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

Nickel is widely known as a common source of contact dermatitis and nickel sensitivity amounts to nearly 10 percent of allergic contact dermatitis patients. Common sources of nickel dermatitis are well known as necklaces, watches, rings, hooks, earrings and spectacle frames. Recently, we have seen five cases of nickel dermatitis the suspected sources of which were metal spectacle frames. The interim patch test result in our occupational and environmental clinic suggests that the metal spectacle frame is one of the most common sources of nickel dermatitis. Out of 84 medical students 27 wore metal spectacle frames. We have done a dimethylglyoxime spot test to the metal spectacle frames and got a positive result in 12 out of 27(44.4%). We conclude that metal spectacle frame seems to be one of the dominant causes of nickel dermatitis and it will be an increasing problem in our society.
Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Ear ; Humans ; Nickel ; Patch Tests ; Students, Medical

We evaluated the clinical manifestations of 326 patients of vitiligo who had visited Seoul National University Hospital. The results were as follows : 1) There were 141 males (43.3%) and 185 females (56.7%). 2) The mean age of onset was 19.6 years (male : 18.3 years, female : 20.6 years). 3) The mean age at the first visit wss 23.9 years (male : 22.5 years, female : 24.9 years). 4) Duration of disease was less than 2 year in 156 patients (47.9%). 5) The most common site of initial involvement was face (36.2%). The common sites of involvement were face (55.2), abdomen (32.5%), neck (26.7%) and scalp (24.8%) in decreasing order of frequency. 6) There were 167 cases (51.2%) of generalized type, 118 cases (36.2%) of localized type, 31 cases (9.5%) of dermatomal type and 10 cases (3.1) of halo nevus. The most frequent site of dermatomal type was neck. Gray hair was noted in 91 cases (27.9%) and mucosal involvement was present in 43 cases (13.2%). 7) Family history was obtained in 24 cases (7.4%). Koebner phenomenon was present in 48 cases (14%). There were no precipitating factors in 309 cases (94.8%) prior to development of vitiligo. 8) The associated diseases were 1 csse of thyroiditis and 3 cases of alopecia areata.
Abdomen ; Age of Onset ; Alopecia Areata ; Female ; Hair ; Humans ; Male ; Neck ; Nevus, Halo ; Precipitating Factors ; Scalp ; Seoul ; Thyroid Gland ; Thyroiditis ; Vitiligo*

No abstract available.
Chylothorax* ; Lymphangiectasis*

No abstract available.
Bronchopulmonary Sequestration* ; Lung* ; Ultrasonography, Prenatal*

No abstract available.

Febrile ulceronecrotic PLEVA is an unusually severe from of PLEVA, characterized by the sudden onset of diffuse ulceronecrotic eruption aasociated with high fever. A mild eruption precede the acute fulminating course, We observed a 13-year-old boy presenting the form of febrile ulceronecrotic PLEVA. The histologic features were those of PLEVA. He received the systemic corticosteroids with aupportive care. To recognize this disorder is important because of a possibly fatal outcome, So close attention and vigorous therapy are necessary.
Adolescent ; Adrenal Cortex Hormones ; Fatal Outcome ; Fever ; Humans ; Male ; Pityriasis Lichenoides* ; Pityriasis*

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

Nine patient with paralyzed strabismus of large deviation(Seven patients with lateral rectus or medial rectus muscle palsy and two patients with double elevator palsy) had full tendon transposition procedure. If remained strabismus was large postoperatively, recession of anatagonist of paralyzed muscle and botulinum toxin infection was performed respectively. Five patients achieved single binocular vision within central 10 degree of visual field. And six patients achieved less than 10 prism diopter of deviation in primary position. Our method compares favorably with previously descrived transposition procedure for muscle palsy in terms of the amount of correction and the extent of the window of single binocular vision with low risk of anterior ischemia syndrome.
Botulinum Toxins ; Elevators and Escalators ; Humans ; Ischemia ; Paralysis ; Strabismus* ; Tendons* ; Vision, Binocular ; Visual Fields

Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection.
Axilla ; Breast ; Breast Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eating ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Snakes ; Sparganosis* ; Water Pollution