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Letter to the Editor
Neonatology (Perinatology)
B-type natriuretic peptide may have a role in the management of patent ductus arteriosus
Jang Hoon Lee
Clin Exp Pediatr. 2018;61(2):68-69.   Published online February 28, 2018
Case Report
Neurology
Mild encephalopathy with a reversible splenial lesion in a girl with acute pyelonephritis
Jung Sook Yeom, Chung Mo Koo, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Hyang-Ok Woo, Hee-Shang Youn
Clin Exp Pediatr. 2018;61(2):64-67.   Published online February 28, 2018

We report the case of a 12-year-old girl who had mild encephalopathy with a reversible splenial lesion (MERS) associated with acutepyelonephritis caused by Escherichia coli. The patient was admitted with a high fever, and she was diagnosed with acute pyelonephritis based on pyuria and the results of urine culture, which detected cefotaxime-sensitive E. coli. Although intravenous cefotaxime and tobramycin were...

Original Article
Cardiology
Cardiac function associated with home ventilator care in Duchenne muscular dystrophy
Sangheun Lee, Heeyoung Lee, Lucy Youngmin Eun, Seung Woong Gang
Clin Exp Pediatr. 2018;61(2):59-63.   Published online February 28, 2018
Purpose

Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups.

Methods

We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic...

Oncology
Excellent treatment outcomes in children younger than 18 months with stage 4 MYCN nonamplified neuroblastoma
Chiwoo Kim, Young Bae Choi, Ji Won Lee, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo
Clin Exp Pediatr. 2018;61(2):53-58.   Published online February 28, 2018
Purpose

Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma.

Methods

We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and...

Infection
Treatment-failure tularemia in children
Arzu Karlı, Gülnar Şensoy, Şule Paksu, Muhammet Furkan Korkmaz, Ömer Ertuğrul, Rıfat Karlı
Clin Exp Pediatr. 2018;61(2):49-52.   Published online February 28, 2018
Purpose

Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment.

Methods

A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included.

Results

Before diagnosis, the duration of symptoms in...

Cardiology
Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection
Jong Han Kim, Hye Ree Kang, Su Yeong Kim, Ji-Eun Ban
Clin Exp Pediatr. 2018;61(2):43-48.   Published online February 28, 2018
Purpose

Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection.

Methods

A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain...

Review Article
Nephrology (Genitourinary)
Atypical hemolytic uremic syndrome and eculizumab therapy in children
Seong Heon Kim, Hye Young Kim, Su Young Kim
Clin Exp Pediatr. 2018;61(2):37-42.   Published online February 28, 2018

Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is...

Letter to the Editor
Genetics and Metabolism
Commentary on “Megalencephaly-capillary malformation-polymicrogyria syndrome: the first case report in Korea”
Sung-Min Park, Byung-Soo Kim, Moon-Bum Kim, Hyun-Chang Ko
Clin Exp Pediatr. 2018;61(1):35-36.   Published online January 22, 2018
Case Report
Neonatology (Perinatology)
Case of mucinous adenocarcinoma of the lung associated with congenital pulmonary airway malformation in a neonate
Juneyoug Koh, Euiseok Jung, Se Jin Jang, Dong Kwan Kim, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Clin Exp Pediatr. 2018;61(1):30-34.   Published online January 22, 2018

Congenital pulmonary airway malformation (CPAM), previously known as congenital cystic adenomatoid malformation, is a rare developmental lung abnormality associated with rhabdomyosarcoma, pleuropulmonary blastoma, and mucinous adenocarcinoma of the lung. We report an unusual case of a 10-day-old male newborn with a left lower lobe pulmonary cyst who underwent lobectomy, which revealed type II CPAM complicated by multifocal mucinous adenocarcinoma. KRAS...

Original Article
Nephrology (Genitourinary)
Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection
Nani Jung, Hye Jin Byun, Jae Hyun Park, Joon Sik Kim, Hae Won Kim, Ji Yong Ha
Clin Exp Pediatr. 2018;61(1):24-29.   Published online January 22, 2018
Purpose

The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.

Methods

A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in...

Is vaginal reflux associated with urinary tract infection in female children under the age of 36 months?
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Clin Exp Pediatr. 2018;61(1):17-23.   Published online January 22, 2018
Purpose

To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months.

Methods

A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment...

Cardiology
C-reactive protein and N-terminal pro-brain natriuretic peptide discrepancy: a differentiation of adenoviral pharyngoconjunctival fever from Kawasaki disease
Jung Eun Choi, Hee Won Kang, Young Mi Hong, Sejung Sohn
Clin Exp Pediatr. 2018;61(1):12-16.   Published online January 22, 2018
Purpose

To differentiate adenoviral pharyngoconjunctival fever (PCF) from acute Kawasaki disease (KD) using laboratory tests before results of virus-real time polymerase chain reaction and ophthalmologic examination are obtained.

Methods

Baseline patient characteristics and laboratory measurements were compared between 40 patients with adenovirus infection and 123 patients with KD.

Results

The patients with adenovirus infection were generally older than those with KD (median: 3.9 years vs....

Developmental and Behavioral Medicine
Mid-upper-arm circumference as a screening measure for identifying children with elevated body mass index: a study for Pakistan
Muhammad Asif, Muhammad Aslam, Saima Altaf
Clin Exp Pediatr. 2018;61(1):6-11.   Published online January 22, 2018
Purpose

Mid-upper-arm circumference (MUAC) is considered an alternative screening method for obesity. The aims of this investigation were to examine the ability of MUAC to correctly identify children with elevated body mass index (BMI) and to determine the best MUAC cutoff point for identification of children with high BMI.

Methods

Anthropometric measurements (height, weight, and MUAC) from a cross-sectional sample of 7,921 Pakistani...

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...

Case Report
Genetics and Metabolism
The First Korean case of combined oxidative phosphorylation deficiency-17 diagnosed by clinical and molecular investigation
Young A Kim, Yoo-Mi Kim, Yun-Jin Lee, Chong Kun Cheon
Clin Exp Pediatr. 2017;60(12):408-412.   Published online December 22, 2017

Combined oxidative phosphorylation deficiency-17 (COXPD-17) is very rare and is caused by homozygous or compound heterozygous mutations in the ELAC2 gene on chromosome 17p12. The ELAC2 gene functions as a mitochondrial tRNA processing gene, and only 4 different pathogenic mutations have been reported in ELAC2-associated mitochondrial dysfunction involving oxidative phosphorylation. Affected patients show various clinical symptoms and prognosis, depending on...

Original Article
Endocrinology
The effect of low-dose intravenous bisphosphonate treatment on osteoporosis in children with quadriplegic cerebral palsy
Soon Jeong Moon, Young Min An, Soon Ki Kim, Young Se Kwon, Ji Eun Lee
Clin Exp Pediatr. 2017;60(12):403-407.   Published online December 22, 2017
Purpose

Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients.

Methods

Ten quadriplegic patients on antiepileptic...

The influence of gonadotropin-releasing hormone agonists on anthropometric change in girls with central precocious puberty
Jong Wan Yoon, Hyun A Park, Jieun Lee, Jae Hyun Kim
Clin Exp Pediatr. 2017;60(12):395-402.   Published online December 22, 2017
Purpose

The potential effect of gonadotropin-releasing hormone agonist (GnRHa) treatment on the weight of girls with central precocious puberty (CPP) remains a controversy. We investigated anthropometric changes during and after GnRHa treatment among girls with CPP.

Methods

This retrospective study evaluated data from 127 girls with CPP who received GnRHa treatment for ≥2 years. Height, weight, and body mass index (BMI) values were...

Cardiology
Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience
Myung Chul Hyun
Clin Exp Pediatr. 2017;60(12):390-394.   Published online December 22, 2017
Purpose

Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients.

Methods

We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016...

Neonatology (Perinatology)
Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?
Zeinab A El-Kabbany, Nadin N Toaima, Tamer N Toaima, Mona Y Gamal EL-Din
Clin Exp Pediatr. 2017;60(12):385-389.   Published online December 22, 2017
Purpose

This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates.

Methods

A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using...

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
Cardiology
A comparative study of established z score models for coronary artery diameters in 181 healthy Korean children
Kyungguk Ryu, Jeong Jin Yu, Hyun Ok Jun, Eun Jung Shin, Young Hee Heo, Jae Suk Baek, Young-Hwue Kim, Jae-Kon Ko
Clin Exp Pediatr. 2017;60(11):373-378.   Published online November 27, 2017
Purpose

The aim of this study was to investigate the statistical properties of four previously developed pediatric coronary artery z score models in healthy Korean children.

Methods

The study subjects were 181 healthy Korean children, whose age ranged from 1 month to 15 years. The diameter of each coronary artery was measured using 2-dimensional echocardiography and converted to the z score in the...

Apoptosis and remodeling in adriamycin-induced cardiomyopathy rat model
Young Mi Hong, Hyeryon Lee, Min-Sun Cho, Kwan Chang Kim
Clin Exp Pediatr. 2017;60(11):365-372.   Published online November 27, 2017
Purpose

The mechanism for the pathogenesis of adriamycin (ADR)-induced cardiomyopathy is not yet known. Different hypotheses include the production of free radicals, an interaction between ADR and nuclear components, and a disruption in cardiac-specific gene expression. Apoptosis has also been proposed as being involved in cardiac dysfunction. The purpose of this study was to determine if apoptosis might play a role...

Subtle inflammation: a possible mechanism of future cardiovascular risk in obese children
Watchareewan Sontichai, Prapai Dejkhamron, Peraphan Pothacharoen, Prachya Kongtaweelert, Kevalee Unachak, Nuthapong Ukarapol
Clin Exp Pediatr. 2017;60(11):359-364.   Published online November 27, 2017
Purpose

The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children.

Methods

A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any...

Neonatology (Perinatology)
Hearing loss screening tool (COBRA score) for newborns in primary care setting
Watcharapol Poonual, Niramon Navacharoen, Jaran Kangsanarak, Sirianong Namwongprom, Surasak Saokaew
Clin Exp Pediatr. 2017;60(11):353-358.   Published online November 27, 2017
Purpose

To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool.

Methods

This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary...

Review Article
Cardiology
Neonatal arrhythmias: diagnosis, treatment, and clinical outcome
Ji-Eun Ban
Clin Exp Pediatr. 2017;60(11):344-352.   Published online November 27, 2017

Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia,...

Psychiatric / Psychology
The opportunities of virtual reality in the rehabilitation of children with attention deficit hyperactivity disorder: a literature review
Azadeh Bashiri, Marjan Ghazisaeedi, Leila Shahmoradi
Clin Exp Pediatr. 2017;60(11):337-343.   Published online November 27, 2017

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. This disorder, in addition to its main symptoms, creates significant difficulties in education, social performance, and personal relationships. Given the importance of rehabilitation for these patients to combat the above issues, the use of virtual reality (VR) technology is helpful. The aim of this study...

Case Report
Infection
Acute pancreatitis in hand, foot and mouth disease caused by Coxsackievirus A16: case report
Byungsung Park, Hyuckjin Kwon, Kwanseop Lee, Minjae Kang
Clin Exp Pediatr. 2017;60(10):333-336.   Published online October 20, 2017

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. She was admitted because of poor oral...

Original Article
Endocrinology
Screening of SHOX gene sequence variants in Saudi Arabian children with idiopathic short stature
Abdulla A. Alharthi, Ehab I. El-Hallous, Iman M. Talaat, Hamed A. Alghamdi, Matar I. Almalki, Ahmed Gaber
Clin Exp Pediatr. 2017;60(10):327-332.   Published online October 20, 2017
Purpose

Short stature affects approximately 2%–3% of children, representing one of the most frequent disorders for which clinical attention is sought during childhood. Despite assumed genetic heterogeneity, mutations or deletions in the short stature homeobox-containing gene (SHOX) are frequently detected in subjects with short stature. Idiopathic short stature (ISS) refers to patients with short stature for various unknown reasons. The goal...

Nutrition
Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia
Tantut Susanto, Syahrul, Lantin Sulistyorini, Rondhianto, Alfi Yudisianto
Clin Exp Pediatr. 2017;60(10):320-326.   Published online October 20, 2017
Purpose

This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia.

Methods

A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from...

Developmental and Behavioral Medicine
Usefulness of the Korean Developmental Screening Test for infants and children for the evaluation of developmental delay in Korean infants and children: a single-center study
Chung-Hyuk Yim, Gun-Ha Kim, Baik-Lin Eun
Clin Exp Pediatr. 2017;60(10):312-319.   Published online October 20, 2017
Purpose

To evaluate the usefulness of the Korean Developmental Screening Test (K-DST) for infants and children for developmental delay assessment.

Methods

This study was based on retrospective studies of the results of the K-DST, Preschool Receptive-Expressive Language Scale (PRES), Sequenced Language Scale for Infants (SELSI), Childhood Autism Rating Scale (CARS), Modified Checklist for Autism in Toddlers (M-CHAT), electroencephalography, magnetic resonance imaging, and extensive...

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