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Review Article
Physiology of sleep
Kyu Young Chae
Clin Exp Pediatr. 2007;50(8):711-717.   Published online August 15, 2007
Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Normal sleep comprises non-rapid eye movement (NREM) and REM periods that alternate through the night. Sleep usually begins in NREM and progresses through deeper NREM stages (2, 3, and 4 stages), but newborns enter REM sleep (active sleep) first before NREM (quiet sleep). A...
Hematopoietic stem cell transplantation : overview for general pediatrician
Tai Ju Hwang
Clin Exp Pediatr. 2007;50(7):613-621.   Published online July 15, 2007
Hematopoietic stem cell transplantation (HSCT) has expanded and evolved substantially in the last decades to treat various malignant and nonmalignant diseases. However, the conditioning regimen can lead to transplantation related death by major organ dysfunction, severe infection and bleeding. In the allogeneic setting, graft versus host disease may also develop, making post-transplant management complex. To overcome these problems, new stem...
Solid tumors in childhood: risk-based management
Hong Hoe Koo
Clin Exp Pediatr. 2007;50(7):606-612.   Published online July 15, 2007
Since the introduction of chemotherapy for the treatment of childhood leukemia more than 50 years ago, the results of childhood cancer have improved dramatically. The 5-year survival rate of disease, many of which were uniformly fatal in the prechemotherapy era, reached to more than 75%. This remarkable improvement in survival is a direct result of the incorporation of chemotherapeutics into...
Acute lymphoblastic leukemia in children: past, present and future
Hyoung Jin Kang, Hee Young Shin, Hyo Seop Ahn
Clin Exp Pediatr. 2007;50(7):601-605.   Published online July 15, 2007
The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even...
Recent advances in histiocytic disorders
Jong Jin Seo
Clin Exp Pediatr. 2007;50(6):524-530.   Published online June 15, 2007
The recent advances in the basic hematology and immunology have significantly enhanced the understanding of histiocytic disorders. The Histiocyte Society which was established in 1985 enabled the randomized trials for these diseases, and important knowledge regarding pathogenesis, clinical presentation, diagnosis, therapy and late consequences has been obtained. The treatment of Langerhans cell histiocytosis (LCH) has varied greatly over last decades,...
Aplastic anemia
Hack Ki Kim
Clin Exp Pediatr. 2007;50(6):519-523.   Published online June 15, 2007
Aplastic anemia is a rare disease, which is characterized by pancytopenia and hypocellular bone marrow without infiltration of abnormal cells or fibrosis. The incidence in Asia is higher than in the West and new cases are diagnosed at a rate of 5.1 per million pediatric populations per year in Korea. The pathophysiology is understood roughly by defective hematopoiesis, impaired bone...
Hemolytic anemia in pediatrics
Jeong Ok Hah
Clin Exp Pediatr. 2007;50(6):511-518.   Published online June 15, 2007
To understand the hemolytic anemia (HA) in children, the diagnostic approach and management of hereditary and acquired HA are described. The hereditary hemolytic anemia (HHA) can be classified according to the pathogenesis into three types : RBC membrane defects, hemoglobinopathies, and RBC enzymopathies. Clinical characteristics, laboratory findings and molecular defects of these three types are presented briefly. In Korea,...
Pathophysiology and management of disorders in water metabolism
Dong Un Kim
Clin Exp Pediatr. 2007;50(5):430-435.   Published online May 15, 2007
Even though we drink and excrete water without recognition, the amount and the composition of body fluid remain constant everyday. Maintenance of a normal osmolality is under the control of water balance which is regulated by vasopressin despite sodium concentration is the dominant determinant of plasma osmolality. The increased plasma osmolality (hypernatremia) can be normalized by the concentration of urine,...
Lung function tests in preschool children
Yong-Mean Park
Clin Exp Pediatr. 2007;50(5):422-429.   Published online May 15, 2007
Measurement of lung function is an integral component of respiratory physiology and of clinical assessment of lung diseases in school age children and adults. Pulmonary function test of infants and children under the age of 2 years have now been standardised and are being used both in research and as an adjunct to clinical management. By contrast, until recegntly, children...
Clinical significance of serum IgE
Hai Lee Chung
Clin Exp Pediatr. 2007;50(5):416-421.   Published online May 15, 2007
Many previous studies have proved that human allergic disease resulted from the formation of antibodies belonging to a unique immunoglobulin isotype termed immunoglobulin E (IgE). Most of IgE- producing plasma cells are found in the lymphoid tissue associated with the gastrointestinal and respiratory tracts. IgE may be found free in the mucosal secretions of these tissues, bound to local mast...
Allergic skin test
Byong Kwan Son, Dae Hyun Lim
Clin Exp Pediatr. 2007;50(5):409-415.   Published online May 15, 2007
Allergy skin prick test and intradermal test represent one of the major tools in the diagnosis of IgE- mediated diseases like as atopic asthma, allergic rhinitis, atopic dermatitis, food and drug allergy, and insect bite when properly performed. Skin tests are of particular importance in fields such as allergen standardization, pharmacology, and epidemiology. Even if skin tests seem easy to...
Allergic rhinitis, sinusitis and asthma - evidence for respiratory system integration -
Hyun Hee Kim
Clin Exp Pediatr. 2007;50(4):335-339.   Published online April 15, 2007
The link between upper airway disease (allergic rhinitis and sinusitis) and lower airway disease (asthma) has long been of interest to physicians. Many epidemiological and pharmacological studies have provided a better understanding of pathophysiologic interrelationship between allergic rhinitis and asthma. The vast majority of patients with asthma have allergic rhinitis, and rhinitis is a major independent risk factor for asthma...
The management of sinusitis in children
Manyong Han
Clin Exp Pediatr. 2007;50(4):328-334.   Published online April 15, 2007
Sinusitis is a common medical problem in children. The prevalence of penicillin-resistant S. pneumoniae infection has been increased during the last decade. The medical management is based on the choice of antimicrobial agents. This article reviews current literatures on the management of acute bacterial sinusitis and chronic sinusitis, with an emphasis on penicillin-resistant S. pneumoniae infection. This article also explores...
The diagnosis of pediatric sinusitis
Chang-Keun Kim
Clin Exp Pediatr. 2007;50(4):323-327.   Published online April 15, 2007
Although most clinicians now agree that sinusitis can afflict children of all ages, appropriate diagnosis remain controversial. Sinusitis is one of the most challenging diagnoses for a clinician, because there is a lack of validated diagnostic criteria for acute rhinosinusitis. Symptoms generally include nasal congestion, purulent nasal discharge, and cough .The physical examination is often unsuccessful in confirming the diagnosis....
Evaluation of function and disorders of the adrenal gland in neonates
Il Tae Hwang
Clin Exp Pediatr. 2007;50(3):236-240.   Published online March 15, 2007
Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than 15 g/dL (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response...
Calcium and phosphate metabolism and disorders in the newborn
Hae Soon Kim
Clin Exp Pediatr. 2007;50(3):230-235.   Published online March 15, 2007
In the early neonatal period, the neonate is challenged by the loss of the placental calcium transport and manifests a quick transition, from an environment in which PTHrP plays an important role to a PTH- and 1,25-dihydroxyvitamin D-controlled neonatal milieu. Disturbances in mineral homeostasis are common in the neonatal period, especially in premature infants and infants who are hospitalized in...
Glucose metabolism and evaluation of hypoglycemia in neonates
Eun Young Kim
Clin Exp Pediatr. 2007;50(3):223-229.   Published online March 15, 2007
The fetus is completely dependent on mother for glucose and other nutrient transfer across the placenta. At birth, when the maternal supply is discontinued, the neonate must adjust to an independent existence. The changes in the neonate's glucose homeostasis during this transition to the extrauterine environment are influenced by the mother's metabolism and intrinsic fetal and placental problems. Maturation of...
Fever and rash
Jin Han Kang
Clin Exp Pediatr. 2007;50(2):132-137.   Published online February 15, 2007
Patients with febrile illness and skin rashes need full and immediate attention. In general, these diseases show mild manifestations and good prognosis. However, causalities of some diseases with fever and rash may be life threatening or trivial. So, the differential diagnosis for those patients is extensive. A through history, a careful physical examination and close observation of clinical progress are...
Diagnostic approach to the fever of unknown origin in children - Emphasis on the infectious diseases -
Eun Hwa Choi
Clin Exp Pediatr. 2007;50(2):127-131.   Published online February 15, 2007
Fever of unknown origin (FUO) has been a convenient term used to classify patients who warrant a particular systemic approach to diagnostic evaluation and management. The greatest clinical concern in evaluating FUO is identifying patients whose fever has a serious or life-threatening cause when a delay in diagnosis could jeopardize successful intervention. Thorough history and complete physical examination are critical...
Fever
Taek Jin Lee, Dong Soo Kim
Clin Exp Pediatr. 2007;50(2):121-126.   Published online February 15, 2007
Fever has been recognized as a cardinal feature of disease since antiquity, but only recently has the pathophysiology of fever come to be understood. It became clear that the ultimate cause of fever is not a bacterial product (a so-called exogenous pyrogen) but a product of host inflammatory cells (i.e., an endogenous pyrogen). Many studies have demonstrated that mononuclear phagocytes...
Post discharge care of prematurity
Hye Sun Yoon
Clin Exp Pediatr. 2007;50(1):14-19.   Published online January 15, 2007
Advances in neonatal care have been responsible for the improved survival of prematurity but have not resulted in decreased morbidity. Once the high-risk infants is discharged from the hospital, his or her many special care needs do not cease. A well-coordinated multidisciplinary approach is essential in the follow-up care of these infants. Special attention must be given to their growth...
Newborn hearing screening
Lee Suk Kim
Clin Exp Pediatr. 2007;50(1):7-13.   Published online January 15, 2007
Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing...
Regionalization of neonatal care and neonatal transport system
Jong Beom Sin
Clin Exp Pediatr. 2007;50(1):1-6.   Published online January 15, 2007
In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis...
Report about the health status of Korean adolescents - A comprehensive overview of the Korean adolescent health through demographics -
Hea Kyoung Lee
Clin Exp Pediatr. 2006;49(12):1267-1274.   Published online December 15, 2006
Adolescent nutrition and growth
Sanghee Park
Clin Exp Pediatr. 2006;49(12):1263-1266.   Published online December 15, 2006
Adolescent menstrual disorders
Chang-Ho Hong
Clin Exp Pediatr. 2006;49(12):1257-1262.   Published online December 15, 2006
Treatment and management of patients with inherited metabolic diseases
Jin-Sung Lee
Clin Exp Pediatr. 2006;49(11):1152-1157.   Published online November 15, 2006
Inherited metabolic disease is rare disorders that show symptoms mainly in pediatric age and early treatment is important for preventing complications of the disease. Recent development in molecular and biochemical techniques help clinicians with proper diagnosis of patients, however, many of the disease still remain lack of effective therapeutic strategies. Better understanding on biochemical and molecular basis of pathogenesis of...
Diagnosis of inherited metabolic disorders based on their diverse clinical features and laboratory tests
Han-Wook Yoo
Clin Exp Pediatr. 2006;49(11):1140-1151.   Published online November 15, 2006
Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of “inborn error of metabolism” or “chemical individuality”, more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse...
Newborn screening of inherited metabolic disease in Korea
Dong Hwan Lee
Clin Exp Pediatr. 2006;49(11):1125-1139.   Published online November 15, 2006
In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia & congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU & congenital hypothyroidism to increase test numbers with same...
Concept of developmental disability and the role of a pediatrician
Young Jong Woo
Clin Exp Pediatr. 2006;49(10):1031-1036.   Published online October 15, 2006
In this article, the following topics will be discussed: What is a developmental disability? What are the risk factors for developmental disability? What are the causes of delayed motor development? What are the early manifestations of developmental disability in young infants? What are the goals of early intervention and the forms or types of early intervention services? What are the...
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