Diese Arbeit erhielt Förderprogramme der Europäischen Union Horizont 2020 (Grant Agreement Nr. 645710) und 7. Rahmen (Grant Abkommen Nr. 612547 und 319010). Die Autoren danken Dr. Fotini Sourli-Chasioti für die Unterstützung bei der Biopsie-Verfahren. Die Autoren danken Herrn Yiorgos Paterakis auch für seine wertvolle Hilfe bei der Erstellung des Videos.

die Studie entsprach dem Standard der Deklaration von Helsinki und wurde von der Universität von Thessalien, Fachbereich Bewegungswissenschaft, Βiοethics Ausschuss genehmigt.
 1. Vorbereitung der Operation Ausrüstung und Verbrauchsmaterial <ol><li>Position eine desinfizierte OP-Feld auf einem 4-Rad chirurgische Mayo Stand.</li>
	<li>Positionieren Sie das folgende Verbrauchsmaterialien und chirurgische Geräte auf einem 4-Rad chirurgische Mayo-Stand: 
	Ein paar geraden OP Schere (15 cm) ein Skalpell (Nr. 11) ein Skalpell Griff ein paar gebogene Schere (14 cm) eine Mücke Zange ein paar Kocher Pinzette eine chirurgische Pinzette Povidon-Jod (auf eine sterile Gaze) eine Naht (4.0) ein paar geraden Schere (11 cm) einen Nadelhalter (15 cm) fünf sterile Gazen eine selbstklebende steriler Gaze eine 10-mL-Spritze mit einer desinfizierten Nadel 10 mL Xylocain 2 % (kein Adrenalin) einer desinfizierte chirurgische Handschuhe</li> <li>positionieren Sie die folgenden Materialien auf einer separaten Bank: zwei Mikrozentrifugenröhrchen eine Tube mit 5 mL 10 % Formalin einen kleinen Behälter mit 50-100 mL flüssiger Stickstoff bei-190 ° C. </li></ol> 2. Vorbereitung der Teilnehmer <ol><li>haben die Teilnehmer eine schnelle 8 h 15 vor dem Biopsie-Verfahren folgen.</li>
	<li>Haben Teilnehmer zu unterlassen, körperliche Betätigung, übermäßigen Stressoren, Alkohol und aktiven und passiven Rauchens 72 h vor der Biopsie 16 , 17.</li>
</ol> 3. Durchführung der subkutanen Fettgewebe Biopsie <ol><li>den Teilnehmer auf dem chirurgischen Bett in Rückenlage positionieren.</li>
	<li>Die Region des Schnittes mit Povidon-Jod desinfizieren.</li>
	<li>Spritzen 10 mL Xylocain 2 % (kein Adrenalin), langsam und stetig 18 in der ausgewählten Region als örtlicher Betäubung dienen.</li>
	<li>Positionieren Sie ein steriles Operationsfeld über das Gebiet um den Körper des Teilnehmers, ausgenommen die Region des Schnittes bedecken.</li>
	<li>Mindestens 3-5 min danach Druck mit einer Pinzette auf den Bereich der Lokalanästhesie und dem Teilnehmer zu Fragen, ob er spürt Schmerzen 19 um sicherzustellen, dass örtliche Betäubung erreicht wurde.</li>
	<li>Skalpell-Griff Nr. 11 Skalpell beimessen.</li>
	<li>Erstellen Sie einen Schnitt von 2-2,5 cm lang, ca. 3-5 cm nach links oder rechts des Nabels.</li>
	<li>Entfernen Sie das subkutane Gewebe mit einer von gerade 15 cm Betrieb Schere.</li>
	<li>Sobald das Fettgewebe aufgedeckt ist, erfassen sie mit der Pinzette und eine Schere gebogen 14 cm.</li>
	<li>Schneiden und entfernen Sie ca. 1 g des Fettgewebes.</li>
	<li>Nach Gewebeentnahme, positionieren Sie sterile Gazen über die Inzision zur Blutstillung zu erreichen.</li>
	<li>Bestätigung der Blutstillung erfassen die 4.0 Naht mit einer Nadel 14 cm und die Haut mit einer chirurgische Pinzette bis das subkutane Gewebe sichtbar ist.</li>
	<li>Der Naht-Nadel in die Haut, das subkutane Gewebe hin, während die Haut und Unterhaut genau aneinander ausgerichtet sind.</li>
	<li>Mit der Naht-Nadel, folgen eine kontinuierliche Zick-Zack-Technik in das subkutane Gewebe, bis sich die Haut nach außen getrieben. Weiter, bis der Hautschnitt geschlossen ist.</li>
	<li>Extern binden des Nahtmaterials.</li>
	<li>Reinigen Sie den Bereich der Inzision mit Kochsalzlösung und bedecken Sie es mit einem Klebstoff steriler Gaze.</li>
</ol> 4. Ablagerung des Gewebes <ol><li>trennen die gesammelten Fettgewebe in drei Teile: 150, 350 und 500 mg.</li>
	<li>Positionieren Sie die 150 und 350 mg Teile der Probe Gewebe in Mikrozentrifugenröhrchen.</li>
	<li>Tauchen die beiden Mikrozentrifugenröhrchen in den kleinen Behälter mit flüssigem Stickstoff bei-190 ° C bis zum endgültigen Ablagerung in einem Gefrierschrank bei-80 ° c 
	Hinweis: im Voraus eine sterile Nadel verwenden, um ein kleines Loch in die Mikrozentrifugenröhrchen Tasse Versagen bei der Immersion der Mikrozentrifugenröhrchen in flüssigem Stickstoff bei-190 zu vermeiden Punktion ° C.</li>
	<li>Tauchen die 500 mg Stück Probe Gewebe-für histologische Analyse verwendet werden-in ein Röhrchen mit 5 mL 10 % Formalin. 
	Hinweis: Verwenden der Moskito-Zange nur in Fällen des übermäßigen Blutungen während der Operation. In solchen Fällen erfassen das Schiff mit der Mücke Pinzette verbinden und schließen bis Blutstillung erreicht wird.</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>

Die Autoren erklären, dass sie keine finanziellen Interessenkonflikte.

Das Ziel dieser Studie war eine chirurgische Technik für subkutane abdominalen Fettgewebe Biopsie, unter örtlicher Betäubung durchgeführt, mit einer nicht-Diathermie-Methode bei gesunden Männern zu standardisieren. Diathermie ist in den OP-Saal verbreitet; Allerdings können mögliche Nebenwirkungen (z. B. Stichflammen und Umwelttoxizität)9 und Verzögerungen bei der Heilung10 auftreten. Diese unerwünschten Wirkungen der Diathermie können gesundheitliche Ri...

Fettgewebe Biopsien bieten Gewebeproben, die bei der Analyse, einen aufschlussreichen Überblick über Mechanismen, die in Bezug auf Stoffwechsel und Krankheit bedeuten können. Zum Beispiel dienen sie für Brust Krebs Tumor Identifikation1, Fettsäure-Zusammensetzung Prüfung2und Forschung wichtige Stoffwechsel- und hormonellen Erkrankung Wege3. Um Subkutane Fettgewebe Biopsien im Bauchbereich zu erhalten, verwenden Forscher und Ärzte entweder eine chirurgische oder eine Nadel-basierte Technik. Allerdings bieten chirurgische subkutane Fett Biopsien Gewebeproben, die einen umfassenderen Überblick über komplexe biologische Mechanismen [z. B. Messenger Ribonukleinsäure (mRNA) Ausdruck, histologische Analyse usw.]vorsehen4 . Sie haben früher in gesunden Erwachsenen4 und auf dem Nachttisch5sicher durchgeführt werden können.
Die Nadel-basierte Biopsie Technik erfordert intensive Fettabsaugung, die die Integrität des Gewebes zerstören kann, und es ruft in der Regel eine kleine Menge des Gewebes (100-500 mg)6. Diese Gewebeproben möglicherweise nicht geeignet für komplexe wissenschaftliche Studien. Darüber hinaus bieten im Vergleich zu der Nadel-basierte Technik, chirurgische subkutane Fett Biopsien Gewebeproben, die ein vollständigeres Bild von mehreren entzündlichen Indizes (z. B. B und T-Zell-Signalisierung); ziehen kann Zytoskelett Verordnung; zelluläre Signalwege; Stoffwechselwege der Lipide, Kohlenhydrate und Aminosäuren; und Oxidative Phosphorylierung Wege4. Die Nadel-basierte Technik bietet auch ein höheres Risiko für Blutkörperchen Kontamination als eine chirurgische4, gleichzeitig wenig Informationen über die fibrotischen Regionen des Gewebes4,7,8 .
Eine chirurgische Fettgewebe Biopsie umfasst in der Regel, eine Diathermie-Behandlung für Kauterisieren Blutgefäße verhindern übermäßige Blutungen9. Eine Diathermie wird auch verwendet, zu brennen und zu zerstören Gewebe betroffen sind Tumoren und Warzen oder Gewebe, die durch Krankheit9angesteckt werden. Diese Technik ist vor allem für Neurochirurgie und Auge Chirurgie-9.
Der übermäßige Einsatz von Diathermie führen zur Bildung von nekrotischen Gewebe, verursachen Infektionen und verzögern den heilenden Prozess10. In der Tat haben Nebenwirkungen wie Stichflammen und Hautveränderungen im Gewebe nach Diathermie9berichtet wurde. Darüber hinaus haben Bedenken geäußert, über die Toxizität von chirurgischen Rauch durch Diathermie in die Chirurgie-Umwelt, die durch den Teilnehmer/Patienten und der operativen Mitarbeiter9eingeatmet werden kann. In der Tat, die Verwendung von Diathermie verursachen Luft Toxizität im OP-Saal, produziert durch Rauchen sechs Zigaretten11 gleich, und obwohl OP-Säle in der Regel gute Lüftungssysteme, die Kontamination kann dauern für mindestens 20 min12 . Allerdings hat die Diathermie-Methode bei Patienten, die Durchführung einer Tonsillektomie Operation, weniger, aber nicht signifikant, postoperative Schmerzen13 und blutenden14 als die klassischen Ligatur Blutstillung Methode gezeigt. Insgesamt gibt es Beweise in Bezug auf Unterschiede in der postoperativen Schmerzen und Blutungen Preise nach Fettgewebe Biopsien bei gesunden Menschen kaum. Angesichts des Mangels an beweisen und die Nebenwirkungen der Diathermie, ist Standardisierung einer nicht-Diathermie-Methode für Fettgewebe Biopsie gerechtfertigt. Dementsprechend war das Ziel dieser Studie, eine OP-Technik für subkutane abdominalen Fettgewebe Biopsie, durchgeführt unter örtlicher Betäubung mit einer nicht-Diathermie-Methode bei gesunden Männern zu standardisieren. Darüber hinaus erläutern wir die Verfahren für die Gewebe-Sammlung, mRNA Ausdruck und Proteinkonzentration zu bestimmen und histologische Analysen durchzuführen.

<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

Fettgewebe Biopsien bieten Gewebeproben, die bei der Analyse, aufschlussreiche Übersichten über Mechanismen, die in Bezug auf Stoffwechsel und Krankheit bedeuten können. Um Subkutane Fettgewebe Biopsien im Bauchbereich zu erhalten, verwenden Forscher und Ärzte entweder eine chirurgische oder eine Nadel-basierte Technik. Allerdings bieten chirurgische subkutane Fett Biopsien Gewebeproben, die einen umfassenderen Überblick über die Komplexität der biologischen Indizes im weißen Fettgewebe vorsehen. Eine chirurgische Fettgewebe Biopsie umfasst in der Regel, eine Diathermie-Behandlung von ätzenden Blutgefäße, übermäßige Blutungen zu verhindern. Dennoch wurden Nebenwirkungen wie Stichflammen und Hautveränderungen im Gewebe, nach Diathermie beschrieben. Deshalb wollten wir eine chirurgische abdominalen Fettgewebe Biopsie durchgeführt unter örtlicher Betäubung mit einer nicht-Diathermie-Methode zu standardisieren. Wir haben 115 subkutanem Fettgewebe Biopsien bei gesunden Männern, die mit einer nicht-Diathermie Abdominal-chirurgische Biopsie-Methode durchgeführt. Unsere Resultate zeigten drei Fälle von übermäßiger postoperative Blutungen aus 115 Operationen (2,61 %). Zusammenfassend kann unsere standardisierten subkutane abdominalen Fettgewebe chirurgische Biopsie mit einer nicht-Diathermie-Methode sicher auf gesunde Männer am Krankenbett, mit minimalen Nebenwirkungen angewendet werden.

Die Merkmale der Teilnehmer sind in Tabelle 1angegeben. Die Stiche im Bereich des Schnittes fiel innerhalb der nächsten 8 bis 12 Tage. Wir haben insgesamt 115 subkutanem Fettgewebe Biopsien mit der nicht-Diathermie Abdominal-chirurgische Biopsie-Methode bei gesunden erwachsenen Männern (Alter: 35,2 ± 6,9 Jahre; Body-mass-Index: 27,3 ± 4,4; und Körperfettanteil: 27,0 ± 9,0 %). Nach Biopsie übermäßige Blutungen beobachtet wurde, in drei Fällen (Prävalenz: 2,61 %)...

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

Wir standardisierte eine abdominalen Fettgewebe Biopsie mit einer nicht-Diathermie-Methode unter örtlicher Betäubung durchgeführt. Drei Fälle von übermäßiger postoperative Blutungen aus 115 Operationen (2,61 %) aufgetreten. Wir schließen, dass eine abdominale Fettgewebe chirurgische Biopsie mit einer nicht-Diathermie-Methode sicher auf gesunden Männern angewendet werden kann.

Eine Technik zur subkutanen abdominalen Fettgewebe Biopsie über eine nicht-Diathermie-Methode

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

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15.0K Aufrufe.  University of Thessaly. Wir standardisierte eine abdominalen Fettgewebe Biopsie mit einer nicht-Diathermie-Methode unter örtlicher Betäubung durchgeführt. Drei Fälle von übermäßiger postoperative Blutungen aus 115 Operationen (2,61 %) aufgetreten. Wir schließen, dass eine abdominale Fettgewebe chirurgische Biopsie mit einer nicht-Diathermie-Methode sicher auf gesunden Männern angewendet werden kann.

Serie: 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.

Durchführung und Abwicklung der FNA Anterior Fat Pad für Amyloid

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

Forschung

Medizin

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.

Immunomagnetische Trennung von Fett Depot-spezifische Sca1<sup&gt; Hoch</sup&gt; Fettgewebe gewonnene Stammzellen (ASC)

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

Entwicklungsbiologie

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.

Menschlichen Skelettmuskelbiopsie Verfahren unter Verwendung der modifizierten Technik Bergström

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.

Lokalisierung, Identifizierung und Exzision Murine Fettgewebe 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 ...

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.

Mensch<em&gt; Vastus lateralis</em&gt; Skeletal Muscle Biopsy die Weil-Blakesley Conchotom Verwendung

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.

Dreidimensionale Kultivierung von vaskularisiertem thermogenem Fettgewebe aus mikrovaskulären Fragmenten

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

Biotechnik

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.

Klinisches Protokoll zur Herstellung von Fettgewebe abgeleitet Stromazellen vaskulären Bruchteil für potenzielle Knorpelregeneration

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.

Probenahme von subkutanem Fettgewebe beim Menschen mit einer Mini-Fettabsaugungstechnik

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: Ein Gewebe Clearing-Methode für die dreidimensionale Darstellung von Fettgewebe

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

Biologie

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.

Human Adipose Tissue Mikrofragmentierung für Zell-Phänotypisierung und Secretome-Charakterisierung

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

Eine Technik zur subkutanen abdominalen Fettgewebe Biopsie über eine nicht-Diathermie-Methode

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