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Review Article
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...

The role of the pediatrician in youth violence prevention
Soon Ki Kim, Nam Su Kim
Clin Exp Pediatr. 2013;56(1):1-7.   Published online January 29, 2013

School bullying has become a major social problem in Korea after the emergence of media reports on children who committed suicide after being victimized by bullies. In this article, we review the characteristics of bullying, and investigate the role of the pediatrician in the prevention of and intervention against bullying and school violence. Bullying can take on many forms such...

Current status of measles in the Republic of Korea: an overview of case-based and seroepidemiological surveillance scheme
Young June Choe, Geun-Ryang Bae
Clin Exp Pediatr. 2012;55(12):455-461.   Published online December 20, 2012

Following the Five Year Measles Elimination Program, measles has been declared eliminated from the Republic of Korea since 2006. However, there remain challenges related to the surveillance of measles in the postelimination phase. Even though the routine surveillance system has revealed a gradual decrease in the number of reported cases since 2002, 4 resurgences have occurred, notably due to outbreaks....

Impact of attachment, temperament and parenting on human development
Yoo Rha Hong, Jae Sun Park
Clin Exp Pediatr. 2012;55(12):449-454.   Published online December 20, 2012

The purpose of this review is to present the basic concepts of attachment theory and temperament traits and to discuss the integration of these concepts into parenting practices. Attachment is a basic human need for a close and intimate relationship between infants and their caregivers. Responsive and contingent parenting produces securely attached children who show more curiosity, self-reliance, and independence....

Indirect revascularization surgery for moyamoya disease in children and its special considerations
Kyu-Chang Wang, Ji Hoon Phi, Ji Yeoun Lee, Seung-Ki Kim, Byung-Kyu Cho
Clin Exp Pediatr. 2012;55(11):408-413.   Published online November 23, 2012

Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in...

Understanding noninferiority trials
Seokyung Hahn
Clin Exp Pediatr. 2012;55(11):403-407.   Published online November 23, 2012

Noninferiority trials test whether a new experimental treatment is not unacceptably less efficacious than an active control treatment already in use. With continuous improvements in health technologies, standard care, and clinical outcomes, the incremental benefits of newly developed treatments may be only marginal over existing treatments. Sometimes assigning patients to a placebo is unethical. In such circumstances, there has been...

Renal scar formation after urinary tract infection in children
Young Seo Park
Clin Exp Pediatr. 2012;55(10):367-370.   Published online October 29, 2012

Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis,...

Enterovirus infection in Korean children and anti-enteroviral potential candidate agents
Kwi Sung Park, Young Jin Choi, Joon Soo Park
Clin Exp Pediatr. 2012;55(10):359-366.   Published online October 29, 2012

Although most enterovirus infections are not serious enough to be life threatening, several enteroviruses such as enterovirus 71 are responsible for severe, potentially life-threatening disease. The epidemic patterns of enteroviruses occur regularly during the year, but they may change due to environmental shifts induced by climate change due to global warming. Therefore, enterovirus epidemiological studies should be performed continuously as...

The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders
Munhyang Lee
Clin Exp Pediatr. 2012;55(9):316-321.   Published online September 14, 2012

The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its anti-epileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency...

Need for a safe vaccine against respiratory syncytial virus infection
Joo-Young Kim, Jun Chang
Clin Exp Pediatr. 2012;55(9):309-315.   Published online September 14, 2012

Human respiratory syncytial virus (HRSV) is a major cause of severe respiratory tract illnesses in infants and young children worldwide. Despite its importance as a respiratory pathogen, there is currently no licensed vaccine for HRSV. Following failure of the initial trial of formalin-inactivated virus particle vaccine, continuous efforts have been made for the development of safe and efficacious vaccines against...

Effects of phytoestrogen on sexual development
Shin Hye Kim, Mi Jung Park
Clin Exp Pediatr. 2012;55(8):265-271.   Published online August 23, 2012

Phytoestrogen is an estrogenic compound that occurs naturally in plants. The most common sources of phytoestrogen are soybean products, which contain high levels of isoflavones. This compound, which has structural similarity with estrogen, can act as an estrogen receptor agonist or antagonist. Animal studies provide evidence of the significant effects of phytoestrogen on sexual development, including altered pubertal timing, impaired...

Early childhood wheezing: various natural courses and their relationship to later asthma
Dong In Suh, Young Yull Koh
Clin Exp Pediatr. 2012;55(8):259-264.   Published online August 23, 2012

Wheezing is one of the most frequent complaints that lead to the use of medical resources in younger children. Generally, wheezing is caused by bronchiolitis and resolves spontaneously without recurrence, but sometimes, wheezing can progress into asthma. Early data on the natural history of childhood wheezing was mostly obtained from retrospective reviews of medical records or from questionnaires, which made...

Endocrine problems in children with Prader-Willi syndrome: special review on associated genetic aspects and early growth hormone treatment
Dong-Kyu Jin
Clin Exp Pediatr. 2012;55(7):224-231.   Published online July 17, 2012

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. The main clinical features include neonatal hypotonia, distinctive facial features, overall developmental delay, and poor growth in infancy, followed by overeating with severe obesity, short stature, and hypogonadism later in development. This paper reviews recent updates regarding the genetic aspects of this disorder. Three mechanisms (paternal deletion,...

Umbilical cord blood transplantation
Hong Hoe Koo, Hyo Seop Ahn
Clin Exp Pediatr. 2012;55(7):219-223.   Published online July 17, 2012

Since the first umbilical cord blood transplantation (CBT) in 1998, cord blood (CB) has now become one of the most commonly used sources of hematopoietic stem cells for transplantation. CBT has advantages of easy procurement, no risk to donor, low risk of transmitting infections, immediate availability and immune tolerance allowing successful transplantation despite human leukocyte antigen disparity. Several studies have...

Effects of probiotics on the prevention of atopic dermatitis
Nam Yeun Kim, Geun Eog Ji
Clin Exp Pediatr. 2012;55(6):193-201.   Published online June 21, 2012

Atopic dermatitis (AD) is an immune disorder that is becoming increasingly prevalent throughout the world. The exact etiology of AD remains unknown, and a cure for AD is not currently available. The hypothesis that appropriate early microbial stimulation contributes to the establishment of a balanced immune system in terms of T helper type Th1, Th2, and regulatory T cell (Treg)...

Ambient air pollution and allergic diseases in children
Byoung-Ju Kim, Soo-Jong Hong
Clin Exp Pediatr. 2012;55(6):185-192.   Published online June 21, 2012

The prevalence of allergic diseases has increased worldwide, a phenomenon that can be largely attributed to environmental effects. Among environmental factors, air pollution due to traffic is thought to be a major threat to childhood health. Residing near busy roadways is associated with increased asthma hospitalization, decreased lung function, and increased prevalence and severity of wheezing and allergic rhinitis. Recently,...

Cognitive function of idiopathic childhood epilepsy
Su Jeong You
Clin Exp Pediatr. 2012;55(5):159-163.   Published online May 21, 2012

Most children with epilepsy are of normal intelligence. However, a significant subset will have temporary or permanent cognitive impairment. Factors that affect cognitive function are myriad and include the underlying neuropathology of the epilepsy, seizures, epileptiform discharges, psychosocial problems, age at seizure onset, duration of epilepsy, and side effects associated with antiepileptic drugs. This review article discusses cognitive function in...

Food allergy
Youngshin Han, Jihyun Kim, Kangmo Ahn
Clin Exp Pediatr. 2012;55(5):153-158.   Published online May 21, 2012

Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal...

Treatment of high-risk neuroblastoma
Ki Woong Sung
Clin Exp Pediatr. 2012;55(4):115-120.   Published online April 30, 2012

Although high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) have improved the prognosis for patients with high-risk neuroblastoma (NB), event-free survival rates remain in the range of 30 to 40%, which is unsatisfactory. To further improve outcomes, several clinical trials, including tandem HDCT/autoSCT, high-dose 131I-metaiodobenzylguanidine treatment, and immunotherapy with NB specific antibody, have been undertaken and pilot studies have reported...

Diagnosis of incomplete Kawasaki disease
Jeong Jin Yu
Clin Exp Pediatr. 2012;55(3):83-87.   Published online March 16, 2012

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be...

Epidemiology of astrovirus infection in children
Hye Sook Jeong, Ahyong Jeong, Doo-Sung Cheon
Clin Exp Pediatr. 2012;55(3):77-82.   Published online March 16, 2012

Human astrovirus (HAstV) is a major cause of acute diarrhea among children, resulting in outbreaks of diarrhea and occasionally hospitalization. Improved surveillance and application of sensitive molecular diagnostics have further defined the impact of HAstV infections in children. These studies have shown that HAstV infections are clinically milder (diarrhea, vomiting, fever) than infections with other enteric agents. Among the 8...

Mycoplasma pneumoniae pneumonia in children
You-Sook Youn, Kyung-Yil Lee
Clin Exp Pediatr. 2012;55(2):42-47.   Published online February 14, 2012

Mycoplasma pneumoniae (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the...

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