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Editorial
Nephrology (Genitourinary)
Genetic diagnosis of Alport syndrome
Hae Il Cheong
Clin Exp Pediatr. 2019;62(5):164-165.   Published online January 3, 2019
Neonatology (Perinatology)
Association of vitamin D status at birth and respiratory outcomes in preterm infants
Sook-Hyun Park
Clin Exp Pediatr. 2019;62(5):162-163.   Published online April 8, 2019
Review Article
Neonatology (Perinatology)
Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future
Ga Won Jeon
Clin Exp Pediatr. 2019;62(5):155-161.   Published online February 8, 2019
Following the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. Synthetic surfactants were designed to overcome limitations of natural surfactants such as cost, immune reactions, and infections elicited by animal proteins contained in natural surfactants. However, first-generation synthetic surfactants...
Nutrition
A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan Vandenplas, Zakiudin Munasir, Badriul Hegar, Dewi Kumarawati, Ahmad Suryawan, Muzal Kadim, Julistio Tb Djais, Ray Wagiu Basrowi, Deni Krisnamurti
Clin Exp Pediatr. 2019;62(5):149-154.   Published online January 14, 2019
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option...
Case Report
Reninoma: a rare cause of curable hypertension
Ji Hye Kim, Ji Hyun Kim, Myung Hyun Cho, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Kyung Chul Moon, Il-Soo Ha, Hae Il Cheong
Clin Exp Pediatr. 2019;62(4):144-147.   Published online October 29, 2018
The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma...
Original Article
Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease
Soo-kyeong Jeon, Geena Kim, Hoon Ko, Joung-Hee Byun, Hyoung Doo Lee
Clin Exp Pediatr. 2019;62(4):138-143.   Published online November 22, 2018

Purpose: Prognostic factors of coronary aneurysms in Kawasaki disease have been investigated in many studies. The aim of this study was to identify risk factors associated with early and late coronary artery outcomes in treated patients with Kawasaki disease. Methods: A total of 392 patients diagnosed with Kawasaki disease from January 2012 to December 2015 in Pusan National University Children’s Hospital...
Respiratory syncytial virus-associated seizures in Korean children, 2011–2016
Teahyen Cha, Young Jin Choi, Jae-Won Oh, Chang-Ryul Kim, Dong Woo Park, In Joon Seol, Jin-Hwa Moon
Clin Exp Pediatr. 2019;62(4):131-137.   Published online October 23, 2018

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results: During this period, 1,193...
The association between preeclampsia and autism spectrum disorders among children: a meta-analysis
Ensiyeh Jenabi, Manoochehr Karami, Salman Khazaei, Saeid Bashirian
Clin Exp Pediatr. 2019;62(4):126-130.   Published online December 24, 2018

Purpose: In this meta-analysis, relevant case-control and cohort studies were pooled to evaluate the association between preeclampsia and the risk of autism spectrum disorders (ASDs) in children. Methods: A search for relevant studies in major databases, including Web of Science, PubMed, and Scopus, was performed up to May 2018. The odds ratios (ORs) or rate ratios (RRs) with 95% confidence intervals...
Editorial
Predictive risk factors of coronary artery aneurysms in Kawasaki disease
Hyang-Ok Woo
Clin Exp Pediatr. 2019;62(4):124-125.   Published online February 19, 2019
Review Article
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...
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
Neonatology (Perinatology)
Iron status in small for gestational age and appropriate for gestational age infants at birth
Hyeon A Kim, Sook-Hyun Park, Eun Joo Lee
Clin Exp Pediatr. 2019;62(3):102-107.   Published online October 24, 2018

Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth. Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total...
Cardiology
Changes of Bax, Bcl-2, CCR-2, MCP-1, and TGF-β1 genes in the left ventricle of spontaneously hypertensive rat after losartan treatment
Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2019;62(3):95-101.   Published online October 24, 2018

Purpose: Increased apoptosis was recently found in the hypertrophied left ventricle of spontaneously hypertensive rats (SHRs). Although the available evidence suggests that apoptosis can be induced in cardiac cells by various insults including pressure overload, cardiac apoptosis appears to result from an exaggerated local production of angiotensin in adult SHRs. Altered expressions of Bcl associated X (Bax), Bcl-2, chemokine receptor...
Other
Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study
Min Jeng Cho, Jihoon Kim, Sung Jeep Kim, Kyu Hyouck Kyoung, Min Ae Keum, Sung Kyun Park
Clin Exp Pediatr. 2019;62(3):90-94.   Published online March 11, 2019

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries...
Nephrology (Genitourinary)
Changes in the thyroid hormone profiles in children with nephrotic syndrome
Sun Hee Jung, Jeong Eun Lee, Woo Yeong Chung
Clin Exp Pediatr. 2019;62(3):85-89.   Published online October 4, 2018

Purpose: We compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission. Methods: This study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4. Results: Of the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8...
Review Article
Infection
Central line-associated bloodstream infections in neonates
Hye Jung Cho, Hye-Kyung Cho
Clin Exp Pediatr. 2019;62(3):79-84.   Published online December 19, 2018
Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central...
Case Report
Allergy
Drug eruption by antihistamine mistaken for chronic urticaria in a child
Gun Moo Lee, Shou-Yu Chu, Sung Yeon Kang, Hyo-Bin Kim, Jin-Sung Park, Ja Kyoung Kim
Clin Exp Pediatr. 2019;62(2):75-78.   Published online October 30, 2018
Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and...
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...
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