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Original Article
Pulmonology
The changes of prevalence and etiology of pediatric pneumonia from National Emergency Department Information System in Korea, between 2007 and 2014
Eun Ju Shin, Yunsun Kim, Jin-Young Jeong, Yu Mi Jung, Mi-Hee Lee, Eun Hee Chung
Clin Exp Pediatr. 2018;61(9):291-300.   Published online September 15, 2018

Purpose: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. Methods: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. Results: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was...
Cardiology
Change of voltage-gated potassium channel 1.7 expressions in monocrotaline-induced pulmonary arterial hypertension rat model
Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2018;61(9):271-278.   Published online September 15, 2018

Purpose: Abnormal potassium channels expression affects vessel function, including vascular tone and proliferation rate. Diverse potassium channels, including voltage-gated potassium (Kv) channels, are involved in pathological changes of pulmonary arterial hypertension (PAH). Since the role of the Kv1.7 channel in PAH has not been previously studied, we investigated whether Kv1.7 channel expression changes in the lung tissue of a monocrotaline...
Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment
Yu-Mi Seo, Hyun-Mi Kang, Sung-Churl Lee, Jae-Won Yu, Hong-Ryang Kil, Jung-Woo Rhim, Ji-Whan Han, Kyung-Yil Lee
Clin Exp Pediatr. 2018;61(5):160-166.   Published online May 28, 2018
Purpose

This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients.

Methods

Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between...

Neurology
Long-term prenatal stress increases susceptibility of N-methyl-D-aspartic acid-induced spasms in infant rats
Hyeok Hee Kwon, Taekwan Lee, Jinpyo Hong, Dong Woon Kim, Joon Won Kang
Clin Exp Pediatr. 2018;61(5):150-155.   Published online May 28, 2018
Purpose

Infantile spasms, also known as West syndrome, is an age-specific epileptic seizure. Most patients with this condition also exhibit delayed development. This study aimed to determine the effect of long-term prenatal stress on susceptibility to infantile spasms.

Methods

We subjected pregnant rats to acute or chronic immobilization stress. Resulting offspring received N-methyl-D-aspartic acid (15 mg/kg, intraperitoneally) on postnatal day 15, and their...

General Pediatrics
Sudden unexpected cardio-respiratory arrest after venipuncture in children
Goun Jeong, Son Moon Shin, Nam Su Kim, Young Min Ahn
Clin Exp Pediatr. 2018;61(4):108-113.   Published online April 23, 2018
Purpose

This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children.

Methods

We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest.

Results

Fourteen patients were...

Infection
Association between vitamin D and urinary tract infection in children
Abolfazl Mahyar, Parviz Ayazi, Sara Safari, Reza Dalirani, Amir Javadi, Shiva Esmaeily
Clin Exp Pediatr. 2018;61(3):90-94.   Published online March 19, 2018
Purpose

The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children.

Methods

In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured...

Gastroenterology
Clinical manifestation of Campylobacter enteritis in children
Joon Yeol Bae, Dong Hyuk Lee, Kyung Ok Ko, Jae Woo Lim, Eun Jeong Cheon, Young Hwa Song, Jung Min Yoon
Clin Exp Pediatr. 2018;61(3):84-89.   Published online February 28, 2018
Purpose

Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent.

Methods

The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from...

Cardiology
Cardiac function associated with home ventilator care in Duchenne muscular dystrophy
Sangheun Lee, Heeyoung Lee, Lucy Youngmin Eun, Seung Woong Gang
Clin Exp Pediatr. 2018;61(2):59-63.   Published online February 28, 2018
Purpose

Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups.

Methods

We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic...

Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection
Jong Han Kim, Hye Ree Kang, Su Yeong Kim, Ji-Eun Ban
Clin Exp Pediatr. 2018;61(2):43-48.   Published online February 28, 2018
Purpose

Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection.

Methods

A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain...

Nephrology (Genitourinary)
Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection
Nani Jung, Hye Jin Byun, Jae Hyun Park, Joon Sik Kim, Hae Won Kim, Ji Yong Ha
Clin Exp Pediatr. 2018;61(1):24-29.   Published online January 22, 2018
Purpose

The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.

Methods

A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in...

Is vaginal reflux associated with urinary tract infection in female children under the age of 36 months?
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Clin Exp Pediatr. 2018;61(1):17-23.   Published online January 22, 2018
Purpose

To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months.

Methods

A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment...

Cardiology
C-reactive protein and N-terminal pro-brain natriuretic peptide discrepancy: a differentiation of adenoviral pharyngoconjunctival fever from Kawasaki disease
Jung Eun Choi, Hee Won Kang, Young Mi Hong, Sejung Sohn
Clin Exp Pediatr. 2018;61(1):12-16.   Published online January 22, 2018
Purpose

To differentiate adenoviral pharyngoconjunctival fever (PCF) from acute Kawasaki disease (KD) using laboratory tests before results of virus-real time polymerase chain reaction and ophthalmologic examination are obtained.

Methods

Baseline patient characteristics and laboratory measurements were compared between 40 patients with adenovirus infection and 123 patients with KD.

Results

The patients with adenovirus infection were generally older than those with KD (median: 3.9 years vs....

Case Report
Genetics and Metabolism
The First Korean case of combined oxidative phosphorylation deficiency-17 diagnosed by clinical and molecular investigation
Young A Kim, Yoo-Mi Kim, Yun-Jin Lee, Chong Kun Cheon
Clin Exp Pediatr. 2017;60(12):408-412.   Published online December 22, 2017

Combined oxidative phosphorylation deficiency-17 (COXPD-17) is very rare and is caused by homozygous or compound heterozygous mutations in the ELAC2 gene on chromosome 17p12. The ELAC2 gene functions as a mitochondrial tRNA processing gene, and only 4 different pathogenic mutations have been reported in ELAC2-associated mitochondrial dysfunction involving oxidative phosphorylation. Affected patients show various clinical symptoms and prognosis, depending on...

Review Article
Psychiatric / Psychology
The opportunities of virtual reality in the rehabilitation of children with attention deficit hyperactivity disorder: a literature review
Azadeh Bashiri, Marjan Ghazisaeedi, Leila Shahmoradi
Clin Exp Pediatr. 2017;60(11):337-343.   Published online November 27, 2017

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. This disorder, in addition to its main symptoms, creates significant difficulties in education, social performance, and personal relationships. Given the importance of rehabilitation for these patients to combat the above issues, the use of virtual reality (VR) technology is helpful. The aim of this study...

Original Article
Allergy
Accuracy of maximal expiratory flow-volume curve curvilinearity and fractional exhaled nitric oxide for detection of children with atopic asthma
Sang Hoo Park, Min Ji Im, Sang-Yong Eom, Youn-Soo Hahn
Clin Exp Pediatr. 2017;60(9):290-295.   Published online September 21, 2017
Purpose

Airway pathology in children with atopic asthma can be reflected by the concave shape of the maximal expiratory flow-volume (MEFV) curve and high fractional exhaled nitric oxide (FeNO) values. We evaluated the capacity of the curvilinearity of the MEFV curve, FeNO, and their combination to distinguish subjects with atopic asthma from healthy individuals.

Methods

FeNO and angle β, which characterizes the general...

Review Article
Neonatology (Perinatology)
Update of minimally invasive surfactant therapy
Gyu-Hong Shim
Clin Exp Pediatr. 2017;60(9):273-281.   Published online September 21, 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials...

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
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
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
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...

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...

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...

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...

Case Report
Neurology
Megalencephaly-capillary malformation-polymicrogyria syndrome: the first case report in Korea
Yeon-Chul Choi, Mi-Sun Yum, Min-Jee Kim, Yun-Jung Lee, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(Suppl 1):S152-S156.   Published online November 30, 2016

Megalencephaly-capillary malformation-polymicrogyria syndrome (MCAP), previously known as macrocephaly-cutis marmorata telangiectatica congenita and macrocephaly-capillary malformation syndrome, is a rare multiple-malformation syndrome that is characterized by progressive megalencephaly, capillary malformations of the midline face and body, or distal limb anomalies such as syndactyly. Herein, we report a female infant case that satisfies the recently proposed criteria of MCAP and describe the distinctive...