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Pediatric Lecture

Pediatric Lecture research room

Research room overview

Basic philosophy of the Pediatric Lecture research room

The Department of Pediatrics specializes in various diseases of newborn to adolescence. The purpose of pediatric treatment is the healthy growth and development of children both physically and mentally. We treat ill children and support them and their family troubled by the illness.

At the Department of Pediatrics of Wakayama Medical University, there are skilled specialists in the fields of neurology and psychosomatic disease, infections and immunology, the cardiovascular system, the renal system, hematology and oncology, premature infants and newborns, endocrine, and genes. As the base of pediatric medicine in Wakayama prefecture, we cooperate with each other to fulfill our duties.

Education overview

Organizer, Daisuke Tokuhara

I　General study purpose

Fully understand the pediatric characteristics during the growing process and acquire abilities to solve health issues of various fields, including acute and chronic diseases, congenital and acquired diseases, infectious diseases, immune disorders, hematologic diseases and malignant tumors, metabolism and endocrine disorders, neurological disorders, cardiovascular disorders, and gastrointestinal disorders, in cooperation with patients' families and the social community.

II　Individual study purposes

(1) Introduction to Pediatrics
1. Can explain the characteristics of children during the growing process.
(2) Pediatric Nutrition
2. Can explain why breast milk is required. Also can explain about milk and therapeutic diet.
(3) Genetic and Chromosomal Abnormalities
3. Can state the idea of genetic diseases. Can explain major chromosomal abnormalities.
(4) Immunity and Allergic Diseases
4. Can explain the characteristics of humoral and cell-mediated immune deficiencies. Can state food allergies, etc.
(5)Metabolic abnormalities
5. Can explain symptoms specific to diabetes mellitus, lactose intolerance, and mucopolysaccharidosis, etc., and enzyme diagnosis of these diseases.
6. Can explain hyperglycinemia, phenylketonuria, and complex lipid storage diseases.
(6) Newborns and premature infants
7．Can explain the changes in hemodynamics from fetus to newborn. Can explain the diagnosis and treatments for neonatal respiratory failure, which is a common disorder in newborns. Learn the method of resuscitation in asphyxia of the newborn and can understand the significance of cerebroprotective therapy.
8．Can explain diagnoses and treatments representative of complications in extremely-low birth weight infants.
9． Can explain the symptoms and prevention of kernicterus. Can explain the characteristics and complications of perinatal infections including rubella, toxoplasmosis, cytomegalovirus, and B streptococcus. Can explain perinatal complications associated with multiple birth and their outcomes. Can explain the causes, diagnoses, and treatments of endocrine disorders that develop during the neonatal period.
(7) Infections
10. Can explain the latent period, diagnoses, prevention, and complications of common viral infectious diseases. Can explain viral infections with a rash, such as rubella, measles, chickenpox, and Epstein Barr virus infection.
11. Can explain diagnosis and treatments of purulent meningitis, a severe type of bacterial infection. In addition, can state diagnoses and treatments of bacterial infections that develop in children.
(8) Renal disorders
12. Can explain diagnoses and treatments of renal disorders, with a focus on nephrotic syndrome.
13. Can explain diagnoses and treatments of acute and chronic nephritis.
14. Can explain diagnosis and treatments of renal failure that develops in children.
(9) Endocrine disorders
15. Can explain diagnoses and treatments of growth hormone hyposecretion, cretinism, etc. and tolerance test.
16. Can state diagnoses and treatments of DiGeorge syndrome, congenital adrenal hyperplasia syndrome, etc.
(10) Malignant diseases in children
17. Can explain the classification and diagnosis of leukemia, with a focus on surface markers, and bone marrow transplant.
18. Can state diagnoses and treatments of hemophilia, abnormal platelet function, etc.
19. Can explain the necessity of early diagnoses of solid tumors, with focuses on neuroblastoma and Wilms' tumor, and genetic diagnosis.
(11) Respiratory disorders
20. Can state the concept, treatment, and diagnostic guidelines of asthma. Can explain the trachea and bronchostenosis requiring differentiation. Additionally, can explain diagnoses and treatments of bacterial, mycoplasma, and viral lower respiratory tract infections.
(12) Collagen disease and Kawasaki disease in children
21. Can explain diagnoses and treatments of juvenile idiopathic arthritis (JIA), rheumatic fever, and Kawasaki disease.
(13) Pediatric neuromuscular diseases
22. Learn major disorders among muscle diseases and can state diagnostic importance and daily rehabilitation.
23. Can explain the diagnostic imaging of diseases that suddenly develop in brain and motor functions.
24. Can provide diagnoses of seizure disorders based on videos and can state treatments.
(14) Psychiatric disorders, psychosomatic disease, and abuse in children with strong social connection.
25. Can explain the characteristics and treatments of psychiatric disorders and psychosomatic disease that develop in children. Also can state child abuse.

Latter term training

For physicians who completed the two-year program of the former period clinical training at Wakayama Medical University or other institutions and those who choose Wakayama Medical University to receive third-year latter term training, we plan to provide the latter training program.

Research overview and achievements

  • Research overview
  • Books
  • Review
  • Original article
  • Academic meeting reports
  • Research grant status

Cardiovascular group
The cardiovascular group conducts clinical research on congenital heart diseases and acquired heart diseases, with focuses on Kawasaki disease and cardiomyopathy. As for congenital heart disease, we provide diagnoses and treatments of cases with fetal diagnosis and cases of severe cardiac diseases that were diagnosed postnatally. We perform an average of 70 surgeries yearly under the cooperation with the Cardiovascular Department. For severe cases, we provide diagnoses and determine whether they should undergo surgeries. We are also responsible for medical management before and after surgery and monitor many cases of patients who do not undergo surgeries but require pediatric management on an outpatient basis.

As for Kawasaki disease, in terms of clinical research, we participate in a trial, as a central facility, to evaluate the efficacy and safety of immunoglobulin plus cyclosporine A in patients with severe Kawasaki disease (KAICA Trial), an investigator initiated trial for Kawasaki disease, and conduct research to develop new therapies for the disease. Additionally, we actively introduced the optical coherence tomography (OCT) under the support of physicians in the Cardiovascular Department. Using the device, we assess more detailed coronary lesions with cardiac catheterization in patients with coronary lesions in Kawasaki disease during the follow-up period to develop management plan or therapy for the follow-up period. In terms of basic research, we challenge to reveal the cause (such as involvement of superantigen derived from hemolytic streptococcus) using a molecular biology technique. Furthermore, we challenge to reveal the mechanism of therapeutic effects of cyclosporine (an analysis of intracellular signaling associated with inflammatory cytokine).

Nephrology group
We conduct a multicenter clinical therapeutic research (the Ministry of Health, Labour, and Welfare's Health and Labour Science Research, the Pediatric IgA Nephropathy of Treatment Study Group, and the Study Group of Refractory Renal Disease in Children) to establish therapeutic methods for IgA nephropathy and nephrotic syndrome, and our research has produced results. We analyze the pathologies of IgA nephropathy, purpura nephritis, nephrotic syndrome, Alport's syndrome, polycystic kidney disease, etc. using molecular biological and morphological methods.

Neurology group
The Department of Pediatrics of Wakayama Medical University is registered as a training facility for board-certified specialists of the Japanese Society of Child Neurology, and we engage in treatments for overall pediatric diseases. We deal with status epilepticus, which is a primary emergency, to severe diseases requiring ICU management. We provide clinical diagnoses of convulsive disorders, such as epilepsies, using videos in the wards and electroencephalography. Additionally, we conduct basic research on pathophysiology of acute encephalitis and encephalopathy. (Chemokine expression in human astrocytes in response to shiga toxin 2. Int J Inflam. 2012)

Furthermore, we provide treatments for eating disorders and psychosomatic disease, and conduct clinical research through inpatient treatments (Total parenteral nutrition treatment efficacy in adolescent eating disorders. Pediatr Int. 2015).

Pediatric oncology and hematology group
We provide treatment of all kinds of pediatric cancers and hematologic diseases. Since pediatric cancer develops in various parts of the body, we provide combined modality therapies in cooperation with the Department of Neurological Surgery (for brain tumor), Department of Orthopedic Surgery (for osteochondromatosis), Department of Pediatric Surgery (for neuroblastoma, nephroblastoma, and hepatoblastoma), Department of Ophthalmology (for retinoblastoma), Department of Dermatology (for angioma), and Department of Radiology (for radiotherapy). Additionally, our department is a facility certified by the Japan Marrow Donor Program and the Cord Blood Bank to perform unrelated hematopoietic cell transplantations. Therefore, all treatments required for pediatric cancers and hematologic diseases can be completed in our Pediatric Medical Center. Furthermore, we provide treatment for autoimmune diseases, such as juvenile idiopathic arthritis (rheumatoid arthritis), inflammatory bowel disease, primary immunodeficiency, and autoinflammatory diseases.

Premature infants and newborns group
As the only perinatal medical center for mother and child in Wakayama prefecture, we respond to neonatal emergencies within the prefecture 24 hours using an ambulance for newborns and doctor helicopter. We provide treatment of all neonatal diseases in cooperation with Department of Obstetrics, Department of Pediatric Surgery, Department of Cardiovascular Surgery, and Department of Ophthalmology. We aim to prevent intracranial hemorrhage in premature babies, assess blood flow using echo for appropriate circulatory management, and conduct research using a Doppler rheometer. Additionally, how to relieve chronic pulmonary diseases is another important issue. High-frequency oscillating ventilation and nitric oxide inhalation therapy, in combination with drug therapy for pulmonary hypertension, are utilized for early extubation. The intubation-surfactant-extubation (INSURE) strategy is also used for selected patients.

Genetics group
Our clinical geneticists provide overall treatment for congenitally-abnormal diseases. We treat various congenitally-abnormal diseases, such as chromosomal disorders, with a focus on Down's syndrome, genetic diseases, and malformation syndromes of unknown cause. In collaboration with other departments in the hospital and rehabilitation facilities in Wakayama prefecture, we provide the following as needed: diagnoses of each disease and syndrome, information, early response to complications, long-term health management including growth and development, and consultation for rehabilitation. Recently advanced research on genetics made genetic tests more common, and we handle genetic tests in collaboration with research institutions. Our outpatient clinic is open on Thursdays, and we provide counseling on the first Thursday of every month. We take plenty of time to provide accurate information on each disease and accept consultations on various problems for patients who were referred by other departments of the hospital or other medical institutions. Needless to say, we strictly protect the privacy of our patients regarding consultation contents and test results.