ABSTRACT CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.

Abstract: Congenital self-healing reticulohistiocytosis is a rare, benign, self-limiting variant of Langerhans cell histiocytosis (LCH). LCH encompasses a group of idiopathic disorders characterized by the clonal proliferation of Langerhans cells. Congenital self-healing reticulohistiocytosis typically appears at birth or in the neonatal period as isolated cutaneous lesions, often appearing as multiple crusted papules with no systemic findings. Although clinical features seem aggressive, the lesions tend to involute spontaneously within weeks to a few months leaving residual hypo or hyperpigmented macules. Timely diagnosis with histology, immunocytochemistry, and electron microscopic studies will eliminate unnecessary therapeutic interventions. Although mostly self-resolving, it carries a variable clinical course in some patients with cases of extracutaneous involvement and/or recurrences. Hence, reassurance and long-term follow-up play key roles in the management of this disease.

The prosthetic leg (PL) is a typical human-machine system in which the dynamic interaction between the human body and PL (machine) determines a high requirement of ergonomics design for PL and consequently needs to consider an indicator of usability indicating the performance of gait biomechanics. How to evaluate the indexes of usability for PL products is critical to the design technology of PL based on ergonomics. The gait symmetry of PL products, which is a core usability index, was experimentally analyzed by using a specially designed testing device in this paper. The test results show that the swing speed symmetry for intelligent prosthetic leg (IPL) is high up to 96.5%, which indicates a high performance for gait tracking. Then, a comprehensive evaluation was made for the usability of PL products with the analysis method of Grey Correlation Degree. Three types of PL product, including ordinary PL, IPL and Gait-following IPL (GL-IPL), were used in the evaluation. The evaluation results show that the GL-IPL product is the best in usability while both of IPL and GF-IPL products based on ergonomics are obviously better than the ordinary PL. The method of usability evaluation studied here is expected to help directing the design of prosthetic leg products.