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Review Article
Change in the treatment strategy for pediatric Crohn's disease
Mi Jin Kim, Yon Ho Choe
Clin Exp Pediatr. 2010;53(9):830-833.   Published online September 13, 2010

Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as...

Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders
Jae Hong Park
Clin Exp Pediatr. 2010;53(9):824-829.   Published online September 13, 2010

The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. Skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every...

General considerations and updates in pediatric gastrointestinal diagnostic endoscopy
Yong Joo Kim
Clin Exp Pediatr. 2010;53(9):817-823.   Published online September 13, 2010

Gastrointestinal and colonic endoscopic examinations have been performed in pediatric patients in Korea for 3 decades. Endoscopic procedures are complex and may be unsafe if special concerns are not considered. Many things have to be kept in mind before, during, and after the procedure. Gastrointestinal endoscopy is one of the most frequently performed procedure in children nowadays, Since the dimension...

Disease-specific pluripotent stem cells
Hoon-Chul Kang
Clin Exp Pediatr. 2010;53(8):786-789.   Published online August 31, 2010

Induced pluripotent stem (iPS) cells are generated by epigenetic reprogramming of somatic cells through the exogenous expression of transcription factors. Recently, the generation of iPS cells from patients with a variety of genetic diseases was found to likely have a major impact on regenerative medicine, because these cells self-renew indefinitely in culture while retaining the capacity to differentiate into any...

Multimodal neuroimaging in presurgical evaluation of childhood epilepsy
Da Eun Jung, Joon-Soo Lee
Clin Exp Pediatr. 2010;53(8):779-785.   Published online August 31, 2010

In pre-surgical evaluation of pediatric epilepsy, the combined use of multiple imaging modalities for precise localization of the epileptogenic focus is a worthwhile endeavor. Advanced neuroimaging by high field Magnetic resonance imaging (MRI), diffusion tensor images, and MR spectroscopy have the potential to identify subtle lesions. 18F-FDG positron emission tomography and single photon emission tomography provide visualization of metabolic alterations...

Renal fibrosis
Min Hyun Cho
Clin Exp Pediatr. 2010;53(7):735-740.   Published online July 31, 2010

Renal fibrosis, characterized by tubulointerstitial fibrosis and glomerulosclerosis, is the final manifestation of chronic kidney disease. Renal fibrosis is characterized by an excessive accumulation and deposition of extracellular matrix components. This pathologic result usually originates from both underlying complicated cellular activities such as epithelial-to-mesenchymal transition, fibroblast activation, monocyte/macrophage infiltration, and cellular apoptosis and the activation of signaling molecules such as...

Genetics of kidney development: pathogenesis of renal anomalies
Hyewon Hahn
Clin Exp Pediatr. 2010;53(7):729-734.   Published online July 31, 2010

Congenital anomalies of the kidney and urinary tract (CAKUT) account for more than 50% of abdominal masses found in neonates and involve about 0.5% of all pregnancies. CAKUT has a major role in renal failure, and increasing evidence suggests that certain abnormalities predispose to the development of hypertension and cardiovascular disease in adulthood. To understand the pathogenesis of human renal...

Pulmonary hypertension in infants with bronchopulmonary dysplasia
Gi Beom Kim
Clin Exp Pediatr. 2010;53(6):688-693.   Published online June 23, 2010

An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type...

Practical stepwise approach to rhythm disturbances in congenital heart diseases
June Huh
Clin Exp Pediatr. 2010;53(6):680-687.   Published online June 23, 2010

Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects,...

Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management
Jae Young Lee
Clin Exp Pediatr. 2010;53(6):669-679.   Published online June 23, 2010

The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis...

Update on pertussis and pertussis immunization
Jung Yun Hong
Clin Exp Pediatr. 2010;53(5):629-633.   Published online May 31, 2010

Pertussis is a highly contagious respiratory tract disease caused by Bordetella pertussis infection. The clinical manifestation of this infection can be severe enough to cause death. Although pertussis has been supposed to be a vaccine-preventable disease ever since the widespread vaccination of children against pertussis was started, since the 1990s, cases of pertussis and related fatalities are on the rise,...

Reemergence of mumps
Kyong Min Choi
Clin Exp Pediatr. 2010;53(5):623-628.   Published online May 31, 2010

The mumps virus is a single-stranded, non-segmented, negative-sense RNA virus belonging to the Paramyxoviridae family. Mumps is characterized by bilateral or unilateral swelling of the parotid gland. Aseptic meningitis is a common complication, and orchitis is also common in adolescents and adult men. Diagnosis is based on clinical findings, but because of high vaccination coverage, clinical findings alone are not...

Enterovirus 71 infection: An experience in Korea, 2009
Kyung Hyo Kim
Clin Exp Pediatr. 2010;53(5):616-622.   Published online May 31, 2010

Enterovirus 71 (EV71) has been recognized as a frequent cause of epidemics of hand-foot-and-mouth disease (HFMD) associated with severe neurological symptoms. In the spring of 2009, HFMD was epidemic in Korea. Severe cases with complication, including death, have been reported and it has become a public health issue. Most symptomatic EV71 infections commonly result in HFMD or herpangina. These clinical...

Late physical effects of childhood cancer survivors
Young-Ho Lee
Clin Exp Pediatr. 2010;53(4):477-480.   Published online April 15, 2010
Advances in research and medical and supportive care have contributed to a growing population of adults formerly treated for childhood cancer. History of cancer and its therapy can have significant life-long health implications. Late effects of cancer therapy can be insidious on onset, occur outside the pediatric age, and contribute to premature morbidity and mortality. In this review, I have focused on the...
Psychosocial aspects of childhood cancer survivors
Jong Jin Seo
Clin Exp Pediatr. 2010;53(4):471-476.   Published online April 15, 2010
The majority of childhood cancer survivors and their families will be psychologically healthy, but may desire and benefit from preventive care. A significant portion of the survivor population will be psychosocially distressed in various aspects by their harsh experience of long cancer treatment, and may warrant professional intervention and treatment. Pediatricians should be aware of the late psychological effects that can occur a...
Long-term follow-up study and long-term care of childhood cancer survivors
Hyeon Jin Park
Clin Exp Pediatr. 2010;53(4):465-470.   Published online April 15, 2010
The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake...
Clinical application of gonadotropin-releasing hormone analogs in children and adolescents
Ho-Seong Kim
Clin Exp Pediatr. 2010;53(3):294-299.   Published online March 15, 2010
Although the increasing incidence of central precocious puberty (CPP) in Korea has recently raised public concerns about health and growth problems, there are many areas of uncertainty regarding the pathogenesis, diagnosis, and management of CPP. In this paper, we review the definition of precocity, the assessment of CPP, and the hormonal abnormalities that support the diagnosis. In addition, we review...
Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application
Jung Sub Lim
Clin Exp Pediatr. 2010;53(3):286-293.   Published online March 15, 2010
Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric...
Genetic testing in clinical pediatric practice
Han Wook Yoo
Clin Exp Pediatr. 2010;53(3):273-285.   Published online March 15, 2010
Completion of the human genome project has allowed a deeper understanding of molecular pathophysiology and has provided invaluable genomic information for the diagnosis of genetic disorders. Advent of new technologies has lead to an explosion in genetic testing. However, this overwhelming stream of genetic information often misleads physicians and patients into a misguided faith in the power of genetic testing....
Natural killer T cell and pathophysiology of asthma
Gwang Cheon Jang
Clin Exp Pediatr. 2010;53(2):136-145.   Published online February 15, 2010
Natural killer T (NKT) cell is a special type of T lymphocytes that has both receptor of natural killer (NK) cell (NK1.1, CD161c) and T cell (TCR) and express a conserved or invariant T cell receptor called Vα14Jα18 in mice or Va24 in humans. Invariant NKT (iNKT) cell recognizes lipid antigen presented by CD1d molecules. Marine-sponge-derived glycolipid, α- galactosylceremide (α-GalCer),...
Human rhinoviruses and asthma in children
Woo Kyung Kim
Clin Exp Pediatr. 2010;53(2):129-135.   Published online February 15, 2010
Human rhinoviruses (HRVs) is a nonenveloped, single stranded RNA virus belonging to the family Picornavirudae. Transmission by direct contact such as hand-to-hand, hand-to-nose, and hand-to-eye has been readily demonstrated in experimental settings. HRV are the most frequent causes of common cold infection, however, they are also known to replicate in the lower respiratory tract and associated with more severe respiratory...
Environmental tobacco smoke and childhood asthma
Dae Jin Song
Clin Exp Pediatr. 2010;53(2):121-128.   Published online February 15, 2010
In recent years, environmental tobacco smoke (ETS) has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and...
Congenital and perinatal cytomegalovirus infection
Chun Soo Kim
Clin Exp Pediatr. 2010;53(1):14-20.   Published online January 15, 2010
Cytomegalovirus (CMV) is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID), which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and...
Enteral nutrition of the premature infant
Su Jin Cho
Clin Exp Pediatr. 2010;53(1):7-13.   Published online January 15, 2010
Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in...
Neonatal respiratory distress: recent progress in understanding pathogenesis and treatment outcomes
So Young Kim
Clin Exp Pediatr. 2010;53(1):1-6.   Published online January 15, 2010
Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal...
Nutrition requirements in child and adolescent athletes
Jae Ock Park
Clin Exp Pediatr. 2009;52(12):1327-1336.   Published online December 15, 2009
Increasing numbers of children and adolescents prefer undertaking physical exercise to overcome overweight or obesity. Children and adolescents are in the growth stage and require adequate nutrient supply. More calories and nutrients are required especially when they are engaged in physical exercise. Exercise is the only means to increase lean body mass and decrease body fat, but adequate nutrient supply...
Prevention strategies for obesity in children and adolescents
Kyung Rye Moon
Clin Exp Pediatr. 2009;52(12):1321-1326.   Published online December 15, 2009
Prevalence of obesity in Korean children and adolescents has dramatically increased since the last 10–20 years. It is important to initiate prevention efforts early in childhood because prevalence of obesity in adolescence is the strongest predictor of its prevalence in adulthood. Intrauterine life, infancy, and preschool years may comprise the critical periods that are essential for the long-term regulation of...
Obesity in children and adolescents
Jeong Wan Seo
Clin Exp Pediatr. 2009;52(12):1311-1320.   Published online December 15, 2009
Childhood obesity has rapidly increased in Korea during the past 20–30 years. Approximately 1 of 10 children and adolescents is obese. Appropriate prevention and intervention measures urgently need. Obesity prevention starts early in life, i.e., obesity prevention and education begins during the period of fetal development in utero. Behavioral changes are the most positively reflected during pregnancy. Infants should be...
Child sexual abuse and pediatricians
Insil Lee
Clin Exp Pediatr. 2009;52(11):1200-1206.   Published online November 15, 2009
Child sexual abuse is not a rarely encountered problem. Child sexual abuse is a pediatric disease entity with lifelong impact. Child sexual abuse, different from sexual assault, is not always accompanied by violent force and usually repeated over a period of time. Child sexual abuse should be approached by multidisciplinary team experts. Every pediatrician should know the child protection network...
Child abuse, can we find child abuse? - Role of the pediatrician
Ki Sik Min
Clin Exp Pediatr. 2009;52(11):1194-1199.   Published online November 15, 2009
Child abuse is defined by a recent act or failure to act that results in death, serious physical or emotional harm, sexual abuse or exploitation, or imminent risk of serious harm; involved a child; and is carried out by a parent or caregiver. This report provides guidance in the clinical approach to the evaluation of suspected physical abuse in children,...