The possible laser systems for HpD tumors diagnostics and therapy are presented in this paper. The principal laser system for those applications is based on Forsterite laser. Generation two wavelengths -- for therapy ((lambda) equals 630 plus or minus 10 nm) and diagnostics ((lambda) equals 400 plus or minus 5 nm) are possible in those systems.

This study presents possibilities of neoplasm localization applying the laser-induced fluorescence method using new porphyrin derivatives -- complexes of protoporphyrin and amino acids. These compounds show a strong retention in diseased tissues. Their spectral characteristics and photosensitizing properties are similar to hematoporphyrin derivatives, so they can be used both in the photodynamic therapy method and neoplasm diagnosis.

From January 1989 to December 1993, in the Neurosurgery Department of Mine Hospital in Sosnowiec, a Nd:YAG mediLas 4060 N (MBB) laser with the radiation wavelength of 1.064 micrometer was used for operation of 104 patients with intracranial neoplasm. Fifty-five patients were operated on without any use of the Nd:YAG laser. The coagulation capabilities of the Nd:YAG made it possible to achieve the hemostasis sooner and more certainly that brought an opportunity operate in a dry field. The shrinkage of a tumor, especially in the cases of meningioma and metastases, facilitated their preparation to a great extent. Removal of a lesion took place with negligible mechanical damage of the surrounding cerebral tissue. The Nd:YAG laser is particularly useful in the cases of well vascularized brain meningiomas; in this way larger tumors can be removed radically with milder postoperational course and good results of therapy were achieved significantly more frequently than in the control group. It was clearly demonstrated with significantly less frequent bouts of consciousness disturbance and pareses. The application of this Nd:YAG laser does not influence upon the postoperational course, the tumor regrowth and the number of persons with the expanding process recurrence in the glioma cases.

The aim of the work was the determination of the usefulness and value of carbon dioxide laser knife of Polish production in surgical treatment of breast cancer.

The authors present initial investigations of used holmium laser during experimental cataract surgery. The investigations were performed 'in vitro' and 'in vivo.' The presented results of the experiments show that structure of the lens can be emulsified with the use of the holmium laser.

The authors present initial results of treatment selected complications of dry eye syndrome with holmium laser. The lacrimal puncta obliteration and coagulation of the corneal ulcer surface were done.

The laser stimulation is used in ophthalmology as a supplement toother way of therapy. Nowadays, the following types of procedures are being performed: eyeball anterior segment stimulation, lacrimal gland stimulation, eyeball posterior pole stimulation, trigeminal nerve opening stimulation. Laser stimulation can be used as an independent procedure or together with pharmacological treatment.

The iris of a gray rabbit has been used for the studies on the process of coagulation with the frequency-doubled Nd:YAG laser. Coagulation spots image have been processed using programs for the image analysis. In places of exposure gas bubble cavitation has been identified. It has been stated in the research that the process of coagulation spots formation is longer than it has been estimated.

A polycystic ovaries disease occurs in the case of women with anovulatory cycles as the result of neurohormonal disorders. Patients with this disease suffer from infertility and many symptoms, such as: irregular menstrual bleeding, hirsutism, obesity. The paper presents a method of the carbon dioxide laser laparoscopy in the polycystic ovary disease treatment. The study included 96 women operated on (carbon dioxide laser laparoscopy) in the II Clinic Of Obstetric and Gynecology in Warsaw. Each woman measured her body temperature in order to evaluate her menstrual cycle and had vaginal USG examination or a cytohormonal one before laparoscopy and within 6 months after the surgery. Performing the laparoscopy the operator punctured each ovary in at least 15 points using the carbon dioxide laser. The patients were followed-up for 6 months. The Chi test was used to make the statistic analysis. Comparing the percent of ovulatory cycles and regular ones before and after surgery we noticed that the differences were statistically relevant. Eighty-five patients (88%) had regular cycles and in 88 cases (92%) there was a diphasic curve of the body temperature after the laparoscopy. Fourteen percent of infertile women with polycystic ovary disease conceived.

Introduction of the endoscopic techniques into gynecology enabled a change in the procedures in the case of ectopic pregnancy. This paper aims at presenting 76 cases of non-ruptured tubal pregnancies treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the Nd:YAG laser. The investigated group consisted of 76 patients. Forty-one (54%) of them were operated on using electrocoagulation and 35 (46%) using the Nd:YAG laser. Sixty-three pregnancies (83%) were localized in the ampulla. The ectopic pregnancy was confirmed histopathologically in 74 cases (97%). There were no complications noticed in the postoperative course. There were no differences in the efficacy and the postoperative general condition in cases treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the laser.

Hysteroscopy, which is a kind of endoscopy, makes it possible to evaluate macroscopically the cervical canal, uterine cavity, and the uterine opening of the oviducts. Laser hysteroscopy is used for removing septa and intrauterine adhesions, polyps, small submucosus myomas, and for endometrium ablation in abnormal metrorrhagias. The paper aims at the initial evaluation of laser hysteroscopy in removing intrauterine adhesions in the cases of 41 infertile women. Among all infertile patients 16 women (39%) conceived. Among others 1 woman (2.5%) did not want to conceive and 19 had other causes of infertility. Thirteen (93%) out of 14 patients with hypomenorrhea before surgery reported improvement of the menstruation cycle after the treatment. Five patients (12%) had adhesions for the second time. The patients had the second laser hysteroscopy. The control diagnostic hysteroscopy showed no adhesions in those cases.

The study aimed at evaluating the success rate of the operative laparoscopy assisted by electrocoagulation and laser as well as danazol and lynestrenol in the endometriosis treatment. One-hundred-ninety women with the recognized endometriosis were included into the study. In the I degree(s) endometriosis the operative or hormonal therapy was applied, in the II-IV degree(s) the combined therapy was used. The complete cure was achieved in 159 of the patients (84%): 28 women conceived, in 131 of the cases remission was recognized during the second laparoscopy. Eighteen women found improvement (9%) while 13 women (7%) reported the lack of improvement.

The aim of the studies was to attempt to investigate the results of treating young women with CIN I - III of the cervix and epithelial VIN I - III lesions of the vulva by means of the laser technique (vaporization).

The comparison between results of scissors- and Nd-YAG laser-resection of intrauterine septa in hysteroscopy was shown. In 12 patients the scissors-resection and in 11 women the laser- resection was done. In the group of patients after laser procedure 10 of them were pregnant and 9 delivered healthy children. One missed abortion was diagnosed in the twenty-first week of gestation. After scissors-resection 7 women became pregnant and 5 of them bore mature children. Two of those seven lost their gestation (spontaneous abortions in the nineteenth and twentieth weeks of pregnancy). In the authors' opinion hysteroscopy is a very useful method of diagnostics and therapy of intrauterine septa. The Nd-YAG laser-resection of intrauterine septa seems to be the method with the lowest number of complications. Fertility and parity highly improves after removal of the septa localized in the uterine cavity.

The results of laser therapy in the treatment of condylomata acuminata of male reproductive organs are reported. Between November 1991 and February 1995 in the Department of Reproduction, Institute of Gynecology and Obstetrics, Karol Marcinkowski University School of Medical Sciences, Poznan in 28 patients with condylomatous changes of reproductive organs carbon-dioxide laser therapy under colposcopic control was done. In 24 of them the healing was achieved. In four patients second laser therapy was done. All patients are still under control in the Department of Reproduction and there was no recurrence diagnosed.

The results of treatment of condylomata acuminata of the anogenital region in pregnant women are presented. All patients were treated between the 28th and 35th weeks of gestation. The laser surgery was done in 23 patients. One laser procedure was done in 14 women. In 5 patients we performed two and in 4 women 3 laser therapies. Complete destruction of pathological changes was obtained and no recurrences were diagnosed. There were no clinical signs of HPV infection in all neonates. In the authors' opinion the use of carbon-dioxide laser under colposcopic control is an efficient and safe method in the treatment of condylomata acuminata in pregnant women. Colposcopic control allows us to discover and coagulate the bleeding spots using the defocused laser beam with low power density.

The study shows the treatment of superficial endometriosis of the uterine cervix in 79 patients. After first vaporization 74 patients were cured successfully. In two cases the laser procedure should be repeated and in 3 women the operation should be performed for the third time. All patients are still under control in our department and there is no recurrence observed. Carbon- dioxide laser vaporization under colposcopic control is an efficient method of treatment of superficial endometriosis of the uterine cervix that requires no anaesthesia. The healing process after laser procedures is fast and without complications. The number of recurrences is low. Use of carbon-dioxide laser under colposcopic control because of precise destruction of lesions, fast healing and a low number of recurrences seems to be the method of choice.

Introduction of the first laser by Maiman in 1960 led to a rapid increase in the biological application of this device. The first application of laser energy in the treatment of airway pathology was by Strong et al. In 1981 Toty et al described the first use of a neodymium:yttrium-aluminum garnet (Nd:YAG) laser for resection of a bronchial tumor. Subglottic and tracheal stenosis have been treated endoscopically for many years with electrocautery, cryosurgery, by mechanical dilatation, and more recently since the mid 1970s with the carbon-dioxide laser. Early series demonstrated a moderate success rate in about 60% of the cases. Recently a new modification of the Nd:YAG laser was made available by Dornier (formerly MBB - Germany). The FIBERTOM^TM is a unique method of controlling the temperature at the tip of the light guide allowing precise, direct contact cutting. Eleven patients (age 35.1 plus or minus 20.7 years) with post inflammatory airway stenoses were treated. Thirty-six procedures were carried out. An immediate dilatation of the narrowed airway was produced in 86%. Endoscopic control carried out 52 weeks after the initial procedure confirmed restoration of the airway lumen in 82%. Clinical improvement was seen in all.

Neodymium yttrium aluminum garnet (Nd:YAG) laser, with its infrared wavelength of 1064 nm, is at present the most useful modality in treatment of lower airways obstruction of the lower airways by malignant and benign lesions. In fact that was the first indication for a successful restoration of a narrowed airway by Toty et al. The therapeutical effects of this laser are based on thermal action. The exposed tissue undergoes a progressive transformation by a localized increase in the temperature from warming, protein coagulation, to evaporation of water and vaporization of the tissue. This study represents the initial experience with the use of the FIBERTOM^TM Nd:YAG laser in removal of obstructing malignant and non- malignant lesions of the lower airways. Twenty-six patients (mean age 55.7 plus or minus 17.4 years) were included in the study. The main indications for laser therapy were in 16 patients exophytic cancerous lesions of the trachea and main bronchi, benign tumors of the major airways in 6, and in 4 cancerous lesions of the lobar bronchi. Squamous cell lung cancer and adenocarcinoma were diagnosed most often. The degree of obstruction ranged from 70% to 99%. Complete recanalization was achieved in 19 of the 26 patients, in only one patient recanalization was not achieved. The major complication was fever -- seen in 17 (65.4%) patients and cough (19.2%). Long term observation identified 18 patients alive after 52 weeks following laser therapy.

In this paper the authors present an unconventional method of intravenous laser therapy applied to nine patients treated in ICU for acute respiratory insufficiency. The laser therapy treatment was applied twice in 24 hours by introducing a quartz light pipe into a peripheral vein of the forearm connected to the He-Ne laser produced by Amber, Poland. In order to irradiate the whole circulating blood the procedure lasted twenty minutes. The initial observation showed the improvement of the respiratory parameters and the decrease of leucocytosis. During the intravenous laser therapy the ARDS was not observed in the patients, despite the existence of risk factors.

The results of the laser microsurgical treatment of the 273 patients with different pathological changes in the larynx are presented in the paper. In this number are included cases with tumors (80), precancers (40), papillomatosis (17), and stenosis of the larynx (71). Patients were treated with carbon-dioxide surgical laser with the laser beam power ranging from 12 to 28 watts depending on the pathology and its advance. Positive results of the treatment were observed in 73% to 100% of cases in different groups of patients. The authors suggest that in some cases the carbon-dioxide laser is only an alternative tool but in many cases, e.g., in papillomatosis, it is much better than traditional equipment. There are also cases such as hemangioma where the laser is an unreplaceable surgical technique.

Forty-nine patients with alveoalgia were selected into three groups. Group I consisted of 17 patients treated with a conservative method. Group II comprised 16 patients subjected to conservative treatment together with laserotherapy. In group III 16 patients received laser treatment only. Results showed the greatest success in group II. The intended clinical effect -- the significant reduction of pain -- was already achieved during the initial exposure to the laser and after the third exposure there was a total disappearance of symptoms.

In a group of 66 patients treated for difficult dentition of the lower wisdom tooth, 33 were subjected to biostimulative laser therapy. In this group 20 persons were treated conservatively together with laser therapy and 13 underwent surgical treatment together with exposure to laser irradiation. During the treatment a positive influence of the laser was found, i.e. a decrease in pain, edema, and trismus.

Low power laser therapy of Costen's syndrome had a significant influence on the regression of pain symptoms. Laser therapy was followed by prosthetic treatment in the form of overdentures.

Two-hundred-ninety-six patients with various vascular lesions of the face have been treated with argon laser LAK-1 in the Department of Dermatology Warsaw Medical Academy since April 1992. The diagnosis of the treated lesions was port-wine stains, multiple telangiectasiae and small, most often induced by trauma hemangioma cavernosum of the lip. Best results were achieved in the patients with small hemangiomas cavernosum of the lip and multiple telangiectasiae on the face. Cure rate in this group was 100%. In 112 port-wine stain cases fading of 50 - 75% comparing with the adjacent skin was achieved. With stress, the argon laser therapy is a method of choice for the treatment of hemangioma cavernosum, port-wine stains and multiple teleagiectasiae of the face.

In the Department of Dermatology Warsaw School of Medicine 15 children with condylomata acuminata have been treated with Nd:YAG laser. The patients were at the age of 2 - 15. The radiation treatment was conducted using from 120 to 1900 J -- depending on size and a number of skin rashes. After one radiation session all skin changes disappeared in 7 children, three children required two sessions, in four cases three sessions were needed. In one case the treatment proved unsuccessful. During 1.5 years of observation there was no recurrence of the disease in 14 out of 15 patients (93.4%).

For the first time laserotherapy is described as a method of port wine stain decolorization in plastic surgery. The authors present their 20-year experience in the treatment of port wine stains with the argon laser and dye laser.

The authors summarize their experience in the use of Nd-YAG laser in chronic occlusion of lower limb arteries. Percutaneous transluminal laser angioplasty (PTLA) with laser-heated metal and sapphire tips were used as an adjuvant to conventional balloon angioplasty. In cases of reocclusions, endovascular stents were implanted. Laser recanalization was performed in 46 arteries (iliac, superficial femoral, and popliteal). Indications for the procedure were: limb salvage, claudication below 100 m, and temporal or rest pain. Initial clinical and hemodynamic improvement was observed in 37 (80%) patients. Four perforations occurred without clinical sequel. The one-year cumulative clinical patency was 27 (58%) of the 46 lesions. PTLA may be appropriate for high-risk patients, who are unsuitable for surgical reconstruction because of the concomitant diseases. The combination of laser recanalization and implantation of vascular stents may be a promising method in the management of limb ischemia.

Twenty seven patients with femoral artery occlusion were treated by transluminal Nd:YAG laser angioplasty, in 16 patients the procedure was combined with intraarterial infusion of rTPA (actilyse-Boehringer Ing). In 5 out of 11 patients from the initial group recanalization was not successful. In 16 patients from the rTPA group satisfactory immediate results were achieved in all cases. In long time observations ranging from 9 to 24 months all patients remained free from symptoms, although in 4 of them angiography and Doppler ultrasound examination reveal no flow in the femoral artery. In the remaining 12 patients (75%), the previously occluded artery is patent. No complications of laser angioplasty nor intraarterial infusion of rTPA were noted in this series.

The authors present their experience in the endoscopic laser photocoagulation of bleeding peptic ulcer. From 1991 to June 1995, 203 patients admitted for UGI bleeding from peptic ulcer have been treated by this method. The source of bleeding was confirmed by endoscopy. The patients were divided into two groups: actively bleeding peptic ulcer (group IA and IB according to Forrest's classification) and ulcer with stigmata of recent bleeding (group IIA/IIB). The former group consisted of 106 patients, among whom over 40 percent (45 patients) presented signs of hypovolemic shock on admission. Nd:YAG laser (Surgical Laser Technologies) was used in a continuous mode with a contact (8 - 20 watts) or non-contact (over 50 watts) method of coagulation. In actively bleeding patients photocoagulation resulted in stopping the hemorrhage in 95 (90%). Recurrent bleeding occurred in 16 cases; in 9 of them it was stopped by repeated photocoagulation. In this group 18 patients required surgical intervention. The mortality was of 10.3% (11 patients). In 97 patients with recent bleeding stigmata photocoagulation provoked heavy hemorrhage in 3 (in 2 cases stopped by prolonged coagulation). In 9 of the remaining 94 patients recurrent bleeding occurred. Nine patients required surgical intervention. Mortality in this group was of 6%.

The authors present their basic and clinical experience aiming at the evaluation of the possibilities of different types of YAG-laser. The aim of the present study was the assessment of the degree of tissue destruction for the most adequate clinical application of laser; the work was carried out using experimental animals and cadavers.

The paper presents the way laser light affects tissue, especially kidney tissue. Animal experiments include the use of Nd:YAG laser in kidney surgery. When the outcome of these experiments turned out to be good Nd:YAG laser was used to operate on kidneys in 45 human patients. The results of a five-year follow-up period of these patients let Nd:YAG laser be considered a good tool to cut and coagulate renal parenchyma.

The following paper covers evaluation of low-power laser therapy results in chronic Achilles tendon damage and external Epicondylalia (tennis elbow). Fifty patients with Achilles damage (18 women and 32 men, age average 30, 24 plus or minus 10, 39 years) and fifty patients having external Epicondyalgiae (31 women and 19 men, age average 44, 36 plus or minus 10, 88 years) have been examined. The patients were irradiated by semiconductor infrared laser wavelength 904 nm separately or together with helium-neon laser wavelength 632.8 nm. The results of therapy have been based on the patient's interviews and examinations of patients as well as on the Laitinen pain questionnaire. The results prove analgesic effects in usage of low- power laser radiation therapy can be obtained.

Irradiation of the hyaline or fibrous cartilage excised from the body of a human cadaver with Er:YAG laser beam, single pulse with a dose of 1 J, produces a crater with a depth of approximately 500 micrometers and a diameter varying from 5 to 300 micrometers. Histological examination has revealed that the laser-made craters were surrounded by a thin rim (2-10 micrometer) of charred and coagulated tissue. No damage was observed in the cartilage surrounding the rim. The presence of sharp demarcation between the tissue areas ablated by laser energy and the undamaged areas argues for the potential usefulness of the Er:YAG laser in surgery of cartilages.