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Case Report
Neurology
Complete occlusion of the right middle cerebral artery associated with Mycoplasma pneumoniae pneumonia
Ben Kang, Dong Hyun Kim, Young Jin Hong, Byong Kwan Son, Myung Kwan Lim, Yon Ho Choe, Young Se Kwon
Clin Exp Pediatr. 2016;59(3):149-152.   Published online March 31, 2016

We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory....

Original Article
Nephrology (Genitourinary)
Acute tubular necrosis as a part of vancomycin induced drug rash with eosinophilia and systemic symptoms syndrome with coincident postinfectious glomerulonephritis
Kyung Min Kim, Kyoung Sung, Hea Koung Yang, Seong Heon Kim, Hye Young Kim, Gil Ho Ban, Su Eun Park, Hyoung Doo Lee, Su Young Kim
Clin Exp Pediatr. 2016;59(3):145-148.   Published online March 31, 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to...

Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection
Song Yi Han, I Re Lee, Se Jin Park, Ji Hong Kim, Jae Il Shin
Clin Exp Pediatr. 2016;59(3):139-144.   Published online March 31, 2016
Purpose

Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a...

Emergency Medicine
A nationwide study of children and adolescents with pneumonia who visited Emergency Department in South Korea in 2012
Chang Hyu Lee, Youn Kyoung Won, Eui-Jung Roh, Dong In Suh, Eun Hee Chung
Clin Exp Pediatr. 2016;59(3):132-138.   Published online March 31, 2016
Purpose

Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012.

Methods

We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients...

Gastroenterology
Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis
Dong Ho Shim, Dong Yeon Kim, Ky Young Cho
Clin Exp Pediatr. 2016;59(3):126-131.   Published online March 31, 2016
Purpose

To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG).

Methods

In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial...

Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year
Hye Il Jin, Yoo Mi Lee, You Jin Choi, Su Jin Jeong
Clin Exp Pediatr. 2016;59(3):120-125.   Published online March 31, 2016
Purpose

Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region.

Methods

We evaluated 345 pediatric patients (203 males, 142 females; age,...

General Pediatrics
Reference values of lead in blood and related factors among Korean adolescents: the Korean National Health and Nutrition Examination Survey 2010-2013
Min-Gyu Choi, Mi-Jung Park, Shin-Hye Kim
Clin Exp Pediatr. 2016;59(3):114-119.   Published online March 31, 2016
Purpose

This study aimed to assess the reference values and factors influencing blood lead levels among Korean adolescents.

Methods

The study population consisted of 1,585 adolescents (801 males, 784 females; aged 10-19 years) who participated in the Korea National Health and Nutrition Examination Survey 2010-2013. We analyzed blood lead concentrations in relation to demographic/lifestyle characteristics for all participants. "Reference values" of blood lead...

Review Article
Hematology
Diffuse alveolar hemorrhage and recombinant factor VIIa treatment in pediatric patients
Jeong A Park
Clin Exp Pediatr. 2016;59(3):105-113.   Published online March 31, 2016

Diffuse alveolar hemorrhage (DAH) is a life-threatening pulmonary complication in patients with hematologic malignancies or autoimmune disorders. The current treatment options, which include corticosteroids, transfusions, extracorporeal membrane oxygenation (ECMO), and immunosuppressants, have been limited and largely unsuccessful. Recombinant activated factor VII (rFVIIa) has been successfully administered, either systemically or bronchoscopically, to adults for the treatment of DAH, but there are...

Case Report
Nephrology (Genitourinary)
Recombinant Human Erythropoietin Therapy for a Jehovah's Witness Child With Severe Anemia due to Hemolytic-Uremic Syndrome
Da Eun Woo, Jae Min Lee, Yu Kyung Kim, Yong Hoon Park
Clin Exp Pediatr. 2016;59(2):100-103.   Published online February 29, 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening...

Neonatology (Perinatology)
Successfully treated infective endocarditis caused by methicillin-resistant Staphylococcus Aureus in extremely low birth weight infant
Sehwa Jung, Kyung Uk Jeong, Jang Hoon Lee, Jo Won Jung, Moon Sung Park
Clin Exp Pediatr. 2016;59(2):96-99.   Published online February 29, 2016

Survival rates of preterm infants have improved in the past few decades, and central venous catheters play an important role in the intensive medical treatment of these neonates. Unfortunately, these indwelling catheters increase the risk of intracardiac thrombosis, and they provide a nidus for microorganisms during the course of septicemia. Herein, we report a case of persistent bacteremia due to...

Neurology
A new mosaic der(18)t(1;18)(q32.1;q21.3) with developmental delay and facial dysmorphism
Young-Jin Choi, Eunsim Shin, Tae Sik Jo, Jin-Hwa Moon, Se-Min Lee, Joo-Hwa Kim, Jae-Won Oh, Chang-Ryul Kim, In Joon Seol
Clin Exp Pediatr. 2016;59(2):91-95.   Published online February 29, 2016

We report the case of a 22-month-old boy with a new mosaic partial unbalanced translocation of 1q and 18q. The patient was referred to our Pediatric Department for developmental delay. He showed mild facial dysmorphism, physical growth retardation, a hearing disability, and had a history of patent ductus arteriosus. White matter abnormality on brain magnetic resonance images was also noted....

Original Article
Cardiology
Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease
Jin-Young Baek, Min Seob Song
Clin Exp Pediatr. 2016;59(2):80-90.   Published online February 29, 2016
Purpose

Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques.

Methods

All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For...

Neurology
Epilepsy in children with a history of febrile seizures
Sang Hyun Lee, Jung Hye Byeon, Gun Ha Kim, Baik-Lin Eun, So-Hee Eun
Clin Exp Pediatr. 2016;59(2):74-79.   Published online February 29, 2016
Purpose

Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures

Methods

The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between...

Endocrinology
Impact of lifestyle factors on trends in lipid profiles among Korean adolescents: the Korea National Health and Nutrition Examination Surveys study, 1998 and 2010
Shin-Hye Kim, Young-Hwan Song, Sangshin Park, Mi-Jung Park
Clin Exp Pediatr. 2016;59(2):65-73.   Published online February 29, 2016
Purpose

Only a few studies have explored nationwide trends in lipid profiles among Asian adolescents. We aimed to assess trends in lipid profiles and the associated lifestyle factors among Korean children.

Methods

We analyzed data for 2,094 adolescents who were aged 10–18 years and had participated in the Korea National Health and Nutrition Examination Surveys in 1998 and 2010.

Results

During 1998–2010, the prevalence of...

Cardiology
Infantile Marfan syndrome in a Korean tertiary referral center
Yeon Jeong Seo, Ko-Eun Lee, Gi Beom Kim, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
Clin Exp Pediatr. 2016;59(2):59-64.   Published online February 29, 2016
Purpose

Infantile Marfan syndrome (MFS) is a rare congenital inheritable connective tissue disorder with poor prognosis. This study aimed to evaluate the cardiovascular manifestations and overall prognosis of infantile MFS diagnosed in a tertiary referral center in Korea.

Methods

Eight patients diagnosed with infantile MFS between 2004 and 2014 were retrospectively evaluated.

Results

Their median age at the time of diagnosis was 2.5 months (range,...

Comparison between Kawasaki disease with lymph-node-first presentation and Kawasaki disease without cervical lymphadenopathy
Jung Ok Kim, Yeo Hyang Kim, Myung Chul Hyun
Clin Exp Pediatr. 2016;59(2):54-58.   Published online February 29, 2016
Purpose

We evaluated the characteristics of patients with Kawasaki disease (KD) who presented with only fever and cervical lymphadenopathy on admission, and compared them with the characteristics of those who presented with typical features but no cervical lymphadenopathy.

Methods

We enrolled 98 patients diagnosed with KD. Thirteen patients had only fever and cervical lymphadenopathy on the day of admission (group 1), 31 had...

Review Article
Allergy
A practical view of immunotherapy for food allergy
Tae Won Song
Clin Exp Pediatr. 2016;59(2):47-53.   Published online February 29, 2016

Food allergy is common and sometimes life threatening for Korean children. The current standard treatment of allergen avoidance and self-injectable epinephrine does not change the natural course of food allergy. Recently, oral, sublingual, and epicutaneous immunotherapies have been studied for their effectiveness against food allergy. While various rates of desensitization (36% to 100%) and tolerance (28% to 75%) have been...

Case Report
Infection
Tuberculosis-associated hemophagocytic lymphohistiocytosis in adolescent diagnosed by polymerase chain reaction
Ju-Hee Seo, Jun Ah Lee, Dong Ho Kim, Joongbum Cho, Jung Sub Lim
Clin Exp Pediatr. 2016;59(1):43-46.   Published online January 22, 2016

We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, 2,020 cells/µL; hemoglobin, 10.2 g/dL; platelets, 52,000 cells/µL), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of...

Oncology
Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome
Do Hee Ahn, Jung Hee Rho, Hann Tchah, In-Sang Jeon
Clin Exp Pediatr. 2016;59(1):40-42.   Published online January 22, 2016

Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with...

Original Article
Neurology
Intravenous levetiracetam versus phenobarbital in children with status epilepticus or acute repetitive seizures
Yun-Jeong Lee, Mi-Sun Yum, Eun-Hee Kim, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(1):35-39.   Published online January 22, 2016
Purpose

This study compared the efficacy and tolerability of intravenous (i.v.) phenobarbital (PHB) and i.v. levetiracetam (LEV) in children with status epilepticus (SE) or acute repetitive seizure (ARS).

Methods

The medical records of children (age range, 1 month to 15 years) treated with i.v. PHB or LEV for SE or ARS at our single tertiary center were retrospectively reviewed. Seizure termination was defined...

Neonatology (Perinatology)
Clinical features of Bednar's aphthae in infants
Seung-Woo Nam, Seol Hee Ahn, Son-Moon Shin, Goun Jeong
Clin Exp Pediatr. 2016;59(1):30-34.   Published online January 22, 2016
Purpose

Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae.

Methods

Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters...

Neurology
Factors associated with mumps meningitis and the possible impact of vaccination
Kyuyol Rhie, Heung-Keun Park, Young-Soo Kim, Jung Sook Yeom, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
Clin Exp Pediatr. 2016;59(1):24-29.   Published online January 22, 2016
Purpose

Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease.

Methods

We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea...

Genetics and Metabolism
Identification of 1p36 deletion syndrome in patients with facial dysmorphism and developmental delay
Go Hun Seo, Ja Hye Kim, Ja Hyang Cho, Gu-Hwan Kim, Eul-Ju Seo, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Clin Exp Pediatr. 2016;59(1):16-23.   Published online January 22, 2016
Purpose

The 1p36 deletion syndrome is a microdeletion syndrome characterized by developmental delays/intellectual disability, craniofacial dysmorphism, and other congenital anomalies. To date, many cases of this syndrome have been reported worldwide. However, cases with this syndrome have not been reported in Korean populations anywhere. This study was performed to report the clinical and molecular characteristics of five Korean patients with the...

Nephrology (Genitourinary)
Impaired angiogenesis in the enalapril-treated neonatal rat kidney
Hyung Eun Yim, Kee Hwan Yoo, Eun Soo Bae, Young Sook Hong, Joo Won Lee
Clin Exp Pediatr. 2016;59(1):8-15.   Published online January 22, 2016
Purpose

Nephrogenesis is normally accompanied by a tightly regulated and efficient vascularization. We investigated the effect of angiotensin II inhibition on angiogenesis in the developing rat kidney.

Methods

Newborn rat pups were treated with enalapril (30 mg/kg/day) or vehicle (control) for 7 days after birth. Renal histological changes were checked using Hematoxylin & Eosin staining. We also investigated the intrarenal expression of vascular...

Review Article
Endocrinology
Catch-up growth and catch-up fat in children born small for gestational age
Won Kyoung Cho, Byung-Kyu Suh
Clin Exp Pediatr. 2016;59(1):1-7.   Published online January 22, 2016

Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life....

Case Report
Alveolar rhabdomyosarcoma with massive disseminated intravascular coagulopathy treated with systemic chemotherapy
Byung Gyu Yoon, Hee Jo Baek, Burm Seok Oh, Dong Kyun Han, Yoo Duk Choi, Hoon Kook
Clin Exp Pediatr. 2015;58(12):505-508.   Published online December 22, 2015

It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy...

Giant coronary aneurysm caused by Kawasaki disease: consistency between catheter angiography and electrocardiogram gated dual-source computed tomography angiography
Eun-Ha Hwang, Jung-Ki Ju, Min-Jung Cho, Ji-Won Lee, Hyoung-Doo Lee
Clin Exp Pediatr. 2015;58(12):501-504.   Published online December 22, 2015

We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography...

Original Article
Intercontinental comparison of caustic ingestion in children
Mandana Rafeey, Morteza Ghojazadeh, Amir Mehdizadeh, Hakimeh Hazrati, Leila Vahedi
Clin Exp Pediatr. 2015;58(12):491-500.   Published online December 22, 2015
Purpose

To investigate the caustic ingestion in children among different continents according to demographic characteristics (core purpose), main symptoms, common caustic agents, signs and symptoms, management, treatment and complications.

Methods

This systematic review was performed by searching the databases Science Direct, ProQuest, Google Scholar, and PubMed, electronically and manually. We included studies that were published from 1980 to 2013, at University of Medical...

A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma
Yeong Ju Yun, Yun Hee Gyon, Sohyoung Yang, Youn Kyung Lee, Joohyun Park, Meerim Park
Clin Exp Pediatr. 2015;58(12):484-490.   Published online December 22, 2015
Purpose

To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response.

Methods

Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12...

Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals
Mi Suk Choi, Ji Hye Chun, Kyung Suk Lee, Yeong Ho Rha, Sun Hee Choi
Clin Exp Pediatr. 2015;58(12):478-483.   Published online December 22, 2015
Purpose

Information on the clinical features of lung abscess, which is uncommon in children, at hospitalizationis helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups.

Methods

The medical records of 11 lung abscess...