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Clinical Lecture
Common Urinary Symptoms in Outpatient Clinic - Voiding Dysfunction in Children -
Kee Hyuck Kim, Young Sig Kim
Clin Exp Pediatr. 2005;48(6):575-579.   Published online June 15, 2005
Urinary incontinence is the most common urinary symptom in children and causes considerable anxiety in children and parents. In most cases, there is no underlying organic pathology and the long- term prognosis is excellent. Despite these reassuring facts, children with wetting problems can be a challenge for primary pediatrician. This is probably because the problem is poorly understood, there is...
Erratum
A Case of Vitamin D-Dependent Rickets, Type 1
Ji Hye Hur, Chong Guk Lee, Chung Wook Sur
Accepted January 1, 1970  
"Rickets" is the term applied to impaired mineralization at epiphyseal growth plate, resulting in deformity and impaired linear growth of long bones. Rickets may arise as a result of vitamin D deficiency or abnormality in metabolism. Vitamin D-dependent rickets(VDDR) is rare autosomal recessive disorder in which affected individuals have clinical features of vitamin D deficiency. In 1961, Prader first described...
Tacrolimus versus Cyclosporine Immunosuppression in Pediatric Renal Transplantation : Pharmacokinetic Consideration
Jung Sue Kim
Clin Exp Pediatr. 2005;48(5):476-480.   Published online May 15, 2005
Immunosuppressive therapy in pediatric renal transplant recipients is changing consequence of the increasing number of available immunosuppressive agents. The optimal use of immunosuppressive agents requires a thorough understanding of the pharmacokinetic characteristics, but the information on the pharmacokinetic characteristics of these drugs in pediatric transplant recipients is still limited. In general, patients younger than 5 years old show higher clearance...
Clinical Lecture
The Effects of Postpartum Depression on the Development of Children
Esook Oh
Clin Exp Pediatr. 2005;48(5):469-475.   Published online May 15, 2005
Mother-infant interaction is a crucial component of an infant's cognitive, emotional and behavioral development. Most people are preoccupied with fetal education, the physical conditions of the postpartum mother and baby, and emphasizing an early start in the child's education. However, the effects of a mother's postnatal emotional state on the development of the infant are often overlooked. Postpartum depression is...
Approach to the Children with Recurrent Infections
Jae Ho Lee
Clin Exp Pediatr. 2005;48(5):461-468.   Published online May 15, 2005
The major function of immune system is to protect infections. The immune systems are composed of innate and adaptive immunity. In adaptive immunity, the cellular and humoral components interact each other. Neonates and infants are infected frequently, because immune systems are naive and easy to expose to infectious agents. The complete history and physical examination is essential to evaluate the...
Medical Lecture Course
Constipation in Children
Jae Young Kim
Clin Exp Pediatr. 2005;48(4):355-362.   Published online April 15, 2005
Constipation is very common phenomenon during childhood that accounts approximately 3% of general pediatric outpatient visits and up to 25% of visit to the pediatric gastroenterologist. The diagnosis of functional constipation is based on the historical features and absence of physical abnormalities. Most infants and children with chronic constipation require no diagnostic tests. Constipation and subsequent fecal retention behavior often...
Clinical Lecture
Clinical Approach to Headache in Childhood
Soo Ahn Chae
Clin Exp Pediatr. 2005;48(4):349-354.   Published online April 15, 2005
Headache is a common complaint in pediatric office practices as well as in children presenting to emergency departments. Children who complain of headache usually are brought to medical attention by their parents, who seek reassurance that the headaches are not a sign of a serious illness. The etiologies of headache range from school problems to brain tumors. A history taking,...
Medical Lecture Course
CpG DNA for Treatment of Allergic Diseases
Sung Min Choi
Clin Exp Pediatr. 2005;48(3):251-259.   Published online March 15, 2005
Atopy is a highly prevalent and serious health problem. The prevalence and severity of asthma and allergic diseases have increased over recent decades, particularly in industrialized nations. Early life infections may protect against the development of atopy and allergic diseases like asthma. The inverse relationship between the incidence of atopy and childhood infections has led to the 'hygiene hypothesis', which...
Clinical Lecture
Acute infectious Diarrhea in Pediatirc Patients
Sang Hyuk Ma
Clin Exp Pediatr. 2005;48(3):235-250.   Published online March 15, 2005
Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include : ① normal variant stool versus diarrhea ② infectious versus non-infectious condition and ③ bacterial versus non-bacterial etiology. The use of antibiotics should...
Medical Lecture Course
Recent Advances in Regulating Energy Homeostasis and Obesity
Mi Jung Park
Clin Exp Pediatr. 2005;48(2):126-137.   Published online February 15, 2005
New insights in the complex metabolic pathways and its control mechanism for energy homeostasis have refined our understanding of the pathophysiology of obesity. It is now recognized that there are several additional regulatory mechanism such as peripheral signals including leptin, ghrelin, GLP-1 and PYY and cellular signals including uncoupling proteins and β Adrenergic receptors, which contribute to the regulation of...
Clinical Lecture
Differential Diagnosis and Treatment of Anemia in Children
Young Tak Lim
Clin Exp Pediatr. 2005;48(2):121-125.   Published online February 15, 2005
Anemia can be defined as a reduction in blood hemoglobin concentration or red cell mass relative to age matched normal values. Clinical presentation may range from obviously pale and lethargy to an incidental finding during screening of an otherwise well appearing child. The differential diagnosis of anemia in each instance is broad with numerous possible etiologies. A careful history and...
Medical Lecture Course
Helper T Cell Polarizing Through Dendritic Cells
Manyong Han
Clin Exp Pediatr. 2005;48(1):6-12.   Published online January 15, 2005
In the last few years, a spectrum of dendritic cells(DCs), including toll like receptors(TLRs), might play a critical role in regulating allergy and asthma. DC plays a central role in initiating immune responses, linking innate and adaptive responses to pathogen. Human peripheral blood has three non- overlapping dendritic subset that expressed various 11 TLRs. These dendritic subsets and TLR contribute...
Clinical Lecture
Benign Arrhythmias in Infants and Children
Jae Kon Ko
Clin Exp Pediatr. 2005;48(1):1-5.   Published online January 15, 2005
Pediatricians often encounter some electrocardiographic abnormalities in infants and children. However, treatment or referral to pediatric cardiologist is not indicated for all arrhythmias. Many of them are benign in nature. Benign arrhythmias can be defined as the arrhythmias that no serious problem currently exists and no treatment is needed. The prognosis of benign arrhythmias is so good that the condition...
Treatment of Immue Thrombocytopenic Purpura in Childhood
Hwang Min Kim
Clin Exp Pediatr. 2004;47(12):1262-1265.   Published online December 15, 2004
Childhood immune thrombocytopenic purpura(ITP) is a typically benign self-limiting bleeding disorder of not fully known autoimmune etiology. Chronic ITP, which is defined by duration of more than 6 months, occurs in approximately 20% of children. Neither the risk of bleeding nor the type of disease, acute or chronic, can be predicted at initial presentation. The indication of treatment, choice...
Hematuria in Children
Ja Wook Koo
Clin Exp Pediatr. 2004;47(12):1255-1261.   Published online December 15, 2004
The detection of even microscopic amounts of blood in a child's urine, whether accompanied by symptoms or asymptomatic, alarms the patient, parents, and physician, and often prompts the performance of many laboratory studies. Hematuria is one of the most important signs of renal or bladder disease, but proteinuria is a more important diagnostic and prognostic finding, except in the case...
Neurological Examination after the Newborn Period until 3 Years of Age
Soonhak Kwon
Clin Exp Pediatr. 2004;47(11):1142-1148.   Published online November 15, 2004
The children should not be regarded as miniature adults since they are in the dynamic process of growth and development. Among many pediatric problems, the developmental delay may be central to them. For this reason, primary care physicians, especially pediatricians should be able to manage children with probable developmental delays because early detection and treatment of developmental delay or neurological...
Medical Lecture Course
Role of Mast Cells in Allergic Inflammation and Innate Immunity
Kangmo Ahn
Clin Exp Pediatr. 2004;47(11):1137-1141.   Published online November 15, 2004
Mast cells play a key role in elicitation of the early-phase and late-phase IgE-mediated allergic inflammatory reactions. Mast cells are derived from pluripotent stem cells from the bone marrow. These cells migrate through circulation into connective tissues and mucosal surfaces where they mature. On the cell surfaces, mast cells have high affinity IgE receptor(FcεRI), which react with specific IgE to...
Clinical Lecture
Clinical Approach to the Children with Coagulation Deficiencies
Sang Kyu Park
Clin Exp Pediatr. 2004;47(10):1036-1040.   Published online October 15, 2004
This review deals with the coagulation deficiencies which are due to the abnormality in one of three hemostatic systems. It explains about the diagnostic examinations that should be done to differentiate for patients with bleeding tendency and the things to consider when preoperative screening tests for coagulation are abnormal.
Medical Lecture Course
Factors Involved in Lung Development and Alveolarization
Min Soo Park
Clin Exp Pediatr. 2004;47(10):1031-1035.   Published online October 15, 2004
Lung development is a sum of processes that involve harmonized orchestration of expressions of various factors in time and space. The mastermind governing these phenomena is not known, but cumulative efforts so far have helped us gain some insights as to what are involved in and how complex the developmental process is. Beginning as primitive foregut, lungs undergo processes called...
Clinical Lecture
Acquired Thyroid Disorders in Childhood
Ho-Seong Kim
Clin Exp Pediatr. 2004;47(9):926-932.   Published online September 15, 2004
Thyroid hormones influence growth and development, oxygen consumption, heat production, nerve function, and metabolism, thus play a critical role as a regulator of nervous system myelination, of growth and of puberty. Disorders affecting thyroid function may cause irreversible and permanent nervous system damage and developmental delay, especially in early infancy. Appropriate medical care of children with thyroid disorders requires refined...
Medical Lecture Course
Regulatory T Cells and Allogeneic Transplantation
Dae Chul Jeong
Clin Exp Pediatr. 2004;47(9):919-925.   Published online September 15, 2004
Allogeneic organ or hematopoietic stem cell transplantation(HSCT) is the treatment of choice for end-stage organ diseases or various hematologic disorders. The induction of alloantigen specific T cell tolerance and its maintenance are critical for preventing immune responses, including graft rejection or graft-versus-host disease(GVHD) in allogeneic transplantation. CD4＋ T cells are classified as immune functions : Th1 CD4＋ cells for cellular...
Clinical Lecture
The Pharmacotherapy of Childhood Epilepsy
Sang Ook Nam
Clin Exp Pediatr. 2004;47(8):821-826.   Published online August 15, 2004
Epilepsy is one of the most common and disabling neurologic disorders in childhood. The primary goal of epilepsy treatment is to choose the treatment modality that provides the best chance of improving the patient's quality of life. In addition to classic antiepileptic drugs, newly developed antiepileptic drugs ketogenic diet, epilepsy surgery, and vagal nerve stimulation have improved the ability to...
Medical Lecture Course
Impact of Host Genetics on Susceptibility and Outcome of Viral Infections
Eun Hwa Choi
Clin Exp Pediatr. 2004;47(8):815-820.   Published online August 15, 2004
The generation of a draft sequence of the human genome has lead to an opportunity to characterize human diversity, including the differences in host response to numerous pathogens. Host responses upon exposure to a pathogen can determine the wide spectrum of illness from subclinical or mild to severe diseases. Host factors, particularly genetic backgrounds, influence the pathogenesis of infectious diseases....
Clinical Lecture
About the Reformed Medical Terms
In Seok Lim
Clin Exp Pediatr. 2004;47(7):716-718.   Published online July 15, 2004
Concerning our medical history, the importance of medical terms has been neglected for a long time. In addition, medical terminologies are unaccustomed to the patients including the public. The separation of communications between the public and medical participants has been enlarged more and more. The importance of terms which can be easily recognized, comfortable to the ear, and familiar to...
Pathophysiology of Persistent Pulmonary Hypertension of the Newborn
Yong Hoon Jun
Clin Exp Pediatr. 2004;47(7):707-715.   Published online July 15, 2004
Persistent pulmonary hypertension of the newborn(PPHN) is a disorder characterized by persistence of the pattern of fetal circulation after birth due to a sustained elevation of pulmonary vascular resistance. The two primary events in the pathophysiology of neonatal pulmonary hypertension are hypoxic pulmonary vasoconstriction(HPV) and hypoxic pulmonary vascular remodeling(HPR). Chronic hypoxemia may cause increased muscularity of the pulmonary arteries and...
Medical Lecture Course
Recurrent Early-Life Seizures and Changes in GABAA Receptors Expression in Hippocampus
Doo Kwun Kim
Clin Exp Pediatr. 2004;47(6):596-603.   Published online June 15, 2004
The immature brain differs from the adult brain in its susceptibility to seizures, seizure characteristics, and responses to antiepileptic drugs. Gamma(γ)-aminobutyric acid(GABA) is the predominant inhibitory neurotransmitter in the adult brain. GABA exerts its main action through GABAA receptors, which are coupled to a ligand-gated chloride channel. The receptor protein is a pentameric structure composed of multiple subunits of different...
Clinical Lecture
New Guideline of Pediatric Cardiopulmonary Resuscitation
Yong Won Park
Clin Exp Pediatr. 2004;47(6):591-595.   Published online June 15, 2004
A primary cardiac arrest is rare in children. The usual course begins with respiratory arrest and culminates in profound bradycardia or asystole and cardiovascular collapse, so it is vitally important to quickly restore ventilation in pediatric patients(phone-fast). Children over 8 years of age follow the same sequence as adults; that is calling emergency medical services before providing rescue breathing(phone-first).
Medical Lecture Course
Renal Transport Proteins Involved in Urinary Concentrating Mechanism
Dong Un Kim
Clin Exp Pediatr. 2004;47(5):480-484.   Published online May 15, 2004
Renal tubule and vasa recta are arranged in complex but specific anatomic relationships and the production of a concentrated urine is achieved by countercurrent multiplication mechanism in the renal medulla. This model requires that the ascending thin limb is highly permeable to NaCl but impermeable to water, while the descending thin limb is impermeable to NaCl but highly permeable to...
Clinical Lecture
Detection and Diagnosis of Primary Immunodeficiency Diseases
Youn-Soo Hahn
Clin Exp Pediatr. 2004;47(5):475-479.   Published online May 15, 2004
Primary immunodeficiency diseases result from innate defects of immune system. As a consequence, recurrent viral, bactrial, fungal, and protozoal infections of varying severity ensue. Although primary immunodeficiency diseases are relatively rare, intensive study of these disorder has expanded our understanding of immunity. Recent progress in immunobiology and genetics has identified the causes of many of the primary immunodeficiency diseases. Diagnosis...
Erratum
A Clinical Approach to Failure to Gain Weight in Infants
Jin-Bok Hwang
Clin Exp Pediatr. 2004;47(4):355-361.   Published online April 15, 2004
Failure to thrive is a term used to describe growth failure in infants and young children that may be accompanied by retarded social and motor achievements. The three categories of failure to thrive is based on anthropometric measurements of weight, length, and head circumference for age. Type 1 category, inadequate growth or loss of body weight with relatively normal height...
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