Biomedical subjects

Brian B Graham

Publications and source records attributed to Brian B Graham.

4 recordsLinked to original sources

PubMed2026

Integrated Cytokine and Immune Cell Profiling Reveals a Distinct Immune Signature Associated with High-Altitude Pulmonary Edema.

High-altitude pulmonary edema (HAPE) is a rapidly progressive, life-threatening disorder arising in otherwise healthy individuals upon ascent to high altitude, yet the mechanisms underlying maladaptive vascular leak remain poorly defined. Although elevated pulmonary arterial pressure and capillary stress failure are recognized as central hemodynamic drivers, accumulating evidence indicates that innate immune dysregulation is an equally critical, largely unexplored determinant of HAPE. To systematically delineate the immune and molecular programs that distinguish pathological responses to hypobaric hypoxia from acclimatization, peripheral blood along with clinical details was collected from low-altitude controls (LA-Cntrl, number of participants, (n = 19), healthy high-altitude sojourners (HA-Cntrl, n = 47), and HAPE patients (n = 90). Plasma proteomic markers were quantified using a targeted panel, while monocyte and dendritic cell subsets in peripheral blood mononuclear cells were immunophenotyped by multicolor flow cytometry. HA-Cntrl subjects displayed an anti-inflammatory profile, marked by the suppression of CXC chemokine receptor 3 axis chemokines. HAPE patients, in contrast, exhibited a pro-inflammatory, vascular injury signature, with elevated levels of inflammatory interleukins and myeloid and chemotactic factors. This inflammatory signature was accompanied by the expansion of classical monocytes, implicating a myeloid vascular program associated with HAPE.

Humans↗

PubMed2005

Primary pulmonary lymphoma.

BACKGROUND: Primary pulmonary lymphoma is a rare disease. The clinical characteristics, methods of treatment, and outcomes are not well elucidated. METHODS: A retrospective review of primary pulmonary lymphoma cases at a single institution from 1990 to 2002 was performed. RESULTS: Eighteen patients were included, with a mean follow-up of 2.9 years. Fourteen patients had mucosa-associated lymphoid tissue (MALT) lymphoma, 2 had large cell transformation of sheet cells in MALT lymphoma, and 1 each had Hodgkin's disease and follicular lymphoma. Computed tomography-guided biopsy was diagnostic in only two of eight attempts. Eleven patients had disease confined to the pulmonary parenchyma, and 7 had parenchymal disease as well as mediastinal lymphadenopathy. Treatment methods included observation only (n = 1), surgery only (n = 6), surgery plus chemotherapy (n = 8), surgery plus radiotherapy (n = 1), and surgery plus chemotherapy plus radiotherapy (n = 2). Kaplan-Meier estimate of median time to disease recurrence or death was 6 years. Only 1 patient died of disease-related causes. Patients who had bilateral disease were more likely to have recurrent disease or death (p = 0.03). CONCLUSIONS: A wide range of treatments were used for patients with generally MALT lymphoma, resulting in good outcomes, and recurrent disease was well controlled.

Adult↗

PubMed2004

End-to-side venous anastomosis with the internal jugular vein stump: a preliminary report.

BACKGROUND: Failure of free flaps is frequently because of failure of the venous vascular anastomosis. A new venous anastomosis technique that uses the stump of the internal jugular vein (IJV) is described, with preliminary data on operative outcomes. METHODS: Retrospective analysis of eight head and neck free flap operations in which a venous anastomosis to the stump of an IJV was used compared with 222 other free flap operations in the same period (1995-2001) at a single institution. RESULTS: None of the eight free flaps that used venous end-to-side anastomoses to the stump of an IJV failed. There were 15 failures associated with the other 222 venous microvascular anastomoses (6.8%). CONCLUSIONS: This new technique resulted in no failures in eight operations. Advantages of this technique include avoiding creating an anastomosis under tension or requiring a saphenous vein graft and reducing pedicle torsion at the hilum of the flap.

Adolescent↗

PubMed2002

Pediatric tracheal surgery.

BACKGROUND: Pediatric tracheal procedures are uncommon. We reviewed our experience to clarify management and results. METHODS: Retrospective single-institution review of pediatric tracheal operations, 1978 to 2001. RESULTS: One hundred sixteen children were evaluated, mean age 10.4 years (10 days to 18 years). Tracheal pathology was postintubation stenosis (n = 72; 62%), congenital stenosis (n = 23; 20%), neoplasm (n = 8; 7%), tracheomalacia (n = 7; 6%), and trauma (n = 6; 5%). Twenty-nine patients had previous tracheal operations. Thirty-six patients received only a minor procedure. Eighty patients had major operations: tracheal resection (n = 46; 58%), laryngotracheal resection (n = 22; 28%), slide tracheoplasty (n = 7; 9%), and carinal resection (n = 5; 6%). The mean length of airway resected was 3.3 cm (1.5 to 6 cm), which represented 30% of the entire trachea. Twenty-eight patients (35%) had complications. These included tracheomalacia (n = 3), recurrent nerve injury (n = 3), laryngeal edema requiring intubation (n = 2), stroke (n = 1), esophageal leak (n = 1), and lobar collapse (n = 1). Nineteen patients had anastomotic failure: severe restenosis (n = 6), mild restenosis (n = 9), dehiscence (n = 2), dehiscence with tracheoesophageal fistula (n = 1), and tracheoinnominate fistula (n = 1). Two children died (2.5%). Complications were more frequent in children less than 7 years of age (p = 0.05) and after previous operations (p = 0.02). Longer fractions of tracheal resection (> 30%) were more likely to result in anastomotic failure (p = 0.0005). Sixty-four (80%) patients achieved a stable airway free of any airway appliance. All patients with neoplasms are alive. CONCLUSIONS: The principles of adult tracheal operations are directly applicable to children and usually lead to a stable, satisfactory airway. Children tolerate anastomotic tension less well than adults; resections more than 30% have a substantial failure rate.

Adolescent↗