The Effect of Heparin on Gene Expression of Collagen, MMP, TGF-beta Isoforms Using Cultured Fibroblast from Transverse Carpal Ligament of Carpal Tunnel Syndrome

PURPOSE: Noninflammatory synovial fibrosis has been noted for main causal factor of carpal tunnel syndrome (CTS). Recently, there are some reports that heparin have not only anti-coagulative effect but also anti-inflammatory and anti-fibrotic potential and have an effect on interstitial pulmonary fiborosis. Authors examined whether heparin affects pathogenesis of CTS. METHODS: First, heparin was administered to fibroblast that was cultured from patient's transverse carpal ligament. Secondly, we evaluated the expression from genes of type I, III collagen, TGF beta isoforms and MMP. Fibroblasts were isolated and cultured from transverse carpal ligaments of 5 patients with CTS. Heparin (0, 1, 10,100microgram/ml) was administered to cultured fibroblast and reverse transcription PCR for mRNA expression of type I, III collagen, TGF-beta isoforms and MMP was done. RESULTS: Heparin suppressed gene expression of type I, III collagen and TGF-beta1, beta3 but promoted gene expression of TGF-beta(2) and MMP-2. CONCLUSION: Heparin directly suppress gene expression of type I, III collagen. But, It is undetermined that heparin can present it's effect mediated by TGF beta iso forms or MMP.

Comparison of Treatment Effect between Superficial Suction and Subdermal Excision in Osmidrosis

Osmidrosis develops in many young people due to the apocrine gland becoming active after the adolescent period and can cause difficulty in social activities and personal relationships. We compared 2 surgical treatment methods for osmidrosis, superficial suction and subdermal excision, to determine how many of apocrine glands could be removed and examine if a significant difference was present in treatment outcome. The subjects used for the present study included 62 patients of whom 46 patients underwent subdermal excision and 16, superficial suction. We counted the total number of apocrine glands in tissue samples obtained using those 2 methods, fixed in formalin and treated with usual histologic treatment. We calculated the number of apocrine glands per unit area by measuring the axillary area of the surgery site determined before surgery. The patients who underwent surgery using those 2 methods were divided into satisfactory group and unsatisfactory group by evaluating the results subjectively and objectively after surgery. The satisfactory rate was 95.7% in 46 patients who underwent subdermal excision and 81.25% in 16 patients who underwent superficial suction. An average of 127.82 apocrine glands/ cm2 were removed through subdermal excision and 72.71 apocrine glands/cm2, through superficial suction. We determined that more apocrine glands were removed with a statistical significance using subdermal excision. However, considering the result that 81.25% satisfactory rate was seen despite 57% of apocrine glands being removed with superficial suction compared with subdermal excision, superficial suction would be also effective in reducing the number of apocrine glands to below a threshold.

Epicanthoplasty with three-dimensional Z-Plasty

The presence of epicanthal folds in Asian eyelids is one of their unique features, in combination with the lack of supratarsal folds. Western culture has influenced many people to prefer to eliminate the prominent epicanthal fold. A number of surgical techniques have been suggested for their correction. However, difficulty with design, excessive and prominent scarring of medial canthal and nasal area, recurrence, and rigidity of application are potential problems associated with many procedures. This paper describes a epicanthoplasty with three-dimensional Z-plasty. Through epicanthal fold incision, the medial canthal tecdon is medially advanced and sutured to the periosteum of nasal bone. After the transposition of the flaps, trimming of the flap is usually required. Three-dimensional Z-plasty crates the attactive eyes. From March, 1995 to March, 1997, the technique was applied to 37 patients with epicanthal fold and was performed with or without double-fold operation. There were 34 females and 3 males with ages ranging from 17 to 30 years. Through 2 years follow-up, this techniques has delivered esthetically good results with minimal postoperative scar and could made the reduction of ICD from 40 +/- 2.13mm to 34 +/- 1.98mm. The advantages of epicanthoplasty procedure using three-dimensional Z-plasty(Yoon's method) are as follows; 1) simple in design 2) minimal postoperative scar in the medial canthal area 3) versatile in its application 4) no recurrence 5) no hypertrophic scar 6) preserving ethnic identity.