In addition, early epithelialization and moderate stricture were observed by a number of transplanted cell sheets. These endoscopic delivery devices for cell sheet would enable easily transplantation of cell sheets onto the lumen
of the esophagus. Additionally, anti-CTLA-4 antibody a number of allogeneic epidermal cell sheets might be useful for prevention of stricture as well as autologous one. Figure options Download full-size image Download high-quality image (181 K) Download as PowerPoint slide Figure options Download full-size image Download high-quality image (212 K) Download as PowerPoint slide “
“The accepted palliative treatment for malignant gastric outlet obstruction (GOO) is surgical bypass or placement of self-expandable metal stents. Surgical gastrojejunostomy causes morbidity of about 30%. In endoscopic stent placement, because of recurrent obstruction, many have to go through re-intervention. So we developed a safe and durable endoscopic gastrojejunostomy with a fully covered, lumen-apposing metal stent using a porcine model. Under general anesthesia, 11 female Yorkshire pigs underwent gastrojejunostomy PI3K activity with a 4-cm length lumen-apposing metal stent. After gastrotomy formation using a needle knife, the jejunum was drawn into the stomach with alligator forceps. A jejunotomy was then performed in the gastric cavity, which was followed by deployment of a lumen-apposing metal stent
under fluoroscopic guidance. Next, the first portion of the duodenum was resected by an endoscopic linear stapler via laparoscopy, thereby creating the GOO model. Oral feeding was resumed 24 h after the procedure, and animals were euthanized at 1, 2, and 4 weeks after the operation. Side-to-side gastrojejunostomy was successfully completed endoscopically in 10/11
animals. One case failed due to jejunal perforation during jejunotomy. The mean gastrojejunostomy procedure time was 41 min (range 15-94 min). No pigs died before the planned sacrifice date. At the end of 4 weeks, two pigs showed significant weight gain with a maximum increase of 101% from their initial body weight. Histological examination revealed adequate submucosal apposition without evidence of necrotic changes in all 10 experimental pigs. Creating a gastrojejunostomy ever endoscopically using a lumen-apposing metal stent seems to be a safe, feasible, durable, and reproducible method. Schematic diagram of the endoscopic gastrojejunostomy technique by transgastric endoluminal insertion of the GJ stent. “
“With the remarkable growth of disability- and rehabilitation-related research in the last decade, it is imperative that we support the highest quality research possible. With cuts in research funding, rehabilitation research is now under a microscope like never before, and it is critical that we put our best foot forward.