Vol 4, No 2 (2018)

The objective of the present study was an in-depth assessment of the main human metabolic parameters upon longterm (60 days) containment in a normobaric argon-based hypoxic gas mixture (AHGM) for checking the possibility to develop gas media able to reduce the risk of ignitions and fires in inhabited sealed objects, such as submarines. Study group included six male subjects aged 20 to 51 years and found to be fit for sea trips lasting for up to 90 days. Continuing containment in the test medium comprising 30–35% V/V argon, 13,3–14,5% V/V oxygen, and up to 0,8% V/V, the rest being nitrogen, lasted for 60 days. During this time the subject were engaged in typical physical activities and operator routines. Venous blood samples were taken before, every 15 days in the course of, and 5 days after containment. This regimen has been found to be associated with the gradual accumulation of under-oxidized products of carbohydrate, protein and cholesterol metabolism in the blood and with increasing atherogenicity index. Adaptation to this regimen was manifested as decreases in the magnitudes of the above changes suggesting that metabolism may be tuned to increase body tolerance to hypoxia. Within 5 days after containment, virtually complete normalization of parameters studied was observed. The data confirm that it is possible to make gas mixtures for improving fire safety of inhabited sealed objects, in particular submarines.

At the Department of Navy Surgery, military students are educated according to the three main principles: adherence to the profile of the Department, emergency surgery under conditions specific for Navy, and continuing education. The Department educates in surgery academic years 4, 5 and 6 students of Faculty IV. The following disciplines are taught: «Faculty Surgery and Urology», «Hospital and Pediatric Surgery», and «Navy Surgery». Thematic navy surgery lessons are conducted at a training simulator reproducing the mess room of the modern diesel submarine «Varshavianka», which has been constructed at the shipbuilding enterprise «Admiralteyskiye Verfi». Special attention in training is paid to combined mechanical and hypothermic lesions, a theme of undoubtful applied value. NATO nations are currently intensifying their military activities inArctic. In response, we restore out navy base on Novosibirsk Isles, as President V. V. Putin has proclaimed. The staff members of the Department involved in medical services for the arctic convoys that travel toKotelnyiIslandconvey their experience to students at lectures and training sessions. To provide students, especially postgraduates, adequately with emergency patients, the Department makes use of other clinical bases, such as I. I. Dzhanelidze Research Institute of Acute Care, Hospitals No. 14, 17 and 38, and Oncological Dispensary of Leningrad Oblast. It should be noted that, whereas at the first two of the medical facilities emphasis is put on the tactics of abdominal emergency surgery under conditions prevalent in navy ships and divisions, emphasis at Hospital No. 14 is put not only on the theory of emergency care in cases of acute putrescent infections but also and even more on practical experience in local anesthesia. The key issue of military preparedness of navy ships medical services is the continuity of training in navy surgery.

Systemic vasculitis are characterized by heterogeneity of clinical-immunological forms and determined the need for differential diagnostic search to except a wide range of diseases, such as allergic, infectious, hematological, oncological, which often presents significant difficulties for physicians of various specialties. The article presents clinical observations demonstrating the difficulties of diagnostic search in establishing the diagnosis of systemic vasculitis associated with antineutrophil cytoplasmic antibodies, which include a rare disease — eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome). Carefully collected anamnesis, participation of specialists of different profiles, retrospective analysis of laboratory and instrumental data allowed to verify the diagnosis, to prescribe adequate therapy. The aim of the publication is to discuss the need for early diagnosis of eosinophilic granulomatosis with polyangiitis, which can improve the effectiveness of therapy and improve the overall prognosis for this disease, taking into account modern approaches based on the main provisions of international recommendations that were prepared in 2015 with the participation of leading experts from Europe, USA and Canada and were called to become the basis for choosing a personalized patient therapy strategy.

The paper present a retrospective analysis of surgical treatment of 22 elderly patients aged 60 to 80 years who had complicated degenerative stenosis of lower thoracic and lumbar spine segments associated with neurological deficits ranging from mild peripheral manifestations to severe unilateral and bilateral paresis. The severity of degenerative spine lesions and compressive stenosis of spinal channel contents correlated with patients’ age and culminated in the maximal degenerative stenotic alterations, up to 5,5±0,9 cm, at the L3 to L5 level at the age of 76,5±1,4 years. Surgery performed to decompress the spinal channel and cauda equina roots and to stabilize the spine with Stryker and Fixpain transpedicular inner fixation and correction devices resulted in the regress of neurological deficits and restoration of lower limbs motor functions up to the capability of unassisted locomotion in old age.

Barotrauma of the lungs is a serious diver’s professional disease with the rupture of lung tissue and gas spreading away from the alveolar space. The radical way of treatment of the barotrauma of the lungs is the urgent therapeutic recompression in the diving chamber. The clinical case of a successful treatment of the barotrauma of the lungs combined with the drowning using the modern mobile autonomous barocomplex is particularly observed. The diagnostic data obtained during the examination in the hospital is analyzed. The results of the computed tomography of the chest for effi ciency evaluation of the treatment are given. The therapeutic recompression outcome in the diving chamber as a potential influence of the gaseous products of human metabolism is analyzed. The decisive and appropriate actions during the therapy of the barotrauma of the lungs allow to reduce the impact to a minimum and preserve the aptitude of the diver. 

The authors attempted to create an integrated picture of the contribution of the sailors of the Siberian Navy to the establishment of a resort system in the Far East of Russia. The article contains historical information since the creation of the Russian military flotilla in theFar Eastfrom the XVIII to the end of the XIX century. The contribution of outstanding historical figures, the will of fate turned out to be the first on mineral springs or contributed to their discovery and development is described. The contribution of the staff of the Far Eastern State Medical University to the study of the mechanism of action of mineral water and the expansion of indications for its application.

The scientific, pedagogic, and medical activities of Prof. V. M. Uvarov are describedbased on the available literature. During World War I, he was at service in Russian Army; then he worked at medical facilities in Crimea (assistant at the Department of Physiology and, later, at the Department of Surgery ofCrimeanUniversity). Positions occupied by him in the Northwest of Russia were Head of the Surgical Department of Municipal Hospital in Shlisselburg and senior assistant at the Department of Stomatology of I. P. Pavlov First Medical Insitute of Leningrad. He conducted research at Navy Medical Academy and S. M. Kirov military Medical Academy, contributed to the organization of dental care service in Soviet Navy before and during World War II, organized dentistry departments of Navy hospitals, developed advanced educational courses for dentists and courses for military medical assistants retraining into dentists, and contributed to Volume 6 of the monograph «The Experience of Soviet Medicine Gained During the Great Patriotic War in 1941–1945». In September 1956, whenNavyMedicalAcademywas fused withS.M.KirovMilitaryMedicalAcademy, the staff of the Department of Oral Surgery and Dentistry was reinforcedwith specialists in the organization of dental care services, including Professor V. M. Uvarov, Assistant Professor D. Ye. Tanfilyev and Candidates of Medical Sciences Yu. B. Gorskiy and V. A. Malyshev. This made it possible to expand the range of issues tackled at the Department. Prof. V. M. Uvarov was Head Dentist of Soviet Navy in 1942–1953 and of the Ministry of Defense of theUSSRin 1953–1954. His is the author of several monographs, including «Oral Injuries Treatment at Rear Line Hospitals», «Clinics of and Therapy for Osteomyelitis of Jaws» (1947), «Odonthogenic Maxillary Sinusitis» (1962), «Manual of Stomatology and Oral Surgery (1967), and «Odontjogenic Inflammatory Processes».