Citations

This study combines an ergometric wheelchair, a six-camera video motion capture system and a prototype computer graphics based musculoskeletal model (CGMM) to predict shoulder joint loading, muscle contraction force per muscle and the sequence of muscular actions during wheelchair propulsion, and also to provide an animated computer graphics model of the relative interactions. Five healthy male subjects with no history of upper extremity injury participated. A conventional manual wheelchair was equipped with a six-component load cell to collect three-dimensional forces and moments experienced by the wheel, allowing real-time measurement of hand/rim force applied by subjects during normal wheelchair operation. An Expert Vision™ six-camera video motion capture system collected trajectory data of markers attached on anatomical positions. The CGMM was used to simulate and animate muscle action by using an optimization technique combining observed muscular motions with physiological constraints to estimate muscle contraction forces during wheelchair propulsion. The CGMM provides results that satisfactorily match the predictions of previous work, disregarding minor differences which presumably result from differing experimental conditions, measurement technologies and subjects. Specifically, the CGMM shows that the supraspinatus, infraspinatus, anterior deltoid, pectoralis major and biceps long head are the prime movers during the propulsion phase. The middle and posterior deltoid and supraspinatus muscles are responsible for arm return during the recovery phase. CGMM modelling shows that the rotator cuff and pectoralis major play an important role during wheelchair propulsion, confirming the known risk of injury for these muscles during wheelchair propulsion. The CGMM successfully transforms six-camera video motion capture data into a technically useful and visually interesting animated video model of the shoulder musculoskeletal system. The CGMM further yields accurate estimates of muscular forces during motion, indicating that this prototype modelling and analysis technique will aid in study, analysis and therapy of the mechanics and underlying pathomechanics involved in various musculoskeletal overuse syndromes.

The nonfamilial Carney triad includes paraganglioma, gastrointestinal stromal tumor (GIST), and pulmonary chondroma. Some paraganglioma-GIST diads are familial and inherited in an apparent autosomal dominant manner. The familial paraganglioma-GIST syndrome differs from the Carney triad by the absence of female predilection and predominance of paragangliomas. We report the cases of a 12-year-old boy with a paraganglioma of the organ of Zuckerkandl, and his 13-year-old monozygotic twin with a gastric GIST. These two patients, to our knowledge, are the first to be reported as likely having the familial paraganglioma-GIST syndrome following its description by Carney and Stratakis (Am J Med Genet 2002;108:132–139) in 12 patients from five families. A lifetime follow-up and a periodic search for both tumors are indicated in these patients and their families.

Abstract Linkage disequilibrium, the nonrandom association of alleles from different loci, can provide valuable information on the structure of haplotypes in the human genome and is often the basis for evaluating the association of genomic variation with human traits among unrelated subjects. But, linkage phase of genetic markers measured on unrelated subjects is typically unknown, and so measurement of linkage disequilibrium, and testing whether it differs significantly from the null value of zero, requires statistical methods that can account for the ambiguity of unobserved haplotypes. A common method to test whether linkage disequilibrium differs significantly from zero is the likelihood-ratio statistic, which assumes Hardy-Weinberg equilibrium of the marker phenotype proportions. We show, by simulations, that this approach can be grossly biased, with either extremely conservative or liberal type I error rates. In contrast, we use simulations to show that a composite statistic, proposed by Weir and Cockerham, maintains the correct type I error rates, and, when comparisons are appropriate, has similar power as the likelihood-ratio statistic. We extend the composite statistic to allow for more than two alleles per locus, providing a global composite statistic, which is a strong competitor to the usual likelihood-ratio statistic.