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Review Article
General Pediatrics
Quality improvement in pediatric care
Moon Sung Park
Clin Exp Pediatr. 2018;61(1):1-5.   Published online January 22, 2018

We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite...

Original Article
Infection
Effects of clarithromycin treatment in scrub typhus in children: comparison with chloramphenicol and azithromycin
Min Lee, June Kim, Dae Sun Jo
Clin Exp Pediatr. 2017;60(4):124-127.   Published online April 25, 2017
Purpose

Chloramphenicol and tetracycline are not recommended for treating scrub typhus in pediatric patients because of potential side effects, such as aplastic anemia or tooth discoloration. While clarithromycin has recently been used in adults, few reports have been published on its effects in pediatric patients. We report the clinical profiles of pediatric scrub typhus and the effects of clarithromycin on scrub...

Oncology
Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
Clin Exp Pediatr. 2017;60(3):86-93.   Published online March 27, 2017
Purpose

To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children.

Methods

We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital.

Results

Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed...

Case Report
Neurology
A pediatric case of idiopathic Harlequin syndrome
Ju Young Kim, Moon Souk Lee, Seung Yeon Kim, Hyun Jung Kim, Soo Jin Lee, Chur Woo You, Jon Soo Kim, Ju Hyung Kang
Clin Exp Pediatr. 2016;59(Suppl 1):S125-S128.   Published online November 30, 2016

Harlequin syndrome, which is a rare disorder caused by dysfunction of the autonomic system, manifests as asymmetric facial flushing and sweating in response to heat, exercise, or emotional factors. The syndrome may be primary (idiopathic) with a benign course, or can occur secondary to structural abnormalities or iatrogenic factors. The precise mechanism underlying idiopathic harlequin syndrome remains unclear. Here, we...

Gastroenterology
Granular cell tumor of the esophagus in an adolescent
Ji Sun Lee, Kyung Ok Ko, Jae Woo Lim, Eun Jeong Cheon, Young Jin Kim, Jang Sin Son, Jung Min Yoon
Clin Exp Pediatr. 2016;59(Suppl 1):S88-S91.   Published online November 30, 2016

Esophageal granular cell tumor (GCT) is a rare neoplasm originating from the Schwann cells of the submucosal neuronal plexus. Histology is the gold standard for its diagnosis. Endoscopic resection or surgical excision should be considered, depending on the potential for malignancy. Here, we report a case of an esophageal GCT in an adolescent. A 12-year-old boy presented with a 1-year...

Review Article
Endocrinology
Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk
Eun-Gyong Yoo
Clin Exp Pediatr. 2016;59(11):425-431.   Published online November 18, 2016

The waist-to-height ratio (WHtR), calculated by dividing the waist circumference (WC) by height, has recently gained attention as an anthropometric index for central adiposity. It is an easy-to-use and less age-dependent index to identify individuals with increased cardiometabolic risk. A WHtR cutoff of 0.5 can be used in different sex and ethnic groups and is generally accepted as a universal...

Original Article
Infection
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...

Review Article
Gastroenterology
Nutritional concerns in pediatric inflammatory bowel disease
Yong Joo Kim
Clin Exp Pediatr. 2016;59(6):247-251.   Published online June 30, 2016

The pathophysiology and fundamental etiologic mechanism of inflammatory bowel disease (IBD) is not well understood even though therapeutic regimens and drugs are rapidly evolutionary. IBD has complicated connections with genetic, immunologic, gut microbial, environmental, and nutritional factors. It is not clearly well known to the physicians how to feed, what nutrients are more helpful, and what food to be avoided....

Original Article
Gastroenterology
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,...

Case Report
The first pediatric case of tularemia in Korea: manifested with pneumonia and possible infective endocarditis
Jung Sook Yeom, Kyuyol Rhie, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
Clin Exp Pediatr. 2015;58(10):398-401.   Published online October 21, 2015

Tularemia is a potentially severe zoonotic disease caused by Francisella tularensis. A lack of awareness about tularemia can be embarrassing and could result in delayed treatment because of improper diagnosis. The diagnosis of tularemia is difficult, because the infections are rare and the clinical spectrum is broad. As only 1 adult case has been reported in Korea thus far, pediatricians...

Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child
Sook Young Jung, Ben Kang, Yoon Mee Choi, Jun Mee Kim, Soon Ki Kim, Young Se Kwon, Ji Eun Lee
Clin Exp Pediatr. 2015;58(2):69-72.   Published online February 28, 2015

Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia....

Original Article
The relationship between primary headache and constipation in children and adolescents
Mi-Na Park, Min-Gyu Choi, Su Jeong You
Clin Exp Pediatr. 2015;58(2):60-63.   Published online February 28, 2015
Purpose

Many patients presenting with headache also complain of constipation; the relationship between these two symptoms has not been explored in detail. The aim of this study was to investigate the association between primary headache and constipation.

Methods

This retrospective study included all children who attended the Inje University Sanggye Paik Hospital complaining of headache, and who had been followed up for at...

Review Article
Advancements in the treatment of pediatric acute leukemia and brain tumor - continuous efforts for 100% cure
Hee Young Ju, Che Ry Hong, Hee Young Shin
Clin Exp Pediatr. 2014;57(10):434-439.   Published online October 31, 2014

Treatment outcomes of pediatric cancers have improved greatly with the development of improved treatment protocols, new drugs, and better supportive measures, resulting in overall survival rates greater than 70%. Survival rates are highest in acute lymphoblastic leukemia, reaching more than 90%, owing to risk-based treatment through multicenter clinical trials and protocols developed to prevent central nervous system relapse and testicular...

Original Article
Clinical outcome of acute necrotizing encephalopathy in related to involving the brain stem of single institution in Korea
Cha Gon Lee, Ji Hye Kim, Munhyang Lee, Jeehun Lee
Clin Exp Pediatr. 2014;57(6):264-270.   Published online June 30, 2014
Purpose

Acute necrotizing encephalopathy (ANE) is a fulminant disease of the brain characterized by bilateral thalamic lesions, and is prevalent among children in East Asia. The prognosis of ANE is usually poor with a high mortality rate and neurological sequelae. This study aimed to delineate the clinical characteristics and prognostic factors of ANE.

Methods

We retrospectively analyzed clinical data of 399 pediatric patients...

Review Article
Magnetoencephalography in pediatric epilepsy
Hunmin Kim, Chun Kee Chung, Hee Hwang
Clin Exp Pediatr. 2013;56(10):431-438.   Published online October 31, 2013

Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data...

Original Article
Intravenous fluid prescription practices among pediatric residents in Korea
Jiwon M. Lee, Younghwa Jung, Se Eun Lee, Jun Ho Lee, Kee Hyuck Kim, Ja Wook Koo, Young Seo Park, Hae Il Cheong, Il-Soo Ha, Yong Choi, Hee Gyung Kang
Clin Exp Pediatr. 2013;56(7):282-285.   Published online July 19, 2013
Purpose

Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education.

Methods

A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each...

Review Article
The role of the pediatrician in youth violence prevention
Soon Ki Kim, Nam Su Kim
Clin Exp Pediatr. 2013;56(1):1-7.   Published online January 29, 2013

School bullying has become a major social problem in Korea after the emergence of media reports on children who committed suicide after being victimized by bullies. In this article, we review the characteristics of bullying, and investigate the role of the pediatrician in the prevention of and intervention against bullying and school violence. Bullying can take on many forms such...

Regionalization of pediatric emergency care in Korea
Do Kyun Kim
Clin Exp Pediatr. 2011;54(12):477-480.   Published online December 31, 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill...

Respiratory syncytial virus infection in children with congenital heart disease: global data and interim results of Korean RSV-CHD survey
Jo Won Jung
Clin Exp Pediatr. 2011;54(5):192-196.   Published online May 31, 2011

Respiratory syncytial virus (RSV) is a main cause of hospitalization for bronchiolitis and pneumonia in infants worldwide. Children with hemodynamically significant congenital heart disease (HS-CHD), as well as premature infants are at high risk for severe RSV diseases. Mortality rates for CHD patients hospitalized with RSV have been reported as about 24 times higher compared with those without RSV infection....

Original Article
Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies
Sul Hee Bae, Dong Kyun Han, Hee Jo Baek, Sun Ju Park, Nam Kyu Chang, Hoon Kook, Tai Ju Hwang
Clin Exp Pediatr. 2011;54(4):169-175.   Published online April 30, 2011
Purpose

Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies.

Methods

We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic...

Review Article
General considerations and updates in pediatric gastrointestinal diagnostic endoscopy
Yong Joo Kim
Clin Exp Pediatr. 2010;53(9):817-823.   Published online September 13, 2010

Gastrointestinal and colonic endoscopic examinations have been performed in pediatric patients in Korea for 3 decades. Endoscopic procedures are complex and may be unsafe if special concerns are not considered. Many things have to be kept in mind before, during, and after the procedure. Gastrointestinal endoscopy is one of the most frequently performed procedure in children nowadays, Since the dimension...

Original Article
Effect of hyperglycemia on mortality rates in critically ill children
Seongkuk Kim, Bo Eun Kim, Eun Ju Ha, Mi Young Moon, Seong Jong Park
Clin Exp Pediatr. 2010;53(3):323-328.   Published online March 15, 2010
Purpose : To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis. Methods : From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU) at Asan Medical Center and who survived for more than 7 days...
Review Article
Child sexual abuse and pediatricians
Insil Lee
Clin Exp Pediatr. 2009;52(11):1200-1206.   Published online November 15, 2009
Child sexual abuse is not a rarely encountered problem. Child sexual abuse is a pediatric disease entity with lifelong impact. Child sexual abuse, different from sexual assault, is not always accompanied by violent force and usually repeated over a period of time. Child sexual abuse should be approached by multidisciplinary team experts. Every pediatrician should know the child protection network...
Original Article
Outcome and risk factors of pediatric hemato-oncology patients admitted in pediatric intensive care unit
Bo Eun Kim, Eun Ju Ha, Keun Wook Bae, Seongguk Kim, Ho Joon Im, Jong Jin Seo, Seong Jong Park
Clin Exp Pediatr. 2009;52(10):1153-1160.   Published online October 15, 2009
Purpose : To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods : We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal...
Erratum
An overview and preparation of Korean pediatrician according to the expansion of national immunization program coverage
In Sung Cho
Clin Exp Pediatr. 2008;51(12):1275-1281.   Published online December 15, 2008
National Immunization Program (NIP) in korea is regulated by government for effective prevention of infectious diseases since 1954. But the program is only performed in public health center, so many people had various complaints such as inconvenience to use public center, high cost when vaccinated in private medical organization and lack of speciality and registration etc. In this reason, it...
Original Article
Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study
Hui Seung Hwang, Na Young Lee, Seung Beom Han, Ga Young Kwak, Soo Young Lee, Seung Yun Chung, Jin Han Kang, Dae Chul Jeong
Clin Exp Pediatr. 2008;51(11):1158-1164.   Published online November 15, 2008
Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003...
Erratum
Changes related term alteration of pediatrics and roles of pediatrician
Yong Kyu Sohn
Clin Exp Pediatr. 2008;51(11):1133-1135.   Published online November 15, 2008
The ultimate goal of the term alteration to pediatrics is that not only infants and children but also adlescents are subjet to pediatrics. At 27, June, 2007 the term pediatrics was altered to pediatrics (children and aoldescent medicine). From now on the roles of pediatricians for adolescents are needed and adolescent medicine should be reorganized in Korea. Although the numbers...
Review Article
Pediatric approach to early detection of learning disabilities
In Kyung Sung
Clin Exp Pediatr. 2008;51(9):911-921.   Published online September 15, 2008
Learning disabilities (LD) are heterogeneous group of disorders with evidences of genetic or familial trait, intrinsic to the individual and presume to be due to central nervous dysfunction. Learning disabilities and attention deficit hyperactivity disorder (ADHD) are the two of the most common disorders in the population of school-age children. Typically academic achievements in children with learning disabilities are significantly...
Original Article
Therapeutic compliance and its related factors in pediatrics patients
Ki Soo Park, Sin Kam, Heung Sik Kim, Jeong Kwon Lee, Jin-Bok Hwang
Clin Exp Pediatr. 2008;51(6):584-596.   Published online June 15, 2008
Purpose : This study was conducted to investigate treatment compliance and related factors in pediatric patients. Methods : Three hundred and fifty-five patients diagnosed with various acute diseases at a teaching hospital or clinic in October 2003 were enrolled. Data were analyzed using the Health Belief Model, which includes items on self-efficacy and family assistance. Results : The study found that...
Erratum
An overview and the future of pediatric subspecialty board certification of the Korean Pediatric Society
Chong Guk Lee
Clin Exp Pediatr. 2008;51(6):555-558.   Published online June 15, 2008
Committee for pediatric subspecialty board certification of the Korean Pediatric Society (KPA) was established for the subspecialty certification and formal training programs in 2005. Pediatric allergy and pulmonology was the first pediatric subspecialty among 9 subdivisions of KPA to petition for the certification in 2006, and 7 additional subdivisions of KPA, pediatric cardiology, pediatric endocrinology, pediatric gastroenterology and nutrition, pediatric...
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