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Editorial
Neurology
Recent trends in autism spectrum disorder research using text mining of PubMed: importance of early detection
Seung Soo Kim
Clin Exp Pediatr. 2021;64(7):339-340.   Published online November 9, 2020
Behavioral therapy, the most widely proven intervention for the core symptoms of autism spectrum disorder (ASD), is required for life for individuals with ASD. Parent involvement, early detection, and early therapy play important roles. We must organize the risk factors for ASD and develop a screening tool that can be easily applied in the clinical, daycare, or school setting.
Psychogenic nonepileptic seizures; beyond differentiating from epileptic seizures
Sang Ook Nam
Clin Exp Pediatr. 2021;64(6):282-283.   Published online November 12, 2020
Review Article
Cardiology
Application of CRISPR-Cas9 gene editing for congenital heart disease
Heeyoung Seok, Rui Deng, Douglas B. Cowan, Da-Zhi Wang
Clin Exp Pediatr. 2021;64(6):269-279.   Published online March 2, 2021
Clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9 (CRISPR-Cas9) system has made a big step in the genome editing which still requires technical developments for the efficient applications in the many fields including congenital heart diseases (CHDs), closely related to the genomic abnormality. In this review, we tried to cover the most updated researches of CRISPR-Cas9 in the CHDs to understand the current technologies, eventually becoming therapeutic bases for the CHD patients.
Neurology
Myths and truths about pediatric psychogenic nonepileptic seizures
Jung Sook Yeom, Heather Bernard, Sookyong Koh
Clin Exp Pediatr. 2021;64(6):251-259.   Published online October 17, 2020
• Psychogenic non-epileptic seizures (PNES) are events that look like epileptic seizures but are not caused by abnormal electrical discharges.
• PNES are a manifestation of psychological and emotional distress.
• Treatment for PNES does not begin with the psychological intervention but starts with the diagnosis and how the diagnosis is delivered.
• A multifactorial biopsychosocial process and a neurobiological review are both essential components when treating PNES
Genetics and Metabolism
Understanding the genetics of systemic lupus erythematosus using Bayesian statistics and gene network analysis
Seoung Wan Nam, Kwang Seob Lee, Jae Won Yang, Younhee Ko, Michael Eisenhut, Keum Hwa Lee, Jae Il Shin, Andreas Kronbichler
Clin Exp Pediatr. 2021;64(5):208-222.   Published online July 15, 2020
Bayesian false-discovery probability and false-positive report probability are the 2 major Bayesian methods used to evaluate noteworthiness of a genetic variant.
Application of stricter P value is needed to confirm statistical significance in meta-analyses.
Gene network analysis of noteworthy genetic variants shows a blueprint of the genetic background in complex diseases.
Critical Care Medicine
The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis
Silver Heinsar, Sainath Raman, Jacky Y. Suen, Hwa Jin Cho, John F. Fraser
Clin Exp Pediatr. 2021;64(5):188-195.   Published online August 10, 2020
Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation...
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...
Review article
Immunology
Systematic review of literature and analysis of big data from the National Health Insurance System on primary immunodeficiencies in Korea
Sohee Son, Ji-Man Kang, Younsoo Hahn, Kangmo Ahn, Yae-Jean Kim
Clin Exp Pediatr. 2021;64(4):141-148.   Published online July 13, 2020
In this article, a systematic review of reported primary immunodeficiency disease (PID) cases in Korea was performed and we attempted to estimate the number of PID patients and healthcare costs for the first time in Korea. Our review revealed that Korean PID cases are greatly underreported in the literature based on health insurance. Physicians in the field and health care policymakers should be aware of the disease burden of PID.
Original Article
Neonatology (Perinatology)
The protective effect of CXC chemokine receptor 2 antagonist on experimental bronchopulmonary dysplasia induced by postnatal systemic inflammation
Seung Hyun Lee, Chang Won Choi
Clin Exp Pediatr. 2021;64(1):37-43.   Published online July 15, 2020
Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)?
Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats.
Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD.
Review Article
Gastroenterology
Changing prevalence of Helicobacter pylori infection in children and adolescents
Ji Sook Park, Jin Su Jun, Ji-Hyun Seo, Hee-Shang Youn, Kwang-Ho Rhee
Clin Exp Pediatr. 2021;64(1):21-25.   Published online July 15, 2020
Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future.
H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.
Original Article
Developmental and Behavioral Medicine
Development of the Korean Developmental Screening Test for Infants and Children (K-DST)
Hee Jung Chung, Donghwa Yang, Gun-Ha Kim, Sung Koo Kim, Seoung Woo Kim, Young Key Kim, Young Ah Kim, Joon Sik Kim, Jin Kyung Kim, Cheongtag Kim, In-Kyung Sung, Son Moon Shin, Kyung Ja Oh, Hee-Jeong Yoo, Hee Joon Yu, Seoung-Joon Lim, Jeehun Lee, Hae-Ik Jeong, Jieun Choi, Jeong-Yi Kwon, Baik-Lin Eun
Clin Exp Pediatr. 2020;63(11):438-446.   Published online May 14, 2020
Question: Can the Korean Developmental Screening Test for Infants and Children (K-DST) be a useful screening tool for infants and children in Korea?
Finding: The K-DST has high reliability (internal consistency of 0.73–0.93, test-retest reliability of 0.77–0.88) and a high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979.
Meaning: The K-DST is an effective and reliable screening tool for infants and children with neurodevelopmental disorders in Korea.
Neonatology (Perinatology)
Knowledge and perceptions of kangaroo mother care among health providers: a qualitative study
Hadi Pratomo, Tiara Amelia, Fatmawati Nurlin, Asri C. Adisasmita
Clin Exp Pediatr. 2020;63(11):433-437.   Published online July 21, 2020
Question: What are health providers’ knowledge and perceptions of Kangaroo mother care (KMC)?
Finding: Health providers’ knowledge of KMC was sufficient; however, some of their perceptions about it could create barriers to the successful implementation of hospital KMC programs.
Meaning: Health providers’ perceptions about KMC should be considered to ensure successful KMC implementation. Locally designed on-site training programs could overcome the challenges.
Review Article
Neurology
Health effects of electromagnetic fields on children
Jin-Hwa Moon
Clin Exp Pediatr. 2020;63(11):422-428.   Published online May 26, 2020
· The nervous systems of children are more vulnerable to the effects of electromagnetic waves than adults.
· The exposure to electromagnetic fields (EMFs) among children should be minimized.
· According to International Agency for Research on Cancer EMFs are possibly carcinogenic, it should not be overlooked or interpreted with bias.
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...
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