Hoehn and Yahr (H-Y) staging and the Unified Parkinson's Disease Rating Scale (UPDRS) are commonly used for clinical evaluation of Parkinson's disease (PD). Iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and single photon emission computed tomography (SPECT) are useful for the differential diagnosis of PD from other Parkinsonism. Additionally, gravicorders or gait analysis systems and upper limb voluntary movement analyzing systems may be helpful for the quantitative evaluation of parkinsonian symptoms. From the early stage of H-Y, PD patents should be informed and coached about rehabilitation programs by expert therapists. Educational and health promotional gymnastics are the main programs used in stage I and II. Muscle stretching exercises, postural exercises, balance training and activity/instrumental-activity training are needed in stage III and IV. Finally, preventing changes due to disuse and lightening the caregiver load are the main purpose of rehabilitation in stage V. It is very important to understand not only the patients' clinical stages but also their personal situations such as their life-stage and life-style and their family situation. Home visit rehabilitation is useful to discover the actual daily living problems faced by patients and their families. Then, evaluation according to the International Classification of Functioning, Disability and Health (ICF) is available to clarify and solve the problems. With the progression of the clinical stage, patients need many social resources. Therefore, medical social workers (MSW) should be a part of the rehabilitation team to support the home care of patients from their incipient stage.

Introduction : Catheter which strays in the ascending lumbar vein during femoral vein catheterization can cause complications such as retroperitoneal hematoma. However, not much is known of this phenomenon.
Methods : We retrospectively studied 107 patients who had indwelling femoral vein catheter in our hospital between March 2013 and April 2011.
Results : The catheter went straying in the ascending lumbar vein 11/110 times (10.0%) , 5/34 times (14.7%) on the left side, and 6/76 times (7.9%) on the right side. The possibility of the catheter straying was maximum when the catheter was displaced laterally or raised sharply towards the caudal side, as seen through abdominal radiographic examination.
Conclusion : Femoral central venous catheter misplacement in the ascending lumbar veins is fairly common. Tests such as additional abdominal CT or radiographs should be conducted if misplacement is suspected.