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Junker, Johan
Alternative names
Publications (10 of 18) Show all publications
Toll John, R., Henricson, J., Junker, J., Jonson, C.-O., Nilsson, G., Björk Wilhelms, D. & Anderson, C. D. (2018). A cool response: the influence of ambient temperature on capillary refill time. Journal of Biophotonics, 11(6)
Open this publication in new window or tab >>A cool response: the influence of ambient temperature on capillary refill time
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2018 (English)In: Journal of Biophotonics, ISSN 1864-063X, E-ISSN 1864-0648, Vol. 11, no 6Article in journal (Refereed) Published
Abstract [en]

Objective

To describe the effect of low ambient temperature on skin temperature and capillary refill (CR) time in forehead, sternum and finger pulp.

Methods

An observational, nonrandomized experimental study on 15 healthy subjects (6 females) in a cold room (8°C). Outcome measures were skin temperature and quantified CR test after application of a standardized blanching pressure (9 N/cm2) using digital photographic polarization spectroscopy to generate CR times.

Results

The finger pulp showed marked temperature fall and prolonged CR times (>10 seconds). The CR registrations of the forehead and sternum were more comparable to curves observed in a control material at room temperature, and skin temperature falls were less marked. CR times were not prolonged in forehead measurements. At the sternum, some individuals showed CR times beyond guideline recommendations despite only a marginal reduction in skin temperature.

Conclusions

Low ambient temperature is a strong independent factor for CR time at peripheral sites. Reservation about sternum as a site of measurement is warranted since cold provocation produced prolonged CR times in some individuals. We found that the forehead is the most thermostable of the 3 sites and thus the preferred site to avoid ambient temperature artifact in measuring CR time.

Place, publisher, year, edition, pages
Wiley-VCH Verlagsgesellschaft, 2018
National Category
Atom and Molecular Physics and Optics
Identifiers
urn:nbn:se:liu:diva-145527 (URN)10.1002/jbio.201700371 (DOI)000434641700017 ()29384267 (PubMedID)
Note

Funding agencies: Socialstyrelsen; Region Ostergotland

Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2019-04-30Bibliographically approved
Lampi, M., Junker, J., Tabu, J. S., Berggren, P., Jonson, C.-O. & Wladis, A. (2018). Potential benefits of triage for the trauma patient in a Kenyan emergency department. BMC Emergency Medicine, 18(49), 1-7
Open this publication in new window or tab >>Potential benefits of triage for the trauma patient in a Kenyan emergency department
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2018 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, no 49, p. 1-7Article in journal (Refereed) Published
Abstract [en]

Background

Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.

Methods

A prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.

Results

A total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.

Conclusion

The results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Triage, Trauma, Emergency department
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-153305 (URN)10.1186/s12873-018-0200-7 (DOI)30497397 (PubMedID)2-s2.0-85057551142 (Scopus ID)
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-05-07Bibliographically approved
Lampi, M., Junker, J., Berggren, P., Jonson, C.-O. & Vikström, T. (2017). Pre-hospital triage performance after standardized trauma courses. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25, Article ID 53.
Open this publication in new window or tab >>Pre-hospital triage performance after standardized trauma courses
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2017 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 25, article id 53Article in journal (Refereed) Published
Abstract [en]

Background: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. Methods: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course. Results: One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean +/- standard deviation 2.4 +/- 0.68, post-test mean +/- standard deviation 2.60 +/- 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation. Conclusions: Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be modified in order to assure proper training in triage skills.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Mass Casualty Incident; Advanced Trauma Life Support; Pre-Hospital Trauma Life Support
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-138244 (URN)10.1186/s13049-017-0395-8 (DOI)000401773100001 ()28526053 (PubMedID)
Available from: 2017-06-14 Created: 2017-06-14 Last updated: 2018-05-02
Junker, J., Lönnqvist, S., Rakar, J., Karlsson, L. K., Grenegård, M. & Kratz, G. (2013). Differentiation of human dermal fibroblasts towards endothelial cells. Differentiation, 85(3), 67-77
Open this publication in new window or tab >>Differentiation of human dermal fibroblasts towards endothelial cells
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2013 (English)In: Differentiation, ISSN 0301-4681, E-ISSN 1432-0436, Vol. 85, no 3, p. 67-77Article in journal (Refereed) Published
Abstract [en]

The ultimate goal of vascular tissue engineering is the production of functional grafts for clinical use. Difficulties acquiring autologous endothelial cells have motivated the search for alternative cell sources. Differentiation of dermal fibroblasts towards several mesenchymal lineages as well as endothelial cells has been proposed. The aim of the present study was to investigate the endothelial differentiation capacity of human dermal fibroblasts on a gene expression, protein expression and functional physiological level. Endothelial differentiation of fibroblasts was induced by culturing cells in 30% human serum, but not in fetal calf serum. Expression of proteins and genes relevant for endothelial function and differentiation was increased after induction. Furthermore, fibroblasts exposed to 30% human serum displayed increased uptake of low-density lipoprotein and formation of capillary-like networks. The results of this study may have an impact on cell sourcing for vascular tissue engineering, and the development of methods for vascularization of autologous tissue engineered constructs.

Place, publisher, year, edition, pages
Wiley-Blackwell / Elsevier, 2013
Keywords
Differentiation; Endothelial cell; Fibroblast; Tissue engineering; Human serum
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96492 (URN)10.1016/j.diff.2013.01.005 (DOI)000320766300001 ()
Available from: 2013-08-23 Created: 2013-08-20 Last updated: 2017-12-06
Nyman, E., Huss, F., Nyman, T., Junker, J. & Kratz, G. (2013). Hyaluronic acid, an important factor in the wound healing properties of amniotic fluid: In vitro studies of re-epithelialisation in human skin wounds. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 47(2), 89-92
Open this publication in new window or tab >>Hyaluronic acid, an important factor in the wound healing properties of amniotic fluid: In vitro studies of re-epithelialisation in human skin wounds
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2013 (English)In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, no 2, p. 89-92Article in journal (Refereed) Published
Abstract [en]

Foetal wounds are unique in their ability to heal rapidly without forming scars. The amniotic fluid, rich in nutrients, growth factors, and hyaluronic acid, surrounds the foetus and is essential to foetal wound healing. The wound healing properties of foetal wounds may be the result of high concentrations of hyaluronic acid. This study aimed to verify that amniotic fluid induces re-epithelialisation in human skin wounds in vitro and to study whether this ability is dependent on hyaluronic acid. Standard deep dermal wounds were produced in vitro in human skin. The skin samples, with a central wound, were incubated in different culture media. Varying concentrations of amniotic fluid and amniotic fluid with added hyaluronidase were tested, and re-epithelialisation was assessed at 3, 7, and 12 days using light microscopy, after staining with haematoxylin and eosin. Amniotic fluid 50% resulted in a significantly higher (p andlt; 0.05) grade of re-epithelialisation than Dulbeccos modified Eagles medium and 10% amniotic fluid at all time points. When 50% amniotic fluid was compared with 10% foetal calf serum, no significant difference was found in grades of re-epithelialisation on days 3 and 12 and significantly higher grades of re-epithelialisation on day 7 (p andlt; 0.05). Degradation of hyaluronic acid in the medium that contained 50% amniotic fluid gave significantly impaired re-epithelialisation (p andlt; 0.05) on culture days 3 and 7. In conclusion, amniotic fluid promotes accelerated re-epithelialisation and hyaluronic acid is an important ingredient.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
Amniotic fluid, fibroblasts, human, hyaluronic acid, hyaluronidase, in vitro, keratinocytes, wound healing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91006 (URN)10.3109/2000656X.2012.733169 (DOI)000316362300002 ()
Note

Funding Agencies|Swedish Fund for Research without Animal Experiments||

Available from: 2013-04-11 Created: 2013-04-11 Last updated: 2019-01-07Bibliographically approved
Sommar, P., Junker, J., Strandenes, E., Ness, C., Hansson, T., Johnson, H. & Kratz, G. (2013). Osteogenically-induced human dermal fibroblasts as a tool to regenerate bone. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 47(1), 8-13
Open this publication in new window or tab >>Osteogenically-induced human dermal fibroblasts as a tool to regenerate bone
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2013 (English)In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, no 1, p. 8-13Article in journal (Refereed) Published
Abstract [en]

Engineering of bone tissue could help to overcome the need for extensive reconstruction and associated donor site morbidity, and it has been proposed that osteogenic biomaterials, which are scaffolds that contain osteocompetent cells, could be used to fill large bone defects. This study investigated the potential of osteogenically-induced human dermal fibroblasts cultured on gelatin microcarriers combined with platelet-rich plasma in a model of a femoral defect in athymic rats. Defects were transplanted with one of the following six combinations: 1 = sodium chloride, 2 = platelet-rich plasma, 3 = microcarriers + platelet-rich plasma, 4 = human dermal fibroblasts on microcarriers + platelet-rich plasma, 5 = human osteoblasts on microcarriers + platelet-rich plasma, and 6 = osteogenically induced human dermal fibroblasts on microcarriers + platelet-rich plasma. The femoral defects were assessed 4 weeks postoperatively with computed tomography (CT), routine histological staining, fluorescence in situ hybridisation, and polyclonal antibodies directed towards osteocalcin and osteonectin. Radiographs of all groups taken 4 weeks postoperatively showed unhealed defects. Femoral defects transplanted with osteogenically-induced human dermal fibroblasts on microcarriers (group 6) contained dense clusters of cells with large quantities of extracellular matrix. These clusters were exclusive to this group and stained strongly for osteocalcin and osteonectin. Fluorescence in situ hybridisation showed viable human cells in femoral defects that had been transplanted with microcarriers seeded with cells, which confirmed the survival of implanted cells. In conclusion, osteogenically-induced human dermal fibroblasts survived in this new niche, and bone-like structures were apparent in the defects.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
Tissue engineering, stem cells, human dermal fibroblasts, differentiation, osteogenic induction, formation of bone
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89513 (URN)10.3109/2000656X.2012.731411 (DOI)000313681700002 ()
Available from: 2013-02-27 Created: 2013-02-26 Last updated: 2017-12-06
Seland, H., Gustafson, C.-J., Johnson, H., Junker, J. & Kratz, G. (2011). Transplantation of acellular dermis and keratinocytes cultured on porous biodegradable microcarriers into full-thickness skin injuries on athymic rats. BURNS, 37(1), 99-108
Open this publication in new window or tab >>Transplantation of acellular dermis and keratinocytes cultured on porous biodegradable microcarriers into full-thickness skin injuries on athymic rats
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2011 (English)In: BURNS, ISSN 0305-4179, Vol. 37, no 1, p. 99-108Article in journal (Refereed) Published
Abstract [en]

In search of an optimal transplantation regime for sufficient dermal and epidermal regeneration after a full-thickness skin injury, wounds on athymic rats were grafted with split-thickness skin grafts or acellular human dermis followed by transplantation with human keratinocytes either in single-cell suspension or cultured on porous biodegradable micro-carriers. After 2 weeks, all wounds grafted with acellular human dermis showed a well organised and vascularised dermal component and reepithelialisation on the grafted dermal matrix was complete 21 days after transplantation with human keratinocytes. Wounds grafted with human keratinocytes seeded on biodegradable microcarriers or split-thickness skin grafts displayed over time (i.e. 16-21 days post-transplantation) a significantly thicker epithelial cell layer in comparison to wounds grafted with keratinocytes in single-cell suspensions or microcarriers not seeded with cells. Furthermore, measurements of dermal thickness in the closed wounds 21 days after grafting showed a significantly thicker and well organised neodermal component in wounds transplanted with keratinocytes seeded on microcarriers or split-thickness skin grafts compared to all other wounds. Positive immunostaining towards von Willebrand factor revealed the plausible proangiogenic effects of transplantation with keratinocytes seeded on microcarriers. Analysis of representative tissue sections after fluorescence in situ hybridisation visualised that grafted human keratinocytes were present in the epidermal layers covering the wounds 16 and 21 days after transplantation, strongly indicating preservation of cell viability. These results shows that the use of biodegradable microcarriers in the culture of autologous keratinocytes for treatment of full-thickness wounds not only facilitate the cultivation, transportation and transplantation processes but also enhances the dermal regeneration induced by a dermal scaffold which results in a clinical result that is significantly superior to the one obtained when keratinocytes are transplanted in a single-cell suspension.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam., 2011
Keywords
Athymic rats, Full-thickness skin injury, CFD, Microcarrier cell culture, Transplantation, Reepithelialisation, Soft-tissue regeneration
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-66147 (URN)10.1016/j.burns.2010.03.014 (DOI)000287072800014 ()
Available from: 2011-03-04 Created: 2011-03-04 Last updated: 2011-03-04
Junker, J., Sommar, P., Skog, M., Johnson, H. & Kratz, G. (2010). Adipogenic, Chondrogenic and Osteogenic Differentiation of ClonallyDerived Human Dermal Fibroblasts. Cells Tissues Organs, 191(2), 105-118
Open this publication in new window or tab >>Adipogenic, Chondrogenic and Osteogenic Differentiation of ClonallyDerived Human Dermal Fibroblasts
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2010 (English)In: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 191, no 2, p. 105-118Article in journal (Refereed) Published
Abstract [en]

The apparent need of an autologous cell source for tissueengineering applications has led researchers to explore thepresence of cells with stem cell plasticity in several humantissues. Dermal fibroblasts (FBs) are easy to harvest, expandin vitro and store, rendering them plausible candidates forcell-based therapies. The aim of the present study was toobserve the effects of adipogenic, chondrogenic and osteogenicinduction media on the phenotype of human FBs.Human preadipocytes obtained from fat tissue have beenproposed as an adult stem cell source with suitable characteristics,and were used as control cells in regard to their differentiationpotential. Routine staining, immunohistochemicalanalysis and alkaline phosphatase assay were employed,in order to study the phenotypic shift. FBs were shown topossess multilineage potential, giving rise to fat-, cartilageandbone-like cells. To exclude contaminant progenitor cellsor cell fusion giving rise to tissue with adipocyte-, chondrocyte-and osteoblast-like cells, single-cell cloning was performed.Single-cell-cloned FBs (sccFBs) displayed a similardifferentiation potential as primary-culture FBs. The pres-ence of ‘stem-cell-specific’ surface antigens was analyzedusing flow cytometry. The results reveal that sccFBs haveseveral of the markers associated with cells exhibiting stemcell plasticity. The findings presented here are corroboratedby the findings of other groups, and suggest the use of humandermal FBs in cell-based therapies for the reconstructionof fat, cartilage and bone.

Place, publisher, year, edition, pages
Basel: Karger AG, 2010
Keywords
Adipogenesis, Chondrogenesis, Fibroblasts, Osteogenesis, Tissue engineering
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-19711 (URN)10.1159/000232157 (DOI)
Available from: 2009-07-16 Created: 2009-07-16 Last updated: 2017-12-13Bibliographically approved
Sommar, P., Pettersson, S., Ness, C., Johnson, H., Kratz, G. & Junker, J. P. (2010). Engineering three-dimensional cartilage- and bone-like tissues using human dermal fibroblasts and macroporous gelatine microcarriers. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 63(6), 1036-1046
Open this publication in new window or tab >>Engineering three-dimensional cartilage- and bone-like tissues using human dermal fibroblasts and macroporous gelatine microcarriers
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2010 (English)In: Journal of plastic, reconstructive & aesthetic surgery : JPRAS, ISSN 1878-0539, Vol. 63, no 6, p. 1036-1046Article in journal (Refereed) Published
Abstract [en]

The creation of tissue-engineered cartilage and bone, using cells from an easily available source seeded on a suitable biomaterial, may have a vast impact on regenerative medicine. While various types of adult stem cells have shown promising results, their use is accompanied by difficulties associated with harvest and culture. The proposed inherent plasticity of dermally derived human fibroblasts may render them useful in tissue-engineering applications. In the present study, human dermal fibroblasts cultured on macroporous gelatine microcarriers encapsulated in platelet-rich plasma into three-dimensional constructs were differentiated towards chondrogenic and osteogenic phenotypes using specific induction media. The effect of flow-induced shear stress on osteogenic differentiation of fibroblasts was also evaluated. The generated tissue constructs were analysed after 4, 8 and 12 weeks using routine and immunohistochemical stainings as well as an enzyme activity assay. The chondrogenic-induced tissue constructs were composed of glycosaminoglycan-rich extracellular matrix, which stained positive for aggrecan. The osteogenic-induced tissue constructs were composed of mineralised extracellular matrix containing osteocalcin and osteonectin, with cells showing an increased alkaline phosphatase activity. Increased osteogenic differentiation was seen when applying flow-induced shear stress to the culture. Un-induced fibroblast controls did not form cartilage- or bone-like tissues. Our findings suggest that primary human dermal fibroblasts can be used to form cartilage- and bone-like tissues in vitro when cultured in specific induction media.

Keywords
Dermal fibroblast; Chondrogenesis; Osteogenesis; Microcarrier; Tissue engineering; Regenerative medicine
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54113 (URN)10.1016/j.bjps.2009.02.072 (DOI)000277356900025 ()19329368 (PubMedID)
Available from: 2010-02-23 Created: 2010-02-23 Last updated: 2010-10-29
Karlsson, L. K., Junker, J. P., Grenegård, M. & Kratz, G. (2009). Human Dermal Fibroblasts: A Potential Cell Source for Endothelialization of Vascular Grafts. Annals of Vascular Surgery, 23(5), 663-674
Open this publication in new window or tab >>Human Dermal Fibroblasts: A Potential Cell Source for Endothelialization of Vascular Grafts
2009 (English)In: Annals of Vascular Surgery, ISSN 0890-5096, E-ISSN 1615-5947, Vol. 23, no 5, p. 663-674Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Recently, there has been an intense ongoing search for suitable cell sources for vascular tissue engineering. Previous studies report that cells with multilineage potential have been found within the connective stroma of the skin. In line with this, preliminary data from our group suggest that human dermal fibroblasts have the capacity to alter their phenotype into an endothelial cell-like phenotype in vitro. As a first step in using these cells in vascular tissue engineering, we investigated their ability to form an endothelial cell-like layer on a scaffold in vitro. Furthermore, we studied the possibility of seeding dermal fibroblasts on a scaffold and later commencing with induction toward an endothelial cell-like phenotype. METHODS: Cells cultured in either normal fibroblast medium or endothelial induction medium were seeded on a gelatin-based scaffold. To study the organization of cells, routine staining was performed. Differentiation was confirmed by Western blotting and immunohistochemistry with antibodies directed toward molecules commonly used to identify endothelial cells. RESULTS AND CONCLUSION: Our data support that human dermal fibroblasts differentiated toward endothelial cell-like cells prior to seeding showed histological resemblance to mature endothelial cells, while fibroblasts seeded and later induced into endothelial differentiation grew in multilayer. However, expression of various surface molecules indicative of an endothelial phenotype was seen using both techniques. In conclusion, the results presented in this study indicate that human dermal fibroblasts differentiated toward an endothelial cell-like phenotype may be a novel cell source for endothelialization of vascular grafts.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-19714 (URN)10.1016/j.avsg.2009.03.007 (DOI)19576728 (PubMedID)
Available from: 2009-07-16 Created: 2009-07-16 Last updated: 2017-12-13Bibliographically approved
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