- OZONE IN ONCOLOGY

OZONE IN THE ONCOLOGY Introduction N. Altman (1995) summarizing the available experimental and clinical experience of world practice of ozone therapy in his book "Oxygen healing therapies" wrote that ozone has been used in the oncology for about ten years. The works dedicated to investigations into the action of ozone in malignant tumors were made by the scientists from Germany, Cuba, the USA, Italy, Switzerland and have been recently continued in Russia. The foreign researches based their attempts at using ozone in the oncology on two discoveries. The first discovery was made by O. Warburg (1966, Germany) that the key reason for development of tumor is oxygen deficiency on the cellular level. The second discovery made by J. Varro (1974, Germany) showed intolerance of peroxides by tumor cells. In this connection there was made a supposition that ozone and hydrogen peroxide can affect metabolism of cancer cells. However, the works of J. Varro as well as the results of the earlier investigations made by the Russian scientists A.I. Zhuravleva, B.N. Tarusova (1962) that the content of peroxides in tumors is decreased as compared with normal tissues were not put to use in clinical oncology. In 1980 F. Sweet et al. furnished proofs about a tumor-inhibitory effect of ozone in vitro. The investigations into the influence of certain ozone concentrations on the development of cultures of tumor cells received from malignant tumors of lung, mammary gland and uterus have established the suppression of neoplasma growth in 90% of cases. At the same time, it has been pointed out to a slight ability of tumor cells to compensate the oxidative stress induced by ozone in comparison with normal cells (Sweet, 1980). M. Arnan, L. DeVries (1983) investigated the influence of ozone on carcinoma inoculated to mice. The results of that experiment showed that the animals exposed to ozone lived by 30-40 days longer that the animals of control group. H. Karlic et al. (1987) established the selective suppression of tumor cell growth of ovarian carcinoma, ovarian adenocarcenoma and endometrial carcinoma. The similar results were demonstrated by K. Zanker and Krozek (1989). In the conditions of normal cell respiration reactive-inert molecular oxygen converts to active metastable form only through enzyme-substrate complexes of electronic-transport chain of mitochondrions. In cancer cell this enzymatic chain is inactivated and destroyed. The use of ozone results in the formation of active oxygen metabolites that can react with hydrogen substrate and put into action the disturbed end oxidation of tumor cell thereby activating the respiration through the substituted mechanism as the protein-containing enzymes cannot be substituted. Thus, ozone provides an anti-tumor effect (N. Altman, 1995). As discussed earlier, the growth of induced and inoculated tumors is associated with aggravation of oxygen supply, tissue hypoxia, and the pharmaceutical agents for treatment and prevention of hypoxic conditions in different diseases are mostly focused on the improvement of oxygen transportation to the tissues. In this connection the antihypoxic effect of ozone allows making a supposition that ozone can be also used as electron-acceptor compound - radiosensibilizator of hypoxic tumor cells. So, in cultures of skin cancer cells through ozone in vitro it came to sensibilization to radiation. Zanker at al. proved a synergetic effect of ozone and chemotherapeutic preparation 5-fluorine-urazila on cell cultures of large intestine cancer and mammary gland cancer. At the same time, the use of ozone in oncology is restricted as in the most of cases it has been used empirically without rational basis and appropriate methods of control. It is known that the increased concentration of ozone in air contributes to pulmonary toxicity (V. Bocci, 1997). This problem was subject of several works, one of which showed an insignificant statistically unreliable increase in pulmonary tumors in mice of strain A/J that allowed making a conclusion that ozone is not a carcinogen for this strain (Witschi et al., 1999). At the same time, there are some investigations pointing out to inefficiency of ozone introduced intravenously in case of Erlich's carcinoma and sarcoma-180 or establishing an increase in pulmonary metastasis in mice with fibrosarcoma NR-FS (Kobayashi et al., 1987). The availability of such contradictory data can be explained by the fact that ozone therapy is dose-related and requires careful selection of conditions when ozone therapy is reasonable for use. However, analyzing the mechanisms of the known anti-tumor physical-chemical methods we have formed an opinion that they all are focused on changing oxygen, free-radical homeostasis. From our point of view, ozone therapy (in particular, in the form of ozonated physiological saline) is the most physiological, effective and accessible method allowing influencing free-radical processes. A very interesting investigation was conducted by the scientists from the Tcherkasskiy Engineering Institute G.S.Stolyarenko, V.N.Vyazovik and from the oncological health center M.T.Shaposhnikova, A.V.Gromiko. In the experiments in vitro they found such conditions (selection of ozone solvents, saturation time of solution by oxidant) when it was possible to observe lysis, cell pyknosis, numerous destruction of nuclear substance of tumor cells. The authors pointed out that the observed processes are similar to radiation as in the zone of tumors in liquid phase under exposure to radiation it also comes to synthesis of oxygen-containing oxidants or active oxygen forms. But in case of ozone-radical chemodestruction there is no burn, necrosis of normal cells (along the line of radiation) and apparently no influence due to effect of high-frequency fluctuations. The specialists called this process "mild radiation" (G.S. Stolyarenko, 2001). Exactly thanks to the above-mentioned investigations we believe that ozone should occupy its own deserving niche in the complex treatment of malignant tumors. Results of Experimental Investigations A success of each therapeutic method based on the use of physical factors is defined by knowledge of the nature of disturbances on which these factors are focusing, on the one hand, and the mechanisms of their biological action, on the other hand. Since in the metabolism of malignant tumor cells dominance belongs to the glycolysis, a phylogenetically older process than oxidation, tumor represents an original return to the earlier evolution level of development, a primitive and stable form of existence. In this connection it is logical to suppose that the creation of "evolution leap" - artificial oxidant environment of tumor - can contribute to disorganization of primitive anaerobic metabolism of neoplasma. The disturbance of free-radical balance at presence of tumor is manifested as the antioxidant activity of tumor tissue, on the one hand, and exhaustion of the antioxidant defense of the organism-tumor carrier, on the other hand. It is considered that many anti-tumor methods can be divided into two groups. The methods of one group are focused on decreasing the level of free-radical oxidation. On the contrary, the therapeutic methods of the other group are somewhat connected with further intensification of free-radical oxidation in tumor cells. A many-stage work on studying possible use of ozone in neoplasia "in vitro" has been made in the Central Scientific Research Laboratory of the Nizhny Novgorod Medical Academy (Russia) commencing 1994. The first stage covered the experiment on the modeled systems of sarcoma-45 (not-metastasizing strain) and Pliss' lymphosarcoma (metastasizing strain). For local intensification of oxidative reactions in tumor tissue ozone was used in the form of ozonated physiological saline by methods of intra- and paratumoral administration. It is important to add that the use of ozonated physiological saline was started just after the transplanted tumor has reached a size of 1 cm in diameter, on the 14th day after inoculation when self-rejection of tumor tissue is already impossible. This is the important condition to investigate the effect of ozonated physiological saline. By the way, the experiment presented at the 2nd International Symposium on Ozone Applications (Cuba, 1997) was conducted incorrectly. The authors made a report that rectal application of ozone is able not only to stop the growth of tumor cell colonies, but also leads to complete resorption of tumor tissues of strain: RL-67, L-1210, LP-388, S-37 (Y. Rodriguez, 1997). However, the use of ozone was started after first 24 hours from tumor transplantation when there were no proofs about its transplantability in the organism of animal-recipient. Even if we would ignore this remark and consider that the transplanted cells were vital, the anti-tumor effect of ozone as reported by the authors is the effect in vitro. It has been established that the local intra- and paratumoral introduction of ozone in the form of ozonated physiological saline creates a free-radical blockade of tumor, destroys its antioxidant defense, and as a result the intensified free-radical oxidation affects tumor considerably increasing the volume of necrotized tissue. That results primarily in restoration of prooxidant-antioxidant balance of the organism-tumor carrier. As criterion of efficiency of any anticancerogenic method is considered prolongation of lifetime of experimental animals. This parameter for rats with sarcoma-45 was 27% and 30% for rats with Pliss' lymphosarcoma. The second stage of the investigation was focused on studying a possible systemic effect of ozone introduced by parenteral methods and determination of the most effective concentration of ozone bubbled into the physiological solution for parenteral use. As criterion of efficiency serves a decrease in tumor diameter and at the same time a minimum disturbing effect of ozone on the integral organism. The experiments were conducted using ozonated physiological saline bubbled with ozone concentrations in gas mixture of 100, 400, 900 mcg/L. The use of ozonated physiological saline was started on reaching a tumor size of 2 cm in diameter. The appropriate ozone concentration was determined - 400 mcg/L - and used on the next stage of the investigation to study the combined effect of ozone and ionizing radiation. The mechanism of action of ionizing radiation (dominant in the anti-tumor therapy) is connected with the processes including free-radical reactions. Ozone modifies the action of ionizing radiation through the oxygen effect. It increases radiosensitivity of tumor by means of its artificial oxygenation (overcome of radioresistance of hypoxic tumor cells). Ozone used before the radiation increases a therapeutic interval between the tumor and normal tissue that allows reducing the radiation dosage used and therefore decrease load on health tissues, mobilize antioxidant resources, restore the organism's own defense properties. Thus, ozone in high concentrations used by local methods produces an anticancerogenic effect, and in combination with ionizing radiation increases the efficiency of anti-tumor therapy. However, the "triumph" of ozone was disturbed by the following important fact. It was established that ozone concentration of 900 mcg/L used by parenteral method contributes to resorption of primary tumor knot, but results in metastasis of lymphosarcoma in 17% of animals. Although ozonated physiological saline leads to destruction of tumor, it also induces a powerful free-radical attack exceeding the organism's antioxidant potential and thereby creates cancerophilic conditions for normal tissues that leads to metastasis of tumor. This discovery was confirmed both in the experimental works of foreign scientists and theoretical works of Russian scientists. Actually the stable prooxidant condition and the excessive level of lipid peroxidation in the cell create a "cancerogenic" situation inducing blastomatous transformation. Anyone should know this and remember before using ozone in the oncology as well as that ozone therapy is dose-related and requires careful selection of conditions when ozone therapy is reasonable for use. All anti-tumor physical-chemical methods are focused on changing oxygen, free-radical homeostasis. Ozone therapy (in particular, in the form of ozonated physiological saline) is the most physiological, effective and accessible method allowing influencing free-radical processes. Ozone in the complex treatment of malignant tumors must occupy its own deserving niche. (S.P.Aljohina, T.G.Tscherbatyuk "Ozone therapy: clinical and experimental aspects" - Nizhny Novgorod, 2003)

- OZONE IN OPTHALMOLOGY

OZONE THERAPY IN THE OPTHALMOLOGY

Here you can find the list of eye diseases and recommended methods of local ozone therapy. The systemic methods of ozone therapy (minor and major AHT with ozone, ozonated saline drips) are indicated in case of generalized process for disinfection, desintoxication, anti-ischemic defense, normalization of the oxido-reduction system, immunomodulation.

- OZONE IN COSMETIC

OZONE THERAPY IN THE COSMETOLOGY

The progress of today medical science is oriented to development of new technologies allowing not only highly effective treating diseases, but also preventing them, increasing the vital potential of the organism.

One of such progressive approaches is ozone therapy.

It has a wide range of action in surgery, dermatology, urology, internal medicine. It would be strange if ozone would not be put into use in cosmetology - one of the most progressive fields of its application. In methods of treatment with ozone a particular attention is paid to improvement of microcirculation, oxygenation, energy supply of cells, proper trophism and protection of skin. Many cosmetic problems - acne, teleangiectatic rosacea, outflowing of the hair, wrinkles, allergy, cellulites, fatness - are reflecting the internal state of the organism, therefore they should be treated not only from the outside, but also inside. And this task can be successfully done by ozone producing a detoxication, antimicrobial, antiviral effect and increasing the organism's immunity.

Ozone is a unique agent preserving and restoring the natural beauty and health of skin. Ozone therapy does not mask defects of skin, but normalizes its natural functions and stimulates its own work.

The mechanism of action of ozone can be demonstrated on the example of its use within a complex program for skin rejuvenescence.

Aging at the level of epidermis is induced by inhibition of proliferous cell division, exhaustion of epidermis, increase in keratin layer, decrease in elasticity and increase in residual epidermis deformation ("crow's-foot"), formation of deeper wrinkles.

Skin functions properly and looks young only in case of proper trophism and division of epidermis cells. The natural mechanism of cell trophism is realized by means of tissue liquid, lymph and blood plasma.

The functional efficiency of this network and quality of epidermis trophism are considerably decreased under the influence of negative factors of environment Aging at the level of dermis is induced by changes in the structure of collagenous and elastic fibers. On exposure of collagen to free radicals it comes to "together-sewing" of collagen, therefore collagenase enzyme responsible for collagen degradation in normal conditions is not able to realize its function. It comes to accumulation of pathologically modified collagenous fibers, a decrease in their water-retaining ability and in the total level of water in dermis. It comes to a functional disturbance of hyaluronidase, the specific enzyme producing an effect on hyaluronic acid and defining skin penetrance.

Owing to aging it comes to a decrease in the activity of some key enzymes of respiratory chain and intensity of cytochromoxidase synthesis that leads to energy deficiency in cells. It comes to inhibition of epidermis cell regeneration, exhaustion and fragmentation of elastin fibers, and a result of all these pathological processes is formation of wrinkles.

Skin aging can be inhibited, and skin structure can be restored through neutralization of the above-mentioned pathological processes thereby eliminating the reason, but not only the consequence - formation of wrinkles. Exactly this is the target of ozone therapy. Ozone is a substance created by the nature, produces a complex, integral effect on the human body. For treatment of "problem" skin and wrinkles it is recommended to use the methods of local and systemic ozone therapy: by local route - subcutaneous ozone injections and ozonized olive oil in the form of face packs and for massage; by systemic route - intravenous drop-by-drop infusions (drips) of ozonated solutions, major and minor autohaemotherapy with ozone, rectal ozone insufflations. The approach to treatment and choice of methods are strictly individual for each patient.

Ozone introduced subcutaneously activates metabolic processes in macroergic cells, normalizes active membrane transport (K-Na pump), penetrance, deformability, viscosity and electric properties of membranes. At the same time, it comes to an increase in the intensity of energy processes: on the one hand, through the increased utilization of oxygen by cells owing to activation of aerobic glycolysis, Krebs' cycle, B-oxidation of fatty acids, and on the other hand - through optimization of the oxygen-transport function of blood (at presence of ozone the erythrocytes are able to bond and transfer 10 times more oxygen and more easier release it to tissues). Besides, it comes to stopping of "oxidative stress", activation of the antioxidant defense system and neutralization of the destroying effect of free radicals. It comes to stimulation of protein synthesis including its own collagen and elastin, an increase in the regenerative potential of proliferative skin layer. It comes to an increase in tissue liquid volume in deep layers and restoration of the natural skin ability to retain water, and as a result, it comes to ironing and disappearance of "crow's-foot", deeper wrinkles, and the rejuvenescence effect is well manifested.

The essential difference of ozone therapy from other cosmetic remedies and procedures is its dual action from the outside and inside of the organism that leads to normalization of trophism, oxygenation, moistening, protection and exchange restoration of skin. It helps to achieve general cleaning, sanation and tonization, but not only a temporary cosmetic effect.

Thus, ozone therapy is a revolutionary remedy for rejuvenescence allowing to restore the barrier, immune, water-retaining, reparative and separative functions of skin as well as to improve its structure.

Especially noticeable and fast results through ozone therapy are observed in patients with diagnosis "skin stress".

The most frequent method of administration of ozone for rejuvenescence is by intravenous drop-by-drop route and in the form of ozone bath "torso". This is convenient as during the ozonization the cosmetologist can perform other procedures on face, neck, d?collet? that saves the patient's time.

For the organism's cleaning, elimination of roughages and toxins including stress toxins producing a negative effect on skin the complex treatment of skin fading contains global intestinal cleaning. On completing this procedure it is recommended to perform rectal ozone insufflation thereby creating beneficial conditions for regeneration of "healthy" intestinal flora and producing a beneficial effect on the whole organism.

For correction of available signs of skin fading after 35 years of great benefit can be the rejuvenescence courses of ozone therapy in the form of subcutaneous injections at the places of wrinkle localization and other places with manifested skin fading (chin, cheeks, neck). After the procedure it is recommended to perform manual massage - plastithermic or cosmetic for equal distribution of ozone-oxygen gas mixture.

The well-manifested effect is observed already after 3-4 procedures: ironing of fine wrinkles, an increase in skin turgor, a decrease in face pastosity, improvement of face color, appearance of glow. The patients report about a decrease in skin dryness, disappearance of skin constriction sensation even after washing. Both the patients and doctors notice a lifting effect in submaxillary and cheen-chin areas. And what is very important is improvement of general feeling.

Acne disease. Ozone therapy is used in the form of local ozone injections onto inflammatory areas (infiltrates, pustular elements). In some cases it is recommended to perform primary focal sanation by method of electrocoagulation, opening and elimination of purulent content, and then ozone therapy. The depth and number of injections under one focus depends on the size of inflammatory element. Up to 5 ml of ozone-oxygen gas mixture is injected into each point.

On average one treatment course consists of 5-6 procedures at an interval of 5 days. All patients show clinical improvement already after one procedure. This manifests in infiltrate softening, a decrease in swelling, exudation, hyperemia, painfulness. Treatment time is reduced by 2-3 times as compared with traditional methods.

Any complications and side effects are not observed.

In case of torpid course of acne disease, diffused process the most effective method is autohaemotherapy with ozone considerably increasing the immunity and producing an antibacterial effect.

Ozone is also an integral part of postoperative rehabilitation for prevention of complications. Ozone helps to intensify lymphodrainage, restore microcirculation, improve tissue trophism, stimulate metabolic processes.

The effect is noticeable already after one-two procedures: a decrease in edema, tissue thickening and painfulness. After 4-5 procedures it comes to restoration of skin sensitivity, a decrease in hyperemia and disappearance of constriction sensation in the area of postoperative sutures. More comfortable sensations of the patient have a positive influence on his evaluation of results of the performed operation.

After the wide practical introduction of such methods as middle and deep chemical peelings, laser and mechanical skin grinding, injection contour plasty we are facing a serious problem - hypertrophic scars. Ozone gas injections around the scar induce disappearance of skin constriction sensation, paling and softening of scars and their further resorption. As a result, it comes to significant ironing of scar surface, restoration of tissue elasticity.

Obviously, ozone therapy in the form of injections allows solving many serious problems arising in the practice of dermatocosmetologist. Of great importance is the fact that the result of similar procedures is not only solution of esthetic problems being a reason for a visit to doctor, but also improvement in general feeling of patients through the many-sided non-specific effect of ozone on tissues and the organism as a whole.

OZONE THERAPY WITHIN A COMPLEX TREATMENT OF CELLULITES AND FIGURE MODELING

Edematous-fibrosclerotic panniculopathy or cellulites is an exclusively female problem and represents a pathological state of fat cells (adipocytes). Among the reasons and risk factors inducing a change of fatty tissue are numbered genetic, family, national features, pubescence period, pregnancy and delivery, hormonal disturbances and intake of contraceptive preparations, age and life way.

According to various sources, 80% to 95% of women are suffering from cellulites. The affected areas are thighs and buttocks, more rarely - back and arms.

The initial stage of cellulites is characterized by microcirculatory disorder, swelling, stagnation of liquid in subcutaneous tissue. So, it comes to edematous form of cellulites that in case of further progression is transformed to fibrosclerotic form.

Fatty tissue fulfills a function of energy depot in the organism. Each fat cell is closely surrounded by capillary network, therefore it is in continuous and close contact with blood. In healthy fatty tissues the adipocytes receive a sufficient quantity of oxygen and nutritious substances, and products of cell activity are removed via cell membrane and taken away by blood flow. A disturbance of this mechanism leads to development of local hypoxia, toxicosis and acidosis and in further to cellulites. In conditions of oxygen deficit in acidic environment it comes to active growth of connective tissue that surrounds fat cells by membrane and forms cellulites small knots (micronodules). Fat cells degenerate, make groups and form in connective tissue thick conglomerates (macronodules) that block circulation and lymphatic flow, it comes to calcination of fat cells. Edematous-fibrosclerotic panniculopathy is characterized by development of microangiopathies and disturbances of lymphatic structure manifested as lymphangiectasia and lymph edema. On the initial stage of cellulites a cosmetic effect in skin is manifested in the form of insignificant hilliness, the so-called "orange peel" that in case of further progression is transformed to "grape bunches".

Thus, the main mechanism of cellulites development is microcirculatory disorder that leads to edema, which in turn aggravates hemodynamics closing circulus vitiosus.

Cellulites treatment should be focused:

·       Firstly, on removal of disease reason;

·       Secondly, on correction of pathogenetic mechanisms of disease development;

·       Thirdly, on liquidation of its appearances and consequences.

All these tasks can be successfully fulfilled by ozone.

It is mostly rational to start cellulites treatment on early stages when it only represents an esthetic problem. In this case ozone can be used as a monotherapy, and it takes a few procedures in the form of subcutaneous ozone injections to achieve a good cosmetic effect. The program of cellulites therapy combines local ozone therapy (subcutaneous ozone injections, massage and wrapping on ozonized olive oil) and systemic ozone therapy (intravenous infusion of ozonated solutions, patent's autoblood) that provides a more noticeable and stable result. The parenteral methods restore hormonal background, protein, fat and carbohydrate metabolism, quickly remove consequences of stress and chronic tiredness, balance the processes of excitation and inhibition of nervous system, increase oxygen supply of the whole organism.

Treatment variants should be determined individually depending on the stage and form of cellulites, volume of affected surface, age, associated pathology, individual features of the organism (pain sensitivity etc.). The usual course of therapy includes a certain number of sessions (from 10 to 20) with frequency 1-3 times a week. Gas is introduced subcutaneously by means of special microneedles with length of 4 or 13 mm. Positive results of treatment are observed already after 3-5 sessions and well manifested, the patients start to notice lightness in the lower limbs and a decrease in pastosity and edema. On the next stage it comes to reduction or complete disappearance of "orange peel", a decrease in volumes of subcutaneous tissue.

Through ozone therapy it comes to a fast-progressive decrease in fat layers, fatty tissue becomes more thick and compact. Good results can be also achieved in the formation of body contours (non-surgical modeling of figure - non-surgical liposuction): correction of double chin, face oval, forms of breast, thighs and buttocks.

Ozone facilitates fast elimination of fat from stomach, particularly from its lower part that undergoes a little change through traditional methods of correction and practically no change through diet therapy and general slimming.

The essential difference of ozone therapy from other forms of lipolysis (mechanical, electric, ultrasound, chemical) is that ozonolipolysis or ozonolysis (destruction of fatty tissue by ozone) combines both a local and systemic detoxication effect, intensifies fat splitting and utilization. It comes to stimulation of cellular processes, an increase in the oxygen-transport function of blood and accordingly the oxidoreduction potential of the organism. Ozone introduced by parenteral route does not only activate lipid exchange, but also initiates the mechanism of natural processing of the organism own energy resources i.e. fat. Ozone stimulates B-oxidation of fatty acids, energy production and activity of the hepatocytes focused on processing of lipid fractions; on this way liver is not affected. Under the action of ozone in the hepatocytes it comes to activation of structural-functional mechanisms of transformation of fat energy substrates to carbohydrate ones. Ozonization induces production of catalase and peroxides involved in the catabolism of fatty acids and synthesis of glycogen and glucose from products of this catabolism i.e. ozone performs the antioxidant and detoxication functions. The anticellulites effect and slimming are realized on a background of tonus restoration, strengthening and tonization of all tissues exposed to ozone therapy. Skin is not hanging like after usual slimming and other methods of cellulites treatment, on the contrary - it becomes more elastic, its appearance improves. It comes to normalization of connective tissue structure as ozone has a fibrinolytic effect, a decrease in the level of hypertrophic adipocytes and metabolism restoration in subcutaneous tissue.

As a rule, cellulites is not an independent pathology, but manifests on a background of the main disease owing to the organism's intoxication. Therefore, without removing a reason it is impossible to cure a consequence. Ozone producing a complex effect on the organism acts on the molecular, cellular, systemic levels and treats both actual diseases and their consequence i.e. cellulites. Ozone therapy provides remission for half to one year, but not only 1-2 months like traditional treatment. So, ozone is used to treat cellulites, but not only to achieve a temporary cosmetic effect.

Based on the results of numerous clinical investigations it can be claimed that for today ozone therapy is one of the most effective methods for prevention and treatment of cellulites. Within a short time (less than 1,5 months) one specialist performs more than 300 procedures that allows completely covering the costs of ozone device and accessories.

The gathered experience allows making a conclusion that ozone therapy is characterized by simplicity of application, good tolerance by patients, practically complete absence of side-effects, high efficiency and reasonable prices for appropriate equipment. This is a very profitable method of treatment.

Thus, ozone therapy in conditions of cosmetic salon allows:

·       To widen the spectrum of medical services;

·       To increase the salon image;

·       To attract new patients, increase their flow;

·       To reduce treatment time;

·       To improve efficiency of cosmetic procedures;

·       To achieve a stable positive result;

    To increase the salon income.

- OZONE: DERMATOLOGY

OZONE THERAPY IN THE DERMATOLOGY

In the dermatology "the universality" of ozone therapy is explained by physico-chemical properties of medical ozone and a wide range of its therapeutic effects: bactericidal, viricidal, fungicidal, anti-inflammatory, stimulating, immunomodulating. More often ozone therapy is used in a complex with traditional methods to speed up the healing process, but it can also be used as a monomethod. A treatment course of one nosological form includes several methods of ozone therapy.

Dermatovenereology

In the dermatology the most frequently used methods are minor ozonated autohaemotherapy in the treatment of allergodermia, acne, herpes; ozone chambers in the treatment of varicose symptocomplex (as a variant - ozone caps in the treatment of alopecia areata); intravenous infusions of ozonated saline solution in the treatment of angiitis, severe forms of allergodermia, alopecia, lichen planus; subcutaneous ozone injections in the treatment of alopecia, acne disease, lipodystrophy.

One of the central mechanisms of positive action of O3 in different diseases is correction of hypoxic conditions by increasing deformability of the erythrocytes, partial oxygen tension in arterial blood, by improving release of oxygen by oxyhemoglobin.

Immunomodulating effects of ozone therapy are related to an increase in the production of cytokines. Of particular interest is the report of H. Kief (1993) about an increase in the level of interleukin 2 and gamma-interferon through ozone therapy provided to patients with allergosis (food allergy, bronchial asthma, atopic dermatitis).

The investigation into the effect of ozone therapy on the course of HIV-infection was a starting point for studying the mechanism of immunocorrective properties of O3. The results of the experiments "in vitro" have shown that ozone is able to inactivate extracellular HIV in the organism's liquids and suppress the growth of intracellular HIV in concentrations being safe for cells. It has been established that the antiviral effect of ozone includes destruction of virus particles, inactivation of reverse transcriptase and disability of virus to adhere its receptor to target cells. The investigations have shown that by conveying O3 through virus-containing liquid it comes to complete inactivation of virus, chronically infected cells treated with ozone lose their ability to initiate infection in case of joint cultivation with intact sensitive cells. Thus, O3 is a promising method of inactivation of human retroviruses in the organism's liquids and blood preparations.

The experimental investigations conducted by Italian scientists V.Bocci and L.Paulesu in 1990 established that ozone acts on monocytes and lymphocytes as an inductor of cytokines towards the production of interferon and tumor necrosis factor and apparently on many other immune functions as well. V.Bocci supposes that these cytokines in turn can activate further lymphoid cells, lead to immunostimulation without side effects. Of great importance are the data about absence of carcinogenic and teratogenic effects of moderate ozone concentrations. The use of high ozone concentrations for external applications allows achieving a viricidal effect. Through interaction of microorganisms with high ozone concentrations it comes to elimination of both bacteria and viruses resulted from oxidative destruction of their capsulated membrane. Cleavage products of DNA and RNA were found out through ozone by different authors. Disturbances of physical properties of membranes occur due to changes in the composition of their lipid fraction in case of excessive free-radical oxidation. The mechanism of action of high ozone concentrations is of great importance for practical medicine i.e. for treatment of trophic ulcers, burn surfaces and infected wounds with ozone/oxygen gas mixtures.

Nowadays, dermatovenereology and dermatocosmetology are the fields of medicine where ozone therapy is widely used in the form of parenteral methods of introduction, treatment of damaged areas with O2/O3 gas mixtures and ozonized external remedies, in particular ozonized olive oil. High ozone concentrations are indicated for bactericidal and mycocidal action, low ozone concentrations - for inactivation of viruses and immunomodulating effects. The mechanisms of sanogenesis of ozone therapy in atopic dermatitis are most well-investigated. It has been shown that improvement of clinical picture is associated with normalization of immune indices, activation of some enzymatic antioxidants along with non-stimulation of lipid peroxidation, increase in the levels of histaminopexia and serotoninopexia. Nowadays, ozone therapy of atopic dermatitis is performed in the form of minor ozonated autohaemotherapy, rectal insufflations of O2/O3 gas mixtures, intravenous infusions of ozonated saline solution, major ozonated autohaemotherapy, applications with ozonized olive oil. Thanks to similar etiology and pathogenesis ozone therapy is effective in another allergodermia as well, in particular - eczema. The generally accepted method of laboratory control over efficiency and safety of ozone therapy is determination of lipid peroxidation products, spectrum of enzymatic antioxidants, in particular superoxiddismutase and catalase of the erythrocytes and integral index - total antioxidant plasma activity.

The ability of ozone to inactivate viruses is used in the treatment of dermatosis of viral etiology, in particular herpes, the method of choice is major ozonated autohaemotherapy. J.Delgano et al. (1997) reported about efficiency of subcutaneous injections of O2/O3 in the treatment of pemphigus.

The use of ozone therapy in the treatment of viral diseases is especially actual in the conditions of growing spread of HIV-infection. The important aspect explaining a positive influence of ozone therapy in AIDS is the action of ozone on causative agents of opportunistic infections (herpes, mycosis, folliculitis). Besides, ozone can not only inactivate HIV, but also stimulate immunocompetent cells through normalization in the level of T-helpers and relationship Tx/Tc. The efficient antiviral effect of ozone is proved by evidence about complete disappearance of pointed condylomas in women after applications with ozone-containing drug products. Nowadays, ozonized olive oil has a hygienic certificate and is a remedy for cosmetic care. Its production requires lengthy perfusion of O2/O3 gas mixture with high ozone concentrations through a column of olive oil. As a result of reaction between ozone and unsaturated fatty acids it comes to formation of peroxides characterized by low reactivity. While gaseous ozone exerts an instant bactericidal effect, the effect of ozone-related oily products can last for many hours. Ozonized olive oil has well-manifested fungicidal properties and can be efficiently used in the treatment of onychomycosis caused by Tr. rubrum and yeast fungi.

Ozonized olive oil is also used in the treatment of trophic ulcers, microbic eczema, chronic ulcerous pyoderma, herpes. The use of ozonized olive oil in the treatment of different pyodermas is proved by in vitro investigations of its bactericidal activity.

Dermatocosmetology

The high therapeutic efficiency of ozone therapy can be considered as a basis for its successful use in dermatocosmetology. Nowadays, ozone therapy is used in the treatment of acne, cicatricial changes, alopecia, for correction of age related changes. Ozone therapy is most widely used in the form of subcutaneous injections of O²/O³gas mixtures.

One of variants for external application of O3 is balneotherapy that can be used in both large dermatological clinics and SPA salons. Baths with ozonated mineral water are indicated for disturbances of peripheral blood circulation, varicosity, tropic ulcers, eczemas. Mineral water facilitates improvement of diffuse processes in skin so that tissues, blood bed and lymphatic system receive not only oxygen and ozone, but also mineral substances.

In the treatment of acne minor ozonated autohaemotherapy is recommended for use. Nowadays, ozone therapy is considered as a successful method of treatment for acne rash of moderate stage of severity as well as acne conglobata. The dynamics of indices of pro- and antioxidant systems through ozone therapy in acne rash is well studied. In many cosmetological clinics priority is given to cosmetic injections of O2/O3 gas mixtures into and around the elements of acne rash that should not exclude the systemic methods of ozone therapy.

Besides, nowadays ozone therapy is also used in cosmetological surgery. Subcutaneous ozone injections at concentrations of about 10 mg/L during the operations of liposuction and blepharoplasty provide a disinfectant, oxygenizing and healing effect. At the pre-operative stage the patients can receive rectal insufflations with O2/O3 gas mixture that facilitates detoxication of the patient's organism and improvement of operation results. There are some reports about the successful use of ozone therapy for correction of failures in the field of injection cosmetology and lipoplasty.

There are some reports about the efficiency of minor ozonated autohaemotherapy, intravenous infusions of ozonated physiological saline and subcutaneous ozone injections in the treatment of alopecia. In 106 patients with alopecia areata it came to normalization of the initially decreased level of oxygen in the area of alopecia proved by oxymetric method, oxygen deficit in hairs decreased according to the data of gas analysis.

In the treatment of different forms of scleroderma ozone therapy is used as a component of complex treatment in the form of minor ozonated autohaemotherapy, ozone chambers and ozone injections.

The treatment of patients with local lipodystrophy and indurative hypodermatitis by means of subcutaneous injections of O2/O3 gas mixture showed well-manifested efficiency of ozone therapy in comparison with traditional methods. J.L.Cidon (1977) believes that subcutaneous introduction of O2/O3 gas mixture is a promising method of treatment for cellulites through exposure on degenerative changed fatty tissue. A positive effect of ozone in cellulites and local lipodystrophy can be explained by its influence on the metabolism of fatty tissue and improvement of blood circulation in damaged areas. The Medozons Company manufactures modified models of medical ozone generators with a multi-injector for low-flow injections of O2/O3 gas mixtures at great volumes into problem areas, this method received very positive reviews.

Of great interest is correction of vascular defects by means of ozone. In the foreign literature there are some reports about intravascular introduction of O2/O3 gas mixture with high ozone concentrations that results in instant coagulation of vascular wall, this method can be used in the treatment of telangiectasia and "vascular stars". Our own observations have shown a good perspective for ozone therapy in complicated forms of rosacea in the form of ozone injections in the field of telangiectasia into the lumen of vessel at ozone concentration of 10 mg/L in combination with subcutaneous ozone injections at ozone concentration of 5 mg/L according to the method of mesotherapy. A positive effect of this new method is characterized by regress of telangiectasia, decrease in facial tissue swelling, regress of pustular rash. We are now developing methods of mesotherapy with ozone for treatment of different complicated forms of rosacea, including pustular, conglobated, granulomatous as well rhinophyma and phymas of different localizations. Pathogenetic links of pathogenesis of rosacea, namely vascular disturbances, disorder of derma connective tissue shell, immune shifts give us a hope for successful use of ozone therapy in the treatment of this pathology providing serious competition to laser methods.

For today the influence of ozone therapy on the pathology of connective tissue is terra incognita. There are made first attempts of treatment of hypertrophic and keloid scars by means of ozone injections, gathered a successful clinical experience in the treatment of patients with collagenoses proved by positive dynamics of immune indices, data of lipid peroxidation and antioxidant system, improvement of metabolic indices of connective tissue (regulatory protein and fibronectin) in the treatment of patients with atopic dermatitis. Of interest is the investigation of proteolytic activity in the course of ozone therapy. The effects of ozone allowing successfully using ozone in gerontocosmetology are apparently connected with changes of collagenic fibers and certainly - with improvement of oxygen release to tissues, activation of enzymatic antioxidants (in particular catalase of the erythrocytes and superoxiddismutase) that performs an important role in the inhibition of skin aging process.

- OZONE: OBSTETRICS & GYNAECOLOGY

OZONE THERAPY IN THE OBSTETRICS & GYNAECOLOGY

Obstetrics and gynecology can be with certainty numbered among the fields of medicine where the whole spectrum of therapeutic properties of ozone can be successfully used. The list of indications for ozone therapy is as wide as the totality of medical problems requiring an improvement of macro- and microcirculation, correction of immunological status or lipid peroxidation processes. Owing to the capacity of medical ozone to act on the basic links of pathogenesis, ozone therapy has proved to be particularly effective in the following pathologies:

·       Spontaneous abortion

·       EPH-gestosis

·       Pregnancy anemia

·       Early toxicosis

·       Fetoplacental insufficiency

·       Inflammatory diseases of internal genital organs (adnexitis, endomyometritis)

·       Inflammatory diseases of lower female genital organs (colpitis, endocervicitis, bacterial vaginosis)

·       Oncogynecological pathology

·       Vulva dystrophy

Ozone therapy is successfully used fro prophylaxis of:

·       Intrauterine fetus infection

·       Fatness-associated pregnancy complications

The therapeutic effect of ozone is based on the well-known mechanisms of its biological action:

1.     Owing to its high oxidating power, highly concentrated ozone used at the local level produces a bactericidal, fungicidal and viricidal effect versus the most important species of gram-positive and gram-negative bacteria, viruses, pathogenic fungi and protista;

2.     The systemic effect of medium and low ozone concentrations produced by parenteral route of administration in medical conditions associated with hypoxia situations is based on the activation of the oxygen-dependent processes;

3.     The ozonides resulted from the ozonolysis of unsaturated fatty acids modify cell membranes at the structural-functional level, intensify the enzymatic systems and thereby improve the energy metabolism.

4.     The immunomodulating effect of ozone is based on its ability to activate the phagocytosis through the formation of peroxides and stimulation of the production of cytokines by lymphocytes and monocytes.

5.     Modification of blood corpuscle membranes and fine-structure of vascular bed as well as a decrease in the viscosity properties of blood lead to an improvement of the blood micro-flow and respiratory metabolism at the tissue level.

Before the practical use of ozone in clinics for women, the following fundamental facts were experimentally established:

1.     During the pregnancy ozone concentration in gas mixture bubbled into saline solution (method of intravenous drop-by-drop infusions of ozonated saline solution) may range within 400-800 mcg per liter. This result was obtained on the basis of investigations into the influence of different ozone concentrations on the parameters of lipid peroxidation and antioxidant defense system in blood samples taken from the patients with different obstetric pathologies (series of experiments in vitro).

2.     The safety of these ozone concentrations relating to teratogenecity was confirmed by a series of experiments in vivo on pregnant laboratory rats.

Further fundamental investigations have fully confirmed the applicability of ozone therapy in the treatment of gestational complications since it has been reliably established that the use of ozone leads to correction of basic links of the pathogenesis and the most important clinical appearances of disease:

·       Improvement of macro- and microcirculation that results in the normalization of placenta hormonogenic function;

·       Decrease in the activity of lipid peroxidation processes and simultaneous stimulation of the antioxidant defense system of human body;

·       Immunomodulating action develops particularly through a decrease in blood level of circulating immune complexes, IgM, group and Rh antibodies, increase in the phagocytic activity of neutrophiles;

·       Decrease (if available) in the hypercoagulation activity of blood;

·       Intensification of the protein-synthesizing function of liver;

·       Ozone therapy exerts a beneficial influence on the clinical course of threatened abortion, gestosis, pregnancy anemia, fetoplacental insufficiency, reduces a risk of intrauterine fetus infection and a risk of fatness-associated pregnancy complications, improves a prognosis of these diseases;

·       Ozone therapy reduces stationary treatment time, reduces the use of medicinal agents;

·       Ozone therapy significantly reduces a risk of such complications as delivery weakness, postnatal and early postnatal bleedings;

·       The use of ozone as a component of treatment complex improves perinatal adaptation of newborn children.

Inflammatory diseases of pelvic organs i.e. internal genitals being considered one of the most frequent pathologies of the woman's body require a new therapeutic approach due to resistance of microorganisms to available antibiotics, high allergization of human body, immunodeficiency and metabolic disturbances associated with the basic pathology.

As a result of the experiments conducted in vivo the pathogenetically proved and at the same time safe ozone concentration is 1200 mcg/L bubbled into saline solution.

The clinical investigations allow making the following conclusions:

1.     Ozone therapy for inflammatory diseases of pelvic organs is considered as a component of antioxidant therapy as well as exerts a corrective influence on the cellular and humoral immunity confirmed by an increase in immunoregulative index, a decrease in the level of IgM and circulating immune complexes.

2.     The addition of medical ozone to the multimodality therapy exerts a positive influence on the clinical appearances of acute inflammatory diseases of pelvic organs providing a detoxication, analgesic and sedative effect that allows considerably reducing the use of appropriate traditional medicaments. This improves immediate results, particularly reduces residuals of inflammation. A decrease in relapse percentage after the use of ozone as a component of pathogenetic therapy speaks in favor of optimization of remote results.

The experimental-clinical investigations into the influence of ozone on the course of inflammatory processes of lower female genital organs have shown that ozone in gas phase at certain concentrations and methods of administration exerts a beneficial influence on the factors of local genital immunity that allows stopping the inflammation.

The well-known antimicrobic properties of ozonized olive oil as found out can be successfully used in the treatment of vulvar dystrophic diseases. Ozone therapy produces not only an anti-inflammatory effect, but also improves tissue trophism, allows rejecting the use of hormonal ointments and laser therapy.

The practice has shown that the method of intravenous drop-by-drop infusions of ozonated saline solution is the most suitable and applicable one for obstetric clinic. Saline solution is the optimal carrying agent of ozone as it does not undergo any chemical conversions during the ozonization. Ozonated saline solution is produced by conveying an ozone-oxygen gas mixture through a standard glass bottle with 400 ml of sterile 0,9% sodium chloride solution for 15-20 minutes (by using a 200 ml bottle the ozonization lasts for 10-15 minutes). With consideration for instability of ozone in aqueous medium, the ozonated saline solution should be used immediately after its production. It is recommended to administer the ozonated saline solution in the form of drips into the cubital vein at a flow rate of 8-10 ml per minute similar to flow infusions that ensures a minimum loss of ozone. With consideration for dose-related effects of ozone, it is necessary to strictly follow the given mode of ozonization. The safety measures are usual for intravenous infusions.

The method of intravenous drop-by-drop infusions of ozonated saline solution has proved very well in the treatment of inflammatory diseases of pelvic organs as well. Systemic ozone therapy can be also provided in the form of flow rectal insufflations of an ozone/oxygen gas mixture.

In case of inflammatory process in uterine or vaginal cavity it is possible to use the antimicrobic effect of ozone in different variants of its local application (as a carrying agent of ozone can be used distilled water, purified olive oil, ozone therapy in gas phase is possible too).

Ozonized distilled water is produced like the ozonated saline solution, but with consideration that the half-life of ozone in distilled water is more (1,5-2 hrs); therefore the ozonized distilled water keeps its properties longer than the ozonated saline solution.

Production of ozonized olive oil requires more time due to lower solubility of ozone in olive oil and depends on the volume of oil produced (ozone saturation of 100 ml of oil lasts for 2 hrs). It is recommended to use the ready-made ozonized olive oil O'THREE-Ozonide.

The use of ozone in gas phase is possible by means of special attachments as demonstrated below: