bluuebunny/crossref_metadata_2025 huggingface dataset:
THE COMPOSITION OF PRIVATE PEDIATRIC PRACTICE IN A SMALL COMMUNITY IN THE SOUTH OF THE UNITED STATES
Authors: Boulware J. R.
Published: December 2021

A summary of the preventive treatments given, and the different types of diseases and conditions seen in 25 years of private pediatric practice in a small southern community is divided into 19 classifications. An estimate of the percentage of time devoted to each classification is presented. Preventive medicine, i.e., routine care of infants, preventive treatments and routine examinations, constituted about two-fifths of this pediatric practice.

Granting that firm scientific conclusions cannot be drawn from this study it is the author's opinion, based on records resulting from 25 years of practice, that an awareness of a disease in the mind of the pediatrician influences his diagnosis, that the locale of a practice will make for differences in incidence of certain diseases, and that the pattern of diagnosis, as well as of diseases, changes.
Fillers
Authors: CUMMINGS E. E.
Published: December 2021

"To be nobody-but-yourself—in a world which is doing its best, night and day, to make you somebody else—means to fight the hardest battle which any human being can fight; and never stop fighting."
Pediatric Index
Authors: MAY CHARLES D.
Published: December 2021

While one must admire the diligence and dedication which enabled the author to spend "six years of laborious reading, study, and writing" in the preparation of this book, it is difficult to evaluate its usefulness. It can only be suggested that if a practitioner feels the need of another "index," similar to The Compleat Pediatrician, and believes that this sort of compilation actually facilitates the clinical management of patients, this book deserves to be examined. If he is faced with an infant with diarrhea, termed enteritis in the Index, he will be advised to rule out mononucleosis, brucellosis, influenza, virus disease, food poisoning, various types of arthritis, meningitis, food intolerance, etc.! Treatments listed range from mild sedation and restriction of diet through a list of antibiotics which have been recommended for the treatment of diarrhea extending from the sulfonamides to Synnematin B®.
THIRTY-FOUR FERTILIZED HUMAN OVA, GOOD, BAD AND INDIFFERENT, RECOVERED FROM 210 WOMEN OF KNOWN FERTILITY
Authors: Hertig A. T. , Rock John , Adams E. C. , Menkin M. C.
Published: December 2021

From a study of 34 early human ova (24 normal and 10 abnormal) recovered from a series of 107 patients known to be fertile whose conditions for conception were optimal it appears that the maximum fertility rate at implantation is 58%; the maximum normal fertility rate after the twelfth day of ovular development is 42%; the probable maximum fertility rate during the preimplantation stages is from 80 to 90%; the greatest ovular loss is in the preimplantation stage; the next greatest loss is during the week after implantation; the ovular loss after the first missed period may be as great as 28.6%, either with or without clinical signs and is therefore comparable to the clinical abortion rate; these defective human fertilized ova rise because of intrinsic defects rather than from defects of the local or endocrine environment, and, finally, the fertility rates and fate of fertilzed ova are roughly comparable in man and other mammals.
FLUID THERAPY IN SURGERY OF THE NEWBORN
Authors: COOKE ROBERT E.
Published: December 2021

AFTER reviewing recent monographs and articles on fluid therapy of infants undergoing surgery, the author is impressed with the confusion that must exist in the minds of pediatricians and surgeons as to appropriate therapy.

Dosage of water and electrolyte is related to body weight, surface area or caloric turnover. Restriction of water intake is recommended or advised against. Administration of sodium is prohibited by some, but plasma is used liberally by the same authors. Potassium is used by some therapists even during surgery but is withheld by others for several days after surgery.

It is not the purpose of this commentary to prescribe a specific therapeutic program, but rather to emphasize certain principles which have been neglected at times by all writers on tile subject (including the present one).
THE RESPECTIVE EFFECTS OF STARVATION AND CHANGED BODY COMPOSITION ON ENERGY METABOLISM IN MALNOURISHED INFANTS
Authors: Varga F.
Published: December 2021

Oxygen consumption in pyloric stenosis is low, and does not change after rehydration. After operation and realimentation, oxygen consumption increases to normal before wasting of the body is corrected, and the weight curve begins to rise. Thus, low oxygen consumption is clearly connected with starvation.

Oxygen consumption in the common nonedematous type of infantile malnutrition, with a flat weight curve and normal caloric intake, was found to be high as reported by other authors.

Oxygen consumption is invariably low in the severest type of progressive infantile malnutrition complicated by starvation ("athrepsia").

The oxygen consumption of the malnourished infant is ultimately determined by two factors: 1) change in body structure and composition; and 2) starvation. With increasing disappearance of fat tissue, oxygen consumption per kilogram of body weight tends to rise. Low values are due to concomitant starvation, as in untreated pyloric stenosis, "athrepsia" and probably in kwashiorkor.

In similar studies of adults, malnutrition was usually associated with, and also brought about by, semistarvation; that is the reason oxygen consumption was always reported to be low. The cause of apparent difference in oxygen consumption between the "adult" and "infantile" types of malnutrition may be in the absence of actual starvation in many of the latter.
Die Pränatalen Infektionen des Menschen unter Bensonderer Berücksichtigung von Pathogenese und Immunologie
Authors: BRAND THEODOR VON
Published: December 2021

This book summarizes the literature concerning human prenatal infections, but also contains discussions of relevant findings and experiments on animals. Special emphasis is laid on etiology, clinical manifestations, and pathogenesis, while the therapy has been omitted. The infections are reviewed in three sections. The first and longest (63 pages) deals with virus infections, most details being given for rubeola and poliomyelitis infections and for cytomegaly. A long series of other viral infections is dealt with more briefly. Interstitial plasmacellular pneumonia is mentioned in connection with cytomegaly, but the possible etiologic role of Pneumocytis carinii is mentioned neither in this nor in the section dealing with protozoal infections.
AMMONIA METABOLISM IN NORMAL NEWBORN INFANTS AND THOSE WITH IDIOPATHIC HYPERBILIRUBINEMIA
Authors: McGovern Joseph J. , McDermott William V. , McGovern Mary N. , Russell Mary , McGrath Edward , Holtz Albert
Published: December 2021

Normal newborn infants are shown to have a higher content of ammonia in the peripheral blood than their mothers, and the high levels persist for at least 10 days after birth. The level of ammonia in the blood of parturient women is normal. Infants with idiopathic hyperbilirubinemia have abnormally high levels of ammonia in the blood.

Samples of blood from the umbilical vein near the entrance of the portal vein have higher concentrations of ammonia than are found in the infant's peripheral venous blood. Therefore, blood from the portal vein seems to contain elevated levels of ammonia in the newborn. The mechanism of this is not clear. The placenta appears to remove ammonia from the blood of the fetus.

The high ammonia content of stored blood, and its possible effects on the infant in exchange transfusions were investigated and are discussed. A correlation between concentrations of unconjugated bilirubin and ammonia in the blood was not found in the newborn period.
Pediatric Methods and Standards
Authors: FRANKLIN DAVID N.
Published: December 2021

This compact little book covers essentially the same ground as most standard handbooks but it attempts to provide a more thorough tabulation of certain standard data and a better discussion of the principles underlying some aspects of therapy. Herein lie its particular advantages and disadvantages.

In an attempt to give detailed information on nutrition, metabolism and growth and development, as well as standards for assessing these functions in a particular child, much material is included which seems superfluous. Twenty pages are devoted to the Pryor-Stolz width-weight tables, which are unduly detailed for usual clinical needs. The charts on the nutritional value of various foodstuffs and the weight of various organs at different ages might be dispensed with, as well as the section on the routine history and physical examination.
Can the New Pediatrics Be Practiced?
Authors: STEIN ALFRED B.
Published: December 2021

After 13 years of private pediatric practice (8 solo and 5 in partnership), I am venturing to write on the question, "Can the New Pediatrics Be Practiced?"

Early in my practice, I came to a conclusion similar to that of Dr. Lewis M. Fraad who said, "I have never been able to charge as much as I felt the work was worth. However, as a pediatrician, I have long since stopped worrying about getting rich, preferring to get my rewards from other sources." The satisfaction of being a family friend and counsellor must rank high as a reward. However, with the population mobility characteristic of present-day America, some of this is lost. The rewards inherent in watching the growth and development of children in a family to whom you have become endeared are no longer present when families move in and out of neighborhoods in a relatively short time.
Leukemia and Medical Radiation
Authors: MILLER ROBERT W.
Published: December 2021

Polhemums and Koch (Leukemia and medical radiation. Pediatrics, 23:453, 1959) seem to provide new evidence that leukemia is causally related to medical radiation exposure. The methodology of the study, however, does not exclude alternative explanations which could discount the association found.

The differences observed were not in radiation exposure, but in a history of such exposure. In the study reported it has not been shown that the reliability of the histories for the two groups was comparable. One might expect that parents of leukemic children would search their memories more carefully than would those of children in good health. Checking hospital and physicians' records of a subsample of each group could have provided the documentation necessary.
PSYCHOLOGIC CONSIDERATIONS IN THE MANAGEMENT OF DEATHS ON PEDIATRIC HOSPITAL SERVICES
Authors: Solnit Albert J. , Green Morris
Published: December 2021

The aid given by the physician to the family of a child who dies in the hospital begins before that event and continues after it. The competence, sincerity and consideration shown by the medical staff during the period of fatal illness establish the atmosphere in which this crucial human experience occurs. The most important aspect of this atmosphere is the relationship between the physician and the patient, including his family. This relationship has the potential of helping the family to cope with their grief when the child dies. This is optimally achieved when there is one doctor whom the parents can identify as the child's physician. It is necessary to emphasize the importance of the one doctor when the most efficient hospital service is continuously faced with the weakening of this relationship, because of the many professional personnel actively involved in hospital care of patients. The child's physician provides the medical continuity in the management of the patient in his fatal illness.

Althoug there is the tendency and opportunity to withdraw one's interest from the fatally ill child in the hospital, the physician's persistent attention and efforts are of real value to the dying child and his family. This is not to say that unrealistic, last-minute procedures are necessary or can make up for a lack of attention earlier in the course of the dying patient. By making the child and parents as comfortable as possible the physician establishes himself as one who will help them endure the crisis for which they are preparing. Through his skill in communicating with child and parents in this situation the physician helps the child and family to feel appropriately dependent on the doctor and his staff.

Unless a parent is severely disturbed emotionally, the best preparation he can have for the painful and tragic experience of losing his child is to know what is going to happen next, insofar as it is possible to know. The parents may need to have the diagnosis, as well as the nature of the treatment, explained many times before they will be able to understand and accept the painful reality of the situation.
NOTES ON A VISIT TO THE SOVIET UNION IN AUGUST AND SEPTEMBER 1958
Authors: Stokes Joseph
Published: December 2021

THE FOLLOWING is written for the purpose of supplementing the account of Doctor Milton Senn concerning his visit to the Soviet Union during mid-1958. Dr. Senn visited first in the early summer; and I was there from mid-August to mid-September We have agreed that Dr. Senn will cover the family and child health aspects, and I shall make some remarks on the overall scene. Both of us visited with more than one companion and both of us had interpreters. In my own case we were furnished with an excellent interpreter who had written his final English thesis on a comparison of the satire of Charles Dickens and Mark Twain, but we also had a scholar from the United States who spoke Russian fluently, Dr. Samuel Corson, a physiologist whose knowledge of scientific Russian filled well the gaps in the medical knowledge of our interpreter. Dr. George Perera of Columbia-Presbyterian Medical Center, N.Y., was the third member of our group, and at times he aided in contacts through his knowledge of French. In addition, the number of American visitors in the Soviet Union in 1958 was over 5,000, as confirmed to us by Ambassador Menshikov after our return; we met several official delegations of teachers, agriculturalists, physicians, and of those studying social security, pension plans, etc.

Before leaving the United States we had the opportunity of obtaining helpful pointers from Dr. Senn who had just returned, and also had checked with a number of medical and other groups who had been there in recent years.
INCLUSION-BEARING CELLS IN THE URINE IN CERTAIN VIRAL INFECTIONS
Authors: Bolande Robert P.
Published: December 2021

An inclusion-bearing cell is described which appears in the urine of patients with measles, german measles, chickenpox, mumps and herpangina.

The presence of the inclusion-bearing cells in large numbers in the urine is very characteristic of measles, but not pathognomonic of that illness or viral disease in general.

The possibility that the inclusions represent the cytopathic effects of viral infection on cells derived from the blood or urinary tract stroma is discussed.
POSTHEMORRHAGIC ANEMIA AND SHOCK IN THE NEWBORN DUE TO HEMORRHAGE DURING DELIVERY
Authors: Kirkman Henry N. , Riley Harris D.
Published: December 2021

A multiparous woman (VDRL-negative, Rh-positive) was admitted in labor to an Air Force hospital at an estimated 38 weeks of pregnancy. A 1,928-gm, male infant was delivered precipitously. Immediately after expulsion, the infant was noted to be extremely pale and weak, although it breathed and cried promptly. A second male infant, of similar weight, was then delivered spontaneously and appeared normal.

The contrast in appearance between the two infants was striking. The first infant, receiving oxygen by mask, had obvious pallor without cyanosis or respiratory retractions. The respirations were irregular and gasping, the cry feeble. Neither peripheral nor precordial pulses of the first baby were palpable, but a faint, rapid heart beat was heard on auscultation.

The second infant was pink, active, and crying vigorously, even without the administration of oxygen. Neither baby had edema, a palpable spleen or liver.

A diagnosis of posthemorrhagic shock in the first infant was made.

Soon thereafter, a single placenta with velamentous insertions of the cords (Fig. 1) at each side was delivered. The umbilical vessels of one cord were totally avulsed at the velamentous insertion, except for a thread-like strand which later separated in handling.

Thirty milliliters of dextran were injected immediately into a cutaneous vein of the first infant, approximately 15 minutes after delivery. The baby immediately became much more vigorous and developed a discernible pulse. Further improvement occurred when 30 ml of Group-O, Rh-negative blood was injected, approximately 30 minutes later.

The first hemoglobin determination, deferred until 20 hours of age to avoid unnecessary handling was 10.6 gm/100 ml in the first infant, as compared to 16 gm/100 ml in the second.

Further replacement and comparative studies are shown in Figure 2. Neither infant developed icterus during the stay in the nursery. Both infants received a transfusion toward the end of the hospitalization. Blood studies and development of both infants were normal at 2 and 5 months, respectively.
ENZYME DEFICIENCY IN ERYTHROCYTES IN CONGENITAL NONSPHEROCYTIC HEMOLYTIC ANEMIA
Authors: Shahidi Nasrollah T. , Diamond Louis K.
Published: December 2021

Two cases of congenital nonspherocytic hemolytic anemia are reported. The patients were brothers and both showed severe metabolic defects in the erythrocytes, consisting of a low content of reduced glutathione, markedly abnormal reduced glutathione stability test, and a very low activity of glucose-6-phosphate dehydrogenase. These metabolic defects were also found in the erythrocytes from the mother but to a milder degree. While both children showed evidences of chronic hemolytic anemia, the mother was found to be healthy. This clinical discrepancy between mother and children is thought to be the result of the degree of the severity of the metabolic defects. The occurrence of the chronic hemolytic process in these patients in the absence of exposure to drugs indicates that the erythrocyte deficient in glucose-6-phosphate dehydrogenase does not necessarily require the injurious effect of a drug to undergo hemolysis. In view of the above findings, it is suggested that reduced glutathione stability test and an assay of glucose-6-phosphate dehydrogenase be performed in all instances where the diagnosis of congenital nonsphenocytic hemolytic anemia is made.
Preventive Medicine in World War II. Vol. IV: Communicable Diseases
Authors: KRUGMAN SAUL
Published: December 2021

This book is the 4th volume of a series of the official history of the Medical Department, U.S. Army in World War II. It is the first of 3 volumes which will deal with the problems of communicable disease in military practice.

This excellent book is written from the viewpoint of preventive medicine by 21 highly qualified authorities in the field of infectious diseases. It is divided into three sections: Part I—an introduction dealing with general considerations of modes of transmission; Part II—discussion of diseases transmitted chiefly through the respiratory tract; and Part III— diseases transmitted chiefly through the alimentary tract.

It is an attractive, cleanly printed text, amply and cleanly illustrated with 91 tables and 48 charts.
DIVERTICULUM OF THE BLADDER IN CHILDREN
Authors: Forsythe Ian W. , Smyth Brian T.
Published: December 2021

Thirteen children with diverticulum of the bladder are described. Twelve were boys and one a girl. The children form two groups—those with infravesical obstruction and those with no obstruction.

Eight children with diverticulum of the bladder were among 487 children investigated for persistent urinary incontinence.

The incidence, pathology, symptoms, signs, diagnosis and treatment of diverticula of the bladder are discussed. In eight cases the diverticulum was not removed. The results of treatment are reviewed.
SIGNIFICANCE OF TRANSAMINASE ACTIVITY OF SERUM
Authors: BESSMAN SAMUEL P.
Published: December 2021

THE MEASUREMENT of enzyme activity of serum as an indicator of disease has a long history in medicine. In the past, it has been the aim of the designers of these methods to make them as specific as possible for assay of an enzyme characteristic of a particular system or group of similar organs. Examples of these venerable tests are those for amylase, acid phosphatase, alkaline phosphatase and choline esterase in the serum.

Warburg made the first departure from this specificity by demonstrating that the activity of triosephosphate dehydrogenase in the serum of animals with cancer was much greater than that of controls. This test was partially specific, for as Warburg had earlier shown, the glycolytic activity of tumors is much greater than that of normal tissues.

The non-specific approach became extreme with the introduction of the measurement of the glutamic-oxalacetic transaminase reaction in the diagnosis of acute coronary disease.
STUDIES OF VARIATIONS OF GLUTAMIC-OXALACETIC TRANSAMINASE IN SERUM IN INFECTIOUS HEPATITIS
Authors: Schneider A. J. , Mosley James W.
Published: December 2021

Comparison of the incidence of abnormal variability in activity of glutamic-oxalacetic transaminase in the serum (S-GOT) in two groups of children who were household contacts of infectious hepatitis with the incidence in suitable control groups, demonstrated differences with a high degree of statistical significance.

This difference was interpreted as evidence that a person with: a) a range of variation in S-GOT in excess of 22 Karmen units, b) exposure to a clinically recognized case of infectious hepatitis, and c) no other condition known to cause abnormality of S-GOT, may be considered to have infectious hepatitis himself, whether symptomatic or not.

Immune globulin apparently prevented the abnormality in S-GOT expected in hepatitis contacts in one epidemic, but did not do so in another.

Both in the presence and in the absence of jaundice, a significant percentage of patients with infectious hepatitis are characterized by persistent or recurring abnormalities in S-GOT for periods of at least several months. No correlation between magnitude and duration of abnormality in S-GOT and degree of clinical illness was observed.

The ratio of icteric to non-icteric cases of infectious hepatitis was found to be a function of the age of the patient. The ratio was greater than one in the 10 to 14-year age group and less than one at other ages.
ACTIVITY OF GLUTAMIC-OXALACETIC TRANSAMINASE AND LACTIC DEHYDROGENASE IN CEREBROSPINAL FLUID AND PLASMA OF NORMAL AND ABNORMAL NEWBORN INFANTS
Authors: Lending Miriam , Slobody Lawrence B. , Stone Martin L. , Hosbach Richard E. , Mestern Joan
Published: December 2021

The activity of the enzymes, glutamic-oxalacetic transaminase and lactic dehydrogenase, in the cerebrospinal fluid and plasma was studied in 54 normal full-term newborn infants from 2½ to 240 hours of age, and in 20 newborn infants suspected to have intracranial pathology.

The normal range of activities of these enzymes in cerebrospinal fluid and plasma are described. In the infants with suspected intracranial pathology, the average glutamic-oxalacetic transaminase activity of cerebrospinal fluid was 82% higher than in the normal newborn infant, and plasma glutamic-oxalacetic transaminase activity, had an 18% mean increase over normal.

In the cerebrospinal fluid of the abnormal infants, lactic dehydrogenase activity had a mean increase of 309% over normal, and plasma lactic dehydrogenase activity revealed an increase of 11% over normal.

Enzyme determinations in cerebrospinal fluid, particularly lactic dehydrogenase, may be useful in the study of newborn infants suspected of intracranial pathology.
STUDY OF THE VALUE OF BACTERIAL VACCINES IN THE TREATMENT OF BRONCHIAL ASTHMA ASSOCIATED WITH RESPIRATORY INFECTIONS
Authors: Johnstone Douglas E.
Published: December 2021

A controlled study of the value of bacterial vaccines in 118 infants and children subject to repeated episodes of asthma associated with respiratory infections is described. Both vaccine-treated and a control group, treated similarly except for omission of bacterial vaccines from hyposensitization therapy, were compared before and at the end of a 3½-year period.

When the maximum dose of vaccine was administered every 28 days, no statistically significant differences were observed between the two groups with regard to the following criteria: 1) number of asthmatic episodes per year; 2) average number of days wheezing per year; 3) average number of days school missed per year during asthmatic episodes; 4) number of children with 100%, 50-100% or 0-50% reduction in number of asthma attacks per year.

In the vaccine-treated group the type of vaccine used did not appear to influence the degree of improvement as reflected in number of asthmatic attacks per year in the last year of the study compared to the year preceding the study.

The incidence of positive skin tests to stock bacterial vaccines and a commercially prepared vaccine was approximately the same in both groups.
PREOPERATIVE EVALUATION OF THE PULMONARY VASCULAR BED IN PATIENTS WITH PULMONARY HYPERTENSION ASSOCIATED WITH LEFT TO RIGHT SHUNTS
Authors: Crittenden I. Hunter , Adams Forrest H. , Latta Harrison
Published: December 2021

Eighteen patients with pulmonary hypertension associated with left to right cardiac shunts have been studied using acetylcholine injected into the pulmonary artery to determine the distensibility of the vascular bed. The response is considered as an index of severity of vascular disease and of operative risk.

Six cases failed to respond to the drug. One of these had received atropine, and the data may not be reliable. Five were 6 years of age or older and had relatively less left to right shunting than the others. Surgery was performed in two of this group of six, and it proved fatal. The small pulmonary arteries in both patients had marked intimal disease.

All of the 12 cases that responded to acetylcholine had shunting of at least 140% of the systemic flow, and in five patients tested the shunt increased following injection of the drug. The five cases operated upon from this group had hypertrophy of the media of the small pulmonary arteries and in two cases minimal proliferation of the intima was present. The pulmonary artery pressures were similar in both groups. These observations suggest that the severity of pulmonary vascular disease may be predicted by the method described.
DELAYS IN THE DIAGNOSIS OF DEAFNESS AMONG PRESCHOOL CHILDREN
Authors: Schweinitz Louise de , Miller C. Arden , Miller June B.
Published: December 2021

Data from the histories of 48 deaf preschool children revealed that parents usually suspected deafness before the physician who cared for the child openly considered the possibility. Parents frequently suspected deafness by the first birthday and nearly always by the second birthday. In seeking medical opinion concerning the possibility of deafness, the parents frequently complained of delayed speech rather than hearing disorder. Long delays in establishing the diagnosis occurred after the first consultation with a physician. In nearly half of the children deafness was not adequately diagnosed until after the third birthday.

Medical conditions, such as meningitis, which might have altered the physician to the possibility of deafness as a sequella did not always result in prompt recognition of this complication. The diagnosis was made in retarded children at a later age.

Presence of a hearing loss can usually be determined by simple testing procedures before the first birthday. Skilled audiologists can estimate the severity of hearing losses in the first years of life and can obtain a fairly complete audiogram by 3 years of age.

The importance of early diagnosis in planning for the deaf child and his family is emphasized.
SUCROSURIA AND MENTAL DEFICIENCY: A COINCIDENCE
Authors: Perry Thomas L. , Lippman Richard W. , Walker Dorothy , Shaw Kenneth N. F.
Published: December 2021

The results of an oral sucrose loading test carried out with 25 normal children, 37 normal adults, and 37 mentally defective subjects are presented. Sucrosuria occurred in most of these subjects, and was as common a finding in normal subjects as in mentally defective individuals.

Sucrose was present in the urine of some infants fed a commonly-used formula containing cane sugar. The degree of sucrosuria produced in many normal individuals by the ingestion of 1.0 gm/kg of sucrose was of the same order as that reported previously for patients having mental defect, hiatus hernia and sucrosuria.

It seems clear that the presence of sucrose in the urine after this sugar has been ingested is entirely physiologic and is unrelated causally to mental deficiency.
ATTITUDE STUDY OF PARENTS OF MENTALLY RETARDED CHILDREN
Authors: Graliker Betty V. , Parmelee Arthur H. , Koch Richard
Published: December 2021

Initial reactions and concerns of parents to a diagnosis of mental retardation in their child are recorded in 67 families. The cause of the retardation and rejection of the child were the two chief areas of subjective concern. Other reactions were rejection of the diagnosis and solicitude for other medical problems of the child. Even after complete diagnostic study, rejection of the diagnosis of retardation occurred in one third of these families. Our data suggest that initial counseling of parents of retarded children should be centered primarily on a discussion of diagnosis, etiology, and immediate problems. Subsequent counseling should be directed toward the problems of future care. The importance of sympathetic follow-up care by the physician is emphasized.
Foreign Bodies in Puncture Wounds Through Shoes
Authors: ROSENWEIG JOSEPH L.
Published: December 2021

Two similar experiences in the past 2 weeks prompt this letter. The first was a nail puncture of the foot, and the child stated definitely that the nail penetrated at least three-fourths of an inch through his "shoe" and into the foot. The wound was cleaned and inspected in the usual manner, soaks were advised and tetanus administered. Two days later the foot was swollen, and examination revealed a red foreign body at the entrance to the wound. It was removed easily with a forceps and was found to be a small cone-shaped piece of sponge rubber. Only then did I learn his "shoe" had been an oriental type thong sandal, the type which is very popular now.
Diseases of Laboratory Primates
Authors: MAY CHARLES D.
Published: December 2021

This book will be invaluable to investigators making use of primates in their experiments. The present volume is Part I of a comprehensive series that will make up a Handbook of the Primates. Preparation of the book has been aided by a grant from the National Institutes of Health in recognition of the growing importance of the use of primates in research. The present volume covers the nutritional requirements and diseases of nutrition as well as summarizing the available knowledge concerning all of the diseases that affect the various organs and systems of primates. An astounding mass of information has been assembled and the coverage is not only complete but scholarly and critical.
PATTERNS OF GROWTH IN HEIGHT AND WEIGHT FROM BIRTH TO EIGHTEEN YEARS OF AGE
Authors: Reed Robert B. , Stuart Harold C.
Published: December 2021

In this report is displayed the range of variation observed in the growth curves of height and weight in a series of 134 children observed from birth to 18 years. For purposes of simplification the individuals have been classified on the basis of their rates of growth during three successive 6-year intervals.

Even in terms of this crude classification several basic facts about individual growth patterns of height and weight are apparent. The wide range of differences between individuals applies not only to facts about size at specific ages but also to the pattern of change followed from age period to age period.

The rate of growth during early childhood, i.e. before 6 years of age, is associated with, but not specifically predictive of, size at maturity and timing of the adolescent growth spurt. Individuals with rapid growth before 6 years of age tend to have large mature size and early adolescent growth spurt.

It will be the objective of future reports from this research project to determine the manner in which the individual differences in growth demonstrated and classified here are related to aspects of physical development, to environmental influences such as dietary intake and to the level of health of the child.
PREDNISONE IN CHILDHOOD LEUKEMIA
Authors: Hyman Carol B. , C Eduardo Borda , Brubaker Charles , Hammond Denman , Sturgeon Phillip
Published: December 2021

Thirty children with acute lymphatic leukemia were treated with 2.2 mg/kg/day of prednisone for 28 days. After this initial course, they were alternately given interrupted or continuous therapy. In the group receiving the interrupted therapy, the dose was gradually discontinued over the succeeding 5 to 7 days. In the continuous therapy group, prednisone was continued, but at a reduced dose of 0.55 mg/kg/day. Both groups were followed by serial evaluation of the bone marrow, blood, physical findings and symptoms. The therapy period was considered terminated when relapse occurred as judged by the bone marrow.

The groups did not differ significantly in the number of remissions induced, their duration, or the duration of clinical control. One patient in each group failed to obtain a remission of any degree.

These studies do not indicate any advantage for continuous therapy over interrupted therapy with prednisone. On the other hand, with continuous therapy, there are the disadvantages of increased side-effects, higher cost, and the probability of permanent refractoriness to the drug.
RECOGNITION OF SPONTANEOUS PNEUMOTHORAX IN PREMATURE INFANTS
Authors: Lubchenco Lula O.
Published: December 2021

An analysis of the clinical records of 27 infants who developed spontaneous pneumothorax in the neonatal period is presented; 17 (63%) were premature infants.

The age at onset of the disease varied with the birth weight. The infants with birth weights of 1,500 grams or less averaged 24 days of age at the onset of spontaneous pneumothorax, and the full-term infants developed the disease in the immediate newborn period.

The diagnosis of spontaneous pneumothorax was suspected when symptoms of respiratory distress alternated with unusual activity, with an increase of symptoms when the infant was fed or removed from oxygen.

The immature infant showed cyanosis or apneic spells, alternating with alertness or apparent hunger. The more mature infant manifested greater respiratory distress and greater activity. The activity assumed the form of irritability, restlessness and, at times, opisthotonus. These symptoms were considered to be due to a persistent lowgrade hypoxia caused by the pneumothorax rather than being manifestations of a vigorous, healthy infant. Signs of infection were minimal or absent. The importance of roentgenograms in establishing the diagnosis is emphasized.

Treatment should include relief of hypoxia by administration of oxygen in low concentration and prevention of acute respiratory embarrassment due to distention of the stomach by feedings. Removal of air from the pneumothorax or pneumomediastinum is necessary in severe cases.
STUDIES ON THE MECHANISM OF PRODUCTION OF A NEPHROTIC SYNDROME IN RATS BY A NUCLEOSIDE
Authors: Wilson S. G. F. , Heymann Walter , Goldthwait D. A.
Published: December 2021

The dimethyl adenosine derivative originally isolated from Puromycin® produced a nephrotic syndrome in rats, but not in guinea pigs or rabbits. The urinary excretion products in these species were examined after injection of this compound.

All species excreted the dimethyl- and the monomethyl adenosine derivatives. The rat and rabbit excreted the adenosine derivative and the rabbit also excreted the inosine derivative. All species excreted monomethyl adenosine and/or dimethyl adenosine derivatives substituted most likely on the sugar.

The nephrotic syndrome was produced by injection of the monomethyl-, the methyl propyl-, and the diethyl adenosine derivatives, but not by the adenosine, inosine or dipropyl adenosine derivatives.

The dimethyl-, monomethyl-, and adenosine derivatives inhibited to approximately the same extent a crude adenosine kinase enzyme obtained from yeast. These three compounds were also converted to nucleotides by this preparation. The dimethyl adenosine derivative was the least effective nucleotide precursor.

It seems probable that several derivatives are capable of producing the nephrotic syndrome. The enzymatic locus of action may be adenosine kinase, but action at the nucleotide level has not been ruled out.

Methods are indicated for the isolation and characterization of this series of nucleosides and nucleotides.
Ciba Foundation Symposium: Regulation of Cell Metabolism
Authors: LOWE CHARLES U.
Published: December 2021

This is hardly a volume one would sit down and read from cover to cover, nor can it be read as a textbook. Instead, it is a volume to be perused by the inquisitive; a volume which will permit the curious a view of new directions in cellular biochemistry. Much of the contents concern work as yet incomplete, though by no means either inconclusive or undocumented; there is a freshness and excitement in many of the chapters which is infectious. The speculations are stimulating and the discussions which follow each chapter are not only illuminating but also enliven the text by including differences of opinion and frank controversy.
INFLUENCE OF PROTEIN AND FAT CONTENT OF DIET ON THE BODY COMPOSITION OF PIGLETS
Authors: Filer L. J. , Baur L. S. , Rezabek Helen
Published: December 2021

Varying the level of dietary protein from 11 to 39% of the calories in a high-fat diet is without effect on body composition of the 8-week-old pig.

Varying the level of dietary protein from 17 to 62% of the calories in a low-fat diet is without effect on body composition of the 8-week-old pig.

With low-fat diets, the carcasses contained a higher percentage of protein, calculated from micro-Kjeldahl determinations, on a fat-free, dry-tissue basis.

Liver and kidney weights were greater as percentage of protein in the diet increased. With the exception of three animals on Diet 5, electrolyte content of the carcass did not vary significantly.

Highest and lowest protein content of the liven occurred with low-protein diets containing low and high percentage of fat, respectively.

Extrapolation of these data to the nutrition of human infants is discussed.
NITROGEN METABOLISM IN CHILDREN WITH KWASHIORKOR RECEIVING MILK AND VEGETABLE DIETS
Authors: Hansen John D. L. , Schendel Harold E. , Wilkins Joachim A. , Brock John F.
Published: December 2021

The nitrogen metabolism of 43 children admitted to the hospital with kwashiorkor has been investigated during the early and convalescent phases of recovery by means of 168 nitrogen balance studies. These observations have been supplemented by clinical assessment, including weight gain and serial estimations of serum albumin. Milk diets were used as a standard for comparison with diets in which maize meal was the sole source of protein. The effects of supplementation of maize meal with glycine, or with pea flour with or without maize germ have been evaluated.

With milk diets nitrogen retention was significantly higher in the first 2 weeks of treatment than after that time. The better retentions of the earlier phase of treatment take place in the presence of impaired absorption of nitrogen from the gastrointestinal tract. These findings indicate that degree of protein depletion is an important variable in the interpretation of nitrogen balance in the early recovery phase of kwashiorkor.

Nitrogen retention with pure maize meal diets was significantly less than that resulting from an equicaloric and equinitrogenous milk diet. With maize diets during convalescence, concentration of serum albumin decreases and weight gain is less consistent than with milk diets. Maize meal is not improved by a supplement of glycine. While absorption of nitrogen (as a percentage of nitrogen intake) from maize diets is less than from milk diets, the data also indicate less efficient tissue utilisation of nitrogen from maize protein.

Supplementation of maize with pea flour, (Pisum sativum) with or without maize germ, resulted in significant improvement of nitrogen retention. These supplemented maize diets are capable of curing mild cases of kwashiorkor and maintaining a satisfactory concentration of serum albumin and weight gain for as long as 150 days. It is concluded that while these simple vegetable mixtures are not as efficient sources of protein as diets containing milk, they are effective in maintaining nitrogen retention and growth under metabolic ward conditions. They may therefore prove of value in the prevention of kwashiorkor.
PATTERNS OF FAT EXCRETION IN FECES OF PREMATURE INFANTS FED VARIOUS PREPARATIONS OF MILK
Authors: Davidson Murray , Bauer Charles H.
Published: December 2021

Four groups of infants were fed diets containing various types and amounts of fat.

The per cent of fat absorbed was not significantly different, irrespective of amount of fat or protein in the diet, in three groups in which the source was animal fat.

In a fourth group, in which corn oil was substituted for animal fat, there was a significantly greater degree of fat absorption.

The usually observable improvement in the ability of prematurely born infants to absorb fat with increasing age and weight did not appear to play a role in the differences observed in this study.

There was a relatively constant output of saturated fatty acid with each of the diets, the per cent of the stool being made up of these acids varying more with the type of diet than with the per cent fat being absorbed.

The last finding suggests that the source of fat in the stool of the premature infant is virtually all exogenous in origin and that the wide variations in fat output in the stools normally encountered cannot be accounted for on the basis of endogenous losses.
EPILEPSY, LIGHT-SENSITIVITY AND LEFT-HANDEDNESS IN A FAMILY WITH MONOZYGOTIC TRIPLETS
Authors: Herrlin Karl-Magnus
Published: December 2021

A family consisting of monozygotic, now 14-year-old triplets, their elder brother and parents are described. One triplet is right-handed and the other two are left-handed, as are a number of their relatives. After an analysis of the probable course in cleavage of the embryos, the hypothesis is put forward that the different handedness is due to a mirror-image mechanism in cleavage of one or possibly of both embryos. It is suggested that such a mechanism can also explain the reversed asymmetry in the papillary pattern of their hand prints in the hypothenar region.

In the mother, myoclonic jerks are elicited by intermittent sunlight. During photic stimulation with the stroboscope, they are synchronous with the light flashes. The elder son has photogenic epilepsy. In his case, as in the triplets, intermittent light flashes from the stroboscope elicit a clinical seizure. It is postulated that the sensitivity to light in this family is due to a probably dominant, genetically determined cerebral dysfunction, which can be manifested clinically in different ways.
ALLERGENICITY OF COW'S MILK PROTEINS
Authors: Crawford Lloyd V.
Published: December 2021

By means of the dual-ingestion passive transfer test it has been demonstrated that the heat-denatured milks, whether in liquid or powder form, were markedly reduced in allergenicity of the beta-lactoglobulin and alpha-lactalbumin fractions, but retained the allergenicity of the alpha-casein fraction. On the other hand, pasteurized skimmed and pasteurized homogenized milk resulted in frequent reactions at sites passively sensitized to alpha-casein, beta-lactoglobulin and alpha-lactalbumin. The findings in this study suggest that the vast majority of infants sensitive to cow's milk could tolerate heat-denatured milk.
CONGENITAL NONHEMOLYTIC ICTERUS WITH DAMAGE TO THE CENTRAL NERVOUS SYSTEM
Authors: Whitington Gene L.
Published: December 2021

A case of nonhemolytic icterus with damage to the central nervous system, without familial incidence, occurring in a 2-year-old Negro female is presented. Jaundice began in this patient at an early age, and has been associated with severe central nervous system damage. There has been a continuous marked elevation of the indirect-reacting bilirubin in the serum. The liver is histologically normal, and neither hemolytic disorder nor biliary obstruction has been demonstrated. The fecal excretion of urobilinogen is normal. The clinical and laboratory findings are given. The possible relationship of this syndrome to recent advances in the knowledge of bilirubin metabolism is cited.
A NEW APPROACH TO CATHETERIZATION OF THE UMBILICAL VEIN FOR EXCHANGE TRANSFUSION
Authors: Sanchez Francisco R.
Published: December 2021

As a result of this study the use of the technique described here for the catheterization of the umbilical vein is recommended in all patients in whom difficulty in direct caterization is encountered in the performance of exchange transfusion.
Neurology of Infancy
Authors: HAMMILL JAMES F.
Published: December 2021

Dr. Dekaban states that his purpose in writing this excellently printed and illustrated text is to provide those concerned with anatomic and developmental landmarks of the maturation of the central nervous system during the first 2 years of life, and to outline the principles and clinical manifestations of neurologic disorders occurring during infancy, stressing the differences between the mature patient and infants in these regards.

The text fulfills the author's aims in scope encompassing the neurologic spectrum from metabolic to neoplastic and degenerative disorders.
Ciba Foundation Study Group. No. 1. Pain and Itch
Authors: Low NIELS L.
Published: December 2021

Pain and Itch is a booklet which constitutes the proceedings of a Ciba Foundation conference on the nervous mechanisms of pain and itch. This publication is described as experimental but the reviewer hopes that this experiment will be continued and become regular practice. The very prompt printing following the conference is commendable.

The meeting was opened with introductory remarks by Lord Adrian who pointed out that pain was a central and crucial point in medicine but that not much was known about its mechanism.
The Dentition of the Growing Child: A Longitudinal Study of Dental Development Between 3 and 18 Years of Age
Authors: MEREDITH HOWARD V.
Published: December 2021

This research monograph is based on dental casts for 184 white children residing in Massachusetts and Delaware. The topics discussed pertain to tooth size, dental arch size, and positional interrelationships of the teeth in the two arches.

On each subject, the investigator had available a series of dental casts "covering the transition from the primary to the secondary dentition" (p. 40). The casts were amassed in part at the Center for Research in Child Health and Development, Boston (Dr. Harold C. Stuart), and in part at a public school in Wilmington, Delaware (Dr. Richard H. Stucklen).