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Review Article
Diagnosis and management of asthma in infants and preschoolers
Hai Lee Chung
Asthma is one of the most common chronic disease affecting children, and it often starts in infancy and preschool years. In previous birth cohorts, frequent wheezing in early life was associated with the development of asthma in later childhood and reduced lung function persisting into adulthood. Preschool wheezing is considered an umbrella term for distinctive diseases with different clinical features...
Neurology
Neonatal seizures: diagnostic updates based on new definition and classification
Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee
Clin Exp Pediatr. 2022;65(8):387-397.   Published online April 4, 2022
· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.
Original Article
Endocrinology
Zinc transporter 8 autoantibody in the diagnosis of type 1 diabetes in children
Nur Rochmah, Muhammad Faizi, Siti Wahyu Windarti
Clin Exp Pediatr. 2020;63(10):402-405.   Published online October 6, 2020
Question: Can zinc transporter 8 autoantibody (ZnT8A) be used for diagnosing type 1 diabetes (T1D)?
Finding: Twenty-two of 30 subjects with type 1 diabetes (73.3 %) were positive for ZnT8A compared to 5 of 18 controls (27.8%).
Meaning: ZnT8A has potential for clinical applications in the diagnosis of T1D.
Review Article
Genetics and Metabolism
Neurofibromatosis type I: points to be considered by general pediatricians
Eungu Kang, Hee Mang Yoon, Beom Hee Lee
Clin Exp Pediatr. 2021;64(4):149-156.   Published online July 15, 2020
Neurofibromatosis type 1 (NF1), a prevalent genetic disease that is transmitted in an autosomal dominant manner, is characterized by multiple cutaneous café-au-lait spots and neurofibromas as well as various degrees of neurological, skeletal, and neoplastic manifestations. The clinical features of NF1 increase in frequency with age, while the clinical diagnosis can remain undetermined in some pediatric patients. Importantly, affected patients...
Original Article
Allergy
Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea
Dong Hyeon Lee, Ji-Won Kwon, Hyung Young Kim, Ju-Hee Seo, Hyo-Bin Kim, So-Yeon Lee, Gwang-Cheon Jang, Dae-Jin Song, Woo Kyung Kim, Young-Ho Jung, Soo-Jong Hong, Jung Yeon Shim
Clin Exp Pediatr. 2020;63(3):104-109.   Published online November 8, 2019
Question: Is physician-diagnosed current asthma in preschool children associated with the asthma predictive index, atopic sensitization, or pulmonary function test?
Finding: Physician-diagnosed current asthma in preschool children was associated with the asthma predictive index, but not with spirometry, methacholine provocation test, fractional expiratory nitric oxide level, and atopic sensitization.
Meaning: Physician-diagnosed asthma in preschool children may be different from classic atopic asthma in school children or adolescents.
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...
Review Article
Nutrition
How to approach feeding difficulties in young children
Hye Ran Yang
Clin Exp Pediatr. 2017;60(12):379-384.   Published online December 22, 2017

Feeding is an interaction between a child and caregiver, and feeding difficulty is an umbrella term encompassing all feeding problems, regardless of etiology, severity, or consequences, while feeding disorder refers to an inability or refusal to eat sufficient quantities or variety of food to maintain adequate nutritional status, leading to substantial consequences, including malnutrition, impaired growth, and possible neurocognitive dysfunction....

Original Article
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...

Cardiology
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...

Diagnostic characteristics of supplemental laboratory criteria for incomplete Kawasaki disease in children with complete Kawasaki disease
Hyun Ok Jun, Jeong Jin Yu, So Yeon Kang, Chang Deok Seo, Jae Suk Baek, Young-Hwue Kim, Jae-Kon Ko
Clin Exp Pediatr. 2015;58(10):369-373.   Published online October 21, 2015
Purpose

In 2004, the American Heart Association (AHA) had published an algorithm for the diagnosis of incomplete Kawasaki disease (KD). The aim of the present study was to investigate characteristics of supplemental laboratory criteria in this algorithm.

Methods

We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease....

Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls
Jung Yu, Ha Young Shin, Sun Hee Lee, You Sung Kim, Jae Hyun Kim
Clin Exp Pediatr. 2015;58(8):294-300.   Published online August 21, 2015
Purpose

It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development.

Methods

This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical,...

Review Article
Kawasaki disease in infants
Jung Sook Yeom, Hyang Ok Woo, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Hee-Shang Youn
Clin Exp Pediatr. 2013;56(9):377-382.   Published online September 30, 2013

Kawasaki disease (KD) is an acute febrile illness that is the predominant cause of pediatric acquired heart disease in infants and young children. Because the diagnosis of KD depends on clinical manifestations, incomplete cases are difficult to diagnose, especially in infants younger than 1 year. Incomplete clinical manifestations in infants are related with the development of KD-associated coronary artery abnormalities....

Noninvasive diagnosis of pediatric nonalcoholic fatty liver disease
Hye Ran Yang
Clin Exp Pediatr. 2013;56(2):45-51.   Published online February 25, 2013

Because nonalcoholic steatohepatitis can progress towards cirrhosis even in children, early detection of hepatic fibrosis and accurate diagnosis of nonalcoholic fatty liver disease (NAFLD) are important. Although liver biopsy is regarded as the gold standard of diagnosis, its clinical application is somewhat limited in children due to its invasiveness. Noninvasive diagnostic methods, including imaging studies, biomarkers of inflammation, oxidative stress,...

Eosinophil-derived neurotoxin: a novel biomarker for diagnosis and monitoring of asthma
Chang-Keun Kim
Clin Exp Pediatr. 2013;56(1):8-12.   Published online January 29, 2013

Asthma is associated with increased levels of eosinophils in tissues, body fluids, and bone marrow. Elevated levels of eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) have been noted in asthma patients. Higher levels of EDN and ECP are also associated with exacerbated asthmatic conditions. Thus, EDN, along with ECP, may aid the diagnosis and monitoring of asthma. Several groups...

Diagnosis of incomplete Kawasaki disease
Jeong Jin Yu
Clin Exp Pediatr. 2012;55(3):83-87.   Published online March 16, 2012

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be...

Case Report
Misdiagnosis of fetus-in-fetu as meconium peritonitis
Yoon Joo Kim, Se Hyung Sohn, Ju Young Lee, Jin A Sohn, Eun Hee Lee, Ee Kyung Kim, Chang Won Choi, Han Suk Kim, Beyong Il Kim, Jung Hwan Choi
Clin Exp Pediatr. 2011;54(3):133-136.   Published online March 31, 2011

Fetus-in-fetu (FIF) is a rare congenital condition in which a fetiform mass is detected in the host abdomen and also in other sites such as the intracranium, thorax, head, and neck. This condition has been rarely reported in the literature. Herein, we report the case of a fetus presenting with abdominal cystic mass and ascites and prenatally diagnosed as meconium...

Review Article
Juvenile idiopathic arthritis: Diagnosis and differential diagnosis
Ki Hwan Kim, Dong Soo Kim
Clin Exp Pediatr. 2010;53(11):931-935.   Published online November 30, 2010

Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of several disease subtypes that are characterized by the onset of arthritis before the age of 16 years and has symptoms lasting at least 6 weeks. The previous classification of JIA included seven different categories, whereas its current classification was compiled by the International League of the Association for Rheumatology,...

Practical stepwise approach to rhythm disturbances in congenital heart diseases
June Huh
Clin Exp Pediatr. 2010;53(6):680-687.   Published online June 23, 2010

Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects,...

Diagnosis of neonatal seizures
Hee Jung Chung, Yun Jung Hur
Clin Exp Pediatr. 2009;52(9):964-970.   Published online September 15, 2009
Neonatal seizures are generally not only brief and subtle but also not easily recognized and are usually untreated. In sick neonates, seizures are frequently not manifested clinically but are detected only by electroencephalography (subclinical EEG seizures). This phenomenon of electroclinical dissociation is fairly common in neonates. On the other hand, neonates frequently show clinical behaviors such as stiffening, apnea, or...
Assessment of retinopathy of prematurity (ROP) revisited
Jeong Hun Kim, Young Suk Yu
Clin Exp Pediatr. 2009;52(1):22-27.   Published online January 15, 2009
Retinopathy of prematurity (ROP) is a major cause of blindness that affects premature infants. With advances in neonatology, ROP is likely to emerge as the most serious problem of vision loss in children even in developed countries; such a situation could be called the third epidemic of ROP. However, controversy and uncertainty still surround favorable outcomes of ROP. For successfully...
Neuromuscular disorders in children : Diagnosis and treatment
Jong Hee Chae
Clin Exp Pediatr. 2008;51(12):1295-1299.   Published online December 15, 2008
Inherited muscle diseases are heterogeneous with varying genetic etiologies and present with common symptoms and signs, including weakness, motor developmental delay, and hypotonia. To diagnose these various diseases, a meticulous family and clinical history, physical and neurological examinations, laboratory findings with electromyography, muscle biopsy, and genetic testing are needed. Here, I review several inherited muscle diseases, with a focus on...
Differential diagnosis of abdominal masses in children
Ki Woong Sung
Clin Exp Pediatr. 2008;51(8):787-791.   Published online August 15, 2008
Enlargement of organs or other solid tissues usually presents as an abdominal mass. Often, abdominal masses in children are found by an unsuspected parent or by a physician during a routine examination. Most masses have no specific signs or symptoms. Abdominal masses in children require immediate attention. History and physical examination may provide clues to the diagnosis. Ultrasound examination is...
Juvenile rheumatoid arthritis
Dong Soo Kim
Clin Exp Pediatr. 2007;50(12):1173-1179.   Published online December 15, 2007
The diagnosis of juvenile rheumatoid arthritis (JRA) is based on patient's age at disease onset, symptom duration, gender, and clinical manifestations. JRA is of unknown origin, begins under the age of 16, and persists for a minimum of 6 weeks. JRA is categorized into three principal types, systemic, oligoarticular and polyarticular. Infection, other connective tissue diseases, malignancy, trauma, and immunodeficiency...
Non-epileptic paroxysmal events during sleep - Differentiation from epileptic seizures -
In Kyu Lee
Clin Exp Pediatr. 2007;50(8):726-731.   Published online August 15, 2007
This review describes the wide spectrum of paroxysmal events during sleep in infancy and childhood. The differential diagnosis between sleep-related non-epileptic paroxysmal events and epileptic seizures is difficult in special occasions. The nocturnal frontal lobe seizure and of the more common non- epileptic paroxysmal events during sleep are described. The main differentiating features characterizing parasomnias are: onset in early...
The diagnosis of pediatric sinusitis
Chang-Keun Kim
Clin Exp Pediatr. 2007;50(4):323-327.   Published online April 15, 2007
Although most clinicians now agree that sinusitis can afflict children of all ages, appropriate diagnosis remain controversial. Sinusitis is one of the most challenging diagnoses for a clinician, because there is a lack of validated diagnostic criteria for acute rhinosinusitis. Symptoms generally include nasal congestion, purulent nasal discharge, and cough .The physical examination is often unsuccessful in confirming the diagnosis....
Fever and rash
Jin Han Kang
Clin Exp Pediatr. 2007;50(2):132-137.   Published online February 15, 2007
Patients with febrile illness and skin rashes need full and immediate attention. In general, these diseases show mild manifestations and good prognosis. However, causalities of some diseases with fever and rash may be life threatening or trivial. So, the differential diagnosis for those patients is extensive. A through history, a careful physical examination and close observation of clinical progress are...
Original Article
Diagnostic value of various screening tests in neonatal sepsis
Hyun Gon Je, Young Mi Jeoung, Soo Jin Jeong
Clin Exp Pediatr. 2006;49(11):1167-1173.   Published online November 15, 2006
Purpose : To evaluate various sepsis screening tests, individually and in combination, to formulate a guideline for the diagnosis of neonatal sepsis. Methods : The study was a retrospective cohort study. It took place at the neonatal intensive care unit of the Paediatric Department, Il Sin Christian Hospital, Busan, Korea, over a period of 68 months from 1st, April, 2001 to...
Review Article
Diagnosis of inherited metabolic disorders based on their diverse clinical features and laboratory tests
Han-Wook Yoo
Clin Exp Pediatr. 2006;49(11):1140-1151.   Published online November 15, 2006
Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of “inborn error of metabolism” or “chemical individuality”, more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse...
Hemophilia
Ki Young Yoo
Clin Exp Pediatr. 2006;49(8):821-829.   Published online August 15, 2006
Hemophilia is the most common coagulation disorder. It has a long history. Hemophilia A is caused by FVIII gene mutation, and hemophilia B by FIX gene mutation. Those genes are located on X chromosome long arm. Bleedings in hemophiliacs predominantly occur in joints and muscles. Because those site are insufficient in tissue factor to induce hemostasis. Among joints knee, ankle...
Original Article
Diagnostic limitation and usefulness of 99mTc-DISIDA hepatobiliary scanning on neonatal cholestasis
Jung Mi Kim, Byung-Ho Choi, You Cheol Jang, Ki Won Oh, Min Hyun Cho, Kyung Hee Lee, Jin-Young Park, Heng Mi Kim
Clin Exp Pediatr. 2006;49(7):737-744.   Published online July 15, 2006
Purpose : To assess the usefulness of 99mTc-DISIDA scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the...
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