Introduction: Several investigators demonstrated that routine nasogastric decompression after abdominal surgery was unnecessary and can be safely eliminated. Some authors suggested that early feeding could be tolerated by the majority of patients after elective colorectal surgery. PURPOSE: The aim of our study was to prospectively assess the safety and tolerability of early oral feeding after colorectal surgery. METHODS: This trial included 69 patients who underwent an colon or rectal operation between April 1997 and August 1998. Patients were randomized after the operative procedure into one of two groups. Group 1: early oral feeding-all patents received a clear liquid diet on the first postoperative day followed by a regular diet as tolerated. Group 2: delayed feeding-all patients were treated in the traditional way with feeding only after the resolution of their postoperative ileus. Both groups had intraoperative nasogastric tubes that were removed at the end of surgery. The patients were monitored for vomiting, nasogastric tube reinsertion, time of regular diet consumption, complication, and length of hospitalization. The nasogastric tube was reinserted if two or more episodes of vomiting of more than 100 ml occurred in the absence of bowel movement. RESULTS: Sixty-nine consecutive patients were studied, 34 patients in group 1 (12 males and 22 females, mean age 58.1+/-12.7), and 35 patients in group 2 (16 males and 19 females, mean age 58.5+/-12.7). Significant differences were not noted in age and type of procedures. No significant differences were seen in rates of vomiting and overall complications. However, early feeding group well tolerated a regular diet (postoperative period to take regular diet of group 1: 5.4+/-4.0 days, group 2 : 8.1+/-4.6 days, p=0.013), and were discharged from hospital significantly earlier than the delayed feeding group(group 1: 14.0+/-5.1 days, group 2: 19.1+/-8.6 days, p=0.004). CONCLUSION: Early feeding after colorectal surgery is successfully tolerated by the majority of patients and led to earlier hospital discharge.
Colon ; Colorectal Surgery* ; Decompression ; Diet ; Female ; Hospitalization ; Humans ; Ileus ; Male ; Prospective Studies ; Research Personnel ; Surgical Procedures, Operative ; Vomiting

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

No abstract available.
Humans*

No abstract available.
Child* ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans

A 74-year-old female patient was diagnosed with unilateral vocal fold paralysis without any brain lesions, but with a history of influenza infection 1 week ago. No significant manifestations were observed in the oral phase in the Video Fluoroscopic Swallowing Study (VFSS). However, during swallowing aspiration, 50% of the residue after swallowing was measured as semisolid, and aspiration was observed when swallowing in the liquid form. The Penetration Aspiration Scale (PAS) score was 6 points, and the Functional Dysphagia Scale (FDS) was 46 points.Vocal-fold adduction was performed by injecting hyaluronic acid. Four days after the vocal fold injection, VFSS showed no aspiration during the swallowing of semisolids. Moreover, compared to the initial test, 10% of the residue measured after swallowing semisolids was decreased. No aspiration was observed when swallowing the liquid.Scores obtained for the Penetration Aspiration Scale (PAS) and the Functional Dysphagia Scale (FDS) were 4 and 26, respectively. Taken together, our results indicate that in a situation where upper respiratory infections are increasing due to the COVID-19 pandemic, hyaluronic acid injections have the potential to improve dysphagia in patients with unilateral vocal fold paralysis due to a viral infection.

No abstract available.
Kidney* ; Perfusion* ; Radionuclide Imaging*

Inflammatory bowel disease (IBD) is a long-standing disease that often requires long-term use of immunosuppressive agents including immunomodulators (such as azathioprine, 6-mercaptopurine and methotrexate) and tumor necrosis factor-alpha inhibitors (such as infliximab and adalimumab). Introduction of immunosuppressive therapies, however, involves the risk of host susceptibility to opportunistic infections in this patient population. Therefore, adequate immunization for vaccine-preventable infectious diseases is currently recommended for all patients with IBD and is emerging as an important target for quality improvements in IBD care. However, ongoing issues regarding underuse of immunization, safety and efficacy of vaccines in patients with IBD remain. For quality improvements in IBD care, all physicians should follow the recent immunization guidelines proposed by professional IBD societies. Additionally, there are ongoing needs for intensive educational programs regarding a role of immunization in long-term care of IBD and up-to-date immunization guidelines. Immunization status should be checked at the time of diagnosis of IBD and timely vaccination before initiation of immunosuppressive therapies can be a practical solution for maximizing the efficacy of vaccination at this point. Inactivated vaccines can be used safely irrespective of immunization status of patients, while attenuated vaccines are contraindicated in patients on immunosuppressive therapies. This article reviews an ideal strategy for vaccinating patients with IBD based on the currently recommended immunization guidelines.
Antibodies, Monoclonal/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammatory Bowel Diseases/diagnosis/drug therapy/*immunology ; Influenza Vaccines/immunology ; Influenza, Human/prevention & control ; Pneumonia/prevention & control ; *Vaccination ; Vaccines, Synthetic/immunology

Real-time ultrasonogram was performed in 31 Pt. with CHPS, who was admitted at the pediatric department of Wonkwang University hospital from January 1991 to June 1993. Those who had positive results of pyloric volume for diagnosis of CHPS and were confirmed by surgery. The results were at follows: 1) The average ultrasonographic measurements of pyloric muscle thickness, pyloric diameter, pyloric length were 4.9+/-1.09mm, 14.42+/-2.69mm, 19.17+/-2.37mm, and pyloric volume was 3.26+/-1.39ml. 2) The diagnostic reliabilities with the ultrasonographic measurements of muscle thickness (>4mm), pyloric diameter (>12mm) and pyloric length (>15mm) by Stunden's criteria in 31 cases were compared, which were not significant difference among them. 3) In ultrasonographic measurements of 31 cases for diagnosis of CHPS, positive results with 3 parameters were 80.6% and with 2 parameters and double tract signs were 87.1%. So. we conclude pyloric volume greater than 1.4ml was the most reliable parameter, which was satisfied 100% with diagnosis of CHPS.
Diagnosis* ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography

Cancer tissues are characterized by increased glucose uptake. 18F-fluorodeoxyglucose(FDG), a glucose analogue is used for the diagnosis of cancer in PET studies. This study was aimed to compare the glucose uptake and glucose transporter l(GLUT1) expression in various human colon cancer cells. We measured FDG uptake by cell retention study and expression of GLUTI using Western blotting. Human colon cancer cells, SNU-C2A, SNU-C4 and SNU-C5, were used. The cells were incubated with 1micro Ci/ml of FDG in HEPES-buffered saline for one hour. The FDG uptake of SNU-C2A,SNU-C4 and SNU-C5 were 16.8+/-1.36, 12.3+/-5.55 and 61.0+/-2.17cpm/microgram of protein, respectively. Dose-response and time-course studies represent that FDG uptake of cancer cells were dose dependent and time dependent. The rate of FDG uptake of SNU-C2A, SNU-C4 and SNU-C5 were 0.29+/-0.03, 0.21+/-0.09 and 1.07+/-0.07cpm/min/microgram of protein, respectively. Western blot analysis showed that the GLUT1 expression of SNU-C5 was significantly higher than those of SNU-C2A and SNU-C4. These results represent that FDG uptake into human colon cancer cells are different from each other. In addition, FDG uptake and expression of CLUT1 are closely related in human colon cancer cells.
Blotting, Western ; Colon* ; Colonic Neoplasms* ; Diagnosis ; Glucose ; Glucose Transport Proteins, Facilitative ; Humans*