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Review Article
Neonatology (Perinatology)
Quantifying myelin in neonates using magnetic resonance imaging: a systematic literature review
Nabila Hanem Arshad, Hasyma Abu Hassan, Nur Farhayu Omar, Zurina Zainudin
Clin Exp Pediatr. 2024;67(8):371-385.   Published online December 6, 2023
Question: This systematic review attempts to discover the best magnetic resonance imaging (MRI) technique for myelin quantification in neonates by evaluating various MRI parameters and their reproducibility.
Finding: Since the benefits of using synthetic MRI for quantifying myelin in neonates outweigh the very minor draw- backs, it is recommended.
Meaning: The findings suggest the importance of identifying noninvasive MRI techniques available to assess myelin tissue in neonates, which aid in diagnosing neurodevelopmental disorders.
Neurology
Gut microbiota affects brain development and behavior
Gun-Ha Kim, Jung-Ok Shim
Clin Exp Pediatr. 2023;66(7):274-280.   Published online November 8, 2022
· The gut microbiota can alter a host’s brain development and behavior.
· Gut bacteria communicate with the brain via the microbiota-gut-brain axis.
· Fecal microbial transplantation is a promising treatment strategy for autism spectrum disorder.
Cognitive outcomes in late childhood and adolescence of neonatal hypoxic-ischemic encephalopathy
Bo Lyun Lee, Hannah C. Glass
Clin Exp Pediatr. 2021;64(12):608-618.   Published online May 24, 2021
∙ Cognitive impairments occur in children with hypoxic-ischemic encephalopathy (HIE) even without neuromotor deficits.
∙ Therapeutic hypothermia has improved neurodevelopmental outcomes of children with HIE; however, 40% of children remain at risk of death/disability or cognitive impairments necessitating the development of adjunctive neuroprotective therapies.
∙ Long-term follow-up until adolescence is required to identify cognitive dysfunction.
∙ A pattern of watershed injury on brain imaging is associated with poor cognitive outcomes.
Original Article
Neonatology (Perinatology)
Effects of carnosine and hypothermia combination therapy on hypoxic-ischemic brain injury in neonatal rats
Jun Chul Byun, Seong Ryong Lee, Chun Soo Kim
Clin Exp Pediatr. 2021;64(8):422-428.   Published online February 24, 2021
Question: How can we further improve the neuroprotective effects of hypothermia in newborns with hypoxic-ischemic (HI) brain injury?
Finding: Combination carnosine and hypothermia therapy effectively reduced brain damage in neonatal rats. The in situ zymography, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunofluorescence study results showed that neuroprotective effects were achieved with combination therapy only.
Meaning: Carnosine and hypothermia have synergistic neuroprotective effects against brain damage following HI injury
Predictive factors of death in neonates with hypoxic-ischemic encephalopathy receiving selective head cooling
Behnaz Basiri, Mohammadkazem Sabzehei, Mohammadmahdi sabahi
Clin Exp Pediatr. 2021;64(4):180-187.   Published online August 27, 2020
Question: What is the most important factor that increases mortality in infants with hypoxic-ischemic encephalopathy (HIE) who receive selective head cooling?
Finding: All cases of neonatal mortality were severe HIE (stage 3), and a severely abnormal amplitude-integrated electroencephalography and mortality were increased with the need for advanced neonatal resuscitation upon delivery.
Meaning: Advanced neonatal resuscitation affects HIE outcomes, and medical personnel should be prepared to provide the best intervention.
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...
Patterns of ischemic injury on brain images in neonatal group B Streptococcal meningitis
Seo Yeol Choi, Jong-Wan Kim, Ji Won Ko, Young Seok Lee, Young Pyo Chang
Clin Exp Pediatr. 2018;61(8):245-252.   Published online August 15, 2018

Purpose: This study investigated patterns of ischemic injury observed in brain images from patients with neonatal group B Streptococcal (GBS) meningitis. Methods: Clinical findings and brain images from eight term or near-term newborn infants with GBS meningitis were reviewed. Results: GBS meningitis was confirmed in all 8 infants via cerebrospinal fluid (CSF) analysis, and patients tested positive for GBS in both blood and CSF cultures....
Cardiology
Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide
Jung Eun Choi, Yujin Kwak, Jung Won Huh, Eun-Sun Yoo, Kyung-Ha Ryu, Sejung Sohn, Young Mi Hong
Clin Exp Pediatr. 2018;61(5):167-173.   Published online May 28, 2018
Purpose

Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with many causes, including Kawasaki disease (KD). The purpose of this study was to identify the laboratory tests needed to easily differentiate KD with HLH from incomplete KD alone.

Methods

We performed a retrospective study on patients diagnosed with incomplete KD and incomplete KD with HLH (HLH-KD) between January 2012 and March 2015. We compared...

Neonatology (Perinatology)
Neuroprotective effects of erythropoietin against hypoxic injury via modulation of the mitogen-activated protein kinase pathway and apoptosis
Ji Eun Jeong, Jae Hyun Park, Chun Soo Kim, Sang Lak Lee, Hai Lee Chung, Woo Taek Kim, Eun Joo Lee
Clin Exp Pediatr. 2017;60(6):181-188.   Published online June 22, 2017
Purpose

Hypoxic-ischemic encephalopathy is a significant cause of neonatal morbidity and mortality. Erythropoietin (EPO) is emerging as a therapeutic candidate for neuroprotection. Therefore, this study was designed to determine the neuroprotective role of recombinant human EPO (rHuEPO) and the possible mechanisms by which mitogen-activated protein kinase (MAPK) signaling pathway including extracellular signal-regulated kinase (ERK1/2), JNK, and p38 MAPK is modulated in...

Cardiology
Predictive factors of resistance to intravenous immunoglobulin and coronary artery lesions in Kawasaki disease
Hye Young Lee, Min Seob Song
Clin Exp Pediatr. 2016;59(12):477-482.   Published online December 31, 2016
Purpose

We conducted a study to determine which factors may be useful as predictive markers in identifying Kawasaki disease (KD) patients with a high risk of resistance to intravenous immunoglobulin (IVIG) and developing coronary artery lesions (CAL).

Methods

We enrolled 287 patients in acute phase of KD at a single center. The demographic, clinical and laboratory data were collected retrospectively.

Results

There were 34 patients...

Neurology
Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia
Sun Young Seo, Gyu Hong Shim, Myoung Jae Chey, Su Jeong You
Clin Exp Pediatr. 2016;59(11):440-445.   Published online November 18, 2016
Purpose

This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia.

Methods

All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2...

Review Article
Neurology
Enterovirus 71 infection and neurological complications
Kyung Yeon Lee
Clin Exp Pediatr. 2016;59(10):395-401.   Published online October 17, 2016

Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children,...

Original Article
Neurology
Venous angioma may be associated with epilepsy in children
Bo Ryung Kim, Yun Jin Lee, Sang Ook Nam, Kyung Hee Park
Clin Exp Pediatr. 2016;59(8):341-345.   Published online August 24, 2016
Purpose

Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy.

Methods

The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients...

Uveitis as an important ocular sign to help early diagnosis in Kawasaki disease
Han Seul Choi, Seul Bee Lee, Jung Hyun Kwon, Hae Soon Kim, Sejung Sohn, Young Mi Hong
Clin Exp Pediatr. 2015;58(10):374-379.   Published online October 21, 2015
Purpose

Incomplete Kawasaki disease (KD) is frequently associated with delayed diagnosis and treatment. Delayed diagnosis leads to increasing risk of coronary artery aneurysm. Anterior uveitis is an important ocular sign of KD. The purpose of this study was to assess differences in laboratory findings, including echocardiographic measurements, clinical characteristics such as fever duration and treatment responses between KD patients with and...

Case Report
Hemophagocytic lymphohistiocytosis diagnosed by brain biopsy
Hee Young Ju, Che Ry Hong, Sung Jin Kim, Ji Won Lee, Hyery Kim, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin, Jong-Hee Chae, Ji Hoon Phi, Jung-Eun Cheon, Sung-Hye Park, Hyo Seop Ahn
Clin Exp Pediatr. 2015;58(9):358-361.   Published online September 21, 2015

Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, splenomegaly, jaundice, and pathologic findings of hemophagocytosis in bone marrow or other tissues such as the lymph nodes and liver. Pleocytosis, or the presence of elevated protein levels in cerebrospinal fluid, could be helpful in diagnosing HLH. However, the pathologic diagnosis of the brain is not included in the diagnostic criteria for this...

Parry-Romberg syndrome with ipsilateral hemipons involvement presenting as monoplegic ataxia
Yun-Jin Lee, Kee-Yang Chung, Hoon-Chul Kang, Heung Dong Kim, Joon Soo Lee
Clin Exp Pediatr. 2015;58(9):354-357.   Published online September 21, 2015

Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the...

Original Article
Neuroprotective effects of mild hypoxia in organotypic hippocampal slice cultures
Seh Hyun Kim, Woo Soon Lee, Na Mi Lee, Soo Ahn Chae, Sin Weon Yun
Clin Exp Pediatr. 2015;58(4):142-147.   Published online April 22, 2015
Purpose

The aim of this study was to investigate the potential effects of mild hypoxia in the mature and immature brain.

Methods

We prepared organotypic slice cultures of the hippocampus and used hippocampal tissue cultures at 7 and 14 days in vitro (DIV) to represent the immature and mature brain, respectively. Tissue cultures were exposed to 10% oxygen for 60 minutes. Twenty-four hours...

Diencephalic syndrome: a frequently neglected cause of failure to thrive in infants
Ahlee Kim, Jin Soo Moon, Hye Ran Yang, Ju Young Chang, Jae Sung Ko, Jeong Kee Seo
Clin Exp Pediatr. 2015;58(1):28-32.   Published online January 31, 2015
Purpose

Diencephalic syndrome is an uncommon cause of failure to thrive in early childhood that is associated with central nervous system neoplasms in the hypothalamic-optic chiasmatic region. It is characterized by complex signs and symptoms related to hypothalamic dysfunction; such nonspecific clinical features may delay diagnosis of the brain tumor. In this study, we analyzed a series of cases in order...

Effect of adenotonsillar hypertrophy on right ventricle function in children
Jin Hwan Lee, Jung Min Yoon, Jae Woo Lim, Kyung Og Ko, Seong Jun Choi, Jong-Yeup Kim, Eun Jung Cheon
Clin Exp Pediatr. 2014;57(11):484-488.   Published online November 30, 2014
Purpose

Chronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH.

Methods

Twenty-one children (male/female, 15/6; mean age, 92.3¡¾39.0 months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched...

Case Report
Overlapping Guillain-Barré syndrome and Bickerstaff's brainstem encephalitis associated with Epstein Barr virus
Young Il Rho
Clin Exp Pediatr. 2014;57(10):457-460.   Published online October 31, 2014

A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed to be a sign of overlapping Guillain-Barré syndrome (GBS). In addition, BBE and Fisher syndrome, which are clinically similar and are both associated with the presence of the immunoglobulin G anti-GQ1b antibody, represent a specific autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia and ataxia. A 2-year-old...

Review Article
Advancements in the treatment of pediatric acute leukemia and brain tumor - continuous efforts for 100% cure
Hee Young Ju, Che Ry Hong, Hee Young Shin
Clin Exp Pediatr. 2014;57(10):434-439.   Published online October 31, 2014

Treatment outcomes of pediatric cancers have improved greatly with the development of improved treatment protocols, new drugs, and better supportive measures, resulting in overall survival rates greater than 70%. Survival rates are highest in acute lymphoblastic leukemia, reaching more than 90%, owing to risk-based treatment through multicenter clinical trials and protocols developed to prevent central nervous system relapse and testicular...

Original Article
Clinical characteristics and serum N-terminal pro-brain natriuretic peptide as a diagnostic marker of Kawasaki disease in infants younger than 3 months of age
Hyun Kyung Bae, Do Kyung Lee, Jung Hyun Kwon, Hae Soon Kim, Sejung Sohn, Young Mi Hong
Clin Exp Pediatr. 2014;57(8):357-362.   Published online August 25, 2014
Purpose

The incidence of Kawasaki disease (KD) is rare in young infants (less than 3 months of age), who present with only a few symptoms that fulfill the clinical diagnostic criteria. The diagnosis for KD can therefore be delayed, leading to a high risk of cardiac complications. We examined the clinical characteristics and measured the serum levels of N-terminal pro-brain natriuretic...

Review Article
Oxidative stress and the antioxidant enzyme system in the developing brain
So-Yeon Shim, Han-Suk Kim
Clin Exp Pediatr. 2013;56(3):107-111.   Published online March 18, 2013

Preterm infants are vulnerable to the oxidative stress due to the production of large amounts of free radicals, antioxidant system insufficiency, and immature oligodendroglial cells. Reactive oxygen species (ROS) play a pivotal role in the development of periventricular leukomalacia. The three most common ROS are superoxide (O2•-), hydroxyl radical (OH), and hydrogen peroxide (H2O2). Under normal physiological conditions, a balance...

Original Article
Log-transformed plasma level of brain natriuretic peptide during the acute phase of Kawasaki disease is quantitatively associated with myocardial dysfunction
Sunhee Bang, Jeong Jin Yu, Myung-Ki Han, Hong Ki Ko, Sail Chun, Hyung Soon Choi, Young-Hwue Kim, Jae-Kon Ko, In-Sook Park
Clin Exp Pediatr. 2011;54(8):340-344.   Published online August 31, 2011
Purpose

Brain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance.

Methods

We attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration.

Results

Serum C-reactive...

The neuroprotective effect of recombinant human erythropoietin via an antiapoptotic mechanism on hypoxic-ischemic brain injury in neonatal rats
Moon Sun Kim, Yoo Kyung Seo, Hye Jin Park, Kye Hyang Lee, Kyung Hoon Lee, Eun Jin Choi, Jin Kyung Kim, Hai Lee Chung, Woo Taek Kim
Clin Exp Pediatr. 2010;53(10):898-908.   Published online October 31, 2010
Purpose

The neuroprotective effects of erythropoietin (EPO) have been recently shown in many animal models of brain injury, including hypoxic-ischemic (HI) encephalopathy, trauma, and excitotoxicity; however, limited data are available for such effects during the neonatal periods. Therefore, we investigated whether recombinant human EPO (rHuEPO) can protect against perinatal HI brain injury via an antiapoptotic mechanism.

Methods

The left carotid artery was ligated...

Review Article
Pulmonary hypertension in infants with bronchopulmonary dysplasia
Gi Beom Kim
Clin Exp Pediatr. 2010;53(6):688-693.   Published online June 23, 2010

An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type...

Original Article
Brain abscess in Korean children: A 15-year single center study
Cha Gon Lee, Seong Hun Kang, Yae Jean Kim, Hyung Jin Shin, Hyun Shin Choi, Jee Hun Lee, Mun Hyang Lee
Clin Exp Pediatr. 2010;53(5):648-652.   Published online May 31, 2010
Purpose

A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses.

Methods

A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea.

Results

Twenty-five patients were included in this study. On average, 1.67 cases...

Case Report
A case of Bickerstaff's brainstem encephalitis in childhood
Ji Youn Kim, Young Ok Kim, Young Jun Son, Young Jong Woo
Clin Exp Pediatr. 2010;53(4):607-611.   Published online April 15, 2010
Bickerstaff's brainstem encephalitis (BBE) is a rare disease diagnosed by specific clinical features such as 'progressive, relatively symmetric external ophthalmoplegia and ataxia by 4 weeks' and 'disturbance of consciousness or hyperreflexia' after the exclusion of other diseases involving the brain stem. Anti-ganglioside antibodies (GM, GD and GQ) in the serum or cerebrospinal fluid (CSF) are sometimes informative for the diagnosis...
Original Article
Taurine exerts neuroprotective effects via anti-apoptosis in hypoxic-ischemic brain injury in neonatal rats
Ji Eun Jeong, Tae Yeol Kim, Hye Jin Park, Kye Hyang Lee, Kyung Hoon Lee, Eun Jin Choi, Jin Kyung Kim, Hai Lee Chung, Eok Su Seo, Woo Taek Kim
Clin Exp Pediatr. 2009;52(12):1337-1347.   Published online December 15, 2009
Purpose : Taurine (2-aminoethanesulfonic acid) is a simple sulfur-containing amino acid. It is abundantly present in tissues such as brain, retina, heart, and skeletal muscles. Current studies have demonstrated the neuroprotective effects of taurine, but limited data are available for such effects during neonatal period. The aim of this study was to determine whether taurine could reduce hypoxic-ischemic (HI) cerebral...
Review Article
Brain death and organ transplantation
Sang-Ook Nam
Clin Exp Pediatr. 2009;52(8):856-861.   Published online August 15, 2009
Cardiopulmonary arrest has long been accepted as an unquestionable definition of death. An advent of cardiopulmonary resuscitation and artificial ventilation along with the development of organ transplantation has prompted the emergence of the concept of brain death. The criteria for brain death are based mainly on the clinical examination of coma, apnea and total loss of brain stem function. Although organ transplantation by...