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Review Article
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...
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...
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