Findings of Eye Screening Examinations with Wide-Field Digital Imaging System in Healthy Newborns

PURPOSE: To present the results of eye screening examinations using RetCam in healthy newborns. METHODS: Eye screening examinations were performed using the RetCam wide-field digital imaging system (Clarity Medical System, Pleasanton, CA, USA), as requested by parents, on healthy newborns within a week after birth in an obstetrics and gynecology hospital between June 2012 and September 2014. During the examination, photographs were taken showing red reflex and the fundus. The reading was conducted by a pediatric ophthalmologist. RESULTS: The examinations included a total of 10,023 newborn babies, and abnormalities were discovered in 2,916 patients (29.09%). The most commonly found abnormality was retinal hemorrhage, which was discovered in 2,796 babies (27.89%) and 471 patients showed a large amount of bleeding or macular hemorrhage. In 71 patients (0.7%), ophthalmologic examination was recommended after newborns presented with one of the following conditions: congenital cataracts, retinoblastoma, persistent hyperplastic primary vitreous, vitreous hemorrhaging, persistent pupillary membrane, choroidal nevus or albinism. Due to unclear photographs, 85 eyes of 49 patients (0.48%) could not be read. CONCLUSIONS: Ophthalmologic screening using RetCam is a safe, simple and useful technique for discovering ophthalmologic abnormalities. Additionally, when abnormalities are suspected, the role of a pediatric ophthalmologist is increasingly important in helping patients receive appropriate ophthalmologic treatment. Furthermore, retinal hemorrhage, which occurred in the majority of all observed abnormalities, requires further investigation to examine the possibilities of amblyopia in cases with a large amount of bleeding or macula involvement.

Prevalence and Risk Factors of Early-Stage Age-Related Macular Degeneration in Patients Examined at a Health Promotion Center in Korea

We evaluated the prevalence and risk factors for early age-related macular degeneration (AMD) in Koreans 50 yr of age or older who were examined at a single health promotion center. We retrospectively reviewed the records of 10,449 subjects who visited the center over a 6-month period. Fundus photography was performed on all subjects, and systematic risk factor analysis was conducted using a structured questionnaire. All patients (n = 322) were initially diagnosed with drusen or early AMD using fundoscopy; the control group (n = 10,127) were those yielding normal fundoscopy findings. The age- and gender-adjusted prevalence of early AMD was 3.08%. Advanced age, male gender, smoking status, hyperlipidemia, working outdoors, and residence in rural areas were all significantly associated with an increased risk for development of early AMD. Higher-level ingestion of fruit or herbal medication and an increased amount of exercise were associated with a lower risk of early AMD development. In our Korean cohort, consisting principally of relatively healthy, middle-class urban adults, the prevalence of early AMD was 3.08% that is similar to that reported in earlier epidemiological studies. Several modifiable risk factors such as smoking and hyperlipidemia are associated with the prevalence of early AMD in our cohort.

Interval Breast Cancer / 한국유방암학회지

PURPOSE: The aim of this research was to reduce the interval of breast cancer by reviewing and analyzing its occurrence METHODS: Of the 311 breast cancer patients observed at our clinic between 1998 and 2002, the 14 that had developed breast cancer within the 24 months of their previous screening examination were the subjects of this study. RESULTS: Ductal carcinoma in situ (DCIS) was found in 3 patients revealing changes of, or newly developed, microcalcification. 5 patients, believed to have benign lesion, where follow-up checking was recommended, were later found to have breast cancer. There were 3 failed cases from early diagnosis of cancer due to a dense breast. In 2 cases, the cancer was thought to have progressed due to the lack of an active recommendation for a biopsy, even after suspicious abnormal findings were observed. For all the other cases, the cancer was detected early during routine follow-ups. CONCLUSION: In case of dense breast, intense and thorough examinations including ultrasonography should be recommended because dense breast may prevent the detection of small masses. Especially, it is a fact in Korean women who carry dense breasts in many cases. Even if mass or microcalcification is thought to be benign, a biopsy should be encouraged. For a suspicious lesion, a biopsy should be recommended to a greater extent than the other follow-up measures. Routine screening examinations should be recommended once a year, but can be performed between 6 months and 2 years depending on the patients' age or degree of dense breast.

Screening Examination for Retinopathy of Prematurity with Dual Parameter Protocol

So far most screening protocols for retinopathy of prematurity (ROP)have used a single parameter such as chronological age or postconceptional age. We attempted to test a screening protocol for ROP using dual parameter, chronological age and postconceptional age, to determine whether it could reduce the number of screening examinations safely.We retrospectively reviewed medical records of 23 infants (43 eyes)who had undergone laser treatment for threshold ROP.Mean gestational age at birth was 28 weeks and mean birth weight was 1055 gms.The mean age at which the study infants reached threshold ROP was 10 weeks in chronological age and 38 weeks in postconceptional age.Screening examinations as early as chronological age of 7 weeks or postconceptional age of 35 weeks could detect all threshold ROP while reducing the number of unnecessary early examinations.

Screening Examination of Breast Cancer: Review of the Recommended Guidelines / 영남의대학술지

BACKGROUND: Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. MATERIALS AND MATHODS: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows: Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefullness in detecting breast cancer in patients under 35 years and over 60 years of age. RESULTS: The mammographic results are as follows: 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows: 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breas cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. CONCLUSION: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors inyoung women and may correlae with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

The Relationship between Loewenstein Occupational Therapy Cognitive Assessment and Functional Assessments in Brain-Injured Patients

The Loewenstein Occupational Therapy Cognitive Assessment(LOTCA) battery provides an initial profile of the cognitive abilities of the brain-injured patient that can be used as a starting point for occupational therapy intervention and as a screening test for further assessment. Reliability and validity for the LOTCA have been reported in the literatures. This study investigated the relationship between LOTCA scores and functional assessments in 34 brain-injured patients, consisting of 21 stroke patients and 13 traumatic brain injury patients. Subjects were administered the LOTCA and, as functional assessment tools, the Cognitive Capacity Screening Examination(CCSE) and the Modified Barthel Index(MBI) upon referral to occupational therapy initially, and again at discharge. The initial and the last LOTCA scores were significantly related to the initial and the last CCSE scores and the MBI scores, respectively, in brain-injured patients. Each of the last LOTCA scores, CCSE scores, and MBI scores increased significantly compared to the initial scores. There were no significant differences in the initial and the last LOTCA scores, CCSE scores, and MBI scores between stroke patients and traumatic brain injury patients. Greater LOTCA gain was significantly related to greater MBI gain. These results suggest that the LOTCA battery for brain-injured patients is related not only to cognitive function, but also to functional evaluation as activities of daily living and functional recovery at discharge.