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Biomedical subjects

R J Brewer

Publications and source records attributed to R J Brewer.

15 recordsLinked to original sources

Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm.

Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. These may be primary fistulas, in cases of thoracic aortic aneurysm without previous repair, or secondary fistulas occurring after surgical repair of thoracic aortic aneurysm. Surgical treatment has been successful in a small number of cases of primary aortoesophageal fistula, secondary to thoracic aortic aneurysm, but techniques used have varied. We report a successful repair of primary aortoesophageal fistula, secondary to descending thoracic aortic aneurysm, and review the evolution of management since the three previously reported successful repairs at our institution.

Aorta, Thoracic↗

Nonspecific enhancement of host defenses against infection: experimental evidence of a new order of efficacy and safety.

Enhancement of nonspecific host defenses against bacterial challenge has been a long-standing goal often thwarted by variable efficacy, inconsistent bioassay, and paradoxic immunosuppression. Muramyl dipeptide provides enhanced survival after intravenous challenge with less than 8 x 10(3) Klebsiella, as well as improved local control of infection at sites of intramuscular bacterial injection, with and without a surgical foreign body. No depression of host response was seen over wide ranges of doses and intervals. Muramyl dipeptide provides a new order of efficacy and safety and warrants continued careful assessment.

Acetylmuramyl-Alanyl-Isoglutamine↗

The dynamic aortic root. Its role in aortic valve function.

By attaching appropriate measuring devices to the wall of an intact aortic root at the level of leaflet coaptation, we have measured a 16 per cent diameter change during each cardiac cycle. The dimensional changes observed can by themselves explain aortic valve function and obviate the postulation that the leaflets shorten and lengthen during each cardiac cycle. The tissue composition of the aortic root and leaflets is more compatible with this theory than with other postulations. Such a dynamic aortic root may explain the longevity of the actual aortic leaflets, in that leaflet fatigue stress is minimized by changes in aortic root dimension.

Animals↗

Laboratory studies in cross-species lung transplantation.

The lack of sufficient suitable human donor lungs for the many patients requiring pulmonary transplantation as life-saving therapy for end-stage lung diseases has generated extensive interest in cross-species lung transplantation. Ethical concerns and those of animal rights advocates have prompted studies of nonprimate species as potential solid organ donors for humans. This paper provides an overview of some of the laboratory studies of cross-species pulmonary transplantation performed over the past 20 years and focuses, in particular, on more recent work (from our laboratory and others) in the area of porcine-to-primate pulmonary xenotransplantation.

Animals↗