磨削术后皮肤组织变化的实验研究

为了解磨削术后皮肤组织结构的变化，选用小型猪为动物模型进行皮肤磨削术，术后对组织进行光镜，电镜的组织结构观察，并测定胶原一变化和成纤维细胞中的ＳＤＨ及胶原纤维含量变化，以及用天狼猩红偏光法对Ⅰ、Ⅲ型胶原纤维进行分型观察。     

磨削术后皮肤组织变化的实验研究

为了解磨削术后皮肤组织结构的变化，选用小型猪为动物模型进行皮肤磨削术，术后对组织进行光镜、电镜的组织结构观察，并测定胶原含量变化和成纤维细胞中的ＳＤＨ及胶原纤维含量变化，以及用天狼猩红偏光法对Ⅰ、Ⅲ型胶原纤维进行分型观察。结果表明磨削术后皮肤细小皱纹消除，真皮浅层形成新的胶原带，胶原总量及Ⅰ型胶原纤维增多。磨削术不仅能消除细小皱纹，而且促进胶原代谢更新，使Ⅰ型胶原增多，故对改善皮肤的老化有一定的作用。     

皮肤撕脱伤后丙二醛含量变化及其意义

目的：研究氧自由基在皮肤撕脱伤组织继发坏死中的作用。方法：用自行研制的皮肤撕脱伤模型机复制猪后肢皮肤撕脱伤模型，分别测定了正常、伤后1、2、4、8、12、24小时血清、撕脱皮肤和皮下组织中的丙二(MDA)含量，绘制了其时间的变化曲线。结果：皮肤撕脱伤后24小时内组织和血清中丙二醛含量均显著升高，其变化有一定的规律。结论：皮肤撕脱伤组织中脂质过氧化反应增强，推测自由基在撕脱皮瓣继发坏死中能发挥重要的作用。     

持续恒压扩张和常规间断扩张后皮肤超微结构的改变

目的：对比观察持续恒压扩张（CPTE）和常规间断扩张（CITE）后皮肤组织的超微结构改变。方法：用白色小家猪制作CPTE和CITE动物模型，切取组织样本做电镜观察。结果：CPTE组与正常皮肤和CITE组皮肤比较，皮肤基底细胞和棘细胞间距明显增大，细胞连接明显减少。两实验组扩张后的真皮中，胶原纤维结构基本正常，CPTE组成纤维细胞和血管内皮细胞的活化程度高于CITE组。两实验组中均可见到胶原溶解和成纤维细胞凋亡现象，CPTE组中表现明显。两种扩张方法均可引起毛细血管破裂出血。结论：扩张后皮肤中具有组织生长和退化的双重超微结构改变。     

皮肤伸展术后生物力学和组织学的实验研究

目的：观察皮肤伸展作用后生物力学特性和组织学的改变。方法：取４只体重２０ｋｇ左右的猪为实验动物,采用自身对照方式进行,对伸展作用侧及对照侧皮肤标本分别进行拉伸断裂强度,拉伸断裂伸长百分率、皮肤本构关系等生物力学指标的测定及组织学的检查。结果：伸展皮肤的粘弹性下降,组织学观察可见伸展后表皮细胞层次增多,真皮层稍变薄。结论：皮肤伸展作用后,其生物力学性质及组织学均有明显变化。临床上可采用皮肤伸展术,以     

持续弹性外牵引对雌性小型猪乳头及其支撑组织的作用

目的观察持续弹性外牵引对雌性小型猪乳头及其支撑组织的作用，以此探讨该技术矫正乳头内陷的作用机制。方法选用3个月龄均有12个乳头的雌性小型猪3只，每只留取4个乳头作为对照组，其余8个乳头作为实验组，安放乳头内陷矫治器进行持续弹性外牵引。分别于牵引后2、4、8、12周测量相应乳头的直径和高度，然后将乳头切除行HE染色，观察内部组织结构的变化，并光镜下计数毛细血管数量。结果牵引后乳头体积明显增大，乳头直径和高度与对照组相比，差异均有统计学意义（P〈0．01），而且，随牵引时间延长乳头高度呈逐渐增加的趋势；HE染色组织学观察，牵引组表皮增厚，基底细胞、成纤维细胞及毛细血管等增生明显，毛细血管计数与对照组比较，差异均有统计学意义（P〈0．01）。结论持续弹性外牵引能有效促进乳头及其支撑组织增生，使乳头增大、增高。     

胎猪皮肤前体组织异种移植研究

目的 系统筛选猪胚胎皮肤前体组织异种移植的最佳妊娠时间窗,了解其创面修复能力. 方法 取胎龄35、42、56、70 d的胎猪皮肤前体组织,制成微粒后移植于BABL/c裸鼠背部创面,以整形患者术后剩余皮肤或者成年猪皮覆盖.观察术后移植物生长发育特性,并于移植后6、12周取材,用组织学方法观察其形态结构及成瘤性. 结果 胎猪皮肤前体组织移植后具有如下特点:(1)能成活并继续生长发育,微粒可融合成片;胎龄35、42、56、70 d的前体组织移植后12周,新生组织面积分别为(18±8)、(47±6)、(31±12)、(20±8)mm2,其中胎龄42 d的组织与其余三者比较,差异有统计学意义(P＜0.05).(2)新生(猪)皮肤组织具有表皮层和真皮层,真皮乳头明显.(3)能生长成为具有毛发、皮脂腺及汗腺等皮肤附属器的"完整"皮肤,且表皮层有黑索细胞.(4)胎龄56、70 d的胎猪皮肤前体组织移植后未出现畸胎瘤. 结论 胎龄56 d的胎猪皮肤前体组织可用于异种移植修复皮肤创面.     

微等离子束对动物皮肤组织的作用效应

目的 观察应用微等离子束对皮肤组织的结构变化及其超微结构变化的作用效应,初步探讨微等离子束的作用机制.方法 选择30只豚鼠,随机分为3组,分别给予40 W、10 kJ,60 W、10 kJ和80 W、10 kJ的微等离子束照射,每只豚鼠背部划分为实验侧和空白对照侧2个等分区域,于作用后即刻、1周后和1个月后分别切取实验侧及空白对照侧皮肤行组织病理和透射电镜检测.结果 不同剂量设置作用于豚鼠皮肤即刻变化明显不同,40 W、10 kJ作用时,表皮基本完整,真皮浅层胶原组织可见轻微均质化;60 W、10 kJ作用时,表皮局灶性出现点阵状改变,真皮浅层胶原组织出现点阵化和明显均质化;80 W、10 kJ作用时,表皮完全汽化缺失或者坏死变性,真皮浅中层胶原组织出现大面积均质化.1周后皮肤浅层胶原组织结构逐渐致密,排列有序,1个月后皮肤浅层胶原组织明显增厚,排列致密.透射电镜显示,作用后表皮细胞较完整,细胞间结构正常,但真皮胶原丧失正常结构,细胞结构消失,大量细胞凋亡明显,1个月后仍可见少量细胞凋亡,但胶原结构逐渐恢复.结论 微等离子束对皮肤组织作用有明显的剂量效应,其主要靶组织为真皮胶原组织,可以明显刺激皮肤新生胶原的增生.     

持续低热致深度烧伤的实验观察

目的：研制持续低热烧伤模型，观察基本规律并探讨其机制。方法：（1）将大鼠按不同温度及时相点随机分组，背部持续接触热源，观察创面形成过程，全层皮肤密度及病理变化，（2）将温度计置于大鼠背部皮肤筋膜下，观察不同时间和温度下，大鼠皮下温度的变化。结果：（1）随温度上升，创面形成时间明显缩短，损伤程度逐渐加重，大鼠皮肤密度的变化，在不同时间表现为不规则双曲线或三曲线。（2）稳定实验条件后，各组大鼠皮下温度的变化呈抛物线状。结论：（1）持续接触低热，皮下温度的快速增高及曲此造成的变性，坏死是导致深度烧伤的原发因素，（2）皮肤组织损伤的变化规律是热源损伤，毛细血管通透性增加，组织重量变化等多重作用的结果。     

同种异体大鼠外耳郭移植组织学改变的实验研究

目的 研究同种异体大鼠外耳廓移植后组织形态学改变及免疫细胞的浸润情况。方法 将动物分为自体，异体移植组，自体移植组以SD大鼠兼职供体与受体，进行自体移植；异体移植组以SD大鼠为供体，WISTAR大鼠为受体（SD→WISTAR)，然后观察外耳郭的生存情况与组织学变化。结果 异体外耳廓 移植后可能存在快速排斥反应，组织中不但有T淋巴细胞的浸润而且也发现大量单核细胞的浸润。结论 血管化的皮肤复合组织移植物的排斥反应机制与皮肤移植可能有着明显差异。进一步了解其排斥反应机制是解决移植物长期生存的理论基础。     

体外超声辅助面部吸脂术

目的:探索一种有效的面部吸脂方法。方法:在肿胀麻醉下,用体外超声系统功率15W/cm2,5min/每侧后,注射器吸脂法均匀吸出面部皮下脂肪。结果:体外超声波可乳化皮下脂肪、刺激皮肤回缩,有利于脂肪抽吸均匀。用此法行手术32例,均获得比较理想的手术效果。结论:体外超声系统辅助面部吸脂,创伤小、术后恢复快、效良好、成功率高。     

肿胀麻醉下外超声与非超声吸脂术的比较研究

目的：比较肿胀麻醉法下的外超声吸脂与单纯负压吸脂术的差别，以探讨外超声吸脂术的优点，方法：将10－例吸脂者的腹部均分为左右两侧，在肿胀麻醉下一侧行外超声吸脂，另一侧行单纯负压吸脂，比较吸脂效果并分析吸出物，结果：临床吸脂患者中，外超声作用侧所吸出的上层脂肪占总吸出量的百分比大于非超声吸脂侧（P＜0．001），吸出物中外超声吸脂侧血红蛋白浓度低于非超声吸脂侧（P＜0．001），三酰甘油浓度高于非超声吸脂侧（P＜0．001），血红蛋白与三酰甘油的比值低于非超声侧（P＜0．001），提示外超声吸脂明显较非超声吸脂术脂肪乳化好，出血亦少，且操作省力，术后并发症轻，皮肤收缩效果好，结论：外超声吸脂术是一种去除局部堆积脂肪的更为安全，有效的方法。     

A New Approach for Adipose Tissue Treatment and Body Contouring Using Radiofrequency-Assisted Liposuction

A new liposuction technology for adipocyte lipolysis and uniform three-dimensional tissue heating and contraction is presented. The technology is based on bipolar radiofrequency energy applied to the subcutaneous adipose tissue and subdermal skin surface. Preliminary clinical results, thermal monitoring, and histologic biopsies of the treated tissue demonstrate rapid preaspiration liquefaction of adipose tissue, coagulation of subcutaneous blood vessels, and uniform sustained heating of tissue.     

Adipose tissue extract enhances skin wound healing

The main function of adipose tissue has been considered as storage of triglycerides. Adipose tissue was considered harmful for healing extensive and deep burns because of poor circulation and easy liquefaction in wound beds, which offer an excellent culture medium for bacteria. However, these traditional concepts have been challenged with the discovery of the endocrine function of adipose tissue. To investigate the effects of adipose tissue extract on wound healing, we created four 3.0 x 2.5 cm full-thickness wounds on each side of the back of male Wu Zhi Shan minipigs (n=6), for eight wounds in each animal. The wounds were randomly divided to receive normal saline (0.5 mL; controls), adipose tissue extract (1.5 g), basic fibroblast growth factor (50 U/cm(2)), and epidermal growth factor (50 U/cm(2)). Reduction in wound area and wound volume was accelerated with adipose tissue treatment as compared with growth factor or control treatment. The thickness of the regenerated epidermis and the number of new vascular nets were markedly increased in adipose tissue-treated wounds. Biopsy of adipose tissue-treated wounds showed enhanced expression of proliferation cell nuclear antigen (PCNA) and Factor VIII-related antigen, which indicated active cell differentiation and proliferation. In vitro study in rat tissue showed adipose tissue extracts stimulating skin growth. Bacteriology results showed no significant differences in amount or type of bacteria, whatever the treatment. These results may challenge the traditional concept that adipose tissue plays a negative role in wound healing and may offer direct evidence for encouraging the retention of adipose tissue in autologous skin grafting for skin wounds.     

Comparison of fibrogenesis caused by dermal and adipose tissue injury in an experimental model

Mammalian skin is composed of three layers, the epidermis, the dermis, and the subcutis, which is composed primarily of adipose tissue. The dermal and adipose tissues are involved simultaneously when partial and full‐thickness burns occur, and often induce scar formation. However, little is known about the role of the dermis and adipose tissue injury in scar formation or the difference in fibrogenesis between the two tissues. In this study with female red Duroc pigs, we created flaps of skin with a dermal plane of injury or deeper flaps with an adipose plane of injury on the back. We compared the extent of fibrogenesis by observing the deposition of extracellular matrix as well as the characteristics of cells in the injured area. In skin flaps with a dermal level of tissue injury, scar formation that was characterized by more extracellular matrix deposition and less apoptotic myofibroblasts in the injured area was observed. Our results suggest that scar formation does not correlate with injury at the level of the adipose tissue, and that adipose tissue might serve to alleviate fibrogenesis.     

In vivo culturing of a bilayered dermal substitute with adipo-stromal cells

BACKGROUND: Skin grafting is an important procedure to cover skin defects. Recently, cultured epidermal sheets and bilayered cultured skin have been used clinically, but they lack subcutaneous tissue. The objective of this study was to produce a bilayered dermal substitute with adipose tissue simultaneously in vivo. MATERIALS AND METHODS: We disseminated adipo-stromal cells on one side of a collagen sponge at a density of 1,0 x 10(5)cells/cm(2) and incubated overnight. Then, we turned over the sponge and disseminated dermal fibroblasts and keratinocytes at a density of 1,0 x 10(6)cells/cm(2) on the other side of the sponge. Finally, we cultured this for 1 wk and implanted it on the backs of severe combined immunodeficiency mice with or without basic FGF. RESULTS: Six weeks after implantation, specimens were harvested. Macroscopically, the formed tissue in the bFGF-administered group was thick, and the epidermal component, the dermal component, and adipose tissue were formed in the cross section. The thickness of newly formed tissue in bFGF-administered group was significantly greater than that in the group without bFGF administration. The area of the newly formed capillaries in the bFGF-administered group was significantly larger than that in the group without bFGF administration. CONCLUSIONS: We could produce a thick composite tissue in vivo, combining three kinds of human cells, collagen scaffold, and bFGF. This composite graft was thicker than the bilayered dermal substitute and could be a substitute for a skin flap.     

External Ultrasound-Assisted Lipoplasty from Our Own Experience

External ultrasound-assisted liposuction (XUAL) is a new technique that requires traditional aspirative liposuction after the application of high frequency ultrasonic fields delivered through the skin into a wetted tissue. Initial data suggest that it has some advantages over the traditional procedure, especially regarding the achievement of less traumatic surgery with superior clinical outcome. This preliminary report describes a comparative study between conventional liposuction and the external ultrasound-assisted technique as the modality of treatment for fat deposits in 65 bilateral anatomical areas. The results showed considerable superiority of the ultrasound-assisted series. We found less resistance to the canulla with more rapid removal of fat and the aspirated tissue showed less blood content with intact viable fat cells. Patients report less pain and discomfort on the ultrasound-treated sides and we found less swelling and bruising, with superior skin shrinkage. Clinical recovery was also enhanced by the external ultrasound and no complications were reported with the technique.     

Reduction in adipose tissue volume using a new high-power radiofrequency technology combined with infrared light and mechanical manipulation for body contouring

A growing patient demand for a youthful skin appearance with a favorable body shape has led to the recent development of new noninvasive body contouring techniques. We have previously demonstrated that the combination of bipolar radiofrequency (RF) and optical energies with tissue manipulation is an efficient reshaping modality. Here, we investigated the efficacy and safety of a new high-power version of this combined technology, in terms of adipose tissue reduction and skin tightening. Thirty-five patients received one treatment per week over 6 weeks to their abdomen/flank, buttock, or thigh areas and were followed up to 3 months post completion of the treatment protocol. This new device has an increased power in the bipolar RF, as this parameter appears to be the most important energy modality for volume reduction. Patient circumferences were measured and comparisons of baseline and post treatment outcomes were made. Diagnostic ultrasound (US) measurements were performed in 12 patients to evaluate the reduction in adipose tissue volume, and a cutometer device was used to assess improvements in skin tightening. We observed a gradual decline in patient circumferences from baseline to post six treatments. The overall body shaping effect was accompanied with improvement in skin tightening and was clearly noticeable in the comparison of the before and after treatment clinical photographs. These findings correlated with measurements of adipose tissue volume and skin firmness/elasticity using diagnostic US and cutometer, respectively. The thickness of the fat layer showed on average a 29 % reduction between baseline and the 1-month follow up. The average reduction in the circumference of the abdomen/flanks, buttocks, and thighs from baseline to the 3-month follow-up was 1.4, 0.5, and 1.2 cm, respectively, and 93 % of study participants demonstrated a 1–60 % change in fat layer thickness. Patients subjectively described comfort and satisfaction from treatment, and 97 % of them were satisfied with the results at the follow-up visit. The application of high-power RF energy combined with infrared (IR), mechanical massage, and vacuum appears to be an effective modality for the reduction in circumferences of the abdomen/flank, buttock and thigh regions, and the improvement of skin appearance. The present study performed with a new device suggests that the underlying mechanism of action is reduction in the subcutaneous adipose tissue volume and intensification of dermal matrix density.     

Adipose tissue within peripheral nerves. Study of the human sciatic nerve

AIM: To describe the distribution of intraneural adipose cells in relation to nerve fascicles in a portion of peripheral nerve usually involved in accomplishing an anesthetic blockade of a lower extremity. METHOD: Using a scanning electron microscope, we studied sciatic nerve samples from the point of amputation of a lower limb of three patients. The samples were obtained at the upper angle of the popliteal fossa, 10-15 cm cephalad to the knee joint line. RESULTS: During dissection of the sciatic nerve samples, we observed a solitary trunk, but examination of the cross-sections under the microscope revealed the components of two clearly separated branches joined by supporting tissue. The sciatic nerve had an oval form in the portion under study, measuring 6.5 to 7.5 mm by 3.6 to 3.9 mm. Between the fascicles, the adipose tissue varied in thickness from 0.5 mm in the central zones to 0.2 mm in the peripheral zones. The adipocytes, which were all similar in the size with diameters of 40 microns, were empty, as a result of elimination of the lipid vacuoles during fixation. The adipose tissue was distributed inside the epineurium to surround isolated fascicles or groups of fascicles. CONCLUSIONS: The adipose tissue inside a nerve surrounded the fascicles to form adipose sheaths that separated the fascicles from one another. The thicknesses of these adipose sheaths varied from one fascicle to another. Cells join to make it possible to create a compact adipose sheet that can delay the diffusion of local anesthetic injected near a nerve and that can therefore interfere with the characteristics of an anesthetic blockade.