Bu eser Avrupa Birliği'nin ufuk 2020 (hibe sözleşmesi No 645710) ve 7 Framework (hibe anlaşmaları No 612547 ve 319010) programları fon aldı. Yazarlar Dr Fotini Sourli-Chasioti biyopsi prosedürü ile ilgili yardım için teşekkür etmek istiyorum. Yazarlar ayrıca Bay Yiorgos Paterakis video hazırlanmasında değerli yardım için teşekkür ederiz.

çalışma Helsinki bildirimi tarafından belirlenen standartlarını standartlarla uyumlu ve Teselya Üniversitesi, Egzersiz Bilimi Bölümü Βiοethics Komitesi tarafından kabul edildi.
 1. ameliyat ekipmanları ve sarf malzemeleri hazırlanması <ol><li>dezenfekte cerrahi alan 4 tekerlekten cerrahi Mayo stand üzerinde konumlandırın.</li>
	<li>Pozisyon aşağıdaki sarf malzemeleri ve cerrahî donanımlar 4 tekerlekten cerrahi bir Mayo stand: 
	Düz çalışma makas (15 cm) bir çift bir neşter (No. 11) bir neşter kolu eğri makas (14 cm) bir çift bir sivrisinek forseps Kocher cımbız bir çift bir cerrahi cımbız Povidone-iyot (üzerinde bir steril Gazlı bez) bir dikiş (4.0) düz makas (11 cm) bir çift bir iğne bağı (15 cm) beş steril gauzes bir yapışkan steril gazlı bez bir 10 mL şırınga dezenfekte iğneyle 10 mL % 2 xylocaine (adrenalin) bir dezenfekte cerrahi eldivenleri</li> <li>aşağıdaki belgeleri ayrı bir bankta pozisyon: iki microcentrifuge tüp 5 mL % 10 formalin de içeren bir tüp 50-100 mL sıvı azot-190 ° C'de içeren bir küçük kap </li></ol> 2. Katılımcılar hazırlanması <ol><li>katılımcılar bir 8 h hızlı 15 önce biyopsi prosedürü izleyin.</li>
	<li>Biyopsi 16 , 17 katılımcılar kaçınmalıdır fiziksel egzersiz, aşırı stres, alkol ve aktif ve pasif sigara 72 h önceden var.</li>
</ol> 3. Cilt altı yağ dokusu biyopsi performans <ol><li>cerrahi yatakta sırtüstü pozisyonda katılımcı konumlandırın.</li>
	<li>Povidone-iyot kullanarak kesi bölgesinde dezenfekte.</li>
	<li>10 mL % 2 xylocaine (adrenalin) yavaş yavaş ve sürekli enjekte 18 lokal anestezi hizmet etmek için seçili bölgeye.</li>
	<li>Steril cerrahi alan alanının üstünde belgili tanımlık kesme bölgesi hariç katılımcı, gövdesi kapak konumlandırın.</li>
	<li>En az 3-5 dk. daha sonra basınç cımbız bir çift ile lokal anestezi alanına uygulamak ve katılımcının bu lokal anestezi elde emin olmak için herhangi bir ağrı 19 hissettiğini sormak.</li>
	<li>No 11 neşter bisturi sapı ekleyin.</li>
	<li>2-2,5 cm uzunluğunda, 3-5 cm sola veya sağa göbek bir kesik oluşturun.</li>
	<li>Düz 15 cm işletim makas çifti ile subkutan dokuyu.</li>
	<li>Yağ dokusu ortaya sonra cımbız bir çift ve bir eğri 14 cm makas ile yakalamak.</li>
	<li>Kesti ve yaklaşık 1 g yağ dokusunun kaldırın.</li>
	<li>Doku kaldırma steril gauzes hemostaz elde etmek belgili tanımlık kesme üzerinde konumlandırın.</li>
	<li>Hemostaz onaylandığında, subkutan doku görünene kadar 14 cm iğne ile 4.0 dikiş ve cilt cerrahi cımbız bir çifti yakalamak.</li>
	<li>Dikiş iğne deri ve subkutan yakından uyumlu subkutan doku doğru hareket deri içine takın.</li>
	<li>Dışarıdan derisini tahrik kadar subkutan doku içine bir sürekli zig-zag teknik dikiş iğne ile izleyin. Cilt kesi kapatılıncaya kadar devam.</li>
	<li>Dışarıdan dikişi kravat.</li>
	<li>Serum fizyolojik ile kesi alanı temizleyin ve yapışkan steril gazlı bez ile kapak.</li>
</ol> 4. Doku birikimi <ol><li>toplanan yağ dokusu üç parçaya ayırın: 150, 350 ve 500 mg.</li>
	<li>Örnek doku 150 ile 350 mg parçalarını microcentrifuge tüplerde konumlandırın.</li>
	<li>-190 ° c son ifade-80 adlı bir dondurucuda kadar sıvı azot ile küçük kap bırakın iki microcentrifuge tüplerde ° C. 
	Not: peşin, -190, sıvı nitrojen microcentrifuge tüplerde daldırma sırasında Kupası hatalarını önlemek üzere microcentrifuge tüpler küçük bir delik delmek için steril bir iğne kullanın ° C.</li>
	<li>Bırakın örnek doku 500 mg parça-histolojik çözümleme için kullanılacak-5 mL % 10 formalin de içeren bir tüp. 
	Not: yalnızca durumlarda ameliyat sırasında aşırı kanama sivrisinek forseps kullanın. Bu gibi durumlarda, gemi ligate ve hemostaz elde kadar kapatmak için sivrisinek Forseps ile yakalamak.</li>
</ol>

<ol>
	<li>Bruening, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+review:+comparative+effectiveness+of+core-needle+and+open+surgical+biopsy+to+diagnose+breast+lesions.">Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions.</a> Ann Intern Med. 152, 238-246 (2010).</li><li>Beynen, A. C., Katan, M. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rapid+sampling+and+long-term+storage+of+subcutaneous+adipose-tissue+biopsies+for+determination+of+fatty+acid+composition.">Rapid sampling and long-term storage of subcutaneous adipose-tissue biopsies for determination of fatty acid composition.</a> Am J Clin Nutr. 42, 317-322 (1985).</li><li>Wang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscle+and+adipose+tissue+biopsy+in+older+adults+with+type+2+diabetes+.">Muscle and adipose tissue biopsy in older adults with type 2 diabetes .</a> J Diabetes Mellitus. 1, 27-35 (2011).</li><li>Mutch, D. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Needle+and+surgical+biopsy+techniques+differentially+affect+adipose+tissue+gene+expression+profiles.">Needle and surgical biopsy techniques differentially affect adipose tissue gene expression profiles.</a> Am J Clin Nutr. 89, 51-57 (2009).</li><li>Ikeda, S., Sekijima, Y., Tojo, K., Koyama, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnostic+value+of+abdominal+wall+fat+pad+biopsy+in+senile+systemic+amyloidosis.">Diagnostic value of abdominal wall fat pad biopsy in senile systemic amyloidosis.</a> Amyloid. 18, 211-215 (2011).</li><li>Alderete, T. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+biopsy+method+to+increase+yield+of+subcutaneous+abdominal+adipose+tissue.">A novel biopsy method to increase yield of subcutaneous abdominal adipose tissue.</a> Int J Obes. 39, 183-186 (2015).</li><li>Padoin, A. V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+wedge+and+needle+hepatic+biopsy+in+open+bariatric+surgery.">A comparison of wedge and needle hepatic biopsy in open bariatric surgery.</a> Obes Surg. 16, 178-182 (2006).</li><li>Kral, J. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+surgical+treatment+of+the+metabolic+syndrome+on+liver+fibrosis+and+cirrhosis.">Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis.</a> Surgery. 135, 48-58 (2004).</li><li>Fitzgerald, J. E., Malik, M., Ahmed, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+single-blind+controlled+study+of+electrocautery+and+ultrasonic+scalpel+smoke+plumes+in+laparoscopic+surgery.">A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery.</a> Surg Endosc. 26, 337-342 (2012).</li><li>Memon, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+Diathermy.">Surgical Diathermy.</a> Br J Hosp Med. 52, (1994).</li><li>Tomita, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mutagenecity+of+smoke+condensates+induced+by+CO-laser+irradiation+and+electrocauterization.">Mutagenecity of smoke condensates induced by CO-laser irradiation and electrocauterization.</a> Mutat Res. 89, 145-149 (1989).</li><li>Brandon, H., Young, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterisation+and+removal+of+electrosurgical+smoke.">Characterisation and removal of electrosurgical smoke.</a> Surg Serv Manag. 3, 14-16 (1997).</li><li>Attner, P., Hemlin, C., Soderman, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ligasure+versus+diathermy+scissors+tonsillectomy:+A+controlled+randomized+study.">Ligasure versus diathermy scissors tonsillectomy: A controlled randomized study.</a> Acta Otolaryngol. 130, 1180-1184 (2010).</li><li>Ecker, T., Carvalho, A. L., Choe, J. H., Walosek, G., Preuss, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hemostasis+in+thyroid+surgery:+harmonic+scalpel+versus+other+techniques--a+meta-analysis.">Hemostasis in thyroid surgery: harmonic scalpel versus other techniques--a meta-analysis.</a> Otolaryngol Head Neck Surg. 143, 17-25 (2010).</li><li>Campbell, K. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+pilot+study+of+sampling+subcutaneous+adipose+tissue+to+examine+biomarkers+of+cancer+risk.">A pilot study of sampling subcutaneous adipose tissue to examine biomarkers of cancer risk.</a> Cancer Prev Res. 2, 37-42 (2009).</li><li>Jamurtas, A. Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+a+single+bout+of+exercise+on+resting+energy+expenditure+and+respiratory+exchange+ratio.">The effects of a single bout of exercise on resting energy expenditure and respiratory exchange ratio.</a> Eur J Appl Physiol. 92, 393-398 (2004).</li><li>Adriaens, P. E. M., Schoffelen, F. M. P., Westerterp, K. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intra-individual+variation+of+basal+metabolic+rate+and+the+in&#64258;uence+of+daily+habitual+physical+activity+before+testing.">Intra-individual variation of basal metabolic rate and the in&#64258;uence of daily habitual physical activity before testing.</a> Brit J Nutri. 90, 419-423 (2003).</li><li>Latham, J. L., Martin, S. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Infiltrative+anesthesia+in+office+practice.">Infiltrative anesthesia in office practice.</a> Am Fam Phys. 89, 956-962 (2014).</li><li>Jurevic, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plasma+levels+of+2%+lidocaine+with+1:100,000+epinephrine+with+young+children+undergoing+dental+procedures.">Plasma levels of 2% lidocaine with 1:100,000 epinephrine with young children undergoing dental procedures.</a> Anesth Prog. 45, 87-90 (1998).</li><li>Kale, S. S., Yende, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+Aging+on+Inflammation+and+Hemostasis+through+the+Continuum+of+Critical+Illness.">Effects of Aging on Inflammation and Hemostasis through the Continuum of Critical Illness.</a> Aging Dis. 2, 501-511 (2011).</li></ol>

Yazarlar onlar rakip hiçbir mali çıkarları var bildirin.

Bu çalışmada subkutan karın yağ doku biyopsisi, sağlıklı erkeklerde sigara diyatermi yöntemi ile lokal anestezi altında yapılan bir cerrahi tekniği standartlaştırmak için yapıldı. Diyatermi genellikle ameliyat odasında kullanılır; Ancak, olası yan etkileri (Yani, flaş patlar ve çevre toksisite)9 ve10 iyileşmesinde gecikme meydana gelebilir. Diyatermi bu istenmeyen etkileri sağlık riskleri çalışma personel ve hastalar/katılımcılar iç...

Yağ doku biyopsisi, çözümlemesini sağlayan, metabolizma ve hastalığı ile ilgili mekanizmalar anlayışlı bir bakış doku örnekleri sunuyoruz. Örneğin, bunlar meme kanseri tümörü kimlik1, yağ asidi kompozisyonu muayene2ve araştırma önemli metabolik ve hormonal hastalığı yolları3için kullanılır. Cilt altı yağ dokusu biyopsi karın bölgesi içinde elde etmek için araştırmacılar ve doktorlar bir cerrahi ya da iğne tabanlı tekniği kullanın. Ancak, cerrahi subkutan yağ biyopsisi karmaşık biyolojik mekanizmaları [Örneğin, haberci ribonükleik asit (mRNA) ifade, histolojik analiz, vb] daha kapsamlı bir bakış sağlayabilir doku örnekleri sunabilir4 . Onlar daha önce sağlıklı yetişkin4 ' te kullanılan ve başucu5güvenli bir şekilde gerçekleştirilebilir.
Doku bütünlüğü bozabilir yoğun liposuction iğne tabanlı biyopsi tekniği gerektirir ve genellikle doku (100-500 mg)6küçük bir miktar alır. Bu doku örnekleri karmaşık araştırma çalışmaları için uygun olmayabilir. Ayrıca, iğne tabanlı tekniği için karşılaştırıldığında, cerrahi subkutan yağ biyopsisi (Örneğin, B ve T hücre sinyallemesi); çeşitli inflamatuar endeksi daha kapsamlı bir resmi çekmek olabilir doku örnekleri sunabilir sitoiskeleti yönetmelik; hücresel yolları; metabolik yollar yağlar, karbonhidrat ve amino asitler; ve oksidatif fosforilasyon yolları4. Ayrıca, iğne tabanlı teknik doku4,7,8 fibrotik bölgeler hakkında çok az bilgi sağlarken cerrahi bir4, kan hücresi kirlenme için daha yüksek bir risk içerir .
Genellikle, bir cerrahi yağ doku biyopsisi damarların aşırı kanama9önlemek için doldurarak bir diyatermi tedavi içerir. Bir diyatermi yakmak ve neoplazmlar ve siğiller veya hastalık9tarafından enfekte dokular tarafından etkilenen doku yok etmek için de kullanılır. Bu teknik, Nöroşirürji ve göz ameliyatı9' özellikle geçerlidir.
Diyatermi aşırı kullanımı enfeksiyonlar neden ve iyileşme süreci10geciktirerek nekrotik doku oluşumuna neden olabilir. Nitekim, diyatermi9aşağıdaki flaş patlar ve deri lezyonları doku gibi yan etkiler bildirilmiştir. Ayrıca, endişeleri cerrahi duman katılımcı/hasta ve çalışma personel9tarafından inhale cerrahi ortamına diyatermi tarafından yayımlanan toksisitesi hakkında yol. Nitekim, diyatermi kullanımı hava toksisite ameliyathane yasaktır altı sigara11 tarafından üretilen eşit neden olabileceğini ve ameliyathane, genellikle iyi bir havalandırma sistemleri olmasına rağmen kontaminasyon en az 20 dk12 sürebilir . Bununla birlikte, tonsillektomi cerrahi girişim hastalarda, ama önemli olmayan, ameliyat sonrası ağrı13 ve kanama14 klasik tüp ligasyonu hemostaz yönteminden daha az diyatermi yöntemi göstermektedir. Genel olarak, zar zor oranları yağ doku biyopsisi sağlıklı bireylerde sonra kanama ve operatif ağrı farklılıkları ile ilgili kanıt bulunmaktadır. Delil yetersizliğinden ve diyatermi yan etkileri göz önüne alındığında, bir sigara diyatermi yöntem yağ doku biyopsisi için standardizasyon garanti kapsamındadır. Buna göre bu çalışmada subkutan karın yağ doku biyopsisi, sağlıklı erkeklerde bir sigara diyatermi yöntemiyle lokal anestezi altında yapılan bir cerrahi tekniği standartlaştırmak için yapıldı. Ayrıca, doku koleksiyonu mRNA ifade ve protein konsantrasyonu belirlemek için ve histolojik çözümlemesi yapma için yordamlar açıklanmıştır.

<table><tbody><tr><td>&amp;nbsp;Disinfected surgical field&amp;nbsp;</td><td>Hartmann</td><td>23516-00</td><td></td></tr><tr><td>Stainless Steel Instrument Stands (surgical Mayo)</td><td>Medical Device Depot Inc.</td><td>32000</td><td></td></tr><tr><td>Operating Scissors straight 15 cm</td><td>Karl Storz</td><td>791903</td><td></td></tr><tr><td>Scalpel No 11&amp;nbsp;</td><td>Swann-Morton</td><td>203</td><td>Bipolar, catalog number 429011</td></tr><tr><td>Scarpel handle No 3</td><td>Karl Storz</td><td>488090</td><td></td></tr><tr><td>Scissors curved 14 cm</td><td>Karl Storz</td><td>511514, 752918</td><td></td></tr><tr><td>Mosquito forceps</td><td>Karl Storz</td><td>535012</td><td></td></tr><tr><td>Tweezers Kocher&amp;nbsp;</td><td>Karl Storz</td><td>530416</td><td>Bipolar, catalog number 830316</td></tr><tr><td>Surgical tweezers</td><td>Karl Storz</td><td>793216</td><td>Bipolar, catalog number 831016</td></tr><tr><td>Povidone-iodine&amp;nbsp;</td><td>Various</td><td>Not applicable</td><td></td></tr><tr><td>Suture 4.0 Vicryl</td><td>Johnsons</td><td>V4970H&amp;nbsp;</td><td></td></tr><tr><td>Scissors straight 11 cm</td><td>Karl Storz</td><td>512511 DS</td><td></td></tr><tr><td>Needle holder 15 cm</td><td>Karl Storz</td><td>515515</td><td>Bipolar, catalog number 213015</td></tr><tr><td>&amp;nbsp;Sterile gauzes</td><td>Hartmann</td><td>3021</td><td></td></tr><tr><td>&amp;Alpha;dhesive sterile gauze&amp;nbsp;</td><td>Digas medical equipment</td><td>2889</td><td></td></tr><tr><td>10 mL syringe with disinfected needle</td><td>Alpha medical solutions</td><td>10310-55-0010</td><td></td></tr><tr><td>2%-xylocaine (no adrenaline)</td><td>Various</td><td>Not applicable</td><td></td></tr><tr><td>Sterile surgical gloves&amp;nbsp;</td><td>Sempermed</td><td>10001</td><td></td></tr><tr><td>Eppendorf tubes</td><td>Kartell</td><td>16283</td><td></td></tr><tr><td>10% formalin&amp;nbsp;</td><td>Alpha medical solutions</td><td>11016-30-2909</td><td></td></tr><tr><td>Tubes 120 mL</td><td>Digas medical equipment</td><td>9025</td><td></td></tr><tr><td>Liquid nitrogen at -190&amp;deg;C</td><td>Revival</td><td>Not applicable</td><td></td></tr></tbody></table>

a technique for subcutaneous abdominal adipose tissue biopsy via a non-diathermy method

Yağ doku biyopsisi, çözümlemesini sağlayan, metabolizma ve hastalığı ile ilgili mekanizmalar, anlayışlı genel bakış doku örnekleri sunuyoruz. Cilt altı yağ dokusu biyopsi karın bölgesi içinde elde etmek için araştırmacılar ve doktorlar bir cerrahi ya da iğne tabanlı tekniği kullanın. Ancak, cerrahi subkutan yağ biyopsisi beyaz yağ dokusu içinde biyolojik endeksleri karmaşıklığı daha kapsamlı bir bakış sağlayabilir doku örnekleri sunabilir. Genellikle, aşırı kanama önlemek kan damarlarının doldurarak diyatermi tedavisinde cerrahi yağ doku biyopsisi içerir. Yine de, diyatermi sonra flaş patlar ve doku, deri lezyonları gibi yan etkiler bildirilmiştir. Bu nedenle, bir sigara diyatermi yöntemiyle lokal anestezi altında yapılan cerrahi karın yağ dokusu biyopsi standartlaştırmak amaçladık. Biz bir sigara diyatermi abdominal cerrahi biyopsi yöntemiyle sağlıklı erkeklerde 115 cilt altı yağ dokusu biyopsi yapılan. Sonuçlarımız 115 işlemleri (%2,61) dışında kanama aşırı sonrası işlemi üç kasa gösterdi. Sonuç olarak, bir sigara diyatermi yöntemiyle bizim standart subkutan karın yağ dokuları cerrahi biyopsi sağlıklı erkek yatağımın en az yan etkileri ile güvenli bir şekilde uygulanabilir.

Katılımcılar özellikleri Tablo 1' de verilmiştir. Sonraki 8-12 gün içinde belgili tanımlık kesme alanında dikiş düştü. Toplam 115 cilt altı yağ dokusu biyopsi sağlıklı Yetişkin erkeklerde diyatermi abdominal cerrahi biyopsi yöntemiyle tamamladık (Yaş: 35.2 ± 6.9 yıl; vücut kitle indeksi: 27,3 ± 4.4; ve vücut yağ yüzdesi: % 27.0 ± 9.0). Sonrası biyopsi aşırı kanama üç durumda gözlenen (yaygınlık: %2,61) ameliyattan sonra iki gün. A?...

Watch this Scientific Journal Video about A Technique for Subcutaneous Abdominal Adipose Tissue Biopsy via a Non-diathermy Method at JoVE.com

A Technique for Subcutaneous Abdominal Adipose Tissue Biopsy via a Non-diathermy Method

Lokal anestezi altında yapılan bir sigara diyatermi yöntemiyle bir karın yağ doku biyopsisi standart. Üç kasa 115 işlemleri (%2,61) dışında kanama aşırı sonrası işlem oluştu. Biz bir sigara diyatermi yöntemiyle bir karın yağ dokuları cerrahi biyopsi güvenle sağlıklı erkek için uygulanması sonucuna.

Bir teknik subkutan karın yağ doku biyopsisi diyatermi sigara yöntemi ile için

Adipose tissue biopsies offer tissue samples that, upon analysis, may provide insightful overviews of mechanisms relating to metabolism and disease. To ...

a-technique-for-subcutaneous-abdominal-adipose-tissue-biopsy-via-non

Research

JoVE Journal

Medicine

15.0K Görüntüleme.  University of Thessaly. Lokal anestezi altında yapılan bir sigara diyatermi yöntemiyle bir karın yağ doku biyopsisi standart. Üç kasa 115 işlemleri (%2,61) dışında kanama aşırı sonrası işlem oluştu. Biz bir sigara diyatermi yöntemiyle bir karın yağ dokuları cerrahi biyopsi güvenle sağlıklı erkek için uygulanması sonucuna.

Video: A Technique for Subcutaneous Abdominal Adipose Tissue Biopsy via a Non-diathermy Method

Performing and Processing FNA of Anterior Fat Pad for Amyloid

Historically, heart, liver, and kidney biopsies were performed to demonstrate amyloid deposits in amyloidosis. Since the clinical presentation of this disease is so variable and non-specific, the associated risks of these biopsies are too great for the diagnostic yield. Other sites that have a lower biopsy risk, such as skin or gingival, are also relatively invasive and expensive. In addition, these biopsies may not always have sufficient amyloid deposits to establish a diagnosis. Fat pad aspiration has demonstrated good clinical correlation with low cost and minimal morbidity. However, there are no standardized protocols for performing this procedure or processing the aspirated specimen, which leads to variable and nonreproducible results. The most frequently utilized modality for detecting amyloid in tissue is an apple-green birefringence on Congo red stained sections using a polarizing microscope. This technique requires cell block preparation of aspirated material. Unfortunately, patients presenting in early stage of amyloidosis have minimal amounts of amyloid which greatly reduces the sensitivity of Congo red stained cell block sections of fat pad aspirates. Therefore, ultrastructural evaluation of fat pad aspirates by electron microscopy should be utilized, given its increased sensitivity for amyloid detection. This article demonstrates a simple and reproducible procedure for performing anterior fat pad aspiration for the detection of amyloid utilizing both Congo red staining of cell block sections and electron microscopy for ultrastructural identification.

Fat pad aspiration is a preferred, minimally invasive, and low cost approach as compared to other methods to detect amyloid for diagnosis of systemic amyloidosis. This video article demonstrates a procedural outline for performing fat pad aspiration with appropriate processing of the specimen for the optimal diagnostic outcome.

Amiloid için Anterior Fat Pad FNA Sahne ve İşleme

Historically, heart, liver, and kidney biopsies were performed to demonstrate amyloid deposits in amyloidosis.  Since the clinical presentation of this ...

Tıp

Immunomagnetic Separation of Fat Depot-specific Sca1high Adipose-derived Stem Cells (ASCs)

The isolation of adipose-derived stem cells (ASCs) is an important method in the field of adipose tissue biology, adipogenesis, and extracellular matrix (ECM) remodeling. In vivo, ECM-rich environment consisting of fibrillar collagens provides a structural support to adipose tissues during the progression and regression of obesity. Physiological ECM remodeling mediated by matrix metalloproteinases (MMPs) plays a major role in regulating adipose tissue size and function1,2. The loss of physiological collagenolytic ECM remodeling may lead to excessive collagen accumulation (tissue fibrosis), macrophage infiltration, and ultimately, a loss of metabolic homeostasis including insulin resistance3,4. When a phenotypic change of the adipose tissue is observed in gene-targeted mouse models, isolating primary ASCs from fat depots for in vitro studies is an effective approach to define the role of the specific gene in regulating the function of ASCs. In the following, we define an immunomagnetic separation of Sca1high ASCs.

Immunomagnetic Separation of Fat Depot-specific Sca1high Adipose-derived Stem Cells ASCs

We present the techniques required to isolate the stromal vascular fraction (SVF) from mouse inguinal (subcutaneous) and perigonadal (visceral) adipose tissue depots to assess their gene expression and collagenolytic activity. This method includes the enrichment of Sca1high adipose-derived stem cells (ASCs) using immunomagnetic cell separation.

Yağ Deposu özgü SCA1 ve İmmunomanyetik Ayırma<sup&gt; yüksek</sup&gt; Yağ türetilmiş Kök Hücreler (TSK)

The isolation of adipose-derived stem cells (ASCs) is an important method in the field of adipose tissue biology, adipogenesis, and extracellular matrix ...

Gelişim Biyolojisi

Human Skeletal Muscle Biopsy Procedures Using the Modified Bergstr&#246;m Technique

The percutaneous biopsy technique enables researchers and clinicians to collect skeletal muscle tissue samples. The technique is safe and highly effective. This video describes the percutaneous biopsy technique using a modified Bergstr&#246;m needle to obtain skeletal muscle tissue samples from the vastus lateralis of human subjects. The Bergstr&#246;m needle consists of an outer cannula with a small opening (&#8216;window&#8217;) at the side of the tip and an inner trocar with a cutting blade at the distal end. Under local anesthesia and aseptic conditions, the needle is advanced into the skeletal muscle through an incision in the skin, subcutaneous tissue, and fascia. Next, suction is applied to the inner trocar, the outer trocar is pulled back, skeletal muscle tissue is drawn into the window of the outer cannula by the suction, and the inner trocar is rapidly closed, thus cutting or clipping the skeletal muscle tissue sample. The needle is rotated 90&#176;&#160;and another cut is made. This process may be repeated three more times. This multiple cutting technique typically produces a sample of 100-200 mg or more in healthy subjects and can be done immediately before, during, and after a bout of exercise or other intervention. Following post-biopsy dressing of the incision site, subjects typically resume their activities of daily living right away and can fully participate in vigorous physical activity within 48-72 hr. Subjects should avoid heavy resistance exercise for 48 hr to reduce the risk of herniation of the muscle through the incision in the fascia.

The purpose of this video is to present the modified Bergstr&#246;m skeletal muscle biopsy technique on human subjects.

Modifiye Bergström Tekniği İnsan İskelet Kası Biyopsi Prosedürleri

The percutaneous biopsy technique enables researchers and clinicians to collect skeletal muscle tissue samples. The technique is safe and highly ...

Localization, Identification, and Excision of Murine Adipose Depots

Obesity has increased dramatically in the last few decades and affects over one third of the adult US population. The economic effect of obesity in 2005 reached a staggering sum of $190.2 billion in direct medical costs alone. Obesity is a major risk factor for a wide host of diseases. Historically, little was known regarding adipose and its major and essential functions in the body. Brown and white adipose are the two main types of adipose but current literature has identified a new type of fat called brite or beige adipose. Research has shown that adipose depots have specific metabolic profiles and certain depots allow for a propensity for obesity and other related disorders. The goal of this protocol is to provide researchers the capacity to identify and excise adipose depots that will allow for the analysis of different factorial effects on adipose; as well as the beneficial or detrimental role adipose plays in disease and overall health. Isolation and excision of adipose depots allows investigators to look at gross morphological changes as well as histological changes. The adipose isolated can also be used for molecular studies to evaluate transcriptional and translational change or for in vitro experimentation to discover targets of interest and mechanisms of action. This technique is superior to other published techniques due to the design allowing for isolation of multiple depots with simplicity and minimal contamination.

Due to the drastic and negative connection between obesity and other comorbidities, research on the role adipose plays in disease and overall health is warranted. We present a protocol for the isolation and excision of adipose depots allowing for the study of adipose using in situ and in vitro methods.

Yerelleştirme, Kimlik ve Eksizyon Kemirgen Yağ depolarının

Obesity has increased dramatically in the last few decades and affects over one third of the adult US population. The economic effect of obesity in 2005 ...

Human Vastus Lateralis Skeletal Muscle Biopsy Using the Weil-Blakesley Conchotome

Percutaneous muscle biopsy using the Weil-Blakesley conchotome is well established in both clinical and research practice. It is a safe, effective and well tolerated technique. The Weil-Blakesley conchotome has a sharp biting tip with a 4 - 6 mm wide hollow. It is inserted through a 5 - 10 mm skin incision and can be maneuvered for controlled tissue penetration. The tip is opened and closed within the tissue and then rotated through 90 -180&#176; to cut the muscle. The amount of muscle obtained following repeated sampling can vary from 20 mg to 290 mg which can be processed for both histology and molecular studies. The wound needs to be kept dry and vigorous physical activity kept to a minimum for approximately 72 hr although normal levels of activity can restart immediately following the procedure. This procedure is safe and effective when close attention is paid to the selection of subjects, full asepsis and post procedure care. &#160;Both right and left vastus lateralis are suitable for biopsy dependent on participant preference.

Human Vastus Lateralis Skeletal Muscle Biopsy Using the Weil-Blakesley Conchotome

This video demonstrates the technique of percutaneous muscle biopsy of the human vastus lateralis using the Weil-Blakesley conchotome.

İnsan<em&gt; Vastus lateralis</em&gt; Weil-Blakesley Conchotome kullanılması İskelet Kası Biyopsi

Percutaneous muscle biopsy using the Weil-Blakesley conchotome is well established in both clinical and research practice. It is a safe, effective and ...

Three-Dimensional Culture of Vascularized Thermogenic Adipose Tissue from Microvascular Fragments

Engineering thermogenic adipose tissue (e.g., beige or brown adipose tissues) has been investigated as a potential therapy for metabolic diseases or for the design of personalized microtissues for health screening and drug testing. Current strategies are often quite complex and fail to accurately fully depict the multicellular and functional properties of thermogenic adipose tissue. Microvascular fragments, small intact microvessels comprised of arteriole, venules, and capillaries isolated from adipose tissue, serve as a single autologous source of cells that enable vascularization and adipose tissue formation. This article describes methods for optimizing culture conditions to enable the generation of three-dimensional, vascularized, and functional thermogenic adipose tissues from microvascular fragments, including protocols for isolating microvascular fragments from adipose tissue and culture conditions. Additionally, best practices are discussed, as are techniques for characterizing the engineered tissues, and sample results from both rodent and human microvascular fragments are provided. This approach has the potential to be utilized for the understanding and development of treatments for obesity and metabolic disease.

Here, we present a detailed protocol outlining the use of microvascular fragments isolated from rodent or human fat tissue as a straightforward approach to engineer functional, vascularized beige adipose tissue.

Mikrovasküler Fragmanlardan Vaskülarize Termojenik Yağ Dokusunun Üç Boyutlu Kültürü

Engineering thermogenic adipose tissue (e.g., beige or brown adipose tissues) has been investigated as a potential therapy for metabolic diseases or for ...

Biyomühendislik

Clinical Protocol of Producing Adipose Tissue-Derived Stromal Vascular Fraction for Potential Cartilage Regeneration

Osteoarthritis (OA) is one of the most common debilitating disorders.&#160;Recently, numerous attempts have been made to improve the functions of the knees by using different forms of mesenchymal stem cells (MSCs). In Korea, bone marrow concentrates and cord blood-derived stem cells have been approved by the Korean Food and Drug Administration (KFDA) for cartilage regeneration. In addition, an adipose tissue-derived stromal vascular fraction (SVF) has been allowed by the KFDA for joint injections in human patients. Autologous adipose tissue-derived SVF contains extracellular matrix (ECM) in addition to mesenchymal stem cells. ECM excretes various cytokines that, along with hyaluronic acid (HA) and platelet-rich plasma (PRP) activated by calcium chloride, may help MSCs to regenerate cartilage and improve knee functions. In this article, we presented a protocol to improve knee functions by regenerating cartilage-like tissue in human patients with OA. The result of the protocol was first reported in 2011 followed by a few additional publications. The protocol involves liposuction to obtain autologous lipoaspirates that are mixed with collagenase. This lipoaspirates-collagenase mixture is then cut and homogenized to remove large fibrous tissue that may clog up the needle during the injection. Afterwards, the mixture is incubated to obtain adipose tissue-derived SVF. The resulting adipose tissue-derived SVF, containing both adipose tissue-derived MSCs and remnants of ECM, is injected into knees of patients, combined with HA and calcium chloride activated PRP. Included are three cases of patients who were treated with our protocol resulting in improvement of knee pain, swelling, and range of motion along with MRI evidence of hyaline cartilage-like tissue.

Here, we present a protocol to produce an adipose tissue-derived stromal vascular fraction and its application to improve knee functions by regenerating cartilage-like tissue in human patients with osteoarthritis.

Yağ dokusundan elde edilen Stromal vasküler kesir için potansiyel kıkırdak rejenerasyon üreten klinik protokol

Osteoarthritis (OA) is one of the most common debilitating disorders.&#160;Recently, numerous attempts have been made to improve the functions of the ...

Human Subcutaneous Adipose Tissue Sampling Using a Mini-Liposuction Technique

Studies on adipose tissue are useful in understanding metabolic and other conditions. Human subcutaneous adipose tissue is accessible. With appropriate training and strict adherence to aseptic technique, subcutaneous adipose samples can be safely and efficiently obtained in a non-clinical setting by researchers. Following the administration of local anesthetic lateral to the umbilicus, a 14 G needle attached to a 5 or 10 mL syringe is inserted through the skin into the subcutaneous tissue. Under suction, the syringe is moved in a reciprocating, slicing motion to isolate fragments of adipose tissue. Withdrawing the plunger is enough to ensure that adipose tissue fragments are aspirated through the needle into the syringe. A single biopsy can collect about 200 mg of tissue. This biopsy technique is very safe for both participants and research staff. Following the biopsy, participants can resume most everyday activities, although they should avoid swimming and overly strenuous activities for 48 h to avoid excessive bleeding. Participants can safely undergo 2 biopsies within a single day, meaning that the technique can be applied in before-after acute intervention studies.

The manuscript and associated video demonstrate a percutaneous biopsy technique to obtain samples of subcutaneous adipose tissue from areas surrounding the umbilicus. This method is a low-risk and efficient way to investigate a range of parameters (e.g., gene or protein expression, enzyme activity, lipid content) within adipose tissue.

Mini Liposuction Tekniği ile İnsan Subkutan Yağ Dokusu Örneklemesi

Studies on adipose tissue are useful in understanding metabolic and other conditions. Human subcutaneous adipose tissue is accessible. With appropriate ...

Adipo-Clear: A Tissue Clearing Method for Three-Dimensional Imaging of Adipose Tissue

Adipose tissue plays a central role in energy homeostasis and thermoregulation. It is composed of different types of adipocytes, as well as adipocyte precursors, immune cells, fibroblasts, blood vessels, and nerve projections. Although the molecular control of cell type specification and how these cells interact have been increasingly delineated, a more comprehensive understanding of these adipose-resident cells can be achieved by visualizing their distribution and architecture throughout the whole tissue. Existing immunohistochemistry and immunofluorescence approaches to analyze adipose histology rely on thin paraffin-embedded sections. However, thin sections capture only a small portion of tissue; as a result, the conclusions can be biased by what portion of tissue is analyzed. We have therefore developed an adipose tissue clearing technique, Adipo-Clear, to permit comprehensive three-dimensional visualization of molecular and cellular patterns in whole adipose tissues. Adipo-Clear was adapted from iDISCO/iDISCO+, with specific modifications made to completely remove the lipid stored in the tissue while preserving native tissue morphology. In combination with light-sheet fluorescence microscopy, we demonstrate here the use of the Adipo-Clear method to obtain high-resolution volumetric images&#160;of an entire adipose tissue.

Due to the high lipid content, adipose tissue has been challenging to visualize using traditional histological methods. Adipo-Clear is a tissue clearing technique that allows robust labeling and high-resolution volumetric fluorescent imaging of adipose tissue. Here, we describe the methods for sample preparation, pretreatment, staining, clearing, and mounting for imaging.

Adipo-Clear: Bir doku Yöntem yağ dokusu üç boyutlu görüntüleme için temizlenmesi

Adipose tissue plays a central role in energy homeostasis and thermoregulation. It is composed of different types of adipocytes, as well as adipocyte ...

Biyoloji

Human Adipose Tissue Micro-fragmentation for Cell Phenotyping and Secretome Characterization

In the past decade, adipose tissue transplants have been widely used in plastic surgery and orthopaedics to enhance tissue repletion and/or regeneration. Accordingly, techniques for harvesting and processing human adipose tissue have evolved in order to quickly and efficiently obtain large amounts of tissue. Among these, the closed system technology represents an innovative and easy-to-use system to harvest, process, and re-inject refined fat tissue in a short time and in the same intervention (intra-operatively). Adipose tissue is collected by liposuction, washed, emulsified, rinsed and minced mechanically into cell clusters of 0.3 to 0.8 mm. Autologous transplantation of mechanically fragmented adipose tissue has shown remarkable efficacy in different therapeutic indications such as aesthetic medicine and surgery, orthopedic and general surgery. Characterization of micro-fragmented adipose tissue revealed the presence of intact small vessels within the adipocyte clusters; hence, the perivascular niche is left unperturbed. These clusters are enriched in perivascular cells (i.e., mesenchymal stem cell (MSC) ancestors) and in vitro analysis showed an increased release of growth factors and cytokines involved in tissue repair and regeneration, compared to enzymatically derived MSCs. This suggests that the superior therapeutic potential of microfragmented adipose tissue is explained by a higher frequency of presumptive MSCs and enhanced secretory activity. Whether these added pericytes directly contribute to higher growth factor and cytokine production is not known. This clinically approved procedure allows the transplantation of presumptive MSCs without the need for expansion and/or enzymatic treatment, thus bypassing the requirements of GMP guidelines, and reducing the costs for cell-based therapies.

Here, we present human adipose tissue enzyme-free micro-fragmentation using a closed system device. This new method allows the obtainment of sub-millimeter clusters of adipose tissue suitable for in vivo transplantation, in vitro culture, and further cell isolation and characterization.

Hücre Fenotimi ve Sekretom Karakterizasyonu için İnsan Yağ Dokusu Mikro-parçalanma

In the past decade, adipose tissue transplants have been widely used in plastic surgery and orthopaedics to enhance tissue repletion and/or regeneration. ...

Bir teknik subkutan karın yağ doku biyopsisi diyatermi sigara yöntemi ile için

Özet

Daha Fazla Video Keşfet

Bu videodaki bölümler