A large number of congenital dislocation of the hip remains undiagnosed before a child begins to walk, unless screening tests are performed on newborns and infants. It is well-known that congenital dislocation of the hip can result in marked acetabluar dysplasia, in deformity of the femoral head and in a change of the femoral-neck angle: conversely, a normal hip joint can be expected when the femoral head is replaced in time in the acetabular socket. The authors studied 33 cases of 37 congenital dislocations of the hip treated with closed reduction and immobilization in a changing cast after adequate premanipulative skeletal traction at the orthopedic department of the Presbyterian Hospital, Taegu. As result of this study, the following conclusions were reached: 1. The preponderance of girls to boys was found to be 3.7 : 1. 2. The ratio of unilateral to bilateral cases was 29 : 4 and of right to left was 12 : 17. All 4 bilateral cases were female. 3. An associated congenital anomaly was observed in a case of thyroglossal duct cyst. There were 2 cases of breech presentation. 4. Instead of a soft tissue releasing operation, in most cases we applied adequate skeletal traction(plus one to two station) in the distal femur for 2 to 3 week before reduction. That was the same as a series of traction stations referred to by Gage and Winter(1972) which relates the position of the femoral head to the acetabulum by traction. 5. The average time of following up was 24 months. 6. There were 2 cases of epiphyseal change. One of the cases did not appear as a proximal femoral epiphysis until the 8th month of postreduction and the other was a fragmentation of the femoral epiphysis without signs of increased density after reduction. These 2 cases resulted from inadequate traction. We will follow up these cases for an adequate time. 7. There were several cases of unsatisfactory results functionally and anatomically, in acetabulum and head relationship and the femoral-neck angle. 8. The duration which required for joint stability clinically was shortened in cases of early treatment. 9. The average time of cast immobilization was 7 months.
Acetabulum ; Breech Presentation ; Child ; Congenital Abnormalities ; Daegu ; Dislocations ; Epiphyses ; Female ; Femur ; Follow-Up Studies ; Head ; Hip Joint ; Hip ; Humans ; Immobilization ; Infant ; Infant, Newborn ; Joints ; Mass Screening ; Orthopedics ; Pregnancy ; Protestantism ; Thyroglossal Cyst ; Traction

Skin grafts on bare bone, denuded of perioteum, is one of the most difficult problems to deal with, but has good clinical application. Most surgeons have stated that skin grafts will not take on unprepared bare bone and have refused to raft skin on bare bone, but they have successfully grafted skin on bare bone after preparation of the recipient site in one of several ways. The authors have treated bare bones with multiple holes drilled through the outer cortex of bone in to the marrow cavity to start growth of granulation from the marrow cavity, followed by skin graft. It has been both successful and has shortened the convalescent period.
Bone Marrow ; Skin ; Surgeons ; Transplants

A 48-year-old woman presented with a 1-day history of aggressive behavior. Hashimoto encephalopathy was first suspected based on elevated levels of serum anti-thyroid peroxidase antibody. Her clinical symptoms did not improve despite treatment with intravenous corticosteroid. Abdominal computed tomography revealed liver cirrhosis, and brain T2-weighted magnetic resonance imaging revealed midbrain hyperintensity, and she was finally diagnosed with Wilson’s disease. The Wilson’s disease should be considered in the differential diagnosis in adults presenting with unexplained hepatic, neurological, or psychiatric abnormalities.

Background: Glucagon-like peptide-1 (GLP-1) analogues regulate glucose homeostasis and have anti-inflammatory properties, but cause gastrointestinal side effects. The fibroblast growth factor 21 (FGF21) is a hormonal regulator of lipid and glucose metabolism that has poor pharmacokinetic properties, including a short half-life. To overcome these limitations, we investigated the effect of a low-dose combination of a GLP-1 analogue and FGF21 on atherosclerosis-related molecular pathways. Methods: C57BL/6J mice were fed a high-fat diet for 30 weeks followed by an atherogenic diet for 10 weeks and were divided into four groups: control (saline), liraglutide (0.3 mg/kg/day), FGF21 (5 mg/kg/day), and low-dose combination treatment with liraglutide (0.1 mg/kg/day) and FGF21 (2.5 mg/kg/day) (n=6/group) for 6 weeks. The effects of each treatment on various atherogenesisrelated pathways were assessed. Results: Liraglutide, FGF21, and their low-dose combination significantly reduced atheromatous plaque in aorta, decreased weight, glucose, and leptin levels, and increased adiponectin levels. The combination treatment upregulated the hepatic uncoupling protein-1 (UCP1) and Akt1 mRNAs compared with controls. Matric mentalloproteinase-9 (MMP-9), monocyte chemoattractant protein-1 (MCP-1), and intercellular adhesion molecule-1 (ICAM-1) were downregulated and phosphorylated Akt (p-Akt) and phosphorylated extracellular signal-regulated kinase (p-ERK) were upregulated in liver of the liraglutide-alone and combination-treatment groups. The combination therapy also significantly decreased the proliferation of vascular smooth muscle cells. Caspase-3 was increased, whereas MMP-9, ICAM-1, p-Akt, and p-ERK1/2 were downregulated in the liraglutide-alone and combination-treatment groups. Conclusion Administration of a low-dose GLP-1 analogue and FGF21 combination exerts beneficial effects on critical pathways related to atherosclerosis, suggesting the synergism of the two compounds.

BACKGROUND: Bone strength is impaired in patients with type 2 diabetes mellitus despite an increase in bone mineral density (BMD). Thiazolidinedione (TZD), a peroxisome proliferator activated receptor γ agonist, promotes adipogenesis, and suppresses osteoblastogenesis. Therefore, its use is associated with an increased risk of fracture. The aim of this study was to examine the in vitro and in vivo effects of lobeglitazone, a new TZD, on bone. METHODS: MC3T3E1 and C3H10T1/2 cells were cultured in osteogenic medium and exposed to lobeglitazone (0.1 or 1 µM), rosiglitazone (0.4 µM), or pioglitazone (1 µM) for 10 to 14 days. Alkaline phosphatase (ALP) activity, Alizarin red staining, and osteoblast marker gene expression were analyzed. For in vivo experiments, 6-month-old C57BL/6 mice were treated with vehicle, one of two doses of lobeglitazone, rosiglitazone, or pioglitazone. BMD was assessed using a PIXImus2 instrument at the baseline and after 12 weeks of treatment. RESULTS: As expected, in vitro experiments showed that ALP activity was suppressed and the mRNA expression of osteoblast marker genes RUNX2 (runt-related transcription factor 2) and osteocalcin was significantly attenuated after rosiglitazone treatment. By contrast, lobeglitazone at either dose did not inhibit these variables. Rosiglitazone-treated mice showed significantly accelerated bone loss for the whole bone and femur, but BMD did not differ significantly between the lobeglitazone-treated and vehicle-treated mice. CONCLUSION: These findings suggest that lobeglitazone has no detrimental effects on osteoblast biology and might not induce side effects in the skeletal system.
Adipogenesis ; Alkaline Phosphatase ; Animals ; Biology ; Bone and Bones ; Bone Density* ; Diabetes Mellitus, Type 2 ; Femur ; Gene Expression ; Humans ; In Vitro Techniques ; Infant ; Mice* ; Osteoblasts ; Osteocalcin ; Peroxisomes ; RNA, Messenger ; Thiazolidinediones ; Transcription Factors