The Validity of the Bayley-III and DDST-II in Preterm Infants With Neurodevelopmental Impairment: A Pilot Study

OBJECTIVE: To identify the usefulness of both the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) and Denver Developmental Screening Test II (DDST-II) in preterm babies with neurodevelopmental impairment, considering the detection rate as regulation of criteria. METHODS: Retrospective medical chart reviews which included the Bayley-III and DDST-II, were conducted for 69 preterm babies. Detection rate of neurodevelopmental impairment in preterm babies were investigated by modulating scaled score of the Bayley-III. The detection rate of DDST-II was identified by regarding more than 1 caution as an abnormality. Then detection rates of each corrected age group were verified using conventional criteria. RESULTS: When applying conventional criteria, 22 infants and 35 infants were detected as preterm babies with neurodevelopmental impairment, as per the Bayley-III and DDST-II evaluation, respectively. Detection rates increased by applying abnormal criteria that specified as less than 11 points in the Bayley-III scaled score. In DDST-II, detection rates rose from 50% to 68.6% using modified criteria. The detection rates were highest when performed after 12 months corrected age, being 100% in DDST II. The detection rate also increased when applying the modified criteria in both the Bayley-III and DDST-II. CONCLUSION: Accurate neurologic examination is more important for detection of preterm babies with neurodevelopmental impairment. We suggest further studies for the accurate modification of the detection criteria in DDST-II and the Bayley-III for preterm babies.

Change of Bone Mineral Density and Relationship to Clinical Parameters in Male Stroke Patients

OBJECTIVE: To investigate the clinical characteristics that significantly contribute to a decreased bone mineral density (BMD), the BMD changes and clinical characteristics of men who experienced a stroke between the ages of 50 years and 65 years were studied between 3 months and 4 months after the stroke. METHODS: Subjects had a brain hemorrhage or a cerebral infarction. Only men aged 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis. All subjects underwent a BMD test between 3 months and 4 months after their strokes. Also, patients with a medication history that might have caused a secondary osteoporosis before a stroke were excluded. RESULTS: The BMD for the lumbar spine and hemiplegic side of the femoral neck correlated significantly with the results of the manual muscle test (MMT) of the hemiplegic lower extremity and the Modified Barthel Index (MBI) score. This result suggests that the immobility from the decreased muscle strength and the weakened daily functionality might have reduced the BMD. According to a multiple linear regression analysis, the MBI score is significantly correlated with the lumbar BMD. The BMD of the hemiplegic femoral neck is significantly correlated with the MMT and the MBI score. CONCLUSION: This study showed that BMD monitoring should be considered in male stroke patients, especially for patients with a high dependency in daily functions and a decreased muscle strength in the hemiplegic lower extremity.

A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

OBJECTIVE: To support the establishment of lymphedema education plans and the actual practice of education by investigating the current lymphedema awareness status of Korean breast cancer patients. METHODS: cross-sectional population survey was conducted in 116 breast cancer patients in the Busan-Gyeongnam area. The survey included questions regarding demographic characteristics, breast cancer-related lymphedema (BCRL) risk factors, and characteristics and treatments of the disease. Some of the items were scored to determine the level of awareness. The items that affect the awareness of lymphedema were investigated by statistical analysis. RESULTS: Eighty-one of the 116 patients answered that they had heard of lymphedema, and 30 of them (25.86%) had received explanations about the possibility of lymphedema before surgery. Only 20 patients (17.25%) knew that lymphedema is not a completely curable disease, 24 patients (20.68%) thought that lymphedema does not require any treatment, and only 56 patients (48.27%) knew that lymphedema is treated in the Department of Rehabilitation Medicine. The main factors that affected patients' awareness of lymphedema were their age, chemotherapy, duration of breast cancer, and lymphedema treatment history. CONCLUSION: The majority of survey participants who were breast cancer patients either lacked awareness of BCRL or had false ideas about it, indicating the inadequate level of education provided for lymphedema. In the case of breast cancer diagnosis, early and continuous education for future management is essential, and the framework for the provision of education including education protocols related to age, disease duration, and lymphedema treatment is needed.

The Actual Implementing Status of the Preplacement Medical Examination after the Annulment of the Preemployment Medical Examination / 대한산업의학회지

OBJECTIVES: We investigated the status of the preplacement medical examination after the revision of the industrial safety and health law on Oct. 7, 2005 by the Ministry of Labor. METHODS: Preplacement medical certificates of 6,507 recruits issued by two hospitals in Busan, Kyeongnam Province from Jan. 1 to Dec. 31, 2006 were reviewed. Telephone interviews were performed to the recruits with disease and self-reported questionnaires were administrated to health and safety personnel from May 1 to Sep. 30, 2007. RESULTS: Interviews were conducted with 185(56.1%) recruits with disease, 51(27.4%) of whom were rejected for employment due to the preplacement medical certificate. The questionnaire survey for the health and safety personnel revealed that 39(22.9%) personnel were unaware of the annulment of the preemployment medical examination. Eighty(48.8%) of the health and safety personnel answered that they performed a preplacement medical examination after employment, and 63(37.3%) made a practical application of the workers' placement. The recruits with chronic conditions were refused employment: 20 (11.8%) due to hypertension, 21(12.4%) diabetes mellitus and 22(13.0%) hyperlipidemia. The recruits with work-related diseases were also refused employments: 76(44.4%) due to lumbar spine abnormality and 75(43.8%) hearing loss. CONCLUSIONS: Despite the annulment of the pre-employment medical examination, a preplacement medical examination was often used to discriminate among healthy and diseased recruits. Employers must respect the law for the point of time of the preplacement medical examination and the payment of cost. The government should publicize the revision of the objectives of the law. We suggest that health professionals elucidate the job fitness through the development of the assessment tools and maintain the confidentiality of recruits.