bluuebunny/crossref_metadata_2025 huggingface dataset:
PEDIATRIC PRACTICE: HUMAN MILK AND BREAST-FEEDING
Authors: Smith Clement A.
Published: December 2021

AT THE END OF 1962, the local Directory for Mother's Milk closed its doors. The decision to terminate the work of a pioneer institution which, at least for the early part of its 52-year existence, had filled vital needs, was not easy. The decision was made, of course, not because human milk had been demonstrated to be inherently any less valuable than it always was for babies. But with the advance of nutritional and technological knowledge, with the rapidly widening availability of sterilizing and refrigerating equipment, and the more prompt control of infections by antibiotic drugs, other ways of feeding babies had become inherently better. It is of some interest that this all happened in one pediatric lifetime. Dr. Fritz B. Talbot, who spoke at the closing ceremonies of the Directory, was the organizer of the service at its beginning (as a Directory for Wet Nurses) in 1910. With rare objectivity and perception, Dr. Talbot chose to express gratitude for a half-century of public health and pediatric progress, rather than alarm over a reduction in the local availability of human milk.

Most pediatricians today would probably feel similarly. Many would also join those who reflected that today's need for services to help mothers initiate breast-feeding is greater than that for organizations to preserve and dispense the milk of one mother so that it can be fed to the infants of others. Few would nowadays think that persuading mothers to initiate breast-feeding is as necessary as helping them to do so. Quite a few mothers are now seeking help which pediatricians and obtetricians might arrange for them in the hurried routines of today's hospitals.
ANTIBODIES TO GAMMA-GLOBULIN IN INFANTS AND CHILDREN EXPOSED TO ISOLOGOUS GAMMA-GLOBULIN
Authors: Stiehm E. R. , Fudenberg H. H.
Published: December 2021

Isoantibodies directed against human gamma-globulin were found in children receiving single and repeated injections of gamma-globulin and in those who had received blood transfusions at birth. Nine of 14 children receiving repeated gamma-globulin injections had anti-gamma-globulin antibodies. One-third of all children exposed to gamma-globulin by transfusion or injection, but only 6% of unexposed children had anti-gamma-globulin antibodies. Females appear to have a higher incidence of sensitization than males.

The possibility exists that these antibodies may be implicated in reported anaphylactic reactions to gamma-globulin.
The Difficult Child
Authors: WORK HENRY
Published: December 2021

This book is very different from most in its field. Written particularly for the school teacher, it has divided difficult children into groups which are not common medical categories. For example, there is a chapter on, "The Lazy Child" and one on "The Pampered Child."

This fractionation of children leaves the reader with the difficult task of pulling these symptoms together to comprehend the troubles of any one child. Very little attention is paid to any over-all understanding of children of which these problem might be symptomatic
Lactulosuria in the Neonate: A Preliminary Report
Authors: GRYBOSKI JOYCE D. , BOEHM JOHN J.
Published: December 2021

Urines from 121 neonates were examined for sugars by a high-voltage electrophoresis technique. Lactosuria and maltosuria occurred in 15.4% and 7.7% respectively of infants taking evaporated milk formula. Lactosuria occurred in 21.6% of infants receiving Similac and in 28.6% of the breast-fed infants. Lactulose, a sugar not previously described in urines of normal newborns, was present in the urine of 15.4% of infants taking evaporated milk and in 38.6% of infants taking Similac.
THE SIGNIFICANCE OF MILK ANTIBODIES
Authors: GOLD ELI , ROBBINS FREDERICK C.
Published: December 2021

THE paper by Rothberg and Farr in this issue raises again the problem of the significance of cow's milk antibodies in the sera of children. The early studies of Schloss and others demonstrated that antibodies to cow's milk proteins could be detected in the blood of infants fed cow's milk. This finding was observed more frequently in babies with diarrhea and directed interest toward the permeability of the bowel to unaltered protein molecules and to the effect of disease upon this process. It was recognized that some infants were intolerant to cow's milk and certain of them appeared to have a true allergy to cow's milk proteins.
SOLITARY PULMONARY HYDATID CYST
Authors: Vachier Eduardo , Hillman David C.
Published: December 2021

A case of solitary Echinococcus cyst of the lung was presented. The diagnosis can be suspected from the clinical history which should include animal contact. The presented patient had been in an endemic area; however, cases can occur in individuals who have never left the United States. This patient had a solitary pulmonary mass. The mass grew in size under observation with a pleural effusion which cleared spontaneously. The laboratory work-up was completely negative including lack of eosinophilia and a negative Casoni and complement fixation test. The semilunar air shadow within the mass suggested the preoperative diagnosis of Echinococcus cyst of the lung. If the diagnosis is considered, it is possible that it may be established preoperatively with increasing frequency.
Nuclear Projections of Neutrophils in the 13-15 Trisomy Syndrome
Authors: FINE RICHARD N. , WOO WANG MAY Y. F. , HEATH CLARK W.
Published: December 2021

Nuclear projections in polymorphonuclear neutrophils from patients with 13-15 trisomy syndrome have been previously reported as distinctive of this syndrome. A study of peripheral blood smears from neonates showed [See Fig 2. in Source Pdf.] projections to be present both in a patient with 13-15 trisomy and in normal controls. While the percentage of neutrophils containing projections and the number of projections per neutrophil were greater in the trisomy case than in the controls, the difference was not striking. These findings suggest that the presence of nuclear projections in neutrophils is not of practical value in the diagnosis of the 13-15 trisomy syndrome in the neonatal period.
When A Child Is Different
Authors: BAKWIN HARRY
Published: December 2021

Maria Egg has written a wise and understanding book for the parents of mentally retarded children. The book is filled with practical suggestions about every-day management—toilet training, self-feeding, dressing, and undressing, how to handle the siblings, the child in the community and the like. Emphasis is placed on family responsibility, rather than community responsibility, for the care of the retarded child. Families with a retarded child should find solace and help in this small, well-written book.
Letters to the Editor
Authors: WIENER GERALD
Published: December 2021

"Full-term" is what we meant. I'm sorry for the error and can only hope that Dr. Setleis is the only one sensitive (or perceptive) enough to have been disturbed by it. However, it did provoke him into a spate of wit, so all was not lost. Once again, sorry.
Screening of Infants for Metabolic Disease
Authors: MACCREADY ROBERT A.
Published: December 2021

The report of the Committee on Fetus and Newborn of the American Academy of Pediatrics on "Screening of Newborn Infants for Metabolic Disease," appearing in Pediatrics (35:499) contains the statmeent, "A blood test for elevated concentration of phenylalanine performed no sooner than 24 hours after onset of milk feeding and prior to discharge from the hospital is recommended for all newborn infants." It is important to add that this test should be performed on blood drawn as late as possible before discharge of the newborn baby from the hospital.
PLASMA BILIRUBIN DETERMINATION IN THE NEWBORN INFANT
Authors: Michaëlsson M. , Nosslin B. , Sjölin S.
Published: December 2021

A method for plasma bilirubin determination is described. It is a modification of the Jendrassik and Grof alkaline diazo-coupling procedure and allows determination of both conjugated and unconjugated bilirubin in small amounts of plasma.

Five commonly used diazo-coupling methods are compared with special reference to the influence of hemolysis in the sample.

The Jendrassik and Grof method as modified by Nosslin and Michaëlsson is shown to have the smallest methodological error and to be insignificantly influenced by hemolysis in the sample, in contrast to the methods of Malloy and Evelyn, Lathe and Ruthven, Ducci and Watson, and Powell.

The bilirubin standardization procedure, methodological errors, and the influence of hemolysis in the sample are discussed.
The Effects of Steroids in the Treatment of Typhoid Fever
Authors: ESKES PHILIP W. H.
Published: December 2021

The results are presented of the treatment of 99 infants and children with initially Uncomplicated typhoid fever. The effect of addition of steroids to the chloramphenicol treatment and usual therapeutic regime is discussed. The rapid relief of fever and toxicity, noted eleswhere, was confirmed. This changed our treatment from a mostly inpatient to a mostly outpatient basis, such as is particularly useful, when possible, for hospitals in overcrowded, underdeveloped areas.

The striking reduction in mortality and morbidity in steroid-treated patients warrants further investigation. Caution is recommended in the use of steroids in patients with history of fever for 2 weeks or more, as most typhoid perforations occur in the third week.
Errors in Understanding of Handicapped Children
Authors: LEVY LOIS E.
Published: December 2021

Today pediatricians are subject to such demands that they must necessarily delegate much of the office routine to their nurses and office assistants. The necessity for close teamwork among all groups concerned with the optimum health and welfare of children is graphically illustrated by a recent experience observed in connection with an examination for a handicapped child.

Pursuant to a telephone conversation with Mary's mother, I agreed to take Mary, my deaf student, to her physician in order to keep her appointment for an ophthalmological examination.
Research in Deafness in Children
Authors: GOODMAN ALLAN C.
Published: December 2021

This is a report of the proceedings of a two-day conference called by the National Deaf Children's Society of England to assess the state of knowledge about deafness in children. It is by no means an exhaustive discussion of present knowledge and research needs but by the same token it is not exhausting. It provides a lively and stimulating summary of the state of the art with respect to two broad categories: causes of deafness and testing of hearing in very young children.
ION EXCHANGE CHROMATOGRAPHY OF THE FREE AMINO ACIDS IN THE PLASMA OF THE NEWBORN INFANT
Authors: Dickinson Johanne C. , Rosenblum Herman , Hamilton Paul B.
Published: December 2021

1. A micromethod for the determination of amino acids by ion exchange chromatography was applied to the quantitative determination of the free amino acids in 0.1 ml of plasma of the newborn infant. The precision of the method was in general within the range ± 5%. An interpretive analysis of a typical chromatogram is given.

2. Plasma was best stored at -68°C pending analysis; errors likely to arise on storage at -20°C and higher temperatures are pointed out. Some errors likely to arise in the preparation and storage of plasma protein free filtrates are also indicated.

3. Comparison of the free amino acids in the femoral vein plasma of 25 newborn infants was made with the literature values of the free amino acids in the plasma of adults. The differences noted were not great, but were apparently characteristic. On comparing heel puncture plasma, some amino acids were higher than in femoral vein plasma, but it was concluded that heel puncture plasma would be satisfactory for routine clinical purposes. Some possible sources of error which might explain the elevated amino acids in the heel puncture plasma were noted.

4. On comparison of newborn with 3-day-old infants, some changes in amino acid levels were noted. The changes were not great, but seemed to be characteristic and consistent.

5. A number of small peaks which have not been noted previously in plasma have been indicated on the chromatogram. They were not identified, but were mentioned to draw attention to the possibilities of hitherto unrecognized ninhydrin-positive components of plasma.
THE HANDICAPPED CHILD
Authors: BONGIOVANNI ALFRED M.
Published: December 2021

A SEMINAR on Motor Handicapped Children was convened at the International Children's Center in Paris on December 7, 8, 9, 1964. and was notable for the deep concern displayed by the many representative nations for the disabled child. There appeared to be a universal expansion of the concept of the handicapped child to include many conditions beyond those of an orthopedic nature. The Children's Bureau of the United States now concerns itself with many problems including disorders of any one of the senses, epilepsy, congenital heart disease, and other congenital defects. One of the broadest definitions was that provided by Andersen of the Danish National Institute of Social Research wherein was included all individuals with a disease or defect of such degree that the afflicted person, if unskilled and without support from his surroundings "would have difficulty coping with daily life on an equal footing with others."
Ciba Foundation Symposium—Cellular Biology of Myxovirus Infections
Authors: KATZ SAMUEL L.
Published: December 2021

Although this volume, which is the report of a recent symposium held in London under the auspices of the CIBA Foundation, would be of greatest interest to laboratory workers in virology, it should also be available for reference reading to anyone concerned with problems of infectious disease. The participants at this symposium were principally from England but there were also a scattering of others from the United States, Germany, Russia, France, and Czechoslovakia. The book contains thirteen individual chapters which are actually the formal papers read by the authors, and following each manuscript is added the recorded discussion of fellow participants.
Child Health: Its Origins and Promotion
Authors: ALPERT JOEL J.
Published: December 2021

The editors of this book quickly point out that it is intended to meet a need created "by the intensification in teaching in health and health matters to teachers in training, to equip them more effectively to teach health in schools" and that it also is of value to students of social work, speech therapy, occupational therapy, and the social sciences, as well as the medical undergraduate and perhaps even graduate physicians. In large part they have achieved their aim. Reflecting much of the thinking of Australia, they have retained the knack of many writers of their mother country in getting the most out of the written word.
Proteins—Their Chemistry and Politics
Authors: CONE THOMAS E.
Published: December 2021

This book wrtten in a reasonably non-technical style deals with diverse subjects which have in common the word "protein." The major emphasis is on two important and related topics—the role of proteins in the human diet and the terribly vexing problem of how to go about improving the quantity and quality of world protein supply. Protein and politics are linked together because, unless we learn how to provide an adequate amount of this foodstuff to meet at least the minimum needs of our expanding world population, we shall continue to see little political stability in the face of mass hunger.
Human Pasteurelloses, Activation of Interest in Some Latent Problems
Authors: HUBBERT WILLIAM T.
Published: December 2021

(Editor's Note: The following communication is to appear in several medical publications. Attention of readers of Pediatrics is solicited.)

Classic consideration of human infections due to members of the genus Pasteurella is concerned with plague (P. pestis) and tularemia (P. tularensis). There have been extensive investigations on plague and tularemia in the U.S. and elsewhere in the world which now provide excellent clinical and epidemiological pictures of these two diseases.

However, there are at least four other species of Pasteurella (hemolytica multocida, pneumotropica, and pseudotuberculosis), known human pathogens, for which we have little or no understanding of their clinical importance or epidemiological patterns. Each species has been recovered from a variety of domestic and sylvatic animal reservoirs and each is, to some degree, a veterinary medical problem. Although a measure of the importance of these diseases in domestic animals in the United States is available from U.S. Department of Agriculture statistics, no comparable morbidity figures are reported for man. The occasional case reports that are published indicate, nevertheless, that a problem exists. The question remains, "how extensive is the problem?"

The first human infection due to P. multocida to be reported (1913) was a case of puerperal fever. Numerous cases have been reported since, involving respiratory tract infections, appendicitis, bitewound infections, as well as other forms.

Until the 1950's cases of P. pseudotuberculosis infection were considered rare, with less than 20 reports of fatal septicemia appearing in the literature. Recently, however, several hundred cases of mesenteric adenitis, often confused with acute appendicitis, have been observed primarily in Europe. In addition, recent cases of erythema nodosum as well as other forms have been described. Furthermore, P. pseudotuberculosis is of considerable importance as a source of diagnostic confusion due to many cultural and biochemical characteristics that this organism shares in common with P. pestis.

One case of P. hemolytica infection simulating ulceroglandular tularemia has been reported. Atypical strains of P. hemolytica have been isolated from the respiratory tract and from a case of endocarditis. A number of isolations of P. pneumotropica have been obtained from the respiratory tract.

No assessment of the importance of these agents as causes of disease in man in the United States can be made unless clinical and laboratory data can be accumulated. As a step in the right direction, it is suggested that clinical résumés, cultures, and paired sera from any patients, whether typical or atypical cases, be submitted to the U. S. Public Health Service, Communicable Disease Center, San Francisco Field Station, for further study and/or tabulation.
TRACHEOTOMY IN THE MANAGEMENT OF SEVERE BRONCHIOLITIS
Authors: Canby John P. , Redd Henry J.
Published: December 2021

During an epidemic of bronchiolitis 64 patients were admitted to Martin Army Hospital. Four moribund patients received tracheotomy as an emergency procedure. Improvement was dramatic and immediate. A theory to explain why tracheotomy is of value to patients with bronchiolitis is discussed.
STOOL LOSSES AND ACIDOSIS IN DIARRHEAL DISEASE OF INFANCY
Authors: Teree Thomas M. , Mirabal-Font Eduardo , Ortiz Antonio , Wallace William M.
Published: December 2021

1. Simultaneously obtained specimens of serum and stool were obtained from infants with diarrheal disease. From the majority of patients these were obtained at a juncture in the disease where acidosis and dehydration had supervened. The pH, osmolality, and chemical composition of 19 sera and 33 stools from 28 patients were determined. In 24 of the 33 stools the pH was below 7.00. Only 5 stools contained more than 10 mM of CO2 per liter.

2. Analysis of the data obtained for the concentrations of inorganic cations and anions shows, in keeping with all previous analyses of such stools, that appreciable quantities of unidentified organic anion exist in the water phase of the stool. The mechanism by which the loss of such anion, regardless of the stool pH, could contribute acid to the body fluids is discussed.

3. When the data obtained in this study are considered in terms of known maximal and minimal diarrheal daily stool volumes, it appears that, unless fecal volume is extremely large, the acid contributed by the stool loss is within the normal range of renal excretory ability. This is in accord with the original postulates of Howland and Mariott and of Schloss, that reduction in renal excretory function secondary to dehydration is the primary cause of the acidosis in infantile diarrhea.
MORE CHILDREN AND MORE RESPONSIBILITIES FOR PEDIATRICIANS
Authors: WISHIK SAMUEL M.
Published: December 2021

AT THE recent meeting of the American Academy of Pediatrics in Chicago, the Executive Board formulated two statements which are printed in full immediately following these comments. These statements are a policy response to the many important current developments in our country referable to the health of children. This commentary touches on certain aspects of these policies.

The Executive Board takes note of new efforts to marshal the resources of the nation to meet the health needs of large numbers of children. The Academy will contribute what it can so that these efforts can attain greatest effectiveness with the highest possible standards of care.
The Undescended Testicle, Timing of Surgery
Authors: SKLAIRE MARTIN W.
Published: December 2021

Dr. Bongiovanni's article on "The Undescended Testicle" (Pediatircs, 36:786, 1965) was read with great interest. The decision to defer surgery until seven to eight years of age also involves psychological factors which merit consideration, along with medical and surgical factors. This communication is for the purpose of re-emphasizing the meaning of the operation to the child, for the purpose of determining optimal timing for the surgery.

Surgical correction of cryptorchidism is a procedure requiring careful preparation of the child.
Letters to the Editor
Authors: GITZELMANN RICHARD
Published: December 2021

There is no reasonable doubt that some galactose will be liberated from alpha-galactosides by bacterial hydrolysis in any child's large intestine. However, such galactose will be available for absorption only if not metabolized by the microorganisms. Since the absorption rate of the colon is extremely low, little if any galactose is absorbed under normal conditions. In this hospital, soybean formula is preferred for galactosemic infants since in contrast to commercial low-lactose preparations from casein it is never contaminated with lactose.
Elevation of Protein-Bound Iodine in an 8 year old Due to Transplacental Passage of an Organic Iodine Dye
Authors: HUNG WELLINGTON
Published: December 2021

The transplacental passage of Teridax, a cholecystographic agent, is demonstrated in an 8 7½-year-old girl causing elevation of the PBI. This report probably represents the longest period that Teridax has been shown to be present in a mother and child due to placental transfer. Teridax causes elevated PBI and BEI levels for years following its administration The serum thyroxine iodine level can also be falsely elevated if the method by which this test is performed does not exclude organic iodine.
Letters to the Editor
Authors: CHERRY JAMES D. , JAHN CHARLES L.
Published: December 2021

Thank you for the opportunity to comment upon the letter from Doctor Steigman. In the interest of brevity we made no attempt to clarify our understanding of classical clinical herpangina. However, classic descriptions are recorded in our references. Doctor Steigman suggests that the brief description of the clinical lesions ("characterized by papular, vesicular and ulcerative lesions. . .") in our paper is "unauthorized." This description is, of course, not ours but that of Zahorsky: "Herpangina is a specific febrile disease characterized by the appearance of minute papules, vesicles, and ulcers in the throat."
CONGENITAL CEREBRAL GRANULOMAS
Authors: Sturgill Benjamin C. , Brown Audrey K.
Published: December 2021

Four cases of congenital cerebral granulomas occurring in male siblings who died during the first 24 hours of life are presented. The lesions are suggestive of toxoplasmosis and salivary gland virus disease. However, the repeated occurrence in siblings and the inability to demonstrate organisms or inclusions make these diagnoses unlikely. The cases reported probably constitute a previously undescribed clinical and pathologic entity.
Le Message Héréditaire
Authors: MIGEON BARBARA R.
Published: December 2021

Doctor de Grouchy has previously written of the earlier discoveries in molecular genetics in a book entitled L'Hérédite Moleculaire published in 1958. He is now inspired to write this book by the many exciting recent advances in our knowledge of the nature of the giant molecules which carry and transmit the genetic message from cell to daughter cell, from nucleus to cytoplasm, and which also control protein synthesis.

The book is in two parts.
The Human Dentition Before Birth
Authors: SWANSON LEONARD T.
Published: December 2021

Until the appearance of this text, little documented evidence of antenatal dental morphology was available. The authors, drawing on the unique collection of fetal material at the University of Pittsburgh, have carried out an unusually thorough investigation with the data well supported. Their study of ontogenetic development is based on whole embryonic crowns stained with alizarin red S. which provided specimens that could readily be examined morphologically and eliminated the tedious reconstruction from serial histological sections.
Pediatric Electrocardiography, Normal and Abnormal Patterns, Incorporating the Vector Approach, by Warren G. Guntheroth, M.D. Philadelphia: W.B. Saunders Company, 1965, 150 pp., $7.00
Authors: Hugenholtz Paul G.
Published: December 2021

This book is well written, well organized, concise and clear. One finds little fault with its concepts or the way they are presented. They are better summarized than in most textbooks in the field. The illustrations in particular are excellent and complement the text admirably. They bring out one of the strongest components of the book, namely, the correlation between the vectorial and scalar approach. A particularly useful device is in the inclusion in the book of looseleaf tables containing selected criteria and ranges of normal values for electrocardiograms in the pediatric patient.

However, as with most small books which emphasize brevity and accentuate "the introduction" as their approach, the intellectual appetite is stimulated rather than satisfied. In the entire field of electrocardiography, but particularly in congenital heart disease, the time has come to quantitate disorders and to free the field from the restrictions imposed by the descriptive terminology from older textbooks. The author would appear eminently qualified to undertake such a task and one can only hope that this book is a first installment. The need to correlate the electrocardiogram with hemodynamic events is growing rapidly and it is from laboratories such as that of Doctor Guntheroth that one expects an answer.

As a consequence, I can recommend this book heartily but only to the medical student and to the physician not familiar with the field. For those wishing more detailed information the need for a more comprehensive coverage of electrocardiography in congenital heart disease remains.
DISACCHARIDASE DEFICIENCY IN INFANCY AND CHILDHOOD
Authors: Townley R. R. W.
Published: December 2021

CARBOHYDRATES provide a substantial proportion of the total caloric content of our diet. The dietary carbohydrates of quantitative importance are the polysaccharide starch and the disaccharides sucrose and lactose. Hydrolysis of each of these to monosaccharide form is necessary before significant absorption can occur.

The principal product of starch digestion by amylases of the salivary glands and pancreas is maltose, a disaccharide in which two glucose units are joined by 1-4 α linkages. The other products are oligosaccharides including the disaccharide isomaltose, in which 1-6 α linkages are present.

Further hydrolysis of maltose and oligo 1-6 glucosides, produced from starch, and the hydrolysis of sucrose and lactose ingested as such, is dependent on enzymes of the small intestinal mucosa, the disaccharidases.

Figure 1 summarizes the sequence of digestion of the common dietary carbohydrates.

For many years, clinicians have recognized that diarrhea in some patients is related to the ingestion of certain forms of carbohydrate. Recent years have seen an increasing interest in the detection of such patients, and the application of new techniques to their investigation.

The development of instruments for intraluminal biopsy of the small intestinal mucosa was a notable advance, since it allowed specimens of this tissue to be obtained and some of its digestive capacities, including those concerned with disaccharide digestion, to be studied directly.

By these means, it has been established that deficiency of one or more of the intestinal disaccharidases is often the basis of disaccharide intolerance.

The terms "disaccharide intolerance" and "disaccharidase deficiency" are frequently used in this article, but have rather different meanings, so that a preliminary discussion of the sense in which each is used seems warranted.
ATTITUDES OF PEDIATRICIANS TOWARD DAY CARE
Authors: Scurletis T. D. , Peters Ann DeHuff , Robie W. A.
Published: December 2021

This is a report of the attitudes expressed by 103 pediatricians in North Carolina toward the day care of children. They indicate a concentration of interest in the individual child and his health rather than on the broad community needs and problems in day care. There is more recognition of the needs and value of day care to the handicapped child in contrast to the normal child. However, the variety and spontaneity of many responses, and the willingness of the great majority of respondents to help in better development of day care seems to indicate interest of physicians in this growing field of child care and is being further explored.
TRANSITORY HYPERTENSION FOLLOWING UROLOGIC SURGERY IN CHILDREN
Authors: Berens Stephen C. , Linde Leonard M. , Goodwin Willard E.
Published: December 2021

Sixteen pediatric patients developed 18 episodes of transient postoperative hypertension after operations on the urogenital system. Fifteen of the 16 patients had hydronephrosis. The onset of hypertension was from 1 to 9 days after the operation. The mean duration was 3.8 days. This transient type of postoperative hypertension usually resolved without anti-hypertensive therapy. Control studies showed that patients undergoing operations for non-urologic disorders also developed transient postoperative hypertension but of much shorter duration. Possible mechanisms and causes for this reaction are discussed.
SUDDEN UNEXPECTED DEATH IN INFANCY AND VIRAL INFECTION
Authors: Balduzzi Piero C. , Greendyke Robert M.
Published: December 2021

The relationship between sudden, unexpected death of infants and enteric viruses was investigated. A total of 97 cases of sudden deaths and 33 "control" cases, comparable from several points of view, were studied.

One viral strain was found in the stool of a "control" case and 14 agents were isolated from the sudden death group; 9 strains were found in stools and 5 strains, all Coxsackie B, were isolated from organ tissues obtained at necropsy. While this last finding suggests that enteric viruses may cause sudden deaths, the frequency of isolation is too low to be significant in a sample of the size investigated here.
DIAGNOSIS AND TREATMENT: ADVANCES IN THE MANAGEMENT OF STATUS ASTHMATICUS IN CHILDREN
Authors: Downes John J. , Wood David W. , Striker Theodore W. , Lecks Harold I.
Published: December 2021

Status asthmaticus in infants and children is associated with increased work of breathing, arterial hypoxemia, and metabolic and respiratory acidosis. Humidified oxygen, intravenous fluids with glucose, intravenous sodium bicarbonate, and light sedation with chloral hydrate sustain the patient in nearly every case until the bronchomotor response to epinephrine returns. A limited number of patients develop respiratory failure characterized by severe respiratory acidosis and hypoxemia that lead to coma and circulatory arrest. By careful clinical observation and serial arterial pH and blood gas measurements, respiratory failure can be diagnosed and treated effectively with mechanical ventilation and intensive respiratory care for the 20 to 30 hours which may elapse before recovery begins.
Ferment in Medicine
Authors: CRONKITE LEONARD W.
Published: December 2021

Most physicians who write about their own profession fall into one of several categories: those who deplore all change in the fabric of society and write sentimental nonsense about the good old days; those who predict doom for both themselves and their patients if present social, economic, and governmental trends continue; and, finally, those who write what are essentially psycho-political rationalizations for a form of medical practice with which they themselves are comfortable. Happily, Dr. Magraw's book, Ferment in Medicine, is none of these.
Physiology of Puberty
Authors: JOHNSTON JOSEPH A.
Published: December 2021

This book is invaluable for the student of growth and for the endocrinologist, bringing together as it does nearly 500 studies on the phenomena of puberty. We know of no other work in which this material is available. For anyone interested in adolescence, the book is a must. It is slanted more toward the laboratory than to the clinic, but it contains a body of fact indispensable to the latter.
CARDIAC MAN IFESTATIONS OF CONGENITAL HYPOTHYROIDISM IN INFANTS
Authors: Contis George , Nadas Alexander S. , Crigler John F.
Published: December 2021

1. The cardiovascular status of 40 patients under 6 months of age with uncomplicated congenital hypothyroidism was studied.

2. A significant number of these infants presented with symptoms which suggested cardiovascular disease.

3. The majority had heart murmurs and x-ray and electrocardiographic changes on admission, but these disappeared rapidly, in almost all instances, shortly after onset of thyroid therapy.

4. Autopsy findings in two infants with hypothyroidism and heart murmurs, as well as cardiac catheterization of two patients, failed to shed light on the etiology of the cardiac findings.
Allergic Factors in the Etiology of Spasmodic Croup and Laryngo-tracheitis
Authors: WOLF I. J.
Published: December 2021

I agree with Dr. Gilles Marion (Pediatrics, 37:854, 1966) who recommends the use of an antihistaminic in the emergency treatment of croup. I use Chlortrimeton by injection, plus the use of epinephrine and aminophylline in addition to the use of a broad spectrum antibiotic.

In my experience too (Ann. Allerg., 24:79, 1966), practically none of my croup patients are hospitalized. In over 30 years of pediatric practice I have only had two tracheotomies performed during this period of time.
Lupus Erythematosus, A Review of the Current Status of Discoid and Systemic Lupus Erythematosus and Their Variants
Authors: ROSEN FRED S.
Published: December 2021

Despite the productive investigations on lupus erythematosus during the past decade, this protean disease remains a baffling problem which eludes definition. The current knowledge on the subject has been assembled in a big and beautiful book by the editor.

The first part of the book deals with the pathology of lupus. Several subsequent chapters by Mackay, the Mieschers, and others bring together current immunological concepts about this puzzling disease. The last two thirds of the book are devoted to a description of over 400 patients with lupus based on the editor's broad experience with this malady
COPPER DEFICIENCY COMPLICATING SEVERE CHRONIC INTESTINAL MALABSORPTION
Authors: Cordano Angel , Graham George G.
Published: December 2021

A case of chronic, severe diarrhea and maldigestion beginning in early infancy and possibly due to primary lactase deficiency is presented. By the age of 19 months, this had resulted in marked copper deficiency with anemia, neutropenia, osteoporosis, pathological fractures and probably aggravation of intestinal enzyme activity deficiency. At 6 4/12 years of age copper therapy produced a dramatic improvement in all manifestations, including the maldigestion, and there was a striking growth response.
POTASSIUM-40: SERIAL DETERMINATIONS IN INFANTS
Authors: Maresh Marion , Groome David S.
Published: December 2021

OUR interest in the changes in body composition of the newborn infant as he grows through his first postnatal year has been accelerated in recent years as we look to the total body counter for further evidence of the variability in the relative amounts of adipose and nonadipose tissue in the body. Anderson and Langham in Los Alamos and Forbes and Hursh in Rochester, New York, have shown that K measurements can be used in the determinations of total potassium in children of school age and adults of all ages. There have been few K counts on infants, although some infants were included in the Los Alamos data.

In 1961 the Colorado State Department of Public Health installed a total body counter. Learning of our interest in body potassium studies in 1963, they offered us the use of the facility for a pilot infant study. After 6 months of experimenting with position of detector and child and means of monitoring the sleeping infant, most of the difficulties had been satisfactorily met.

The counting shield is a 2.4 x 2.4 x 2.4 m (8 x 8 x 8 ft) room with 12.7 cm (5 in.) steel walls lined with 3 mm (⅛ in.) lead. The child is quiescent in a prone position on a tight canvas frame supported from the walls of the room. A 10.2 x 22.9 cm (4 x 9 in.) NaI (Tl) detector utilizing four photomultiplier tubes is located under the canvas with the position dependent upon the height and weight of the child, varying from contact with the canvas to 7.5 cm (3 in.) from the infant.
Potential Hazard of Moistening the Cord Stump
Authors: GROSSMAN MOSES
Published: December 2021

The recent paper by McCormack and Kunin (Pediatrics, 37:750, 1966) presents an interesting account of a small epidemic in a newborn nursery. This paper stresses the environmental factors and the circumstances which permitted Serratia marcescens to be disseminated in the nursery, namely, the use of plastic bottles which could not be properly sterilized. It is worth pointing out that in addition to the environmental factors there appears to have been an important host factor in this incident.
Pediatric Pathology
Authors: EDLOW JULES
Published: December 2021

In 1959 the need for a volume devoted exclusively to the pathology of pediatrics was readily evident. The first edition of this book, which appeared at that time, found wide use by those who sought specific or additional information for their understanding of pediatric pathology.

Now, 7 years later, this book has been revised and a second edition issued. Information on the thymus and metabolic diseases has been brought up to date and a chapter on chromosomes has been added. Concepts related to embryology have been incorporated to explain some pathologic processes.
FAMILIAL INTRAHEPATIC CHOLESTASIS WITH MENTAL AND GROWTH RETARDATION
Authors: Juberg Richard C. , Holland-Moritz Roxie M. , Henley Keith S. , Gonzalez Carlos F.
Published: December 2021

Four siblings have been described with similar onset and progression of intrahepatic cholestasis. Pruritus at 3 to 5 months was the presenting manifestation and was accompanied by jaundice, an enlarged abdomen, bilirubinuria, and occasional light stools. Liver enlargement, retarded growth, and mild mental retardation have been present in all.

The elevation of the serum bilirubin is predominantly of the conjugated fraction and is associated with increased serum alkaline phosphatase, transaminases, cholesterol, and alteration of the electrophoretic pattern of the proteins, with elevation of the α2 and β globulin fractions.

Liver biopsies have been characterized by bile stasis in the presence of bile ducts. Two of the children show hepatic fibrosis which appears to be progressive and irreversible.

Aside from one aunt with cholangitis and cholangiolitis, there are no family members with liver disease. Autosomal recessive inheritance is suggested.
A SIMPLIFIED CULTURE METHOD FOR DETECTING ASYMPTOMATIC BACTERIURIA IN CHILDREN
Authors: Hobday John D.
Published: December 2021

A simple, miniature culture technique for testing urines for significant bacteriuria is described. Evaluation of this method shows a high reliability rate when compared with standard pour plate culture.
Sex Difference in Incidence of Antinuclear Factors in Juvenile Rheumatoid Arthritis
Authors: MILLER JOHN J. , HENRICH VERNON L. , BRANDSTRUP NIELS E.
Published: December 2021

Antinuclear factors were found in 14 of 25 girls with juvenile rheumatoid arthritis, but in only 2 of 17 boys. This difference is statistically significant.
A Practical Suggestion for Poison Control in the Pediatric Age Group
Authors: NATHAN MAX T.
Published: December 2021

Congratulations to Dr. J. A. Jones for taking action in the education of his patients and the public at large for the purpose of poison control. In his opening paragraph, he mentions that he has been "unsuccessful in developing a foolproof container that is economically feasible to manufacture."

I'm sure Dr. Jones, and many others, will be pleased to know that such a container is now available, as a result of the efforts of The Ontario Association for the Control of Accidental Poisoning (O.A.C.A.P.).
Handbuch der Kinderheilkunde, Vol. 2 (in 2 parts)
Authors: EICHENWALD HEINZ F.
Published: December 2021

Volume 2 of Springer's monumental Handbuch der Kinderheilkunde is divided into two parts, each a separate book, but both must be purchased together. Part 1 deals with the pediatric diagnosis; Part 2 with therapy.

Part 1 (Diagnosis) contains chapters by 71 different authors, mostly drawn from German institutions with a few Swiss, Swedish, and Austrian contributors. The book contains three main sections: (1) general diagnostic methods (including history and physical examination), (2) more specialized diagnostic procedures employed in endocrinology, genetics, radiology, orthopedics, urology, neurology, cardiology, etc., and (3) special laboratory procedures.
COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

Because of the limited information available it is not possible to derive precise figures for daily requirements of vitamin B6 in infants and children at this time. Data currently available suggest that the daily need in childhood is 0.5 to 1.5 mg and in adolescence is 1.5 to 2 mg. The requirement in infancy is clearly related to protein intake and is 20µg/gm of dietary protein.

Requirements of a few individuals will undoubtedly be higher than the estimates for the normal population. Some of these patients will manifest frank biochemical and clinical signs of deficiency which will usually be promptly reversed by administration of small additional amounts of pyridoxine. Another group of patients will require large amounts of the vitamin to balance the heritable alteration in binding properties of a specific apoenzyme requiring pyridoxal phosphate for normal activity.

It would appear that most infants, children and adults will have little difficulty in achieving an adequate intake of vitamin B6 if they receive what is considered to be in other respects an adequate diet.
Letters to the Editor
Authors: GOLD ARNOLD P.
Published: December 2021

It is hoped that Dr. García's letter further stresses the importance of depigmented nevi in the diagnosis of tuberous sclerosis.

The article referred to in his letter discussed in detail the classic triad of tuberous sclerosis with retardation, adenoma sebaceum, and seizures. The authors stressed the high frequency of depigmented nevi. There was no statement concerning a possible relationship between these lesions and infantile spasms. This article failed to state when the depigmented lesions occurred, and the only reference was that depigmented nevi, café-au-lait spots, and subcutaneous nodules were present in addition to the adenoma sebaceum.
CENTRAL NERVOUS SYSTEM COMPLICATIONS FOLLOWING BLALOCK-TAUSSIG OPERATION
Authors: Clarkson Patricia M. , Gomez Manuel R. , Wallace Robert B. , Weidman William H.
Published: December 2021

Two cases of severe neurologic symptoms after a Blalock-Taussig anastomosis are presented in detail. The histories of 116 patients with cyanotic congenital heart disease who had such an anastomotic operation at the Mayo Clinic were reviewed. There was a low incidence (less than 1%) of postoperative neurologic complications in patients without evidence of focal dysfunction of the central nervous system prior to operation. The review suggested an increased incidence of complications in those patients with a cerebrovascular abnormality before surgery. It is likely that these complications are related to alterations in the vertebrobasilar arterial system associated with this procedure.
ISLET CELL ADENOMA IN CHILDHOOD: REPORT OF A CASE
Authors: Drash Allan , Schultz Robert
Published: December 2021

The case of an 11-year-old boy with multiple islet cell adenoma of the pancreas is described. The case is of particular interest because the mild and infrequent symptoms resulted in an incorrect diagnosis of a primary convulsive disorder. The problems of accurate pre-operative diagnosis, despite the availability of all current diagnostic studies, are emphasized. The absence of abnormal elevations in serum insulin, as observed in this patient, cannot be used to exclude the possibility of islet cell adenoma.

Review of the literature as well as the experience of The Johns Hopkins Hospital underlines the importance of islet cell adenoma as a primary cause for hypoglycemia in the older child. Absence of severe hypoglycemia must not dissuade the physician from complete evaluation of such patients.
CELLULAR GROWTH IN HUMAN PLACENTA
Authors: Winick Myron , Coscia Anthony , Noble Adele
Published: December 2021

Fifty normal human placentae from various gestations were analyzed for total DNA, RNA, and protein content. The data indicate that, although weight, RNA, and protein continue to increase linearly until term, the rate of increase in DNA rapidly declines when the placenta reaches about 300 gm or the fetus 2,300 gm. When these data are interpreted in terms of number and size of cells they suggest that cell division stops in human placenta about 1 month prior to term. The latter portion of placental growth is by enlargement of already existing cells. These data establish normal values for human placenta from 26 through 42 weeks and provide a base line to compare placentae of abnormal pregnancies.
THE DANGERS OF A SUCCESSFUL PKU PROGRAM
Authors: GERALD PARK S.
Published: December 2021

WHEN the concept of mass screening of newborns for phenylalaninemia was first proposed, many voices were raised in protest. Chief among the objections listed was the impracticability of searching for a disease so rare that only one such infant would be found in 20,000 tested.

Today, mass screening for phenylalaninemia is a fact rather than a concept, but the storm of controversy has increased rather than subsided. There is, however, no longer any argument about the practicability of mass screening; the techniques used have proved eminently successful, in part helped by the finding that the incidence of presumptive PKU is now believed to be one in 10,000 or nearly double the earlier estimate.
CONGENITAL HEPATIC ARTERY ANEURYSM WITH SUPERIOR MESENTERIC ARTERY INSUFFICIENCY: A STEAL SYNDROME
Authors: Gryboski Joyce D. , Clemett Arthur
Published: December 2021

An unusual congenital vascular abnormality is described which caused chronic superior mesenteric artery insufficiency and eventual fatal small bowel infarction in an 18-week-old infant. During life the patient had post-prandial distress, intractible diarrhea, persistent melena, malabsorption, and a probable protein-losing enteropathy.
WATER INTOXICATION IN TWO INFANTS FOLLOWING THE VOLUNTARY INGESTION OF EXCESSIVE FLUIDS
Authors: Dugan Sam , Holliday Malcolm A.
Published: December 2021

Two cases of water intoxication which developed in infants following the voluntary ingestion of unusually large amounts of very dilute feedings are described.