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

No abstract available.

No abstract available.
Radionuclide Imaging*

No abstract available.

No abstract available.
Humans ; Seoul*

No abstract available.
Immunosuppression* ; Prognosis* ; Transplantation*

BACKGROUND: To evaluate the changing pattern of liver abscess treatment, we did a retrospective analysis of 80 patients with liver abscess, treated surgically and medically at the Department of Surgery and Internal Medicine, Wonkwang University Hospital from January 1985 to December, 1995. RESULTS: Among 80cases of liver abscess, 59 cases(76%) were pyogenic abscess and 21 cases(24%) were amebic abscess. The liver abscess was more commonly located in the right lobe. In the 59cases of pyogenic liver abscess, etiologic factors were biliary stones with cholangitis(19 cases), cholecystitis(6 cases), hepatobiliary cancer(4 cases), diabetes mellitus(3 cases). All 21 cases of amebic abscess were treated with percutaneous catheter drainage and metronidazole administration; 20 cases were treated successfully and 1 case died of sepsis. Among the 59 cases of pyogenic liver abscess, 38 cases were treated with percutaneous catheter drainage; 30 cases were successful, but 8 cases were not. Operations were performed in 21 cases because of underlying intraabdominal conditions requiring surgical correction( 19cases) and panperitonitis due to rupture of liver abscess(2cases). CONCLUSION: In the treatment of amebic abscss, percutaneous catheter drainage and metanidazole adminstration should be considered first. Percutaneous catheter drainage and antibiotic treatment tend to increase more than surgical treatment in the pyogenic liver abscess therapy. The liver abscess is no more surgical indication, unless it is associated with underlying intraabdominal conditions requiring surgical correction and panperitonitis due to rupture of liver abscess.
Abscess ; Amebiasis ; Catheters ; Drainage ; Humans ; Internal Medicine ; Liver Abscess* ; Liver Abscess, Amebic ; Liver Abscess, Pyogenic ; Liver* ; Metronidazole ; Retrospective Studies ; Rupture ; Sepsis

The etiology and pathogenesis of lumbar disc herniation is not clearly proved although biochemical change, physical stress, genetic factor, autoimmune phenomenon and psychophysiologic phenomenon have been considered by many investigators. The most important one is a result of pathologic acceleration of normal aging of the tissue. The present study is aimed to investigate the changes of mucosubstances in normal aging and herniated disc which might have possible role on the disc herniation. The materials used in this study consisted of 123 cases of surgically removed herniated disc and 7 cases of normal control disc obtained from autopsy. Sections were cut and stained with periodic acid-schiff (P.A.S.)-alcian blue (pH 2.5) for the detection of neutral mucosubstances, alcian blue at pH 2.5 for nonsulfated acid mucosubstances, and alcian blue at pH 1.0 and Spicers diamine method (HID) for sulfated mucosubstances. The results were as follows. l. Of the 123 cases of lumbar disc herniation, there was a slight male preponderance over female with a ratio of 1.5:1.0. The most commonly affected level was L4-5 comprising 69 cases (56.1%), and up to three quarters of the patients the age was from 3rd to 5th decades in which it was rather evenly distributed. 2. The time interval between the appearance of symptoms and operation was less than 1 year in 77 cases (62.6%), in 32 cases (26.0%) being within 3 months. 3. Histochemical studies of the normal discs showed increase of neutral mucopolysaccharides with reduction of acid and sulfated mucopolysaccharides in the nucleus pulposus, and increase of all the mucosubstances in the annulus fibrosus by aging. 4. Histochemical studies of herniated disc showed an acceleration of the changes seen in normal changes. 5. Cartilaginous end plate formation was noted in 46,3% of herniated discs. The results obtained by the present investigation suggest that herniation of lumbar diosc is closely associated with accelerated or premature degeneration of the disc.
Acceleration ; Aging ; Alcian Blue ; Autopsy ; Female ; Glycosaminoglycans ; Humans ; Hydrogen-Ion Concentration ; Intervertebral Disc Displacement ; Male ; Methods ; Research Personnel

No abstract available.
Hypertension*

Background: Subclinical thyroid disease is characterized by abnormal thyroid stimulating hormone (TSH) levels with normal free thyroxine (T4) levels. This study aimed to verify the association between subclinical hypothyroidism and depression measured using the Patient Health Questionnaire-9 (PHQ-9) score in the Korean population. Methods: This cross-sectional study included 1,786 adults aged ≥19 years with normal free T4 levels and serum TSH levels ≥0.45 mIU/L who had participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2014. The PHQ-9 was first introduced in the KNHANES to detect depression (PHQ score of ≥10). Serum TSH level of 0.45–4.49 mIU/L was defined as the reference range. The association between subclinical hypothyroidism and depression according to gender and age was evaluated using the binary logistic regression analysis after adjusting for age, education, and body mass index. Results: There was no association between subclinical hypothyroidism and depression according to gender. The odds ratio for depression was 2.498 (95% confidence interval [CI], 0.905–6.895; P=0.077) in men and 0.727 (95% CI, 0.352–1.503; P=0.390) in women. Additionally, there was no association between subclinical hypothyroidism and depression according to age. Conclusion These results suggest that subclinical hypothyroidism was not associated with depression in Korean adults.