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Case Report
Rheumatology
Recurrent macrophage activation syndrome since toddler age in an adolescent boy with HLA B27 positive juvenile ankylosing spondylitis
Joon Hyeong Park, Yu Mi Seo, Seung Beom Han, Ki Hwan Kim, Jung Woo Rhim, Nack Gyun Chung, Myung Shin Kim, Jin Han Kang, Dae Chul Jeong
Clin Exp Pediatr. 2016;59(10):421-424.   Published online October 17, 2016

Recurrent macrophage activation syndrome (MAS) is very rare. We present the case of an adolescent boy with human leukocyte antigen (HLA) B27-positive ankylosing spondylitis (AS), who experienced episodes of recurrent MAS since he was a toddler. A 16-year-old boy was admitted because of remittent fever with pancytopenia and splenomegaly after surgical intervention for an intractable perianal abscess. He had been...

Original Article
Developmental and Behavioral Medicine
Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age
Kyung Hee Yi, Yoon Young Yi, Il Tae Hwang
Clin Exp Pediatr. 2016;59(10):414-420.   Published online October 17, 2016
Purpose

We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA).

Methods

Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive...

Cardiology
Prediction of unresponsiveness to second intravenous immunoglobulin treatment in patients with Kawasaki disease refractory to initial treatment
Euri Seo, Jeong Jin Yu, Hyun Ok Jun, Eun Jung Shin, Jae Suk Baek, Young-Hwue Kim, Jae-Kon Ko
Clin Exp Pediatr. 2016;59(10):408-413.   Published online October 17, 2016
Purpose

This study investigated predictors of unresponsiveness to second-line intravenous immunoglobulin (IVIG) treatment for Kawasaki disease (KD).

Methods

This was a single-center analysis of the medical records of 588 patients with KD who had been admitted to Asan Medical Center between 2006 and 2014. Related clinical and laboratory data were analyzed by univariate and multivariate logistic regression analyses.

Results

Eighty (13.6%) of the 588 patients...

Allergy
Clinical and laboratory findings of childhood buckwheat allergy in a single tertiary hospital
Kyujung Park, Kyunguk Jeong, Sooyoung Lee
Clin Exp Pediatr. 2016;59(10):402-407.   Published online October 17, 2016
Purpose

Buckwheat allergy is one of the most severe types of food allergy in some countries, especially among children. However, few studies have investigated this condition. The aim of this study was to report the clinical and laboratory findings in Korean children with buckwheat allergy.

Methods

Thirty-seven subjects, aged 1 to 14 years, were enrolled by retrospective medical record review from January 2000...

Review Article
Neurology
Enterovirus 71 infection and neurological complications
Kyung Yeon Lee
Clin Exp Pediatr. 2016;59(10):395-401.   Published online October 17, 2016

Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children,...

Neonatology (Perinatology)
Respiratory support with heated humidified high flow nasal cannula in preterm infants
Ga Won Jeon
Clin Exp Pediatr. 2016;59(10):389-394.   Published online October 17, 2016

The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which...

Erratum
Infection
Erratum: Pneumocystis jirovecii pneumonia in pediatric patients: an analysis of 15 confirmed consecutive cases during 14 years
Kyung-Ran Kim, Jong Min Kim, Ji-Man Kang, Yae-Jean Kim
Clin Exp Pediatr. 2016;59(9):387-387.   Published online September 21, 2016
Neurology
Erratum: Developmental profiles of preschool children with delayed language development
Ji Eun Jeong, Hyung Jik Lee, Jin Kyung Kim
Clin Exp Pediatr. 2016;59(9):386-386.   Published online September 21, 2016
Case Report
Neurology
Painful legs and moving toes syndrome in a 16-year-old girl
Seung Soo Kim, Yong Seung Hwang, Young Chang Kim
Clin Exp Pediatr. 2016;59(9):381-383.   Published online September 21, 2016

Painful legs and moving toes (PLMT) syndrome is characterized by spontaneous movements of the digits and pain in one or both lower extremities. Of the reported cases, a majority of the patients was female, and the mean age of onset was 58 years. Only one pediatric case has been reported so far. Herein, we report the first adolescent case of...

Original Article
Oncology
Metformin displays in vitro and in vivo antitumor effect against osteosarcoma
Yunmi Ko, Aery Choi, Minyoung Lee, Jun Ah Lee
Clin Exp Pediatr. 2016;59(9):374-380.   Published online September 21, 2016
Purpose

Patients with unresectable, relapsed, or refractory osteosarcoma need a novel therapeutic agent. Metformin is a biguanide derivative used in the treatment of type II diabetes, and is recently gaining attention in cancer research.

Methods

We evaluated the effect of metformin against human osteosarcoma. Four osteosarcoma cell lines (KHOS/NP, HOS, MG-63, U-2 OS) were treated with metformin and cell proliferation was evaluated using...

Gastroenterology
Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis
Jea Yeon Choi, Eell Ryoo, Jeong Hyun Jo, Tchah Hann, Seong Min Kim
Clin Exp Pediatr. 2016;59(9):368-373.   Published online September 21, 2016
Purpose

This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy.

Methods

This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed...

Clinical significance of serum alanine aminotransferase and lifestyle intervention in children with nonalcoholic fatty liver disease
Kyoung Ah Kwon, Peter Chun, Jae Hong Park
Clin Exp Pediatr. 2016;59(9):362-367.   Published online September 21, 2016
Purpose

This study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD.

Methods

The clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of...

Review Article
Endocrinology
Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women
Jae-Ho Yoo
Clin Exp Pediatr. 2016;59(9):355-361.   Published online September 21, 2016

The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central...

General Pediatrics
Apparent life-threatening event in infancy
Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2016;59(9):347-354.   Published online September 21, 2016

An apparent life-threatening event (ALTE) is defined as the combination of clinical presentations such as apnea, marked change in skin and muscle tone, gagging, or choking. It is a frightening event, and it predominantly occurs during infancy at a mean age of 1–3 months. The causes of ALTE are categorized into problems that are: gastrointestinal (50%), neurological (30%), respiratory (20%),...

Original Article
Neurology
Venous angioma may be associated with epilepsy in children
Bo Ryung Kim, Yun Jin Lee, Sang Ook Nam, Kyung Hee Park
Clin Exp Pediatr. 2016;59(8):341-345.   Published online August 24, 2016
Purpose

Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy.

Methods

The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients...

Hematology
Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years
Jae Yeob Jung, A Rum O, Je Keong Kim, Meerim Park
Clin Exp Pediatr. 2016;59(8):335-340.   Published online August 24, 2016
Purpose

This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP.

Methods

The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed.

Results

The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years)...

Cardiology
Clinical outcome of patients with refractory Kawasaki disease based on treatment modalities
Hyun Jung Kim, Hyo Eun Lee, Jae Won Yu, Hong Ryang Kil
Clin Exp Pediatr. 2016;59(8):328-334.   Published online August 24, 2016
Purpose

Although a significant number of reports on new therapeutic options for refractory Kawasaki disease (KD) such as steroid, infliximab, or repeated intravenous immunoglobulin (IVIG) are available, their effectiveness in reducing the prevalence of coronary artery lesions (CAL) remains controversial. This study aimed to define the clinical characteristics of patients with refractory KD and to assess the effects of adjuvant therapy...

Review Article
Allergy
Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases
Hyeon-Jong Yang
Clin Exp Pediatr. 2016;59(8):319-327.   Published online August 24, 2016

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards....

Neurology
The use of complementary and alternative medicine in children with common neurologic diseases
Gyu-Min Yeon, Sang Ook Nam
Clin Exp Pediatr. 2016;59(8):313-318.   Published online August 24, 2016

Complementary and alternative medicine (CAM) is a phrase used to describe additional health care methods such as mind/body practices and natural products not regarded as treatments by conventional medicine. The use of CAM in children with common neurologic diseases is more frequent than its use in healthy children (24%–78% vs. 12%). However, less than half of patients report such use...

Case Report
Infection
Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness
Jung Sook Yeom, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn, Ok Jeong Lee, Tae-Hee Han, Ju-Young Chung
Clin Exp Pediatr. 2016;59(7):308-311.   Published online July 31, 2016

We report a human parechovirus-3 (HPeV-3) infection in 2 neonates who had prolonged fever (>5 days) with palmar-plantar erythema. This distinctive rash was observed 4–5 days after fever onset, just before defervescence. Elevated aspartate aminotransferase, lactate dehydrogenase, and ferritin levels were characteristic laboratory findings in the 2 cases, suggesting tissue damage caused by hypercytokinemia. Case 1 was treated with intravenous...

Original Article
Gastroenterology
Dietary habits and gastroesophageal reflux disease in preschool children
You Jin Choi, Eun Kyo Ha, Su Jin Jeong
Clin Exp Pediatr. 2016;59(7):303-307.   Published online July 31, 2016
Purpose

To identify the relationship between dietary habits and childhood gastroesophageal reflux disease (GERD) in preschool children.

Methods

We performed a questionnaire study to analyze the relationship between dietary habits and GERD in 85 preschool children with GERD and 117 healthy children of the same age.

Results

Irregular and picky eating were more p–revalent in the GERD group than in the control group (odds ratio...

Cardiology
Age-adjusted plasma N-terminal pro-brain natriuretic peptide level in Kawasaki disease
Heul Jun, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Gyung Min Lee, Eun Jung Cheon
Clin Exp Pediatr. 2016;59(7):298-302.   Published online July 31, 2016
Purpose

Recent reports showed that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) could be a useful biomarker of intravenous immunoglobulin (IVIG) unresponsiveness and coronary artery lesion (CAL) development in Kawasaki disease (KD). The levels of these peptides are critically influenced by age; hence, the normal range and upper limits for infants and children are different. We performed an age-adjusted analysis of plasma...

Nutrition
Increment in vitamin D level and bone mineral accrual in children with vitamin D deficiency
Yashwant Kumar Rao, Tanu Midha, Satyajeet Singh, Anurag Bajpai, Amita Tilak
Clin Exp Pediatr. 2016;59(7):292-297.   Published online July 31, 2016
Purpose

To compare different regimens of vitamin D with respect to its serum increment levels and bone mineral accrual in vitamin D-deficient children.

Methods

Children identified as being vitamin D deficient (serum levels<20 ng/mL) were divided into 3 treatment groups by stratified block randomization (group 1, 4,000 IU/day of vitamin D3 plus 50 mg/kg/day calcium for 12 weeks; group 2, 30,000 IU/wk of...

Review Article
Neurology
White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?
Jung Sook Yeom, Chan-Hoo Park
Clin Exp Pediatr. 2016;59(7):285-291.   Published online July 31, 2016

That rotavirus infection can cause neurological symptoms in young children has been well established. However, it is surprising why rotavirus infection has been overlooked as a cause of neonatal seizures for many years, despite significant research interest in neonatal rotavirus infection. Neonates are the age group most vulnerable to seizures, which are typically attributed to a wide range of causes....

Case Report
Neurology
Two cases of familial cerebral cavernous malformation caused by mutations in the CCM1 gene
Im-Yong Yang, Mi-Sun Yum, Eun-Hee Kim, Hae-Won Choi, Han-Wook Yoo, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(6):280-284.   Published online June 30, 2016

Cerebral cavernous malformation (CCM) is a vascular malformation characterized by abnormally enlarged capillary cavities without any intervening neural tissue. We report 2 cases of familial CCMs diagnosed with the CCM1 mutation by using a genetic assay. A 5-year-old boy presented with headache, vomiting, and seizure-like movements. Brain magnetic resonance imaging (MRI) revealed multiple CCM lesions in the cerebral hemispheres. Subsequent...

Genetics and Metabolism
A rare case of Sjogren-Larsson syndrome with recurrent pneumonia and asthma
Azita Tavasoli, Shirin Sayyahfar, Babak Behnam
Clin Exp Pediatr. 2016;59(6):276-279.   Published online June 30, 2016

Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation...

Original Article
Neurology
Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children
Eung-Bin Lee, Yun Young Lee, Jae Min Lee, Su Min Son, Su-Kyeong Hwang, Soonhak Kwon, Sae Yoon Kim
Clin Exp Pediatr. 2016;59(6):271-275.   Published online June 30, 2016
Purpose

A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients.

Methods

The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS....

Cardiology
The effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline-induced right ventricular failure
Hyun Kyung Bae, Hyeryon Lee, Kwan Chang Kim, Young Mi Hong
Clin Exp Pediatr. 2016;59(6):262-270.   Published online June 30, 2016
Purpose

Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF.

Methods

The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the...

Infection
Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children
Ki Wook Yun, Young Kwang Kim, Hae Ryun Kim, Mi Kyung Lee, In Seok Lim
Clin Exp Pediatr. 2016;59(6):256-261.   Published online June 30, 2016
Purpose

Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-γ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI.

Methods

We performed a tuberculin skin...


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