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

Cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunocompromised patients. CMV can cause pneumonia, retinitis, gastrointestinal ulcers, and widely disseminated disease, but cutaneous CMV is rare. We report two cases of cutaneous CMV infection presenting as perianal ulcers. A 54 year-old male who had liver transplantation and a 72-year-old male, who was treated with chemotherapy for angioimmunoblastic T-cell lymphoma, presented with perianal ulcers and had systemic symptoms of CMV infection with CMV antigenemia. They had multiple ulcerations with erythematous bases on the perianal area, and histopathologic examinations showed large atypical cytomegalic cells in the dermis, and immunohistochemical stains, with the anti-CMV antibody showed positive reactions.
Aged ; Coloring Agents ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Dermis ; Drug Therapy ; Humans ; Immunocompromised Host* ; Liver Transplantation ; Lymphoma, T-Cell ; Male ; Mortality ; Pneumonia ; Retinitis ; Ulcer

No abstract available.
Child* ; Humans ; Infant* ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
HIV* ; Humans*

No abstract available.
Diabetic Ketoacidosis* ; Drug Therapy* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Remission Induction*

Congenital diaphragmatic eventration is an abnormal elevation of the diaphragm as a result of developmental failure of muscular fibers during the fetal period. Mediastinal shift to the contralateral side may cause significant compression of the affected chest contents resulting in compromised pulmonary function especially when bilaterally involved. The differentiation between congenital diaphragmatic eventration and diaphragmatic hemia is very difficult but eventration has a better perinatal outcome compared to diaphragmatic hernia. We report a case of congenital diaphragmatic eventration on left side with good perinatal outcome after plication in which the initial prenatal diagnosis of diaphragmatic hernia was made by prenatal ultrasonography.
Diaphragm ; Diaphragmatic Eventration* ; Hernia, Diaphragmatic* ; Prenatal Diagnosis ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.

Cutaneous leiomyoma is a benign tnmor originating from smooth muscle fibers which are derived from arrector pili muscle, media of blood vessels and dartoic muscle of scrotum, vulvar, or nipple. It is classified into 3 types according to the site of origin, namely pilar leiomyoma, angioleiomyoma and genital leiomyoma. Leiomyoma of the nipple is the less kquent type of cutaneous leiomyoma. We report a case of cutaneous leiomyoma on the nipple in a 53-year-old man.
Angiomyoma ; Blood Vessels ; Humans ; Leiomyoma* ; Male* ; Middle Aged ; Muscle, Smooth ; Nipples* ; Scrotum

BACKGROUND: Pain is one of the most common presenting complaints in the emergency department(ED) and adequate analgesia for painful conditions is an important goal of emergency medical practice. This study was designed to investigate on the actual condition regarding the use of analgesic injections for traumatized patients in the field of ED and to reconsider the concern and methods of pain management in the future. METHOD: We carried out a prospective, noninterventional observational clinical study of adult patients presenting with acute trauma in the ED. Using a numeric rating scale ranging from 0 to 10, patients quantified their pain intensity on arriving at the ED and on one hour after analgesic administrations in the cases of analgesic use or after initial Assessment in the cases of no analgesic use. They also were interviewed about the level of their satisfaction to pain relief before leaving the ED. RESULTS: Seventy eight percent of all patient received analgesic injections(nonsteroidal antiinflammatory drugs; 62%, opioids; 16%) and the remaining 22 patients(22%) were treated without analgesics. At the time of secondary assessment to pain, initial pain score in the cases of analgesic administration decreased. Patients who are beyond fair in the level of satisfaction were recorded for only 18% of all patient even though 78% of patients received analgesic injections. CONCLUSION: Our data illustrate that the patient of trauma commonly receive analgesic injections in the ED but their levels of satisfaction are under fair. This finding suggests that the concern and methods of pain management have to be reconsidered through the understanding of analgesic pharmacology and pattern of pain relief by analgesics.
Adult ; Analgesia ; Analgesics ; Analgesics, Opioid ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Pain Management* ; Pharmacology ; Prospective Studies