Biomedical Engineering Reference
In-Depth Information
severe inflammation causes esophageal scarring and stenosis,
without any method to enhance wound healing.
71
,
74
We have devel-
oped a method combining ESD with the endoscopic transplantation
ofautologousoralmucosalepithelialcellsheets.
75
Detailedinforma-
tion isgiven as follows.
Cell sheets were noninvasively harvested with the use of a PVDF
support membrane. Immediately after ESD, two autologous oral
mucosal epithelial cell sheets were individually transplanted to
the artificial esophageal ulceration using endoscopy (
n
=
3). An
EMR tube was inserted in the esophagus of each animal, and the
PVDF support membrane with an attached autologous oral mucosal
epithelialcellsheetwasgraspedbyendoscopicforcepsandcarefully
maneuvered to the ulcer site through the EMR tube.
76
Cell sheets
were then placed directly onto the ulcer sites, and gentle pressure
was applied to the overlying PVDF support membranes using the
EMR tube. After 10 minutes, the support membranes were simply
removed by endoscopic forceps, with the cell sheets remaining on
theulcerwoundbeds.AnimalsreceivingonlyESD,withoutcellsheet
transplantation(
n
=
3),wereusedascontrols.Thetransplantedcell
sheets were able to adhere and survive on the underlying muscle
layers within the ulcer sites, providing an intact, stratified epithe-
lium. Four weeks after surgery, complete wound healing, with no
observable stenosis, was seen in the animals receiving autologous
cell sheet transplantation (Fig. 44.8). In contrast, a noticeable
Figure 44.8.
Transplantation of oral mucosal epithelial cell sheets pro-
motes wound healing and reduces postoperative inflammation. Left and
right panels represent transplant and control groups, respectively. (a, c)
Endoscopic photographs taken 4 weeks postoperatively. (b, d) Macroscopic
imagesoftheesophagealsitesreceivingendoscopicsubmucosaldissection,
after4weeks. Reprintedwithpermission fromRef.75.Copyright2006BMJ
Publishing Group.
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