• Clinical and Experimental Pediatrics
• /
• v.65 no.1
• /
• pp.53-55
• /
• 2022

• Clinical and Experimental Pediatrics
• /
• v.49 no.11
• /
• pp.1140-1151
• /
• 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 symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for confirmatory diagnosis of each disease, which challenge to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.13 no.1
• /
• pp.1-19
• /
• 2013

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 600 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that requires immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for the confirmatory diagnosis of each disease, which is challenging to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

• Neonatal Medicine
• /
• v.16 no.1
• /
• pp.1-9
• /
• 2009

Seizures are the most common clinical manifestation of a neurologic insult during the neonatal period. Neonatal seizures continue to present a diagnostic and therapeutic challenge to pediatricians because the recognition and classification of neonatal seizures remains problematic, particularly when clinicians rely only on clinical criteria. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity, and "prime" the brain to increased damage from seizures later in life. Since neonatal seizures, particularly status epilepticus, predict an increased risk for later epilepsy and other neurologic sequelae, accurate diagnoses are needed for aggressive antiepileptic drug use. The present review summarizes the pathophysiology, etiology, and diagnosis of neonatal seizures.

• The Journal of Pediatrics of Korean Medicine
• /
• v.13 no.1
• /
• pp.63-138
• /
• 1999

From all possible chinese medical literatures, I studied the history of chinese pediatrics by dividing into Chunqiu Zhanguo, QinHan dynasties, LiangJin, SuiTang five dynasties, Song Dynasty, Jin and Yuan dynasties, Ming Qing dynasties. The conclusions are summarized as followings 1. The mentions related with pediatrics existed already in Yan ruins turtle shell letters, and 〈Yellow Emperor's classic of internal medicine> in Chunqiu Zhanguo time formed the system of medicine, established the theoretical foundation. 2. Chang Ji established the system of diagnosis and treatment based on overall analysis of symptoms and signs in , and later pediatricians commonly applied his prescriptions to the febrile diseases. 3. The period from LiangJin to SuiTang, Pediatrics was established as special department then in , Chao Yuanfang stated the etiology, pathogenesis, symptomatology of pediatric diseases. 4. In Song dynasty. pediatric 4 major, symptoms that had been mentioned from SuiTang dynasties, were clearly established, pediatrical special books were published, and written by Qian Yi who is considered as the founder of chinese pediatrics, established the foundation of pediatrical division formation in distinction from adult fields. 5. In Jin and Yuan dynasties, four eminent physicians established the actual relationship between the theories and practical applications and insisted various and creative theories based on the classical medicine, for example, the theory that fire and heat in the body was the main cause of diseases of Liu Wansu purgation theory of Zhang Congzheng, qi regulating theory of Liu Gao, ministerial fire theory and the theory that yang is ever in excess while Yin is ever deficient of Zhu Zhenheng, etc, and they applied those theories to pediatrical various sides. 6, In Ming Qing dynasties, pediatrical specialists and pediatrical publications had increased, eg, father and son Xue Kai Xue Ji, Wan Quan, Lu Bai-si, etc in Ming dynasty, Ye Gui, Chen Fuzheng, Xia Ding, etc in Qing dynasty were famous as pediatricians. Specially, the doctrine of epidemic febrile diseases at that time showed prominent effects to children's epidemic febrile diseases.

• The Journal of Pediatrics of Korean Medicine
• /
• v.33 no.2
• /
• pp.1-11
• /
• 2019

Objectives The objectives of this study is to investigate the characteristics of Attention-deficit/hyperactivity disorder (ADHD) pattern identification based on the survey of frequencies of symptoms and signs according to the pediatricians and psychiatrists in Korean Medicine. Methods Eleven pediatricians and fourteen psychiatrists participated in this study. 38 symptoms and signs of 4 ADHD pattern identifications (Kidney yin deficiency and liver yang ascendant hyperactivity 腎虛肝亢, Dual deficiencies in the heart and spleen 心脾兩虛, Phlegm-fire harassing the heart 痰火擾心, Spleen weakness and liver energy preponderance 脾虛肝旺) were used to evaluate the frequencies of ADHD. The differences in frequencies of symptoms and signs amongst ADHD pattern identifications, and the correlations between them were analyzed. Results There were significant differences in the frequencies of symptoms and signs between each pattern identification. Dual Deficiencies in the Heart and Spleen 心脾兩虛 is negatively related with hyperactivity and impulsivity, and positively related with inattention. Phlegm-fire Harassing the Heart 痰火擾心 is positively related with hyperactivity and impulsivity, and negatively related with inattention. Conclusions The results of the characteristics of ADHD pattern identifications from the survey analysis could be used in the clinical practices of ADHD as well as to improve the ADHD pattern identification questionnaire.

• Childhood Kidney Diseases
• /
• v.12 no.1
• /
• pp.78-87
• /
• 2008

Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.

• The Journal of KAIRB
• /
• v.6 no.1
• /
• pp.5-16
• /
• 2024

Purpose: The purpose of this study is to investigate the current status of pediatric assent in nationwide hospitals and to assess the children's comprehension for pediatric assent by interviewing pediatricians/pediatric neurologists to determine whether children of the age (elementary and middle school students) can understand the purpose, risks, benefits, and concepts of voluntary participation in clinical research described in the assent form, and to help improve the administrative efficiency of multicenter clinical trials. Methods: The status of pediatric assent was surveyed online using Google Forms at 141 university hospitals with administrative staff who are members of the Institutional Review Board (IRB) administrative staff subcommittee with in Korean Association of Institutional Review Boards (KAIRB). Additionally, face-to-face interviews were conducted with 7 pediatricians/pediatric neurologists. Survey and interview responses were summarized using descriptive statistics. Results: Out of the 141 institutions surveyed, 35 institutions (24.8%) responded. Among them, 30 institutions (85.7%) reported having age criteria for acquiring pediatric assent forms in the case of children. The age range for pediatric assent acquisition have been from 7 years old to 12 years old (15 institutions, 50%), and from 7 years old to 15 years old (7 institutions, 23.3%). Nine institutions (25.7%) have had criteria for obtaining both parents' consent in cases involving the participation of children. Nineteen institutions (54.3%) have had checklists or guidelines available for use by IRB members in study protocols involving vulnerable research subjects. Three pediatricians/pediatric neurologists have believed that upper-grade elementary school students (5th-6th grade) could comprehensively understand informed consent forms. Two have believed that middle school students would be able to understand them if they included personal information. Two pediatricians/pediatric neurologists have believed that even lower-grade elementary school students (1st-4th grade) could understand the explanations if they were made simpler. Conclusion: It is suggested that not only elementary school students (7-12 years old) but also middle school students (13-15 years old) should receive pediatric assent forms, as it would facilitate a comprehensive understanding of the forms. To enhance the comprehension of assent form content, it is necessary to use age-appropriate words, language, and expressions in the forms hospital. It is also recommended to create comics or videos to make the content of the assent forms more accessible for children.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1049-1054
• /
• 2007

Myocarditis represent an important condition encountered by general pediatricians & general practitioners. Its presentation is varied, and therefore a high index of suspicion must be maintained when the possibility of myocarditis is raised. A progression from viral myocarditis to dilated cardiomyopathy has long been hypothesized. Treatment is initially aimed at achieving hemodynamic stability and is largely supportive. There is currently little evidence to support the immunomodulatory or specific antiviral therapies. Pediatric cardiomyopathies are a heterogeneous group of disorders with diverse genetic, infectious, mitochodrial and metabolic etiologies. The timing and severity of presentation vary according to cardiomyopathy type as well as genetic and ethnic factors. The behavior of specific cardiomyopathies can be predicted by morphological and functional attributes, as well as underlying patient characteristics.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.15 no.2
• /
• pp.79-84
• /
• 2012

Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.