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Zdolsek, Johann
Publications (9 of 9) Show all publications
Abdelrahman, I., Elmasry, M., Steinvall, I., Olofsson, P., Nettelblad, H. & Zdolsek, J. (2018). Versatility of the Extensor Digitorum Brevis Muscle Flap in Lower Limb Reconstruction. Plastic and Reconstructive Surgery – Global Open
Open this publication in new window or tab >>Versatility of the Extensor Digitorum Brevis Muscle Flap in Lower Limb Reconstruction
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2018 (English)In: Plastic and Reconstructive Surgery – Global Open, E-ISSN 2169-7574Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Reconstruction of complex defects in the lower leg is a challenge. Although microvascular free tissue transfer is a popular technique, experience and available resources limit its use. Furthermore, free tissue transfer is not always required in the reconstruction of small lower leg defects, as many of them can be reconstructed with local alternatives such as an extensor digitorum brevis flap (EDB). Our aim was to describe our experience of the last 20 years with the EDB as a local muscle flap to cover small complex lower leg defects to establish its clinical feasibility and to document its associated complications. Methods: All adult patients who were operated with EDB flap reconstruction of the lower limb during 1997–2017 at the Department of Hand and Plastic Surgery, Linköping University Hospital, were included in this retrospective study. Results: Of 64 patients operated, only 7 had total flap failure, and the rate of complete success was 73% (47/64). Most of the skin defects were associated with fractures or complications thereof and were located in the ankle region, the dorsum of the foot, and the distal third of tibia or even the proximal tibia. Defects in the malleolar region and coexisting cardiovascular condition were factors associated with flap loss (either partial or total). Conclusion: The pedicled EDB-flap has, in our hands, proved to be a versatile and safe reconstructive option in the reconstruction of small defects in the lower leg and foot. Long-time follow-up is, however, recommended. 

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-153635 (URN)10.1097/GOX.0000000000002071 (DOI)
Available from: 2019-01-06 Created: 2019-01-06 Last updated: 2019-01-07
Elawa, S., Hallböök, O., Myrelid, P. & Zdolsek, J. (2015). Intestinal obstruction following harvest of VRAM-flap for reconstruction of a large perineal defect. Case Reports in Plastic Surgery and Hand Surgery, 2(3-4), 88-91
Open this publication in new window or tab >>Intestinal obstruction following harvest of VRAM-flap for reconstruction of a large perineal defect
2015 (English)In: Case Reports in Plastic Surgery and Hand Surgery, ISSN 2332-0885, Vol. 2, no 3-4, p. 88-91Article in journal (Refereed) Published
Abstract [en]

A patient with locally advanced adenocarcinoma of the rectum was operated with abdominoperineal resection and perineal reconstruction with a vertical rectus abdominis musculocutaneous flap. Six days postoperatively, there was herniation of the small bowel, between the anterior and posterior rectus sheaths, to a subcutaneous location.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2015
Keywords
Vertical rectus abdominis musculocutaneous flap, perineal defect, rectal
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-126099 (URN)10.3109/23320885.2015.1102640 (DOI)
Available from: 2016-03-21 Created: 2016-03-14 Last updated: 2018-10-28
Zdolsek, J., Morrison, W. A., Dingle, A. M., Palmer, J. A., Penington, A. J. & Mitchell, G. M. (2011). An "off the shelf" vascular allograft supports angiogenic growth in three-dimensional tissue engineering. Journal of Vascular Surgery, 53(2), 435-444
Open this publication in new window or tab >>An "off the shelf" vascular allograft supports angiogenic growth in three-dimensional tissue engineering
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2011 (English)In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 53, no 2, p. 435-444Article in journal (Refereed) Published
Abstract [en]

Objectives! Dense angiogenic sprouting occurs from arteriovenous loops (AVLs) incorporating autologous vein grafts inserted into empty plastic chambers in vivo. The purpose of this study was to determine if angiogenesis from the AVL was limited by substituting an "off the shelf" cold-stored allograft vein instead of an autologous vein. Methods: Four Sprague Dawley rat groups (two AVL configurations x two chamber types) were established for both 2-week and 6-week harvest. Control AVLs were autologous femoral vein grafts harvested from the left femoral vein that were surgically inserted between the cut femoral artery and vein on the right side. Experimental "allograft" AVLs were rat femoral veins cold stored (4 degrees C, sterile) for 4 to 7 weeks and then microsurgically interposed between the right femoral artery and vein of an unrelated rat. The two AVL types were inserted in one of two plastic chamber types smooth or perforated. At harvest, the AVL constructs were checked for patency, weighed, their volume determined, and histology undertaken. Morphometric assessment of percent and absolute volume of major tissue components (including blood vessels) at 6 weeks was completed. Results: There were no significant differences between autograft and allograft groups in construct weight, volume, or morphology at 2 or 6 weeks. No statistical differences occurred in the percent or absolute vascular volume of AVLs incorporating a cold-stored allograft vs autologous vein grafts at 6 weeks regardless of the chamber type. However, perforated chambers caused significant increases in construct weight (P = .015), volume (P = .006), and percent and absolute connective tissue volt tine at 6 weeks (P = .001) compared to smooth chamber constructs, regardless of the graft type. Conclusion: Cold-stored small-caliber allografts interposed in AVLs do not inhibit microcirculatory development and can be used in composite tissue engineering.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam, 2011
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-66288 (URN)10.1016/j.jvs.2010.08.019 (DOI)000286911900024 ()21030196 (PubMedID)2-s2.0-79251599161 (Scopus ID)
Available from: 2011-03-11 Created: 2011-03-11 Last updated: 2017-12-11Bibliographically approved
Zdolsek, J., Eaton, J. & Tang, L. (2007). Histamine release and fibrinogen adsorption mediate acute inflammatory responses to biomaterial implants in humans. Journal of Translational Medicine, 5
Open this publication in new window or tab >>Histamine release and fibrinogen adsorption mediate acute inflammatory responses to biomaterial implants in humans
2007 (English)In: Journal of Translational Medicine, ISSN 1479-5876, E-ISSN 1479-5876, Vol. 5Article in journal (Refereed) Published
Abstract [en]

Background: Medical implants often fail as a result of so-called foreign body reactions during which inflammatory cells are recruited to implant surfaces. Despite the clinical importance of this phenomenon, the mechanisms involved in these reactions to biomedical implants in humans are not well understood. The results from animal studies suggest that both fibrinogen adsorption to the implant surface and histamine release by local mast cells are involved in biomaterial-mediated acute inflammatory responses. The purpose of this study was to test this hypothesis in humans. Methods: Thirteen male medical student volunteers (Caucasian, 21-30 years of age) were employed for this study. To assess the importance of fibrinogen adsorption, six volunteers were implanted with polyethylene teraphthalate disks pre-coated with their own (fibrinogen-containing) plasma or (fibrinogen-free) serum. To evaluate the importance of histamine, seven volunteers were implanted with uncoated disks with or without prior oral administration of histamine receptor antagonists. The acute inflammatory response was estimated 24 hours later by measuring the activities of implant-associated phagocyte-specific enzymes. Results: Plasma coated implants accumulated significantly more phagocytes than did serum coated implants and the recruited cells were predominantly macrophage/monocytes. Administration of both H1 and H2 histamine receptor antagonists greatly reduced the recruitment of macrophages/monocytes and neutrophils on implant surfaces. Conclusion: In humans - as in rodents - biomaterial-mediated inflammatory responses involve at least two crucial events: histamine-mediated phagocyte recruitment and phagocyte accumulation on implant surfaces engendered by spontaneously adsorbed host fibrinogen. Based on these results, we conclude that reducing fibrinogen:surface interactions should enhance biocompatibility and that administration of histamine receptor antagonists prior to, and shortly after, medical device implantation should improve the functionality and longevity of medical implants. © 2007 Zdolsek et al, licensee BioMed Central Ltd.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49288 (URN)10.1186/1479-5876-5-31 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Zdolsek, J., Droog, E., Thorfinn, J. & Lidman, D. (2006). Laser Doppler perfusion imaging of the radial forearm flap: A clinical study. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 40(2), 101-105
Open this publication in new window or tab >>Laser Doppler perfusion imaging of the radial forearm flap: A clinical study
2006 (English)In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 40, no 2, p. 101-105Article in journal (Refereed) Published
Abstract [en]

Laser Doppler perfusion imaging (LDPI) allows non-invasive assessment of blood flow in a predefined area of skin rather than at one single point. We have used LDPI to study the pattern of skin blood flow in the radial forearm flap before and after the flap has been raised. The data were collected from a consecutive series of 11 patients with cancer of the oral cavity or oropharynx in whom the radial forearm flap had been used during the reconstructive procedure. Reperfusion leads to an immediate hyperaemic response both in the flap and the surrounding skin. This hyperaemia remains for at least the first 30 minutes after reperfusion. The perfusion of the radial side of the forearm skin distal to the flap is significantly lower than that on the ulnar side after the skin island has been raised and the distal artery divided. We suggest that LDPI is useful for monitoring the perfusion of free skin flaps. © 2006 Taylor & Francis.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-37039 (URN)10.1080/02844310500415319 (DOI)33535 (Local ID)33535 (Archive number)33535 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Zdolsek, J., Ledin, H. & Lidman, D. (2005). Are mechanical microvascular anastomoses easier to learn than suture anastomoses?. Microsurgery, 25(8), 596-598
Open this publication in new window or tab >>Are mechanical microvascular anastomoses easier to learn than suture anastomoses?
2005 (English)In: Microsurgery, ISSN 0738-1085, E-ISSN 1098-2752, Vol. 25, no 8, p. 596-598Article in journal (Refereed) Published
Abstract [en]

Sutured anastomoses of small vessels are considered difficult to learn. Mechanical anastomosis systems allow a more rapidly performed anastomosis. In order to compare the process of learning to perform sutured and mechanical microvascular anastomoses, two surgeons, with limited microvascular experience, performed 30 aortic and 30 femoral vein anastomoses in 30 Wistar rats. The methods compared were conventional suture, vascular closure system (VCS), and microvascular anastomotic coupler system (MAC). There were no intersurgeon differences regarding patency or time to perform anastomoses. The average time to perform a suture anastomosis was 39 min (patency 80%). Anastomoses with the VCS system took 24 min (patency 25%), whereas the MAC couplers took 13 min to perform (patency 95%). There was a significant learning effect with sutures, but no obvious reduction in time to perform MAC coupler or VCS clip anastomoses was seen. MAC couplers were easiest to use, and allowed us to perform rapid anastomoses with high patency. © 2005 Wiley-Liss, Inc.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31654 (URN)10.1002/micr.20172 (DOI)17463 (Local ID)17463 (Archive number)17463 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Monstein, H.-J., Jonsson, Y., Zdolsek, J. & Svanvik, J. (2002). Identification of Helicobacter pylori DNA in human cholesterol gallstones. Scandinavian Journal of Gastroenterology, 37(1), 112-119
Open this publication in new window or tab >>Identification of Helicobacter pylori DNA in human cholesterol gallstones
2002 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 37, no 1, p. 112-119Article in journal (Refereed) Published
Abstract [en]

Background: The gallbladder mucosa secretes hydrogen ions and is covered by mucus. The environmental conditions for bacterial colonization are similar to those in the stomach. Gallbladder stones often contain DNA from enteric bacteria, but no compelling evidence demonstrates that Helicobacter spp. have been present. The aim of this study was to establish bacterial DNA profiles in cholesterol gallstones with special reference to Helicobacter pylori. Methods: Cholesterol gallstones from 20 patients were subjected to polymerase chain reaction, bacterial profiling by temporal temperature gradient gel electrophoresis, automated DNA sequencing, and Southern blot analysis using a Helicobacter sp. specific primer. A nested ureI-PCR assay was used to discriminate between gastric and non-gastric H. pylori. Results: TTGE, partial 16S rDNA sequencing, and hybridization analysis revealed the presence of DNA presumably representing a mixed bacterial flora in cholesterol gallstones, including H. pylori in the gallstone centres in 11 out of 20 patients. In three cases, the ureI-PCR assay revealed non-gastric H. pylori. Conclusions: These data support the presence of DNA from a mixed bacterial population, including H. pylori in cholesterol gallstones, reflecting either that H. pylori is an indigenous part of a flora in the stone-containing gallbladder or, alternatively, that H. pylori colonization in the biliary tract predisposes to cholesterol gallstone formation.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25397 (URN)10.1080/003655202753387455 (DOI)9840 (Local ID)9840 (Archive number)9840 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Zdolsek, J., Enebog, J., Wallon, C. & Kald, A. (2000). A prospective evaluation of the PerFix® Plug technique for groin hernia repair. Hernia, 4(4)
Open this publication in new window or tab >>A prospective evaluation of the PerFix® Plug technique for groin hernia repair
2000 (English)In: Hernia, ISSN 1265-4906, E-ISSN 1248-9204, Vol. 4, no 4, p. 311-315Conference paper, Published paper (Other academic)
Abstract [en]

The aim of the study was to prospectively evaluate complication rates, sick-leave, recurrence rate, and chronic post-operative pain after mesh-plug hernia repair. All 385 consecutive inguinal hernias (373 patients) operated at our department with the PerFix® Plug from September 1996 to December 1997 were included in the study. Follow-up included a questionnaire 3 and 12 months after the repair. Replies to the both of these questionnaires were obtained from 363 of 373 patients (98%). All patients who either reported a lump or sensory disturbance in the operated groin were offered a clinical examination. A third questionnaire focusing on chronic post-operative pain was completed by 77 of 90 patients reporting groin pain. The recurrence rate was 2% (9/385). After 25 months (17-36 months) 38 patients (10%) still experienced inguinal pain to some degree. In 7 male patients there was either pain or discomfort during sexual activities. In a patient with poorly controlled ascites the plug was removed. Day-case surgery was performed in 86% of patients with epidural or local anaesthesia, and 64% in general- or spinal anaesthesia. Employed/self-employed patients were off work for a median of 7 days (0-65). The median time to full recovery for all patients was 20 days. Conclusion: Mesh-plug hernia repair has a reasonably low complication rate together with quick recovery in a non-specialised surgical setting. Chronic inguinal pain is, however, still present to some degree in 10% of patients after two years.

Keywords
PerFix
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-47534 (URN)10.1007/BF01201092 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Zdolsek, J. (1992). Effects of reactive oxygen species on the cellular vacuolar apparatus. (Doctoral dissertation). Linköping: Linköpings universitet
Open this publication in new window or tab >>Effects of reactive oxygen species on the cellular vacuolar apparatus
1992 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Reactive and potentially harmful oxygen species occur, and are continuously formed, in all cells of a living organism. Increased production of these metabolites are seen in a number of pathological states, for instance in inflammatory foci or during reoxygenation of ischemic tissue. Reactive oxygen species are considered to be associated with aging, the development of cancer and atherosclerosis.

The main aim of this study was to investigate the effects of reactive oxygen species on the cellular vacuolar apparatus, in particlar lysosomes.

It was found that neither superoxide radicals nor hydrogen peroxide alone had any damaging effect on lysosomes. With the presence of iron and, when hydrogen peroxide is concerned, a reducing agent damage to lysosomes was detected in the form of impaired proton gradient, leakage of lysosomal enzyme and lipid peroxidation, suggesting involvement of hydroxyl radicals.

By refining and modifying an existing cytochemical method it was also possible to detect iron at both light- and electron microscopicallevel with preserved ultrastructure. Iron was mainly found in secondary lysosomes.

It was also found that hydrogen peroxide-toxicity to cultured cells is iron dependent and could be much reduced by deferoxamine, an iron-chelator. This drug also prevented the hydrogen peroxide-mediated loss of the lysosomal proton gradient, suggesting intralysosomal Fentonreactions with generation of hydroxyl radicals.

Acridine orange is an acidotropic photosensitizer which mainly accumulates in lysosomes. By exposing acridine orange-loaded cultured cells to blue light reactive oxygen, found to be singlet oxygen, was generated intralysosomally. This lead to loss of the proton gradient over the lysosomal membrane and a decrease in lysosomal cathepsin activity. Inhibition of lysosomal proteases lead to a reduction in acridine orange-mediated cell death suggesting a role for these enzymes in cell death. Electron microscopy revealed bleb-formation and increased autophagocytosis in photosensitized cells.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 1992. p. 41
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 375
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28089 (URN)12855 (Local ID)91-7870-916-4 (ISBN)12855 (Archive number)12855 (OAI)
Public defence
1992-12-19, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Note
Papers, included in the Ph.D. thesis, are not registered and included in the posts from 1999 and backwards.Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-07-23Bibliographically approved
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