Granulocyte-macrophage colony-stimulating factor (GM-CSF) is naturally generating protein that has the healing effect in normal wounds as well as infected nonhealing wounds and ulcers. Ascorbic acid has also been known to stimulate fibroblast stimulation and collagen synthesis. However, there are no reports about the effect of GM-CSF and ascorbic acid co-supplementation in wound healing. Therefore, in this report, we examined the effect of GM-CSF and ascorbic acid co-supplementation on the proliferation of human dermal fibroblasts and collagen synthesis which play a crucial role in wound healing process in vitro. To determine an optimal GM-CSF and ascorbic acid concentration for human dermal fibroblast proliferation and collagen synthesis, the cells were incubated with various concentrations of GM-CSF and ascorbic acid. The activity of fibroblast proliferation was determined by MTT assay. To measure the amount of collagen production, the collagen type I carboxy-terminal propeptide enzyme immunoassay was used. The best fibroblast proliferation was observed at the co-supplementation of 0.5 microgram/ml GM-CSF with 25 microgram/ml ascorbic acid and 1 microgram/ml GM-CSF with 12.5 microgram/ml ascorbic acid. Maximal stimulation of collagen synthesis was observed at the co-supplementation of 1 microgram/ml GM-CSF with 12.5 microgram/ml ascorbic acid. The collagen synthesis per cell was also maximal at concentration of 1 microgram/ml GM-CSF with 12.5 microgram/ml ascorbic acid. This results demonstrates that GM-CSF and ascorbic acid co-supplementation increases human dermal fibroblast proliferation and collagen synthesis and the concentration is the critical factor in vitro.
Ascorbic Acid* ; Collagen Type I ; Collagen* ; Fibroblasts* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Humans ; Immunoenzyme Techniques ; Ulcer ; Wound Healing ; Wounds and Injuries

Complete division of transverse carpal ligament (TCL) is accepted as a standard procedure for carpal tunnel syndrome (CTS). In some cases however, after complete release of TCL, the loss of grip and pinch power occurs frequently. Previous study revealed that normal intracanal pressure is 25-30mmHg, therefore There were the possibility that complete division of TCL is an over-correction for CTS. The purpose of this experiment was to measure the carpal tunnel pressure during the incremental division of TCL. Twenty patients who were confirmed as CTS were selected from September 2002 to February 2003. By step-wise division of TCL, the pressure was obtained for 3 times serially. Comparative pressure changes between the pre-division and post-division were analyzed by SRM (standard responsiveness mean) and ES (effect size). In Carpal tunnel syndrome, the mean intracanal pressure was 215.5mmHg. After partial release of the portion which was revealed as most severely compressed area on inching test, the carpal pressure decreased to 70.6 mmHg. Releasing the remaining portion of TCL resulted in another 30% decompression. Effect size of partial release was 2.86, and after release of the remaining portion of TCL the effect size was 1.19. Comparing the effect size, as much effect as 70% of the total release (4.15) can be obtained by partial release.
Carpal Tunnel Syndrome ; Decompression ; Hand Strength ; Humans ; Ligaments

Expanding cells ex-vivo is very important in tissue- engineering. Culture medium is usually supplemented with fetal bovine serum(FBS) in most of the experiments. However, cells grown in bovine serum media may posses the possibilities of disseminating bovine diseases and/or stimulating the patient's immune reactions. To overcome these problems, autologous or homologous serum should be used instead of the FBS. The purpose of this study is to compare cell proliferation and collagen synthesis depending on the kind of sera mixed on media and to provide a guideline on applying established experimental data to clinical cases. Human dermal fibroblasts were obtained from four patients. Five thousand cells per well in 96-well plates were incubated DMEM/F- 12 Nutrient with varying serum mixture; 10% autologous serum, 10% homologous serum, and 10% FBS. Five days after incubation fibroblast proliferation and collagen production were determined by MTT assay and CICP enzyme immunoassay. The mean cell number were; 3.95x104/well, 2.97x104/well and 2.30x104/well, respectively. The average amounts of collagen synthesized were; 238.13ng/ml, 204.88ng/ml, and 163.88ng/ml in each. These results show that the use of human serum mixture may contribute to, not only preventing disseminated infection of bovine diseases. but also increase cell proliferation and collagen synthesis without simulating the patient's immune reactions.
Animals ; Cattle ; Cattle Diseases ; Cell Count ; Cell Proliferation ; Collagen* ; Fibroblasts* ; Humans ; Immunoenzyme Techniques

PURPOSE: The aim of this study is to report the usability of autogenous bone graft with bone peg in total knee arthroplasty in the patients with tibial medial bone defect from osteoarthritis due to severe varus deformity. MATERIALS AND METHODS: From July 1998 to December 2000, fifteen total knee arthroplasties with autogenous bone graft were performed for the medial tibial bone defects. The proximal tibia was resected and then bone pegs which were prepared from resected portion of distal femur and proximal tibia were inserted into the defect site with the shape of peg in the anterior posterior view using press fitting method. Instead of applying screw or K-wire, we performed press-fitting method for early stability. For attaining the stability, we preserved the sclerotic rim and designed precisely the bony defect site. We reviewed the result using the HSS Knee Rating Scale and observed the radiologic change. RESULTS: In HSS Knee Rating Scale review, 52.4 of preoperative score was improved to 84.7 at postoperative 1 year. Tibio-femoral angle , the average 17.8 degrees of varus was improved to the average 5.8 degrees of valgus at 1 year postoperatively. The average union period was 5 months, and there was no evidence of the displacement of grafted bone and loosening of the inserted implants. CONCLUSION: The method of autogenous bone graft applied with bone peg could be supposed as the stable fixation method without using screws or K-wires.
Arthroplasty* ; Congenital Abnormalities ; Femur ; Humans ; Knee* ; Osteoarthritis ; Tibia ; Transplants*