Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Mech Behav Biomed Mater. 2018 Mar;79:219-225. doi: 10.1016/j.jmbbm.2018.01.002. Epub 2018 Jan 5.
Development of high-performance submucosal injection materials (SIMs) contribute to the advancement of endoscopic therapy for early-stage gastrointestinal neoplasms. This study aimed to develop a new ex vivo model that mimics the human gastrointestinal tract to evaluate the performance (the height and duration of the submucosal elevation) of various SIMs in detail.
A new ex vivo model that applies a constant tension to the tested specimen (the porcine gastric specimen) was developed. SIMs were injected into the submucosa at the center or edge of the tested specimen, and submucosal elevation heights (SEHs) were measured over time.
The average value and standard deviation of SEH determined using the conventional model (the tested specimen was fixed with pins) were higher than those obtained using the new model, which showed that the new model could precisely measure the SEH of a given SIM. In addition, the performance (SEH) of SIMs decreased with increasing tension applied to the specimen, suggesting that the performance of SIMs deteriorates with the over-expansion of the gastrointestinal tract. The submucosal elevation formed at the specimen edge disappeared faster than that formed at the specimen's center.
The proposed new ex vivo model allows accurate SEH measurement under uniform conditions and detailed comparison of the performances of various types of SIMs and can contribute to the development of high-performance materials.
开发高性能黏膜下注射材料（SIMs）有助于推进早期胃肠道肿瘤的内镜治疗。本研究旨在开发一种新的模拟人体胃肠道的离体模型，以详细评估各种 SIMs 的性能（黏膜下抬举的高度和持续时间）。
开发了一种对测试标本（猪胃标本）施加恒定张力的新离体模型。将 SIM 注射到测试标本的黏膜下层中心或边缘，然后测量随时间推移的黏膜下抬举高度（SEH）。
使用传统模型（用销钉固定测试标本）确定的 SEH 的平均值和标准差高于使用新模型获得的值，这表明新模型可以精确测量给定 SIM 的 SEH。此外，随着施加到标本上的张力增加，SIM 的性能（SEH）下降，表明 SIM 的性能随着胃肠道的过度扩张而恶化。标本边缘形成的黏膜下抬举比标本中心形成的黏膜下抬举消失得更快。
所提出的新离体模型可在均匀条件下进行精确的 SEH 测量，并对各种类型的 SIM 的性能进行详细比较，有助于开发高性能材料。
