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Funded articles
Original Article
Neonatology (Perinatology)
New modified version of the Risk Adjustment for Congenital Heart Surgery category and mortality in premature infants with critical congenital heart disease
Young Mi Yoon, Seong Phil Bae, Yoon-Joo Kim, Jae Gun Kwak, Woong-Han Kim, Mi Kyoung Song, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
Clin Exp Pediatr. 2020;63(10):395-401.   Published online July 15, 2020
Questions: This study aimed to describe the survival of premature infants with critical congenital heart disease (CHD) and to identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) associated with mortality.
Finding: For premature infants with critical CHD, survival rate was 76.9% and very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS 5 or more were associated with in-hospital mortality.
Meaning: VLBW, PPHN and BPD, as well as M-RACHS≥5, were risk factors for mortality among premature infants with critical CHD.
Cardiology
Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran
Nastaran ahmadi, Seyedeh Mahdieh Namayandeh, Seyed Mahmood Sadr Bafghi, Mohammad Reza Mohammadi, Masoud Mirzaei, Mohammadtaghi Sarebanhassanabadi, Amir Houshang Mehrparvar, Reza Faraji, Neda Nilforoshan, Ahmad Karimi
Clin Exp Pediatr. 2020;63(8):321-328.   Published online July 21, 2020
Question: What is the 90th, 95th, 99th percentile of blood pressure based on height as the cut point for diagnosis of hypertension in children of our province?
Finding: We used blood pressure of 456 males and 579 females in 6–18 years old in “Iranian Children and Adolescents' Psychiatric Disorders survey.
Meaning: The 90th, 95th, 99th percentiles of systolic and diastolic blood pressure in both sex based on age and 10-cm height intervals were developed in Yazd.
Hematology
Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major
Nora Sovira, Munar Lubis, Pustika Amalia Wahidiyat, Franciscus D. Suyatna, Djajadiman Gatot, Saptawati Bardosono, Mohammad Sadikin
Clin Exp Pediatr. 2020;63(8):314-320.   Published online August 15, 2020
Question: Is the α-tocopherol as an exogenous antioxidant supplementation effective in improving hemolysis and oxidative stress on β-thalassemia major?
Finding: We found significant enhancements in plasma haptoglobin were noted in the α-tocopherol group (3.01 mg/dL; range, 0.60–42.42 mg/dL; P=0.021).
Meaning: The α-tocopherol can improve hemolysis by increasing the haptoglobin level as hemolysis marker.
Review Article
Nutrition
Components of human breast milk: from macronutrient to microbiome and microRNA
Su Yeong Kim, Dae Yong Yi
Clin Exp Pediatr. 2020;63(8):301-309.   Published online March 23, 2020
Human breast milk (HBM) is essential for the infant’s growth and development right after birth and is an irreplaceable source of nutrition for early human survival. Various infant formulas have many similarities to HBM in many components, but there is no perfect substitute for HBM. Recently, various breast milk components and their roles have been studied according to the development...
Neonatology (Perinatology)
Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019
Jang Hoon Lee, YoungAh Youn, Yun Sil Chang; Korean Neonatal Network
Clin Exp Pediatr. 2020;63(8):284-290.   Published online February 5, 2020
The Korean Neonatal Network (KNN) has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. The survival rate of all VLBWIs was 86% in Korea. The overall prevalence of cerebral palsy was 6.2%–6.6%. Bilateral blindness and hearing loss were reported in 0.2%–0.3%, 0.8%–1.9%, respectively. The KNN has published annual reports and papers for facilitating the improvement of VLBWIs outcome in Korea.
Original Article
Immunology
Immunogenicity and safety of a 12-valent pneumococcal conjugate vaccine in infants aged 6–10 weeks: a randomized double-blind active-controlled trial
Jonghoon Shin, Jamaree Teeratakulpisarn, Thanyawee Puthanakit, Tuangtip Theerawit, Ji Hwa Ryu, Jinhwan Shin, Seulgi Lee, Hayoung Lee, Kyungjun An, Hun Kim
Clin Exp Pediatr. 2020;63(7):265-271.   Published online December 6, 2019
Question: The immunogenicity and safety of GBP411 when administered to healthy infants are not understood.
Finding: The intergroup differences were not significant for all 12 serotypes after the booster dose. The overall incidence of solicited local adverse events between the groups did not differ significantly.
Meaning: GBP411 with a 2p+1 dosing schedule induced a substantial immune response, and may be safe for administration to healthy infants.
Review Article
Pulmonology
The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children
Eun Lee, So-Yeon Lee, Soo-Jong Hong
Clin Exp Pediatr. 2020;63(7):251-258.   Published online December 9, 2019
Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%−58.0%. Although...
Original Article
Neonatology (Perinatology)
Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age
Ju Hyun Jin, Shin Won Yoon, Jungeun Song, Seong Woo Kim, Hee Jung Chung
Clin Exp Pediatr. 2020;63(6):219-225.   Published online September 25, 2019
Question: Infants born at moderate to late preterm gestations are known to have little problem later on, but is that really true?
Finding: At school age, cognitive problem was observed in about a quarter of the children. In addition, more than half of the children was suspected of having attention problems.
Meaning: Moderate to late preterm infants are at risk of developing abnormal intelligence and attention problems at early school age, therefore they should not be neglected on longterm follow-up evaluation.
Nephrology (Genitourinary)
Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery
Hee Sun Baek, Youngok Lee, Hea Min Jang, Joonyong Cho, Myung Chul Hyun, Yeo Hyang Kim, Su-Kyeong Hwang, Min Hyun Cho
Clin Exp Pediatr. 2020;63(4):151-156.   Published online February 5, 2020
Question: Can clinical usefulness of biomarkers of acute kidney injury vary on the clinical circumstances?
Finding: In young children undergoing cardiac surgery, urine KIM-1/Cr level peaked at 24 hours with significant difference from baseline level and was significantly higher at 6 hours in the AKI group. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery.
Meaning: Urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery in young children.
Endocrinology
Effect of agricultural pesticide on precocious puberty in urban children: an exploratory study
Junghwan Suh, Han Saem Choi, Ahreum Kwon, Hyun Wook Chae, Ho-Seong Kim
Clin Exp Pediatr. 2020;63(4):146-150.   Published online December 6, 2019
Question: Does agricultural pesticide effect precocious puberty in girls?
Finding: Dinotefuran, an insecticide of neonicotinoid class, was detected in one of 30 patients with precocious puberty, and in 2 girls of the normal control group, which was not statistically significant.
Meaning: There was no close relationship between agricultural pesticides and development of precocious puberty.
Other
Korean parents’ perceptions of the challenges and needs on school re-entry during or after childhood and adolescent cancer: a multi-institutional survey by Korean Society of Pediatric Hematology and Oncology
Jun Ah Lee, Jae Min Lee, Hyeon Jin Park, Meerim Park, Byung Kiu Park, Hee Young Ju, Ji Yoon Kim, Sang Kyu Park, Young Ho Lee, Ye Jee Shim, Heung Sik Kim, Kyung Duk Park, Yeon-Jung Lim, Hee Won Chueh, Ji Kyoung Park, Soon Ki Kim, Hyoung Soo Choi, Hyo Seop Ahn, Jeong Ok Hah, Hyoung Jin Kang, Hee Young Shin, Mee Jeong Lee
Clin Exp Pediatr. 2020;63(4):141-145.   Published online November 14, 2019
Question: What are the parental needs and challenges when their children return to school after cancer?
Finding: In addition to scholastic aptitude-oriented programs, emotional and psychosocial support is necessary for a successful return to school.
Meaning: Pediatric oncologists should actively engage in improving oncology practices to better integrate individualized school plans and educate peers and teachers to improve health literacy to make them understand the needs of children with cancer.
Nutrition
Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study
Min Jeong Jang, Yong Joo Kim, Shinhye Hong, Jaeyoon Na, Jong Hee Hwang, Son Moon Shin, Young Min Ahn
Clin Exp Pediatr. 2020;63(4):135-140.   Published online November 12, 2019
Question: Human milk has stronger antiviral, antibacterial, and anti-inflammatory properties compared with formula milk. How dose breastfeeding affect respiratory syncytial virus infection in Korea?
Finding: Breastfed infants required less oxygen therapy and possible intensive care unit admission than artificial formulafed infants during respiratory syncytial virus infection.
Meaning: This protective role of breast milk on RSV severity can be a supporting evidence for promoting breastfeeding in Korea.
Letter to the Editor
General Pediatrics
Effectiveness of comprehensive hand hygiene module on preschool children in Klang Valley, Malaysia
Mohd Dzulkhairi Mohd Rani, Nurul Azmawati Mohamed, Tengku Zetty Maztura Tengku Jamaluddin, Zarini Ismail, Shalinawati Ramli, Habibah Faroque, Farishah Nur Abd Samad, Abdul Rasyid Ariffien, Aisyah Ar Redha Che Amir Farid, Ilina Isahak
Clin Exp Pediatr. 2020;63(3):115-116.   Published online February 5, 2020
Review Article
Neurology
Advanced neuroimaging techniques for evaluating pediatric epilepsy
Yun Jeong Lee
Clin Exp Pediatr. 2020;63(3):88-95.   Published online February 6, 2020
Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone,...
Original Article
Neonatology (Perinatology)
Effect of red blood cell transfusion on short-term outcomes in very low birth weight infants
Eui Young Lee, Sung Shin Kim, Ga Young Park, Sun Hyang Lee
Clin Exp Pediatr. 2020;63(2):56-62.   Published online February 6, 2020
Question: Does RBC transfusion affect the short-term outcomes of VLBW infants?
Finding: The results showed that RBC transfusion was significantly related to the incidence of BPD (OR, 5.42; P<0.001) and NEC (OR, 3.40; P=0.009).
Meaning: Careful consideration of the patient’s clinical condition and appropriate guidelines is required before administering RBC transfusions.
Editorial
Neonatology (Perinatology)
Prevention and management of pain in the neonatal intensive care unit
Sung Shin Kim
Clin Exp Pediatr. 2020;63(1):16-17.   Published online January 15, 2020
Original Article
Neonatology (Perinatology)
Hypoxia-inducible factor: role in cell survival in superoxide dismutase overexpressing mice after neonatal hypoxia-ischemia
Ga Won Jeon, R. Ann Sheldon, Donna M Ferriero
Clin Exp Pediatr. 2019;62(12):444-449.   Published online October 18, 2019
Background: Sixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies.
Purpose: HIF-1α-deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the...
Systematic review and meta-analysis
Neurobehavior
Evaluation of drug interventions for the treatment of sleep disorders in children with autism spectrum disorders: a systematic review
Ensiyeh Jenabi, Sara Ataei, Saeid Bashirian
Clin Exp Pediatr. 2019;62(11):405-409.   Published online October 2, 2019
A structured review study of drug interventions on sleep disorders in patients with autism spectrum disorders (ASD) has not been published to date. This systematic review aimed to investigate drug interventions for the treatment of sleep disorders in children with ASD. The Web of Science, PubMed, and Scopus databases were searched until March 2019. Study quality was assessed using the...
Original Article
Gastroenterology
Influence of proton pump inhibitor therapy on intestinal inflammation assessed by fecal calprotectin in pediatric patients
Su Yeong Kim, Na Mi Lee, Sin Weon Yun, Soo Ahn Chae, In Seok Lim, Eung Sang Choi, Dae Yong Yi
Clin Exp Pediatr. 2019;62(10):400-404.   Published online July 3, 2019
Background: An increase in the numbers of patients with gastrointestinal symptoms has recently been observed.
Purpose: To investigate the effects of proton pump inhibitor (PPI) therapy on intestinal inflammation in children and adolescents as confirmed by clinical manifestations and objectively assessed by fecal calprotectin (FC) level measurement. Methods: Consecutive children (aged 3–18 years) who presented with gastrointestinal symptoms and were treated with...
Neonatology (Perinatology)
Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
Na Hyun Lee, Soo Kyung Nam, Juyoung Lee, Yong Hoon Jun
Clin Exp Pediatr. 2019;62(10):386-394.   Published online May 22, 2019
Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C.
Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. Methods: A cohort study using prospectively collected data involving...
Editorial
Gastroenterology
Can proton pump inhibitors cause intestinal inflammation in children?
Ben Kang
Clin Exp Pediatr. 2019;62(10):384-385.   Published online October 2, 2019
Systematic review and meta-analysis
General Pediatrics
The maternal prepregnancy body mass index and the risk of attention deficit hyperactivity disorder among children and adolescents: a systematic review and meta-analysis
Ensiyeh Jenabi, Saied Bashirian, Salman Khazaei, Zohreh Basiri
Clin Exp Pediatr. 2019;62(10):374-379.   Published online June 14, 2019
Background: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority.
Purpose: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring. Methods: The search identified studies published through December 2018 in the PubMed, Web...
Original Article
Allergy
Nasal eosinophilia and eosinophil peroxidase in children and adolescents with rhinitis
Yeonu Choi, Haeun Jeon, Eun Ae Yang, Jong-Seo Yoon, Hyun Hee Kim
Clin Exp Pediatr. 2019;62(9):353-359.   Published online April 24, 2019
Background: Researchers have shown that eosinophil peroxidase (EPO) is a relatively accurate marker of eosinophilia and eosinophil activity. However, its use as a marker of eosinophilic inflammation in nasal secretions is limited because the diagnostic cutoff values of EPO for use as a one-time test for allergic diseases such as allergic rhinitis have not been established.
Purpose: To identify the correlation...
Review Article
Allergy
Phenotypes of allergic diseases in children and their application in clinical situations
Eun Lee, Soo-Jong Hong
Clin Exp Pediatr. 2019;62(9):325-333.   Published online April 23, 2019
Allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, are common heterogeneous diseases that encompass diverse phenotypes and different pathogeneses. Phenotype studies of allergic diseases can facilitate the identification of risk factors and their underlying pathophysiology, resulting in the application of more effective treatment, selection of better treatment responses, and prediction of prognosis for each phenotype. In the early phase...
Original Article
Endocrinology
Comparison of effectiveness of growth hormone therapy according to disease-causing genes in children with Noonan syndrome
Kyo Jin Jo, Yoo Mi Kim, Ju Young Yoon, Yeoun Joo Lee, Young Mi Han, Han-Wook Yoo, Hyang-Sook Kim, Chong Kun Cheon
Clin Exp Pediatr. 2019;62(7):274-280.   Published online December 3, 2018

Purpose: To analyze the growth response to growth hormone (GH) therapy in prepubertal patients with Noonan syndrome (NS) harboring different genetic mutations. Methods: Twenty-three patients with prepubertal NS treated at Pusan National University Children’s Hospital between March 2009 and July 2017 were enrolled. According to the disease-causing genes identified, the patients with NS were divided into 4 groups. Three groups were...
Genetics and Metabolism
Clinical and molecular characterization of Korean children with infantile and late-onset Pompe disease: 10 years of experience with enzyme replacement therapy at a single center
Min-Sun Kim, Ari Song, Minji Im, June Huh, I-Seok Kang, Jinyoung Song, Aram Yang, Jinsup Kim, Eun-Kyung Kwon, Eu-Jin Choi, Sun-Ju Han, Hyung-Doo Park, Sung Yoon Cho, Dong-Kyu Jin
Clin Exp Pediatr. 2019;62(6):224-234.   Published online October 4, 2018

Purpose: Pompe disease (PD) is an autosomal recessive disorder caused by a deficiency of acid alphaglucosidase resulting from pathogenic GAA variants. This study describes the clinical features, genotypes, changes before and after enzyme replacement therapy (ERT), and long-term outcomes in patients with infantile-onset PD (IOPD) and late-onset PD (LOPD) at a tertiary medical center. Methods: The medical records of 5 Korean...
Developmental and Behavioral Medicine
Validity of the Korean Developmental Screening Test for very-low-birth-weight infants
Chae Young Kim, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Clin Exp Pediatr. 2019;62(5):187-192.   Published online March 20, 2019

Purpose: The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants. Methods: Subjects included VLBW infants...
Neonatology (Perinatology)
Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants
Ian Kim, Sung Shin Kim, Jee In Song, Seock Hwa Yoon, Ga Young Park, Yong-Wha Lee
Clin Exp Pediatr. 2019;62(5):166-172.   Published online October 24, 2018

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first...
Case Report
Reninoma: a rare cause of curable hypertension
Ji Hye Kim, Ji Hyun Kim, Myung Hyun Cho, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Kyung Chul Moon, Il-Soo Ha, Hae Il Cheong
Clin Exp Pediatr. 2019;62(4):144-147.   Published online October 29, 2018
The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma...
Original Article
Respiratory syncytial virus-associated seizures in Korean children, 2011–2016
Teahyen Cha, Young Jin Choi, Jae-Won Oh, Chang-Ryul Kim, Dong Woo Park, In Joon Seol, Jin-Hwa Moon
Clin Exp Pediatr. 2019;62(4):131-137.   Published online October 23, 2018

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results: During this period, 1,193...