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Biomedical subjects

R Brodman

Publications and source records attributed to R Brodman.

47 records · Page 3Linked to original sources
PubMed1983

Single lung transplantation with cyclosporin immunosuppression. Evaluation of canine and human recipients.

Cyclosporin, a potent new immunosuppressive agent, was used (alone or in combination with other drugs) in 28 canine single lung allograft recipients. Mean recipient survival with good allograft function was 155 days with cyclosporin and far exceeded that obtained in previous single lung allograft recipients treated with standard immunosuppression (15 to 22 days). The results of these experiments were as follows: (1) 20% of the recipient animals exhibited no evidence of rejection whatsoever; (2) four of 28 animals survived more than 350 days with good allograft function; (3) 79% of the animals exhibited some evidence of rejection that was easily reversed in 74% of instances with corticosteroids; (4) 10 of 28 animals exhibited good lung allograft function 5 months or more after operation; (5) in cyclosporin-treated lung allograft recipients, rejection was diagnosed by the presence of infiltrate on chest roentgenogram, analysis of the cellular content of bronchoalveolar lavage samples, and decreased perfusion on 99mtechnetium lung scan; (6) complete healing without stenosis of the bronchial anastomosis occurred in 82% of the animals studied. One of two patients treated with cyclosporin after undergoing single lung allografting survived 7 weeks after transplantation and 4 weeks after contralateral pneumonectomy. Episodes of rejection were reversible, and the bronchial anastomosis healed normally. This overall experience indicates that cyclosporin, although not a perfect immunosuppressive agent, increases the likelihood of success with therapeutic single lung transplantation.

Adult↗
PubMed1982

Surgical treatment of Wolff-Parkinson-White syndrome: division of an anomalous pathway using the superior approach.

The superior approach to the mitral valve through the dome of the left atrium was used for division of a left free wall anomalous pathway. It has been the approach of choice for mitral valve operations at our institution for the past 15 years, facilitating operations particularly when the left atrium is normal in size. Other approaches to the mitral valve are discussed.

Adolescent↗
PubMed1982

Intracardiac electrode detection of early or subendocardial ischemia.

Subendocardial and early transmural ischemia may have significant clinical consequences while manifesting few ECG changes. Catheters were designed to be introduced transvenously into the right ventricle (RV), and coronary sinus (CS) and transarterially into the left ventricle (LV). The intracavitary electrodes were modified so that the electrodes would not contact the endocardium. In twenty-two dogs ninety-eight graded stenoses of the circumflex and left anterior descending coronary arteries were performed while electrograms (EGM) were recorded simultaneously from the intracardiac (IC) electrodes and surface ECG. Of those stenoses resulting in only nonspecific ECG changes, there were specific ischemic changes on 100% of LV, 60% of RV, and 89% of CS electrograms. Of those stenoses which resulted in no ECG change, there were specific ischemic changes in the 9/31 (29%) of LV, 3/31 (10%) of RV, and 6/31 (19%) of CS electrograms. Recognizable patterns of change occur on the intracardiac electrograms in response to both stenosis and reperfusion, earlier than any change on the ECG. Besides being more sensitive, intracardiac electrodes allowed for the detection of ischemia even in the presence of intraventricular conduction defects, strain patterns, and possibly other situations which might otherwise mask ischemic changes on the ECG.

Animals↗
PubMed1981

Internal mammary artery-saphenous vein composite conduit: an alternative for the proximal coronary anastomosis.

A patient who had previously undergone saphenous vein bypass grafting was seen with recurrent angina requiring reoperation. At the second operation, technical problems with the ascending aorta ultimately excluded its use for the proximal anastomosis for the second of two bypass grafts. Anastomosis of the left internal mammary artery to the proximal end of the saphenous vein graft successfully resolved the problem.

Angina Pectoris↗
PubMed1980

Pacemaker implantation through the internal jugular vein.

During a twelve-year experience with 1,808 patients 90 underwent permanent transvenous implantation through the ligated internal jugular vein. Ninety-two implants were performed. In 2 of the patients both internal jugular veins were used without complication. Out of the ninety-two implants there were three complications; one permanent recurrent laryngeal nerve injury and two episodes of severe thrombophlebitis, which receded with nonoperative therapy. The internal jugular vein is a useful and safe route for permanent pacemaker implant.

Humans↗
PubMed1978

Influenzal vaccine response in systemic lupus erythematosus.

The response of patients with systemic lupus erythematosus and normal subjects to systemic immunization and boosting with influenza A vaccines was studied. Symptoms after vaccination were somewhat more frequent in the patients than in the normal subjects; however, all symptoms were minor and no major flare of illness occurred. No significant induction or increase of pre-existing autoantibodies among the patients was detected after vaccination. The immunogenecity of the vaccinations, as assessed by antibody titers, was similar in the patient and control groups. No correlation between serologic response to influenzal antigens and HLA was found. Thus, in this group of patients with systemic lupus erythematosus, who were either in remission or had mild-to-moderate disease activity, killed influenzal vaccination caused no apparent worsening of disease activity.

Adult↗