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Biomedical subjects

K M Fagelman

Publications and source records attributed to K M Fagelman.

8 recordsLinked to original sources
PubMed1989

True clinical entity of vascular compression of the duodenum in adolescence.

Thirteen pediatric patients were diagnosed with superior mesenteric artery syndrome (SMAS) at our institution between 1974 and 1986. Four were successfully treated with nasojejunal feedings only, and nine underwent a derotation procedure designed to alleviate the problem of compression of the duodenum by the superior mesenteric artery. Of the nine patients who were operated upon, only one required a gastrojejunostomy to bypass a persistent obstruction. Therapy was aimed specifically toward the problem of duodenal occlusion at the mesenteric root. Because this therapy was successful in all of the patients, we conclude that SMAS exists as a treatable entity and must be considered in any adolescent patient who presents with symptoms of obstruction of the upper part of the gastrointestinal tract and failure to thrive.

Adolescent↗
PubMed1985

Temporary banding of the gastroesophageal junction in the critically ill neonate with esophageal atresia and tracheoesophageal fistula.

Patients with esophageal atresia and a distal tracheoesophageal fistula with associated conditions contributing to decreased pulmonary compliance present special problems in management. In the face of positive pressure ventilation, the fistula acts as a vent preventing adequate ventilatory effort from reaching the lungs. A thoracic approach to ligate or divide the fistula carries with it a high mortality rate. A technique is described whereby a silicone rubber band is applied to the gastroesophageal junction to effectively occlude the esophagus. It is designed so that is can be adjusted or removed, without operative intervention, according to the patient's clinical course and growth.

Emergencies↗
PubMed1981

Simulated surgical wound infection in mice: effect of stimulation on nonspecific host defense mechanisms.

Experiments were conducted to ascertain whether nonspecific host defenses could be enhanced in a reliable animal model simulating the local bacterial infection that frequently complicates surgical wounds. The test lesion was studied in detail and exemplifies the concept that the ultimate expression of the host-pathogen interaction is the capacity of that pathogen to persist or grow in a given host. Mice were challenged by intramuscular insertion of cotton suture impregnated with 10(7) to 10(8) Escherichia coli K-12. The mice were subsequently killed at intervals, and the suture and muscle mass were retrieved, homogenized, and quantitatively cultured. Numbers of viable organisms in tissue from control animals were compared with those from experimental animals that received BCG (Bacillus Calmette-Guérin) vaccine, a nonspecific immunostimulant, prior to bacterial challenge. Improved tissue antibacterial activity appeared in animals that had received BCG vaccine 13 days prior to bacterial challenge. Differing doses and intervals were not protective. Enhancement of nonspecific host defense mechanisms may be helpful in combination with current measures for improved control of surgical wound infection.

Animals↗
PubMed1979

The effect of splenectomy on pulmonary infection in newborn mice.

Overwhelming postsplenectomy infection is a widely discussed and studied problem. The route of infection, the specific organisms involved, and the age at splenectomy and bacterial challenge are crucial factors in determining the genuine threat of the disease. We studied Staphylococcus aureus respiratory infection in 10-day-old mice who had undergone splenectomy or sham operation 7 days earlier. We did not find an increase in fatal staphylococcal pneumonitis under these conditions. Further laboratory definition of this complex issue is warranted.

Animals↗