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Original Article
Pulmonology
Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study
Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran
Clin Exp Pediatr. 2025;68(4):319-325.   Published online November 13, 2024
Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations?
Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes.
Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function.
Review Article
Endocrinology
A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders
Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir
Clin Exp Pediatr. 2025;68(1):30-52.   Published online November 6, 2024
· The prevalence of vitamin D deficiency is high among children and adolescents and mainly attributed to changes in environmental factors.
· Vitamin D hormone-like properties are associated with many endocrine-related disorders.
· The effect of vitamin D is modulated by the vitamin D receptor, polymorphisms of which are reportedly associated with an increased risk of disease development in children and adolescents.
Original Article
Infection
Construction and validation of predictive models for intravenous immunoglobulin–resistant Kawasaki disease using an interpretable machine learning approach
Linfan Deng, Jian Zhao, Ting Wang, Bin Liu, Jun Jiang, Peng Jia, Dong Liu, Gang Li
Clin Exp Pediatr. 2024;67(8):405-414.   Published online July 23, 2024
Question: Is there a reliable model to predict intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD)?
Finding: We constructed 5 machine learning models to predict IVIG-resistant KD. Extreme gradient boosting (XGBoost) model was superior to logistic, support vector machine, light gradient boosting machine and multiple layers perception models. The SHAP (SHapley Additive exPlanations) value interpreted the contribution of each feature in XGBoost model.
Meaning: XGBoost model showed the excellent performance to predict IVIG-resistant KD with explainable and visualizable machine learning algorithm.
Adolescence Medicine
Relationship between inflammatory biomarkers and insulin resistance in excess-weight Latin children
Mariano Nicolás Aleman, María Constanza Luciardi, Emilce Romina Albornoz, María Cristina Bazán, Adela Victoria Abregú
Clin Exp Pediatr. 2024;67(1):37-45.   Published online December 21, 2023
Question: What is the prevalence of insulin resistance (IR) in excess-weight Latin children, and can proinflammatory biomarkers predict it?
Finding: IR prevalence was elevated and tumor necrosis factor- α, interleukin-6, monocyte chemoattractant protein- 1, soluble CD40 ligand, and high-sensitivity C-reactive protein levels were increased in excess-weight Latin children. However, none predicted IR status.
Meaning: These inflammatory biomarkers were unable to predict IR status. Therefore, further investigations are necessary.
Review Article
General Pediatrics
Metabolic complications of obesity in children and adolescents
Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park
Clin Exp Pediatr. 2024;67(7):347-355.   Published online November 16, 2023
· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.
Endocrinology
Nonalcoholic fatty liver disease and insulin resistance in children
Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae
Clin Exp Pediatr. 2023;66(12):512-519.   Published online January 9, 2023
· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea.
· Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD.
· Insulin resistance is closely related to NAFLD.
Original Article
Infection
Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis
Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei
Clin Exp Pediatr. 2021;64(8):415-421.   Published online November 20, 2020
The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.
Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade
Woosuck Suh, Bi Na Kim, Hyun Mi Kang, Eun Ae Yang, Jung-Woo Rhim, Kyung-Yil Lee
Clin Exp Pediatr. 2021;64(6):293-300.   Published online October 14, 2020
Question: How has the antibiotic susceptibility of urinary pathogens changed and what does it imply?
Finding: A yearly increase in multidrug-resistant and extended-spectrum β-lactamase (ESBL)–producing pathogens was observed. A higher recurrence rate was observed in cases of febrile urinary tract infection caused by ESBL producers in patients with underlying vesicoureteral reflux (VUR).
Meaning: The initial empirical antibiotic should reflect the changing susceptibility patterns and underlying VUR status.
Review Article
Endocrinology
Early menarche and its consequence in Korean female: reducing fructose intake could be one solution
Ji Hyun Kim, Jung Sub Lim
Clin Exp Pediatr. 2021;64(1):12-20.   Published online May 14, 2020
In Korea, the average age of menarche has declined sharply. Early menarche is associated with psychosocial and behavioral problems and cardiometabolic disease. Excess fructose intake has been suggested as one cause of early menarche in recent studies, so reducing fructose intake may be one solution.
Original Article
Endocrinology
Influence of subclinical hypothyroidism on metabolic parameters in obese children and adolescents
Ozlem Kara
Clin Exp Pediatr. 2020;63(3):110-114.   Published online March 6, 2020
Question: Does subclinical hypothyroidism in obese children and adolescents affect metabolic parameters?
Finding: Insulin, HOMA-IR, and TG levels were higher and the HDL-C level was lower in patients with SH.
Meaning: A clear association is observed between SH, and insulin resistance and dyslipidemia in obese children. It can be said that the TSH may be evaluated as a metabolic risk factor in obese patients.
Review Article
Pulmonology
Benefits and risks of therapeutic alternatives for macrolide resistant Mycoplasma pneumoniae pneumonia in children
Hyeon-Jong Yang
Clin Exp Pediatr. 2019;62(6):199-205.   Published online March 15, 2019
Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children....
Predictors and management of intravenous immunoglobulin-resistant Kawasaki disease
Min Seob Song
Clin Exp Pediatr. 2019;62(4):119-123.   Published online March 15, 2019
Kawasaki disease (KD) is a systemic vasculitis that mainly affects younger children. Intravenous immunoglobulin (IVIG) resistant cases are at increasing risk for coronary artery complications. The strategy on prediction of potential nonresponders and treatment of IVIG-resistant patients is now controversial. In this review the definition and predictors of IVIG-resistant KD and current evidence to guide management are discussed.
Trends in the use of antibiotics among Korean children
Young June Choe, Ju-Young Shin
Clin Exp Pediatr. 2019;62(4):113-118.   Published online March 4, 2019
Inappropriate antibiotic use is the most important factor causing increased bacterial resistance to antibiotics, thus affecting patient outcomes. Multidrug-resistant bacteria have become a serious public health threat, causing significant morbidity and mortality worldwide. In Korea, the burden of antibioticresistant bacteria has become an important public health issue. There is increasing evidence of overuse and misuse of antibiotics in Korea, as...
Original Article
Adolescence Medicine
Serum alanine aminotransferase levels are closely associated with metabolic disturbances in apparently healthy young adolescents independent of obesity
Ki Eun Kim, Kyung Suk Baek, Sol Han, Jung Hyun Kim, Youn Ho Shin
Clin Exp Pediatr. 2019;62(2):48-54.   Published online November 23, 2018

Purpose: Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. Methods: A population of 120 apparently healthy adolescents aged 12–13 years was included in the cross-sectional design study; 58 were overweight or obese...
Pulmonology
Increased procalcitonin level is a risk factor for prolonged fever in children with Mycoplasma pneumonia
Ji Eun Jeong, Ji Eun Soh, Ji Hee Kwak, Hye Lim Jung, Jae Won Shim, Deok Soo Kim, Moon Soo Park, Jung Yeon Shim
Clin Exp Pediatr. 2018;61(8):258-263.   Published online August 15, 2018

Purpose: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods: A total of 147 children were recruited. The diagnosis of MPP...
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
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...

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...

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
Inhaled iloprost for the treatment of patient with Fontan circulation
Yong Hyun Kim, Moon Hee Chae, Deok Young Choi
Clin Exp Pediatr. 2014;57(10):461-463.   Published online October 31, 2014

Decreased exercise capacity after Fontan surgery is relatively common and the failure of the Fontan state gradually increases with age. However, there is no further treatment for patients with Fontan circulation. Pulmonary vasodilation therapy is an effective method to solve this problem because pulmonary vascular resistance is a major factor of the Fontan problem. Inhaled iloprost is a chemically stable...

Original Article
Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia
Young Ho Seo, Jang Su Kim, Sung Chul Seo, Won Hee Seo, Young Yoo, Dae Jin Song, Ji Tae Choung
Clin Exp Pediatr. 2014;57(4):186-192.   Published online April 30, 2014
Purpose

The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia.

Methods

A total of 95 patients with M. pneumoniae pneumonia were enrolled in...

Review Article
Antibiotics resistance of Helicobacter pylori and treatment modalities in children with H. pylori infection
Ji-Hyun Seo, Hyang-Ok Woo, Hee-Shang Youn, Kwang-Ho Rhee
Clin Exp Pediatr. 2014;57(2):67-71.   Published online February 24, 2014

Pediatric infection with Helicobacter pylori may occur early in childhood and persist lifelong. Global pediatric clinical studies have reported a decreasing tendency in the overall rate of H. pylori eradication. In pediatric patients with H. pylori infection, pediatric patients with peptic ulcer, and the first-degree relatives of patients with a history of gastric cancer, it is commonly recommended that H....

Original Article
Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern
Sameh Samir Fahmey
Clin Exp Pediatr. 2013;56(8):332-337.   Published online August 27, 2013
Purpose

To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern.

Methods

A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors...

Occurrence and characterization of oseltamivir-resistant influenza virus in children between 2007-2008 and 2008-2009 seasons
Seoung Geun Kim, Yoon Ha Hwang, Yung Hae Shin, Sung Won Kim, Woo Sik Jung, Sung Mi Kim, Jae Min Oh, Na Young Lee, Mun Ju Kim, Kyung Soon Cho, Yeon Gyeong Park, Sang Kee Min, Chang Kyu Lee, Jun Sub Kim, Chun Kang, Joo Yeon Lee, Man Kyu Huh, Chang Hoon Kim
Clin Exp Pediatr. 2013;56(4):165-175.   Published online April 22, 2013
Purpose

There was a global increase in the prevalence of oseltamivir-resistant influenza viruses during the 2007-2008 influenza season. This study was conducted to investigate the occurrence and characteristics of oseltamivir-resistant influenza viruses during the 2007-2008 and 2008-2009 influenza seasons among patients who were treated with oseltamivir (group A) and those that did not receive oseltamivir (group B).

Methods

A prospective study was conducted...

Review Article
Mycoplasma pneumoniae pneumonia in children
You-Sook Youn, Kyung-Yil Lee
Clin Exp Pediatr. 2012;55(2):42-47.   Published online February 14, 2012

Mycoplasma pneumoniae (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the...

Original Article
Reference values for respiratory system impedance using impulse oscillometry in healthy preschool children
Jye Hae Park, Jung Won Yoon, Youn Ho Shin, Hye Mi Jee, Young Sun Wee, Sun Jung Chang, Jung Hwa Sim, Hye Yung Yum, Man Yong Han
Clin Exp Pediatr. 2011;54(2):64-68.   Published online February 28, 2011
Purpose

The normal values for lung resistance and lung capacity of children, as determined by impulse oscillometry (IOS), are different for children of different ethnicities. However, reference values there is no available reference value for Korean preschool children have yet to be determined. The aim of the present study was to determine the normal ranges of IOS parameters in Korean preschool...

Detection of genetic mutations associated with macrolide resistance of Mycoplasma pneumoniae
Chi Eun Oh, Eun Hwa Choi, Hoan Jong Lee
Clin Exp Pediatr. 2010;53(2):178-183.   Published online February 15, 2010
Purpose : The aim of this study was to identify mutations associated with macrolide resistance in Mycoplasma pneumoniae (MP) and to establish a cultural method to determine antimicrobial susceptibility. Methods : Nasopharyngeal aspirates (NPAs) were collected from 62 children diagnosed with MP pneumonia by a serologic method or polymerase chain reaction. The 23S rRNA and L4 ribosomal protein genes of MP...
Oseltamivir efficacy, side effects, and safety in children with influenza
Eun Sun Seo, Geun Hwa Park, Sung Won Kim, Sung Won Kim, Woo Sik Jung, Kyung Soon Cho, Yeon Gyeong Park, Chang Kyu Lee, Chun Kang, Joo Yeon Lee, Woo Young Choi
Clin Exp Pediatr. 2010;53(1):56-66.   Published online January 15, 2010
Purpose : Although oseltamivir is widely used for treatment of influenza, few clinical studies of its efficacy and resistance have been performed in Korea. We evaluated the safety, side effects, and efficacy of oseltamivir treatment in Korean pediatric patients. Methods : We analyzed 321 children diagnosed with influenza at Busan St. Mary's Medical Center, Korea, between January 2008 and June...
Microbiological spectrum and antibiotic susceptibility pattern in more than 24-month-old children with urinary tract infection: A6-year retrospective, single center experience
Jeong Hee Ko, Jee Hyung Lee, Eun Jung Shim, Do jun Cho, Ki Sik Min, Ki Yang Yoo, Dae Young Lee, Hee Jung Kang
Clin Exp Pediatr. 2009;52(10):1147-1152.   Published online October 15, 2009
Purpose : To characterize the pathogens and their antibiotic susceptibilities in more than 24-month-old children with urinary tract infection (UTI) and to study the Escherichia coli antimicrobial susceptibility trend. Methods : We retrospectively reviewed the record of more than 24-month-old children with UTI between January 2003 and December 2008. Positive results for 1 bacterial species with a colony count of...
Salmonellosis in children: Analysis of 72 Salmonella-positive culture cases during the last 10 years
Sung Hoon Noh, Ka Young Yu, Jung Soo Kim, Pyoung Han Hwang, Dae Sun Jo
Clin Exp Pediatr. 2009;52(7):791-797.   Published online July 15, 2009
Purpose : We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis. Methods : Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded. Results...
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