Name: stromal vascular fraction-enriched fat grafting for the treatment of symptomatic end-neuromata
Uploaded: 2017-11-23T13:00:00
Description: Watch this Scientific Journal Video about Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata at JoVE.com

作者没有致谢。

该议定书遵循了大学医院苏黎世人类研究伦理委员会的指导方针。
1. Neuromata 和患者选择的诊断
<ol><li>执行术前神经阻滞的近端, 以确定诊断。评估前臂中间三分之一的块, 排除 SBRN 交叉支配区的潜在诱因, 如侧前臂皮神经 (域)、骨间后神经 (针) 和尺神经背支,10。</li>
	<li>仅在减轻疼痛的患者中进行手术 (在疼痛的视觉模拟量表 (VAS) 上至少有5点)...

<ol>
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A., 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=Multilineage+cells+from+human+adipose+tissue:+implications+for+cell-based+therapies.">Multilineage cells from human adipose tissue: implications for cell-based therapies.</a> Tissue Eng. 7 (2), 211-228 (2001).</li><li>Fraser, J. K., 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+Celution+System:+Automated+Processing+of+Adipose-Derived+Regenerative+Cells+in+a+Functionally+Closed+System.">The Celution System: Automated Processing of Adipose-Derived Regenerative Cells in a Functionally Closed System.</a> Adv Wound Care (New Rochelle). 3 (1), 38-45 (2014).</li><li>Guo, J., 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=Stromal+vascular+fraction:+A+regenerative+reality?+Part+2:+Mechanisms+of+regenerative+action.">Stromal vascular fraction: A regenerative reality? Part 2: Mechanisms of regenerative action.</a> J Plast Reconstr Aesthet Surg. 69 (2), 180-188 (2015).</li><li>Lutz, B. S., Ma, S. F., Chuang, D. C., Chan, K. H., Wei, F. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interposition+of+a+pedicle+fat+flap+significantly+improves+specificity+of+reinnervation+and+motor+recovery+after+repair+of+transected+nerves+in+adjacency+in+rats.">Interposition of a pedicle fat flap significantly improves specificity of reinnervation and motor recovery after repair of transected nerves in adjacency in rats.</a> Plast Reconstr Surg. 107 (1), 116-123 (2001).</li><li>Calcagni, 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=The+novel+treatment+of+SVF-enriched+fat+grafting+for+painful+end-neuromas+of+superficial+radial+nerve.">The novel treatment of SVF-enriched fat grafting for painful end-neuromas of superficial radial nerve.</a> Microsurgery. , (2016).</li><li>Hawker, G. A., Mian, S., Kendzerska, T., French, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measures+of+adult+pain:+Visual+Analog+Scale+for+Pain+(VAS+Pain),+Numeric+Rating+Scale+for+Pain+(NRS+Pain),+McGill+Pain+Questionnaire+(MPQ),+Short-Form+McGill+Pain+Questionnaire+(SF-MPQ),+Chronic+Pain+Grade+Scale+(CPGS),+Short+Form-36+Bodily+Pain+Scale+(SF-36+BPS),+and+Measure+of+Intermittent+and+Constant+Osteoarthritis+Pain+(ICOAP).">Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP).</a> Arthritis Care Res (Hoboken). 63 Suppl. 63, S240-S252 (2011).</li><li>Stokvis, A., van der Avoort, D. J., van Neck, J. W., Hovius, S. E., Coert, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+management+of+neuroma+pain:+a+prospective+follow-up+study.">Surgical management of neuroma pain: a prospective follow-up study.</a> Pain. 151 (3), 862-869 (2010).</li><li>Kolle, S. F., 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=Enrichment+of+autologous+fat+grafts+with+ex-vivo+expanded+adipose+tissue-derived+stem+cells+for+graft+survival:+a+randomised+placebo-controlled+trial.">Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival: a randomised placebo-controlled trial.</a> Lancet. 382 (9898), 1113-1120 (2013).</li><li>Zhu, 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=Adipocyte+regeneration+after+free+fat+transplantation:+promotion+by+stromal+vascular+fraction+cells.">Adipocyte regeneration after free fat transplantation: promotion by stromal vascular fraction cells.</a> Cell Transplant. 24 (1), 49-62 (2015).</li><li>Eto, H., 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=Characterization+of+human+adipose+tissue-resident+hematopoietic+cell+populations+reveals+a+novel+macrophage+subpopulation+with+CD34+expression+and+mesenchymal+multipotency.">Characterization of human adipose tissue-resident hematopoietic cell populations reveals a novel macrophage subpopulation with CD34 expression and mesenchymal multipotency.</a> Stem Cells Dev. 22 (6), 985-997 (2013).</li><li>Premaratne, G. U., 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=Stromal+vascular+fraction+transplantation+as+an+alternative+therapy+for+ischemic+heart+failure:+anti-inflammatory+role.">Stromal vascular fraction transplantation as an alternative therapy for ischemic heart failure: anti-inflammatory role.</a> J Cardiothorac Surg. 6, 43 (2011).</li><li>Paik, K. J., 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=Studies+in+Fat+Grafting:+Part+V.+Cell-Assisted+Lipotransfer+to+Enhance+Fat+Graft+Retention+Is+Dose+Dependent.">Studies in Fat Grafting: Part V. Cell-Assisted Lipotransfer to Enhance Fat Graft Retention Is Dose Dependent.</a> Plast Reconstr Surg. 136 (1), 67-75 (2015).</li></ol>

本研究的目的是有条不紊地说明的技术方面, 特别脂肪移植作为一种新的治疗症状性端 neuromata。
Neuromata 的 SBRN 与外科手术成功率只有 33%12。瓦伦et al.提出了一系列有利的结果, 早期随访使用神经脂肪移植 (框架) 没有添加特别8患者的痛苦 neuromata 的上肢5。然而, 疼痛减少在6月后疼痛复发在12月随访<sup cl...

对有症状的末端 neuromata 的管理 SBRN 仍然是挑战与许多现有的外科治疗。主要地, 神经瘤切除并且剩余的神经末梢被安置入邻居结构例如肌肉1,2, 骨头3, 或静脉4。这被假设通过模仿末端器官的气氛防止再生神经束的 out-sprouting。然而, 这些技术都没有被证明是优越的, 因为高的疼痛复发率和不足的疼痛减少往往被观察到。
最近, 脂肪移植周围剩余的神经残端产生了可喜的结果, 并主张作为一个新的治疗方案的痛苦结束 neuromata 的上肢5。除了作为机械屏障, 以防止继续运动和轻拍疼痛, 脂肪移植的有益方面是相当归因于细胞水平。人体脂肪组织包含多种细胞类型, 包括脂肪、肥大细胞、周、内皮细胞、血管平滑肌细胞、成纤维细胞和脂肪来源的干细胞 (干细胞) 以及造血干细胞6。这种异质细胞群被称为脂肪衍生再生细胞 (ADRCs) 或特别, 并可从 lipoaspirate 获得一个隔离系统 (见材料表) 和应用酶试剂 (见材料表)7。确切的行动机制还没有完全理解;然而, 特别已与改善血管生成, 免疫, 分化和分泌细胞外基质8。
特别的浓缩细胞数量增加到脂肪移植, 以减少吸收率和增加再生潜力的脂肪移植, 最近的研究显示疼痛复发后12月的脂肪移植没有添加特别5. 此外, 生物作用还通过减少残端的轴突发芽和随后的瘢痕坚持对神经本身产生有益的影响, 这可能导致神经卡压.
第一次临床研究描述特别脂肪移植作为一种新的手术选择治疗症状性端 neuromata SBRN 最近发表了10。一般来说, 该技术可以应用于任何发生在意外或医源性神经损伤后的听神经瘤。本次后续研究的目的是有条不紊地说明这一程序的技术方面。

<table border="0" cellpadding="0" cellspacing="0" width="688">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">Cytori Celution System</td>
			<td style="width:71px;">Cytori</td>
			<td style="width:119px;"></td>
			<td style="width:167px;">isolation system</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Celase</td>
			<td style="width:71px;">Cytori</td>
			<td style="width:119px;"></td>
			<td>enyzme reagent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">liposuction system</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:331px;">tumescent solution (500 ml Lactated Ringers, 20 ml of 1% lidocaine and 1 mg epinephrine)</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">14-gauge infiltrator</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">3 mm-collecting cannula (15, 26, 32 cm)</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">60 mL Tommey syringes</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">mosquito clamp</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Toomey syringe stand</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:331px;">4 cannulas (fat injecting cannulas 1.5 mm, syringe NO.2, 90 mm)</td>
			<td style="width:71px;">Chalybs</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">10 mL syringes</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">connecting device for syringes</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">#11- and #15-blade scalpel</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">stevens scissors</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">pins pincette</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">bipolar electrocautery</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:331px;">suture material</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">adhesive dressing</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">binocular loupes magnifier glasses (2.5-3.5x)</td>
			<td style="width:71px;">Carl Zeiss</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:331px;">Statistical Package for Social Sciences, version 22</td>
			<td>IBM</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
	</tbody>
</table>

stromal vascular fraction-enriched fat grafting for the treatment of symptomatic end-neuromata

本研究的目的是有条不紊地说明和突出的关键步骤, 基质血管分数 (特别)-丰富脂肪移植作为一种新的治疗症状端 neuromata 外周感觉神经, 并在本研究, 特别是桡神经 (SBRN) 的浅支。尽管有许多现有的治疗方法, 持续的术后疼痛和常见的疼痛复发仍然是非常普遍的, 独立的程序评估。神经瘤被 microsurgically 切除相应地规范化的协议。而不是在邻近的解剖结构, 如肌肉或骨骼的再生神经残肢的迁移, 脂肪移植应用 perifocally 和作为机械屏障。为了降低脂肪的吸收率, 提高移植物的再生潜能, 将高浓度的特别集成在嫁接中。特别是从皮下脂肪分离的酶和机械 lipoaspirate 由一个特定的商业隔离系统。富含特别的脂肪移植在细胞水平上提供了机械屏障和各种生物效应, 包括改善血管生成、炎症和纤维化。在神经再生过程中, 机械和生物效应都有助于减少神经残端的无条理的轴突突起, 从而防止了痛苦的端 neuromata 的复发。

利用统计软件对数据进行分析, 并以标准偏差表示。应用科尔莫戈罗夫斯米尔诺夫试验验证了研究人群的非参数分布, 证实了负经验分布。根据研究人群的非参数性质, 采用魏氏对相关样本进行测试, 比较术前和术后结局。统计学意义被认为在 p 值小于 0.0510。
五例平均年龄为49.8 ±16.6 岁的患者包括...

Watch this Scientific Journal Video about Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata at JoVE.com

Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata

基质血管部分富集脂肪移植治疗症状性端 neuromata

本研究的目的是为了说明基质血管部分 (特别)-富集脂肪移植的技术过程, 作为一种新的治疗症状性端 neuromata。这种技术提供了机械屏障和生物作用的优势, 在细胞水平的加工和集中特别。

The purpose of this study was to methodically illustrate and highlight the crucial steps of stromal vascular fraction (SVF)-enriched fat grafting as a ...

Research

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Medicine

Thermal Ablation for the Treatment of Abdominal Tumors

热消融治疗腹部肿瘤

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ...

科研

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Experimental Generation of Carcinoma-Associated Fibroblasts (CAFs) from Human Mammary Fibroblasts

Experimental Generation of Carcinoma-Associated Fibroblasts CAFs from Human Mammary Fibroblasts

从人类乳腺成纤维细胞癌相关的成纤维细胞的实验发电（CAFS）

Carcinomas are complex tissues comprised of neoplastic cells and a non-cancerous compartment referred to as the 'stroma'. The stroma consists of ...

Orthotopic Aortic Transplantation in Mice for the Study of Vascular Disease

原位主动脉瓣移植在小鼠血管疾病的研究

Vascular procedures involving anastomoses in the mouse are generally thought to be difficult and highly dependent on the skill of the individual surgeon. ...

Technical Aspects of the Mouse Aortocaval Fistula

在的鼠标Aortocaval瘘的技术方面

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta ...

Three-dimensional Co-culture Model for Tumor-stromal Interaction

对于肿瘤基质相互作用的三维共培养模式

Cancer progression (initiation, growth, invasion and metastasis) occurs through interactions between malignant cells and the surrounding tumor stromal ...

Transplantation Into the Mouse Ovarian Fat Pad

移植到小鼠卵巢脂肪垫

Orthotopic transplantation assays in mice are invaluable for studies of cell regeneration and neoplastic transformation. Common approaches for orthotopic ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

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Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

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

制备脂肪组织基质血管部分用于潜在软骨再生的临床协议

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

Isolation of Adipose Derived Regenerative Cells for the Treatment of Erectile Dysfunction Following Radical Prostatectomy

分离脂肪衍生的再生细胞用于治疗根治性前列腺切除术后的勃起功能障碍

Stem cells are used in many research areas within regenerative medicine in part because these treatments can be curative rather than symptomatic. Stem ...

Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment

建立干细胞治疗心肌梗塞心力衰竭的猪模型

Although advances have been achieved in the treatment of heart failure (HF) following myocardial infarction (MI), HF following MI remains one of the major ...