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Original Article
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....

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...

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...

Neonatology (Perinatology)
Postdischarge growth assessment in very low birth weight infants
Joon-Sik Park, Jungho Han, Jeong Eun Shin, Soon Min Lee, Ho Seon Eun, Min-Soo Park, Kook-In Park, Ran Namgung
Clin Exp Pediatr. 2017;60(3):64-69.   Published online March 27, 2017
Purpose

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved.

Methods

We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24...

Experience and pharmacokinetics of Levetiracetam in Korean neonates with neonatal seizures
Jae Won Shin, Yun Seob Jung, Kyungsoo Park, Soon Min Lee, Ho Seon Eun, Min Soo Park, Kook In Park, Ran Namgung
Clin Exp Pediatr. 2017;60(2):50-54.   Published online February 27, 2017
Purpose

The aims of this study were to evaluate the safety and pharmacokinetics of levetiracetam (LEV) in neonates with seizures and to establish a population pharmacokinetics (PPK) model by using the software NONMEM.

Methods

A retrospective analysis of 18 neonatal patients with seizures, who were treated with LEV, including 151 serum samples, was performed. The mean loading dose was 20 mg/kg, followed by...

Endocrinology
The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25-hydroxyvitamin D and parathyroid hormone
Jung In Kang, Yoon Suk Lee, Ye Jin Han, Kyoung Ae Kong, Hae Soon Kim
Clin Exp Pediatr. 2017;60(2):45-49.   Published online February 27, 2017
Purpose

Serum level of 25-hydroxyvitamin D (25-OHD) is considered as the most appropriate marker of vitamin D status. However, only a few studies have investigated the relationship between 25-OHD and parathyroid hormone (PTH) in children. To this end, this study was aimed at evaluating the lowest 25-OHD level that suppresses the production of parathyroid hormone in children.

Methods

A retrospective record review was...

Cardiology
Relationship between serum sodium level and coronary artery abnormality in Kawasaki disease
Sora Park, Lucy Youngmin Eun, Ji Hong Kim
Clin Exp Pediatr. 2017;60(2):38-44.   Published online February 27, 2017
Purpose

Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in...

The outcome of short-term low-dose aspirin treatment in Kawasaki disease based on inflammatory markers
Jae Won Yoo, Ji Mok Kim, Hong Ryang Kil
Clin Exp Pediatr. 2017;60(1):24-29.   Published online January 24, 2017
Purpose

Previously, Kawasaki disease (KD) treatment with low-dose aspirin was administered for 6–8 weeks after the acute phase. However, inflammatory marker levels normalize before 6–8 weeks. In this study, we aimed to investigate the clinical outcome of short-term low-dose aspirin treatment based on inflammatory and thrombotic marker levels.

Methods

We performed a retrospective review of the medical records of patients with KD who...

General Pediatrics
The correlation of depression with Internet use and body image in Korean adolescents
Chang Hoon Lim, Eun Ji Kim, Jong Hyun Kim, Jue Seong Lee, Yoon Lee, Sang Hee Park
Clin Exp Pediatr. 2017;60(1):17-23.   Published online January 24, 2017
Purpose

To examine the correlation of depression with Internet use and body image perception, and to analyze the risk factors of depression in a total of 920 students in Seoul, Korea.

Methods

Students were recruited by contacting school principals and teachers and were encouraged to fill out a self-report questionnaire designed specifically for this study in July of 2008.

Results

Female participants had an increased...

Neonatology (Perinatology)
The influencing factors on procalcitonin values in newborns with noninfectious conditions during the first week of life
Jueseong Lee, Yong Hyeon Bang, Eun Hee Lee, Byung Min Choi, Young Sook Hong
Clin Exp Pediatr. 2017;60(1):10-16.   Published online January 16, 2017
Purpose

Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life.

Methods

In newborns hospitalized between March 2013 and October 2015, PCT levels...

Neurology
Single-center experience of the Korean-Developmental Screening Test for infants and children
Chae-Ri Suh, Su Ye Sohn, Gun-Ha Kim, Seong-Kwan Jung, Baik-Lin Eun
Clin Exp Pediatr. 2016;59(12):483-489.   Published online December 31, 2016
Purpose

We investigated the number of test takers of the Korean-Developmental Screening Test (K-DST) in a single children's hospital within a year, according to age, referral rate, and follow-up percentage.

Methods

For this study, 4,062 children who visited and received K-DST at Woorisoa Children's Hospital between January and December 2015 were enrolled. Seven test sets were used according to the Korean National Health...

Cardiology
Predictive factors of resistance to intravenous immunoglobulin and coronary artery lesions in Kawasaki disease
Hye Young Lee, Min Seob Song
Clin Exp Pediatr. 2016;59(12):477-482.   Published online December 31, 2016
Purpose

We conducted a study to determine which factors may be useful as predictive markers in identifying Kawasaki disease (KD) patients with a high risk of resistance to intravenous immunoglobulin (IVIG) and developing coronary artery lesions (CAL).

Methods

We enrolled 287 patients in acute phase of KD at a single center. The demographic, clinical and laboratory data were collected retrospectively.

Results

There were 34 patients...

Pulmonology
Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study
Ga Ram Kim, Min Sun Na, Kyung Suk Baek, Seung Jin Lee, Kyung Suk Lee, Young Ho Jung, Hye Mi Jee, Tae Hee Kwon, Man Yong Han, Youn Ho Sheen
Clin Exp Pediatr. 2016;59(12):471-476.   Published online December 31, 2016
Purpose

Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis.

Methods

We obtained the following data at admission: sex, age, neonatal history, past history of...

Cardiology
P wave dispersion on 12-lead electrocardiography in adolescents with neurocardiogenic syncope
Dong-Hyuk Lee, Kyung-Min Lee, Jung-Min Yoon, Jae-Woo Lim, Kyung-Ok Kho, Hong-Ryang Kil, Eun-Jung Cheon
Clin Exp Pediatr. 2016;59(11):451-455.   Published online November 18, 2016
Purpose

Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of...

Impact of postoperative duration of Aspirin use on longevity of bioprosthetic pulmonary valve in patients who underwent congenital heart disease repair
Tae-Woong Hwang, Sung-Ook Kim, Sang-Yun Lee, Seong-Ho Kim, Eun-Young Choi, So-Ick Jang, Su-Jin Park, Hye-Won Kwon, Hyo-Bin Lim, Chang-Ha Lee, Eun-Seok Choi
Clin Exp Pediatr. 2016;59(11):446-450.   Published online November 18, 2016
Purpose

Generally, aspirin is used as a protective agent against thrombogenic phenomenon after pulmonary valve replacement (PVR) using a bioprosthetic valve. However, the appropriate duration of aspirin use is unclear. We analyzed the impact of postoperative duration of aspirin use on the longevity of bioprosthetic pulmonary valves in patients who underwent repair for congenital heart diseases.

Methods

We retrospectively reviewed the clinical data...

Neurology
Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia
Sun Young Seo, Gyu Hong Shim, Myoung Jae Chey, Su Jeong You
Clin Exp Pediatr. 2016;59(11):440-445.   Published online November 18, 2016
Purpose

This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia.

Methods

All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2...

Developmental and Behavioral Medicine
Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age
Kyung Hee Yi, Yoon Young Yi, Il Tae Hwang
Clin Exp Pediatr. 2016;59(10):414-420.   Published online October 17, 2016
Purpose

We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA).

Methods

Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive...

Cardiology
Prediction of unresponsiveness to second intravenous immunoglobulin treatment in patients with Kawasaki disease refractory to initial treatment
Euri Seo, Jeong Jin Yu, Hyun Ok Jun, Eun Jung Shin, Jae Suk Baek, Young-Hwue Kim, Jae-Kon Ko
Clin Exp Pediatr. 2016;59(10):408-413.   Published online October 17, 2016
Purpose

This study investigated predictors of unresponsiveness to second-line intravenous immunoglobulin (IVIG) treatment for Kawasaki disease (KD).

Methods

This was a single-center analysis of the medical records of 588 patients with KD who had been admitted to Asan Medical Center between 2006 and 2014. Related clinical and laboratory data were analyzed by univariate and multivariate logistic regression analyses.

Results

Eighty (13.6%) of the 588 patients...

Allergy
Clinical and laboratory findings of childhood buckwheat allergy in a single tertiary hospital
Kyujung Park, Kyunguk Jeong, Sooyoung Lee
Clin Exp Pediatr. 2016;59(10):402-407.   Published online October 17, 2016
Purpose

Buckwheat allergy is one of the most severe types of food allergy in some countries, especially among children. However, few studies have investigated this condition. The aim of this study was to report the clinical and laboratory findings in Korean children with buckwheat allergy.

Methods

Thirty-seven subjects, aged 1 to 14 years, were enrolled by retrospective medical record review from January 2000...

Oncology
Metformin displays in vitro and in vivo antitumor effect against osteosarcoma
Yunmi Ko, Aery Choi, Minyoung Lee, Jun Ah Lee
Clin Exp Pediatr. 2016;59(9):374-380.   Published online September 21, 2016
Purpose

Patients with unresectable, relapsed, or refractory osteosarcoma need a novel therapeutic agent. Metformin is a biguanide derivative used in the treatment of type II diabetes, and is recently gaining attention in cancer research.

Methods

We evaluated the effect of metformin against human osteosarcoma. Four osteosarcoma cell lines (KHOS/NP, HOS, MG-63, U-2 OS) were treated with metformin and cell proliferation was evaluated using...

Gastroenterology
Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis
Jea Yeon Choi, Eell Ryoo, Jeong Hyun Jo, Tchah Hann, Seong Min Kim
Clin Exp Pediatr. 2016;59(9):368-373.   Published online September 21, 2016
Purpose

This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy.

Methods

This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed...

Clinical significance of serum alanine aminotransferase and lifestyle intervention in children with nonalcoholic fatty liver disease
Kyoung Ah Kwon, Peter Chun, Jae Hong Park
Clin Exp Pediatr. 2016;59(9):362-367.   Published online September 21, 2016
Purpose

This study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD.

Methods

The clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of...

Neurology
Venous angioma may be associated with epilepsy in children
Bo Ryung Kim, Yun Jin Lee, Sang Ook Nam, Kyung Hee Park
Clin Exp Pediatr. 2016;59(8):341-345.   Published online August 24, 2016
Purpose

Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy.

Methods

The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients...

Hematology
Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years
Jae Yeob Jung, A Rum O, Je Keong Kim, Meerim Park
Clin Exp Pediatr. 2016;59(8):335-340.   Published online August 24, 2016
Purpose

This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP.

Methods

The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed.

Results

The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years)...

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