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Because only 10�C20 cases of diazoxide-unresponsive severe CHI are expected to arise in Japan each year,[20] one or two facilities dedicated to CHI would be sufficient to care for all patients with CHI in Japan and possibly in the entire region of East Asia. Domestic and international collaboration is necessary for better outcomes of patients with this disorder. There are several unanswered questions and unmet needs in regards to CHI that should be addressed in the near future. Some of the answers to these questions are on the horizon but are incomplete. Finding the answers to these questions is the responsibility of the current and future investigators in this field. Questions What BML-190 are the genetic causes BI2536 of the remaining 50% of cases of persistent CHI? What are the causes of transient CHI? What are the causes of so-called ��adult nesidioblastosis��? What would be the safe threshold of blood glucose to avoid neurological sequelae? What is the mechanism of spontaneous remission of CHI? How can we explain the dominance of paternal mutation in patients with diffuse CHI on 18F-DOPA PET? Which type of CHI evolves into diabetes later in life? Which novel diagnostic imaging modality is superior to 18F-DOPA PET? How can we surgically manage diffuse, diazoxide-unresponsive CHI? What novel medications could be used for diazoxide-unresponsive CHI? How we can establish international collaborations so that all infants born with CHI will equally benefit from the current standard of care? This work was supported by a grant-in-aid for scientific research this website from the Ministry of Health, Labour, and Welfare of Japan (Research on Measures for Intractable Diseases 2012-070). None of the authors has anything to disclose. ""63403" "Background:? Emergency rooms in Japan are overused by children with non-life-threatening conditions, and utilization of emergency transport for children in Japan should also be analyzed. Methods:? Utilization rates of emergency transport per 1000 live births or 1000 children from 1985 to 2008 in Japan were calculated from national data of emergency transport, child population and annual live births. Results:? Emergency transport per 1000 preschool-age (28?days-6?years old) and school-age (7�C17?years old) children rose, and that for newborn babies (0�C27?days old) per 1000 live births grew from 1985 to 2008. The utilization rates, however, did not grow homogeneously among the different severity groups. The rates of transport for children who needed no hospitalization or those for children who needed inpatient care