bluuebunny/crossref_metadata_2025 huggingface dataset:
PEDIATRICS AND CHILD PSYCHIATRY
Authors: GESELL ARNOLD
Published: December 2021

Pediatrics as a specialty of general medicine is concerned with the promotion conjointly of mental and physical development. Pediatrics cannot encompass the technical areas of child psychiatry which are concerned with severe psychopathologies and complex psychotherapies. It can encompass a preventive and positive type of mental hygiene through parent-child guidance and family counseling. This will require systematic technics for periodic developmental diagnosis and developmental supervision of the action system of the growing child. The principles and methods of pediatric mental health conservation must be based upon a clinical science of normal child development.
OBSERVATIONS OF TOTAL SERUM BASE IN CHILDREN AND YOUNG ADULTS BY A CONDUCTIVITY METHOD
Authors: KELSEY W. M. , LEINBACH L. B.
Published: December 2021

Values for total serum base in 96 normal children under 12 years of age as determined by the conductivity method fell between 143 to 160.5 mEq./l. The mean was 153. Standard deviations for each age group are given.

The values in 73 normal persons above the age of 12 varied from 142 to 160.5 mEq./l. The mean was 147 mEq./l. A statistically significant difference between the total serum base in children and adults was found.
EARLY TREATMENT OF METATARSUS VARUS (ADDUCTUS)
Authors: SIRBU A. B. , COLLOFF BEN
Published: December 2021

Early recognition and treatment of a common deformity of the foot in infants is urged.

The pathology of metatarsus varus has been described, emphasizing the normal hindfoot in the pre-ambulant child. Metatarsus varus may be the precursor of a late hallux valgus deformity. The most efficient method of treatment is the use of wedge casts. None of the cases reported required operative procedures for correction.
PRIMARY DISORDERS OF THE SERUM LIPOPROTEINS IN CHILDHOOD
Authors: WOLFF O. H.
Published: December 2021

ALL LIPIDS are transported in serum in association with proteins. These lipoprotein complexes can be separated by electrophoresis on paper or by ultracentrifugation. Paper electrophoresis is simple and can easily be introduced into any laboratory. In the fasting state two lipoprotein bands are seen: beta-lipoprotein, which has the mobility of beta globulin, and alpha-lipoprotein, which has the mobility of alpha1 globulin. Chylomicra, which appear after a fat containing meal, remain at the point of application of the serum to the paper; because it is situated at the opposite end of the strip to alpha-lipoprotein the chylomicron band has been named omega-lipoprotein.
Antigens for Testing Atypical Mycobacterial Infections
Authors: FERGUSON S. HOWARD
Published: December 2021

The pleas of Cramblett (Pediatrics, 38:381, 1966) and Arnhold (Pediatrics, 39:310, 1967) undoubtedly stem from a need which is felt more urgently in the southern states.

I have not infrequently been asked to assist in obtaining such antigens for diagnostic purposes, not only by pediatricians in a number of general hospitals but also by pediatricians working in two university hospitals; and, unfortunately, I have not been able to help as antigens are not available for these purposes.
Letters to the Editor
Authors: MENKES MIRIAM M. , MENKES JOHN H. , Kennedy Joseph P.
Published: December 2021

Dr. Schwalb appears to object to our study partly on moral grounds. Also, we feel that, if he reread our data and conclusions carefully, this would do away with most of his other objections. The main ones seem to us to be:

1. Our sample is no good because the age range is too wide. It is true that the age of the 18 original patients ranged from 2 years, 7 months to 15 years, 6 months, but, of these, 14 were between 5 and 10 years.
CHILDREN OF INCEST
Authors: Adams Morton S. , Neel James V.
Published: December 2021

Eighteen prospectively ascertained cases of brother x sister and father x daughter matings are described. A series of illegitimate children whose mothers were as nearly matched as possible to the incest mothers for intelligence, age, height, weight, and socioeconomic conditions were used as controls. Six of the children of incest had died or were found to have major defects on follow-up 6 months after birth date, whereas one of the comparison children was so classified. This is a larger inbreeding effect than would be predicted on the basis of published findings from marriages of first cousins. The series is published at this time to encourage others to collect these important, but rare and elusive data, in a prospective, controlled manner.
THE EFFECTS OF PLACENTAL TRANSFUSION ON RESPIRATORY MECHANICS OF NORMAL TERM NEWBORN INFANTS
Authors: Oh William , Wallgren Göran , Hanson John S. , Lind John
Published: December 2021

Lung compliance and crying vital capacity of 52 normal, term, newborn infants were measured by a reverse plethysmograph during the first 5 days of life. Twenty-seven infants had late cord clamping (3 to 5 minutes after birth) and 25 had early cord clamping (within 5 seconds after birth). In 23 of these infants (12 late clamped and 11 early clamped) an additional determination of functional residual capacity was made during the first 6 hours of life.

During the first 6 hours of life, the earlyclamped infants had a slower respiratory rate and higher compliance associated with a larger functional residual capacity.

It is suggested that these findings are related to smaller heart volume and less pulmonary capillary venous filling in the earlyclamped infants as compared to the lateclamped infants.
STUDIES OF CARBOHYDRATE METABOLISM IN THE NEWBORN INFANT
Authors: Pildes Rosita S. , Forbes Audrey E. , Cornblath Marvin
Published: December 2021

Blood sugar determinations were done during the first 5 days of life on 100 sets of twins. Hypoglycemia was found in the smaller member in 8 of 11 pairs who were discordant by more than 25% with the smaller twin weighing less than 2.0 kg. Hypoglycemia occurred in one other pair of the remaining 89 sets of twins. Blood glucose values were not influenced by the birth order or the sex of the infants. Infants who weighed over 2,500 gm had significantly higher blood sugars than those who weighed below 2,500 gm.
Resuscitation of the Apneic Premature Infant
Authors: JOHNSON KIT G. , BABSON S. GORHAM
Published: December 2021

The simplicity and economy of construction and maintenance of this device allow every high risk and premature infant to have an individual resuscitator within the incubator immediately available for use by any nursery personnel.
ON A SIMPLE METHOD OF PREVENTING SORE THROAT
Authors: C. T. E.
Published: December 2021

Therapeutic nihilism was at its peak in the late nineteenth century. An excellent example of a drugless therapeutic procedure is that described almost 80 years ago by Dr. H. V. Knaggs.

The interest that often attaches itself to simple methods of treatment must be my excuse for resuscitating an old but, at the same time, very little known remedy for preventing the recurrence of ordinary sore throats.

Most people, when they hear of it for the first time, are very apt to smile incredulously, and to at once put it down among the category of superstitions, "old women's remedies," etc. In fact, nearly every patient to whom I have suggested it has appeared sceptical of its utility at first, although subsequently a careful trial has frequently convinced them to the contrary. Its prophylactic powers are undoubted.

The treatment alluded to consists merely in placing round the neck from ten to twenty threads of Berlin wool. This must be worn continuously night and day, and not taken off except for the purpose of making ablutions. With some cases it is necessary that the wool should be worn all the year round; with others, during the months when the complaint is likely to return. When it is thought desirable to discontinue its use, it should be done gradually by discarding a single thread each day until none are left. If objected to on the score of unsightliness, a small coin or locket may be attached, which will effectually keep the wool out of sight, and, after a time, out of mind.

Laryngitic and tonsillitic forms for disease, which are especially prevalent among children, are due in very many instances to exposure and cold, and are particularly apt to recur periodically, especially in the colder and more changeable periods of the year. It is in such cases that the treatment is productive of marked benefit.

A considerable number of cases, both among children and adults, have been thus treated in our practice. Observations as to its efficacy have extended over a number of years. Strange as it may seem, scarcely in any single instance has it failed in our hands to avert future attacks.

The question naturally arises, How can a simple remedy like a few threads of wool possibly effect this object? or in what manner does it act? In the first place, we know that wool is a bad conductor of heat. Secondly, according to the principles laid down by Dr. Jaeger in his system of sanitary clothing, ventilation is one of the best means at our disposal for promoting skin action, and for retaining the body at an equable temperature both in summer and winter. It is probable, therefore, that the skein of wool, when attached round the neck, keeps up a belt of skin-action, and so acts continuously, and in a slight degree, as a mild counter-irritant.
Congenital Hypothyroidism and Prolonged Neonatal Hyperbilirubinemia
Authors: MACGILLIVRAY MARGARET H. , CRAWFORD JOHN D. , ROBEY JOHN S.
Published: December 2021

A cretinous infant exhibited prolonged neonatal jaundice which subsided on thyroid replacement therapy. Accidental withdrawal of treatment with recrudescence of jaundice and a second drop in bilirubin on restoration of thyroid treatment served to document the close association of thyroid insufficiency and unconjugated hyperbilirubinemia.
The Empty Fortress: Infantile Autism and the Birth of the Self
Authors: SUSSEX JAMES N.
Published: December 2021

Psychoanalysis has long represented itself as being not only a treatment tool but a method of research. The reason, of course, is that this method of recollection presumably helps the individual to re-experience the feelings he had during significant events or periods of his life-time and, in doing so, to understand why he behaves and feels as he does. Sometimes it seems that the psychoanalyst claims that this is indeed the only way to self-understanding, but even the most died-in-the-wool, orthodox analyst would not in this day and age claim that self-understanding can come in no other ways than through his chosen discipline.
THROMBOSIS OF THE FEMORAL ARTERY FOLLOWING FEMORAL VENIPUNCTURE
Authors: MCKAY R. J.
Published: December 2021

THE REPORT of three instances of arterial thrombosis following femoral venipuncture in edematous nephrotic children by Goldbloom, Hillman, and Santulli in this issue of Pediatrics re-emphasizes the importance of weighing the risks of puncture of deep veins for diagnostic purposes against the benefits to be derived therefrom.

That the risk of femoral arterial thrombosis following femoral venipuncture in edematous patients with the nephrotic syndrome is real is clearly demonstrated by this report. Lest these be thought to be isolated instances, this writer knows of an additional instance within his own experience, and, by word of mouth, he has heard of five others occurring in only two institutions.
QUADRUPLETS SURVIVING WITHOUT ANY SPECIAL CARE IN 1789
Authors: C. T. E.
Published: December 2021

The report below, if true, proves that what the ancients called vis mediatrix naturae must surely play an important role in the survival of the human race. Even today with the best specialized medical and nursing care survival of all four infants in quadruple births is the exception rather than the rule.

A Negro woman, named Benebah, was brought from Africa to Dominica in the year 1782. . . . On the 22nd of February 1789, when, according to her own computation, she had been about nine months pregnant, she was seized with labour-pains; and, by the assistance of a Negro woman on the estate to which she belonged, who officiated as midwife, she was delivered of a boy, to appearance healthy, and of ordinary size. But no placenta coming away, and marks of pregnancy still continuing, an accoucheur was sent for, who, about 24 hours after the birth of her first child, delivered her of three girls, all of the ordinary size; after which, he extracted a placenta of an enormous size, which he computed would have weighed about fifteen pounds. After this she had a very good recovery, and was able to walk about the eighth day. She gave suck to all her four children, also employing, however, with them at the same time a good deal of spoon-meat. Mr. Spencer, an ingenious man-midwife, saw them when about five months old. At the time they were all stout children, and, as well as their mother, in perfect health.

When Benebah was delivered of these children, she was about the 30th year of her age. She measured five feet two inches in height. Her husband, who was in his 35th year, was a stout wellmade man, about the middle size: and it may perhaps be mentioned as a singularity, that both she and her husband were twins.
MAGNESIUM STUDIES IN RELATION TO VITAMIN D-RESISTANT RICKETS
Authors: Anast Constantine S.
Published: December 2021

Magnesium metabolism was found to be unaltered in a 4-year-old boy with untreated vitamin D-resistant rickets who manifested abnormalities of calcium and phosphorous metabolism commonly found in this disease. This is at variance with the previously reported finding of altered magnesium metabolism in a patient with resistant rickets acquired at adolescence. The possibility that this difference may reflect either a variation in the underlying disease process in the two age groups or a difference in the severity of the disease process is discussed.

It is of significance that the gastrointestinal absorption of calcium was decreased while that of magnesium was normal in our untreated patient. This suggests that the mechanisms involved in intestinal transport of these two minerals are not identical.

Treatment with 200,000 to 300,000 I.U. of vitamin D per day resulted in a decrease in the serum magnesium levels with no consistent changes in the urinary excretion, intestinal absorption, or retention of magnesium; during this time, however, the intestinal absorption, urinary excretion, and retention of calcium were all increased. The administration of 350,000 I.U. of vitamin D per day was associated with an increase in both the urinary excretion and intestinal absorption of magnesium. At this dose the retention of magnesium initially increased and subsequently decreased as the increase in urinary magnesium offset the increased intestinal absorption of this mineral. It is not known if the effects of vitamin D on the intestinal absorption and urinary excretion of magnesium represent primary actions of this vitamin on the kidney and gastrointestinal tract or whether they are secondary to changes in calcium and phosphorous metabolism. The fact that vitamin D administration resulted in a lowering of the serum magnesium level before there were any consistent alterations in fecal and urinary magnesium is in keeping with previously reported animal studies which indicate that vitamin D acts to cause a redistribution of magnesium in the body.
Immunoglobulin Deficiencies in Thymic Alymphoplasia
Authors: MILLER MICHAEL E.
Published: December 2021

In the article, "Selective Immunoglobulin Deficiency Associated with Thymic Alymphoplasia" (Pediatrics, 39:506, 1967), Drs. Buckley, Bradford, and Butcher state "the association . . . . lends further support to the hypothesis that immunoglobulin production can take place without a normal thymus and in the face of severe depletion of small lymphocytes." This interpretation by the authors of the findings presented agrees with that suggested in several previously described cases of similar nature. However, an alternative explanation has not been adequately considered in any of these published reports.
The Physician and the Children's Cancer Center
Authors: Hartmann John R. , Hartmann John R.
Published: December 2021

IT HAS BEEN suggested that my role in this conference be twofold: first, supposedly the confessions of a pediatric oncologist; second, the description of our program here in Seattle. The first one is rather difficult to detail concretely. Having been in general pediatric practice at one time, I think the role we oncologists have is one of the most frustrating and difficult but, at times, the most gratifying one in medicine. No one wants to take care of dying children by preference. Most of us have been hematologists and have gotten into the field of oncology because of the therapeutic effects of chemotherapeutic agents, especially in children with leukemia. I think from prior experience we recognize immediately upon original diagnosis the fatal outcome of a child with leukemia. We also try to transmit our deep compassion to the parents and to give them some ray of hope. We often look upon this area as that of a religious experience in which one has to have some beliefs to go on taking care of these children. We must believe within ourselves that a cure is possible, rarely at the present time, but hopefully in the future. I do not think this is being untruthful to the parent because we must give them some ray of hope—either control of the child's disease for a specific length of time or, aside from leukemia, more hope for potential cure.

We are sometimes a little schizoid in our actions because we will treat a child with acute leukemia believing that the treatment of the child is worthwhile, while on the other hand we may cause considerable prolonged emotional conflict in the parents with repeated episodes of crises.
MORTALITY AND MORALITY
Authors: YANKAUER ALFRED
Published: December 2021

AS REPORTED by James Joyce, the following explanations of the problem of infant mortality were advanced by the house staff of a Dublin Maternity Hospital:

Mr. M. Mulligan (Hyg. et Eng. Doc.) blames the sanitary conditions. . . . These factors, he alleges, and the revolting spectacles offered by our streets hideous publicity posters, . . . mutilated soldiers and sailors . . . paranoic bachelors and unfructified duennas . . . were responsible for any and every falling off in the calibre of the race. Kalipedia, he prophesied, would soon be generally adopted. . . . Mr. J. Crotthers (Disc. Bacc.) attributes some of these demises to abdominal trauma in the case of women workers subjected to heavy labours . . . but by far the vast majority to neglect, private or official. . . .
THE EFFECT OF MALNUTRITION ON THE SYNTHESIS OF A MYELIN LIPID
Authors: Chase H. Peter , Dorsey James , McKhann Guy M.
Published: December 2021

The synthesis of sulfatide, a lipid which is a component of the myelin sheath, can be used as a biochemical marker for myelin formation.

Nutritional deprivation during the early life of the rat is associated with a decreased synthesis of sulfatide, as determined by both in vivo and in vitro methods.

The decreased synthesis of sulfatide after a period of poor nutrition is not corrected by refeeding.

These results indicate that the time of active myelin formation is a vulnerable period for the developing nervous system.
PREVALENCE OF HOMOCYSTINURIA AMONG THE MENTALLY RETARDED: EVALUATION OF A SPECIFIC SCREENING TEST
Authors: Spaeth George Link , Barber G. Winston
Published: December 2021

The prevalence of homocystinuria in patients with mental retardation institutionalized in the United States is about 0.02%; this is lower than a previous estimation from Northern Ireland (0.3%). On the other hand, about 5% of patients with dislocated lenses may be expected to have the disease. A silver-nitroprusside test which is almost completely specific for homocystine has been evaluated. It should be useful for screening.
ENTEROVIRAL MENINGITIS IN VERY YOUNG INFANTS
Authors: Nogen Alan G. , Lepow Martha L.
Published: December 2021

Enteroviral meningitis was studied in five infants less than 6 weeks of age.

Eight additional cases of suspected enteroviral meningitis from the Cleveland Metropolitan General Hospital were reviewed with regard to symptoms, CSF findings, neurologic examination, prognosis, and epidemiology.

The entity of enteroviral meningitis should be considered in and viral cultures obtained from any young infant when examination of the CSF reveals a pleocytosis, normal glucose, and absence of organisms on Gram's stain and culture.
JUVENILE OSTEOPOROSIS: REPORT OF A CASE INCLUDING A DESCRIPTION OF SOME METABOLIC AND MICRORADIOGRAPHIC STUDIES
Authors: Cloutier Mark D. , Hayles Alvin B. , Riggs B. Lawrence , Jowsey Jenifer , Bickel William H.
Published: December 2021

A case of idiopathic osteoporosis in a 12-year-old girl has been reported. Quantitative microradiographic studies of a biopsy specimen of iliac crest showed normal bone formation and an almost threefold increase in the level of bone resorption. The patient was observed without treatment, and a spontaneous clinical remission with roentgenographic improvement occurred. A second iliac crest biopsy specimen, obtained 15 months after the initial biopsy at a time when roentgenographic improvement was apparent, showed a return toward normal of the level of bone resorption. Metabolic balance studies conducted at this time showed that the patient was approximately in calcium balance. Because the majority of the previously reported cases have also exhibited spontaneous improvement, it is suggested that initially observation alone is indicated.
Meconium Plug Syndrome with Aganglionosis
Authors: LEEUWEN G. VAN , RILEY W. C. , GLENN L. , WOODRUFF C.
Published: December 2021

The meconium plug syndrome is a well recognized entity—inability of the newborn to pass initial meconium by age 48 hours without manual or enema assistance. The association of this syndrome with congenital aganglionosis has been observed but not well documented. During the past 12 months we have encountered eight infants with the meconium plug syndrome. Six of these infants have developed normally, while two were subsequently proved to have aganglionosis. One of these two was initially diagnosed as having septicemia with paralytic ileus and the other as having anal stenosis. Removal of the meconium plug and antibiotic therapy in the former infant and simple rectal examination in the latter resulted in prompt regression of the signs of intestinal obstruction.
Neonatal Hypertyrosinemia and Folic Acid
Authors: PARTINGTON M. W.
Published: December 2021

Recently Dr. Mathews and I published a small study in Pediatrics showing that a 10 mg daily dose of folic acid by mouth did not prevent neonatal hypertyrosinemia in premature babies. This was somewhat surprising in the light of previous observations. One possible explanation of our findings was a failure of absorption of folic acid from the gut and, at that time, we had no information on this point.

Since then, through the courtesy of Dr. C. P. Gendron of Cyanamid of Canada and Dr. H. D. Piersma of Lederle Laboratories, we have obtained some estimates of the folic acid content of the urine of some of the babies we studied (Table I).
Letters to the Editor
Authors: DAVIS STARKEY D. , WEDGWOOD RALPH J.
Published: December 2021

Dr. Yerushalmy points out the excess mortality in the isoniazid pupulation in two trials: contacts of new cases and patients in mental hospitals. He failed to mention that the Public Health Service has conducted five other isoniazid prophylaxis trials (Table I). In the six trials listed, excluding the one in institutions, the isoniazid groups had more deaths in three trials, the placebo group had more deaths in two trials, and in one trial the number of deaths in each group was equal.
Psychosomatic Ailments in Childhood and Adolescence
Authors: CONE THOMAS E.
Published: December 2021

Although this book contains much information about the psychosomatic ailments encountered in childhood and adolescence, I still hope it is not a harbinger of a new trend in medical publishing. I say this because I miss the personal imprint of an editor whose task I believe should be more than that of selecting a number of papers from various journals and then reprinting them without any change or comment. This book, as I see it, is really a well organized collection of reprints (except for a short final chapter by one of the editors) selected from the American medical and psychiatric literature.
Complications of Vaccination
Authors: THALHEIM ANDREW H.
Published: December 2021

In the article in the June issue by Dr. J. M. Neff, et al., concerning complications of vaccination (Pediatrics, 39:916, 1967) and the other article by the same authors in the New England Journal of Medicine (276:125, 1967), the children under 1 year are grouped together. This, I believe, has led to an erroneous conclusion. My associates at the Ochsner Clinic and I have for 10 years, routinely vaccinated our patients between the ages of 2 and 4 months, most by 3 months.
Das Sogenannte Medulloblastom
Authors: VAWTER GORDON F.
Published: December 2021

In the 40 years since Bailey and Cushing coined the term medulloblastoma, so many difficulties have centered around the localization of the tumor, the tendency to meningeal involvement and spread, the absolute morphologic identification of the constituent cells, and particularly the possible primary or secondary nature of the frequently prominent mesenchymal and vascular components of this tumor that a subgroup has actually been recognized and been termed mesoblastic medulloblastoma.

Doctor Gullotta wished to break completely with the notion of pure neuroectodermal origin of medulloblastoma and prefers to view the tumor as a mixed embryonal tumor or mesodermal embryonal tumor with multiple potentials for differentiation in a manner which has many parallels with Wilms' tumor or nephroblastoma of the kidney.
DIAGNOSIS AND TREATMENT: RECURRENT ABDOMINAL PAIN IN CHILDREN—A SURGEON'S VIEWPOINT
Authors: Marshall Donald G.
Published: December 2021

MUCH has been written in recent years about the importance of psychogenic disturbances as causes of abdominal pain in childhood. Yet, by no means all recurrent abdominal pain is so caused. A recent article in Pediatrics on nonorganic abdominal pain therefore promised this subsequent paper on pain of organic origin.

I would like to caution the reader that his "surgeon's viewpoint" tends to exclude consideration of organic abdominal pain not surgically treated. Perhaps a third paper is indicated.

Abdominal pain of whatever origin requires a planned approach to diagnosis. While it is only too easy for the clinician to submit a patient to innumerable investigations of varying degrees of unlikelihood of revealing disorders of differing degrees of rarity, a detailed history and searching interview with the parents, together with a complete physical examination, will go very far to reduce the number of cases submitted to any but quite simple tests.

The diagnosis of psychogenic pain, no less than that of organic pain, must rest on positive findings. To make a diagnosis of psychogenic pain, there must be something more than the absence of demonstrable organic disease. There must be significant psychopathology. If there is evidence of neither this nor organic disease, one must resolve to be irresolute and decide to be undecided. One must not make a diagnosis of psychic disease simply because one can find no organic cause.

One must also remember that psychic disturbance does not confer immunity from organic disease. A neurotic, psychotic, or brain-damaged child can have appendicitis.
Further Experiences with Water Intoxication
Authors: Nickman Steven L. , Buckler John M. H. , Weiner Leonard B.
Published: December 2021

Two infants are described who presented with seizures due to water intoxication and responded rapidly to therapy with concentrated salt solution. Pathophysiology, rationale of treatment, and the spectrum of symptoms are briefly discussed.
CURE OF THREE PATIENTS WHO HAD SKELETAL METASTASES IN DISSEMINATED NEUROBLASTOMA
Authors: Reilly Douglas , Nesbit Mark E. , Krivit William
Published: December 2021

The long-term survival of three children with disseminated skeletal metastases due to neuroblastoma is reported. These three patients are added to eight other patients reported in the literature who have survived longer than 2 years after the development of their metastatic osseous lesions. A review of the cases did not reveal a specific treatment regime which provided the success in these cases. The presence of skeletal involvement, therefore, should not indicate a hopeless prognosis. A review of 33 patients with neuroblastoma at the University of Minnesota from 1956-1966 is also given to provide overall survival data.
"LATE EDEMA" IN LOW BIRTH WEIGHT INFANTS
Authors: Wu Paul Y. K. , Oh William , Lubetkin Alberto , Metcoff Jack , Gabler Marjorie , Vaughn Mary
Published: December 2021

Twenty 48-hour balance studies were performed on six low birth weight infants with late edema and on four control infants. Each infant had two balance studies: one on a regular milk formula and another on a lower sodium and potassium milk preparation. The urinary outgo of sodium. potassium, nitrogen, and water was similar in both groups of infants, irrespective of the type of milk intake. The internal distribution of electrolyte and water was calculated from the balance data. In the control infants, the retained water and sodium was distributed between the intracellular and extracellular phases. In infants with late edema, the expansion of the extracellular water and sodium was equivalent to the sum of the net retention, plus an internal shift of water and sodium from the non-extracellular or intracellular phases into the extracellular phase.
INFERTILITY IN MALE PATIENTS WITH CYSTIC FIBROSIS
Authors: Denning Carolyn R. , Sommers Sheldon C. , Quigley Herbert J.
Published: December 2021

Repeated semen analyses done on eight mature male patients with cystic fibrosis have consistently shown azoospermic semen of low volume, low or normal viscosity, increased turbidity, yielding a positive color reaction for fructose. All patients are well developed, well nourished and of normal weight and height although seven of the eight have pancreatic insufficiency. The external genitalia and prostate glands of all patients have been judged normal by a urologist. The eight patients have had minimal respiratory symptoms and mild pulmonary disease. All are either finishing college or, having finished, are employed full time. Histologic examination of testicular tissue obtained at biopsy from one subject and at autopsy from nine additional cases showed active spermatogenesis though 50 percent of the spermatozoa had malformed heads. A possible genetic abnormality was suggested by the presence of many binucleate spermatocytes, spermatocytes containing cytoplasmic inclusions resembling polar bodies and many sticky and incomplete meiosis. Other factors which may be responsible for or contribute to infertility in the male with cystic fibrosis are the low serum levels of vitamins A and E or some interference with the normal transport of the sperm.
Subcutaneous Fat Necrosis with Extensive Calcification After Hypothermia in Two Newborn Infants
Authors: Duhn Roland , Schoen Edgar J. , Siu Moyra
Published: December 2021

In two infants who had been immersed in ice water as treatment for neonatal asphyxia, subcutaneous fat necrosis and severe calcification without hypercalcemia appeared 2 to 5 weeks after the procedure. Growth and development have been normal. This complication must be taken into account in assessing the value of hypothermia as treatment for neonatal asphyxia.
EFFECT OF AN ORAL OSMOTIC AGENT ON VENTRICULAR FLUID PRESSURE OF HYDROCEPHALIC CHILDREN
Authors: Hayden Patricia W. , Foltz Eldon L. , Shurtleff David B.
Published: December 2021

To quantitatively measure the effect of oral isosorbide on ventricular fluid pressure in hydrocephalic children, a method for continuous direct pressure recording with a closed isometric system was utilized. A baseline pressure pattern could be established for each patient, and the effect of drug could be observed with follow-through for reestablishment of baseline pressure after the last dose of drug. Fourteen hydrocephalic children have been given oral isosorbide in doses varying from 1 to 3 gm per kilogram. Significant (average 50%) reduction in ventricular fluid pressure was measured in 13 of the 14 children following a single dose of isosorbide. Rebound pressure greater than baseline was measured in 5 of the 10 children given multiple doses of isosorbide. No toxic side effects were observed during the single dose studies. Clinically significant dehydration and hypernatremia began to occur after 72 hours of continuous drug administration. Serum-CSF gradient curves for drug level and osmolarity are included to show the correlation of these gradients to the ventricular fluid pressure. Pressure curves comparing the effects of intravenous urea, intravenous mannitol, and oral acetazolamide show the quantitative differences in pressure response which can be observed when the pressures are being recorded continuously with a closed system.
EMERGENCE OF BACTERIURIA, PROTEINURIA, AND SYMPTOMATIC URINARY TRACT INFECTIONS AMONG A POPULATION OF SCHOOL GIRLS FOLLOWED FOR 7 YEARS
Authors: Kunin Calvin M.
Published: December 2021

A prospective study is presented of emergence of bacteriuria and proteinuria in a large population of girls who were studied on six occasions over a period of 7 years after entering school. Data were also collected on the frequency and age of onset of overt urinary tract infections, treated as such, by physicians in the community. The cumulative rate of bacteriuria over the first 7 years of school was 2.9%, with an annual mean conversion rate of 0.32% per year. The prevalence of bacteriuria was not significantly different in white and Negro girls, but overt episodes of urinary tract infection were rare in Negro girls. The emergence of bacteriuria and overt infection appear to be linear with time up to age 12 to 15 years, as though girls were at equal risk during the entire observation period. Further prospective study of this population should establish whether the projected rate of 5% of detectable bacteriuria can be demonstrated by the time that these girls are graduated from high school.

Proteinuria in childhood was not related to bacteriuria and, even though much more common (cumulatively 12.9%), was usually sporadic and frequently limited to one or two observed episodes.

In view of the high frequency of bacteriuria in school girls and its tendency to recur, it is probable that infection acquired at this time in life may well serve as a reservoir for overt disease encountered in adult women.
Transverse Nail Ridging in Early Infancy
Authors: Turano Andrew F.
Published: December 2021

A previously undetected transverse ridge the fingernails of normal infants has been described as first appearing at the proximal nail at 4 to 6 weeks of age. The ridge grows out to the free edge of the nail by 14 weeks of age. The intent of this report is to call attention to the fact that the ridge exists. The clinical significance of this finding, if any, awaits more extensive observation.
IMMUNOGLOBULINS OF SPECIFIC STAPHYLOCOCCAL ANTIBODIES
Authors: Martin R. Russell , Daugharty Harry , White Arthur
Published: December 2021

Antibodies against a group protein antigen of coagulase-positive staphylococci, Jensen's protein antigen A, were present at similar concentrations in all paired maternal and cord sera. Teichoic acid antibodies were detectable less frequently but were present almost exclusively in cord sera from infants whose mothers' sera also contained teichoic acid antibodies. No IgA and only 0 to 27 mg/100 ml IgM were detected in eight cord sera containing antibodies against both teichoic acids and antigen A. Teichoic acid precipitates from adult sera were predominately also IgG, but 4 to 29% of the teichoic acid immunoglobulins were IgM and 0 to 6% were IgA. As compared to maternal sera, cord sera was deficient in IgM and IgA staphylococcal antibodies even though total concentrations of precipitating antibodies appeared similar in the two groups of sera. The relative effects of different immunoglobulins in preventing or combating staphylococcal diseases are unknown but deserve further study.
Letters to the Editor
Authors: Wishik Samuel M.
Published: December 2021

Recalling his excellent commentary "Should our Children Pay for the Cigarette Commercials?" (Pediatrics 31:535, 1963), we asked Dr. Samuel Wishik to comment. He writes as follows:

It is important and laudable that the American Academy of Pediatrics joined others in a stand on the smoking problem. I am pleased that Dr. Staub's criticism of the Academy is in the direction of seeking a more aggressive position against smoking. I fully endorse the positive actions that he proposes, while I agree with those suggested by the Academy and the American Cancer Society.
Letters to the Editor
Authors: Cain John J.
Published: December 2021

I am sorry that Drs. Feinbloom and Wolff feel so strongly about Creative Playthings' new items for infants, but I think they are attacking straw toys. Let me hasten to assure them, as well as the many pediatricians Who have responded enthusiastically to these toys, that it is not our intention to exploit infants or their families. We could not have remained in business for a quarter of a century and grown to our present size and influence if we did not provide what both parents and professionals have found useful and attractive materials of many kinds–blocks, dolls, games, musical instruments, art supplies, to name a few of them–for learning through playing.
TWO-DIMENSIONAL ULTRASONOGRAPHY: A METHOD TO STUDY NORMAL AND ABNORMAL VENTRICLES
Authors: Lombroso Cesare T. , Erba Giuseppe , Yogo Takeo , Logowitz Nancy
Published: December 2021

The authors describe an atraumatic diagnostic test apt to reveal the presence of hydrocephalus and other intracerebral anomalies in the child. It utilizes a multilevel, two-dimensional (B-mode) ultrasonic technique that is painless, safe, and easily repeatable. The use of ultrasound in neurological investigation is reviewed briefly and the advantages and disadvantages of A-mode (unidimensional) versus B-mode scanning (two-dimensional) are considered. Standards for the technique of multilevel B-mode scanning are proposed. Their validity was tested by visual and statistical correlation between ventricular measurements obtained by this technique and those obtained by classic radiological investigation. High values of the correlation coefficient were found. The results collected in scanning a group of approximately 600 infants and children are described for each of the following ventricular portions: the third ventricle, the anterior horns and the bodies of the lateral ventricles, and the trigone-temporal horn complex. Other indices of significance were those relating to the midline structures, whose shifts can be accurately predicted, and the Brain Mantle Index, which can give a rough estimate of regional or diffuse atrophic processes. While certain landmarks (such as those pertaining to the midline, third and lateral ventricles) are frequently obtained and measurable, others like those pertaining to the trigone and temporal horns are much less easily detected. Illustrative scans in normal and abnormal subjects are presented. It was concluded that this technique, although unable to outline the contour of the ventricles, lends itself to a general anatomical survey of the ventricular system both for normative purposes as well as detection of important anomalies.
Sedation in Epiglottitis
Authors: Mark Mortimer L.
Published: December 2021

Dr. Geraci's discussion of acute epiglottitis1 is a good one, as well as a reminder of the increased need of liason between the pediatric and anesthesiology departments.

Lost in his discussion, is the very controversial use of rectal thiopental in children with airway problems. The hand of the phsician is no longer on the throttle when using these drugs rectally. Duration of action, absorption, and the potential of delayed sequellae (larynglospasm ) are open to doubt and hazard.
Indications for Tetracycline in Pediatrics
Authors: Schmitt Barton D.
Published: December 2021

The overuse of tetracycline and its derivatives is beginning to trouble pediatricians.1 Its misuse in a member of my family has prompted this letter regarding the social repercussions of this problem. My sister recently informed me that her pediatrician usually treats my niece with tetracycline for her tonsil and ear infections. She wonders now if there is anything she can do about her daughter's yellow brown teeth? All I can tell her is that, from my experience, she will probably have no difficulty whatever finding a mate with the same type dentition.
Simple Test for the Diagnosis of Choanal Atresia in the Newborn
Authors: Reisner S. H.
Published: December 2021

It was of some interest to note the high frequency of choanal stenosis and atresia in the article by Van Leeuwen and Glenn (Pdiatrics, 41:147, 1968). The incidence of this malformation is no doubt much higher than that generally reported in the literature (e.g., 1 in 80001), as no screening test for this malformation is ordinarily used in the newborn nursery. Passing a feeding catheter through each naris could be traumatic and is time consuming.
SURGICAL TREATMENT OF MYELOMENINGOCELE
Authors: Matson Donald D.
Published: December 2021

An unfortunate tendency has arisen among many pediatricians, general physicians, and even neurologists, to regard (1) the indications for surgical treatment of myelomeningocele, and (2) the timing of this surgical treatment as one and the same problem. These are, in the opinion of the undersigned, who receives many inquiries in this area, two entirely different problems, of which separate decisions should be reached. Certain statements which have been misinterpreted and misquoted widely have been made and other claims implied by surgeons, pediatricians, and orthopedists. This Commentary is an attempt to answer questions from a number of different sources and clarify, if possible, at least the position of one neurosurgical clinic with a large experience in the management of spina bifida.
DOCTOR HUGH SMITH URGES MOTHERS TO NURSE THEIR INFANTS
Authors: C. T. E.
Published: December 2021

Probably no physician ever urged mothers to nurse their infants with more florid words than Dr. Hugh Smith. This quotation from Letters to Married Women on Nursing and the Management of Children,1 first published in 1772, is an excellent example of the ornate and overly romantic literary taste of that period:

Oh! that I could prevail upon my fair country-women to become still more lovely in the sight of men! Believe it not, when it is insinuated that your bosoms are less charming, for having a dear little cherub at your breast. I speak from the feelings of a man, and of one too who has an universal and generous love for the virtuous part of your sex. Trust me, there is no husband could withstand the fond solicitations of an endearing wife, would she be earnest in her desire of bringing up her own children. Rest assured, when he beholds the object of his soul cherishing and supporting in her arms the propitious reward of wedlock, and fondly traces his own lineaments in the darling boy, it recalls a thousand delicate sensations to a generous mind: perhaps he drops a sympathetic tear in recollecting the painful throes of the mother, which she cheerfully bore, to make him such an inestimable present. His love, tenderness, and gratitude, being thus engaged–with what raptures must he behold her, still carefully intent upon the preservation of his own image!

How ardent forever such as one's affections might be before matrimnony, a scene like this will more firmly rivet the pleasing fetters of love:–for, though a beautiful virgin must ever kindle emotions in a man of sensibility, a chaste and tender wife, with a little one at her breast, is certainly, to her husband, the most exquisitely enchanting object upon earth:–and surely, ladies, had fashion but established this laudable custom amongst you, it would prove so truly amiable, as not only to excite the emulation of your maiden friends to worthy conquests, but also raise their ambition to shine in characters thus dignified.
BIRTH CHARACTERISTICS AND MALOCCLUSION
Authors: Janerich Dwight T. , Carlos James P.
Published: December 2021

Possible associations between selected natality variables and malocclusion were investigated, using birth certificates and clinical examination records of 1,413 high school children in New York state. A significant association was demonstrated between season of birth and the subsequent presence of malocclusion; an excess of children with occlusal disorders were born in the second quarter of the year (April-June). This observation, together with the relatively high prevalence of malocclusion in the population, suggests that adverse environmental factors during the pre- and perinatal period may occur more frequently than was previously believed and may be important in the development of occlusal disorders.
POSTERIOR MITRAL REGURGITATION IN GIRLS POSSIBLY DUE TO POSTERIOR PAPILLARY MUSCLE DYSFUNCTION
Authors: Sreenivasan V. V. , Liebman Jerome , Linton Donald S. , Downs Thomas D.
Published: December 2021

Nine girls are presented with variable late systolic murmurs (usually best heard sitting up); five of the nine had mid systolic clicks, minimal to mild mitral regurgitation, and striking variable primary electrocardiographic T wave abnormalities. Data from a tenth girl, who has not yet had cardiac catheterization, with similar clinical features are included. The functional anatomy of the mitral valve and some of the factors that give rise to such a picture are discussed. A detailed cineangiographic analysis of the mitral regurgitation is made with stress on the role of the posterior leaflet and posterior papillary muscle. A quantitative angular analysis of the T waves is made. The vectorcardiogram's superiority to the standard electrogram is made clear in this regard.

We believe that this syndrome is caused by posterior papillary muscle dysfunction, though the etiology, including the reason why only girls should be affected, is not known. The prognosis is believed to be good.
PENICILLIN ANTIBODIES IN CHILDREN
Authors: Rosh Melvin S. , Shinefield Henry R.
Published: December 2021

Skin and circulating antibodies against penicillin were determined in 73 children with a positive history of penicillin allergy and 99 children with a negative history of penicillin allergy. Eight percent with positive histories had positive skin tests to benzylpenicillin and a degradation product of penicillin (penicilloyl-polylysine), and/or positive hemagglutination tests for circulating penicillin antibodies. One individual had detectable skin antibodies without circulating penicillin antibodies; and conversely, one patient with circulating antibodies did not have any evidence of skin antibodies. The absence of penicillin antibodies in 85% of those children with a rash following the administration of penicillin confirms the suspicion that physicians are over diagnosing penicillin hypersensitivity in children. With the use of an inhibitor of penicilloyl-polylysine (penicilloyl epsilon-aminocaproate), data is presented which suggests that all positive skin tests to penicilloyl-polylysine may not be due to an antibody-antigen reaction.

The authors recommend that any child who has suspected penicillin allergy should be tested for skin and circulating antibodies no less than 1 month and no more than 1 year following the untoward reaction. Observations suggest that a patient without penicillin antibodies may tolerate penicillin therapy with no adverse reaction. However, until further experience is obtained, penicillin should not be used indiscriminately in the absence of penicillin antibodies.