Congenital Syphilis: An Uncommon Cause of Gross Hematuria, Skin Rash, and Pneumonia / 소아감염

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.

Baseline heart rate variability in children and adolescents with vasovagal syncope / 소아과

PURPOSE: This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope. METHODS: To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF). RESULTS: HRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P=0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P=0.015) and normalized HF (61.18 ms vs. 43.19 ms, P=0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P=0.022) and LF/HF ratio (0.76 vs. 1.89, P=0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents. CONCLUSION: The results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.

Allergic Proctocolitis Resembling Ulcerative Colitis of Infancy in a 3-day Old Neonate

Allergic proctocolitis (AP) can be hard to differentiate and diagnose in neonates who manifested watery diarrhea and failure to thrive. The initial symptoms are not specific and colonoscopic findings share similar ulcerated and erythematous lesions as in ulcerative colitis of infancy and infectious colitis. A 3-day-old infant was admitted to the hospital due to loose, blood-tinged stools. An initial workup, including abdominal ultrasound and hepatobiliary scan, was performed, and all results were negative. The patient subsequently required readmission due to pervasive watery diarrhea, severe weight loss, and lethargy. After further investigation, he was eventually diagnosed of allergic proctocolitis by rectosigmoidoscopy and biopsy. Treatment was started with a corticosteroid (prednisone 2 mg/kg/day) due to severe symptoms. After 7 days of steroid therapy, the stools slowly normalized, and the patient started to gain weight. He was discharged home and followed regularly at the outpatient clinic.

Articulation Patterns of Children who Developed Articulation Disorders Associated with Ankyloglossia

PURPOSE: We investigated articulation patterns in children with ankyloglossia who developed articulation disorders in order to determine the relationship between ankyloglossia and articulation disorders, and to clinically detect children who have articulation disorders associated with ankyloglossia. METHODS: The participants of this study were 23 children with articulation disorders that accompanied ankyloglossia and 55 controls with functional articulation disorders independent of anatomical problems, who were admitted to our hospital from January 1, 2002 to December 31, 2012. All children underwent speech-language pathologic evaluation using the Picture Consonant Articulation Test (PCAT; Young-Tae Kim, 1994). We retrospectively compared collected data between the subject and control groups using Fisher's exact test and odds ratio tests with a 95% confidential interval for categorical variables and the independent Mann-Whitney U-test for continuous variables. RESULTS: The number of patients with articulation errors in the velar nasal was lower significantly only in the subject group (P=0.038). The total numbers of articulation errors in the bilabial plosive, velar plosive and velar nasal also were lower (P=0.007, P<0.001, and P=0.034, respectively). There were no differences in the numbers of patients with articulation errors according to phonological changes between the two groups. However, the total numbers of fronting and frication were lower in the subject group (both P<0.001), but the total numbers of plosivation and tensing were higher (P=0.002 and P=0.008, respectively). CONCLUSION: This study showed that the relationship between an articulation disorder and ankyloglossia is doubtful, although some results suggest that ankyloglossia may cause articulation errors only in certain individuals. Therefore, clinicians should be careful when determining the relationship between ankyloglossia and articulation disorders and use caution when making a treatment decision.