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用于女性永久性绝育的宫腔镜输卵管热凝及生物材料技术的初步评估

Preliminary Assessment of a Hysteroscopic Fallopian Tube Heat and Biomaterial Technology for Permanent Female Sterilization.

作者信息

Divakar Prajan, Trembly B Stuart, Moodie Karen L, Hoopes P Jack, Wegst Ulrike G K

机构信息

Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.

Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA.

出版信息

Proc SPIE Int Soc Opt Eng. 2017 Jan-Feb;10066. doi: 10.1117/12.2255843. Epub 2017 Feb 22.

Abstract

Recent failures in hysteroscopic female sterilization procedures have brought into question the implantation of non-resorbable metal devices into the fallopian tubes due to long-term risks such as migration, fragmentation, and tubal perforation. The goal of this study is to assess whether a porous, biodegradable implant can be deposited into the fallopian tube lumen with or without a local mild heat treatment to generate a safe and permanent fallopian tube occlusion/sterilization event. The technologies investigated included freeze-cast collagen-based scaffolds and magnetic nanoparticle (MNP) based scaffolds. assessment of iron oxide MNP-based scaffolds was performed to determine the absorption rate density (ARD); subsequent computational modeling quantified the thermal steady state temperature as a function of tubal radius for treatment planning. For collagen-based scaffolds, testing was performed to study the biocompatibility in a mouse flank model, followed by implantation into an anestrus feline uterine horn (animal model for the fallopian tube). Biological responses were studied histopathologically. Uterine horn patency was assessed via radiographic imaging. Preliminary studies suggest the MNP-impregnated scaffold and a safe, noninvasive AMF excitation field have potential to generate a sufficient focal fallopian tube thermal dose to create a fibrotic healing event and ultimately, permanent tubal occlusion.

摘要

近期宫腔镜下女性绝育手术的失败引发了人们对向输卵管植入不可吸收金属装置的质疑,因为存在诸如移位、碎裂和输卵管穿孔等长期风险。本研究的目的是评估一种多孔、可生物降解的植入物能否在进行或不进行局部温和热处理的情况下沉积到输卵管腔内,以产生安全且永久性的输卵管阻塞/绝育效果。所研究的技术包括冷冻铸造的基于胶原蛋白的支架和基于磁性纳米颗粒(MNP)的支架。对基于氧化铁MNP的支架进行了评估以确定吸收速率密度(ARD);随后的计算建模量化了作为输卵管半径函数的热稳态温度,用于治疗规划。对于基于胶原蛋白的支架,在小鼠侧腹模型中进行测试以研究生物相容性,随后将其植入处于发情间期的猫子宫角(输卵管的动物模型)。通过组织病理学研究生物学反应。通过放射成像评估子宫角通畅情况。初步研究表明,浸渍MNP的支架和安全、无创的交变磁场(AMF)激发场有潜力产生足够的局部输卵管热剂量,以引发纤维化愈合事件并最终实现永久性输卵管阻塞。

相似文献

本文引用的文献

1
Hysteroscopy and contraception.宫腔镜检查与避孕。
Best Pract Res Clin Obstet Gynaecol. 2015 Oct;29(7):940-50. doi: 10.1016/j.bpobgyn.2015.03.013. Epub 2015 Mar 31.
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Bioinspired structural materials.仿生结构材料。
Nat Mater. 2015 Jan;14(1):23-36. doi: 10.1038/nmat4089. Epub 2014 Oct 26.
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Biomaterials by freeze casting.冷冻铸造法生物材料。
Philos Trans A Math Phys Eng Sci. 2010 Apr 28;368(1917):2099-121. doi: 10.1098/rsta.2010.0014.

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