OBJECTIVE: The main purposes of this study were to understand the correlations among Modified Barthel Index (MBI), Functional Independence Measure (FIM), and ESCROW (Environment, Social support, Cluster of family members, Resources, Outlook, Work or School status) Profile, and to establish the more appropriate assessment standards to check patient's conditions in the hospital and in their homes and society. METHOD: Thirty-four patients, who received the rehabilitation treatment and home visiting at the Presbyterian Medical Center, were evaluated for their functions by MBI, FIM, and ESCROW Profile. RESULTS: The mean scores of assessment measures by home visiting were all higher than in the hospital showing an improvement of the patients' functions after discharge from the hospital. The results of MBI and FIM in the hospital and home visiting showed a significant correlation, while the results of MBI and Cognitive FIM measure indicated a relatively low correlation coefficient. Although each result of MBI, FIM, and ESCROW provided a low correlation when the patients were in the hospital, the result for home visiting revealed very significant correlations. Especially, the items of environment, social support, outlook, and work status of ESCROW showed very significant correlations with MBI and FIM. CONCLUSION: The results showed that MBI and FIM measurements were very useful in observing and following up the functional conditions of the patients, while ESCROW profile was more appropriate to evaluate the familial and social rehabilitation status.
House Calls ; Humans ; Protestantism ; Rehabilitation* ; Social Environment

BACKGROUND: Spontaneous bacterial peritonitis(SBP) is an infection of ascitic fluid without any apparent intra-abdominal foci of sepsis. Although the definitive diagnosis of SBP requires a positive ascitic fluid culture, causative organisms are not isolated in up to 65% of patients with well defined SBP probably due to inadequate culture techniques. We compared two culture methods for ascites : conventional and blood culture method. METHODS: From June 1989 until December 1994, the blood culture method of ascitic fluid culture was performed(Group A). Ascitic fluid was inoculated at the bedside directly into one aerobic and one anaerobic BACTEC blood culture bottles. During the period from January to December 1995, ascitic fluid was processed by the conventional culture method of inoculating a sample of ascitic fluid on sheep blood agar, MacConKey agar, brucella agar and into thioglycolate broth(Group B). RESULTS: Ascites cultures were positive more frequently with the blood culture method(25 of 56, 44.6%) than with the conventional method(113 of 370; 30.5%) (P<0.05). Sixteen of the 56 patients in Group A had SBP and 29 had culture negative neutrocytic ascites(CNNA) while 66 of the 370 patients in Group B had SBP and 229 had CNNA The conventional method recovered more contaminating microorganisms than the blood culture method(17.7% vs 6.9%). CONCLUSIONS: The inoculation of ascitic fluid into the BACTEC blood culture bottles at the bedside is more sensitive than the conventional method of inoculation on solid media at the laboratory bench in the recovery of pathogens in SBP and should be used routinely for the optimum diagnosis of SBP.
Agar ; Ascites ; Ascitic Fluid* ; Brucella ; Culture Techniques ; Diagnosis ; Humans ; Peritonitis* ; Sepsis ; Sheep

Frey's syndrome is a fairly common sequelae of surgery, trauma and inflammation of the parotid gland. Some patients with Frey's syndrome may be socially compromised by their gustatory sweating and flushing. In the past three decades, a variety of surgical and pharmacological methods have been unsuccessful in alleviating these symptoms. And since misdirection of auriculotemporal secretomotor nerve fibers has been found to play an important role in the development of the syndrome, a study was initiated to attempt mechnical interference with regenerating nerve fibers. Therefore, the recent trend in management of Frey's syndrome has been the use of prophylactic procedures performed at the time of parotidectomy to prevent its symptoms postoperatively. An additional benefit of this approach is prevention of the typical cheek contour deformity after parotidectomy We reviewed our experience with interposition of a vascularized temporoparietal fascial flap between the parotid bed and overlying skin immediately after complete superficial parotidectomies to prevent Frey's syndrome and hollow contour defects. The result of seven consecutive attempts revealed it to be an effective technique, achieving both goals in all patients with minimal morbidity.
Cheek ; Congenital Abnormalities ; Flushing ; Humans ; Inflammation ; Nerve Fibers ; Parotid Gland ; Skin ; Sweating, Gustatory

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

No abstract available.
Lichen Planus*

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.
Carcinoma, Basal Cell* ; Cicatrix* ; Keratosis, Actinic* ; Laser Therapy*

No abstract available.
Deoxyglucose* ; Shock*

Accidental aspiration of barium contrast medium during the upper gastrointestinal study can occur in patients with swallowing disorder, especially in the elderly patients. We experienced a case of respiratory failure followed by death within a few hours in a 85 year-old patient after barium aspiration.
Aged ; Aged, 80 and over ; Barium* ; Deglutition Disorders ; Humans ; Respiratory Insufficiency*

No abstract available.
Acanthoma*