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Review Article
Neonatology (Perinatology)
Bronchopulmonary dysplasia: how can we improve its outcomes?
Tae-Jung Sung
Clin Exp Pediatr. 2019;62(10):367-373.   Published online May 17, 2019
Bronchopulmonary dysplasia (BPD) is a chronic lung disease of preterm infants with multiple factors affected from prenatal to postnatal periods. Despite significant advances in neonatal care over almost 50 years, BPD rates have not decreased; in fact, they may have even increased. Since more preterm infants, even at periviable gestational age, survive today, different stages of lung development affect the...
Practice for preterm patent ductus arteriosus; focusing on the hemodynamic significance and the impact on the neonatal outcomes
Jin A Lee
Clin Exp Pediatr. 2019;62(7):245-251.   Published online April 8, 2019
Hemodynamically significant preterm patent ductus arteriosus (PDA) affects mortality; comorbidities such as necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia; and adverse long-term neurodevelopmental outcomes in preterm infants, particularly in very low birth weight infants. However, recent studies have indicated that there is no consensus on the causal relationship between PDA and neonatal outcomes, the benefit of PDA treatment, the factors...
Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future
Ga Won Jeon
Clin Exp Pediatr. 2019;62(5):155-161.   Published online February 8, 2019
Following the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. Synthetic surfactants were designed to overcome limitations of natural surfactants such as cost, immune reactions, and infections elicited by animal proteins contained in natural surfactants. However, first-generation synthetic surfactants...
Nutrition
A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan Vandenplas, Zakiudin Munasir, Badriul Hegar, Dewi Kumarawati, Ahmad Suryawan, Muzal Kadim, Julistio Tb Djais, Ray Wagiu Basrowi, Deni Krisnamurti
Clin Exp Pediatr. 2019;62(5):149-154.   Published online January 14, 2019
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option...
Infection
Central line-associated bloodstream infections in neonates
Hye Jung Cho, Hye-Kyung Cho
Clin Exp Pediatr. 2019;62(3):79-84.   Published online December 19, 2018
Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central...
Original Article
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...
Evaluation of prolonged pain in preterm infants with pneumothorax using heart rate variability analysis and EDIN (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) scores
Mehmet Buyuktiryaki, Nurdan Uras, Nilufer Okur, Mehmet Yekta Oncel, Gulsum Kadioglu Simsek, Sehribanu Ozluer Isik, Serife Suna Oguz
Clin Exp Pediatr. 2018;61(10):322-326.   Published online September 16, 2018

Purpose: The EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement...
Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants
Ji Won Koh, Jong-Wan Kim, Young Pyo Chang
Clin Exp Pediatr. 2018;61(10):315-321.   Published online September 16, 2018

Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal...
Infection
Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age
In Sul Lee, Young Jin Park, Mi Hyeon Jin, Ji Young Park, Hae Jeong Lee, Sung Hoon Kim, Ju Suk Lee, Cheol Hong Kim, Young Don Kim, Jun Hwa Lee
Clin Exp Pediatr. 2018;61(9):285-290.   Published online September 15, 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics...
Neonatology (Perinatology)
Oral findings and its association with prenatal and perinatal factors in newborns
Brenda Perez-Aguirre, Uriel Soto-Barreras, Juan Pablo Loyola-Rodriguez, Juan Francisco Reyes-Macias, Miguel Angel Santos-Diaz, Alejandra Loyola-Leyva, Obed Garcia-Cortes
Clin Exp Pediatr. 2018;61(9):279-284.   Published online September 15, 2018

Purpose: This study aimed to determine the frequency of abnormalities in the newborn oral cavity and to evaluate the association with prenatal and perinatal factors. Methods: This cross-sectional study evaluated 2,216 newborns. Oral findings were assessed in the first 24 hours of life using visual examination. Sex, weight, length, gestational age, and medical disorders at birth were recorded. Maternal demographic and...
The impact of a quality improvement effort in reducing admission hypothermia in preterm infants following delivery
Han Saem Choi, Soon Min Lee, Hoseon Eun, Minsoo Park, Kook-In Park, Ran Namgung
Clin Exp Pediatr. 2018;61(8):239-244.   Published online August 15, 2018

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the...
Neurology
Outcome of ultrasonographic imaging in infants with sacral dimple
Jin Hyuk Choi, Taekwan Lee, Hyeok Hee Kwon, Sun Kyoung You, Joon Won Kang
Clin Exp Pediatr. 2018;61(6):194-199.   Published online June 25, 2018
Purpose

Sacral dimples are a common cutaneous anomaly in infants. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. The aim of this study was to determine the clinical manifestations in patients with an isolated sacral dimple and to review the management of spinal cord abnormalities identified with USG.

Methods

We reviewed clinical records and collected...

Long-term prenatal stress increases susceptibility of N-methyl-D-aspartic acid-induced spasms in infant rats
Hyeok Hee Kwon, Taekwan Lee, Jinpyo Hong, Dong Woon Kim, Joon Won Kang
Clin Exp Pediatr. 2018;61(5):150-155.   Published online May 28, 2018
Purpose

Infantile spasms, also known as West syndrome, is an age-specific epileptic seizure. Most patients with this condition also exhibit delayed development. This study aimed to determine the effect of long-term prenatal stress on susceptibility to infantile spasms.

Methods

We subjected pregnant rats to acute or chronic immobilization stress. Resulting offspring received N-methyl-D-aspartic acid (15 mg/kg, intraperitoneally) on postnatal day 15, and their...

Review Article
Neurology
Epilepsy syndromes during the first year of life and the usefulness of an epilepsy gene panel
Eun Hye Lee
Clin Exp Pediatr. 2018;61(4):101-107.   Published online April 23, 2018

Recent advances in genetics have determined that a number of epilepsy syndromes that occur in the first year of life are associated with genetic etiologies. These syndromes range from benign familial epilepsy syndromes to early-onset epileptic encephalopathies that lead to poor prognoses and severe psychomotor retardation. An early genetic diagnosis can save time and overall cost by reducing the amount...

Original Article
Neonatology (Perinatology)
Augmentation of respiratory muscle activities in preterm infants with feeding desaturation
Dong Rak Kwon, Gi Young Park, Ji Eun Jeong, Woo Taek Kim, Eun Joo Lee
Clin Exp Pediatr. 2018;61(3):78-83.   Published online March 19, 2018
Purpose

Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in...

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...

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
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...

Review Article
Neonatology (Perinatology)
Fetal and preterm infant microbiomes: a new perspective of necrotizing enterocolitis
Yong-Sung Choi, In Gyu Song
Clin Exp Pediatr. 2017;60(10):307-311.   Published online October 20, 2017

Necrotizing enterocolitis (NEC) is a devastating condition of hospitalized preterm infants. Numerous studies have attempted to identify the cause of NEC by examining the immunological features associated with pathogenic microorganisms. No single organism has proven responsible for the disease; however, immunological studies are now focused on the microbiome. Recent research has investigated the numerous bacterial species residing in the body...

Original Article
Pulmonology
Comparison of cytokine expression profiles in infants with a rhinovirus induced lower respiratory tract infection with or without wheezing: a comparison with respiratory syncytial virus
Da Eun Roh, Sook-Hyun Park, Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2017;60(9):296-301.   Published online September 21, 2017
Purpose

The aim of this study was to evaluate whether infants with rhinovirus (RV) infection-induced wheezing and those with respiratory syncytial virus (RSV) infection-induced wheezing have different cytokine profiles in the acute stage.

Methods

Of the infants with lower respiratory tract infection (LRTI) between September 2011 and May 2012, 88 were confirmed using reverse transcription polymerase chain reaction and hospitalized. Systemic interferon-gamma (IFN-γ),...

Neonatology (Perinatology)
Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants
Birgul Say, Nurdan Uras, Suzan Sahin, Halil Degirmencioglu, Serife Suna Oguz, Fuat Emre Canpolat
Clin Exp Pediatr. 2017;60(8):248-253.   Published online August 14, 2017
Purpose

Vitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants.

Methods

One hundred seventeen premature...

Individualized ibuprofen treatment using serial B-type natriuretic peptide measurement for symptomatic patent ductus arteriosus in very preterm infants
Jeonghee Shin, Eun Hee Lee, Jee Hyun Lee, Byung Min Choi, Young Sook Hong
Clin Exp Pediatr. 2017;60(6):175-180.   Published online June 22, 2017
Purpose

Plasma level of B-type natriuretic peptide (BNP), an emerging, sensitive, and specific biomarker of hemodynamically significant patent ductus arteriosus (PDA), rapidly decreases in infants receiving cyclooxygenase inhibitors for ductal closure. We investigated the usefulness of serial BNP measurement as a guide for individual identification of early constrictive responses to ibuprofen in preterm infants with symptomatic PDA (sPDA).

Methods

Before March 2010, the...

Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study
Min Sun Kim, In Gyu Song, Ah Reum An, Kyae Hyung Kim, Ji Hoon Sohn, Sei Won Yang
Clin Exp Pediatr. 2017;60(5):138-144.   Published online May 31, 2017
Purpose

Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services.

Methods

We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015....

Nutrition
Maternal food restrictions during breastfeeding
Goun Jeong, Sung Won Park, Yeon Kyung Lee, Sun Young Ko, Son Moon Shin
Clin Exp Pediatr. 2017;60(3):70-76.   Published online March 27, 2017
Purpose

This study investigated self-food restriction during breastfeeding, reviewed the literature showing the effect of maternal diet on the health of breast-fed infants, and explored the validity of dietary restrictions.

Methods

Questionnaire data were collected from breastfeeding Korean mothers who visited the pediatric clinic of Cheil General Hospital & Women's Healthcare Center from July 2015 through August 2015. The survey included items assessing...

Neonatology (Perinatology)
Postdischarge growth assessment in very low birth weight infants
Joon-Sik Park, Jungho Han, Jeong Eun Shin, Soon Min Lee, Ho Seon Eun, Min-Soo Park, Kook-In Park, Ran Namgung
Clin Exp Pediatr. 2017;60(3):64-69.   Published online March 27, 2017
Purpose

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved.

Methods

We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24...

The influencing factors on procalcitonin values in newborns with noninfectious conditions during the first week of life
Jueseong Lee, Yong Hyeon Bang, Eun Hee Lee, Byung Min Choi, Young Sook Hong
Clin Exp Pediatr. 2017;60(1):10-16.   Published online January 16, 2017
Purpose

Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life.

Methods

In newborns hospitalized between March 2013 and October 2015, PCT levels...

Neurology
Single-center experience of the Korean-Developmental Screening Test for infants and children
Chae-Ri Suh, Su Ye Sohn, Gun-Ha Kim, Seong-Kwan Jung, Baik-Lin Eun
Clin Exp Pediatr. 2016;59(12):483-489.   Published online December 31, 2016
Purpose

We investigated the number of test takers of the Korean-Developmental Screening Test (K-DST) in a single children's hospital within a year, according to age, referral rate, and follow-up percentage.

Methods

For this study, 4,062 children who visited and received K-DST at Woorisoa Children's Hospital between January and December 2015 were enrolled. Seven test sets were used according to the Korean National Health...

Review Article
Neonatology (Perinatology)
Enteral nutrition for optimal growth in preterm infants
Myo-Jing Kim
Clin Exp Pediatr. 2016;59(12):466-470.   Published online December 31, 2016

Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the...

Infection
Recommended immunization schedule for children and adolescents: Immunization Guideline (8th edition) released by the Korean Pediatric Society in 2015
Jong-Hyun Kim, Eun Hwa Choi, Su Eun Park, Yae-Jean Kim, Dae Sun Jo, Yun-Kyung Kim, Byung-Wook Eun, Jina Lee, Soo-Young Lee, Hyunju Lee, Ki Hwan Kim, Kyung-Hyo Kim
Clin Exp Pediatr. 2016;59(12):461-465.   Published online December 31, 2016

This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the...

Case Report
Cardiology
Anomalous right coronary artery from pulmonary artery discovered incidentally in an asymptomatic young infant
Kyu Seon Kim, Eun Young Jo, Jae Hyeon Yu, Hong Rang Kil
Clin Exp Pediatr. 2016;59(Suppl 1):S80-S83.   Published online November 30, 2016

Isolated anomalous right coronary artery originating from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that is asymptomatic and discovered incidentally in most cases. ARCAPA is generally not considered a fatal defect in infancy or childhood, although cases of sudden death have been reported. Here, we report a 2-month-old female infant who presented with a prolonged fever that...



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