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Review Article
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,...
The present state of chid abuse in Korea and its system for child protection
Ki-Soo Pai, Shin-Young Kim, Young Ki Chung, Kyeong Hee Ryu
Clin Exp Pediatr. 2009;52(11):1185-1193.   Published online November 15, 2009
An act of children’s welfare was made in 1961 for the first time in Korea but it had been nothing but the name in view of practical impact to prevention of child abuse. Real undertakings of Child Abuse Prevention were commenced overtly since 2000 in Korea, when the law for children’s welfare was revised to put protective settings for the...
Recent concepts on vitamin D in children and adolescents
Hye Ran Yang, Jeong Wan Seo, Yong Joo Kim, Jae Young Kim, Eell Ryoo, Jae Geon Sim, Hye Won Yom, Ju Young Chang, Ji A Jung, Kwang Hae Choi
Clin Exp Pediatr. 2009;52(10):1082-1089.   Published online October 15, 2009
Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin...
Current status of pediatric kidney transplantation
Sung-Do Kim, Byoung-Soo Cho
Clin Exp Pediatr. 2009;52(10):1075-1081.   Published online October 15, 2009
Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on...
Peritoneal dialysis in children and adolescents
Il Soo Ha
Clin Exp Pediatr. 2009;52(10):1069-1074.   Published online October 15, 2009
Peritoneal dialysis is a preferred modality of replacement therapy in children and adolescents with end-stage renal disease waiting for kidney transplantation. Recent development of pediatric swan-neck catheters with cuffs, novel dialysis solutions, and cyclers for automated peritoneal dialysis enabled more flexible prescriptions of dialysis with less complication, and improved patients' activities as well as the dialysis adequacy. Principles and practical...
Treatment of chronic kidney disease in children
Joo Hoon Lee
Clin Exp Pediatr. 2009;52(10):1061-1068.   Published online October 15, 2009
The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth...
Guidelines for childhood urinary tract infection
Seung Joo Lee
Clin Exp Pediatr. 2009;52(9):976-983.   Published online September 15, 2009
Urinary tract infection (UTI), the most common bacterial disease in childhood, is frequently associated with urinary tract anomalies (15-50%) and can induce renal scarring, which is a cause of hypertension and chronic kidney disease. Despite the high risk of renal scarring in infancy, the diagnosis may be delayed due to its nonspecific presenting symptoms; moreover, over-diagnosis is frequent due to...
Treatment and prognosis of neonatal seizures
So-Hee Eun, Baik-Lin Eun
Clin Exp Pediatr. 2009;52(9):971-975.   Published online September 15, 2009
Seizures in the neonatal period are common and frequently indicate serious underlying brain injury. Neonatal seizures continue to present a diagnostic and therapeutic challenge to pediatricians because recognition and classification of neonatal seizures remain problematic, particularly when clinicians rely only on clinical criteria. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity, and "prime" the brain to...
Diagnosis of neonatal seizures
Hee Jung Chung, Yun Jung Hur
Clin Exp Pediatr. 2009;52(9):964-970.   Published online September 15, 2009
Neonatal seizures are generally not only brief and subtle but also not easily recognized and are usually untreated. In sick neonates, seizures are frequently not manifested clinically but are detected only by electroencephalography (subclinical EEG seizures). This phenomenon of electroclinical dissociation is fairly common in neonates. On the other hand, neonates frequently show clinical behaviors such as stiffening, apnea, or...
Neonatal seizures in Korea, 1983-2009
Eun Sook Suh
Clin Exp Pediatr. 2009;52(9):957-963.   Published online September 15, 2009
Neonatal seizures are the most common and distinctive clinical sign of prenatal and/or neonatal brain disorders. Newborn infants with seizures are at risk of mortality and survivors at risk for neurologic impairment, developmental delay, and subsequent epilepsy. Fifteen reports on neonatal seizures in Korea from 1983 to 2009 were analyzed. A total of 731 neonatal seizure cases were reported. Day...
Novel swine-origin H1N1 influenza
Jina Lee, Hoan Jong Lee
Clin Exp Pediatr. 2009;52(8):862-868.   Published online August 15, 2009
Since its identification in April 2009, a swine-origin H1N1 influenza A virus (S-OIV) which is a reassortment of gene segments from both North American triple-reassortant and Eurasian swine influenza has been widely spread among humans in unexpected rapidity. To date, each gene segment of the 2009 influenza A (H1N1) outbreak viruses have shown high (99.9%) neucleotide sequence identity. As of July 6, 94,512...
Brain death and organ transplantation
Sang-Ook Nam
Clin Exp Pediatr. 2009;52(8):856-861.   Published online August 15, 2009
Cardiopulmonary arrest has long been accepted as an unquestionable definition of death. An advent of cardiopulmonary resuscitation and artificial ventilation along with the development of organ transplantation has prompted the emergence of the concept of brain death. The criteria for brain death are based mainly on the clinical examination of coma, apnea and total loss of brain stem function. Although organ transplantation by...
What can we do for dying neonate in NICU?
Chung-Sik Chun
Clin Exp Pediatr. 2009;52(8):851-855.   Published online August 15, 2009
Death is not only a medical problem; it is also an ethical problem. When doctors face a dying neonate, their knowledge of bioethics and the opinions of ethical specialists and religious leaders are helpful for them and the family of the dying baby. In recent years, due to the increase of surviving babies who have suffered from severe illness, those born too...
The change of perspective on brain death, euthanasia and withdrawal of the life supporting medical treatments in Korea for pediatric patients
Ivo Kwon
Clin Exp Pediatr. 2009;52(8):843-850.
A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical...
How to write a medical paper: an introduction
Jin-Bok Hwang
Clin Exp Pediatr. 2009;52(7):756-765.   Published online July 15, 2009
This paper aims to provide an introduction to junior authors on how to write a medical paper in a clearer and more scientific manner. One important thing to be always remembered is that the reviewer and the reader will be reading your paper for the first time, and thus, you should make it as lucid as possible. You should pay...
Hypertension in children and adolescents
Jo Won Jung
Clin Exp Pediatr. 2009;52(7):745-751.   Published online July 15, 2009
Hypertension is a major risk factor for myocardial infarction, stroke, and cardiovascular mortality in adults; its treatment reduces the risk of cardiovascular events. In recent times, attention is being paid to monitoring of blood pressure from childhood to adulthood. Childhood hypertension is associated with hypertension in later life, and early intervention is important. In the Korean socioeconomic background, a rapid...
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