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A novel inkjet system for live cell bioprinting
           would be a major step toward the modeling  of highly   contrast to a previous report evaluating cell injury during
           detailed 3D structures at the resolution of a single cell.   laser bioprinting , no marked increase in necrotic nor in
                                                                            [19]
           The results showed that the new cell-printing head could   apoptotic cells was observed from 0 to 48 h. The results
           eject  cells  with a cell  per droplet  consistent  with the   are potentially because the level of stress induced by our
           Poisson distribution profile, which indicated that the cell   current process is lower than that in laser printing. The
           suspension was maintained in a well-homogenized state   cells recovered and proliferated normally after inkjet
           by the mixing system.                               printing and were expected to maintain the integrity of
             However, to achieve an even narrower distribution and   their functions, including the clonogenicity of stem cells.
           further increase the precision of deposition, it would be   Our printheads bear several features are considerably
           necessary to bring the state of random distribution closer   different from common industrial inkjet heads and could
           to a state of uniform distribution for the cells in suspension   minimize cell damage. The open chamber structure and
           inside the printhead chamber. This would require a strong   the mixing system allow use over extended  periods
           repulsive force that acts between the cells, so that they   without compromising  gaseous exchange,  whereas
           are  not  brought  close  to  each other, for example,  by   rapidly  evacuating  bubbles  before  their  accumulation
           introducing a polymer with a charge polarity that could   increases the risk  of damage following rupture . The
                                                                                                        [20]
           provide an electrostatic repulsive force between the cells.   simplicity of the printhead chamber architecture and the
           We are also investigating  the potential  of employing   use of membrane vibration for droplet generation avert
           additional optical cell count systems to further control the   any excessive increase in liquid pressure and shear stress
           number of cells per droplet.                        before  ejection.  Further investigations  are  required  to
             Regarding the suitability of using the new printheads   assess the physical mechanisms that negatively influence
           with living cells, analysis of cell viability and   cell viability and function the most.
           proliferation revealed that the ejected cells were not   It is also worth noting, from a practical point of view,
           significantly  affected,  even  following  the  application   particularly considering potential biomedical applications
           of sensitive cells such as undifferentiated stem cells. In   that the printhead chamber was intentionally kept simple
                                                               to ensure that low volumes of cell suspensions could be
           A                        B                          loaded easily. Simplifying  the procedures for loading
                                                               and  exchanging  cell  suspensions could  further  reduce
                                                               the risks of environmental stress and contamination. This
                                                               could also be a major advantage when using rare cells
                                                               that  are  difficult  to  expand  since  our  system  does  not
                                                               require filling ink cartridges or wasting cell suspensions
                                                               for maintenance.
                                                                 Achieving a reliable ejection of living cells allowed
           Figure 9. Drop-on-demand two-dimensional patterning evaluation   us to  subsequently  experiment  with  more  advanced
           (A) Fluorescence microscope image of green-  and red-labeled
           NIH/3T3 cells deposited alternately at 500 μm intervals with two   processes for the spatial  positioning of cell-containing
           cell-containing  droplets ejected  at each position. (B) Ability  to   droplets.  We have demonstrated that an on-demand
           control the number of cells based on the number of ejected droplets.   patterning  of  cells  over  a  flat  surface  is  feasible  with
           Cell ink was formulated to contain one cell in two droplets. Error   precise control of cell number at each deposition. Most
           bars show the standard deviations.                  notably, the potential to draw intricate patterns with arrays

                         A                        B                        C






                         F                        E                        D





           Figure 10. Schematic of three-dimensional inkjet cell-printing process. (A) Printing of a scaffold hydrogel precursor before gelation.
           (B) Printing of gelation factor. (C) Printing of the first cell ink. (D) A hydrogel scaffold layer is superimposed onto the cell layer by the
           same procedure in (A) and (B). (E) Printing of the second cell ink. (F) The steps from (A) to (E) are repeated until a multilayer construct
           is achieved.

           36                          International Journal of Bioprinting (2019)–Volume 5, Issue 2
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