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Biomedical subjects

J F Burdick

Publications and source records attributed to J F Burdick.

At least 91 records · Page 5Linked to original sources
PubMed1986

Rejection of murine cardiac allografts. I. Relative roles of major and minor antigens.

The relative contributions of incompatibilities for class I, class II, or minor antigens to primarily vascularized graft rejection have not been previously compared in large numbers of strains. In our experiments, murine primarily vascularized heterotopic cardiac graft rejection was studied in 16 donor-recipient strain combinations, representing different precisely defined major and/or minor histoincompatibilities. Complete major incompatibilities generally produced strong graft rejection, although it was confirmed that prolonged survival occurs in certain combinations that are incompatible for class I, or class I plus class II, antigens. In addition, however, strong rejection of these grafts was produced in some recipient strains when the donor was incompatible only for minor antigens. This strong effect of minor antigens may reflect their strong stimulation of delayed-type hypersensitivity, whereas the influence of class II antigens seems more related to stimulation of mixed lymphocyte culture generation of lymphocyte-mediated cytotoxicity.

Animals↗
PubMed1986

Strong cellular immune responses induced in vivo against minor antigens in the mouse.

Multiple minor antigen incompatibilities produce unexpectedly strong DTH reactions in mice. These experiments showed that this is probably not due to the effect of a single minor incompatibility, and that the response to the MHC is relatively weak compared with that against multiple minor antigens. Assessment of the in vivo response to multiple minor antigens in delayed-type hypersensitivity responses and in priming for subsequent mixed lymphocyte culture generation of lymphocyte-mediated cytotoxicity revealed a major degree of cross-reactivity for antigens not present on the initial in vivo stimulus. Recruitment of cross-reactive cells in vivo might play a role in these strong responses to multiple minor antigens.

Animals↗
PubMed1985

Anergy for delayed-type hypersensitivity in preleukemic AKR mice.

A singular anergy for delayed-type hypersensitivity (DTH) in preleukemic AKR mice was discovered. This total anergy for DTH against allogeneic cells, which developed in the AKR mice by 4 to 5 months of age, was not due to an artifact of route of sensitization or of other assay parameters and was not found in other strains sharing H-2 or other genetic background. The mice had an intact capacity to be stimulated in mixed lymphocyte culture to produce cytotoxic effector cells. Although the relationship to lymphoma was not directly addressed in these experiments, the genetic and temporal characteristics of this anergy suggest a biologically important relationship to the preleukemic state.

Age Factors↗
PubMed1985

The safety of carotid endarterectomy at the time of coronary artery bypass surgery: analysis of results in a high-risk patient population.

From Jan. 1, 1979, to Dec. 31, 1983, 37 patients have undergone simultaneous carotid endarterectomy and myocardial revascularization. There were 27 men and 10 women, and their ages ranged from 45 to 74 years (mean 61.3 years). Unstable angina was present in 61%, significant stenosis in the left main coronary artery in 27%, and either unstable angina or disease of the left main coronary artery in 70% of these patients. All patients had hemodynamically significant stenosis of the carotid artery on the operated side and 14 patients (38%) had bilaterally significant disease; three patients (8%) had a contralateral total occlusion of the carotid artery. There were no deaths resulting from neurologic factors, no permanent, and only one transient (2.7%) neurologic deficits. There were three deaths from cardiac causes (8.1%). Carotid endarterectomy may be performed safely at the time of myocardial revascularization in a patient population with a high incidence of unstable angina and disease of the left main coronary artery. The evolution of and rationale for the combined surgical approach to coexistent carotid and coronary artery disease is discussed and the literature reviewed.

Aged↗
PubMed1985

Abdominal aortic aneurysms: diagnosing and treating on time.

Recent evidence demonstrates that the notion of a "safe" aneurysm is a fallacy. The incidence of rupture, even in small aneurysms, is alarmingly high. Up to half of patients with abdominal aortic aneurysms are asymptomatic before rupture and death. Lateral lumbosacral spine film using bone technique is ideal for rapid evaluation of an an aneurysm. About three-fourths of abdominal aortic aneurysms contain sufficient calcium to allow detection by this method, and estimation of aneurysm size is accurate.

Aged↗
PubMed1984

Renal artery angioplasty. Technical considerations and results.

Renal angioplasty was attempted on 38 renal arteries in 34 patients and was technically successful in 84.2%. Twenty-four patients were followed for 1 to 36 months (mean 15.3 months). The hypertension was cured or improved in 18 (75%), unchanged in 2 and recurrent after an initial period of improvement in four. Six patients were not available for further evaluation as five had additional renovascular surgery and one was lost to followup. Four patients had major complications; loss of the kidney occurred in one patient (2.9%). Respiratory renal mobility, predilatation with tapered teflon catheters and the contralateral femoral approach were found to be important technical aids for successful renal artery angioplasty.

Adolescent↗
PubMed1984

Characteristics of early routine renal allograft biopsies.

The assumption that renal allograft histology should be perfectly normal during quiescence in the absence of rejection or nephrotoxic insults has not been adequately investigated. To study this, routine renal allograft biopsies were performed at approximately 1 and 4 weeks, when patients often had normal function or stable acute tubular necrosis (ATN). These were compared with biopsies from other patients during autologous ATN or clinically evident allograft rejection. There were two new findings: (1) Almost all biopsies contained an interstitial infiltrate, so that only the presence of vasculitis provided a clear distinction between rejection and quiescence. Most of the biopsies with infiltrates were from patients who had never received cyclosporine, so that an infiltrate does not necessarily signify toxicity due to this drug. (2) A major proportion of the cells in some biopsies appeared to express both the helper/inducer and the cytotoxic/suppressor phenotype, and a similar finding after in vitro stimulation suggests that this represents a cell population that is activated in some way.

Antibodies, Monoclonal↗
PubMed1983

Long-term results of aortoiliac angioplasty.

Results of percutaneous transluminal angioplasty of 141 iliac arteries in 112 patients are reported, with a follow-up period extending to 36 months. Initial technical success was achieved in 95.7%, 1-year patency in 91.3%, and accumulated 2- and 3-year patency in 89%. The role of outflow disease and ankle:arm index measurement and the importance of eliminating or significantly reducing the intra-arterial pressure gradients are discussed.

Adult↗
PubMed1982

The urological evaluation and management of patients with congenital lower urinary tract anomalies prior to renal transplantation.

Previously, patients with chronic renal failure and major congenital anomalies of the lower urinary tract (often with urinary diversion) were thought to be poor candidates for renal transplantation. Pre-transplant evaluation and possible urinary reconstruction are essential in these patients to achieve successful renal transplantation. Ten patients, including 7 adults, presented with congenital anomalies of the lower urinary tract that were responsible for renal failure. Percutaneous suprapubic cystostomy aided in the assessment of bladder function. Undiagnosed posterior urethral valves were found in 2 adults. Patients with exstrophy, neurogenic bladder or a contracted bladder (with augmentation cystoplasty) had urinary drainage into the bladder at the time of renal transplantation. Sometimes an imperfect bladder can be used for urinary drainage with transplantation but, otherwise, intestinal conduits are still a viable alternative.

Adult↗
PubMed1982

Percutaneous transluminal angioplasty as an adjunct to the surgical management of peripheral vascular disease.

Percutaneous transluminal angioplasty (PTA) was performed as an adjunct to an operation in 43 patients with peripheral arterial insufficiency. This represents 26% of patients undergoing PTA over the past 44 months. In 23 patients PTA was done in conjunction with planned vascular reconstruction. It was successful in all 23 patients, and patency of the vascular graft was maintained in 22 patients during a mean follow-up period of nine months. Fourteen patients had PTA after operation. It was successful in 13 of them, and vascular patency was maintained in all 13 during a mean follow-up period of four months. Six patients had PTA prior to a distal amputation or a skin graft. All healed promptly. The overall initial success rate of PTA was 98%, the complication rate was 2%, with a late failure rate of 2%. It is concluded that PTA is a valuable adjunct to vascular surgery to improve inflow or outflow for bypass grafts, to reduce the extent of the operation in poor risk patients, to facilitate the healing of distal amputations, and to manage late graft stenosis.

Adult↗
PubMed1982

Antigenic requirement for induced rejection of long-surviving murine heart transplants.

Primarily vascularized B10.BR mouse cardiac allografts survive long-term in untreated B6AF1 recipients. We found that sudden complete rejection of the grafts was produced by sequential "triple treatment" with BCG, cyclophosphamide, and a small number of donor-strain lymphocytes. Neither the graft itself, nor donor-strain platelets or frozen-thawed lymphocytes were an effective substitute for the intact donor-strain lymphocytes. Thus the long-surviving graft presents target antigens but lacks the antigenic characteristics required to stimulate a rejection response that are expressed on lymphocytes.

Animals↗
PubMed1982

Revascularization for bilateral renal artery occlusion after umbilical artery catheterization.

The case of a newborn infant who became hypertensive and oliguric because of bilateral renal artery occlusion following umbilical artery catheterization is presented. Eventual treatment was by microsurgical placement of an aortorenal graft, with subsequent marked improvement in the patient's course. A scan and arteriogram at 1 year showed that the revascularized kidney was responsible for the patient's normal blood urea nitrogen and creatinine concentrations, but the renal artery had recanalized and the graft occluded. The role of umbilical artery catheterization in such catastrophes and the possible future role such microsurgical reconstruction could play in neonatal hypertension are discussed.

Catheterization↗
PubMed1981

The multiple sequential distal bypass graft: improving nature's alternatives.

Sequential femoral-distal bypass grafts were employed to revascularize 21 ischemic limbs. An end-to-side distal anastomosis plus an additional side-to-side anastomosis to an isolated popliteal segment or an additional distal tibial vessel were employed. If one graft that underwent successful early revision is included, the initial patency rate was 100%. After a median follow-up of 8 months, complete graft failure had occurred in three patients. A previously unreported occurrence in two patients was proximal graft segment occlusion, with patency of th distal segment that was successfully revascularized. One additional patient had occlusion of the distal graft segment. Limb salvage was achieved in 20 of the 21 patients. This approach offers several hemodynamic advantages and may be the procedure of choice in patients with distal runoff that si not ideal for a routine femoropopliteal bypass graft.

Aged↗