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Department of Pediatrics

Contents of medical treatment

The Department of Pediatrics covers any diseases in neonates, infants, children, and adolescents. The goal of pediatric medicine is to promote our patients’ healthy growth and development in both mind and body. We perform medical treatment for children's diseases and support the patients as well as their family members. Since the Department of Pediatrics in Wakayama Medical University Hospital has excellent physicians who are specialized in individual fields of nerve and psychosomatic illness, infection and immunity, circulatory system, kidney, blood and tumor, premature and newborn infant, endocrine, and genetics, we will fulfill our responsibility through our united efforts as a base for pediatric medicine in Wakayama prefecture.

The group for the cardiovascular system

Our group performs clinical treatment and studies related to congenital heart diseases and acquired heart diseases centering on such as Kawasaki disease and cardiomyopathy. Regarding congenital heart diseases, we diagnose and treat cases both with a foetus diagnosis and with severe heart disease diagnosed after birth, and perform surgeries in such cases with a yearly average of about 70 cases cooperating with the department of Cardiovascular Surgery. At that time, we are in charge of diagnosis of severe cases, judgment whether operation is indicated or not and pre- and postoperative management which is in the field of pediatric internal medicine, and furthermore, regarding many cases where an operation is not indicated but pediatric management is required, we observe the course of the condition as our outpatient service.
Regarding Kawasaki disease, we participate in an investigator-initiated clinical trial of Kawasaki disease (combination therapy of immunoglobulin and cyclosporin A in severe Kawasaki disease, KAICA trial) as a central facility and are working on development of a new treatment method. Using optical coherence tomography (OCT) with the support of physicians in cardiovascular medicine, we also work on development of the treatment and management method during a period of distance observation by more accurately evaluating the coronary lesion in Kawasaki disease using only a cardiac catheter test. Regarding basic research, we are trying to reveal the cause of Kawasaki disease (the involvement of the superantigen derived from hemolytic streptococcus) using molecular biological methods, and we are also trying to clarify the mechanism of the treatment effect of cyclosporine (an analysis of signal transduction related to inflammatory cytokines in cells).

The group for nephrology

We continue clinical treatment research (scientific research supported by The Ministry of Health, Labour, and Welfare, the Pediatric lgA Nephropathy of Treatment Study Group, and the Study Group of Refractory Renal Disease in Children) and we have received good results. We perform studies of IgA nephropathy, purpura nephritis, Alport syndrome, and polycystic kidney disease etc., using molecular biological and morphological methods.

The group for nerves

The Department of Pediatrics in Wakayama Medical University Hospital is registered as a medical specialist training facility by the Japanese Society of Neurology and we are in charge of treatments for general pediatric neurological disorders. We handle from status epilepticus, for which primary emergency treatment is indicated, to severe diseases which require management in ICU. We perform clinical diagnosis for convulsive disorders such as epilepsy, using video and electroencephalography in wards. We also conduct basic research related to the pathophysiology of acute encephalitis and encephalopathy (Chemokine expression in human astrocytes in response to shiga toxin 2. Int J Inflam. 2012). In addition, we handle eating disorders and psychophysiologic disorders, and perform clinical studies while providing inpatient care (Total parenteral nutrition treatment efficacy in adolescent eating disorders. Pediatr Int. 2015).

The group for childhood cancer and blood

We treat all childhood cancers and blood diseases. Although the site where childhood cancer develops varies, we perform a multidisciplinary therapy in cooperation with the following departments: neurosurgery (brain tumor), orthopedic surgery (bone/soft tissue tumor), pediatric surgery (neuroblastoma, nephroblastoma and hepatoblastoma), ophthalmology (retinoblastoma), dermatology (hemangiomas), and radiology (radiation therapy). Our department is a facility approved for hematopoietic cell transplantation between unrelated individuals by the Japan Marrow Donor Program and cord blood bank, and all treatments related to childhood cancers and blood diseases can be completed in the pediatric medical center. In addition, we are also in charge of medical treatments for autoimmune diseases such as juvenile idiopathic arthritis (rheumatoid arthritis), inflammatory bowel diseases, primary immunodeficiency diseases, and autoinflammatory diseases.

The group for premature and newborn infants

We handle neonate emergencies using an ambulance dedicated to newborn infants and a “doctor helicopter” 24 hours a day in Wakayama prefecture as the only comprehensive Perinatal Medical Center for Mother and Child in Wakayama prefecture. We treat any disease in neonates in cooperation with departments of obstetrics, pediatric surgery, cardiovascular surgery, and ophthalmology etc. We think intracranial bleeding in premature infants is an important issue and study methods of prevention by a Doppler-type skin blood flow meter and blood flow evaluation using echocardiogram for the purpose of appropriate management of circulation. Relieving chronic lung disease is also an important issue, therefore we work on early decannulation using high-frequency oscillatory ventilation and nitrogen monoxide inhalation treatment and by combining this with pulmonary hypertension medicine. We introduce INSURE strategy (Intubation-Surfactant-Extubation) for appropriate cases we select.

The group for chromosomes

Our main focus is diagnosis of congenital disorders and support for patients’ families (genetic counseling, rehabilitation and counseling). We also perform medical management of Down syndrome and judgment of the degree of severity of disease.

Fields of specialty

All diseases in children (excepting for injury and surgical treatment)including kidney diseases, congenital heart diseases, Kawasaki disease, epilepsy, growth and development disorders, liver diseases, endocrine diseases, congenital chromosome abnormalities, and hematologic diseases.