Despite advances in the diagnosis and management of rare diseases (RDs), there remains a tendency to overlook adult RD patients. In addition to the considerable number of adult-onset RDs, advances in the diagnosis and management of pediatric RDs have led to an increase in the survival of these patients into adulthood. Adult RDs exhibit distinct features from pediatric counterparts, necessitating careful consideration during medical assessments. Given the extended life expectancy of adult RD patients, precise diagnosis and management strategies can significantly enhance patient outcomes. This review aims to provide an in-depth exploration of the characteristics unique to adult RDs. Special emphasis will be placed on the importance of cascade screening and prenatal genetic testing in the context of adult RDs, highlighting the need for a comprehensive understanding of these aspects in clinical practice.
Objectives The present study retrospectively investigated clinical outcome of patients with structual scoliosis during Chuna treatment. Methods : The study population consisted of 34 patients(14 patients of adolescent and 20 patients of adult) who were diagnosised as scoliosis with radiological finding. All patients were treated with Chuna treatment, and after treatment, evaluated with radiological measurement by calculating the scoliosis correction angle from the Initial and follow-up spine AP and lateral views. Also the evaluation of clinical outcome was done twice pre and post treatment during this study. Results : The results were summarized as follows ; 1) The 85.3 percent of patients complained physical pain. and adult group had various painful lesion compared with adolescent group. 2) Adult group had treated $18.0{\pm}7.2$ times and adolescent group treated $13.5{\pm}5.7$ times with Chuna treatment. 3) Scoliotic angle is reduced in 92.9 percent of adolescent group and had all of adult group after Chuna treatment, especially, statistically significance appeared in adult group. 4) Adult group was superior to adolescent group in correctability and scoliotic angle change. 5) Correction effect was better in the group which initial scoliotic angle was lessor, or had more time of treatment. 6) According to grade of vertebral body rotation, scoliotic angle is larger and correctability was lower. Conclusions : Chuna treatment was efficacious against scoliosis. And it is necessary for adolescent scoliosis patient to be more carefully treated and observed.
Orthodontic treatment for middle-aged patients has become more commonplace with various reasons including improved socioeconomic status. Understanding of oral status and treatment modalities of middle-aged patients is mandatory for accurate diagnosis and proper treatment planning. This study investigated 100 consecutive patients aged 40s and 50s and 100 aged 20s who had been examined and diagnosed at the Department of Orthodontics, Chonnam National University Dental Hospital. The results were obtained as follows; 1. Gender distribution showed female outnumbered male patients in young-aged adult patients, but middle-aged patients showed similar male and female distribution. 2. The major concern seeking orthodontic treatment was esthetics not only in young-aged but also in middle-aged adult patients, and a number of middle-aged patients were concerned about oral health as well. 3. Considerable number of middle-aged patients were referred by other dental specialties while young-aged adult patients were more self-motivated for orthodontic treatment. 4. Middle-aged adult patients had more missing teeth and periodontal disease than young-aged adults. 5. The most frequently-observed problem was dental spacing in middle-aged patients while dental crowding in young-aged adult patients. Middle-aged patients showed higher prevalence of deep overbite and overjet while most of young-aged adults presented opposite direction of problem in overbite and overjet. 6. Limited orthodontic treatment was required rather than comprehensive treatment in middle-aged patients, and the most common tooth moving area was anterior part of dentition in case of limited treatment. Need of interdisciplinary therapy with other dental specialties was more common in middle-aged patients. 7. Intervention of specific technique such as invisible TP, passive bracketing, passive wire bonding, and lingual orthodontics was more required in middle-aged patients. Considering that middle-aged patients have different characteristics than young-aged adults, the results of the present study suggest that different treatment modalities are required in middle-aged orthodontic patients in order to manage them properly and efficiently.
Cytologlc evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 50 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency. The most common primary CNS neoplasm in children was medulloblastoma.
It could be suggested that adult orthodontic patients may have peculiar psychological features as well as different periodontal tissue conditions compared with adolescent patients. The aims of the present investigation were to explore the relationships between psychological characteristics and treatment compliance of patient to orthodontist and assistants (dental hygienists). Two types of locus of control data (I-score, Internal locus of control score ; E-score, External locus of control score) were obtained for 312 adult patients and 765 adolescents and then analyzed in relation to their sex and treatment compliance. In general, orthodontic patients showed higher I-score trends than ordinary persons and adult patients manifested higher I-score than adolescent patients. Unlike adult patients, female adolescent patients showed higher I-score than male adolescent patients. Adult patients with higher E-score and adolescent patients with higher I-score than their counter-part subgroup were classified into more compliant group. Orthodontist performed more generous decision about patients' compliance than assistants. The results of this study also suggest that psychological survey in orthodontic field could comprise useful diagnostic criteria.
Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.
Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.
Joh, Young Hoo;Park, Dong Ha;Lee, Il Jae;Park, Myong Chul
Archives of Craniofacial Surgery
/
v.16
no.2
/
pp.88-91
/
2015
In adult congenital muscular torticollis (CMT) patients, physical therapy is not as effective because the development of sternocleidomastoid muscle (SCM) muscle is complete. While surgical release can address CMT in adult patients, the risk of general anesthesia and visible postoperative scar is a concern, expecially in patients with mild symptoms. In this paper, we report our experience in treating such patients with minimal-incision myotomy under local anesthesia. A review was performed for all adult patients who had undergone the simple myotomy procedure. Surgical indication was reserved for patients with mild fibrotic band in the SCM muscle with minimal lengthdiscrepancybetween the muscles. All patients had recognizable head tiltand palpation of fibrotic band on affected side of the neck. Surgical details are described in the main body of text. Three female patients had undergone the procedure. Torticollis was resolve in all patients with complete restoration of ranage of motion. There were no postoperative complications, and patient satisfaction was high. We have reported three cases of mild CMT in adult female patients, who had undergone minimal-incision myotomy under local anesthesia. Outcomes were satisafactory with no morbidity to report. With careful patient selection, this method offers an alternate treatment option for adult CMT patients with mild symptoms.
Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.
The purpose of this study was to examne the relationship between sex-role-identity and life adjustment which adult patients perceive by means of the analysis of the relationship between the sex-role-identity and life adjustment which are perceived by adult patients who are hospitalized. The primary purpose of this study is to investigate how the adult patients describe their own Sex role-identity. Sceondary purpose is to find out whether their Sex role-identity is related to life adjustment and which life circumstances. If any are associated with Sex role identity. 207 adult patients who were older than 30 years living under 65 years were admitted to the hospital in Seoul. Were interviewed with measures including the Bem Sex Role Inventory short Form. Life adjustment and current life situation. For data analysis, X$^2$-test, ANOVA, and Scheffe test were used. The results are summarized as follows ; (1) Most adult patients described androgynous Sex role-identity. (2) Sex role-identity differentiated significantly life adjustment. (3) Perceived Sex role identity was related to the Several dimension of life sityation such as marital status family construction activity. By the result of this study, the present writer is to suggest as follows ; Firstly, in the aspect of the study of nursing the many -sided and desirable study on the relation between the sex-role-identity life ajustment, and the study which a nurse can control and prevent the anxiety of adult patients by means of examining the measure and the cause of the emotional support on a patient must be accomplished. Secondly, in the aspect of the aspect of the practical affairs of nursing the practical effort which puts emphasis on the whole personal nursing in the performance of the duty, and the institutional support in the nursing administration must be planned in order to increase the efficiency of the nursing service by promoting the whole -personal nursing role of a nurse.
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