PURPOSE: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. METHOD: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. RESULT: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). CONCLUSION: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care facilities in Korea.
Aged ; Female ; Health Resources/*utilization ; Homes for the Aged/*economics ; Humans ; Korea ; Long-Term Care/*economics ; Male ; Nursing Homes/*economics ; Patients/*classification ; *Prospective Payment System

OBJECTIVE: Multiple birth implicates the important health and social problems such as preterm birth, low birth weight, high perinatal mortality, and increased medical cost. This study was performed to investigate the multiple birth rate in Korea using the birth certificate data. METHODS: Retrospective review and analysis of data from Korean birth certificate in 1996. RESULTS: Multiple birth rate was 1.4% of total births(683,043 cases). Mean birth weight was 3.29+/-0.47kg for singleton birth and 2.57+/-0.58kg for multiple birth. Mean gestational age was 39.56+/-1.32 weeks for singleton birth and 37.47+/-2.41 weeks for multiple birth. Rate of low birth weight (< 2.5kg) was 14 times higher for multiple birth compared with that of singleton birth, and rate of preterm birth(< 37 weeks) was 10 times higher. Multiple logistic regression analysis was performed to examine the relationship between multiple birth and selected variables including maternal age, job and birth order. As the odds ratio(OR) was 2.47(95% CI: 2.34 - 2.59, p<0.001) for the second birth, and 5.31(95% CI: 4.99 - 5.65, p<0.001) for the third and over birth compared with the first birth, there was a significant correlation between multiple birth and birth order. CONCLUSIONS: Based on the birth certificate data in 1996, the incidence of twin and higher order multiple birth was 1.7%, and a significant correlation between multiple birth and birth order was revealed. Further studies are necessary to elucidate the etiology and prognosis of multiple birth and the developmental problems from birth to adolescence.
Adolescent ; Birth Certificates* ; Birth Order ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Logistic Models ; Maternal Age ; Multiple Birth Offspring* ; Parturition* ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Prognosis ; Retrospective Studies ; Social Problems ; Twins

PURPOSE: The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. MATERIALS AND METHODS: We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. we evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. RESULTS: Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear, which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. CONCLUSION: Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present.
Animals ; Anterior Cruciate Ligament* ; Contusions ; Femur ; Horns ; Humans ; Knee Injuries ; Knee Joint* ; Knee* ; Ligaments ; Magnetic Resonance Imaging*

PURPOSE: To evaluate the therapeutic effect and difficulty of embolization of pseudaneurysm of the splanchnic artery. MATERIALS AND METHODS: Between February 1988 and June 1996, we employed transcatheter embolization to treat a total of eleven patients with splanchnic artery pseudoaneurysm by transcatheter embolization. Eight were males and three were females ; their ages ranged from four to 70 years (mean 44). Three patients had previously been operated on, three had undergone biopsy, and on three, percutaneous transhepatic biliary drainage had been performed ; one had been involved in a traffic accident and one had suffered a gun-shot wound. All patients underwent diagnostic angiography and superselective embolization using a 3F microcatheter. We used Gelfoam with microcoil four times, microcoil twice, Gelfoam once, Gelfoam with ethanol once, a detachable balloon once, and Ivalon once. RESULTS: Arteries in which pseudoaneurysm had occurred were as follows: renal, four, hepatic, three; gastroduodenal, two ; superior mesenteric, one. Nine patients underwent one session of procedure and two underwent two session. Nine patients (82%) were treated successfully and without complication by embolization. Two patients failed to embolize due to vascular spasm and tortuosity in one and a wide aneurysmal neck in the other ; one of these died six days later and the other was operated on. CONCLUSION: Although there are therapeutic difficulties in cases of vascular spasm, tortuosity, or a wide aneurysmal neck, embolization of pseudoaneurysm of the splanchnic artery is a safe and effective life-saving procedure.
Accidents, Traffic ; Aneurysm ; Aneurysm, False* ; Angiography ; Arteries* ; Biopsy ; Drainage ; Ethanol ; Female ; Gelatin Sponge, Absorbable ; Humans ; Male ; Neck ; Spasm ; Wounds and Injuries

OBJECTIVE: To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. MATERIALS AND METHODS: We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61yrs.) (13 cases dignosed as discitis and 17 cases as normal) who previonsly underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction, and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5T MRI. RESULTS: Among 14 out of 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement, and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similiar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. CONCLUSION: The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.
Discitis* ; Diskectomy ; Humans ; Intervertebral Disc* ; Laminectomy ; Magnetic Resonance Imaging ; Retrospective Studies

We analyzed the MR findings of spinal epidural mass in 23 patients retrospectively. MR images were performed at 1.5T unit. The lesions were confirmed as metastasis(12 cases), lymphoma (2 cases), leukemia(1 cases), multiple myeloma(2 cases), meningioma(3 cases), neurofibroma(1 case), dysraphism with lipoma(1 case) and lipomatosis(4 cases), Most MRI examinations consisted of T1, proton density and T2 weighted sagittal imaging of the spine, with additional pulse sequences or image planes as needed for clarification. The level of the spinal epidural mass was cervical spine level in 2 cases, thoracic in 15 cases, lumbar in 7 cases, and sacral in 2 cases. The location of epidural mass within the spinal canal was eccentric in 20 cases, multiple in 2 cases, and encircled in 4 cases. Paraspinal mass was seen in 11 cases. Signal intensity of epidural mass was variable. The marrow of spine revealed low signal intensity(SI) on TIWI and high SI on T2WI in 14 cases. In conclusion, MRI is a useful diagnostic tool for the evaluation of spinal epidural mass.
Bone Marrow ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Protons ; Retrospective Studies ; Spinal Canal ; Spine

PURPOSE: To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MATERIALS AND METHODS: MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degrees of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior middle and inferior portions. MR findings were compared with operative findings. RESULTS: There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with par In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt Switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of AC/. CONCLUSIONS: MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear.
Anterior Cruciate Ligament ; Humans ; Knee Joint ; Ligaments ; Magnetic Resonance Imaging*

No abstract available.
Birth Certificates* ; Parturition*

No abstract available.
Placenta* ; Trophoblasts*

Although cystic neoplasms of the pancreas are an uncommon disease, it occures often enough that proper sugicalmanagement depends on accurate preoperative diagnosis. It is very difficult to diagnose accurately by conventionalradiological methods alone. Angiographic findings are fairly characteristic for these tumors, but they are in noway specific. The imaging characteristics of ultrasonography and CT are particularly useful in the diagnosis ofthis particular tumors. This report presents an analysis of 2 cases of cystadenoma and 3 cases cystadenocarcinomaexamined by ultrasonography and CT. Ultrasonography findings are complelx multicytic mass in the pancreas withthick irregular wall, daughter cyst, septa and solid component. These septa and solid component are highlyechogenic if the tumor is mucin producing. Computed tomographic findings are large cyst possessing irregular thickwall, solid component and septa which are enhanced by contrast infusion. Punctate or curvilinear calcification isseen occasionally. Tortuous or beaded vascular collaterals are seen around the cyst. On the other hand, pseudocystis usually a single cyst possessing thin smooth wall, and solid component or septa are unusual in pseudocyst.
Cystadenocarcinoma ; Cystadenoma ; Diagnosis ; Hand ; Mucins ; Nuclear Family ; Pancreas ; Ultrasonography