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Neonatal seizures in Korea, 1983-2009.

Korean Journal of Pediatrics.2009;52(9):957-963. doi:10.3345/kjp.2009.52.9.957

Neonatal seizures are the most common and distinctive clinical sign of prenatal and/or neonatal brain disorders. Newborn infants with seizures are at risk of mortality and survivors at risk for neurologic impairment, developmental delay, and subsequent epilepsy. Fifteen reports on neonatal seizures in Korea from 1983 to 2009 were analyzed. A total of 731 neonatal seizure cases were reported. Day of seizure onset, etiology, type of seizures, electroencephalogram findings, and outcomes were analyzed. It is necessary to establish a basic report for a future nationwide study of neonatal seizures.
Brain Diseases ; Electroencephalography ; Epilepsy ; Humans ; Infant, Newborn ; Korea ; Seizures ; Survivors

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Effects of clarithromycin treatment in scrub typhus in children: comparison with chloramphenicol and azithromycin.

Min LEE ; June KIM ; Dae Sun JO

Korean Journal of Pediatrics.2017;60(4):124-127. doi:10.3345/kjp.2017.60.4.124

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 typhus in children. METHODS: We retrospectively analyzed medical records of 56 children with scrub typhus who were admitted between 2004 and 2013 to Chonbuk National University Hospital, Jeonju, Korea. Cases were divided into 3 groups based on thetreatment drug (chloramphenicol, azithromycin, and clarithromycin). We compared their clinical manifestations and laboratory findings. RESULTS: All patients exhibited fever and rash. Other common clinical manifestations were eschars (66%), lymphadenopathy (48%), upper respiratory symptoms (42%), abdominal pain (32%), and hepatosplenomegaly (14%). Elevated levels of C-reactive protein, erythrocyte sedimentation rates, aspartate transaminase, and alanine transaminase were detected in 95%, 96%, 84%, and 77% of patients, respectively. Additionally, decreased platelet and white blood cell levels were observed in 43% and 36% of patients, respectively. There were no statistical differences between the treatment groups in mean age (P=0.114) or sex (P=0.507). However, time to defervescence after the treatments differed significantly, being the shortest in the clarithromycin group (P=0.019). All patients recovered without complications related to the disease or drugs. CONCLUSION: Clarithromycin was as effective as chloramphenicol and azithromycin in pediatric scrub typhus patients and may be used as a first-line treatment drug.
Abdominal Pain ; Adult ; Alanine Transaminase ; Anemia, Aplastic ; Aspartate Aminotransferases ; Azithromycin* ; Blood Platelets ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Chloramphenicol* ; Clarithromycin* ; Exanthema ; Fever ; Humans ; Jeollabuk-do ; Korea ; Leukocytes ; Lymphatic Diseases ; Medical Records ; Retrospective Studies ; Scrub Typhus* ; Tetracycline ; Tooth Discoloration

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Effect of tuberculosis treatment on leptin levels, weight gain, and percentage body fat in Indonesian children.

Maria MEXITALIA ; Yesi Oktavia DEWI ; Adriyan PRAMONO ; Mohammad Syarofil ANAM

Korean Journal of Pediatrics.2017;60(4):118-123. doi:10.3345/kjp.2017.60.4.118

PURPOSE: Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on the leptin level, BW, and BFP of children with TB. METHODS: The design of this study was a group interrupted time series. The subjects were children with probable TB according to clinical criteria based on an Indonesian scoring system adopted from the Consensus of Expert Panel. BW; BFP; energy intake; fat and protein intake; and leptin levels before, 2 months after (intensive phase), and 6 months after (continuation phase) anti-TB treatment, were measured. About 40 children, aged 5–14 years, participated in this study. RESULTS: The BW, BFP and leptin level increased from before treatment to after completion of the intensive phase and still showed an increased during the continuation phase: BW 18.65 kg, 19.75 kg, and 20.85 kg; BFP 18.3%, 19.5%, and 20.2%; and leptin level 1.9 mg/dL, 3.07 mg/dL, and 3.4 mg/dL, respectively (P<0.01). CONCLUSION: Leptin level, BW, and BFP increased throughout the course of anti-TB treatment, compared with pretreatment values. Further research is needed to compare the results with data for healthy children.
Adipose Tissue* ; Body Weight ; Child* ; Consensus ; Energy Intake ; Humans ; Immunity, Cellular ; Interrupted Time Series Analysis ; Leptin* ; Malnutrition ; Mycobacterium tuberculosis ; Tuberculosis* ; Weight Gain*

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Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children.

Na Hyun LEE ; Hee Joung CHOI ; Yeo Hyang KIM

Korean Journal of Pediatrics.2017;60(4):112-117. doi:10.3345/kjp.2017.60.4.112

PURPOSE: The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD. METHODS: Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as follows: 49 with KD, 111 with viral infections, and 24 with bacterial infections. RESULTS: The mean PCT level in the KD group was significantly lower than that in the bacterial infection group (0.82±1.73 ng/mL vs. 3.11±6.10 ng/mL, P=0.002) and insignificantly different from that in the viral infection group (0.23±0.34 ng/mL,P=0.457). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level in the KD group were significantly higher than those in the viral and bacterial infection groups (P<0.001 and P<0.001 for ESR, P<0.001 and P=0.005 for CRP, respectively). The proportion of patients in the KD group with PCT levels of >1.0 ng/mL was significantly higher in the nonresponders to the initial intravenous immunoglobulin treatment than in the responders (36% vs. 8%, P=0.01). CONCLUSION: PCT levels may help to differentiate KD from bacterial infections. A combination of disease markers, including ESR, CRP, and PCT, may be useful for differentiating between KD and viral/bacterial infections.
Bacteria ; Bacterial Infections ; Blood Sedimentation ; C-Reactive Protein ; Calcitonin ; Child* ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome*

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Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency.

Hasan M ISA ; Masooma S MOHAMED ; Afaf M MOHAMED ; Adel ABDULLA ; Fuad ABDULLA

Korean Journal of Pediatrics.2017;60(4):106-111. doi:10.3345/kjp.2017.60.4.106

PURPOSE: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. METHODS: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed. Data on sex, age at presentation, hospitalization duration, need for ET, hemoglobin (Hb) level, reticulocyte count, direct Coombs test, serum total and indirect bilirubin levels, thyroid function, blood and urine cultures, G6PD status, and blood groups were collected and compared between the G6PD-deficent and G6PD-normal patients. RESULTS: Of 1,159 NIH patients admitted, 1,129 were included, of whom 646 (57%) were male. Among 1,046 patients tested, 442 (42%) were G6PD deficient, 49 (4%) needed ET, and 11 (1%) had suspected Kernicterus. The G6PD-deficient patients were mainly male (P<0.0001), and had lower Hb levels (P<0.0001) and higher maximum bilirubin levels (P=0.001). More G6PD-deficient patients needed ET (P<0.0001). G6PD deficiency (P=0.006), lower Hb level (P=0.002), lower hematocrit count (P=0.02), higher bilirubin level (P<0.0001), higher maximal bilirubin level (P<0.0001), and positive blood culture result (P<0.0001) were significant risk factors for ET. Maximal bilirubin level was a significant risk factor for kernicterus (P=0.021) and independently related to ET (P=0.03). CONCLUSION: G6PD deficiency is an important risk factor for severe NIH. In G6PD-deficent neonates, management of NIH should be hastened to avoid irreversible neurological complications.
Bahrain ; Bilirubin ; Blood Group Antigens ; Case-Control Studies ; Coombs Test ; Glucose-6-Phosphate* ; Glucosephosphate Dehydrogenase Deficiency* ; Glucosephosphate Dehydrogenase* ; Hematocrit ; Hospitalization ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Kernicterus ; Male ; Medical Records ; Prevalence ; Reticulocyte Count ; Retrospective Studies ; Risk Factors ; Thyroid Gland

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IgE-mediated food allergies in children: prevalence, triggers, and management.

Sooyoung LEE

Korean Journal of Pediatrics.2017;60(4):99-105. doi:10.3345/kjp.2017.60.4.99

Food allergy (FA) is a serious health problem, and severe FA such as food-induced anaphylaxis can often be life threatening. The incidence of FA has been increasing especially in children. They usually develop early in life and affect up to 10% of children. The 2 most common food allergens worldwide are milk and eggs, while the third one varies depending on the countries: peanuts in the United States and Switzerland, wheat in Germany and Japan, tree nuts in Spain, sesame in Israel, and walnuts in Korea. These common food allergens are different and difficult to identify because of differing study methodologies, population, geography, age, and dietary exposure patterns. The current management of FA relies on the strict avoidance of culprit allergens, the prompt treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis, monitoring, and education to prevent further reactions. Newer approaches for tolerance induction to FA and FA immunotherapy have been under investigation but are not yet ready for real-world application. Thus, consistent and systematic education of patients, caregivers, and food-handling people is of primary importance for the management and prevention of FA reactions. This review assesses and compares IgE-mediated FA in children in Korea and other countries, with a focus on summarizing the prevalence, common triggers, and management of FA.
Allergens ; Anaphylaxis ; Arachis ; Caregivers ; Child* ; Education ; Eggs ; Epinephrine ; Food Hypersensitivity* ; Geography ; Germany ; Humans ; Hypersensitivity ; Immunotherapy ; Incidence ; Israel ; Japan ; Juglans ; Korea ; Milk ; Nuts ; Ovum ; Patient Education as Topic ; Prevalence* ; Sesamum ; Spain ; Switzerland ; Trees ; Triticum ; United States

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De novo interstitial deletion of 15q22q23 with global developmental delay and hypotonia: the first Korean case.

Ha Su KIM ; Jin Yeong HAN ; Myo Jing KIM

Korean Journal of Pediatrics.2015;58(8):313-316. doi:10.3345/kjp.2015.58.8.313

Interstitial deletions involving the chromosome band 15q22q24 are very rare and only nine cases have been previously reported. Here, we report on a 12-day-old patient with a de novo 15q22q23 interstitial deletion. He was born by elective cesarean section with a birth weight of 3,120 g at 41.3-week gestation. He presented with hypotonia, sensory and neural hearing loss, dysmorphism with frontal bossing, flat nasal bridge, microretrognathia with normal palate and uvula, thin upper lip in an inverted V-shape, a midline sacral dimple, severe calcanovalgus at admission, and severe global developmental delay at 18 months of age. Fluorescence in situ hybridization findings confirmed that the deleted regions contained at least 15q22. The chromosome analysis revealed a karyotype of 46,XY,del(15) (q22q23). Parental chromosome analysis was performed and results were normal. After reviewing the limited literature on interstitial 15q deletions, we believe that the presented case is the first description of mapping of an interstitial deletion involving the chromosome 15q22q23 segment in Korea. This report adds to the knowledge of the clinical phenotype associated with the 15q22q23 deletion.
Birth Weight ; Cesarean Section ; Developmental Disabilities ; Female ; Fluorescence ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; In Situ Hybridization ; Karyotype ; Korea ; Lip ; Muscle Hypotonia* ; Palate ; Parents ; Phenotype ; Pregnancy ; Uvula

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Successful sulfonylurea treatment in a patient with permanent neonatal diabetes mellitus with a novel KCNJ11 mutation.

Sung Yeon AHN ; Gu Hwan KIM ; Han Wook YOO

Korean Journal of Pediatrics.2015;58(8):309-312. doi:10.3345/kjp.2015.58.8.309

Permanent neonatal diabetes mellitus refers to diabetes that occurs before the age of 6 months and persists through life. It is a rare disorder affecting one in 0.2-0.5 million live births. Mutations in the gene KCNJ11, encoding the subunit Kir6.2, and ABCC8, encoding SUR1 of the ATP-sensitive potassium (K(ATP)) channel, are the most common causes of permanent neonatal diabetes mellitus. Sulfonylureas close the K(ATP) channel and increase insulin secretion. KCNJ11 and ABCC8 mutations have important therapeutic implications because sulfonylurea therapy can be effective in treating patients with mutations in the potassium channel subunits. The mutation type, the presence of neurological features, and the duration of diabetes are known to be the major factors affecting the treatment outcome after switching to sulfonylurea therapy. More than 30 mutations in the KCNJ11 gene have been identified. Here, we present our experience with a patient carrying a novel p.H186D heterozygous mutation in the KCNJ11 gene who was successfully treated with oral sulfonylurea.
Diabetes Mellitus* ; Humans ; Insulin ; Live Birth ; Potassium ; Potassium Channels ; Sulfonylurea Compounds ; Treatment Outcome

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Evaluation of three glucometers for whole blood glucose measurements at the point of care in preterm or low-birth-weight infants.

Joon Ho HWANG ; Yong Hak SOHN ; Seong Sil CHANG ; Seung Yeon KIM

Korean Journal of Pediatrics.2015;58(8):301-308. doi:10.3345/kjp.2015.58.8.301

PURPOSE: We evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants. METHODS: Between December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, < or =2,300 g or were < or =36 weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.). RESULTS: The correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels< or =60 mg/dL, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment , after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose < or =60 mg/dL), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively. CONCLUSION: Significant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.
Adult ; Blood Glucose Self-Monitoring ; Blood Glucose* ; Delivery of Health Care ; Glucose ; Humans ; Hypoglycemia ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Sensitivity and Specificity

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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

Korean Journal of Pediatrics.2015;58(8):294-300. doi:10.3345/kjp.2015.58.8.294

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, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. RESULTS: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, 2.45+/-0.50 cm vs. 2.63+/-0.49 cm, P=0.015; uterine volume, 0.95+/-0.62 cm3 vs. 1.35+/-0.76 cm3, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least 1.07 cm3 was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). CONCLUSION: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.
Breast ; Diagnosis* ; Female* ; Gonadotropin-Releasing Hormone ; Humans ; Pelvis ; Puberty, Precocious* ; ROC Curve ; Ultrasonography*

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