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Original Article
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...

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...

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...

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(6):252-255.   Published online June 30, 2016
Purpose

Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center.

Methods

We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review...

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...

Gastroenterology
Efficacy of proton pump inhibitors and H2 blocker in the treatment of symptomatic gastroesophageal reflux disease in infants
Hamid Reza Azizollahi, Mandana Rafeey
Clin Exp Pediatr. 2016;59(5):226-230.   Published online May 31, 2016
Purpose

Gastroesophageal reflux disease (GERD) occurs in pediatric patients when reflux of gastric contents presents with troublesome symptoms. The present study compared the effects of omeprazole and ranitidine for the treatment of symptomatic GERD in infants of 2-12 months.

Methods

This study was a clinical randomized double-blind trial and parallel-group comparison of omeprazole and ranitidine performed at Children Training Hospital in Tabriz, Iran....

Allergy
The relationships among birth season, sunlight exposure during infancy, and allergic disease
Jung Min Hwang, Se Hyun Oh, Mee Yong Shin
Clin Exp Pediatr. 2016;59(5):218-225.   Published online May 31, 2016
Purpose

The recent increase in the prevalence of allergic diseases is hypothetically attributed to immune dysregulation in turn caused by a reduction in exposure to sunlight. We explored relationships between birth season, sunlight exposure, exercise duration, and an allergic disease.

Methods

We performed a questionnaire-based survey on allergic diseases among elementary school students. Birth time was categorized according to the season (summer and...

Neurology
Clinical features and prognostic factors in drowning children: a regional experience
Kyung Lae Son, Su Kyeong Hwang, Hee Joung Choi
Clin Exp Pediatr. 2016;59(5):212-217.   Published online May 31, 2016
Purpose

This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis.

Methods

We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated.

Results

During the study period, 29 children...

Cardiology
Subclinical left ventricular dysfunction in children after hematopoietic stem cell transplantation for severe aplastic anemia: a case control study using speckle tracking echocardiography
Beom Joon Kim, Kyung Pil Moon, Ji-Hong Yoon, Eun-Jung Lee, Jae Young Lee, Seong Koo Kim, Jae Wook Lee, Nack Gyun Chung, Bin Cho, Hack Ki Kim
Clin Exp Pediatr. 2016;59(4):190-195.   Published online April 30, 2016
Purpose

Severe aplastic anemia (SAA), a fatal disease, requires multiple transfusion, immunosuppressive therapy, and finally, hematopoietic stem cell transplantation (HSCT) as the definitive treatment. We hypothesized that iron overloading associated with multiple transfusions and HSCTrelated complications may adversely affect cardiac function. Left ventricular (LV) function was assessed in children after HSCT for SAA.

Methods

Forty-six consecutive patients with a median age of 9.8...

Correlation of B-type natriuretic peptide levels and echocardiographic parameters in preterm infants with patent ductus arteriosus
Hyun Ah Jeong, Jeonghee Shin, Eunji Kim, Eun Hee Lee, Byung Min Choi, Chang Sung Son, Joo Won Lee
Clin Exp Pediatr. 2016;59(4):183-189.   Published online April 30, 2016
Purpose

This study aimed to evaluate the correlation, according to postnatal age, between plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters for the assessment of patent ductus arteriosus (PDA) in preterm infants with respiratory distress.

Methods

We enrolled 42 preterm infants with respiratory distress who underwent serial echocardiographic evaluation with simultaneous plasma BNP measurements until ductal closure. The correlations between BNP levels...

Prediction of nonresponsiveness to medium-dose intravenous immunoglobulin (1 g/kg) treatment: an effective and safe schedule of acute treatment for Kawasaki disease
Kyung Pil Moon, Beom Joon Kim, Kyu Jin Lee, Jin Hee Oh, Ji Whan Han, Kyung Yil Lee, Soon Ju Lee
Clin Exp Pediatr. 2016;59(4):178-182.   Published online April 30, 2016
Purpose

Medium-dose (1 g/kg) intravenous immunoglobulin (IVIG) is effective in the majority of patients with Kawasaki disease (KD) but some patients who do not respond to medium-dose IVIG are at high risk for the development of coronary artery lesions (CALs). The purpose of this study was to identify the clinical predictors associated with unresponsiveness to medium-dose IVIG and the development of...

Usefulness of anterior uveitis as an additional tool for diagnosing incomplete Kawasaki disease
Kyu Jin Lee, Hyo Jin Kim, Min Jae Kim, Ji Hong Yoon, Eun Jung Lee, Jae Young Lee, Jin Hee Oh, Soon Ju Lee, Kyung Yil Lee, Ji Whan Han
Clin Exp Pediatr. 2016;59(4):174-177.   Published online April 30, 2016
Purpose

There are no specific tests for diagnosing Kawasaki disease (KD). Additional diagnostic criteria are needed to prevent the delayed diagnosis of incomplete Kawasaki disease (IKD). This study compared the frequency of coronary artery lesions (CALs) in IKD patients with and without anterior uveitis (AU) and elucidated whether the finding of AU supported the diagnosis of IKD.

Methods

This study enrolled patients diagnosed...

Neonatology (Perinatology)
Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants
Ah Young Choi, Yong Wook Lee, Mea-young Chang
Clin Exp Pediatr. 2016;59(4):165-173.   Published online April 30, 2016
Purpose

To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants.

Methods

The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1...

Nephrology (Genitourinary)
Acute tubular necrosis as a part of vancomycin induced drug rash with eosinophilia and systemic symptoms syndrome with coincident postinfectious glomerulonephritis
Kyung Min Kim, Kyoung Sung, Hea Koung Yang, Seong Heon Kim, Hye Young Kim, Gil Ho Ban, Su Eun Park, Hyoung Doo Lee, Su Young Kim
Clin Exp Pediatr. 2016;59(3):145-148.   Published online March 31, 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to...

Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection
Song Yi Han, I Re Lee, Se Jin Park, Ji Hong Kim, Jae Il Shin
Clin Exp Pediatr. 2016;59(3):139-144.   Published online March 31, 2016
Purpose

Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a...

Emergency Medicine
A nationwide study of children and adolescents with pneumonia who visited Emergency Department in South Korea in 2012
Chang Hyu Lee, Youn Kyoung Won, Eui-Jung Roh, Dong In Suh, Eun Hee Chung
Clin Exp Pediatr. 2016;59(3):132-138.   Published online March 31, 2016
Purpose

Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012.

Methods

We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients...

Gastroenterology
Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis
Dong Ho Shim, Dong Yeon Kim, Ky Young Cho
Clin Exp Pediatr. 2016;59(3):126-131.   Published online March 31, 2016
Purpose

To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG).

Methods

In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial...

Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year
Hye Il Jin, Yoo Mi Lee, You Jin Choi, Su Jin Jeong
Clin Exp Pediatr. 2016;59(3):120-125.   Published online March 31, 2016
Purpose

Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region.

Methods

We evaluated 345 pediatric patients (203 males, 142 females; age,...

General Pediatrics
Reference values of lead in blood and related factors among Korean adolescents: the Korean National Health and Nutrition Examination Survey 2010-2013
Min-Gyu Choi, Mi-Jung Park, Shin-Hye Kim
Clin Exp Pediatr. 2016;59(3):114-119.   Published online March 31, 2016
Purpose

This study aimed to assess the reference values and factors influencing blood lead levels among Korean adolescents.

Methods

The study population consisted of 1,585 adolescents (801 males, 784 females; aged 10-19 years) who participated in the Korea National Health and Nutrition Examination Survey 2010-2013. We analyzed blood lead concentrations in relation to demographic/lifestyle characteristics for all participants. "Reference values" of blood lead...

Cardiology
Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease
Jin-Young Baek, Min Seob Song
Clin Exp Pediatr. 2016;59(2):80-90.   Published online February 29, 2016
Purpose

Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques.

Methods

All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For...

Neurology
Epilepsy in children with a history of febrile seizures
Sang Hyun Lee, Jung Hye Byeon, Gun Ha Kim, Baik-Lin Eun, So-Hee Eun
Clin Exp Pediatr. 2016;59(2):74-79.   Published online February 29, 2016
Purpose

Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures

Methods

The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between...

Endocrinology
Impact of lifestyle factors on trends in lipid profiles among Korean adolescents: the Korea National Health and Nutrition Examination Surveys study, 1998 and 2010
Shin-Hye Kim, Young-Hwan Song, Sangshin Park, Mi-Jung Park
Clin Exp Pediatr. 2016;59(2):65-73.   Published online February 29, 2016
Purpose

Only a few studies have explored nationwide trends in lipid profiles among Asian adolescents. We aimed to assess trends in lipid profiles and the associated lifestyle factors among Korean children.

Methods

We analyzed data for 2,094 adolescents who were aged 10–18 years and had participated in the Korea National Health and Nutrition Examination Surveys in 1998 and 2010.

Results

During 1998–2010, the prevalence of...

Cardiology
Infantile Marfan syndrome in a Korean tertiary referral center
Yeon Jeong Seo, Ko-Eun Lee, Gi Beom Kim, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
Clin Exp Pediatr. 2016;59(2):59-64.   Published online February 29, 2016
Purpose

Infantile Marfan syndrome (MFS) is a rare congenital inheritable connective tissue disorder with poor prognosis. This study aimed to evaluate the cardiovascular manifestations and overall prognosis of infantile MFS diagnosed in a tertiary referral center in Korea.

Methods

Eight patients diagnosed with infantile MFS between 2004 and 2014 were retrospectively evaluated.

Results

Their median age at the time of diagnosis was 2.5 months (range,...

Comparison between Kawasaki disease with lymph-node-first presentation and Kawasaki disease without cervical lymphadenopathy
Jung Ok Kim, Yeo Hyang Kim, Myung Chul Hyun
Clin Exp Pediatr. 2016;59(2):54-58.   Published online February 29, 2016
Purpose

We evaluated the characteristics of patients with Kawasaki disease (KD) who presented with only fever and cervical lymphadenopathy on admission, and compared them with the characteristics of those who presented with typical features but no cervical lymphadenopathy.

Methods

We enrolled 98 patients diagnosed with KD. Thirteen patients had only fever and cervical lymphadenopathy on the day of admission (group 1), 31 had...

Neurology
Intravenous levetiracetam versus phenobarbital in children with status epilepticus or acute repetitive seizures
Yun-Jeong Lee, Mi-Sun Yum, Eun-Hee Kim, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(1):35-39.   Published online January 22, 2016
Purpose

This study compared the efficacy and tolerability of intravenous (i.v.) phenobarbital (PHB) and i.v. levetiracetam (LEV) in children with status epilepticus (SE) or acute repetitive seizure (ARS).

Methods

The medical records of children (age range, 1 month to 15 years) treated with i.v. PHB or LEV for SE or ARS at our single tertiary center were retrospectively reviewed. Seizure termination was defined...

Neonatology (Perinatology)
Clinical features of Bednar's aphthae in infants
Seung-Woo Nam, Seol Hee Ahn, Son-Moon Shin, Goun Jeong
Clin Exp Pediatr. 2016;59(1):30-34.   Published online January 22, 2016
Purpose

Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae.

Methods

Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters...

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