Visual Development of Healthy Full-Term Infants under 24 Months of Age Using the Preverbal Visual Assessment Questionnaire.

As visual perception development proceeds rapidly after birth, early detection of developmental maturity is required. Healthy infants do not have many opportunities for visual perception evaluation, so a reliable evaluation method is necessary. This retrospective study included 276 healthy full-term infants <24 months of age using the Preverbal Visual Assessment (PreViAs) questionnaire, which measures scores of subdivided age-groups for the global scores and 4 domains: visual attention (VA), visual communication (VC), visual-motor coordination (VMC), and visual processing (VP). Through this study, reference values and cutoff scores of the PreViAs questionnaire were presented, reliability was secured, and potential influencing factors of the PreViAs scores were analyzed. Using Cronbach's α coefficient, the global scores were 0.938, 0.781 for VA, 0.660 for VC, 0.874 for VMC, and 0.942 for VP. The internal consistency of the questionnaire was high in the global scores and 3 domains (VA, VMC, and VP). In infants under 12 months, the global scores and the VA, VMC, and VP domains showed positive association with gestational age, whereas the VC domain correlated with sex: which was found to be greater for females (p < 0.05). In those 12 month and above, no clinical factors were significantly associated with the PreViAs scores in all domains. The PreViAs questionnaire is a useful tool for visual assessment of healthy full-term infants under 24 months of age, suggesting reference values and cutoff scores according to age, and estimating the maturation age for visual perception development of each domain.

Visual assessment of preterm and full-term infants under the age of 12 months using the Preverbal Visual Assessment questionnaire.

BACKGROUND: Infants develop many complex visual competences within the first 12 months of life. Premature infants are at high risk for abnormal visual and neurological development. Clinical medical history or neurologic evaluation do not give enough information on visual maturation in infants under 12 months of age. AIMS: To compare visual maturation between preterm and full-term infants aged under 12 months, using the Preverbal Visual Assessment questionnaire (PreViAs). STUDY DESIGN: Retrospective cross-sectional analysis. SUBJECTS: Infants aged under 12 months, who visited our rehabilitation department for early intervention. Infants were categorized as either preterm or full-term, and assigned to one of three subgroups (0-4 months, 4-8 months, 8-12 months) according to corrected or chronological age. OUTCOME MEASURES: PreViAs scores. RESULTS: There were 200 preterm and 225 full-term infants analyzed. The mean global PreViAs scores among preterm infants were significantly lower than among full-term infants in all age groups (0-4 months: p = 0.033, 4-8 months: p = 0.005, and 8-12 months: p = 0.008). The mean global scores and four subdomain scores of the PreViAs were significantly lower (p < 0.001) in very preterm (under 32-weeks gestational age) and very low birth weight (under 1500 g birth weight) than in moderate-to-late preterm infants (between 32- to 37- weeks gestational age) and infants with birth weight above 1500 g. Patent ductus arteriosus, retinopathy of prematurity, and birth weight (percent) showed significant correlation with PreViAs global scores. CONCLUSION: PreViAs is a useful tool for visual assessment of infants under 12 months, especially in high-risk infants.

Anatomy of the nerves to the teres minor and the long head of the triceps brachii for electromyography.

BACKGROUND: We investigated the branching pattern and topographic anatomy of the nerves to the teres minor (Tm) and the long head of the triceps brachii (LHT) in relation to reference lines extending between surface landmarks, to identify the innervation patterns of, and the optimal needle placement points within, the Tm and the LHT. METHODS: The anatomical courses of the nerves to the Tm and the LHT were investigated in 37 upper limbs of fresh-frozen cadavers. Distances from the acromion to nerve penetration points, and crossing points of reference lines with the Tm and LHT were measured in 27 cadaveric upper limbs. RESULTS: The Tm was innervated by the axillary nerve in all specimens in three patterns, and the LHT was innervated exclusively by the radial nerve. Our dissection and measurements indicate that the midpoint of the reference line from the acromion to the inferior angle of the scapula is the optimal needle insertion point for the Tm. The target point for the LHT appears to be the one-third point of the reference line from the acromion to the medial epicondyle, or the two-thirds point of the reference line from the acromion to the axillary fold. CONCLUSIONS: We investigated the branching pattern of the nerves to the Tm and the LHT and propose optimal needle placement points for electromyography of the Tm and LHT.

Bilateral idiopathic neuralgic amyotrophy involving selective branches of peripheral nerves with a stepwise progression: A case report.

RATIONALE: This is a report about a rare case of idiopathic neuralgic amyotrophy (INA) involving selective peripheral nerve branches of bilateral upper extremities, which exhibited a stepwise progression. PATIENT CONCERN: A 66-year-old woman presented with paresis of selective branches of bilateral median nerves, followed by paresis of bilateral posterior interosseous nerve (PIN) 8 weeks later. DIAGNOSES: We diagnosed it as INA involving the selective motor branches of bilateral median nerves and bilateral PINs. Forearm magnetic resonance imaging combined with electrodiagnostic testing helped accurately identify the affected regions, and ultrasonography demonstrated a severe constriction of the left PIN. INTERVENTIONS: Intravenous methylprednisolone partially relieved the pain and paralysis. Surgical neurolysis of the constricted left PIN was done for persistent paralysis. OUTCOMES: The muscle power of the bilateral median nerve territories was recovered to nearly normal, but the muscle power of the left PIN territories remained at grade 1. LESSONS: This case indicates that INA can manifest as a multiple mononeuropathy involving individual fascicular levels of peripheral nerve branches with focal constriction, and electrodiagnostic study combined with forearm MRI and ultrasonography can help in identifying affected lesion and predicting the prognosis.

Lumbar Scoliosis in Patients With Breast Cancer: Prevalence and Relationship With Breast Cancer Treatment, Age, Bone Mineral Density, and Body Mass Index.

OBJECTIVE: To identify the prevalence of lumbar scoliosis in breast cancer patients and to investigate the potential risk factors of lumbar scoliosis. METHODS: A retrospective chart review was performed in breast cancer patients aged more than 40 years who underwent dual energy X-ray absorptiometry (DEXA) scanning between January 2014 and December 2014. We divided the patients into control and experimental groups in order to investigate the influence of breast cancer treatment. The curvature of the lumbar spine was measured by using the Cobb method on a DEXA scan. Scoliosis was defined by the presence of a curvature 10° or larger. The variables, including age, bone mineral density (BMD), body mass index (BMI), and breast cancer treatments, were also obtained from the medical chart. Prevalence of lumbar scoliosis was evaluated, and it was compared between the two groups. The relationships between lumbar scoliosis and these variables were also investigated. RESULTS: Lumbar scoliosis was present in 16 out of our 652 breast cancer patients. There was no difference in the prevalence of lumbar scoliosis between the control group (7/316) and the experimental group (9/336) (p=0.70). According to the logistic regression analysis, lumbar scoliosis had no significant association with operation, chemotherapy, hormone therapy, BMI, and BMD (p>0.05). However, age showed a significant relationship with prevalence of lumbar scoliosis (p<0.001; odds ratio, 1.11; 95% confidence interval, 1.054-1.170). CONCLUSION: Prevalence of lumbar scoliosis in patients with breast cancer was 2.45%. Lumbar scoliosis had no association with breast cancer treatments, BMD, and BMI. Age was the only factor related to the prevalence of lumbar scoliosis.