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

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

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.
Deoxyglucose* ; Shock*

No abstract available.
Lichen Planus*

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

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*

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

No abstract available.
Carcinoma, Squamous Cell* ; Porokeratosis*

BACKGROUND: Changes in body fat distribution and antioxidant status can be shown in patients with coronary heart disease (CHD) and these changes may be more pronounced in CHD patients with than those without diabetes. This study was undertaken to determine the discrimination of body fat distribution, hormones and antioxidants among healthy male and CHD male patients with and without diabetes. METHODS: An oral glucose tolerance test was performed in 64 healthy males and 56 CHD male patients. CHD group was subdivided into patients with and without diabetes. Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, L1, L4 and mid portion of thigh and calf. Fasting serum levels of lipids, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: 28% of healthy males, 33% of CHD patients without diabetes and 15% of CHD patients with diabetes were current smokers. 56% of healthy males, 30% of CHD patients without diabetes and 46% of CHD patients with diabetes supplemented their diet with synthetic vitamin preparation. There were no differences among groups in means of age, body mass index and blood pressure. While CHD patients without diabetes showed an increase in visceral fat area at only L1 level, CHD patients with diabetes showed an increase at both L1 and L4 levels, compared with healthy males. CHD patients with diabetes showed the lowest mean value of HDL-cholesterol and testosterone. The mean response areaof insulin and C-peptide during OGTT was higher in CHD patients without diabetes than healthy males. CHD patients with and without diabetes showed higher plasma level of homocysteine and lower serum levels of IGF-1, superoxide dismutase (SOD) and beta-carotene, compared with healthy males. Serum levels of cryptoxanthin and lycopene were lower in CHD patients with diabetes than healthy males. CONCLUSION: Visceral fat accumulation, an increase in insuline and homocysteine levels and a decrease in IGF-1, SOD and beta-carotene levels in CHD patients indicate a difference in body fat distribution, hormones and antioxidant systems between CHD patients and healthy males. In addition, a further increase in visceral fat and a decrease in the serum levels of HDL-cholesterol, testosterone and carotenoids in CHD patients with diabetes show the increased risk in the simultaneous presence of CHD and diabetes. Thus, the lifestyle modification of these CHD patients such as quitting smoking, reducing abdominal fat and taking antioxidant-rich foods is recommended.
Abdominal Fat ; Adipose Tissue* ; Antioxidants ; beta Carotene ; Blood Pressure ; Body Fat Distribution* ; Body Mass Index ; C-Peptide ; Carotenoids ; Coronary Disease* ; Diet ; Discrimination (Psychology) ; Fasting ; Glucose Tolerance Test ; Homocysteine ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Intra-Abdominal Fat ; Life Style ; Male ; Plasma ; Smoke ; Smoking ; Superoxide Dismutase ; Testosterone ; Thigh ; Vitamins