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Review Article
Environmental tobacco smoke and children's health
Sang-Hyun Hwang, Jong Hee Hwang, Jin Soo Moon, Do-Hoon Lee
Clin Exp Pediatr. 2012;55(2):35-41.   Published online February 14, 2012

Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on...

The genes associated with gonadotropin-releasing hormone-dependent precocious puberty
Jin Soon Hwang
Clin Exp Pediatr. 2012;55(1):6-10.   Published online January 31, 2012

Human puberty is a complex, coordinated biological process with multiple levels of regulations. The timing of puberty varies greatly in children and is influenced by both environmental and genetic factors. The key genes of pubertal onset, KISS1, GPR54, GNRH1 and GNRHR, may be major causal factors underlying gonadotropin-releasing hormone-dependent precocious puberty (GDPP). Two gain-of-function mutations in KISS1 and GPR54 have...

An overview of the national immunization policy making process: the role of the Korea expert committee on immunization practices
Hee Yeon Cho
Clin Exp Pediatr. 2012;55(1):1-5.   Published online January 31, 2012

The need for evidence-based decision making in immunization programs has increased due to the presence of multiple health priorities, limited human resources, expensive vaccines, and limited funds. Countries should establish a group of national experts to advise their Ministries of Health. So far, many nations have formed their own National Immunization Technical Advisory Groups (NITAGs). In the Republic of Korea,...

Infectious diseases in children and adolescents in the Republic of Korea; Past & recent status
Jong-Hyun Kim
Clin Exp Pediatr. 2011;54(12):489-500.   Published online December 31, 2011

Compared to the past decades, in recent decades, environmental and hygienic conditions in the Republic of Korea have improved along with socioeconomic developments, and the incidence of most infectious diseases, especially vaccine-preventable diseases, has greatly decreased due to active immunization with the developed level of health care. However, the incidence of some diseases has been increasing, and new diseases have...

Regionalization of neonatal intensive care in Korea
Yun Sil Chang
Clin Exp Pediatr. 2011;54(12):481-488.   Published online December 31, 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report,...

Regionalization of pediatric emergency care in Korea
Do Kyun Kim
Clin Exp Pediatr. 2011;54(12):477-480.   Published online December 31, 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill...

Changes in the neonatal and infant mortality rate and the causes of death in Korea
Sung-Hoon Chung, Yong-Sung Choi, Chong-Woo Bae
Clin Exp Pediatr. 2011;54(11):443-455.   Published online November 30, 2011

Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and wellbeing of a population. Korea's NMR and IMR fell significantly...

Secular trends of body sizes in Korean children and adolescents: from 1965 to 2010
Jin Soo Moon
Clin Exp Pediatr. 2011;54(11):436-442.   Published online November 30, 2011

An anthropometric survey is one of the most important approaches to use when evaluating the health status of children. Secular trends in body sizes, such as height, weight, head circumference, chest circumference, and body mass index showed significant changes over 40 years in Korea. A series of periodic surveys were conducted in 1967, 1975, 1985, 1997, and 2005 by the...

The changing trends in live birth statistics in Korea, 1970 to 2010
Jae Woo Lim
Clin Exp Pediatr. 2011;54(11):429-435.   Published online November 30, 2011

Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of...

Smoking and adolescent health
Sang-hee Park
Clin Exp Pediatr. 2011;54(10):401-404.   Published online October 31, 2011

With the Westernization and opening of our society, adolescents' smoking is increasing and being popularized. Many adolescents start smoking at an early age out of curiosity and venturesomeness, and earlier start of smoking makes it more difficult to quit smoking. Adolescents' habitual smoking not only becomes a gateway to all kinds of substance abuse but also causes various health problems...

Current health issues in Korean adolescents
Chang Ho Hong
Clin Exp Pediatr. 2011;54(10):395-400.   Published online October 31, 2011

During the adolescent period, they experience rapid physical, emotional, cognitive developments while they establish their lifestyle and habitual routines that strongly influence adult health and life. Recent rapid economic growth in Korea, and the earlier onset of physical, sexual, and psychological maturation of adolescents, has resulted in changes in the health status of adolescents from many years ago. Risk-taking behaviors...

An update on necrotizing enterocolitis: pathogenesis and preventive strategies
Jang Hoon Lee
Clin Exp Pediatr. 2011;54(9):368-372.   Published online September 30, 2011

Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birth-weight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC...

Catheter-related bloodstream infections in neonatal intensive care units
Jung Hyun Lee
Clin Exp Pediatr. 2011;54(9):363-367.   Published online September 30, 2011

Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters,...

Optimal oxygen saturation in premature infants
Meayoung Chang
Clin Exp Pediatr. 2011;54(9):359-362.   Published online September 30, 2011

There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below...

Complications of nephrotic syndrome
Se Jin Park, Jae Il Shin
Clin Exp Pediatr. 2011;54(8):322-328.   Published online August 31, 2011

Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and...

Treatment of steroid-resistant pediatric nephrotic syndrome
Hee Gyung Kang
Clin Exp Pediatr. 2011;54(8):317-321.   Published online August 31, 2011

Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be...

Adolescent nutrition: what do pediatricians do?
Eell Ryoo
Clin Exp Pediatr. 2011;54(7):287-291.   Published online July 31, 2011

Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies...

Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses
Jin Soo Moon
Clin Exp Pediatr. 2011;54(7):282-286.   Published online July 31, 2011

Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to...

Nutritional approach to failure to thrive
Su Jin Jeong
Clin Exp Pediatr. 2011;54(7):277-281.   Published online July 31, 2011

Failure to thrive (FTT) is a term generally used to describe an infant or child whose current weight or rate of weight gains is significantly below that expected of similar children of the same age, sex and ethnicity. It usually describes infants in whom linear growth and head circumference are either not affected, or are affected to a lesser degree...

Mammalian target of rapamycin inhibitors for treatment in tuberous sclerosis
Won Seop Kim
Clin Exp Pediatr. 2011;54(6):241-245.   Published online June 30, 2011

Tuberous sclerosis complex (TSC) is a genetic multisystem disorder that results from mutations in the TSC1 or TSC2 genes, and is associated with hamartomas in several organs, including subependymal giant cell tumors. The neurological manifestations of TSC are particularly challenging and include infantile spasms, intractable epilepsy, cognitive disabilities, and autism. The TSC1- and TSC2-encoded proteins modulate cell function via the...

Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course
Yun Jin Lee
Clin Exp Pediatr. 2011;54(6):234-240.   Published online June 30, 2011

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM...

Excessive crying: behavioral and emotional regulation disorder in infancy
Joon Sik Kim
Clin Exp Pediatr. 2011;54(6):229-233.   Published online June 30, 2011

In the pediatric literature, excessive crying has been reported solely in association with 3-month colic and is described, if at all, as unexplained crying and fussing during the first 3 months of life. The bouts of crying are generally thought to be triggered by abdominal colic (over-inflation of the still immature gastrointestinal tract), and treatment is prescribed accordingly. According to...

Respiratory syncytial virus prevention in children with congenital heart disease: who and how?
Nam Kyun Kim, Jae Young Choi
Clin Exp Pediatr. 2011;54(5):197-200.   Published online May 31, 2011

Respiratory syncytial virus (RSV) is a major cause of respiratory infection in children. Most of the pediatric population have RSV infection before the age of 2, and recurrent infections are common even within one season. Chronic lung disease, prematurity, along with congenital heart disease (CHD) are major risk factors in severe lower respiratory infection. In hemo-dynamically significant CHD patients with...

Respiratory syncytial virus infection in children with congenital heart disease: global data and interim results of Korean RSV-CHD survey
Jo Won Jung
Clin Exp Pediatr. 2011;54(5):192-196.   Published online May 31, 2011

Respiratory syncytial virus (RSV) is a main cause of hospitalization for bronchiolitis and pneumonia in infants worldwide. Children with hemodynamically significant congenital heart disease (HS-CHD), as well as premature infants are at high risk for severe RSV diseases. Mortality rates for CHD patients hospitalized with RSV have been reported as about 24 times higher compared with those without RSV infection....

Congenital heart disease in the newborn requiring early intervention
Sin Weon Yun
Clin Exp Pediatr. 2011;54(5):183-191.   Published online May 31, 2011

Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary...

Recommendation for use of the newly introduced pneumococcal protein conjugate vaccines in Korea
Eun Hwa Choi, Kyung Hyo Kim, Yae Jean Kim, Jong Hyun Kim, Su Eun Park, Hoan Jong Lee, Byung Wook Eun, Dae Sun Jo, Kyong Min Choi, Young Jin Hong
Clin Exp Pediatr. 2011;54(4):146-151.   Published online April 30, 2011

Streptococcus pneumoniae remains a leading cause of invasive infections including bacteremia and meningitis, as well as mucosal infections such as otitis media and pneumonia among children and adults. The 7-valent pneumococcal conjugate vaccine (PCV7) was licensed for use among infants and young children in many countries including Korea. The routine use of PCV7 has resulted in a decreased incidence of...

Recommendation for the use of newly introduced Tdap vaccine in Korea
Kyong Min Choi, Kyung Hyo Kim, Yae-Jean Kim, Jong-Hyun Kim, Su Eun Park, Hoan Jong Lee, Byung Wook Eun, Dae Sun Jo, Eun Hwa Choi, Young Jin Hong
Clin Exp Pediatr. 2011;54(4):141-145.   Published online April 30, 2011

Pertussis is an acute respiratory infection characterized by paroxysmal cough and inspiratory whoop for over 2 weeks. The incidence of pertussis has decreased markedly after the introduction of DTwP/DTaP vaccine, but the incidence of pertussis has increased steadily among young infant and among adolescents and adults in many countries. Td vaccine was used in this age group but the increase...

The treatment of pediatric chronic myelogenous leukemia in the imatinib era
Jae Wook Lee, Nack Gyun Chung
Clin Exp Pediatr. 2011;54(3):111-116.   Published online March 31, 2011

Childhood chronic myelogenous leukemia (CML) is a rare hematologic disease, with limited literature on the methods of treatment. Previously, allogeneic hematopoietic stem cell transplantation (HSCT) was considered the only curative treatment for this disease. Treatment with imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase (TKI), has resulted in prolonged molecular response with limited drug toxicity. Imatinib is now implemented...

Philadelphia chromosome-positive acute lymphoblastic leukemia in childhood
Hong Hoe Koo
Clin Exp Pediatr. 2011;54(3):106-110.   Published online March 31, 2011

In pediatric patients with acute lymphoblastic leukemia (ALL), the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20-30% of Philadelphia chromosome-positive (Ph+) children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of...

Recent advances in the diagnosis and management of childhood acute promyelocytic leukemia
Eun Sun Yoo
Clin Exp Pediatr. 2011;54(3):95-105.   Published online March 31, 2011

Since the successful introduction of all-trans-retinoic acid (ATRA) and its combination with anthracycline-containing chemotherapy, the prognosis for acute promyelocytic leukemia (APL) has markedly improved. With ATRA and anthracycline-based-chemotherapy, the complete remission rate is greater than 90%, and the long-term survival rate is 70-89%. Moreover, arsenic trioxide (ATO), which was introduced for APL treatment in 1994, resulted in excellent remission rates...

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