[Development of coloproctology in the Vishnevsky Central Military Clinical Hospital N 3].

The authors show the development of colonoproctology in the Vishnevsky Central Military Clinical Hospital N 3. The authors chose and described diagnostic possibilities of the proctologic center: videoendoscopy, ultrasonic diagnosis, computing technologies, methods of anatomical verification. The authors gave a characteristic of patients and methods of treatment. Almost half of all patients are oncology patients. Over the last decade 6750 patients were treated in the proctologic center, 1484 of them suffered with primary bowel cancer. 56,7% of patients suffered with colon cancer, 43,3%--rectal cancer. Special attention is paid to the patients with combat trauma. During the military conflicts on the North Caucasus 659 servicemen were treated in the hospital, 72 of them--with gunshot wounds of the colon. The majority of patients had bullet wounds, 15%--mine-blast injuries. All patients were operated on during the early stages of evacuation. Depending on character and location of injury patients were operated on properly. 68% of 72 patients suffered colon injuries, 32%--rectal injuries. 6 patients died (8,3%). The authors came to conclusion that organization and results of diagnostic and treatment, scientific and educational activity show the successful functioning of integration production treatment of patients with colonic pathology. The further ways of development are designed.

[Organization of surgical aid for gunshot wounds of the large bowel in the armed conflicts on Northern Caucasus].

The article presents generalization of experience of organization of surgical aid for gunshot wound of large bowel in the armed conflicts on Northern Caucasus. Were studied results of treatment of 272 wounded persons. Were detected 249 wounds of segmented intestine, 23 wounds of straight intestine. 78% of injured had multisystem injuries. All wounded persons had fire peritonitis, which is a logical result penetrating wound of stomach. On the base of results of treatment were proposed algorithms of surgical tactic in condition of wound of large bowel, also were proposed original methods of closing of major softgranulating wounds of perineum. The article presents a generalized experience of work in sphere of treatment of given category of wounds in coloproctologic center CMCH by Vishnevsky A.A.

Study of regular intracellular and membrane processes in neurons by laser interference microscopy.

Regular fluctuations in the height of phase profile of isolated neuron were studied by laser interference microscopy. The resultant spectra of frequencies of changes in the phase profile height indicate regular local changes in the optical density and/or geometry of neurons. The frequency spectra for the central and pri-membrane regions of the cells are different.

[The state and development of colon proctological care at the Vishnevsky Central Military Clinical Hospital]. / Sostoianie i razvitie koloproktologicheskoi pomoshchi v TsVKG im. A. A. Vishnevskogo.

The work is devoted to the assessment of gastric carcinoma spread using the method of spiral CT. It is established that CT is highly effective at carcinoma advanced stages (II-IV), that's why this method should be the main one in determining the disease spread. Besides the CT possibilities in determining the depth of tumor invasion into gastric wall are not unequivocal. The method is more informative at the advanced tumor (pT2-pT4). Without contrast amplification the CT doesn't allow to conduct differentiation according to T1-T2 invasion degree. At the same time the method gives great opportunities in revealing the tumor spread to gastric serous membrane, i.e. in detection of T3 invasion degree that is of great significance for disease prediction. The use of bolus contrast amplification widens the CT possibilities in detection of tumor invasion into gastric wall and in some cases it permits to differentiate T1 and T2 degrees.

Electrochemical synthesis and structural and physical characterization of one- and two-electron-reduced forms of [SMo12O40]2-.

Isolation of a soluble [NHex4]+ salt has allowed a detailed electrochemical study of the anion alpha-[SMo12O40]2- to be undertaken. Four reversible one-electron-reduction processes are observed in CH2Cl2 solution. Controlled potential electrolysis led to isolation of tetraalkylammonium salts of the one-electron-reduced anion alpha-[SMo12O40]3- and the two-electron-reduced anion alpha-[SMo12O40].4- [SMo12O40]3- is stable to disproportionation in dry solvents (Kdis = 10(-7.4). EPR and magnetic susceptibility data indicate that [SMo12O40]3- is a simple paramagnet (S = 1/2) while [SMo12O40]4- is paramagnetic with the mu eff values decreasing at low temperatures. Solutions of the two-electron-reduced species are EPR silent, but microcrystalline powders show very weak signals. The crystal structure of alpha-[NBu4]3[SMo12O40] has been determined (triclinic P1; a = 13.840(3) A; b = 15.587(4) A; c = 19.370(3) A; alpha = 94.82(2) degrees; beta = 93.10(1) degrees; gamma = 91.05(2) degrees; Z = 2). There is disorder around the C2 axis of the central SO4(2-) tetrahedron. In the presence of aqueous HClO4 (0.045 M) in thf/H2O or MeCN/H2O (98/2 v/v), [SMo12O40]2- exhibits five two-electron-reduction processes. Under these conditions, [SMo12O40]3- protonates and disproportionates into [SMo12O40]2- and the (2e-, 2H+)-reduced anion [H2SMo12O40]2-.

[Therapeutic policy in rectal cancer]. / Lechebnaia taktika pri rake priamoi kishki.

The results of clinical examination and treatment of 751 patients with rectal cancer are presented. A total of 684 (91.0%) patients underwent radical surgery. In 439 (64.2%) from them sphincter saving operations were carried out. The rate of sphincter saving procedures for the last 5 years has increased up to 73.8%, most often of them transbdominal resection was used--284 (64.7%) patients. Sygmoidorectal anastomosis in 158 (55.6%) patients was carried out by the hand sutures, and in 126 (44.4%)--suturing apparatuses were used. The operation was finished by the suture of the pelvic peritoneum by two layers of sutures and the drainage of the area of the anastomosis from the perineum site by two tubes for prevention of the development of peritonitis even in case of insufficiency of the anastomosis was made. All the operated patients underwent preoperative radiotherapy with a total dose 20-25 Gy. The basic stage of the operation was on demand followed by chemohyperthermic perfusion of the abdominal cavity. It was carried out in 30 patients, including 12 patients with rectal cancer. In cancer of the rectum of the II B and III stages the usage of chemotherapy is obligatory. New operations for metastases of cancer of the colon into the liver were made in 4 patients (left and extended right hemihepatectomy). Complications developed in 33.5% of patients, lethality made up 3.8%, including 1.8% for the last 5 years.

Structural, spectroscopic, and electrochemical studies of binuclear manganese(II) complexes of bis(pentadentate) ligands derived from bis(1,4,7-triazacyclononane) macrocycles.

Structural, electrochemical, ESR, and H2O2 reactivity studies are reported for [Mn(dmptacn)Cl]ClO4 (1, dmptacn = 1,4-bis(2-pyridylmethyl)-1,4,7-triazacyclononane) and binuclear complexes of bis(pentadentate) ligands, generated by attaching 2-pyridylmethyl arms to each secondary nitrogen in bis(1,4,7-triazacyclononane) macrocycles and linked by ethyl (tmpdtne, [Mn2(tmpdtne)Cl2](ClO4)2.2DMF, 2), propyl (tmpdtnp, [Mn2(tmpdtnp)Cl2](ClO4)2.3H2O, 3), butyl (tmpdtnb, [Mn2(tmpdtnb)Cl2](ClO4)2.DMF.2H2O, 4), m-xylyl (tmpdtn-m-X, [Mn2(tmpdtn-m-X)-Cl2](ClO4)2, 5) and 2-propanol (tmpdtnp-OH, [Mn2(tmpdtnp-OH)Cl2](ClO4)2, 6) groups. 1 crystallizes in the orthorhombic space group P2(1)2(1)2(1) (No. 19) with a = 7.959(7) A, b = 12.30(1) A, and c = 21.72(2) A; 2, in the monoclinic space group P2(1)/c (No. 14) with a = 11.455(4) A, b = 15.037(6) A, c = 15.887(4) A, and beta = 96.48(2) degrees; 3, in the monoclinic space group P2(1)/c (No. 14) with a = 13.334(2) A, b = 19.926(2) A, c = 18.799(1) A, and beta = 104.328(8) degrees; and [Mn2(tmpdtnb)Cl2](ClO4)2.4DMF.3H2O (4'), in the monoclinic space group P2(1)/n (No. 14) with a = 13.361(3) A, b = 16.807(5) A, c = 14.339(4) A, and beta = 111.14(2) degrees. Significant distortion of the Mn(II) geometry is evident from the angle subtended by the five-membered chelate (ca. 75 degrees) and the angles spanned by trans donor atoms (< 160 degrees). The Mn geometry is intermediate between octahedral and trigonal prismatic, and for complexes 2-4, there is a systematic increase in M...M distance with the length of the alkyl chain. Cyclic and square-wave voltammetric studies indicate that 1 undergoes a 1e- oxidation from Mn(II) to Mn(III) followed by a further oxidation to MnIV at a significantly more positive potential. The binuclear Mn(II) complexes 2-5 are oxidized to the Mn(III) state in two unresolved 1e- processes [MnII2-->MnIIMnIII-->MnIII2] and then to the MnIV state [MnIII2-->MnIIIMnIV-->MnIV2]. For 2, the second oxidation process was partially resolved into two 1e- oxidation processes under the conditions of square-wave voltammetry. In the case of 6, initial oxidation to the MnIII2 state occurs in two overlapping 1e- processes as was found for 2-5, but this complex then undergoes two further clearly separated 1e- oxidation processes to the MnIIIMnIV state at +0.89 V and the MnIV2 state at +1.33 V (vs Fc/Fc+). This behavior is attributed to formation of an alkoxo-bridged complex. Complexes 1-6 were found to catalyze the disproportionation of H2O2. Addition of H2O2 to 2 generated an oxo-bridged mixed-valent MnIIIMnIV intermediate with a characteristic 16-line ESR signal.