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Review Article
Antibiotics resistance of Helicobacter pylori and treatment modalities in children with H. pylori infection
Ji-Hyun Seo, Hyang-Ok Woo, Hee-Shang Youn, Kwang-Ho Rhee
Clin Exp Pediatr. 2014;57(2):67-71.   Published online February 24, 2014

Pediatric infection with Helicobacter pylori may occur early in childhood and persist lifelong. Global pediatric clinical studies have reported a decreasing tendency in the overall rate of H. pylori eradication. In pediatric patients with H. pylori infection, pediatric patients with peptic ulcer, and the first-degree relatives of patients with a history of gastric cancer, it is commonly recommended that H....

Efficacy and effectiveness of extended-valency pneumococcal conjugate vaccines
Hyunju Lee, Eun Hwa Choi, Hoan Jong Lee
Clin Exp Pediatr. 2014;57(2):55-66.   Published online February 24, 2014

The 7-valent pneumococcal protein conjugate vaccine (PCV7) has been shown to be highly efficacious against invasive pneumococcal diseases and effective against pneumonia and in reducing otitis media. The introduction of PCV7 has resulted in major changes in the epidemiology of pneumococcal diseases. However, pneumococcal vaccines induce serotype-specific immunity, and a relative increase in non-vaccine serotypes has been reported following the...

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia
Chang-Ha Lee, Jae Gun Kwak, Cheul Lee
Clin Exp Pediatr. 2014;57(1):19-25.   Published online January 31, 2014

Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt...

Channelopathies
June-Bum Kim
Clin Exp Pediatr. 2014;57(1):1-18.   Published online January 31, 2014

Channelopathies are a heterogeneous group of disorders resulting from the dysfunction of ion channels located in the membranes of all cells and many cellular organelles. These include diseases of the nervous system (e.g., generalized epilepsy with febrile seizures plus, familial hemiplegic migraine, episodic ataxia, and hyperkalemic and hypokalemic periodic paralysis), the cardiovascular system (e.g., long QT syndrome, short QT syndrome,...

Inflammation and hyponatremia: an underrecognized condition?
Se Jin Park, Jae Il Shin
Clin Exp Pediatr. 2013;56(12):519-522.   Published online December 20, 2013

Timely diagnosis of hyponatremia is important for preventing potential morbidity and mortality as it is often an indicator of underlying disease. The most common cause of eurvolemic hyponatremia is the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Recent studies have demonstrated that proinflammatory cytokines such as interleukin (IL) 1β and IL-6 are involved in the development of hyponatremia, a condition...

Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?
Jin-Bok Hwang, Jeana Hong
Clin Exp Pediatr. 2013;56(12):514-518.   Published online December 20, 2013

The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for...

Mechanisms of immune tolerance to allergens in children
Umut C. Kucuksezer, Cevdet Ozdemir, Mübeccel Akdis, Cezmi A. Akdis
Clin Exp Pediatr. 2013;56(12):505-513.   Published online December 20, 2013

Because the prevalence of allergic diseases has significantly increased in recent years, understanding the causes and mechanisms of these disorders is of high importance, and intense investigations are ongoing. Current knowledge pinpoints immune tolerance mechanisms as indispensable for healthy immune response to allergens in daily life. It is evident that development and maintenance of allergens-pecific T cell tolerance is of...

Prevalence of rotavirus genotypes in South Korea in 1989-2009: implications for a nationwide rotavirus vaccine program
Van Thai Than, Wonyong Kim
Clin Exp Pediatr. 2013;56(11):465-473.   Published online November 27, 2013

The epidemiology of human group A rotavirus was analyzed by examining genotypic data acquired from 1989 to 2009 in South Korea. This information was derived from all the available published articles on rotavirus studies in South Korea, retrieved from both the PubMed and KoreaMed databases. Four common G types (G1, G2, G3, and G4) and three common P types (P[8],...

The promotion of mental health and the prevention of mental health problems in child and adolescent
Sun Mi Cho, Yun Mi Shin
Clin Exp Pediatr. 2013;56(11):459-464.   Published online November 27, 2013

Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term "prevention" for efforts that occur before onset of...

Magnetoencephalography in pediatric epilepsy
Hunmin Kim, Chun Kee Chung, Hee Hwang
Clin Exp Pediatr. 2013;56(10):431-438.   Published online October 31, 2013

Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data...

Measurements of fractional exhaled nitric oxide in pediatric asthma
Youn-Soo Hahn
Clin Exp Pediatr. 2013;56(10):424-430.   Published online October 31, 2013

Exhaled nitric oxide (NO) has been extensively investigated as a noninvasive marker of airway inflammation in asthma. The increased NO expression induced by inflammatory mediators in airways can be monitored easily in exhaled air from asthmatic children. Based on the relationship between the increased NO expression and eosinophilic airway inflammation, fractional exhaled nitric oxide (FeNO) measurements become an important adjunct...

Vitamin D status and childhood health
Youn Ho Shin, Hye Jung Shin, Yong-Jae Lee
Clin Exp Pediatr. 2013;56(10):417-423.   Published online October 31, 2013

Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in...

Kawasaki disease in infants
Jung Sook Yeom, Hyang Ok Woo, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Hee-Shang Youn
Clin Exp Pediatr. 2013;56(9):377-382.   Published online September 30, 2013

Kawasaki disease (KD) is an acute febrile illness that is the predominant cause of pediatric acquired heart disease in infants and young children. Because the diagnosis of KD depends on clinical manifestations, incomplete cases are difficult to diagnose, especially in infants younger than 1 year. Incomplete clinical manifestations in infants are related with the development of KD-associated coronary artery abnormalities....

Clinical efficacy and mechanism of probiotics in allergic diseases
Ha-Jung Kim, Hyung Young Kim, So-Yeon Lee, Ju-Hee Seo, Eun Lee, Soo-Jong Hong
Clin Exp Pediatr. 2013;56(9):369-376.   Published online September 30, 2013

A complex interplay between genetic and environmental factors partially contributes to the development of allergic diseases by affecting development during prenatal and early life. To explain the dramatic increase in the prevalence of allergic diseases, the hygiene hypothesis proposed that early exposure to infection prevented allergic diseases. The hygiene hypothesis has changed to the microbial hypothesis, in which exposure to...

Lower fat and better quality diet therapy for children with pharmacoresistant epilepsy
Jung-Rim Yoon, Heung Dong Kim, Hoon-Chul Kang
Clin Exp Pediatr. 2013;56(8):327-331.   Published online August 27, 2013

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary...

Clinical approach to quality of life in children with end-stage renal disease
Min Hyun Cho
Clin Exp Pediatr. 2013;56(8):323-326.   Published online August 27, 2013

Quality of life in addition to various medical problems in children with end-stage renal disease (ESRD) should be objectively assessed to accomplish normal growth and development during childhood. However, unfortunately, studies of quality of life (QoL) in children with ESRD have been not popular yet and there are only fewer suitable assessment tools compared with adults. Recently, disease-specific modules to...

The current status of the Korean student health examination
Hye-Jung Shin
Clin Exp Pediatr. 2013;56(8):313-322.   Published online August 27, 2013

Recent trends place an emphasis on school health care, the ultimate goal of which is to protect, maintain, and promote students' health. School health care is a program that integrates health care services, health education, health counseling, and local social health services. The student health examination (SHE) system is a part of school health care and schools and communities must...

Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes
Yun-Jin Lee, Joon Soo Lee
Clin Exp Pediatr. 2013;56(7):275-281.   Published online July 19, 2013

Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in...

The role of cytokines in seizures: interleukin (IL)-1β, IL-1Ra, IL-8, and IL-10
Youngah Youn, In Kyung Sung, In Goo Lee
Clin Exp Pediatr. 2013;56(7):271-274.   Published online July 19, 2013

Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial...

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair
Byung Won Yoo, Han Ki Park
Clin Exp Pediatr. 2013;56(6):235-241.   Published online June 21, 2013

Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a...

Recommended immunization schedule for children and adolescents: the Korean Pediatric Society, 2013
Dae Sun Jo, Jong-Hyun Kim, Eun Hwa Choi, Su Eun Park, Yae-Jean Kim, Yun Kyung Kim, Jina Lee, Byung Wook Eun, Soo Young Lee, Hyunju Lee, Ki Hwan Kim, Kyung-Hyo Kim
Clin Exp Pediatr. 2013;56(6):231-234.   Published online June 21, 2013

This article contains the recommended immunization schedule by the Committee on Infectious Diseases of the Korean Pediatric Society, updated in March 2013, when Haemophilus influenzae type b vaccine is now included in the National Immunization Program in Korea. It also includes catch-up immunization schedule for children and adolescents who are behind the recommended schedule. These schedules are a minor revision...

Systemic use of fluoroquinolone in children
Soo-Han Choi, Eun Young Kim, Yae-Jean Kim
Clin Exp Pediatr. 2013;56(5):196-201.   Published online May 28, 2013

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S....

Phenotypes and endotypes of severe asthma in children
Young Yoo
Clin Exp Pediatr. 2013;56(5):191-195.   Published online May 28, 2013

Severe childhood asthma is a complicated and heterogeneous disorder with distinct phenotypes. Children with severe asthma have more persistent symptoms despite receiving treatment, more atopy, greater airway obstruction, and more air trapping than those with mild-to-moderate asthma. They also have higher morbidity and substantial airflow limitations that persist throughout adulthood. Identification of the phenotype clusters and endotypes of severe asthma...

Endoscopic treatment of vesicoureteral reflux in pediatric patients
Jong Wook Kim, Mi Mi Oh
Clin Exp Pediatr. 2013;56(4):145-150.   Published online April 22, 2013

Endoscopic treatment is a minimally invasive treatment for managing patients with vesicoureteral reflux (VUR). Although several bulking agents have been used for endoscopic treatment, dextranomer/hyaluronic acid is the only bulking agent currently approved by the U.S. Food and Drug Administration for treating VUR. Endoscopic treatment of VUR has gained great popularity owing to several obvious benefits, including short operative time,...

Oxidative stress and the antioxidant enzyme system in the developing brain
So-Yeon Shim, Han-Suk Kim
Clin Exp Pediatr. 2013;56(3):107-111.   Published online March 18, 2013

Preterm infants are vulnerable to the oxidative stress due to the production of large amounts of free radicals, antioxidant system insufficiency, and immature oligodendroglial cells. Reactive oxygen species (ROS) play a pivotal role in the development of periventricular leukomalacia. The three most common ROS are superoxide (O2•-), hydroxyl radical (OH), and hydrogen peroxide (H2O2). Under normal physiological conditions, a balance...

Right ventricular failure in congenital heart disease
Young Kuk Cho, Jae Sook Ma
Clin Exp Pediatr. 2013;56(3):101-106.   Published online March 18, 2013

Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression,...

Bone mineral density deficits in childhood cancer survivors: Pathophysiology, prevalence, screening, and management
Min Jae Kang, Jung Sub Lim
Clin Exp Pediatr. 2013;56(2):60-67.   Published online February 25, 2013

As chemotherapy and other sophisticated treatment strategies evolve and the number of survivors of long-term childhood cancer grows, the long-term complications of treatment and the cancer itself are becoming ever more important. One of the most important but often neglected complications is osteoporosis and increased risk of fracture during and after cancer treatment. Acquisition of optimal peak bone mass and...

Cardiomyopathies in children
Young Mi Hong
Clin Exp Pediatr. 2013;56(2):52-59.   Published online February 25, 2013

Cardiomyopathy (CMP) is a heterogeneous disease caused by a functional abnormality of the cardiac muscle. CMP is of 2 major types, dilated and hypertrophic, and is further classified as either primary or secondary. Secondary CMP is caused by extrinsic factors, including infection, ischemia, hypertension, and metabolic disorders. Primary CMP is diagnosed when the extrinsic factors of secondary CMP are absent....

Noninvasive diagnosis of pediatric nonalcoholic fatty liver disease
Hye Ran Yang
Clin Exp Pediatr. 2013;56(2):45-51.   Published online February 25, 2013

Because nonalcoholic steatohepatitis can progress towards cirrhosis even in children, early detection of hepatic fibrosis and accurate diagnosis of nonalcoholic fatty liver disease (NAFLD) are important. Although liver biopsy is regarded as the gold standard of diagnosis, its clinical application is somewhat limited in children due to its invasiveness. Noninvasive diagnostic methods, including imaging studies, biomarkers of inflammation, oxidative stress,...

Eosinophil-derived neurotoxin: a novel biomarker for diagnosis and monitoring of asthma
Chang-Keun Kim
Clin Exp Pediatr. 2013;56(1):8-12.   Published online January 29, 2013

Asthma is associated with increased levels of eosinophils in tissues, body fluids, and bone marrow. Elevated levels of eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) have been noted in asthma patients. Higher levels of EDN and ECP are also associated with exacerbated asthmatic conditions. Thus, EDN, along with ECP, may aid the diagnosis and monitoring of asthma. Several groups...

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