Life Support for Trauma and Transport: first field use.

During the Persian Gulf War, the U.S. Army Medical Department (AMEDD) found evacuation distances for patients increasing as a result of the fast movement of the forward line of troops. Thus, there is a need for a trauma and intensive care transport system that avoids the medical dangers that accompany such evacuation distances. In 1998, after a few years of research and development, the AMEDD introduced a prototype transport "trauma pod" called the LSTAT (Life Support for Trauma and Transport). In March 2000, the LSTAT was issued to the 212th Mobile Army Surgical Hospital that deployed to Camp Bondsteel, Kosovo, for its first real-world fielding. This article describes the initial Kosovo fielding phase, highlighting the LSTAT benefits, advantages to military medicine, and recommended enhancements.

Ventral prepucial flap meatoplasty in the treatment of distal urethral male strictures.

OBJECTIVE: The authors evaluate their experience with Jordan flap meatoplasty in the treatment of distal men's urethral stricture from the functional and cosmetic point of view. METHODS: We have performed meatoplasties on 21 patients with distal urethral stenosis with an average age of 48 years (range 35-72). Seven patients had meatal strictures, eight patients had combined meatal and distal urethral strictures and six patients had already undergone a meatotomy which was functionally and cosmetically unsuccessful. The patients were followed-up for an average of 35 months (range 24-40). RESULTS: The reconstruction used was successful in all patients. There was no incidence of recurrence of stricture. All patients were satisfied with cosmetic result. During micturition the flow is consistent and without spray. Uroflowmetry and urethral calibration 24-36 months post surgery didn't reveal any stricture recurrence. To date there have been no complications. CONCLUSIONS: Meatoplasty as described by Jordan is a method with very satisfactory functional and cosmetic results and is suitable for the reconstruction of meatal and distal urethra strictures.

Global down-regulation of HOX gene expression in PML-RARalpha + acute promyelocytic leukemia identified by small-array real-time PCR.

Acute promyelocytic leukemia (APL) is associated with a reciprocal and balanced translocation involving the retinoic acid receptor-alpha (RARalpha). All-trans retinoic acid (ATRA) is used to treat APL and is a potent morphogen that regulates HOX gene expression in embryogenesis and organogenesis. HOX genes are also involved in hematopoiesis and leukemogenesis. Thirty-nine mammalian HOX genes have been identified and classified into 13 paralogous groups clustered on 4 chromosomes. They encode a complex network of transcription regulatory proteins whose precise targets remain poorly understood. The overall function of the network appears to be dictated by gene dosage. To investigate the mechanisms involved in HOX gene regulation in hematopoiesis and leukemogenesis by precise measurement of individual HOX genes, a small-array real-time HOX (SMART-HOX) quantitative polymerase chain reaction (PCR) platform was designed and validated. Application of SMART-HOX to 16 APL bone marrow samples revealed a global down-regulation of 26 HOX genes compared with normal controls. HOX gene expression was also altered during differentiation induced by ATRA in the PML-RARalpha(+) NB4 cell line. PML-RARalpha fusion proteins have been reported to act as part of a repressor complex during myeloid cell differentiation, and a model linking HOX gene expression to this PML-RARalpha repressor complex is now proposed.