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Between 1993 and 2002, apical muscular ventricular septal defects were identified in 99 cases by echocardiographic examination. Spontaneous closure time was analyzed in 42 cases followed up at least two years, retrospectively. The ages of 42 cases ranged between 1 day and 13 years old. Initial examination was performed in 22 cases within the newborn period, in 8 cases between 1 and 6 months of age and in 12 cases at more than 6 months of age. Spontaneous closure was seen in 24 of 42 cases (57.1%) between 1 and 36 months of age, and it was most commonly recorded during the first 6 months. It was remarkable that spontaneous closure occurred in 20 of 22 cases (90%) diagnosed in the neonatal period. Closure was seen in 4 of 8 cases (50%) whose initial examination was performed between 1 and 6 months and in none of the patients diagnosed at more than 6 months of age. In conclusion, the frequency of spontaneous closure in cases diagnosed in the neonatal period is higher than previously believed. It is advisable to follow up patients to determine spontaneous closure, especially within the first two years of life.

Scimitar syndrome is a rare congenital abnormality. Clear anatomic definition is an important issue before operation. We report definition of both abnormal pulmonary venous drainage and anomalous systemic arterial supply by gadolinium-enhanced magnetic resonance angiography and three-dimensional computerized tomography in an eight month-old infant with scimitar syndrome. The presented case study confirms that these noninvasive diagnostic tools can successfully be used to provide valuable information about vascular anatomy in infants with scimitar syndrome.

Poststreptococcal reactive arthritis (PSRA) is an acute, nonsuppurative arthritis following documented streptococcal infections. Although most authors accepted it as a different entity, the differences from acute rheumatic fever (ARF) are not clear. To document and compare the clinical and laboratory characteristics of PSRA and ARF, 24 patients with PSRA and 20 with ARF were enrolled in the study. The latency period from upper respiratory tract infection was shorter in patients with PSRA ( P<0.01). However, 25% of the patients with ARF had also short (<10 days) latency periods. Although symmetric and nonmigratory arthritis were more frequent in patients with PSRA, there was no significant difference for the distribution of mono-, oligo-, and polyarticular disease between PSRA and ARF patients. The frequency of small joint and hip involvement was also similar between the patient groups. Unresponsiveness of articular symptoms to salicylate therapy within 72 h was more frequent in patients with PSRA (P<0.001). However, in a substantial part of the patients with ARF (nine patients, 45%), joint symptoms also had no response during the first 72 h. Since there is a considerable overlap of symptoms, signs, and laboratory features of PSRA and ARF, a line between these two entities could not be easily drawn. We conclude that these two conditions are actually different presentations of the same disease.