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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...
Neurology
Genotype-phenotype correlations in pediatric patients with myotonic dystrophy type 1
Hyeong Jung Kim, Ji-Hoon Na, Young-Mock Lee
Clin Exp Pediatr. 2019;62(2):55-61.   Published online September 23, 2018

Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG...
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...
Review Article
Nephrology (Genitourinary)
Renal replacement therapy in neonates with an inborn error of metabolism
Heeyeon Cho
Clin Exp Pediatr. 2019;62(2):43-47.   Published online November 7, 2018
Hyperammonemia can be caused by several genetic inborn errors of metabolism including urea cycle defects, organic acidemias, fatty acid oxidation defects, and certain disorders of amino acid metabolism. High levels of ammonia are extremely neurotoxic, leading to astrocyte swelling, brain edema, coma, severe disability, and even death. Thus, emergency treatment for hyperammonemia must be initiated before a precise diagnosis is...
Original Article
Neonatology (Perinatology)
Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients
Hyun Jung Sung, Hyun-Seung Lee
Clin Exp Pediatr. 2019;62(2):68-74.   Published online October 1, 2018

Purpose: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. Methods: We carried out a retrospective review of patients who underwent sonography or magnetic resonance imaging (MRI) for OSD because of suspicion of dorsal midline cutaneous stigmata (presumed to be a...
Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit
Se Jin Kim, Ga Eun Kim, Jae Hyun Park, Sang Lak Lee, Chun Soo Kim
Clin Exp Pediatr. 2019;62(1):36-41.   Published online September 27, 2018

Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for...
Gastroenterology
Nonalcoholic fatty liver disease in obese and nonobese pediatric patients
Eun Jeong Kim, Hyun Jin Kim
Clin Exp Pediatr. 2019;62(1):30-35.   Published online September 17, 2018

Purpose: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. Methods: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10–18 years of age....
Review Article
Allergy
Particulate matter and childhood allergic diseases
Song-I Yang
Clin Exp Pediatr. 2019;62(1):22-29.   Published online November 7, 2018
Particulate matter (PM) is a ubiquitous air pollutant that is a growing public health concern. Previous studies have suggested that PM is associated with asthma development and exacerbation of asthma symptoms. Although several studies have suggested increased risks of atopic dermatitis, allergic rhinitis, and allergic sensitization in relation to PM exposure, the evidence remains inconsistent. The plausible mechanisms underlying these...
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...
Editorial
Nutrition
What should we do to prevent and manage obesity in children and adolescents?
Hye Ran Yang
Clin Exp Pediatr. 2019;62(1):1-2.   Published online January 11, 2019
Case Report
Genetics and Metabolism
The first Korean case with Floating-Harbor syndrome with a novel SRCAP mutation diagnosed by targeted exome sequencing
Eun Mi Choi, Dong Hyun Lee, Seok Jin Kang, Ye Jee Shim, Heung Sik Kim, Jun Sik Kim, Jong In Jeong, Jung-Sook Ha, Ja-Hyun Jang
Clin Exp Pediatr. 2018;61(12):403-406.   Published online September 16, 2018
Floating-Harbor syndrome is a rare autosomal dominant genetic disorder associated with SRCAP mutation. To date, approximately 50 cases of Floating-Harbor syndrome have been reported, but none have been reported in Korea yet. Floating-Harbor syndrome is characterized by delayed bony maturation, unique facial features, and language impairment. Here, we present a 6-year-old boy with a triangular face, deep-set protruding eyes, low-set...
Original Article
Cardiology
Outcomes of transcatheter closure of ductus arteriosus in infants less than 6 months of age: a single-center experience
Gwang-Jun Choi, Jinyoung Song, Yi-Seul Kim, Heirim Lee, June Huh, I-Seok Kang
Clin Exp Pediatr. 2018;61(12):397-402.   Published online September 19, 2018

Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6–12 months...
The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea
Dong Yeop Kim, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Young Hwa Song, Eun Jeong Cheon
Clin Exp Pediatr. 2018;61(12):392-396.   Published online October 26, 2018

Purpose: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function. Methods: Thirty-seven children (boy:girl=21:16; mean age, 9.52±2.20 years), who underwent T&A forsleep apnea due to ATH, were...
Neurology
The clinical characteristics and prognosis of subgaleal hemorrhage in newborn
Sun Jin Lee, Jin Kyu Kim, Sun Jun Kim
Clin Exp Pediatr. 2018;61(12):387-391.   Published online September 16, 2018

Purpose: Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH. Methods: We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender...
General Pediatrics
Current use of safety restraint systems and front seats in Korean children based on the 2008–2015 Korea National Health and Nutrition Examination Survey
Seom Gim Kong
Clin Exp Pediatr. 2018;61(12):381-386.   Published online September 19, 2018

Purpose: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. Methods: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint...
Review Article
Endocrinology
The adiposity rebound in the 21st century children: meaning for what?
Min Jae Kang
Clin Exp Pediatr. 2018;61(12):375-380.   Published online December 6, 2018
With the increase in the prevalence of overweight and obesity worldwide, early adiposity rebound, which is known to have a strong association with obesity, has recently been a focus of research. Early adiposity rebound is conventionally known to have a close relationship with non-communicable diseases. However, novel insights into early adiposity rebound have implied an acceleration of growth and puberty,...
Case Report
Infection
Scabies mimicking graft versus host disease in a hematopoietic cell transplant recipient
Dongsub Kim, Soo-Han Choi, Dong Youn Lee, Juyoun Kim, Eunjoo Cho, Keon Hee Yoo, Hong Hoe Koo, Yae-Jean Kim
Clin Exp Pediatr. 2018;61(11):371-373.   Published online November 9, 2018
Scabies is a highly contagious skin infestation caused by the mite, Sarcoptes scabiei var. hominis. Complex responses to scabies mites in the innate, humoral, and cellular immune systems can cause skin inflammation and pruritus. Diagnosis can be challenging because scabies resembles other common skin conditions. We report the first Korean case of scabies in a hematopoietic cell transplant (HCT) recipient,...
Original Article
Infection
A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease
Dongsub Kim, Sodam Lee, Sang-Hee Kang, Mi-Sun Park, So-Young Yoo, Tae Yeon Jeon, Joon-Sik Choi, Bora Kim, Jong Rim Choi, Sun Young Cho, Doo Ryeon Chung, Yon Ho Choe, Yae-Jean Kim
Clin Exp Pediatr. 2018;61(11):366-370.   Published online November 15, 2018

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-Guérin vaccination was diagnosed as having culture-proven...
Cardiology
The change of QRS duration after pulmonary valve replacement in patients with repaired tetralogy of Fallot and pulmonary regurgitation
Yuni Yun, Yeo Hyang Kim, Jung Eun Kwon
Clin Exp Pediatr. 2018;61(11):362-365.   Published online October 24, 2018

Purpose: This study aimed to analyze changes in QRS duration and cardiothoracic ratio (CTR) following pulmonary valve replacement (PVR) in patients with tetralogy of Fallot (TOF). Methods: Children and adolescents who had previously undergone total repair for TOF (n=67; median age, 16 years) who required elective PVR for pulmonary regurgitation and/or right ventricular out tract obstruction were included in this study....
Neurology
Clinical manifestations of headache in children younger than 7 years
Bu Seon Kang, Jinsun Lee, Jin Hyuk Choi, Hyeok Hee Kwon, Joon Won Kang
Clin Exp Pediatr. 2018;61(11):355-361.   Published online September 16, 2018

Purpose: Headache is a common symptom during childhood. It is usually persistent and requires special care. This study aimed to identify the characteristics of headache in children <7 years of age. Methods: We reviewed 3 years of clinical files on children <7 years of age with a chief complaint of headache. Results: This study included 146 children (66 males, 80 females; mean...
Allergy
Common features of atopic dermatitis with hypoproteinemia
So Yoon Jo, Chan-Ho Lee, Woo-Jin Jung, Sung-Won Kim, Yoon-Ha Hwang
Clin Exp Pediatr. 2018;61(11):348-354.   Published online September 16, 2018

Purpose: The purpose of this study was to identify the causes, symptoms, and complications of hypoproteinemia to prevent hypoproteinemia and provide appropriate treatment to children with atopic dermatitis. Methods: Children diagnosed with atopic dermatitis with hypoproteinemia and/or hypoalbuminemia were retrospectively reviewed. The patients’ medical records, including family history, weight, symptoms, treatment, complications, and laboratory test results for allergies and skin cultures,...
Review Article
Nephrology (Genitourinary)
Acute kidney injury and continuous renal replacement therapy in children; what pediatricians need to know
Myung Hyun Cho, Hee Gyung Kang
Clin Exp Pediatr. 2018;61(11):339-347.   Published online October 23, 2018
Acute kidney injury (AKI) is characterized by abrupt deterioration of renal function, and its diagnosis relies on creatinine measurements and urine output. AKI is associated with higher morbidity and mortality, and is a risk factor for development of chronic kidney disease. There is no proven medication for AKI. Therefore, prevention and early detection are important. Physicians should be aware of...
Original Article
Neurology
Comparison of conservative therapy and steroid therapy for Bell’s palsy in children
Hye Won Yoo, Lira Yoon, Hye Young Kim, Min Jung Kwak, Kyung Hee Park, Mi Hye Bae, Yunjin Lee, Sang Ook Nam, Young Mi Kim
Clin Exp Pediatr. 2018;61(10):332-337.   Published online September 12, 2018

Purpose: Bell’s palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell’s palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell’s palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell’s...
Nephrology (Genitourinary)
Renal involvement in children and adolescents with inflammatory bowel disease
Hea Min Jang, Hee Sun Baek, Jung-Eun Kim, Ju Young Kim, Yeon Hee Lee, Hee Yeon Cho, Yon Ho Choe, Ben Kang, Byung-Ho Choe, Bong Seok Choi, Min Hyun Cho
Clin Exp Pediatr. 2018;61(10):327-331.   Published online September 12, 2018

Purpose: The incidence of inflammatory bowel disease (IBD) is rapidly increasing, and several reports have described the renal complications of IBD. We sought to evaluate the clinical manifestations of renal complications in children with IBD in order to enable early detection and prompt treatment of the complications. Methods: We retrospectively reviewed the medical records of 456 children and adolescents aged <20...
Neonatology (Perinatology)
Evaluation of prolonged pain in preterm infants with pneumothorax using heart rate variability analysis and EDIN (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) scores
Mehmet Buyuktiryaki, Nurdan Uras, Nilufer Okur, Mehmet Yekta Oncel, Gulsum Kadioglu Simsek, Sehribanu Ozluer Isik, Serife Suna Oguz
Clin Exp Pediatr. 2018;61(10):322-326.   Published online September 16, 2018

Purpose: The EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement...
Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants
Ji Won Koh, Jong-Wan Kim, Young Pyo Chang
Clin Exp Pediatr. 2018;61(10):315-321.   Published online September 16, 2018

Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal...
Review Article
Endocrinology
Understanding of type 1 diabetes mellitus: what we know and where we go
Chong Kun Cheon
Clin Exp Pediatr. 2018;61(10):307-314.   Published online October 4, 2018
The incidence of type 1 diabetes mellitus (T1DM) in children and adolescents is increasing worldwide. Combined effects of genetic and environmental factors cause T1DM, which make it difficult to predict whether an individual will inherit the disease. Due to the level of self-care necessary in T1DM maintenance, it is crucial for pediatric settings to support achieving optimal glucose control, especially...
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...
Infection
Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age
In Sul Lee, Young Jin Park, Mi Hyeon Jin, Ji Young Park, Hae Jeong Lee, Sung Hoon Kim, Ju Suk Lee, Cheol Hong Kim, Young Don Kim, Jun Hwa Lee
Clin Exp Pediatr. 2018;61(9):285-290.   Published online September 15, 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics...
Neonatology (Perinatology)
Oral findings and its association with prenatal and perinatal factors in newborns
Brenda Perez-Aguirre, Uriel Soto-Barreras, Juan Pablo Loyola-Rodriguez, Juan Francisco Reyes-Macias, Miguel Angel Santos-Diaz, Alejandra Loyola-Leyva, Obed Garcia-Cortes
Clin Exp Pediatr. 2018;61(9):279-284.   Published online September 15, 2018

Purpose: This study aimed to determine the frequency of abnormalities in the newborn oral cavity and to evaluate the association with prenatal and perinatal factors. Methods: This cross-sectional study evaluated 2,216 newborns. Oral findings were assessed in the first 24 hours of life using visual examination. Sex, weight, length, gestational age, and medical disorders at birth were recorded. Maternal demographic and...