Recurrent Oral and Genital Ulcers in an Infant: Neonatal Presentation of Pediatric Behçet Disease

Behçet disease is a complex, multisystem disease characterized by recurrent oral and genital ulcerations. It rarely occurs in infants or children. Neonatal Behçet disease has been reported in infants whose ulcers resolve at or before 9 weeks of age. Few cases of neonatal Behçet disease persisting into childhood have previously been reported. We report the case of a 1‐month‐old infant who presented with severe recurrent genital ulcerations and at 6 months developed recurrent oral ulcerations. Her orogenital ulcerations continue to recur. Human leukocyte antigen testing revealed HLA‐B51 and B44 positivity. This is a case of pediatric Behçet disease in the neonatal period. Behçet disease should be considered in the differential diagnosis of recurrent genital and oral ulcerations in infants and children.     

乳腺管状小叶癌

乳腺管状小叶癌（Tubulolobular carcinoma，TLC）最初是被作为小叶癌的管状变型。作者总结了27例TLC的组织学、免疫表型和临床特征，并与纯小管癌和经典型小叶癌进行了比较。此组患者年龄43-79岁（中位年龄60岁）。1例双侧乳腺受累，5例病变为多灶性。肿瘤直径0．5-2．5cm，色灰褐，质硬。组织学观察：TLC的肿瘤细胞形成管状和条索状两种结构模式并相互混杂，且两者比例相当（统称为管状小叶模式）。     

Die Beurteilung des Kollagenstoffwechsels mittels Hydroxyprolin im Serum und Urin und der Serum-Kollagenpeptidase unter verschiedenen Diätformen

Zusammenfassung Zur Klärung der Frage, ob zwischen Bergleuten mit einer Silikose und Gesunden Unterschiede in der Ausscheidung von Hydroxyprolin (HP) im Sammelurin bestehen und ob diese Messung durch einfacher zu bestimmende Parameter ersetzt werden kann, wurden an insgesamt 34 Probanden HP-Bestimmungen im Sammelurin und im Blutserum sowie die Bestimmung der Serum-Kollagenpeptidase durchgeführt.Die HP-Bestimmungen im Urin und Serum unter verschiedenen Diätformen zeigen, daß eine 24stündige prolinarme Diät vor Beginn der Urinsammelperiode sowie die Weiterführung während der Sammelperiode genügt. Das peptidgebundene HP — bestimmt aus der Differenz von Gesamt-HP und dem ohne Hydrolyse gemessenen HP — weist keine Unabhängigkeit von der Diät auf. Zu den HP-Mengen im Sammelurin haben die Serumwerte eine enge Parallelität. Allein die Kollagenpeptidase ist von der Diät unabhängig und scheint ein geeignetes Maß zur Beurteilung der Aktivität des Kollagenstoffwechsels zu sein.Zwischen Bergleuten mit einer Silikose und Gesunden fanden sich keine Unterschiede.Mit finanzieller Unterstützung der Bergbau-Berufsgenossenschaft Bochum     

Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm

The relationship of scapulothoracic motion to glenohumeral motion, commonly referred to as the scapulohumeral rhythm, has been the subject of numerous investigations. The purpose of this study was to assess the effects of localized muscular fatigue on three-dimensional scapulothoracic motion and the resulting scapulohumeral rhythm during elevation of the humerus in the plane of the scapula. A six-degree-of-freedom digitizing system (Metrecom(TM)) was used to define scapular and trunk reference frames, and three-dimensional Eulerian angles were determined for scapular motion for 0-135 degrees of humeral elevation before and after fatigue of the upper and lower trapezius muscles. Local muscle fatigue was determined using spectral analysis of electromyographic signals for the upper and lower trapezius muscles. The results demonstrated an average of 22% decrease in the median frequencies of the muscles sampled following resistive exercise, suggesting a state of local muscle fatigue. Concomitant with the fatigue was a selective decrease in scapulothoracic motion about two of the three scapular axes. RELEVANCE: Occupational and recreational conditions often require repetitive overhead elevations of the arms, resulting in muscular fatigue and various pathologies. During repetitive arm elevations the scapulohumeral rhythm or synchronization between the humerus and the scapula is balanced to allow the most efficient elevation of the arm. A better understanding of this much-discussed scapulohumeral rhythm and the changes induced by muscular fatigue may provide insight into the pathomechanics associated with shoulder dysfunction.     

Muscle strength at the trunk*

The purpose of this study was to determine the strength of trunk flexors and extensors in normal male subjects during isometric, concentric, and eccentric contractions. Subjects were tested in the sidelying position to minimize the effects of gravity. The pelvis and lower extremities were measured on a custom built force table (lowa Force Table). Muscle strength was expressed as a moment of force (external force times the moment arm) in Newton-meter (Nm) units. Greater Nm were registered in the muscle-lengthened position than in the muscle-shortened position for all isometric contractions. The Nm registered for eccentric contractions always exceeded the Nm registered for concentric contractions of the same muscle group. The Nm registered during contractions of trunk extensors always exceeded the values obtained during corresponding modes of contractions (isometric, eccentric, and concentric) of trunk flexors.J Orthop Sports Phys Ther 1980;1(3):165-170.     

Evaluation of the metrecom and its use in quantifying skeletal landmark locations

Several factors can be involved in evaluating a motion analysis system. The purposes of this study were to evaluate: 1) the accuracy, repeatability, and linearity of the Skeletal Analysis System (Metrecom System) and 2) the reliability of bony landmark identification with a method using the Metrecom Skeletal Analysis System (Metrecom Method) to obtain coordinates for human skeletal landmarks. A calibration control object with 20 known three-dimensional coordinates in a rectangular field was used as the gold standard for evaluating the Metrecom System for measuring X, Y, and Z spatial coordinates. The Metrecom Method was then evaluated using a test-retest approach for 10 bony landmarks on each of 10 normal subjects examined by two different examiners. Relative to the Metrecom System, the results demonstrated that the hysteresis was minimal (1.8 mm), and linearity was excellent. The differences between the true and measured distances for the 20 known points were not statistically significant (p >/= .05). The variability for any point within the field of measurement was homogeneous (p /= .05). The mean intrarater reliability (ICC) for identification of coordinates for 10 bony landmarks was .95 for one examiner and .96 for the other examiner. The mean interrater ICC was .87, with all coefficients being above .80. In conclusion, use of the Metrecom System is affected by controllable human factors, in which case valid and reliable measurements for skeletal landmarks can be obtained. J Orthop Sports Phys Ther 1992;16(4):182-188.