• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.3
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• pp.139-146
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• 2017

The number of papers discussing probiotics increases tremendously that limits the possibility for primary care physicians and clinicians to stay updated. Therefore, the aim of this paper will be to summarize available evidence of probiotic use in well-defined clinical indications of importance for pediatricians. Based on currently available evidence certain probiotic strains (Lactobacillus rhamnosus GG [LGG] and Saccharomyces boulardii) have proven effect in the treatment of acute gastroenteritis and prevention of antibiotic associated diarrhea. Furthermore, LGG was proven to be effective in prevention of nosocomial diarrhea and respiratory tract infection in day care centers. In conclusion, not all probiotic strains have same efficacy for all clinical indications, therefore, only strains with proven efficacy and safety should be recommended.

• Clinical and Experimental Pediatrics
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• v.61 no.11
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• pp.339-347
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• 2018

Acute kidney injury (AKI) is characterized by abrupt deterioration of renal function, and its diagnosis relies on creatinine measurements and urine output. AKI is associated with higher morbidity and mortality, and is a risk factor for development of chronic kidney disease. There is no proven medication for AKI. Therefore, prevention and early detection are important. Physicians should be aware of the risk factors for AKI and should monitor renal function in high-risk patients. Management of AKI includes optimization of volume status and renal perfusion, avoidance of nephrotoxic agents, and sufficient nutritional support. Continuous renal replacement therapy is widely available for critically ill children, and this review provides basic information regarding this therapy. Long-term follow-up of patients with AKI for renal function, blood pressure, and proteinuria is recommended.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.1-5
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• 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 will never be associated with future health problem. However, some of them are benign now, but have potential for variable degrees of change to a nonbenign condition and some form of follow-up is required. For the appropriate management of electrocardiographic abnormalities, not infrequently seen in infants and children, correct diagnosis of abnormal electrocardiogram and understanding of characteristics of arrhythmias are required.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.856-861
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• 2009

Cardiopulmonary arrest has long been accepted as an unquestionable definition of death. An advent of cardiopulmonary resuscitation and artificial ventilation along with the development of organ transplantation has prompted the emergence of the concept of brain death. The criteria for brain death are based mainly on the clinical examination of coma, apnea and total loss of brain stem function. Although organ transplantation by donor brain death has increased in Korea over recent years, there is still a substantial shortage of donor organs compared to the demand. Improvement of government policies and changes of social culture for organ donation are needed for the activation of organ transplantation by donor brain death. Pediatricians have an important role for the search of potential donors in cases of brain death and optimal medical care for successful organ transplantation.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.971-975
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• 2009

Seizures in the neonatal period are common and frequently indicate serious underlying brain injury. Neonatal seizures continue to present a diagnostic and therapeutic challenge to pediatricians because recognition and classification of neonatal seizures remain 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 predict an increased risk for later epilepsy and other neurological sequelae, accurate diagnoses are needed for aggressive antiepileptic drug use. The present review summarizes the treatment and prognosis of neonatal seizures.

• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.514-519
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• 2014

Hemorrhagic cystitis is a common stem cell transplantation-related complication. The incidence of early-onset hemorrhagic cystitis, which is related to the pretransplant conditioning regimen, has decreased with the concomitant use of mesna and hyperhydration. However, late-onset hemorrhagic cystitis, which is usually caused by the BK virus, continues to develop. Although the BK virus is the most common pathogenic microorganism of poststem cell transplantation late-onset hemorrhagic cystitis, pediatricians outside the hemato-oncology and nephrology specialties tend to be unfamiliar with hemorrhagic cystitis and the BK virus. Moreover, no standard guidelines for the early diagnosis and treatment of BK virus-associated hemorrhagic cystitis after stem cell transplantation have been established. Here, we briefly introduce poststem cell transplantation BK virus-associated hemorrhagic cystitis.

• Clinical and Experimental Pediatrics
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• v.56 no.8
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• pp.313-322
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• 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 be available to provide professional health services. Pediatricians also have important roles as experts in both school health care and the SHE system. In this article, the history of school health care, its legal basis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveys from the past few years are reviewed. Through this holistic approach, future directions are proposed for the improvement of SHE and school health care.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1075-1081
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• 2009

Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on the key issues related to pediatric kidney transplantation such as growth, neurocognitive function, nonadherence, and posttransplantation infectious complications, including lymphoproliferative disease, to broaden the understanding of pediatricians who provide pre-and postoperative care to children with end-stage renal disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.26-32
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• 2011

Chronic abdominal pain (CAP) is a common complaint encountered in pediatric clinics and a great concern for patients and their caretakers as well as health care professionals. A constant challenge is detecting individuals with organic diseases or psychosomatic disorders from the majority of patients who have a functional disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical examination, physicians must determine a differential diagnosis of CAP by applying the symptom-based Rome III criteria to positively identify a functional disorder. These findings should then be further analyzed based on diagnostic clues and red flags that indicate the presence of specific organic diseases and/or the need for further testing. Once a functional diagnosis has been made or an organic disease is suspected, physicians can initiate an empiric therapeutic trial. Since psychological distress accompanies both organic and non-organic abdominal pain in children, a cooperative diagnostic approach involving pediatricians and psychiatrists is recommended.

• Clinical and Experimental Pediatrics
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• v.56 no.2
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• pp.52-59
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• 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. Furthermore, the World Health Organization, American Heart Association, and European Cardiology Association have different systems for clinically classifying primary CMP. Primary CMP is rare and associated with a family history of the disease, implying that genetic factors might affect its incidence. In addition, the incidence of CMP varies widely according to patient ethnicity. Genetic testing plays an important role in the care of patients with CMP and their families because it confirms diagnosis, determines the appropriate care for the patient, and possibly affects patient prognosis. The diagnosis and genetic identification of CMP in patients' families allow the possibility to identify novel genes that may lead to new treatments. This review focuses on the epidemiology, pathophysiology, diagnosis, and treatment of CMP, with the aim of providing pediatricians with insights that may be helpful in the early identification and management of idiopathic CMP in children.