Vol 334, No 1 (2013)

There are two triage groups of the walking wounded in a medical company of a brigade/special-purpose medical team: those returning to fighting role and those who have to be evacuated to level 3 echelon of care. The main purposes of surgical care of the walking wounded in the 3rd echelon of care are the following: diagnosis of injury pattern ruling out severe damages and separation of the independent category of the walking wounded. There is medical evacuation of the walking wounded from the 3rd echelon to the 4th echelon deployed in a combat zone. The walking wounded who needs less than 30 days of staying in hospital are evacuated to the garrison military hospitals and medical treatment facilities subordinated to a district military hospital. The wounded with the prolonged period of hospitalization (more than 30 days) are evacuated toward the district military hospital. Treatment of the walking wounded should be accomplished in the military district where the armed conflict goes on.

With the help of scanning electronic and atomic force microscopy structure of red blood cell membranes of the system blood-groove and microcirculatory channels is studied. It is established, that in early stages of skin wounds in a peripheral blood circulation appear compressed red blood cells, losing water. As a result the basic mechanism of destruction of red blood cell membranes are interlayered shifts and stratification. In red blood cells of microvasculature, on the contrary, red blood cells in state of vacuolar degeneration are indentified. It creates preconditions for hydration and bullous deformations of membranes. Porous structures of membranes of both types erythrocytes are exposed to expansion.

With the purpose of improvement of diagnosis of induced gastric ulcer were examined 11 patients who took agressive agents for simulation of gastric ulcer and 33 patients who took pseudo-aggressive agents. Observables, conduced diagnosis of local chemical burn of mucous coat of stomach during initial 6 days after taking aggressive agents. Stages of ulcerous process, resulting from local chemical burn of mucous coat of stomach, coressponds to real gactric ulcer. Gelatin capsule using as a container for delivery of agressive agents, melts in stomach in 5—6 minutes after taking. Independent from body position, mucous coat of greater curvature of the stomach is damaged. It is impossible to simulate duodenal bulb ulcer using the gelatine capsule or ball made of breadcrumb. The last method of delivery of agressive agent can damage the small intestine because of uncontrollability of the place of breaking the ball.

It is established that after the termination of deep saturation dives reorganization of respiratory system at navy aquanauts proceeds. This remodeling is specific, atypical for natural age dynamics.

The US Navy. The present article is the fourth part of the review dedicated to organization and management of medical research in the US Armed Forces. The first, second and the third parts were published in the previous issues of the journal. Specifically this article is dedicated to organization and management of medical research in the US Navy. It is shown that in the US Navy the fundamental and a part of applied investigations are conducted in the Office of Naval Research while more practical research is carried out at the Naval Medical Research Center. The latter includes the Naval Health Research Center, the Naval Submarine Medical Research Laboratory and seven Naval Medical Research Units which are successively presented. The particular research programs conducted in the above mentioned organizations are discussed.

There are biographical details about V.V. Belozyorov (16.02.1932—8.07.1999) — surgeon, talanted seascape poet, former editor-in-chef «Military-medical magazine» (1978—1992), about his official and labour activity, poetic creativity and also about various employees of the magazine.