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Review Article
General Pediatrics
Apparent life-threatening event in infancy
Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2016;59(9):347-354.   Published online September 21, 2016

An apparent life-threatening event (ALTE) is defined as the combination of clinical presentations such as apnea, marked change in skin and muscle tone, gagging, or choking. It is a frightening event, and it predominantly occurs during infancy at a mean age of 1–3 months. The causes of ALTE are categorized into problems that are: gastrointestinal (50%), neurological (30%), respiratory (20%),...

Original Article
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)...

Cardiology
Clinical outcome of patients with refractory Kawasaki disease based on treatment modalities
Hyun Jung Kim, Hyo Eun Lee, Jae Won Yu, Hong Ryang Kil
Clin Exp Pediatr. 2016;59(8):328-334.   Published online August 24, 2016
Purpose

Although a significant number of reports on new therapeutic options for refractory Kawasaki disease (KD) such as steroid, infliximab, or repeated intravenous immunoglobulin (IVIG) are available, their effectiveness in reducing the prevalence of coronary artery lesions (CAL) remains controversial. This study aimed to define the clinical characteristics of patients with refractory KD and to assess the effects of adjuvant therapy...

Review Article
Allergy
Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases
Hyeon-Jong Yang
Clin Exp Pediatr. 2016;59(8):319-327.   Published online August 24, 2016

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards....

Neurology
The use of complementary and alternative medicine in children with common neurologic diseases
Gyu-Min Yeon, Sang Ook Nam
Clin Exp Pediatr. 2016;59(8):313-318.   Published online August 24, 2016

Complementary and alternative medicine (CAM) is a phrase used to describe additional health care methods such as mind/body practices and natural products not regarded as treatments by conventional medicine. The use of CAM in children with common neurologic diseases is more frequent than its use in healthy children (24%–78% vs. 12%). However, less than half of patients report such use...

Case Report
Infection
Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness
Jung Sook Yeom, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn, Ok Jeong Lee, Tae-Hee Han, Ju-Young Chung
Clin Exp Pediatr. 2016;59(7):308-311.   Published online July 31, 2016

We report a human parechovirus-3 (HPeV-3) infection in 2 neonates who had prolonged fever (>5 days) with palmar-plantar erythema. This distinctive rash was observed 4–5 days after fever onset, just before defervescence. Elevated aspartate aminotransferase, lactate dehydrogenase, and ferritin levels were characteristic laboratory findings in the 2 cases, suggesting tissue damage caused by hypercytokinemia. Case 1 was treated with intravenous...

Original Article
Gastroenterology
Dietary habits and gastroesophageal reflux disease in preschool children
You Jin Choi, Eun Kyo Ha, Su Jin Jeong
Clin Exp Pediatr. 2016;59(7):303-307.   Published online July 31, 2016
Purpose

To identify the relationship between dietary habits and childhood gastroesophageal reflux disease (GERD) in preschool children.

Methods

We performed a questionnaire study to analyze the relationship between dietary habits and GERD in 85 preschool children with GERD and 117 healthy children of the same age.

Results

Irregular and picky eating were more p–revalent in the GERD group than in the control group (odds ratio...

Cardiology
Age-adjusted plasma N-terminal pro-brain natriuretic peptide level in Kawasaki disease
Heul Jun, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Gyung Min Lee, Eun Jung Cheon
Clin Exp Pediatr. 2016;59(7):298-302.   Published online July 31, 2016
Purpose

Recent reports showed that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) could be a useful biomarker of intravenous immunoglobulin (IVIG) unresponsiveness and coronary artery lesion (CAL) development in Kawasaki disease (KD). The levels of these peptides are critically influenced by age; hence, the normal range and upper limits for infants and children are different. We performed an age-adjusted analysis of plasma...

Case Report
Neurology
Two cases of familial cerebral cavernous malformation caused by mutations in the CCM1 gene
Im-Yong Yang, Mi-Sun Yum, Eun-Hee Kim, Hae-Won Choi, Han-Wook Yoo, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(6):280-284.   Published online June 30, 2016

Cerebral cavernous malformation (CCM) is a vascular malformation characterized by abnormally enlarged capillary cavities without any intervening neural tissue. We report 2 cases of familial CCMs diagnosed with the CCM1 mutation by using a genetic assay. A 5-year-old boy presented with headache, vomiting, and seizure-like movements. Brain magnetic resonance imaging (MRI) revealed multiple CCM lesions in the cerebral hemispheres. Subsequent...

Genetics and Metabolism
A rare case of Sjogren-Larsson syndrome with recurrent pneumonia and asthma
Azita Tavasoli, Shirin Sayyahfar, Babak Behnam
Clin Exp Pediatr. 2016;59(6):276-279.   Published online June 30, 2016

Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation...

Original Article
Neurology
Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children
Eung-Bin Lee, Yun Young Lee, Jae Min Lee, Su Min Son, Su-Kyeong Hwang, Soonhak Kwon, Sae Yoon Kim
Clin Exp Pediatr. 2016;59(6):271-275.   Published online June 30, 2016
Purpose

A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients.

Methods

The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS....

Cardiology
The effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline-induced right ventricular failure
Hyun Kyung Bae, Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2016;59(6):262-270.   Published online June 30, 2016
Purpose

Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF.

Methods

The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the...

Infection
Pneumocystis jirovecii pneumonia in pediatric patients: an analysis of 15 confirmed consecutive cases during 14 years
Kyung-Ran Kim, Jong Min Kim, Ji-Man Kang, Yae-Jean Kim
Clin Exp Pediatr. 2016;59(6):252-255.   Published online June 30, 2016
Purpose

Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center.

Methods

We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review...

Review Article
Gastroenterology
Nutritional concerns in pediatric inflammatory bowel disease
Yong Joo Kim
Clin Exp Pediatr. 2016;59(6):247-251.   Published online June 30, 2016

The pathophysiology and fundamental etiologic mechanism of inflammatory bowel disease (IBD) is not well understood even though therapeutic regimens and drugs are rapidly evolutionary. IBD has complicated connections with genetic, immunologic, gut microbial, environmental, and nutritional factors. It is not clearly well known to the physicians how to feed, what nutrients are more helpful, and what food to be avoided....

Case Report
Nephrology (Genitourinary)
Bilateral iliac and popliteal arterial thrombosis in a child with focal segmental glomerulosclerosis
Kyoung Hee Han, Ji Youn Park, Seung-Kee Min, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
Clin Exp Pediatr. 2016;59(5):242-245.   Published online May 31, 2016

Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%–5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and...

Original Article
Endocrinology
Lipopolysaccharide-binding protein plasma levels as a biomarker of obesity-related insulin resistance in adolescents
Ki Eun Kim, Young Sun Cho, Kyung Suk Baek, Lan Li, Kwang-Hyun Baek, Jung Hyun Kim, Ho-Seong Kim, Youn Ho Sheen
Clin Exp Pediatr. 2016;59(5):231-238.   Published online May 31, 2016
Purpose

Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess...

Gastroenterology
Efficacy of proton pump inhibitors and H2 blocker in the treatment of symptomatic gastroesophageal reflux disease in infants
Hamid Reza Azizollahi, Mandana Rafeey
Clin Exp Pediatr. 2016;59(5):226-230.   Published online May 31, 2016
Purpose

Gastroesophageal reflux disease (GERD) occurs in pediatric patients when reflux of gastric contents presents with troublesome symptoms. The present study compared the effects of omeprazole and ranitidine for the treatment of symptomatic GERD in infants of 2-12 months.

Methods

This study was a clinical randomized double-blind trial and parallel-group comparison of omeprazole and ranitidine performed at Children Training Hospital in Tabriz, Iran....

Allergy
The relationships among birth season, sunlight exposure during infancy, and allergic disease
Jung Min Hwang, Se Hyun Oh, Mee Yong Shin
Clin Exp Pediatr. 2016;59(5):218-225.   Published online May 31, 2016
Purpose

The recent increase in the prevalence of allergic diseases is hypothetically attributed to immune dysregulation in turn caused by a reduction in exposure to sunlight. We explored relationships between birth season, sunlight exposure, exercise duration, and an allergic disease.

Methods

We performed a questionnaire-based survey on allergic diseases among elementary school students. Birth time was categorized according to the season (summer and...

Neurology
Clinical features and prognostic factors in drowning children: a regional experience
Kyung Lae Son, Su Kyeong Hwang, Hee Joung Choi
Clin Exp Pediatr. 2016;59(5):212-217.   Published online May 31, 2016
Purpose

This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis.

Methods

We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated.

Results

During the study period, 29 children...

Review Article
Nephrology (Genitourinary)
Pathogenesis of minimal change nephrotic syndrome: an immunological concept
Seong Heon Kim, Se Jin Park, Kyoung Hee Han, Andreas Kronbichler, Moin A. Saleem, Jun Oh, Beom Jin Lim, Jae Il Shin
Clin Exp Pediatr. 2016;59(5):205-211.   Published online May 31, 2016

Idiopathic nephrotic syndrome (INS) in children is characterized by massive proteinuria and hypoalbuminemia. Minimal change nephrotic syndrome (MCNS) is the most common form of INS in children. The pathogenesis of MCNS still remains unclear, however, several hypotheses have been recently proposed. For several decades, MCNS has been considered a T-cell disorder, which causes the impairment of the glomerular filtration barrier...

Case Report
Nephrology (Genitourinary)
Deficiency of antidiuretic hormone: a rare cause of massive polyuria after kidney transplantation
Kyung Mi Jang, Young Soo Sohn, Young Ju Hwang, Bong Seok Choi, Min Hyun Cho
Clin Exp Pediatr. 2016;59(4):202-204.   Published online April 30, 2016

A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate...

Original Article
Cardiology
Subclinical left ventricular dysfunction in children after hematopoietic stem cell transplantation for severe aplastic anemia: a case control study using speckle tracking echocardiography
Beom Joon Kim, Kyung Pil Moon, Ji-Hong Yoon, Eun-Jung Lee, Jae Young Lee, Seong Koo Kim, Jae Wook Lee, Nack Gyun Chung, Bin Cho, Hack Ki Kim
Clin Exp Pediatr. 2016;59(4):190-195.   Published online April 30, 2016
Purpose

Severe aplastic anemia (SAA), a fatal disease, requires multiple transfusion, immunosuppressive therapy, and finally, hematopoietic stem cell transplantation (HSCT) as the definitive treatment. We hypothesized that iron overloading associated with multiple transfusions and HSCTrelated complications may adversely affect cardiac function. Left ventricular (LV) function was assessed in children after HSCT for SAA.

Methods

Forty-six consecutive patients with a median age of 9.8...

Correlation of B-type natriuretic peptide levels and echocardiographic parameters in preterm infants with patent ductus arteriosus
Hyun Ah Jeong, Jeonghee Shin, Eunji Kim, Eun Hee Lee, Byung Min Choi, Chang Sung Son, Joo Won Lee
Clin Exp Pediatr. 2016;59(4):183-189.   Published online April 30, 2016
Purpose

This study aimed to evaluate the correlation, according to postnatal age, between plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters for the assessment of patent ductus arteriosus (PDA) in preterm infants with respiratory distress.

Methods

We enrolled 42 preterm infants with respiratory distress who underwent serial echocardiographic evaluation with simultaneous plasma BNP measurements until ductal closure. The correlations between BNP levels...

Neonatology (Perinatology)
Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants
Ah Young Choi, Yong Wook Lee, Mea-young Chang
Clin Exp Pediatr. 2016;59(4):165-173.   Published online April 30, 2016
Purpose

To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants.

Methods

The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1...

Review Article
Neurology
Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes
Eun-Hee Kim, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(4):155-164.   Published online April 30, 2016

Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered...

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...