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Review Article
Metabolic syndrome in children and adolescents
Young Mi Hong
Clin Exp Pediatr. 2009;52(7):737-744.   Published online July 15, 2009
Metabolic syndrome (MS) in children and adolescents has become a global public health problem. MS among Korean children and adolescents has been increasing significantly over the past decade. This paper aims to provide the currently available information on the MS in children and adolescents. This review focuses on the definition, diagnostic criteria, epidemiology and pathophysiology which may be helpful for...
Recent advance in primary immune deficiency disorders
Hyoung Jin Kan, Hee Young Shin, Hyo Seop Ahn
Clin Exp Pediatr. 2009;52(6):649-654.   Published online June 15, 2009
The immune system is comprised of cells and molecules whose collective and coordinated response to the introduction of foreign substance is referred to as the immune response. Defense against microbes is mediated by the early reaction (innate immunity) and the late response (adaptive immunity). Innate immunity consists of the epithelial barrier, phagocytes, complement and natural killer cells. Adaptive immunity, a...
Eosinophil disorders
Sun Young Kim
Clin Exp Pediatr. 2009;52(6):643-648.   Published online June 15, 2009
Blood eosinophilia can be classified as either familial or acquired. Familial eosinophilia is a rare autosomal dominant disorder characterized by a stable eosinophil count. Acquired eosinophilia is classified further into a primary or secondary phenomenon depending on whether eosinophils are considered integral to the underlying disease. Primary eosinophilia is considered clonal in the presence of either a cytogenetic abnormality or...
Neutropenia in children
Eun Sun Yoo
Clin Exp Pediatr. 2009;52(6):633-643.   Published online June 15, 2009
Neutropenia is defined as an absolute neutrophil count (ANC) of ＜1,500/µL, and the severity of neutropenia generally can be graded as mild (1,000-1,500/µL), moderate (500-1,000/µL), or severe (＜500/µL). This stratification aids in predicting the risk of pyogenic infection because the susceptibility to life-threatening infections is significantly increased in patients with prolonged episodes of severe neutropenia. Especially cancer-related neutropenia carry significant...
Pediatric tuberculosis and drug resistance
Yae-Jean Kim
Clin Exp Pediatr. 2009;52(5):529-537.   Published online May 15, 2009
Drug-resistant tuberculosis in children has important implications for both the patients and tuberculosis control programs. In Korea, among all new patients, the isoniazid resistance rate was 9.9% and multidrug-resistant tuberculosis rate was 2.7% in 2004 (in patients aged 10-19 yr, the multidrug-resistant tuberculosis rate reached 2.1%). Tuberculosis in pediatric patients is difficult to diagnose because many children have nonspecific clinical...
Treatment of latent tuberculous infection in children and adolescent
Jong-Hyun Kim
Clin Exp Pediatr. 2009;52(5):519-528.   Published online May 15, 2009
Tuberculosis continues to cause an unacceptably high toll of disease and death among children worldwide. Whereas intense scientific and clinical research efforts into novel diagnostic, therapeutic, and preventive interventions have focused on tuberculosis in adults, childhood tuberculosis has been relatively neglected. However, children are particularly vulnerable to severe disease and death following infection, and those with latent infection become the...
Characteristics of tuberculosis in children and adolescents
Byung Wook Eun
Clin Exp Pediatr. 2009;52(5):513-518.   Published online May 15, 2009
In childhood tuberculosis, it is possible to clearly distinguish among three basic stages: exposure, infection, and disease. The incidence of tuberculosis in children is low compared with that in adults, but latent infection is a major concern because children, who are exposed to Mycobacterium tuberculosis especially early in childhood, are at increased risk of developing the disease. Younger children particularly...
Development and language problems in children of immigrant marriages
Jae Woo Lim
Clin Exp Pediatr. 2009;52(4):417-421.   Published online April 15, 2009
The number of international marriages in South Korea has drastically increased since the year 2000, and among these, the proportion of couples with a Korean husband and foreign wife accounts for more than 70%. At the same time, the number of children resulting from an international marriage has also risen dramatically; this tendency is especially evident in preschool children below...
Overseas adoption in Korea
Jae Yoon Kim
Clin Exp Pediatr. 2009;52(4):410-416.   Published online April 15, 2009
In Korea, overseas adoption has been practiced for more than 50 years. Initially, overseas adoption began with the objective to provide permanent homes for Korean war orphans, including mixed-blood children. From 1953 to 2007, about 160,000 Korean children were placed worldwide through overseas adoption and approximately 70,000 children were adopted in Korea. During that period, Korea developed into one of...
Child raising and education of marriage-based immigrants in Korea: On the focus of infants
Dong-Hoon Seol
Clin Exp Pediatr. 2009;52(4):403-409.   Published online April 15, 2009
Due to recent upsurge in international marriages, the socio-cultural adaptation, the reinforcement of family stability, and the social integration support of marriage-based immigrant family have been the major social issues. This paper tries to show the current status of marriage-based immigrants and their children nation-wide. Specifically, it analyzes the statistical trends in international marriages, traits of marriage-based immigrants and their...
Antibiotics for bacterial pneumonia in children
Hye-yung Yum
Clin Exp Pediatr. 2009;52(3):283-288.   Published online March 15, 2009
Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia...
Mycoplasma and chlamydia infection in Korea
Kyung Won Kim, Kyu-Earn Kim
Clin Exp Pediatr. 2009;52(3):277-282.   Published online March 15, 2009
Pneumonia, which usually requires hospitalization for children, is caused by various pathogens. According to recent surveys, the prevalence of atypical pneumonia caused by Mycoplasma or Chlamydia has increased, especially in preschool children. Also, the evidence has been accumulated that Mycoplasma or Chlamydia infection is associated with asthma including both inception and exacerbation. Therefore, it is important to consider how the...
Acute viral lower respiratory tract infections in children
Joon Soo Park
Clin Exp Pediatr. 2009;52(3):269-276.   Published online March 15, 2009
Viruses are the most common cause of lower respiratory tract infections (LRTIs) in infants and young children and are a major public health problem in this age group. Viruses were identified in 54.9-70.4% of hospitalized infants and children with LRTIs in Korea. The viral pathogens identified included respiratory syncytial virus (RSV) A and RSV B, influenza (Inf) A, Inf B,...
Consequences of being born small for gestational age : More than being small
Eun-Gyong Yoo
Clin Exp Pediatr. 2009;52(2):152-158.   Published online February 15, 2009
Reduced fetal growth is independently associated with increased risk of health problems in later life, particularly type 2 diabetes and cardiovascular diseases. Insulin resistance appears to be a key component underlying these metabolic complications. It is suggested that detrimental fetal environment may program insulin resistance syndrome. An insulin-resistant genotype may also result in both low birth weight and insulin resistance...
Growth and sex differentiation of children born small for gestational age
Se Young Kim
Clin Exp Pediatr. 2009;52(2):142-151.   Published online February 15, 2009
The incidence of small for gestational age (SGA) births is frequent, accounting for 2.3% to 8% of all live births. Several childhood and adult diseases are related to early postnatal growth and birth size, and 10% of children born SGA may have a short stature throughout postnatal life. Additionally, they may have abnormal growth hormone (GH)-insulin like growth factor axis,...
The present condition of Korean children born small for gestational age
Il Tae Hwang
Clin Exp Pediatr. 2009;52(2):137-141.   Published online February 15, 2009
Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than...
Assessment of retinopathy of prematurity (ROP) revisited
Jeong Hun Kim, Young Suk Yu
Clin Exp Pediatr. 2009;52(1):22-27.   Published online January 15, 2009
Retinopathy of prematurity (ROP) is a major cause of blindness that affects premature infants. With advances in neonatology, ROP is likely to emerge as the most serious problem of vision loss in children even in developed countries; such a situation could be called the third epidemic of ROP. However, controversy and uncertainty still surround favorable outcomes of ROP. For successfully...
Neurodevelopmental outcomes of very low birth weight infants and extremely low birth weight infants in Korea, 1984-2008
In Kyung Sung
Clin Exp Pediatr. 2009;52(1):14-21.   Published online January 15, 2009
Neurodevelopmental outcomes of very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI) in Korea on 14 reports from 1984 to 2008 were analyzed. Follow-up rates were varied from 42.9% to 90.2%. Duration of follow-up ranged from 4 months to 5 years. The prevalence of cerebral palsy (CP) of VLBWI was as follows: 4.3-5.3% in 1980s, 7.1-9.1...
Recent progress in the understanding of clinical characteristics, epidemiology, and pathogenesis of new bronchopulmonary dysplasia
Beyong Il Kim
Clin Exp Pediatr. 2009;52(1):6-13.   Published online January 15, 2009
Recent advances in perinatal care have resulted in improved survival of extremely low birth weight infants (ELBWI). However, bronchopulmonary dysplasia (BPD) remains one of the major complications in ELBWI. BPD was originally described over 40 years ago; the clinical characteristics, epidemiology, and pathogenesis of BPD have changed markedly through this period. In this article, I have reviewed recent progress in...
Neuromuscular disorders in children : Diagnosis and treatment
Jong Hee Chae
Clin Exp Pediatr. 2008;51(12):1295-1299.   Published online December 15, 2008
Inherited muscle diseases are heterogeneous with varying genetic etiologies and present with common symptoms and signs, including weakness, motor developmental delay, and hypotonia. To diagnose these various diseases, a meticulous family and clinical history, physical and neurological examinations, laboratory findings with electromyography, muscle biopsy, and genetic testing are needed. Here, I review several inherited muscle diseases, with a focus on...
Epilepsy in various metabolic disorders
Young-Mock Lee
Clin Exp Pediatr. 2008;51(12):1290-1294.   Published online December 15, 2008
Seizures are a frequent symptom in metabolic disorders, although metabolic disorders are rarely found to be the cause of epilepsy. A precise diagnosis might not only influence treatment, but it might also call for counseling of the family, even if there are no direct therapeutic consequences. We review the main characteristics of epilepsy in metabolic disorders with regard to energy...
Pediatric cerebrovascular disease
Ji Hoon Phi, Kyu-Chang Wang, Byung-Kyu Cho, Seung-Ki Kim
Clin Exp Pediatr. 2008;51(12):1282-1289.   Published online December 15, 2008
Recently, accumulated clinical experience and advanced neuroradiological techniques have led to a better understanding of pediatric cerebrovascular disease (CVD), which was once considered rare. Approximately 10% of pediatric neurosurgical patients have CVD; therefore, it is no longer uncommon to pediatricians and pediatric neurosurgeons. Furthermore, children with CVD tend to recover better than adults after stroke because the immature brain is...
Diagnosis and therapy for functional urinary incontinence in childhood
Ju Hyung Kang
Clin Exp Pediatr. 2008;51(11):1147-1151.   Published online November 15, 2008
Functional urinary incontinence, the absence of any neurologic or structural abnormality as a cause of urinary incontinence in children, is one of the most common clinical problems encountered in pediatric and urologic departments, and it can be socially and emotionally distressing for the affected children. The prevalence rates of functional urinary incontinence in school-aged children are not very high and...
Diagnosis and treatment of nocturnal enuresis in children
Chang Hee Hong, Minki Baek, Seong Ho Lee, Jeong Won Lee, Ki-Soo Pai
Clin Exp Pediatr. 2008;51(11):1140-1146.   Published online November 15, 2008
Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on...
Urinary incontinence
Jung Won Lee
Clin Exp Pediatr. 2008;51(11):1136-1139.   Published online November 15, 2008
The genitourinary tract and gastrointestinal system are interdependent but share the same embryological origin, pelvic region, and sacral innervation. Although children with voiding disturbances often present with bowel dysfunction, this coexistence was considered coincidental until recently. However, it is now accepted that dysfunction in emptying of both systems is interrelated. Afferent impulses carrying sensory information are transmitted through the spinal...
The use of fluoroquinolone in children
Jae Kyun Hur
Clin Exp Pediatr. 2008;51(10):1042-1046.   Published online October 15, 2008
The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has...
Once daily dosing of aminoglycoside in children
Seon Hee Shin
Clin Exp Pediatr. 2008;51(10):1038-1041.   Published online October 15, 2008
Aminoglycosides are frequently used antibiotics in children. The multiple daily dosing (MDD) in infants and children is twice or three times daily depending on age. Recent studies in adults have shown that once daily dosing (ODD) maximizes the bactericidal activity and might minimize the toxicity of antibiotics. So, I reviewed many studies about efficacy, toxicity and cost effectiveness of ODD...
Emergence of macrolide resistance and clinical use of macrolide antimicrobials in children
Eun Hwa Choi
Clin Exp Pediatr. 2008;51(10):1031-1037.   Published online October 15, 2008
Macrolide antimicrobial agents including erythromycin, roxithromycin, clarithromycin, and azithromycin are commonly used in the treatment of respiratory tract infections in children. Newer macrolides that have structural modifications of older drug erythromycin show improved change in the spectrum of activity, dosing, and administration. However, recent studies reported that increasing use of macrolide antibiotics is the main force driving the development of...
Attention deficit hyperactivity disorder
So-Hee Eun, Baik-Lin Eun
Clin Exp Pediatr. 2008;51(9):935-943.   Published online September 15, 2008
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness, poor impulse control or impulsivity, and distractibility. The recommended evaluation includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychological conditions, reviewing the child`s developmental history...
Speech and language disorders in children
Hee Jung Chung
Clin Exp Pediatr. 2008;51(9):922-934.   Published online September 15, 2008
Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may...
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