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Original Article
Gastroenterology
Characteristics and prognosis of hepatic cytomegalovirus infection in children: 10 years of experience at a university hospital in Korea
Chae-Yeon Min, Joo Young Song, Su Jin Jeong
Clin Exp Pediatr. 2017;60(8):261-265.   Published online August 14, 2017
Purpose

Studies on cytomegalovirus (CMV) infections in immunocompetent children are lacking, and minimal information is available in the medical literature on hepatic manifestations and complications of CMV. The aims of this study were to evaluate the clinical characteristics, laboratory data, and prognosis of children with CMV hepatitis, and to investigate its prevalence at a single medical center in Korea over a...

Infection
The impact of an educational intervention on parents' decisions to vaccinate their <60-month-old children against influenza
Aery Choi, Dong Ho Kim, Yun Kyung Kim, Byung Wook Eun, Dae Sun Jo
Clin Exp Pediatr. 2017;60(8):254-260.   Published online August 14, 2017
Purpose

Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage.

Methods

A total of 639 parents participated in the pre- and...

Neonatology (Perinatology)
Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants
Birgul Say, Nurdan Uras, Suzan Sahin, Halil Degirmencioglu, Serife Suna Oguz, Fuat Emre Canpolat
Clin Exp Pediatr. 2017;60(8):248-253.   Published online August 14, 2017
Purpose

Vitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants.

Methods

One hundred seventeen premature...

Review Article
Cardiology
Recent advances in pediatric interventional cardiology
Seong-Ho Kim
Clin Exp Pediatr. 2017;60(8):237-244.   Published online August 14, 2017

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously...

Case Report
Pulmonology
A pediatric case of relapsed pulmonary alveolar proteinosis despite successful whole lung lavage
Seung Young Jin, Hye Ri Yun, Yun Jung Choi, Jun Dong Park, Jin Tae Kim, Chang Hyun Kang, Young Sik Park, Young Hun Choi, Woo Sun Kim, Dong In Suh
Clin Exp Pediatr. 2017;60(7):232-236.   Published online July 31, 2017

Pulmonary alveolar proteinosis (PAP) is a rare disease in children characterized by intra-alveolar accumulation of surfactant proteins, which severely reduces gaseous exchange. Whole lung lavage (WLL) is the preferred technique for the treatment of severe PAP. Herein, we present a pediatric case of PAP treated with WLL. An 11-year-old boy was admitted with the chief complaint of a dry cough...

Original Article
Neurology
Effects of low-dose topiramate on language function in children with migraine
Seung-A Han, Eu Jeen Yang, Younghwa Kong, Chan-Uhng Joo, Sun Jun Kim
Clin Exp Pediatr. 2017;60(7):227-231.   Published online July 31, 2017
Purpose

This study aimed to verify the safety of low-dose topiramate on language development in pediatric patients with migraine.

Methods

Thirty newly diagnosed pediatric patients with migraine who needed topiramate were enrolled and assessed twice with standard language tests, including the Test of Language Problem Solving Abilities (TOPs), Receptive and Expressive Vocabulary Test, Urimal Test of Articulation and Phonology, and computerized speech laboratory...

Infection
Uropathogenic Escherichia coli ST131 in urinary tract infections in children
Ki Wook Yun, Mi-Kyung Lee, Wonyong Kim, In Seok Lim
Clin Exp Pediatr. 2017;60(7):221-226.   Published online July 31, 2017
Purpose

Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections.

Methods

We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University...

Cardiology
Relationship between vitamin D levels and intravenous immunoglobulin resistance in Kawasaki disease
Jae Sung Jun, Young Kwon Jung, Dong Won Lee
Clin Exp Pediatr. 2017;60(7):216-220.   Published online July 31, 2017
Purpose

Vitamin D is associated with various pathological conditions such as cardiovascular diseases and cancer. We investigated the relationship between vitamin D and Kawasaki disease (KD).

Methods

We performed a retrospective review of the medical records of patients with KD between February 2013 and March 2016 in Daegu Fatima Hospital. Study participants were grouped according to vitamin D serum concentration. Group 1 included...

Association of Toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease
Soo Jung Kang, Nam Su Kim
Clin Exp Pediatr. 2017;60(7):208-215.   Published online July 31, 2017
Purpose

Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL-10). We aimed to determine the association of the frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) with the outcomes of KD, as well as to compare FTLR2% to the usefulness of sIL-10.

Methods

The FTLR2% in patients...

Review Article
Neonatology (Perinatology)
Chorioamnionitis: Is a major player in the development of bronchopulmonary dysplasia?
Chang Won Choi
Clin Exp Pediatr. 2017;60(7):203-207.   Published online July 31, 2017

Chorioamnionitis is an inflammation in the fetal membranes or placenta. When chorioamnionitis develops, fetal lungs are exposed to inflammatory cytokines and mediators via amniotic fluid. Because inflammation plays a pivotal role in the development of bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity, fetal lung inflammation induced by chorioamnionitis has been considered to be one of the major pathogenetic...

Original Article
Cardiology
The evolution of electrocardiographic changes in patients with Duchenne muscular dystrophies
Woo Hyun Yoo, Min-Jung Cho, Peter Chun, Kwang Hun Kim, Je Sang Lee, Yong Beom Shin
Clin Exp Pediatr. 2017;60(6):196-201.   Published online June 22, 2017
Purpose

Myocardial dysfunction and dysrhythmias are inevitable consequences of Duchenne muscular dystrophy. We aimed to evaluate specific trends of electrocardiographic changes that reflect the progress of cardiomyopathy in patients with Duchenne muscular dystrophy.

Methods

Fifty electrocardiograms (ECGs) of 30 patients (ages 1 to 27 years) who had not been prescribed medications for heart failure treatment at the time of examination were retrospectively analyzed...

Neurology
Effects of lamotrigine on attention-deficit hyperactivity disorder in pediatric epilepsy patients
Seung-A Han, Eu Jeen Yang, Mi-Kyoung Song, Sun Jun Kim
Clin Exp Pediatr. 2017;60(6):189-195.   Published online June 22, 2017
Purpose

The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy.

Methods

Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, 9.1±3.4 years) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses...

Neonatology (Perinatology)
Neuroprotective effects of erythropoietin against hypoxic injury via modulation of the mitogen-activated protein kinase pathway and apoptosis
Ji Eun Jeong, Jae Hyun Park, Chun Soo Kim, Sang Lak Lee, Hai Lee Chung, Woo Taek Kim, Eun Joo Lee
Clin Exp Pediatr. 2017;60(6):181-188.   Published online June 22, 2017
Purpose

Hypoxic-ischemic encephalopathy is a significant cause of neonatal morbidity and mortality. Erythropoietin (EPO) is emerging as a therapeutic candidate for neuroprotection. Therefore, this study was designed to determine the neuroprotective role of recombinant human EPO (rHuEPO) and the possible mechanisms by which mitogen-activated protein kinase (MAPK) signaling pathway including extracellular signal-regulated kinase (ERK1/2), JNK, and p38 MAPK is modulated in...

Individualized ibuprofen treatment using serial B-type natriuretic peptide measurement for symptomatic patent ductus arteriosus in very preterm infants
Jeonghee Shin, Eun Hee Lee, Jee Hyun Lee, Byung Min Choi, Young Sook Hong
Clin Exp Pediatr. 2017;60(6):175-180.   Published online June 22, 2017
Purpose

Plasma level of B-type natriuretic peptide (BNP), an emerging, sensitive, and specific biomarker of hemodynamically significant patent ductus arteriosus (PDA), rapidly decreases in infants receiving cyclooxygenase inhibitors for ductal closure. We investigated the usefulness of serial BNP measurement as a guide for individual identification of early constrictive responses to ibuprofen in preterm infants with symptomatic PDA (sPDA).

Methods

Before March 2010, the...

Review Article
Pulmonology
Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children
Hyeon-Jong Yang, Dae Jin Song, Jung Yeon Shim
Clin Exp Pediatr. 2017;60(6):167-174.   Published online June 22, 2017

Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006–2007, 2011, and 2015–2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a...

Original Article
General Pediatrics
Sleep problems in children and adolescents at pediatric clinics
Dong Soon Kim, Cho Long Lee, Young Min Ahn
Clin Exp Pediatr. 2017;60(5):158-165.   Published online May 31, 2017
Purpose

To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces.

Methods

Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire.

Results

Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male...

Pulmonology
Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children
Eun Lee, Hyun-Ju Cho, Soo-Jong Hong, Jina Lee, Heungsup Sung, Jinho Yu
Clin Exp Pediatr. 2017;60(5):151-157.   Published online May 31, 2017
Purpose

Macrolide resistance rate of Mycoplasma pneumoniae has rapidly increased in children. Studies on the clinical features between macrolide susceptible-M. pneumoniae (MSMP) and macrolide resistant-M. pneumoniae (MRMP) are lacking. The aim of this study was to identify the macrolide resistance rate of M. pneumoniae in Korean children with M. pneumoniae penupmonia in 2015 and compare manifestations between MSMP and MRMP.

Methods

Among 122...

Allergy
Clostridium difficile colonization and/or infection during infancy and the risk of childhood allergic diseases
Sun Hwa Lee, Yun Na Gong, Eell Ryoo
Clin Exp Pediatr. 2017;60(5):145-150.   Published online May 31, 2017
Purpose

The gut microbiota can influence several diseases through immune modulation; however, the exact role of microbes such as Clostridium difficileand the relationship between microbiota colonization and allergic diseases are not well known. This study aimed to determine the relationship between C. difficilecolonization and/or infection (CDCI) during infancy and allergic diseases during early childhood.

Methods

Infants 1–12 months of age presenting changes in...

Neonatology (Perinatology)
Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study
Min Sun Kim, In Gyu Song, Ah Reum An, Kyae Hyung Kim, Ji Hoon Sohn, Sei Won Yang
Clin Exp Pediatr. 2017;60(5):138-144.   Published online May 31, 2017
Purpose

Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services.

Methods

We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015....

Review Article
Oncology
Prognostic factors and treatment of pediatric acute lymphoblastic leukemia
Jae Wook Lee, Bin Cho
Clin Exp Pediatr. 2017;60(5):129-137.   Published online May 31, 2017

The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration...

Original Article
Infection
Effects of clarithromycin treatment in scrub typhus in children: comparison with chloramphenicol and azithromycin
Min Lee, June Kim, Dae Sun Jo
Clin Exp Pediatr. 2017;60(4):124-127.   Published online April 25, 2017
Purpose

Chloramphenicol and tetracycline are not recommended for treating scrub typhus in pediatric patients because of potential side effects, such as aplastic anemia or tooth discoloration. While clarithromycin has recently been used in adults, few reports have been published on its effects in pediatric patients. We report the clinical profiles of pediatric scrub typhus and the effects of clarithromycin on scrub...

Nutrition
Effect of tuberculosis treatment on leptin levels, weight gain, and percentage body fat in Indonesian children
Maria Mexitalia, Yesi Oktavia Dewi, Adriyan Pramono, Mohammad Syarofil Anam
Clin Exp Pediatr. 2017;60(4):118-123.   Published online April 25, 2017
Purpose

Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on...

Cardiology
Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children
Na Hyun Lee, Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2017;60(4):112-117.   Published online April 25, 2017
Purpose

The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD.

Methods

Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as...

Genetics and Metabolism
Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency
Hasan M. Isa, Masooma S. Mohamed, Afaf M. Mohamed, Adel Abdulla, Fuad Abdulla
Clin Exp Pediatr. 2017;60(4):106-111.   Published online April 25, 2017
Purpose

This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus.

Methods

This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between...

Review Article
Allergy
IgE-mediated food allergies in children: prevalence, triggers, and management
Sooyoung Lee
Clin Exp Pediatr. 2017;60(4):99-105.   Published online April 25, 2017

Food allergy (FA) is a serious health problem, and severe FA such as food-induced anaphylaxis can often be life threatening. The incidence of FA has been increasing especially in children. They usually develop early in life and affect up to 10% of children. The 2 most common food allergens worldwide are milk and eggs, while the third one varies depending...

Case Report
Genetics and Metabolism
A compound heterozygous mutation in the FMO3 gene: the first pediatric case causes fish odor syndrome in Korea
Ji Hyun Kim, Sung Min Cho, Jong-Hee Chae
Clin Exp Pediatr. 2017;60(3):94-97.   Published online March 27, 2017

Trimethylaminuria (TMAuria), known as “fish odor syndrome,” is a congenital metabolic disorder characterized by an odor resembling that of rotting fish. This odor is caused by the secretion of trimethylamine (TMA) in the breath, sweat, and body secretions and the excretion of TMA along with urine. TMAuria is an autosomal recessive disorder caused by mutations in flavin-containing monooxygenase 3 (FMO3)....

Original Article
Oncology
Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
Clin Exp Pediatr. 2017;60(3):86-93.   Published online March 27, 2017
Purpose

To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children.

Methods

We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital.

Results

Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed...

Infection
Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center
Yi-Seul Kim, Kyung-Ran Kim, Ji-Man Kang, Jong-Min Kim, Yae-Jean Kim
Clin Exp Pediatr. 2017;60(3):77-85.   Published online March 27, 2017
Purpose

Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories.

Methods

Among...

Nutrition
Maternal food restrictions during breastfeeding
Goun Jeong, Sung Won Park, Yeon Kyung Lee, Sun Young Ko, Son Moon Shin
Clin Exp Pediatr. 2017;60(3):70-76.   Published online March 27, 2017
Purpose

This study investigated self-food restriction during breastfeeding, reviewed the literature showing the effect of maternal diet on the health of breast-fed infants, and explored the validity of dietary restrictions.

Methods

Questionnaire data were collected from breastfeeding Korean mothers who visited the pediatric clinic of Cheil General Hospital & Women's Healthcare Center from July 2015 through August 2015. The survey included items assessing...

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