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Review Article
Hearing loss in neonates and infants
Goun Choe, Su-Kyoung Park, Bong Jik Kim
Hearing in neonates and infants is crucial for their development of language and communication skills. Unless hearing loss is appropriately managed early, it can cause a significant socioeconomic burden considering its detrimental impact on the child's development and its common nature. It is also the most common congenital sensory deficit, with an approximate incidence of 1.5 per 1000 newborns. Its...
Neonatology (Perinatology)
Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
Ga Won Jeon
Clin Exp Pediatr. 2022;65(4):182-187.   Published online October 18, 2021
· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations.
· Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age.
· Platelet counts are positively correlated with gestational age at birth and postnatal age.
· Thrombocytosis is more common in preterm than in term infants.
· Thrombocytosis in newborns is reactive and resolves spontaneously without complications.
Original Article
Neonatology (Perinatology)
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.
Review Article
Infection
Epidemiology and clinical features of coronavirus disease 2019 in children
Soo-Han Choi, Han Wool Kim, Ji-Man Kang, Dong Hyun Kim, Eun Young Cho
Clin Exp Pediatr. 2020;63(4):125-132.   Published online April 6, 2020
Coronavirus disease-2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates...
Original Article
Neonatology (Perinatology)
Effectiveness of various nonpharmacological analgesic methods in newborns
Pancham Kumar, Rakesh Sharma, Sukhdev Rathour, Sunidhi Karol, Mohit Karol
Clin Exp Pediatr. 2020;63(1):25-29.   Published online August 16, 2019
Question: Can nonpharmacological methods be used for neonatal pain management.
Finding: Nonpharmacological methods like Sucrose, breastfeeding etc have shown to significantly reduce the pain caused by intramuscular hepatitis B vaccination.
Meaning: Nonpharmacological methods are the safe and cheap potential modalities of analgesia which can be used during mild to moderate pain in newborns.
Review Article
Neonatology (Perinatology)
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...
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...
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...
Cardiology
Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center
Tae Kyoung Jo, Hyo Rim Suh, Bo Geum Choi, Jung Eun Kwon, Hanna Jung, Young Ok Lee, Joon Yong Cho, Yeo Hyang Kim
Clin Exp Pediatr. 2018;61(7):210-216.   Published online July 15, 2018

Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty...
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
Neonatology (Perinatology)
Hearing loss screening tool (COBRA score) for newborns in primary care setting
Watcharapol Poonual, Niramon Navacharoen, Jaran Kangsanarak, Sirianong Namwongprom, Surasak Saokaew
Clin Exp Pediatr. 2017;60(11):353-358.   Published online November 27, 2017
Purpose

To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool.

Methods

This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary...

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
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...

Case Report
Infection
Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness
Jung Sook Yeom, Ji Sook Park, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn, Ok Jeong Lee, Tae-Hee Han, Ju-Young Chung
Clin Exp Pediatr. 2016;59(7):308-311.   Published online July 31, 2016

We report a human parechovirus-3 (HPeV-3) infection in 2 neonates who had prolonged fever (>5 days) with palmar-plantar erythema. This distinctive rash was observed 4–5 days after fever onset, just before defervescence. Elevated aspartate aminotransferase, lactate dehydrogenase, and ferritin levels were characteristic laboratory findings in the 2 cases, suggesting tissue damage caused by hypercytokinemia. Case 1 was treated with intravenous...

Review Article
Neurology
White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?
Jung Sook Yeom, Chan-Hoo Park
Clin Exp Pediatr. 2016;59(7):285-291.   Published online July 31, 2016

That rotavirus infection can cause neurological symptoms in young children has been well established. However, it is surprising why rotavirus infection has been overlooked as a cause of neonatal seizures for many years, despite significant research interest in neonatal rotavirus infection. Neonates are the age group most vulnerable to seizures, which are typically attributed to a wide range of causes....

Original Article
Cardiology
Infantile Marfan syndrome in a Korean tertiary referral center
Yeon Jeong Seo, Ko-Eun Lee, Gi Beom Kim, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
Clin Exp Pediatr. 2016;59(2):59-64.   Published online February 29, 2016
Purpose

Infantile Marfan syndrome (MFS) is a rare congenital inheritable connective tissue disorder with poor prognosis. This study aimed to evaluate the cardiovascular manifestations and overall prognosis of infantile MFS diagnosed in a tertiary referral center in Korea.

Methods

Eight patients diagnosed with infantile MFS between 2004 and 2014 were retrospectively evaluated.

Results

Their median age at the time of diagnosis was 2.5 months (range,...

Neonatology (Perinatology)
Clinical features of Bednar's aphthae in infants
Seung-Woo Nam, Seol Hee Ahn, Son-Moon Shin, Goun Jeong
Clin Exp Pediatr. 2016;59(1):30-34.   Published online January 22, 2016
Purpose

Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae.

Methods

Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters...

Case Report
A novel association between cerebral sinovenous thrombosis and nonketotic hyperglycinemia in a neonate
Sadık Yurttutan, Mehmet Yekta Oncel, Nursel Yurttutan, Halil Degirmencioglu, Nurdan Uras, Ugur Dilmen
Clin Exp Pediatr. 2015;58(6):230-233.   Published online June 22, 2015

Lethargy in newborns usually indicates central nervous system dysfunction, and many conditions such as cerebrovascular events, infections, and metabolic diseases should be considered in the differential diagnosis. Nonketotic hyperglycinemia is an autosomal recessive error of glycine metabolism, characterized by myoclonic jerks, hypotonia, hiccups, apnea, and progressive lethargy that may progress to encephalopathy or even death. Cerebral sinovenous thrombosis is a...

Asymptomatic maternal 3-methylcrotonylglycinuria detected by her unaffected baby's neonatal screening test
Sun Hee Lee, Yong Hee Hong
Clin Exp Pediatr. 2014;57(7):329-332.   Published online July 23, 2014

3-methylcrotonyl-coenzyme A carboxylase (3MCC) deficiency is an autosomal recessive disorder in which leucine catabolism is hampered, leading to increased urinary excretion of 3-methylcrotonylglycine. In addition, 3-hydroxyisovalerylcarnitine levels increase in the blood, and the elevated levels form the basis of neonatal screening. 3MCC deficiency symptoms are variable, ranging from neonatal onset with severe neurological abnormality to a normal, asymptomatic phenotype. Although...

Review Article
Genetic risk factors associated with respiratory distress syndrome
Heui Seung Jo
Clin Exp Pediatr. 2014;57(4):157-163.   Published online April 30, 2014

Respiratory distress syndrome (RDS) among preterm infants is typically due to a quantitative deficiency of pulmonary surfactant. Aside from the degree of prematurity, diverse environmental and genetic factors can affect the development of RDS. The variance of the risk of RDS in various races/ethnicities or monozygotic/dizygotic twins has suggested genetic influences on this disorder. So far, several specific mutations in...

Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
Young Pyo Chang
Clin Exp Pediatr. 2014;57(3):101-109.   Published online March 31, 2014

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic...

Original Article
Clinical features of macrocephaly at birth in Korea
Goun Jeong, Minkyun Kim, Byoung Hee Han
Clin Exp Pediatr. 2014;57(2):75-78.   Published online February 24, 2014
Purpose

This study aimed to investigate the clinical features of macrocephaly at birth in Korea using ultrasonography.

Methods

We retrospectively investigated the medical records of full-term birth neonates in Cheil General Hospital & Women's Healthcare Center from January 2000 to June 2012. The following parameters were recorded and analyzed: gestational age, sex, birth weight, height, occipitofrontal circumference (OFC), physical examination, perinatal problems, and...

Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern
Sameh Samir Fahmey
Clin Exp Pediatr. 2013;56(8):332-337.   Published online August 27, 2013
Purpose

To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern.

Methods

A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors...

Case Report
A case of mucolipidosis II presenting with prenatal skeletal dysplasia and severe secondary hyperparathyroidism at birth
Ju Sun Heo, Ka Young Choi, Se Hyoung Sohn, Curie Kim, Yoon Joo Kim, Seung Han Shin, Jae Myung Lee, Juyoung Lee, Jin A Sohn, Byung Chan Lim, Jin A Lee, Chang Won Choi, Ee-Kyung Kim, Han-Suk Kim, Beyong Il Kim, Jung-Hwan Choi
Clin Exp Pediatr. 2012;55(11):438-444.   Published online November 23, 2012

Mucolipidosis II (ML II) or inclusion cell disease (I-cell disease) is a rarely occurring autosomal recessive lysosomal enzyme-targeting disease. This disease is usually found to occur in individuals aged between 6 and 12 months, with a clinical phenotype resembling that of Hurler syndrome and radiological findings resembling those of dysostosis multiplex. However, we encountered a rare case of an infant...

Original Article
Birth statistics of high birth weight infants (macrosomia) in Korea
Byung-Ho Kang, Joo-Young Moon, Sung-Hoon Chung, Yong-Sung Choi, Kyung-Suk Lee, Ji-Young Chang, Chong-Woo Bae
Clin Exp Pediatr. 2012;55(8):280-285.   Published online August 23, 2012
Purpose

The authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs) over 50 years in Korea from 1960 to 2010.

Methods

We used 2 data sources, namely, the hospital units (1960's to 1990's) and Statistics Korea (1993 to 2010). The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal...

Review Article
Regionalization of neonatal intensive care in Korea
Yun Sil Chang
Clin Exp Pediatr. 2011;54(12):481-488.   Published online December 31, 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report,...

Case Report
Acute treatment of hyperammonemia by continuous renal replacement therapy in a newborn patient with ornithine transcarbamylase deficiency
Hyo Jeong Kim, Se Jin Park, Kook In Park, Jin Sung Lee, Ho Sun Eun, Ji Hong Kim, Jae Il Shin
Clin Exp Pediatr. 2011;54(10):425-428.   Published online October 31, 2011

Ornithine transcarbamylase (OTC) deficiency is well known as the most common inherited disorder of the urea cycle, and 1 of the most common causes of hyperammonemia in newborns. We experienced a case of a 3-day-old boy with OTC deficiency who appeared healthy in the first 2 days of life but developed lethargy and seizure soon afterwards. His serum ammonia level...

Review Article
Catheter-related bloodstream infections in neonatal intensive care units
Jung Hyun Lee
Clin Exp Pediatr. 2011;54(9):363-367.   Published online September 30, 2011

Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters,...

Neonatal innate immunity and Toll-like receptor
Hye Sun Yoon
Clin Exp Pediatr. 2010;53(12):985-988.   Published online December 31, 2010

The innate immune response is the first line of defense against microbial infections. Innate immunity is made up of the surface barrier, cellular immunity and humoral immunity. In newborn, immunologic function and demands are different to adults. Neonatal innate immunity specifically suppresses Th1-type immune responses, and not Th2-type immune responses, which are enhanced. And the impaired response of macrophages is...

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