Ρ, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΠΎΡΠ°ΠΆΠ°Π΅Ρ ΠΊΠΎΠΆΡ, ΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΡΡ Π°ΠΏΠΎΠΊΡΠΈΠ½Π½ΡΠ΅ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΠ·-Π·Π° Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° Π΄Π°Π½Π½ΡΡ
ΠΏΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ°Π·Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΎΡΡΡΡΡΡΠ²ΡΠ΅Ρ Π΅Π΄ΠΈΠ½ΡΠΉ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π ΠΈ ΠΈΡ
ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠ΅Π³ΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ², Π»Π°Π·Π΅ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ ΠΌΠ΅ΡΡΠ½ΡΡ
ΡΠΈΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΈΠΌΠ΅Π΅Ρ ΡΡΠ΄ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΠΉ. ΠΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π°ΠΌΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΠΠΠ Π ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π€ΠΠ’) ΡΠ²Π»ΡΡΡΡΡ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ, Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΡΡΡ, ΠΈΠ·Π±ΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ, ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΊΠ°Π½ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»Π°, Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
ΠΊΡΡΡΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ Ρ
ΠΎΡΠΎΡΠΈΠ΅ ΠΊΠΎΡΠΌΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π½Π°ΡΠ΅ΠΌ ΠΎΠ±Π·ΠΎΡΠ΅ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ ΠΎΠΏΡΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½Π½ΡΠ΅ Π² 2000-2022 Π³Π³. Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°Ρ
Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π€ΠΠ’ 114 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠΎΠ»Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΎΡΠ°Π³ΠΎΠ² Π±ΡΠ»Π° Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΠ° Ρ 40% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ Π°Π²ΡΠΎΡΠΎΠ² ΠΎΡΠΌΠ΅ΡΠ°ΡΡ, ΡΡΠΎ Π€ΠΠ’ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π΅Π΅ ΠΏΡΠΈ ΠΎΡΠ°Π³Π°Ρ
Π½Π΅Π±ΠΎΠ»ΡΡΠΎΠΉ ΠΏΠ»ΠΎΡΠ°Π΄ΠΈ (Π΄ΠΎ 4 ΡΠΌ2)
Π€ΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΏΡΠΎΡΠΈΠ°Π·ΠΎΠΌ
Photodynamic therapy (PDT) in the treatment of psoriasis remains the subject of much debate. There is no consensus in the scientific community about effective and safe PDT regimens for psoriasis. Described in the published materials doses and concentrations of photosensitizers for psoriasis, as well as light doses, differ by dozens of times. The purpose of this review is to analyze the efficacy and safety profile of various PDT regimens for psoriasis. Some studies demonstrate 100% effectiveness of the method in certain modes (complete or partial clearance of psoriasis foci after PDT). In particular, such efficiency was obtained with the application of 20% 5-ALA (light dose 15 J/cm2) and 0.1% methylene blue (light dose 15 J/ cm2). The main factor limiting the use of PDT in psoriasis, and in some cases even being the reason for treatment interruption, is severe pain during the irradiation procedure. This requires careful development of PDT regimens in patients with psoriasis.ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π€ΠΠ’) Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π° ΠΎΡΡΠ°Π΅ΡΡΡ ΠΏΡΠ΅Π΄ΠΌΠ΅ΡΠΎΠΌ ΠΌΠ½ΠΎΠ³ΠΎΡΠΈΡΠ»Π΅Π½Π½ΡΡ
Π΄ΠΈΡΠΊΡΡΡΠΈΠΉ. Π Π½Π°ΡΡΠ½ΠΎΠΌ ΡΠΎΠΎΠ±ΡΠ΅ΡΡΠ²Π΅ Π½Π΅Ρ Π΅Π΄ΠΈΠ½ΠΎΠ³ΠΎ ΠΌΠ½Π΅Π½ΠΈΡ ΠΎΠ± ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΡ
ΡΠ΅ΠΆΠΈΠΌΠ°Ρ
Π€ΠΠ’ ΠΏΡΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π΅. ΠΠΏΠΈΡΠ°Π½Π½ΡΠ΅ Π² Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΠ΅ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΡΠΈΠ°Π·Π° Π΄ΠΎΠ·Ρ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ²Π΅ΡΠΎΠ²ΡΠ΅ Π΄ΠΎΠ·Ρ ΡΠ°Π·Π»ΠΈΡΠ°ΡΡΡΡ Π² Π΄Π΅ΡΡΡΠΊΠΈ ΡΠ°Π·. Π¦Π΅Π»ΡΡ Π½Π°ΡΡΠΎΡΡΠ΅Π³ΠΎ ΠΎΠ±Π·ΠΎΡΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ ΠΏΡΠΎΡΠΈΠ»Ρ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΡ
Π΅ΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π€ΠΠ’ ΠΏΡΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π΅. Π ΡΠ΄ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΠ΅Ρ 100%-Π½ΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° Π² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΡ
ΡΠ΅ΠΆΠΈΠΌΠ°Ρ
(ΠΏΠΎΠ»Π½ΠΎΠ΅ ΠΈΠ»ΠΈ ΡΠ°ΡΡΠΈΡΠ½ΠΎΠ΅ ΠΎΡΠΈΡΠ΅Π½ΠΈΠ΅ ΠΎΡΠ°Π³ΠΎΠ² ΠΏΡΠΎΡΠΈΠ°Π·Π° ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π€ΠΠ’). Π ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ, ΡΠ°ΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π±ΡΠ»Π° ΠΏΠΎΠ»ΡΡΠ΅Π½Π° ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ Π°ΠΏΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ 20%-ΠΎΠΉ 5-ΠΠΠ (ΡΠ²Π΅ΡΠΎΠ²Π°Ρ Π΄ΠΎΠ·Π° 15 ΠΠΆ/ΡΠΌ2) ΠΈ 0,1%-Π³ΠΎ ΠΌΠ΅ΡΠΈΠ»Π΅Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΈΠ½Π΅Π³ΠΎ (ΡΠ²Π΅ΡΠΎΠ²Π°Ρ Π΄ΠΎΠ·Π° 15 ΠΠΆ/ΡΠΌ2). ΠΡΠ½ΠΎΠ²Π½ΡΠΌ ΡΠ°ΠΊΡΠΎΡΠΎΠΌ, ΠΎΠ³ΡΠ°Π½ΠΈΡΠΈΠ²Π°ΡΡΠΈΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π€ΠΠ’ ΠΏΡΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π΅ ΠΈ Π² ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
ΡΠ»ΡΡΠ°ΡΡ
Π΄Π°ΠΆΠ΅ ΡΠ²Π»ΡΡΡΠΈΠΌΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΏΡΠ΅ΡΡΠ²Π°Π½ΠΈΡ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠΈΠ»ΡΠ½Π°Ρ Π±ΠΎΠ»Π΅Π·Π½Π΅Π½Π½ΠΎΡΡΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΠΏΡΠΎΡΠ΅Π΄ΡΡΡ ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ. ΠΡΠΎ ΡΡΠ΅Π±ΡΠ΅Ρ ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΎΡΡΠ°Π±ΠΎΡΠΊΠΈ ΡΠ΅ΠΆΠΈΠΌΠΎΠ² Π€ΠΠ’ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΡΠΎΡΠΈΠ°Π·ΠΎΠΌ
Π€Π»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΏΡΠΈ Π½Π΅ΠΌΠ΅Π»Π°Π½ΠΎΡΠΈΡΠ°ΡΠ½ΡΡ ΠΎΠΏΡΡ ΠΎΠ»ΡΡ ΠΊΠΎΠΆΠΈ
Fluorescent diagnostics is a promising method for diagnosing non-melanocytic skin tumors, which makes it possible to identify clinically undetectable skin cancer foci and clarify the margin of the tumor lesion. The main drugs for fluorescent diagnostics are drugs based on 5-aminolevulinic acid and its methyl ester. Sensitivity indicators of fluorescent diagnostics in basal cell, squamous cell carcinoma and extramammary Pagetβs disease reach 79.0-100.0%, speci city β 55.6-100%. But the effectiveness of this method may be reduced due to hyperkeratinization, keratinization, and the presence of necrotic tissue on the surface of tumor foci. Comparative studies of the results of fluorescent diagnostics and histological mapping during tumor removal using Mohs micrographic surgery showed approximately equal results in the determining of the tumor edges by these methods, which indicates that safe and technically easily performed fluorescent diagnostics can serve as a good alternative to Mohs micrographic surgery, one of the most accurate, but rather labor-intensive and technically complex method for determining the margin of skin cancer foci.Π€Π»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° β ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π½Π΅ΠΌΠ΅Π»Π°Π½ΠΎΡΠΈΡΠ°ΡΠ½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΊΠΎΠΆΠΈ, ΠΊΠΎΡΠΎΡΡΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π²ΡΡΠ²ΠΈΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΠΌΡΠ΅ ΠΎΡΠ°Π³ΠΈ ΡΠ°ΠΊΠ° ΠΊΠΎΠΆΠΈ ΠΈ ΡΡΠΎΡΠ½ΠΈΡΡ Π³ΡΠ°Π½ΠΈΡΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ°. ΠΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ²Π»ΡΡΡΡΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π° Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ 5-Π°ΠΌΠΈΠ½ΠΎΠ»Π΅Π²ΡΠ»ΠΈΠ½ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ ΠΈ Π΅Π΅ ΠΌΠ΅ΡΠΈΠ»ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΈΡΠ°. ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΡΠΈ Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΌ, ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ ΠΊΠΎΠΆΠΈ ΠΈ ΡΠΊΡΡΡΠ°ΠΌΠ°ΠΌΠΌΠ°ΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ ΠΠ΅Π΄ΠΆΠ΅ΡΠ° Π΄ΠΎΡΡΠΈΠ³Π°ΡΡ 79,0-100,0%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠΈ β 55,6-100%. ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΡΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΌΠΎΠΆΠ΅Ρ ΡΠ½ΠΈΠΆΠ°ΡΡΡΡ Π·Π° ΡΡΠ΅Ρ Π³ΠΈΠΏΠ΅ΡΠΊΠ΅ΡΠ°ΡΠΈΠ½ΠΈΠ·Π°ΡΠΈΠΈ, ΠΎΡΠΎΠ³ΠΎΠ²Π΅Π½ΠΈΡ ΠΈ ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΡ Π½Π΅ΠΊΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΊΠ°Π½ΠΈ Π½Π° ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΎΡΠ°Π³ΠΎΠ². Π‘ΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΡΠ΄Π°Π»Π΅Π½ΠΈΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΌΠΈΠΊΡΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ ΠΠΎΠΎΡΠ° ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ Π²ΡΡΠΎΠΊΡΡ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΡΠ°Π΅Π² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΡΡΠΈΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ, ΡΡΠΎ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎ ΡΠΎΠΌ, ΡΡΠΎ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½Π°Ρ ΠΈ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΈ Π»Π΅Π³ΠΊΠΎ Π²ΡΠΏΠΎΠ»Π½ΠΈΠΌΠ°Ρ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΌΠΎΠΆΠ΅Ρ ΡΠ»ΡΠΆΠΈΡΡ Ρ
ΠΎΡΠΎΡΠ΅ΠΉ Π°Π»ΡΡΠ΅ΡΠ½Π°ΡΠΈΠ²ΠΎΠΉ ΠΌΠΈΠΊΡΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ ΠΠΎΠΎΡΠ° β ΠΎΠ΄Π½ΠΎΠΌΡ ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠΎΡΠ½ΡΡ
, Π½ΠΎ Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ ΡΡΡΠ΄ΠΎΠ·Π°ΡΡΠ°ΡΠ½ΠΎΠΌΡ ΠΈ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΈ ΡΠ»ΠΎΠΆΠ½ΠΎΠΌΡ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π³ΡΠ°Π½ΠΈΡ ΠΎΡΠ°Π³ΠΎΠ² ΡΠ°ΠΊΠ° ΠΊΠΎΠΆΠΈ
Π€ΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΡΠΈ Π°ΠΊΠ½Π΅
Acne is one of the most common skin conditions in the world. A number of studies have shown that photodynamic therapy (PDT) is safe and effective for both inflammatory and non-inflammatory acne and can significantly improve skin conditions in this disease. The effectiveness of PDT against acne is mainly due to a decrease in the amount of sebum produced by the sebaceous glands due to a decrease in their activity as a result of direct photodynamic damage to the sebaceous glands, eradication of Cutibacterium acnes, and a decrease in the level of hyperkeratosis. Compared with systemic drug therapy, PDT treatment of severe acne has the following advantages: fast results, high efficiency, high selectivity, no systemic adverse reactions and drug resistance, and low recurrence rate. Most often for PDT in patients with acne, drugs based on 5-aminolevulinic acid (5-ALA) and its methyl ester (ME-ALA) are used. At the moment, there are no unified recommendations on PDT regimens for the treatment of this skin pathology. Various studies demonstrate the high efficiency of PDT with a wide range of doses of 5-ALA (3-20%) and ME-ALA (4-16%), light doses (15-120 J/cm2 ), and exposure time (30-90 min). The general trend in studies by different authors is that gentle low-intensity PDT regimens for acne demonstrate the same high efficiency with a significant reduction in pain during irradiation and local skin reactions (erythrema, edema, and hyperpigmentation).ΠΠΊΠ½Π΅ β ΠΎΠ΄Π½Π° ΠΈΠ· ΡΠ°ΠΌΡΡ
ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΡ
Π² ΠΌΠΈΡΠ΅ ΠΊΠΎΠΆΠ½ΡΡ
ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΉ. Π ΡΠ΄ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ (Π€ΠΠ’) Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½Π° ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π° ΠΏΡΠΈ Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΈ Π½Π΅Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΎΡΠΌΠ΅ Π°ΠΊΠ½Π΅ ΠΈ ΠΌΠΎΠΆΠ΅Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ»ΡΡΡΠΈΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΊΠΎΠΆΠΈ ΠΏΡΠΈ ΡΡΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΈ. ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π€ΠΠ’ ΠΏΡΠΎΡΠΈΠ² Π°ΠΊΠ½Π΅ Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π° ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° ΠΊΠΎΠΆΠ½ΠΎΠ³ΠΎ ΡΠ°Π»Π°, Π²ΡΡΠ°Π±Π°ΡΡΠ²Π°Π΅ΠΌΠΎΠ³ΠΎ ΡΠ°Π»ΡΠ½ΡΠΌΠΈ ΠΆΠ΅Π»Π΅Π·Π°ΠΌ, Π·Π° ΡΡΠ΅Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΈΡ
Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΡΡΠΌΠΎΠ³ΠΎ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΡΠ°Π»ΡΠ½ΡΡ
ΠΆΠ΅Π»Π΅Π·, ΡΡΠ°Π΄ΠΈΠΊΠ°ΡΠΈΠ΅ΠΉ Cutibacterium acnes ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠ²Π½Ρ Π³ΠΈΠΏΠ΅ΡΠΊΠ΅ΡΠ°ΡΠΎΠ·Π°. ΠΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΠΎΡΠΌΡ Π°ΠΊΠ½Π΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π€ΠΠ’ ΠΈΠΌΠ΅Π΅Ρ ΡΠ»Π΅Π΄ΡΡΡΠΈΠ΅ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π°: Π±ΡΡΡΡΡΠΉ ΡΠ΅Π·ΡΠ»ΡΡΠ°Ρ, Π²ΡΡΠΎΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ, Π²ΡΡΠΎΠΊΠ°Ρ ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ, ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΡ
ΠΏΠΎΠ±ΠΎΡΠ½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ ΠΈ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ, Π½ΠΈΠ·ΠΊΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΎΠ². ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Π΄Π»Ρ Π€ΠΠ’ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π°ΠΊΠ½Π΅ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ 5-Π°ΠΌΠΈΠ½ΠΎΠ»Π΅Π²ΡΠ»ΠΈΠ½ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ (5-ΠΠΠ) ΠΈ Π΅Π΅ ΠΌΠ΅ΡΠΈΠ»ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΈΡΠ° (ΠΠ-ΠΠΠ). ΠΠ° Π΄Π°Π½Π½ΡΠΉ ΠΌΠΎΠΌΠ΅Π½Ρ Π½Π΅ ΡΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ Π΅Π΄ΠΈΠ½ΡΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΡΠ΅ΠΆΠΈΠΌΠ°ΠΌ Π€ΠΠ’ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠΉ ΠΊΠΎΠΆΠ½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π Π°Π·Π»ΠΈΡΠ½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΡΡ Π²ΡΡΠΎΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π€ΠΠ’ Ρ ΡΠΈΡΠΎΠΊΠΈΠΌ Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½ΠΎΠΌ Π΄ΠΎΠ· 5-ΠΠΠ (3-20%) ΠΈ ΠΠ-ΠΠΠ (4-16%), ΡΠ²Π΅ΡΠΎΠ²ΡΡ
Π΄ΠΎΠ· (15-120 ΠΠΆ/ ΡΠΌ2 ) ΠΈ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ (30-90 ΠΌΠΈΠ½). ΠΠ±ΡΠ°Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΡΠ°Π·Π½ΡΡ
Π°Π²ΡΠΎΡΠΎΠ² ΡΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΊ ΡΠΎΠΌΡ, ΡΡΠΎ ΡΠ°Π΄ΡΡΠΈΠ΅ Π½ΠΈΠ·ΠΊΠΎΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΡΠ΅ ΡΠ΅ΠΆΠΈΠΌΡ Π€ΠΠ’ ΠΏΡΠΈ Π°ΠΊΠ½Π΅ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΡΡ ΡΠ°ΠΊΡΡ ΠΆΠ΅ Π²ΡΡΠΎΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»Π΅Π²ΡΡ
ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ ΠΈ ΠΌΠ΅ΡΡΠ½ΡΡ
ΠΊΠΎΠΆΠ½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ (ΡΡΠΈΡΡΠ΅ΠΌΠ°, ΠΎΡΠ΅ΠΊ, Π³ΠΈΠΏΠ΅ΡΠΏΠΈΠ³ΠΌΠ΅Π½ΡΠ°ΡΠΈΡ)
Π€ΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΊΠΎΠΆΠΈ ΡΡΠ½ΠΎΠΉ ΡΠ°ΠΊΠΎΠ²ΠΈΠ½Ρ ΡΡΠ°Π΄ΠΈΠΈ T3N0M0 (ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅)
The article presents a clinical observation. The patient, 72 years old, applied to the MNII them. P.A. Herzen with complaints about the presence of an ulcerated tumor of the left ear. After further examination, a diagnosis was made - basal cell carcinoma of the ear skin with spread to the skin of the parotid region T3N0M0. On July 9, 2021, the patient underwent a course of photodynamic therapy (PDT) using a photosensitizer based on chlorin e6 and a diode laser with a wavelength of 662 nm. After one course of PDT, complete regression of the tumor was recorded.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅. ΠΠΎΠ»ΡΠ½ΠΎΠΉ, 72 Π»Π΅Ρ, ΠΎΠ±ΡΠ°ΡΠΈΠ»ΡΡ Π² ΠΠΠΠΠ ΠΈΠΌ. Π.Π. ΠΠ΅ΡΡΠ΅Π½Π° Ρ ΠΆΠ°Π»ΠΎΠ±Π°ΠΌΠΈ Π½Π° Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΈΠ·ΡΡΠ·Π²Π»Π΅Π½Π½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π»Π΅Π²ΠΎΠ³ΠΎ ΡΡ
Π°. ΠΠΎΡΠ»Π΅ Π΄ΠΎΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ Π΄ΠΈΠ°Π³Π½ΠΎΠ· β Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΉ ΡΠ°ΠΊ ΠΊΠΎΠΆΠΈ ΡΡ
Π° Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ Π½Π° ΠΊΠΎΠΆΡ ΠΎΠΊΠΎΠ»ΠΎΡΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ T3N0M0. ΠΠΎΠ»ΡΠ½ΠΎΠΌΡ 09.07.2021 Π±ΡΠ» Π²ΡΠΏΠΎΠ»Π½Π΅Π½ ΠΊΡΡΡ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π€ΠΠ’) Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ Ρ
Π»ΠΎΡΠΈΠ½Π° Π΅6 ΠΈ Π΄ΠΈΠΎΠ΄Π½ΠΎΠ³ΠΎ Π»Π°Π·Π΅ΡΠ° Ρ Π΄Π»ΠΈΠ½ΠΎΠΉ Π²ΠΎΠ»Π½Ρ 662 Π½ΠΌ. ΠΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΊΡΡΡΠ° Π€ΠΠ’ Π±ΡΠ»Π° Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π° ΠΏΠΎΠ»Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ
Large Scale Structures a Gradient Lines: the case of the Trkal Flow
A specific asymptotic expansion at large Reynolds numbers (R)for the long
wavelength perturbation of a non stationary anisotropic helical solution of the
force less Navier-Stokes equations (Trkal solutions) is effectively constructed
of the Beltrami type terms through multi scaling analysis. The asymptotic
procedure is proved to be valid for one specific value of the scaling
parameter,namely for the square root of the Reynolds number (R).As a result
large scale structures arise as gradient lines of the energy determined by the
initial conditions for two anisotropic Beltrami flows of the same helicity.The
same intitial conditions determine the boundaries of the vortex-velocity tubes,
containing both streamlines and vortex linesComment: 27 pages, 2 figure
ΠΠ±Π·ΠΎΡ ΠΌΠ΅Ρ Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠΎΠ² ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ Ρ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΡΠΊΡΡΡΡ Π² ΠΎΠΏΡΡ ΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ
The review of available theories explaining mechanisms of photosensitizer selective accumulation in tumor tissue is represented in the article. Variants associated with both targeted delivery of compounds with different chemical structure to tumor and low elimination rate of photosensitizers in the tumor are described. Details of tumor cell up-take of photosensitizer bounded with lipoproteins due to increased expression of low solidity lipoproteins receptors comparing with normal cells; mechanisms of photosensitizer accumulation in tumor tissue due to phagocytosis by macrophages localized in this area; mechanisms of binding of porphyrin-based photosensitizer by collagen fibers, production of which is increased in tumor cells, and other mechanisms are reviewed. Perspectives of practical application of knowledge about mechanisms of selective accumulation for induced increase in selectiveness of photosensitizer accumulation in tumor through targeted delivery of agent to pathological tissues are shown. Analysis of world trends in the search of transport systems for photosensitizers is performed.Β Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΠΎΠ±Π·ΠΎΡ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΡ
ΡΠ΅ΠΎΡΠΈΠΉ, ΠΎΠ±ΡΡΡΠ½ΡΡΡΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠΎΠ² Π² ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΡΠΊΠ°Π½ΡΡ
. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ Π²Π°ΡΠΈΠ°Π½ΡΡ, ΡΠ²ΡΠ·Π°Π½Π½ΡΠ΅ ΠΊΠ°ΠΊ Ρ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ Π΄ΠΎΡΡΠ°Π²ΠΊΠΎΠΉ ΡΠΎΠ΅Π΄ΠΈΠ½Π΅Π½ΠΈΠΉ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΡΠΊΡΡΡΡ Π² ΠΎΠΏΡΡ
ΠΎΠ»Ρ, ΡΠ°ΠΊ ΠΈ Ρ Π½ΠΈΠ·ΠΊΠΎΠΉ ΡΠΊΠΎΡΠΎΡΡΡΡ ΡΠ»ΠΈΠΌΠΈΠ½Π°ΡΠΈΠΈ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»Π°ΡΠΎΡΠΎΠ² ΠΈΠ· ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ. ΠΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½Ρ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π·Π°Ρ
Π²Π°ΡΠ° ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠΌΠΈ ΠΊΠ»Π΅ΡΠΊΠ°ΠΌΠΈ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ°, ΡΠ²ΡΠ·Π°Π½Π½ΠΎΠ³ΠΎ Ρ Π»ΠΈΠΏΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½Π°ΠΌΠΈ, Π±Π»Π°Π³ΠΎΠ΄Π°ΡΡ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΎΠΉ, ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΡΠΌΠΈ ΠΊΠ»Π΅ΡΠΊΠ°ΠΌΠΈ, ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² Π»ΠΈΠΏΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½ΠΎΠ² Π½ΠΈΠ·ΠΊΠΎΠΉ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΠΈ; ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° Π² ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ Π·Π° ΡΡΠ΅Ρ ΠΏΠΎΠ³Π»ΠΎΡΠ΅Π½ΠΈΡ Π½Π°Ρ
ΠΎΠ΄ΡΡΠΈΠΌΠΈΡΡ ΡΠ°ΠΌ ΠΌΠ°ΠΊΡΠΎΡΠ°Π³Π°ΠΌΠΈ; ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΡΠ²ΡΠ·ΡΠ²Π°Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° ΠΏΠΎΡΡΠΈΡΠΈΠ½ΠΎΠ²ΠΎΠΉ ΡΡΡΡΠΊΡΡΡΡ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½ΠΎΠ²ΡΠΌΠΈ Π½ΠΈΡΡΠΌΠΈ, ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΡ ΠΊΠΎΡΠΎΡΡΡ
ΡΠ²Π΅Π»ΠΈΡΠ΅Π½Π° Π² ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΊΠ»Π΅ΡΠΊΠ°Ρ
ΠΈ ΡΡΠ΄ Π΄ΡΡΠ³ΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ². ΠΠΎΠΊΠ°Π·Π°Π½Ρ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Ρ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π·Π½Π°Π½ΠΈΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ Ρ ΡΠ΅Π»ΡΡ ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° Π² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΏΡΡΠ΅ΠΌ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ Π΄ΠΎΡΡΠ°Π²ΠΊΠΎΠΉ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π² ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠΊΠ°Π½ΠΈ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΡ
Π² ΠΌΠΈΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ ΠΏΠΎ ΠΏΠΎΠΈΡΠΊΡ ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΠΈΡΡΠ΅ΠΌ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠΎΠ².
ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΌΠ΅ΡΡΠ½ΠΎΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ
The original method of intraoperative photodynamic therapy for multimodality treatment of primary and recurrent breast cancer forΒ devitalization of malifnant cells at wound surface and for prevention of further cancer dissemination was developed in P.A. HerzenΒ Moscow Cancer Research Institute. The developed method was approved in 79 patients with locally advanced breast cancer stageΒ IIB and IIIA,B,C with poor prognostic factors. For photodynamic therapy the photosensitizer photosens (30 min intravenous infusionΒ at dose of 0.3 mg/kg of body weight 2 h before surgery) was used in 56 patients; alasens (solution in 100 ml of still drinking water,Β orally at dose of 30 mg/kg of body weight 2 h before general anesthesia) β in 23 patients. The surgical field was irradiated on aΒ single occasion: the dose of laser irradiation on the bed of removed primary or recurrent tumor was 20β30 J/cm2, in the removedΒ regional lymph nodes area β 50 J/cm2. Long-term results of the treatment were assessed in 34 patients: there were no diseaseΒ progression in 50% of patients, 14.7% of patients had locoregional recurrence, distant metastases were in 35.3% of patients.Β The level of photosensitizer accumulation in tissue was additionally analyzed in 26 patients by fluorescence intensity in tumor and inΒ normal breast tissue. After injection of alasens the increase in level of alasens-induced protoporphyrin IX fluorescence was recorded in tumor (the average diagnostic parameter was 6.5 a.u.) and in intact breast tissue (an average of 0.47 a.u.), tumor/normal tissue fluorescence contrast varied from 3 to 33. The level of protoporphyrin IX accumulation was noticed to be lower in tumors with pathomorphological response after neoadjuvant therapy. For photosens value of the average diagnostic parameter in normal breast tissue was 5.6 a.u., in tumor β 34.3 a.u., tumor/normal tissue fluorescence contrast β from 2 to 9.Π ΠΠΠΠΠ ΠΈΠΌ. Π.Π. ΠΠ΅ΡΡΠ΅Π½Π° ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΠΎΡΠΈΠ³ΠΈΠ½Π°Π»ΡΠ½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π΄Π»Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΈ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ Ρ ΡΠ΅Π»ΡΡ Π΄Π΅Π²ΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΡΠ°ΠΊΠΎΠ²ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΡΠ°Π½Π΅Π²ΠΎΠΉ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈΒ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅Π³ΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ ΡΠ°ΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ°. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° Π°ΠΏΡΠΎΠ±ΠΈΡΠΎΠ²Π°Π½Π° Ρ 79 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΡΠ½ΠΎΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ IIB ΠΈ IIIA,B,C ΡΡΠ°Π΄ΠΈΠΉ Ρ ΠΎΡΡΠ³ΠΎΡΠ΅Π½Π½ΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠ»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ 56 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡ ΡΠΎΡΠΎΡΠ΅Π½Ρ (Π²Π½ΡΡΡΠΈΠ²Π΅Π½Π½ΠΎ ΠΊΠ°ΠΏΠ΅Π»ΡΠ½ΠΎ Π² Π΄ΠΎΠ·Π΅ 0,3 ΠΌΠ³/ΠΊΠ³ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π°Β Π±ΠΎΠ»ΡΠ½ΠΎΠΉ Π·Π° 2 Ρ Π΄ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°); Ρ 23 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ β Π°Π»Π°ΡΠ΅Π½Ρ (ΡΠ°ΡΡΠ²ΠΎΡ Π² 100 ΠΌΠ» Π½Π΅Π³Π°Π·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠΈΡΡΠ΅Π²ΠΎΠΉ Π²ΠΎΠ΄Ρ, Π²Π½ΡΡΡΡΒ Π² Π΄ΠΎΠ·Π΅ 30 ΠΌΠ³/ΠΊΠ³ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° Π±ΠΎΠ»ΡΠ½ΠΎΠΉ Π·Π° 2 Ρ Π΄ΠΎ Π½Π°ΡΠ°Π»Π° Π½Π°ΡΠΊΠΎΠ·Π°). ΠΠ±Π»ΡΡΠ΅Π½ΠΈΠ΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ»Ρ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΎΠ΄Π½ΠΎΠΊΡΠ°ΡΠ½ΠΎ: Π΄ΠΎΠ·Π° Π»Π°Π·Π΅ΡΠ½ΠΎΠ³ΠΎΒ ΠΎΠ±Π»ΡΡΠ΅Π½ΠΈΡ Π½Π° Π·ΠΎΠ½Ρ ΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΈΠ»ΠΈ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 20β30 ΠΠΆ/ΡΠΌ2, Π½Π° Π·ΠΎΠ½Ρ ΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΡ
Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ·Π»ΠΎΠ² β 50 ΠΠΆ/ΡΠΌ2. ΠΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΡΠ»ΠΈ ΠΎΡΠ΅Π½Π΅Π½Ρ Ρ 34 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ: Ρ 50% Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π΅ Π±ΡΠ»ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, Ρ 14,7% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½ Π»ΠΎΠΊΠΎΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΠΉ ΡΠ΅ΡΠΈΠ΄ΠΈΠ², ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·Ρ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ Ρ 35,3% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ.Β Π£ 26 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎ Π±ΡΠ» ΠΈΠ·ΡΡΠ΅Π½ ΡΡΠΎΠ²Π΅Π½Ρ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° Π² ΡΠΊΠ°Π½ΡΡ
ΠΏΠΎ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠΈΠΈ Π² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΈ Π·Π΄ΠΎΡΠΎΠ²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΠΎΡΠ»Π΅ Π²Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π°Π»Π°ΡΠ΅Π½Ρ Π±ΡΠ»ΠΎ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Ρ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠΈΠΈ Π°Π»Π°ΡΠ΅Π½Ρ-ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΎΠΏΠΎΡΡΠΈΡΠΈΠ½Π° IX Π² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ (Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡ ΡΠΎΡΡΠ°Π²ΠΈΠ» 6,5 Ρ.Π΅.) ΠΈ Π½Π΅ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Π½ΠΎΠΉΒ ΡΠΊΠ°Π½ΠΈ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ (Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ 0,47 Ρ.Π΅.), Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠΉ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΡΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Ρ/Π½ΠΎΡΠΌΠ° Π²Π°ΡΡΠΈΡΠΎΠ²Π°Π»ΠΎ ΠΎΡ 3 Π΄ΠΎ 33. ΠΡΠ»ΠΎΒ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ, ΡΡΠΎ ΡΡΠΎΠ²Π΅Π½Ρ Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡ ΠΏΡΠΎΡΠΎΠΏΠΎΡΡΠΈΡΠΈΠ½Π° IX Π² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π½ΠΈΠΆΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π»Π΅ΡΠ΅Π±Π½ΡΠΌ ΠΏΠ°ΡΠΎΠΌΠΎΡΡΠΎΠ·ΠΎΠΌ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π΅ΠΎΠ°Π΄ΡΡΠ²Π°Π½ΡΠ½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠΎΡΠ»Π΅ Π²Π²Π΅Π΄Π΅Π½ΠΈΡ ΡΠΎΡΠΎΡΠ΅Π½ΡΠ° Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ° Π² Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·ΡΒ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ 5,6 Ρ.Π΅., Π² ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ β 34,3 Ρ.Π΅., ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½Π°Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΡΡΡ ΠΎΠΏΡΡ
ΠΎΠ»Ρ/Π½ΠΎΡΠΌΠ° β ΠΎΡ 2 Π΄ΠΎ 9
Π€ΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΈΠ½ΡΡΠ°ΡΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΡΡ Π½Π΅ΠΎΠΏΠ»Π°Π·ΠΈΠΉ ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ, Π²ΡΠ»ΡΠ²Ρ ΠΈ Π²Π»Π°Π³Π°Π»ΠΈΡΠ°
In the present review the authors analyzed the effectiveness of treatment of intraepithelial neoplasia I-II-III of the cervix (CIN), vulva (VIN) and vagina (VaIN) using photodynamic therapy (PDT). PDT is a method based on exposure to light after preliminary introduction of a photosensitizer into the body with the formation of singlet oxygen, which has a cytotoxic effect. The results of research on the use of PDT with various photosensitizers in the complex of therapeutic measures in patients with CIN, VIN, VaIN are presented. These data on the effectiveness and safety of PDT, ease of use allow this medical technology to be attributed to one of the most promising areas in the treatment of pathological intraepithelial changes of the cervix, vulva and vagina. The presented information allows focusing the attention on the PDT method and informing doctors and researchers about the broad prospects for applying this treatment method in clinical practice.Π ΠΎΠ±Π·ΠΎΡΠ΅ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈΠ½ΡΡΠ°ΡΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΠΎΠΏΠ»Π°Π·ΠΈΠΈ I-II-III ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ (CIN), Π²ΡΠ»ΡΠ²Ρ (VIN) ΠΈ Π²Π»Π°Π³Π°Π»ΠΈΡΠ° (VaIN) Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΎΡΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΈΜ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π€ΠΠ’). Π€ΠΠ’ β ΠΌΠ΅ΡΠΎΠ΄, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠΈΜ Π½Π° Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠΈ ΡΠ²Π΅ΡΠΎΠΌ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅Π΄Π²Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π²Π²Π΅Π΄Π΅Π½ΠΈΡ Π² ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ° Ρ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΈΠ½Π³Π»Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΊΠΈΡΠ»ΠΎΡΠΎΠ΄Π°, ΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΡΠΈΡΠΎΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠΈΜ ΡΡΡΠ΅ΠΊΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈΜ ΠΏΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π€ΠΠ’ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΎΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΎΡΠ°ΠΌΠΈ Π² ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ΅ Π»Π΅ΡΠ΅Π±Π½ΡΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΈΜ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ CIN, VIN, VaIN. ΠΡΠΈΠ²Π΅Π΄Π΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΎΠ± ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ Π€ΠΠ’, ΠΏΡΠΎΡΡΠΎΡΠ° ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ Π΄Π°Π½Π½ΡΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΡΡ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΎΡΠ½Π΅ΡΡΠΈ ΠΊ ΡΠΈΡΠ»Ρ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΈΜ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΈΠ½ΡΡΠ°ΡΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ, Π²ΡΠ»ΡΠ²Ρ ΠΈ Π²Π»Π°Π³Π°Π»ΠΈΡΠ°. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½Π°Ρ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ Π°ΠΊΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°ΡΡ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π½Π° Π€ΠΠ’ ΠΈ ΠΈΠ½ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°ΡΡ Π²ΡΠ°ΡΠ΅ΠΈΜ ΠΈ Π½Π°ΡΡΠ½ΡΡ
ΡΠΎΡΡΡΠ΄Π½ΠΈΠΊΠΎΠ² ΠΎ ΡΠΈΡΠΎΠΊΠΈΡ
ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π°Ρ
ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΈΜ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅
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