• Childhood Kidney Diseases
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• v.25 no.2
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• pp.71-77
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• 2021

Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.1-14
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• 2011

Tuberculosis is a disease with high morbidity and mortality in children worldwide. Despite the decrease in the incidence of tuberculosis in Korea, more than 30,000 new patients are diagnosed each year. Active tuberculosis is less frequent in children compared to adults but the risk of miliary tuberculosis and CNS tuberculosis is much higher. The diagnosis of tuberculosis in children and adolescents is difficult due to the nonspecific symptoms upon presentation. Diagnostic work up is based on the confirmation of tuberculosis infection by tuberculin skin test, abnormal radiologic findings, and contact with an adult with active tuberculosis. Anti-tuberculosis medications are prescribed according to the drug susceptibility of the index patient. Latent tuberculosis infection plays an important role in adult tuberculosis by reactivation. Thus, it is critical to accurately diagnose latent tuberculosis in children to prevent reactivation in adulthood. Korean guidelines for diagnosis and treatment of tuberculosis in children and adolescents provide evidence based recommendations in the optimal diagnosis and treatment for active and latent tuberculosis in children and adolescents based on the current Korean situation.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.18 no.2
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• pp.1-8
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• 2023

Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

• Korean Journal of Radiology
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• v.22 no.5
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• pp.840-860
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• 2021

Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.

• Clinical and Experimental Pediatrics
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• v.54 no.6
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• pp.234-240
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• 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 initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.267-273
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• 2024

Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.922-934
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• 2008

Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may prevent the more serious consequences of later academic problems, including learning disabilities. A child's performance in specific speech and language areas, such as phonological ability, vocabulary comprehension, and grammatical usage, is measured objectively using the most recently standardized, norm-referenced tests for a particular age group. Observation and qualitative analysis of a child's performance supplement objective test results are essential for making a diagnosis and devising a treatment plan. Emphasis on the team approach system in the evaluation of children with speech and language impairments has been increasing. Evidence-based therapeutic interventions with short-term, long-term, and functional outcome goals should be applied, because there are many examples of controversial practices that have not been validated in large, controlled trials. Following treatment intervention, periodic follow-up monitoring by a doctor is also important. In addition, a systematized national health policy for children with speech and language disorders should be provided.

• Journal of Korean Medicine for Obesity Research
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• v.12 no.1
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• pp.48-58
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• 2012

Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.2
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• pp.38-48
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• 2012

Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.137-147
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• 2013

Objectives : This study aims to report current trend of Mibyeong health policy and service in China from interview of China Technology Research Group. Methods : China Technology Research Group visited Guanganmen hospital, Yanhuang Dongfang Company, Xinjingzhen health center, and Shanghai Shuguang hospital. With an interpreter, We had interviews about Mibyeong health service and policy trend, medical instrument, and research issue. Results :Mibyeong health service was performed based on KY3H system and collaboration with traditional Chinese medicine hospital. Mibyeong health service consists of diagnosis with nine constitutional type, health guide and preventive treatment. Community health center also provide Mibyeong health service, with cooperative treatment of traditional Chinese medicine and western medicine. China's Mibyeong health policy is established by Top-down decision, even though there is not enough evidence for providing health service to consumer. Through constitutional diagnosis, examinations, and treatment, huge data have been stacked; however, assessment and research based on these data are not processed well. Cooperative treatment of traditional Chinese medicine and western medicine is widely provided to patients, and their works are relatively well classified. Conclusions : China plays leading role in Mibyeong service and it seems to be developed more than Korea's. Further study is necessary to establish Mibyeong policy and health service in Korea.