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

Protein accounts for over one third of the human lens, the remaining two thirds being water. The other constotuents of the lens including lipids, amino acids, electrolytes and a variety of peptides and carbohydrates, account for about 1% of the lens wet weight. Since transparency of the lens is so highly dependent on protein order and structural integrity, it is not surprising that relatively small changes in any of these parameters might lead to the development of opacification resulting in a cataract.We have analyzed electrolytic differences between normal lens and lens of experimentally induced cataract to find the important factor in including cataract after we had extracted one hundred eight pig lenses. We divided these experimentally induced cataract into a group of normal lens capsule and another group of lenses which we performed with a 26 gauge needle. The sodium level was decreased in 15% mannitol solution and increased in normal saline. In every solution the potassium level was decreased. The chloride level was decreased in the 15% mannitol solution and increased in the normal saline solution. The calcium level also was decreased in mannitol and distilled water.Our results indicate that the potassium level of the experimentally induced cataracts decreased in any conditions and may be an important factor in inducing cataract.
Amino Acids ; Calcium ; Carbohydrates ; Cataract* ; Electrolytes ; Humans ; Mannitol ; Needles ; Peptides ; Potassium ; Sodium ; Sodium Chloride ; Water

BACKGROUND/AIMS: The use of laparoscopic adjustable gastric banding (LAGB) is increasing proportionally with the obesity epidemic. However, some postoperative complications have been highlighted as major problems associated with LAGB. There is no consensus concerning the endoscopic management of these adverse events. The aim of this study was to retrospectively review the feasibility and effectiveness of endoscopic treatment for LAGB complications. METHODS: We retrospectively evaluated 352 patients who underwent LAGB between 2011 and 2015. LAGB-associated complications developed in 26 patients (7.4%). This study involved six patients (1.7%) who received endoscopic treatment. RESULTS: Types of LAGB-induced complications in our series included intragastric migration (n=3), gastric leaks (n=2), and gastric fistulas (n=1). The endoscopic treatment of these complications was successful in four of the six patients. Endoscopic band removal was successful in two patients. All gastric leaks were successfully closed via an endoscopic procedure. In two cases (intragastric migration and gastric fistula), endoscopic treatment was not sufficient, and surgery was performed. CONCLUSIONS: Endoscopic procedures afforded acceptable treatment of band migration and gastric leaks after LAGB. However, the results were poor in patients with gastric fistula.
Bariatric Surgery ; Consensus ; Endoscopy ; Far East* ; Gastric Fistula ; Humans ; Obesity ; Postoperative Complications ; Retrospective Studies

BACKGROUND/AIMS: Because the efficacy of standard triple therapy for Helicobacter pylori eradication has declined, new regimens such as sequential therapy (ST) and concomitant therapy (CoCTx) have been introduced. The aim of this study was to compare the efficacy of 10-day ST and 10-day CoCTx for H. pylori eradication. METHODS: We retrospectively reviewed the medical records of 316 patients with proven H. pylori infection. They were assigned to one of 2 regimens; ST (n=191) consisted of, lansoprazole 30 mg and amoxicillin 1 g for 5 days followed by lansoprazole 30 mg, metronidazole 500 mg, and clarithromycin 500 mg for 5 days, and CoCTx (n=125) consisted of lansoprazole 30 mg, amoxicillin 1 g, metronidazole 500 mg, and clarithromycin 500 mg for 10 days. All drugs were administered twice a day. Bacterial eradication was checked by using a 13C-urea breath test at least 4 weeks after completion of treatment. RESULTS: The mean age and male to female ratio was 51.74 and 1.03, respectively. Baseline characteristics were not different in both groups. Ten day CoCTx group (94.4%, 118/125) showed better eradication rate than ST group (82.2%, 157/191) (p=0.002). Drug compliances were not statistically different between the two groups (p=0.19). Side effects were more frequently reported in the CoCTx group than in the ST group (p=0.03). CONCLUSIONS: Ten-day CoCTx was superior to ST in terms of eradicating H. pylori infection. Although the CoCTx producing more side effects than ST, CoCTx can be thought to be a promising alternative to ST as a treatment regimen for H. pylori eradication.
Adult ; Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/*therapeutic use ; Breath Tests ; Clarithromycin/therapeutic use ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Helicobacter Infections/diagnosis/*drug therapy ; *Helicobacter pylori ; Humans ; Lansoprazole/therapeutic use ; Logistic Models ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Proton Pump Inhibitors/*therapeutic use ; Retrospective Studies ; Risk Factors ; Treatment Outcome

BACKGROUND: To investigate the occurrence of falls and their consequences in a representative population and to identify risk factors of falls in the elderly. METHODS: The study participants were community-dwelling elderly people aged 65 years or old as a population based sample of one large city. A total of 828 people 65 years or older participated in this study. They were interviewed over the telephone by a trained interviewer using a structured questionnaire to obtain a fall history and details of their most recent fall including date, time, place, circumstances, and associated injury. As for risk factors for falls, we asked about living arrangement (with family or alone), alcohol intake, exercise, visual and hearing impairments, memory and sensory problems, lower limb weakness, and arthritis symptoms. Fear of falling and fear-related activity restriction were also evaluated. RESULTS: The incidence of falls during the last one year was 13.0%. Women experienced falls more frequently. Falls occurred mainly in spring and summer and from 10 AM to 3 PM. Common causes of falls were slipping and tripping. 14.9% of those who fell suffered consequent fractures. Being female was a significant risk factor for falls; and females tended to get injured more severely following a fall. During the recent one year, decreased proprioception in the lower extremity was a significant risk factor for falls. Those with histories of falls, and especially women, tended to limit their activities due to the fear of falling. CONCLUSION: Overall, it appears that elderly women are more greatly affected by falls at several levels. Female participants fell more frequently and suffered more severe consequences. Fall-related injuries and risk factors for falls disproportionately affected women. And, being female and any amount of decreased sensation in the feet were significant risk factors for falls.
Aged ; Arthritis ; Female ; Foot ; Hearing ; Humans ; Hypogonadism ; Incidence ; Lower Extremity ; Memory ; Mitochondrial Diseases ; Ophthalmoplegia ; Proprioception ; Surveys and Questionnaires ; Residence Characteristics ; Risk Factors ; Sensation ; Telephone

PURPOSE: To evaluate the findings and role of contrast-enhanced fat suppression MR imaging in avascular necrosis(AVN) of the femoral head. MATERIALS AND METHODS: In 15 patients with AVN of the femoral head, MR T1-weighted and T2-weighted images and contrast-enhanced fat-suppression T1-weighted images were obtained, and the findings were re-viewed. Early and advanced groups were classified on the basis of clinical findings and imaging, and the en-hancement pattern was classified as either type I, rim enhancement; type II, surrounding diffuse enhance-ment; type III, intralesional enhancement; or type IV, II + III. RESULTS: Twenty-four cases of AVN of the femoral head were detected; in nine patients, lesions were bilateral. Eight cases occurred in the early group and 16 in the advanced. All eight in the early group showed the "double line sign" on T2-weighted images, with a type-I enhancement pattern. In the advanced goup, type II(8/16) and type IV(8/16) enhancement patterns were seen. Among the cases showing the type-IV pattern, the intrale-sional enhancing area showed low signal intensity on T1-weighted images and isosignal intensity on T2 weighted in one case, and low signal intensity on T1-weighted images and high signal intensity on T2-weight-ed in the other cases. There was no difference in the extent of the disease before and after enhancement. CONCLUSION: Contrast-enhanced fat-suppression MR images may be helpful in evaluating the extent of AVN of the femoral head and predicting the histopathologic findings of the disease
Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis*

Crohn’s disease (CD) is a chronic destructive inflammatory bowel disease that affects young people and is associated with significant morbidity. The clinical spectrum and disease course of CD are heterogeneous and often difficult to predict based on the initial presentation. In this article, changes in the disease location, behavior, clinical course during long-term follow-up, and predictive factors are reviewed. Generally, four different patterns of clinical course are discussed: remission, stable disease, chronic relapsing disease, and chronic refractory disease. Understanding the long-term disease course of CD is mandatory to reveal the underlying pathophysiology of the disease and to move toward a more optimistic disease course, such as remission or stability, and less adverse outcomes or devastating sequelae.

Sixty-six patients with squamous cell carcinoma of the cropharynx were treated with radiation therapy and retrospectively analyzed to evaluate the treatment result in the Department of Therapeutic Radiology, Korea Cancer Center Hospital between January 1980 and December 1986. There were 42 patients with carcinoma of the tonsil including the fossa and pillar, 9 patients with carcinoma of the base of tongue, 12 patients with carcinoma of the soft palate, and 3 patiens with carcinoma of the posterior and lateral pharyngeal walls. Considering all oropharyngeal sites of involvement together, response rates for T1, T2, T3, and T4 were 80%, 77%, 73%, and 40%, respectively, with a overall response rate of 70%. The response rate for N1, N2, and N3 were 69%, 63% and 40%, respectively, with the overall regional response rate of 70%. In lower T status, undifferentiated carcinoma and primary tumor arising from the soft palate, higher response rates were obtained. The 5 year overall and disease-free survival rate were 56%, 55%, respectively. A better prognosis was obtained in early T tage(T1+T2)(p<0.01) and in patients without tumor extension into adjacent structures in carcinomas arising from tonsillar area(p<0.01). Though this study we suggest that, in terms of anatomical and functional preservation, radiation therapy seems to be an effective method for the primary treatment of patients with radiation therapy seems to be an effective method for the primary treatment of patients with oropharyngeal carcinoma.
Carcinoma ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Humans ; Korea* ; Oropharynx ; Palate, Soft ; Palatine Tonsil ; Prognosis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Tongue

BACKGROUND: To investigate the physical function of elderly people in Korea using quantitative and objective tools and to assess the impact of declined physical function on their quality of life. METHODS: The Korean Longitudinal Study on Health and Aging was designed as a population-based prospective cohort study on the health and aging of the elderly people in Korea aged 65 years and older. Within one city's central metropolitan area, 1,000 subjects including a simple random sample and an oldest-old subpopulation participated in a baseline study for one year. We evaluated the isokinetic peak torque of the knee extensors and flexors, grip force, and Short Physical Performance Battery (SPPB) and surveyed their daily physical activities and quality of life using the 36-Item Short Form Health Survey (SF-36). RESULTS: Overall, 676 subjects completed the evaluations of physical function and activity. The isokinetic torque of the knee extensors and flexors declined with age in both men and women. The women in the old-old (75-84 years) group showed lower SPPB and physical activity than women in the young-old (65-74 years) group, but these measures were maintained till age 85 in the men. SPPB and physical activity were significantly associated with the physical component scale (PCS) of the SF-36 in both men and women, while isokinetic torque was associated with PCS in women only. CONCLUSION: Physical performance and activity declined differently in Korean elderly men and women. Both these measures showed to be the main factors associated with quality of life.
Aged ; Aging ; Cohort Studies ; Female ; Hand Strength ; Health Surveys ; Humans ; Knee ; Korea ; Longitudinal Studies ; Male ; Motor Activity ; Prospective Studies ; Quality of Life ; Torque

OBJECTIVE: To evaluate the effects of rehabilitation-start critical pathway (Rehab-CP) based on modified Rankin scale (mRS) on stroke outcomes. METHOD: We compared stroke outcome between before and after the carrying into effect of Rehab-CP by retrospective medical record review. First-onset stroke patients admitted to neurology department, and transferred to rehabilitation department were included in the analysis. Hospital length of stay (LOS), home discharge rate, functional outcome such as mRS, Brunnstrom stage, Korean version of modified Barthel index, Fugl-Meyer scale, mini-mental status examination, Berg Balance scale at discharge and 3 months after onset were analyzed. RESULTS: Thirty-nine patients before the commencement of Rehab-CP and 46 patients after the Rehab-CP were compared. Length of stay in neurology department were 2.5 days shorter in after Rehab-CP group as compared to before Rehab-CP group (p=0.056) and total LOS were 1.9 days shorter in after Rehab-CP group (p=0.485), although this did not reach statistical significant difference. There were no differences in home discharge rate, and other functional outcomes between two groups (p>0.05). CONCLUSION: Rehabilitation-start CP based on mRS may decrease LOS without affecting functional outcome, and this result primarily comes from the shortening of stay in neurology department before transfer to rehabilitation ward.
Critical Pathways ; Humans ; Length of Stay ; Lifting ; Medical Records ; Neurology ; Retrospective Studies ; Stroke