<title>ABSTRACT</title> <p>The U.S. Army has realized the need to change its procurement strategy to demand shorter equipment fielding times, delivering capabilities with clear military value that can be improved in low risk increments. This paper addresses the need for a C4ISR infrastructure based on open standards that can be sourced from multiple vendors and host the full spectrum of applications.</p> <p>The Distributed Computing Environment (DCE) -- is a computing and network infrastructure scalable from handheld and dismounted form factors through redundant, distributed clusters supporting multiple secure enclaves, and qualified for the most stringent of ground combat environments. The DCE captures the benefits of commercial-off-the-shelf (COTS) capitalization surrounding the x86 architecture, and implements open standards including OpenVPX, POSIX, Gigabit Ethernet, the Object Management Group Data Distribution Service, and the Service Availability Forum.</p> <p>Packaged COTS subsystems implement the hardware as rugged chassis comprised of industry standard backplanes with fully integrated computing and I/O modules. The result is rapid availability for high technology readiness level equipment that delivers field-proven technology that will last the lifetime of a combat vehicle, and has a clear technology upgrade path when required.</p>
We have employed a two-stage operative approach to the correction of Crouzon's/Apert's deformity. Extensive use of methyl methacrylate in cranioplasty and frontal bone advancement is employed to obtain finely detailed contours with excellent stability. By adhering to principles of separation of oral contamination and the methyl methacrylate, as well as the provision of adequate soft tissue coverage of the methyl methacrylate, the problems of infection and soft tissue breakdown can be minimized.
The local immune response to allograft dermis and epidermis was studied in a rat skin-graft model. Biopsies taken at varying times after transplantation were analyzed using routine light microscopy and a panel of monoclonal antibodies. The dermis appeared to be spared by the rejection process, whereas the epithelium and adnexal elements of the dermis were destroyed. The persistence of dermis transplanted across major histoincompatibilities may allow it to be useful in reconstructing large skin losses.
A 10-month-old Hispanic male infant with expansile lesions of the third metacarpal and proximal phalanx positively diagnosed as Coccidioides immitis osteomyelitis is presented. Treatment consisted of combined surgical debridement and systemic antifungal therapy and resulted in complete resolution of the lesions. Treatment was guided by clinical response and complement fixation titers. Osteomyelitis is a relatively infrequent manifestation of disseminated coccidioidomycosis. Neonates and infants appear to be more susceptible to the development of dissemination, but less likely to develop toxicity due to systemic therapy. Current therapy consists of concomitant surgical excision of involved lesions and systemic antifungal therapy. Complement fixation titers correlate closely with clinical response to therapy and are useful in detecting subclinical recurrences. Bickel KD, Press BHJ, Hovey LM. Successful treatment of coccidioidomycosis osteomyelitis in an infant. Ann Plast Surg 1993;30:462–465
