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Review Article
Infection
Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment
Ki Wook Yun
Clin Exp Pediatr. 2024;67(2):80-89.   Published online June 14, 2023
· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%).
· Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP.
· CAP should be diagnosed conservatively according to clinical and radiological criteria.
· The etiology should be identified via appropriate test result interpretation.
Original Article
Gastroenterology
Assessing indicators and clinical differences between functional and organic childhood constipation: a retrospective study in pediatric gastroenterology clinics
Hasan M. Isa, Fatema A. Alkharsi, Fatema A. Salman, Maryam S. Ali, Zahra K. Abdulnabibi, Afaf M. Mohamed
Clin Exp Pediatr. 2023;66(7):296-306.   Published online June 14, 2023
Question: What causes childhood constipation, and what can predict organic constipation?
Finding: Constipation represents 14.7% of gastroenterology visits. Functional constipation is more common among constipation types, while organic constipation is more common in young children and those with a low body weight, stunted growth, mucus in the stool, and associated diseases.
Meaning: Younger children and those with lower growth or mucus in the stool should be assessed for underlying organic causes of constipation.
Review Article
Gastroenterology
Update on eosinophilic gastrointestinal disease beyond eosinophilic esophagitis in children
Hye Ran Yang
Clin Exp Pediatr. 2023;66(6):233-239.   Published online January 3, 2023
· Eosinophilic gastrointestinal disease (EGID) is uncommon, with a prevalence of 1–30/100,000 in the general population; however, it is increasing worldwide.
· The diagnosis of EGID is based on histopathological findings of endoscopic mucosal biopsy in which tissue eosinophils are counted in each gastrointestinal tract segment of patients with chronic or recurrent gastrointestinal symptoms.
· Individualized treatment strategies, including adequate dietary and pharmacological therapy, may help improve outcomes of children with EGID.
Original Article
Neurology
Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review
Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga
Clin Exp Pediatr. 2023;66(1):38-45.   Published online November 30, 2022
· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.
Review Article
Pulmonology
Overview of management of children with COVID-19
Dyah Kanya Wati, Arya Krisna Manggala
Clin Exp Pediatr. 2020;63(9):345-354.   Published online July 17, 2020
The specific treatments for COVID-19 in children remain inconclusive and debatable despite effectively decreasing its signs and symptoms.
The need for clinical trials and reports should be investigated.
Genetics and Metabolism
Neurofibromatosis type I: points to be considered by general pediatricians
Eungu Kang, Hee Mang Yoon, Beom Hee Lee
Clin Exp Pediatr. 2021;64(4):149-156.   Published online July 15, 2020
Neurofibromatosis type 1 (NF1), a prevalent genetic disease that is transmitted in an autosomal dominant manner, is characterized by multiple cutaneous café-au-lait spots and neurofibromas as well as various degrees of neurological, skeletal, and neoplastic manifestations. The clinical features of NF1 increase in frequency with age, while the clinical diagnosis can remain undetermined in some pediatric patients. Importantly, affected patients...
Original Article
General Pediatrics
Efficacy of conservative treatment of perianal abscesses in children and predictors for therapeutic failure
Lars Boenicke, Johannes Doerner, Stefan Wirth, Hubert Zirngibl, Mike Ralf Langenbach
Clin Exp Pediatr. 2020;63(7):272-277.   Published online May 15, 2020
Background: The optimal management of perianal abscess in children is controversial.
Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001–2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary...
Review Article
Neonatology (Perinatology)
Practice for preterm patent ductus arteriosus; focusing on the hemodynamic significance and the impact on the neonatal outcomes
Jin A Lee
Clin Exp Pediatr. 2019;62(7):245-251.   Published online April 8, 2019
Hemodynamically significant preterm patent ductus arteriosus (PDA) affects mortality; comorbidities such as necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia; and adverse long-term neurodevelopmental outcomes in preterm infants, particularly in very low birth weight infants. However, recent studies have indicated that there is no consensus on the causal relationship between PDA and neonatal outcomes, the benefit of PDA treatment, the factors...
Guideline
Nutrition
Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition
Dae Yong Yi, Soon Chul Kim, Ji Hyuk Lee, Eun Hye Lee, Jae Young Kim, Yong Joo Kim, Ki Soo Kang, Jeana Hong, Jung Ok Shim, Yoon Lee, Ben Kang, Yeoun Joo Lee, Mi Jin Kim, Jin Soo Moon, Hong Koh, JeongAe You, Young-Sook Kwak, Hyunjung Lim, Hye Ran Yang
Clin Exp Pediatr. 2019;62(1):3-21.   Published online December 27, 2018
The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in...
Original Article
Hematology and Oncology
Lymphocyte-monocyte ratio at day 14 of first cisplatin-doxorubicin chemotherapy is associated with treatment outcome of pediatric patients with localized osteosarcoma
Jun Ah Lee, Hea Lin Oh, Dong Ho Kim, Jung Sub Lim
Clin Exp Pediatr. 2019;62(2):62-67.   Published online October 1, 2018

Purpose: We aimed to determine the prognostic significance of lymphocyte counts and the lymphocytemonocyte ratio (LMR) in pediatric patients with osteosarcoma. Methods: We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma, treated at the Korea Cancer Center Hospital between May 2002 and March 2016. Leukocyte counts and LMR before treatment and on day 14 (LMR14) of...
Case Report
Neurology
A long-term subacute sclerosing panencephalitis survivor treated with intraventricular interferon-alpha for 13 years
Minsun Kwak, Hye-Ryun Yeh, Mi-Sun Yum, Hyun-Jin Kim, Su Jeong You, Tae-Sung Ko
Clin Exp Pediatr. 2019;62(3):108-112.   Published online September 18, 2018
Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha (IFN-α) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of...
Original Article
Infection
Treatment-failure tularemia in children
Arzu Karlı, Gülnar Şensoy, Şule Paksu, Muhammet Furkan Korkmaz, Ömer Ertuğrul, Rıfat Karlı
Clin Exp Pediatr. 2018;61(2):49-52.   Published online February 28, 2018
Purpose

Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment.

Methods

A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included.

Results

Before diagnosis, the duration of symptoms in...

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
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...

Review Article
Efficacy and safety of growth hormone treatment for children born small for gestational age
Il Tae Hwang
Clin Exp Pediatr. 2014;57(9):379-383.   Published online September 30, 2014

Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve...

Original Article
Continuous renal replacement therapy in neonates weighing less than 3 kg
Young Bae Sohn, Kyung Hoon Paik, Hee Yeon Cho, Su Jin Kim, Sung Won Park, Eun Sun Kim, Yun Sil Chang, Won-Soon Park, Yoon-Ho Choi, Dong-Kyu Jin
Clin Exp Pediatr. 2012;55(8):286-292.   Published online August 23, 2012
Purpose

Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for supporting critically ill pediatric patients. However, a few studies present have reported CRRT use and outcome in neonates weighing less than 3 kg. The aim of this study is to describe the clinical application, outcome, and complications of CRRT in small neonates.

Methods

A retrospective review was performed in 8...

Successful and safe treatment of hemangioma with oral propranolol in a single institution
Sun Hee Chung, Dong Hyuk Park, Hye Lim Jung, Jae Won Shim, Deok Soo Kim, Jung Yeon Shim, Moon Soo Park, Hong Hoe Koo
Clin Exp Pediatr. 2012;55(5):164-170.   Published online May 21, 2012
Purpose

Dramatic improvement of hemangioma to propranolol has been recently reported; however, details on dose and duration of treatment, potential risks, and monitoring have not been determined. The objective of this study is to describe and analyze the use of propranolol as a first-line treatment or as a single therapy in management of complicated hemangioma.

Methods

A retrospective chart review of eight patients...

Review Article
Treatment of steroid-resistant pediatric nephrotic syndrome
Hee Gyung Kang
Clin Exp Pediatr. 2011;54(8):317-321.   Published online August 31, 2011

Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be...

The treatment of pediatric chronic myelogenous leukemia in the imatinib era
Jae Wook Lee, Nack Gyun Chung
Clin Exp Pediatr. 2011;54(3):111-116.   Published online March 31, 2011

Childhood chronic myelogenous leukemia (CML) is a rare hematologic disease, with limited literature on the methods of treatment. Previously, allogeneic hematopoietic stem cell transplantation (HSCT) was considered the only curative treatment for this disease. Treatment with imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase (TKI), has resulted in prolonged molecular response with limited drug toxicity. Imatinib is now implemented...

Systematic review of the clinical and genetic aspects of Prader-Willi syndrome
Dong Kyu Jin
Clin Exp Pediatr. 2011;54(2):55-63.   Published online February 28, 2011

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that is caused by the lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. This syndrome has a characteristic phenotype including severe neonatal hypotonia, early-onset hyperphagia, development of morbid obesity, short stature, hypogonadism, learning disabilities, behavioral problems, and psychiatric problems. PWS is an example of a genetic condition caused...

Change in the treatment strategy for pediatric Crohn's disease
Mi Jin Kim, Yon Ho Choe
Clin Exp Pediatr. 2010;53(9):830-833.   Published online September 13, 2010

Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as...

Original Article
The characteristic laboratory findings of non-responsiveness to intravenous immunoglobulin in children with Kawasaki disease
Han Gil Cho, Young Kuk Cho, Jae Sook Ma
Clin Exp Pediatr. 2010;53(2):228-234.   Published online February 15, 2010
Purpose : Although intravenous immunoglobulin (IVIG) treatment is an effective first-line treatment for Kawasaki disease, 10-20% of the patients develop persistent fever or coronary artery complications. Medical records of Kawasaki disease patients were reviewed to assess the characteristic laboratory findings of IVIG nonresponsiveness. Methods : We reviewed the clinical records of 118 children with Kawasaki disease who were treated at...
Review Article
Treatment of chronic kidney disease in children
Joo Hoon Lee
Clin Exp Pediatr. 2009;52(10):1061-1068.   Published online October 15, 2009
The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth...
Original Article
Bilateral retinoblastoma: Long-term follow-up results from a single institution
Sang Yul Choi, Dong Hwan Kim, Kang Min Lee, Hyun Jae Lee, Mi-Sook Kim, Tai-Won Lee, Sang Wook Choi, Dong Ho Kim, Kyung Duk Park, Jun Ah Lee
Clin Exp Pediatr. 2009;52(6):674-679.   Published online June 15, 2009
Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy....
Clinical experience with amitriptyline for management of children with cyclic vomiting syndrome
Ye Jee Shim, Jung-mi Kim, Soonhak Kwon, Byung-Ho Choe
Clin Exp Pediatr. 2009;52(5):538-543.   Published online May 15, 2009
Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the...
Analysis of cytosine adenine repeat polymorphism of the IGF-I promoter gene in children with idiopathic short stature
Jae Hoon Moon, Woo Yeong Chun
Clin Exp Pediatr. 2009;52(3):356-363.   Published online March 15, 2009
Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The...
Review Article
Assessment of retinopathy of prematurity (ROP) revisited
Jeong Hun Kim, Young Suk Yu
Clin Exp Pediatr. 2009;52(1):22-27.   Published online January 15, 2009
Retinopathy of prematurity (ROP) is a major cause of blindness that affects premature infants. With advances in neonatology, ROP is likely to emerge as the most serious problem of vision loss in children even in developed countries; such a situation could be called the third epidemic of ROP. However, controversy and uncertainty still surround favorable outcomes of ROP. For successfully...
Neuromuscular disorders in children : Diagnosis and treatment
Jong Hee Chae
Clin Exp Pediatr. 2008;51(12):1295-1299.   Published online December 15, 2008
Inherited muscle diseases are heterogeneous with varying genetic etiologies and present with common symptoms and signs, including weakness, motor developmental delay, and hypotonia. To diagnose these various diseases, a meticulous family and clinical history, physical and neurological examinations, laboratory findings with electromyography, muscle biopsy, and genetic testing are needed. Here, I review several inherited muscle diseases, with a focus on...
Original Article
Diamond-Blackfan anemia: long-term follow-up of six cases
Young Jun Son, Hee Jo Baek, Hoon Kook
Clin Exp Pediatr. 2008;51(11):1211-1216.   Published online November 15, 2008
Purpose : Diamond-Blackfan anemia (DBA) is a rare heterogeneous genetic disorder of infancy and early childhood. It is characterized by red cell aplasia, congenital anomalies, and a predisposition to cancer. Corticosteroids and red cell transfusions are the mainstays of therapy. We describe our experience of 6 cases of DBA that were encountered over a period of 16 years. Methods :...
Delayed closure effect in preterm infants with patent ductus arteriosus
Hyun Ju Lee, Gyu Hong Sim, Kyung Eun Jung, Jin A Lee, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim, Jung-Hwan Choi
Clin Exp Pediatr. 2008;51(10):1065-1070.   Published online October 15, 2008
Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results :...
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