bluuebunny/crossref_metadata_2025 huggingface dataset:
SOME COMPLICATIONS OF TRANSFUSION, ENDOCRINE THERAPY AND OXYGEN ADMINISTRATION
Authors: Chute A. L.
Published: December 2021

IN NO FIELD has medical opinion reversed itself so completely as in that of blood letting versus blood replacement.

A short time ago while visiting the reconstructed colonial town of Williamsburg, one saw the tools of the old barber surgeons. A copy of a manuscript on the wall stated that George Washington was bled on several occasions during his terminal illness, without seeming benefit.

In this paper, I would like to emphasize some of the ills of blood replacement rather than withdrawal.

Due to the impetus given by life-saving transfusions during the war, blood transfusion has become universally available in all parts of the country. This has not proved an unmixed blessing, however, for the dangers associated with blood transfusion have also been greatly multiplied thereby.

The factors which give rise to these dangers are as follows: 1) those associated with donor; 2) those associated with stored blood; 3) those associated with act of transfusion; 4) those associated with recipient.

1. Factors Associated with Donor

1. Homologous serum jaundice.

2. Allergic reactions.

3. Transmission of tropical and other infections.

The danger of transmitting the virus which causes jaundice is greater than may be realized, and is rebated to the incidence of the carrier state in the population. The incidence in the general population has been estimated as from 0.1% to 0.5% to 0.35%. In one Army Camp in the United States it was found to be as high as 5%.

As one might expect the danger of transmission is greatest the more recently the donor has had jaundice, but some work in Germany suggests that even 6 years or more after having hepatitis, donors may transmit the virus to 3.6% of recipients.
PERINATAL PULMONARY PATHOLOGY
Authors: Briggs J. N. , Hogg Georgina
Published: December 2021

A series of 153 necropsies of liveborn infants was reviewed. Data from 110 of these and 26 stillborn infants were accepted for study. It was noted that 61.9% of the children died from major pulmonary disorders. Hyaline membrane was present in 33.6% of the 110 liveborn infants.

The time relationships of the various conditions was reviewed.

A new pathologic appearance—hyaline type of atelectasis but with the absence of the true membrane—was noted. This condition is considered to fall into the same clinical and pathologic group as hyaline membrane and pulmonary hemorrhage.
THE REACTIONS OF HOSPITALIZED CHILDREN TO ILLNESS
Authors: Blom Gaston E.
Published: December 2021

The emotional reactions of the hospitalized child to illness are determined by the nature and degree of stress from both realistic and unconscious sources and the balance of forces within the child, his parents, and the hospital environment which facilitate or impede adaptation.
TRIMETHADIONE (TRIDIONE®) NEPHROSIS
Authors: HEYMANN WALTER
Published: December 2021

TRIMETHADIONE (3,5,5-trimethyl-2,4-oxazolidinedione, Tridione® is a useful drug in the management of petit mal seizures. It may, however, like many pharmacologically effective agents, have untoward reactions. These can involve: 1) the central nervous system (diplopia, vertigo, headaches and hiccups); 2) the hematopoetic system (depression of bone marrow activity); 3) the skin (various forms of rashes, erythema exudativum multiforme and angioneurotic edema; and 4) the kidneys.

Renal complications of trimethadione administration are noted in two different forms. Microscopic hematuria and cellular casts have been reported, and 10 years ago, the nephrotic syndrome due to prolonged trimethadione treatment was first described by Barnett.
RENAL BIOPSY IN CHILDREN
Authors: VERNIER ROBERT L. , GOOD ROBERT A.
Published: December 2021

RENAL biopsy offers invaluable aid in the clinical diagnosis of kidney disease and is an important technique in research designed to clarify the etiology, pathogenesis, and evaluation of therapeutic agents, in a variety of renal diseases.

The majority of the scientific reports describing renal biopsy have concerned adult patients. The few available reports of renal biopsy in children do not discuss the risks attending the procedure or the specific problems peculiar to kidney biopsy in children. A review of our experience in 150 renal biopsies in children may afford a basis for evaluation of these questions.

The available techniques of renal biopsy include: 1) surgical exploration and removal of a segment of kidney cortex, and 2) percutaneous needle biopsy.
METACHROMATIC LEUKO-ENCEPHALOPATHY
Authors: Hain Raymond F. , LaVeck Gerald D.
Published: December 2021

Metachromatic leuko-encephalopathy is a familial degenerative disease of the central nervous system included with Schilder's disease as a type of diffuse cerebral sclerosis. The disease usually has its onset early in childhood and is characteried by progressive motor and mental deterioration with ataxia, muscular weakness, spasticity, optic atrophy, convulsions and finally dementia. The concentration of protein of the cerebrospinal fluid is frequently elevated.

The pathologic findings consist of demyelination, destruction of axons, gliosis and the accumulation of metachromatic granules in the brain and other organs. The metachromasia can be demonstrated in formalin-fixed frozen sections with a toluidine blue stain. It is not demonstrable in paraffin sections. Histochemical studies indicate this abnormal material is probably a complex of glycolipids and protein. It has been reported elsewhere that early diagnosis can be established by demonstrating the metachromatic materials in urinary sediment or in a real biopsy. An illustrative case has been presented.
ALTERATIONS OF pH, GASES AND HEMOGLOBIN IN BLOOD AND ELECTROLYTES IN PLASMA OF FETUSES OF DIABETIC MOTHERS
Authors: Kaiser Irwin H. , Goodlin Robert C.
Published: December 2021

The pregnant diabetic at or near term, in the absence of clinical metabolic disorder, ordinarily exhibits only minor differences from normal pregnant women in regard to pH, content of gases, and concentration of hemoglobin in blood and concentration of electrolytes in plasma. The diabetic in labor is likely to evidence signs of metabolic acidosis which is only partially compensated.

The fetus of the diabetic, on the other hand, is frequently found to have marked changes in pH, pCO2 and oxygen saturation of the blood. There is a small decrease in total concentration of electrolytes, which is apparently related to dilution of the blood. Concentration of hemoglobin is slightly increased, but if dilution is taken into consideration, this probably represents a significant increase in total hemoglobin mass. The variability of several components of the blood is greater than in normal fetuses.

The changes in pH and pCO2 are sufficient, in their effect on dissociation of oxyhemoglobin, to account for the mean decrease in saturation observed in the fetuses of diabetics without any change in pO2. The average fetus, therefore, cannot properly be said to be hypoxic. However, individual fetuses are observed with very marked reductions in oxygen saturation which undoubtedly reflect true hypoxia. Biochemical alterations in these fetuses are out of proportion to maternal changes but, once proper pulmonary ventilation is established, can be readily reversed. It appears from this that the lesion is likely to be placental rather than maternal or fetal.

Biochemical deviations from normal in the present series are only irregularly related to neonatal difficulty. The two infants who died in the present study were the only prematures, and only one manifested severe and disproportional changes. The biochemical changes observed do not per se appear to be sufficient to account for the known neonatal difficulties of the infants of diabetic mothers, but, in aggravated form, might account for fetal death.
METABOLIC STUDIES OF NORMAL FULL-TERM INFANTS FED A PREPARED FORMULA PROVIDING INTERMEDIATE AMOUNTS OF PROTEIN
Authors: Fomon Samuel J. , May Charles D.
Published: December 2021

Twelve normal full-term infants have been studied during ad libitum feeding of a prepared formula of cow's milk (Formula S) which provided an intake of protein intermediate between that of infants consuming human milk and that of infants receiving commonly employed formulas that supply two-thirds of the calories from cow's milk and one-third from additional carbohydrate.

Growth of the infants proceeded along normal developmental channels but, as in the case of infants fed human milk, the growth curves generally fell at or below the 50th percentiles of the Iowa Growth Charts. The studies were designed to compare nitrogen retention of groups of infants growing normally. Proper evaluation of growth of infants fed different foods would require larger numbers of infants in each group.

The mean concentrations of total protein and urea nitrogen in the serum were 5.3 gm/100 ml and 8.9 mg/100 ml, respectively.

The mean volume of intake was 198 mg/kg/day (providing 133 cal/kg/day) in metabolic balance studies performed during the first 1½ months of life and 142 ml/kg/day (providing 95 cal/kg/day) during similar studies performed between 4½ and 6 months of age. The mean intakes of nitrogen during the corresponding periods were 534 mg (= 3.3 gm protein) and 398 mg (= 2.5 gm protein)/kg/day, and the mean retentions of nitrogen were 211 and 102 mg/kg/day, respectively.

The retentions of nitrogen by infants ingesting Formula S ad libitum were as large as, or greater than, those of infants ingesting human milk ad libitum.
INFANTILE SPASMS WITH MENTAL RETARDATION
Authors: Low Niels L.
Published: December 2021

Seven of ten children with infantile spasms and retardation showed clinical and electroencephalographic improvement when treated with ACTH or cortisone. The number of children treated is small and the period of observation is still short, but the initial results are promising enough to justify a report in order to encourage other investigators to evaluate this treatment. The mechanism of this favorable response is not understood.
Seizures Following Phenothiazine Tranquilizers
Authors: BOWEN EDWARD H.
Published: December 2021

Dr. Edward Shaw's letter (Pediatrics, 22:175, July, 1958) performs a valuable service by calling attention to the importance of recognizing what may often be sudden and alarming side effects of the use of phenothiazine compounds. Dr. Shaw reported on reactions in seven children and two adults who experienced "convulsions" while receiving phenothiazine compounds. (Seven of the patients were treated with Compazine®, a Smith, Kline & French Laboratories' product.) I think it might be useful to comment briefly about reactions such as those observed by Dr. Shaw.
Vitamin B12 Supplementation
Authors: HOWE E. E.
Published: December 2021

I have read the report of the Committee on Nutrition (Pediatrics, 21:860, 1958) appraising the use of vitamins B1 and B12 as supplements for the stimulation of growth and appetite in children with a great deal of interest. My own interest in this area has been centered on vitamin B12 and my comments will be limited to the studies with this vitamin. I think anyone who has studied the literature on this subject carefully, realizes the complexity of the problem and the difficulties that are involved in its evaluation.
CRANIOFACIAL DYSOSTOSIS OF CROUZON
Authors: Shiller Jack G.
Published: December 2021

THIS REPORT describes an infant with craniofacial dysostosis noted at birth. As in the original description by Crouzon, the infant demonstrated a bony-hard protrusion of the skull in the region of the anterior fontanelle, with widening of the transverse diameter and anteroposterior shortening. In addition, the presence of relative prognathism and exophthalmos with divergent strabismus completed the classic picture.

Crouzon's first description of the syndrome was reported in 1912 in a woman and her son. Three years later he described a family in which 7 of 21 members were affected. That paper stressed the hereditary aspects of the syndrome. Since then few papers have been concerned with heredity. Atkinson collected 86 cases of the malformation, in which 56 patients had positive family histories. Fogh-Anderson suggested the pattern of simple dominance, when he described an affected mother who had affected children in two different marriages. One of hen pregnancies produced dizygotic twins, only one of whom was affected. Flippen reported a family in which 10 of 21 progeny in four generations were affected. He concluded that this represents the expression of ". . . an heterozygous, dominant trait."

Extensive investigation of the family history of the patient reported herein revealed the data which comprise the body of this report.

CASE REPORT

Clinical History

The patient was born at home and transferred immediately to Norwalk Hospital. At the time of admission he weighed 3,360 gm. Physical examination revealed a well-developed infant, normal except for the head which is better illustrated than described (Fig. 1). The skull malformation was bony-hard to palpation except for the anterior fontanelle, which measured less than 1 by 1 cm. All suture lines were closed. The posterior fontanelle was not palpable. Hypertelorism and exophthalmos were present. Bilateral divergent strabismus was observed intermittently. The optic fundi appeared normal.

Roentgenograms of the skull showed premature closure of all sutures. A small segment of the anterior fontanelle was open. The remainder of the protuberance in the midline anteriorly was supported by plates of bone (Fig. 2).

The infant sucked and swallowed well and had normal motor activity. Reflexes were normal. Two craniectomies were performed uneventfully for excision of bone in the area of the coronal sutures. He was discharged home at the age of 4 months with minimal noticeable change in skull shape.
Surgery in Infancy and Childhood
Authors: EBBS J. H.
Published: December 2021

This textbook deals with surgery for the senior student and nurse. The general treatment of the important subjects of pre- and postoperative care, anesthesia and specialized conditions of infancy and childhood are features of early chapters. It is noted that numerous rare conditions are mixed in with common every-day surgical problems without indication of the incidence nor all common conditions dealt with. It is obvious that the textbook is not intended to replace a textbook of general surgery.

The description of the clinical features and treatment of most conditions is not complete, yet it is probably adequate for the student in medicine. On the other hand such conditions as intussusception are extremely well written and documented.
Tuberculosis Pulmonar Infantil
Authors: SMITH MARGARET H. D.
Published: December 2021

This profusely and very beautifully illustrated textbook should be a welcome addition to the libraries of our Spanish-reading colleagues. Particularly good chapters on segmental anatomy of the lungs and on roentgenographic findings in the chest in tuberculous children are followed by chapters on the evolution of the primary complex; on endobronchial tuberculosis and obstructive lesions; pleurisy and pericarditis; progressive primary lesions with cavitation; hematogenous dissemination; chronic pulmonary tuberculosis of "reinfection" type in children and adolescents. Shorter chapters are devoted to such special problems as primary infection during puberty, primary infection in adults, congenital tuberculosis and the chronology of tuberculous infection in children.
HEMOLYSIS OF TRANSFUSED CELLS DURING USE OF THE INJECTION (PUSH) TECHNIQUE FOR BLOOD TRANSFUSION
Authors: Macdonald William B. , Berg Robert B.
Published: December 2021

A case of hemoglobinemia and hemoglobinuria, occurring during an injection transfusion, is presented. Experiments were carried out which indicate that the unexpeditious use of force applied in injecting blood through a narrow-gauge needle resulted in hemolysis.
Negroes and Medicine
Authors: CRUMP E. PERRY
Published: December 2021

The present position of the Negro physician in American medicine is by no means fortuitous, nor is it the result of timely official decree. Historically, the Negro doctor has faced the same rugged pattern of uphill struggle for initial training opportunities, for hospital staff privileges in the care and follow-up of his patients, and for recognition by and integrainto the major medical society (A.M.A.) in this county, as has his lay counterpart in analogous nonmedical settings.

In a well arranged, highly authentic book of some 400 pages, Dietrich C. Reitzes tells the story under the title, Negroes and Medicine.
COMPOSITION OF MUCOPROTEIN FRACTIONS FROM DUODENAL FLUID OF PATIENTS WITH CYSTIC FIBROSIS OF THE PANCREAS AND FROM CONTROLS
Authors: Dische Zacharias , Sant'Agnese Paul di , Pallavicini Charles , Youlos Joshua
Published: December 2021

The mucus of the duodenal fluid of children contains a mixture of carbohydrateprotein complexes with the character of mucoids and glycoproteins.

In duodenal fluids from patients with cystic fibrosis of the pancreas about one-third in controls about 90%, of the mucoid material is soluble in trichloroacetic acid (TCA).

In duodenal fluids from patients with cystic fibrosis about one-third of the mucoid becomes denatured and insoluble in water when precipitated with an ethanolbenzene mixture.

The TCA-soluble mucoid from patients with cystic fibrosis and controls was separated by fractionated ethanol precipitation into four fractions: three precipitating at 50% (A); 67% (B); and 90% (C), respectively; and one soluble in 90% ethanol.

All four fractions contain as carbohydrate moiety a fucomucopolysaccharide.

Fractions C and D contain about equivalent amounts of galactose and mannose and in patients with cystic fibrosis only one hexosamine (glucosamine) in demonstrable amounts. Fractions A and B contain glucosamine as well as galactosamine in comparable amounts, but the hexose present is galactose to an extent of more than 80%.

The polysaccharides of all four mucoid fractions differ in their content of sialic acid. The least-soluble fraction A contains less of it than the more soluble fractions.

The content of sialic acid in the mucopolysaccharide of the water-insoluble mucoid, and of the TCA-insoluble water-soluble fraction from pooled duodenal fluids of patients with cystic fibrosis, approaches that of fraction A and is lower than that of other fractions.

The molar ratio of fucose to hexosamine in fraction A, and in the water-insoluble mucoid from patients with cystic fibrosis, is higher than in all fractions from controls.
Vision Screening for Elementary Schools
Authors: LAWSON LAWRENCE J.
Published: December 2021

This book reports a statistical study made of 1,000 Orinda, California, children who were given annual school visual screening tests of various types for 3 consecutive years. Throughout the report a plea is made for agreement between ophthalmologists and optometrists via an interprofessional committee to establish screening standards that will identify children requiring visual attention. It is repeatedly emphasized that performance on visual acuity alone does not adequately refer all those needing care, but a more comprehensive analysis is necessary. The study attemps to determine the cut-off points on selected criteria which would separate the correct referrals from the unnecessary ones as accurately as possible.
MENTAL HYGIENE IN THE NEW PEDIATRICS
Authors: MAY CHARLES D.
Published: December 2021

THE PRACTICE of the New Pediatrics in the office and the home is comprised preponderantly of supervision of growth and development of well children and treatment of the less profound disturbances of physical and mental health. Pediatricians have pioneered in efforts to incorporate mental hygiene into medical practice, although with considerable hesitation and confusion. It is particularly in this area, during the past two decades, that new concepts have been introduced—with inevitable disruption of the teaching as well as the practice of pediatrics. This may be the crux of the problems presented by the New Pediatrics.

Other recent advances, however impressive, have been more technical than conceptual. In general, progress in knowledge of infectious disease, nutrition, cardiology, metabolic disorders, endocrine disease and genetics has followed the natural course of discovery and increasing complexity that develops from application of new techniques to established concepts.
COMMITTEE OF THE SECTION ON DISEASES OF THE CHEST
Authors: ALWAY ROBERT H. , KENDIG EDWIN L. , NELSON WALDO E. , ROBINSON ARTHUR M. , SIFONTES JOSE E. , LINCOLN EDITH M.
Published: December 2021

THE FACT has been established that children may acquire a primary tuberculosis infection with tubercle bacilli resistant to streptomycin. The source of the infection can often be traced to an adult previously treated with streptomycin from whom drug-resistant organisms can be cultured. Relatively little information about primary infections in children with bacilli showing drug resistance to isoniazid is available, and no reports have been published from the United States. The Committee therefore decided it was of importance to determine if possible the incidence of such infections.

Most of the 57 members of the Section on Diseases of the Chest are actively engaged in care of tuberculous children. A questionnaire was distributed to them in the spring of 1958 in an attempt to learn the incidence of initial infection with drug-resistant tubercle bacilli. Replies were received from everyone, but 20 individuals had little or no information to give. Thirty-seven members of the Section furnished information from 34 clinics.

The present report is based on the data supplied from 31 clinics in which cultures of gastric lavages were done regularly prior to treatment. Only 7 of these 31 clinics did drug-susceptibility studies on positive cultures routinely; 21 clinics reported that susceptibility studies were not done regularly, and 3 reported that drug susceptibility of cultures of tubercle bacilli was never tested.

It was possible to estimate that the seven clinics which did drug-susceptibility tests routinely had reported on a total group of about 2,500 tuberculous children, of whom about 1,800 had been under observation since the introduction of isoniazid into drug regimens. Only 4 of the 7 clinics which did drug-susceptibility tests routinely reported the finding of initial (pretreatment) drug-resistant cultures of tubercle bacilli. Only 2 of the 3 clinics reporting bacterial resistance to isoniazid did catalase tests routinely.

The method of expressing bacterial resistance varied in each clinic. In the present report we have considered that bacterial resistance to isoniazid was present if 1% of the total population grew in 0.2µg/ml, and bacterial resistance to streptomycin if 1% of the total population grew in 2.0µg/ml.
More About the Backward Child
Authors: RIGG L. ISOBEL
Published: December 2021

As the title suggests, this book is by nature of a supplement to two previous publications, The Retarded Child and Training the Backward Child. The author intends the reader to be familiar with the earlier books. The present work is concerned with Miss Loewy's experiences in her small residential school for backward girls and she directs herself to "teachers, parents, and all concerned with the welfare of backward children."

The volume is divided into five sections: 1) General; 2) Sex and the Backward Child; 3) Delinquency and the Backward Child; 4) More About Education; and 5) Case Book.

American readers will experience some difficulty with the British terminology as well as some of the problems and suggestions. The stated attempt to avoid medical terms mystifies rather than simplifies.
PHONOCARDIOGRAPHY IN ACYANOTIC CONGENITAL HEART DISEASE
Authors: Auerback Marvin L. , Sokolow Maurice
Published: December 2021

The phonocardiographic data in 210 cases of acyanotic congenital heart disease were studied, with particular reference to correlation of phonocardiograms with auscultatory findings noted at the bedside and with physiologic data (such as blood pressure and flow) obtained by cardiac catheterization or during surgical procedures. Examples of a wide variety of lesions are presented and discussed.

Congenital cardiac lesions are manifested by certain characteristic murmurs and sounds which are modified in a predictable manner by the physiologic disturbances secondary to the cardiac defect (such as pulmonary hypertension of varying degrees). Although the lesions often can be diagnosed by auscultation alone, the correlations in this study indicate that phonocardiography is more precise than the ear in gauging the degree of the secondary disturbances. [See Fig. in Source Pdf.]

As shown by representative tracings included in this report, phonocardiography records fine changes in the timing, configuration, duration, intensity and localization of cardiac sounds and murmurs which cannot always be detected by auscultation.

The use of phonocardiography as an adjunct to auscultation results in more accurate assessment of the lesions of congenital heart disease and a greater understanding of the associated physiologic changes. This ultimately leads to a more rational basis for decisions which the physician must make regarding definitive treatment. With experience in correlating auscultatory and phonocardiographic findings, the physician often can improve his auscultatory accuracy but he can never equal the refinement of a good graphic recording.
Child Welfare: Principles and Methods
Authors: PARMELEE A. H.
Published: December 2021

This book is well-organized into five parts with the following headings: 1) The Inheritance of a New Nation; 2) Significant Events in the Nineteenth Century; 3) The Child in the Twentieth Century; 4) Children in Need of Special Protection; and 5) Services for Children with Special Needs. Each part is further subdivided into several chapters.

In the first two parts the historical development of public attitudes and actions with regard to child welfare in England and the United States are systematically reviewed. Present-day child welfare principles and practices as they have developed in the United States are presented in Part Three as a logical outcome of the previously outlined historical background.
SURGICAL TREATMENT OF ATRIAL SEPTAL DEFECT IN CHILDREN
Authors: McGoon Dwight C. , DuShane James W. , Kirklin John W.
Published: December 2021

All patients aged 14 years or less operated on for atrial septal defect that was not associated with other cardiovascular anomalies at the Mayo Clinic before December, 1958, were studied. There were 58 such patients.

In the majority of operations, the atrial well technic of repair was employed. In seven, the technic using extracorporeal circulation was considered necessary; this technic was chosen in each instance because other or associated anomalies were suspected. In no case in which the atrial well technic was chosen was a condition discovered that was inoperable by this approach.

No mortality occurred, and the result in each case is considered excellent.

These results indicate that repair of an atrial septal defect of significant size is usually advisable even in the absence of appreciable disability.
STUDY OF STAPHYLOCOCCAL ANTIBODIES OF THE RANTZ TYPE: PLACENTAL TRANSFER AND TITERS IN SERA OF CHILDREN OF VARIOUS AGES
Authors: Neter E. , Rajnovich E. , Gorzynski E. A.
Published: December 2021

Basic hemagglutination and enzyme hemagglutination procedures were employed for the detection and titration of staphylococcal antibodies of the Rantz type. Staphylococcal antibodies were detected in 37 out of 42 specimens of cord serum and in 40 out of 42 corresponding specimens of maternal serum. The titers of antibodies in cord and maternal blood were similar (ratio of 1 or 0.5) in 62% of paired specimens. Study of specimens of serum from 185 children of various ages revealed that staphylococcal antibodies of the Rantz type were present in 94% of infants up to 3 weeks of age, in 25% of infants 6 to 10 weeks of age, and in all children older than 6 years.

In 25 infants the antibody titers were determined several weeks or months apart, and it was found that a substantial decrease occurred in 9 out of 10 infants between the ages of 6 and 12 weeks and a significant rise in 12 out of 13 infants between the ages of 4 months and 2 years.

In parallel experiments it was shown that antibodies against the somatic antigen of E. coli O55:B5 are transferred from mother to infant less frequently and less efficiently than staphylococcal antibodies of the Rantz type.

The enzyme (protease) hemagglutination test proved to be considerably more sensitive for the demonstration and titration of staphylococcal antibodies of the Rantz type than the basic hemagglutination procedure.
CYTOMEGALIC INCLUSION DISEASE OF THE NEWBORN
Authors: Kluge Robert C. , Wicksman Robert S. , Weller Thomas H.
Published: December 2021

Clinical and virologic studies are reported of a patient with neonatal cytomegalic inclusion disease. Jaundice, purpura and hepatosplenomegaly were noted shortly after birth and thereafter the course during a 2-year follow-up period was primarily one of improvement. At the end of this period signs suggestive of developmental difficulty were present as evidenced by impairment of speech and a head circumference below the 3rd percentile for age.

Cytomegalic virus was recovered from the urine at 2 and 5 weeks and at 3, 16, 21, and 26 months of age, suggesting that viruria was a constant feature during the period of observation. Neutralizing antibody for the virus was present in the patient's serum during the period of viruria. Recovery of cytomegalic virus from the urine during the neonatal period would appear to be a useful diagnostic procedure. However, the demonstration of viruria in the older infant does not necessarily have the same diagnostic significance.
GENETICS AND METABOLISM
Authors: Childs Barton
Published: December 2021

IT IS the part of wisdom when about to give a dissertation which one hopes will at once instruct and entertain, to provide at the outset some definition of the subject matter. Genetics is the study of the heritable components of variation; the heritable factors which determine the range or extent of diversity. So, genetics is concerned with heritable differences and likenesses between individuals and between species. One emphasizes the differences because one can be certain of genetic determination of a particular characteristic only when it exists in a population in two or more alternative forms. It is the variants which catch the eye and hold the attention of the investigator, and which by their presence suggest more than one form of the gene or genes which determine that particular characteristic. I would like in what follows to present some examples of investigations of some aspects of genetics in human populations.

ADRENAL HYPERPLASIA

Several years ago Dr. Melvin Grumbach and I studied the genetics of adrenal hyperplasia, using as our material the patients of Dr. Lawson Wilkins. Since the disease occurs in more than one member of a sibship and since parents are unaffected, we suspected that it was genetically determined and that the affected patient possessed a double dose of a mutant gene; that is, the characteristic was recessive.
INTUSSUSCEPTION IN CHILDHOOD
Authors: Robins M. Moreno , Plenk Henry P.
Published: December 2021

A city-wide study of intussusception in childhood is reported. The classic signs and symptoms (vomiting, abdominal pain, bloody stools, palpable abdominal mass) are reported in percentages approximating those previously reported by other authors. Intussusception in childhood occurred about once in every 13,000 admissions to general hospitals. Of 26 cases, 3 had surgery without barium enema. In 11 of 23 patients who had roentgenographic examination the intussusception was reduced by enemas (48%). In one patient the lesion recurred after 24 hours.

No deaths were encountered in this small series.

Provided certain precautions are followed, barium enema is a safe procedure which will save about one-half of the patients a surgical procedure and unnecessary prolonged hospitalization.
Disturbances in Gastrointestinal Motility
Authors: DAVIDSON MURRAY
Published: December 2021

This book, comprised of contributions by 28 individuals, has resulted from a 3-day conference held in December 1958 at the University of California School of Medicine on "The Pathophysiology and Treatment of Disturbances in Gastrointestinal Motility. "The editors, in spite of their recognized competence to do so, have failed to weave the thread of continuity which is necessary to elevate such reports of the proceedings of symposia from the disjointed efforts of a number of individuals into a treatise of unified orientation and purpose.
ACUTE BACTERIAL MENINGITIS IN CHILDREN
Authors: Haggerty Robert J. , Ziai Mohsen
Published: December 2021

A controlled study of the treatment of bacterial meningitis with single and multiple, potentially antagonistic antimicrobial drugs was undertaken. Sixty-five patients received a single and 71 received several drugs in combination. The two groups were generally comparable. There was no significant difference in the results: that is antagonism could not be demonstrated in this clinical study. It seems reasonable to recommend that, in patients over 1 month of age with acute primary bacterial meningitis in whom an etiologic agent cannot be promptly identified, the use of multiple drugs aimed at the three most likely organisms (pneumococcus, meningococcus, H. influenzae) can be employed without danger of clinically apparent antagonism.
STAPHYLOCOCCAL ANTIBODIES IN CYSTIC FIBROSIS OF THE PANCREAS
Authors: Halbert S. P. , di Sant'Agnese P. A. , Kotek F. Rotman
Published: December 2021

It has been shown that the sera of patients with cystic fibrosis reveal more numerous and frequent antibody responses to extracellular products of strains of Staphylococcus aureus than do sera from control subjects of a similar age, time and place.

In a significant percentage of patients with cystic fibrosis multiple antibody responses were found against extracts of a Hemophilus influenzae strain. Such multiple antibodies were not seen in sera of the control group. These findings suggest that this organism may not infrequently be involved in the pathogenesis of the pulmonary lesions.

Many more patients with cystic fibrosis than controls failed to reveal antibodies against the extracellular products of a strain of group A hemolytic streptococcus. No detectable antibodies were found in any of the sera against pneumococcal type 2 polysaccharide, old tuberculin or a mouse peritoneal toxoplasma concentrate.

The potential value of this approach for the analysis of the underlying etiologic agents involved in the respiratory infections of patients with cystic fibrosis is discussed.
The Mother-Child Interaction in Psychosomatic Disorders, Ann M. Garner and Charles Wenar, Urbana, Illinois, University of Illinois Press, 1959, 290 pp., $6.00
Authors: Senn Milton J. E.
Published: December 2021

For a number of years the Department of Psychiatry at the University of Illinois maintained an in-patient service for physically sick children whose illness seemed to stem from psychologic difficulties. This ward for psychosomatic patients served children with bronchial asthma, rheumatoid arthritis, ulcerative colitis, peptic ulcer and atopic eczema. The staff, made up chiefly of psychiatrists and psychologists included a pediatrician, an educator and an occupational therapist. From their experiences here the staff started research with ambulant patients who lived in their own homes, attended public schools, and who might have had periods of hospitalization previously but were not in-patients when studied intensively for the psychologic etiology of their illnesses.
THE PRESENTING MANIFESTATIONS OF OBSTRUCTIVE URINARY ANOMALIES IN CHILDREN
Authors: McGovern John H.
Published: December 2021

Urinary infections are abnormal and the overwhelming majority occurring in children are based upon obstructive anomalies. This is demonstrably true of persistent or recurrent infections. While most obstructions are readily detectable by urologic means, catheterization and intravenous pyelography particularly, there are poorly understood uropathies that are difficult to recognize. Although antibacterial medication will often suppress the invading organism, a true cure rarely results until the obstruction is relieved. It is also important to remember that the kidneys can be destroyed by obstruction alone, in the absence of or during the suppression of infection. Early detection usually depends upon the pediatrician's awareness of the common manifestations of urinary obstructions.
VALUE OF HYPOSENSITIZATION THERAPY FOR PERENNIAL BRONCHIAL ASTHMA IN CHILDREN
Authors: Johnstone Douglas E. , Crump Lee
Published: December 2021

The responses of children with perennial bronchial asthma to three conventional methods of hyposensitization therapy and to a saline control treatment have been compared. There were approximately 40 children in each treatment group. The measures of response utilized were incidence of new allergies during treatment, incidence of wheezing on exertion and with upper respiratory illness after 4 years of treatment, and numbers of asthma attacks and days wheezing during the fourth year of treatment relative to the numbers in the year preceding treatment.

The conclusion was that hyposensitization therapy, using sufficiently high doses of the antigen mixture, is quite effective in controlling the symptoms indicated above.
THE MANAGEMENT OF ACUTE POISONING BY FERROUS SULFATE
Authors: Schafir Michael
Published: December 2021

Two cases, one extremely acute, the other one only moderately so, of iron poisoning are reported. Both patients survived without sequelae. The pathophysiology of acute iron poisoning and its treatment are discussed. A therapeutic regimen is offered with the realization that many facets need further elucidation. The potential usefulness of a chelating agent, edathamil, is discussed.
A SIMPLIFIED TECHNIQUE FOR VACCINATION AGAINST SMALLPOX
Authors: Kravitz Harvey
Published: December 2021

A new device for performing vaccination against smallpox has been successfully used in 323 patients.

The percentage of vaccination "takes" of the experimental scarifier "loaded" with vaccine material (Groups III, IV and V) is greater than the presently-used multiple-pressure method, although the difference is not statistically significant.

The new vaccinator provides uniformly smaller and cosmetically superior scars.

Struggling of infants and children is eliminated by this procedure.

The fear of the sight of the currently employed vaccinating needle is eliminated in children by the use of this new procedure.

There is less pain with the proposed method since the points are designed to press into the epidermis, and pricking of the dermis is minimized.

A vaccination can be performed in 2 to 3 seconds with ease in all age groups.
The Anonymous Mycobacteria in Human Disease
Authors: BLATMAN SAUL
Published: December 2021

The proceedings of a conference on Anonymous Mycobacteria in Human Disease, held at the University of Texas Southwestern Medical School, are reported. The ideas expressed by the authorities participating are extremely informative. Dr. John S. Chapman, the editor of this book, has done a considerable amount of work on the problem of anonymous mycobacteria in human disease and is indeed welt qualified to edit this volume.

The report of this conference offers a comprehensive coverage of the bacteriologic characteristics of the anonymous mycobacteria, as well as the human pathology and known clinical aspects of disease produced by these organisms.
VENOUS REMNANTS PRODUCING NEONATAL CHYLOUS ASCITES
Authors: Gross John I. , Goldenberg Victor E. , Humphreys Eleanor M.
Published: December 2021

Neonatal chylous ascites is a rare syndrome. No single etiology dominates in its genesis. However, the presence of a chyloperitoneal effusion usually implies an obstructive process or defect in the lymphatics, centrally or peripherally. The case reported was produced by congenital venous remnants obstructing the mesentery. Detailed findings, including necropsy examination are presented.
CATECHOLAMINES IN TISSUES OF THE HUMAN FETUS
Authors: Greenberg Robert E. , Lind John
Published: December 2021

Various tissues of the early human fetus were studied, in terms of their catecholamine content, as a means of evaluating the level of maturation of the sympathetic nervous system and chromaffin tissue.

Epinephrine was found in significant amounts in the adrenal medulla but not in para-aortic chromaffin tissue. Its presence in the medulla was recorded by fluorescent analysis, bioassay and quantitative paper chromatography. Although the reasons for the differences between these findings and those reported previously by others remains unclarified, the following conclusions may be made: 1) the total catecholamine content of fetal adrenal glands is extremely low, reflecting the scanty occurrence of adrenal chromaffin tissue, 2) norepinephrine is the predominant amine in chromaffin tissue in fetal life, present in greater absolute and relative amounts in extramedullary rather than medullary chromaffin tissue, 3) epinephrine is present in the adrenal gland from a very early stage of fetal life, and 4) the physiologic importance of either epinephrine or norepinephrine in the chromaffin tissue of the fetus awaits elucidation.

In organs, the content of catecholamines roughly parallels that of adult members of other species, indicating the presence of a potentially functioning adrenergic nerve supply at an early stage of development.

In cerebral tissue, the content of catecholamines appears to be much lower than adult tissue in the early fetus. Dopamine is not present in brains of fetuses, at least during the first trimester of pregnancy, suggesting a dissociation of function between dopamine and norepinephrine in the central nervous system.
THE VARIOUS TYPES OF THYROID MALFUNCTION IN CRETINISM AND THEIR RELATIVE FREQUENCY
Authors: Carr Edward A. , Beierwaltes William H. , Neel James V. , Davidson Ruth , Lowrey George H. , Dodson Vernon N. , Tanton John H.
Published: December 2021

Previous comprehensive biochemical studies of thyroidal function in cretins were each performed on a few individuals. Such studies do not permit an evaluation of the incidence of various thyroidal defects in cretins. We have therefore performed a comprehensive clinical and biochemical study of 56 cretins from the State of Michigan, including 41 born after the introduction of iodized salt into Michigan.

Cretins were considered to have a thyroid gland if it was palpable, was found surgically, demonstrated by scintigram, or showed a net radioactive iodine (I131) uptake over the thyroidal area exceeding 10%, or if there was evidence of incorporation of administered I131 into circulating compounds. The minimum incidence of thyroid glands in cretins was 21% and the probable incidence 32%.

Inability of the thyroid gland to organify iodine was detected by discharge of I131 after administration of potassium thiocyanate (KSCN) to six patients, and chromatography of the thyroid gland hydrolysates in four patients. Inability to organify iodine was the most common clearly identifiable defect in these cretins with thyroid glands.

The familial incidence of cretinism was higher in subjects with thyroid glands than in athyrotic subjects. Cretins with thyroid glands co-existed in the same sibship with athyrotic cretins. Serial studies of thyroidal function indicate that progressive postnatal failure of thyroid function may result in athyreosis.
THE WEIGHT OF THE HEART OF MATURE INFANTS AFTER ASPHYXIA NEONATORUM
Authors: Burnard E. D. , James L. S.
Published: December 2021

The average weight of the heart in mature babies dying after asphyxiation at birth was greater than in controls matched for birth weight. Diagnosis at necropsy included cardiac hypertrophy of both ventricles in several instances.

There was a tendency for heart weight to increase beyond that expected for birth weight, the longer the baby survived. This indicated developing hypertrophy, because there is normally little change in the first month.

The observation is discussed in the light of other evidence implicating failure of the left ventricle as an early event in babies who become ill after undue asphyxia at birth.
Systemic Lupus Erythematosus
Authors: CRAIG JOHN M.
Published: December 2021

This small but easily read book is a carefully documented summary of the clinical, laboratory and necropsy experience at the Presbyterian Hospital in New York City in 200 cases of systemic lupus erythematosus during a 20-year period. The disease process is presented according to manifestations in individual organs and laboratory examinations. This approach emphasizes the role of the disease as one of the "great imitators" of medicine, along with syphilis, tuberculosis and malaria. Of great value are the careful observations and long-term follow-up of these patients, which gives a genuine picture of the natural history of the disease, one of the stated aims of the author.
The Electroencephalogram of the Normal Child
Authors: GIBBS FREDERIC A.
Published: December 2021

The following is the Preface to this book by Dr. Frederic A. Gibbs, who is well qualified to appraise it:

"The Italian edition of L'Elettroencefalogramma del Bambino Normale was so lucid, well illustrated and useful that it demanded an English translation. Dr. Fois, in collaboration with Dr. Niels L. Low, has produced an English edition which improves on the original.

"Verbal description cannot convey the mass of detail that is needed for the diagnosis and precise interpretation of electroencephalograms. The written word can only underline certain aspects of the electroencephalogram and indicate its meaning. Accurate reading of such tracings requires experience with actual examples; this book helps to provide such experience.
DEVELOPMENTAL RETARDATION ASSOCIATED WITH AN ABNORMALITY IN TYROSINE METABOLISM
Authors: Menkes John H. , Jervis George A.
Published: December 2021

An infant with seizures, spasticity, and failure in weight gain was shown to excrete p-hydroxyphenylpyruvic acid, p-hydroxyphenyllactic acid, and p-hydroxyphenylacetic acid, indicating the likelihood of an impairment in the oxidation of p-hydroxyphenylpyruvate. Institution of a phenylalanine-free diet coincided with marked clinical improvement and disappearance of the abnormal urinary metabolites. The cause of the temporary enzyme defect is discussed, and it is concluded that it represents a persistence into extrauterine life of the relative enzyme inactivity observed in fetal tissues.
CHONDRODYSTROPHIA CALCIFICANS CONGENITA
Authors: Josephson Barry M. , Oriatti Mario D.
Published: December 2021

A case of chondrodystrophia calcificans congenita in a newborn infant, born of a hypothyroid mother who had episodes of tetany during pregnancy, is reported. On the basis of a review of significant findings in 88 cases reported in the world literature the following conclusions are drawn.

Chondrodystrophia calcificans congenita is a disorder that is well established at the time of birth. The diagnosis is based primarily on roentgenologic findings; it may be missed either if insufficient indication for radiologic investigation is present or if radiologic investigation is delayed beyond 4 years of age, when the epiphyses begin to fuse.

A possible relationship between this disorder and dysplasia epiphysialis multiplex is indicated by the similarity in the radiologic features of each and the inability to differentiate between the two, once epiphysial fusion has commenced. One wonders whether the reported cases of dysplasia epiphysialis multiplex may represent partial fusion in chondrodystrophia calcificans congenita. Further pathologic investigation is necessary to elucidate this point.

Maternal hypothyroidism may have a teratogenic role in this disorder, as in other congenital anomalies.

In those patients surviving infancy and childhood, the prognosis for useful function is good if anomalies of other systems are not present. The skeletal deformities can be managed by orthopedic surgery, and the cataracts can be extirpated.