bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDIES OF ENZYMES IN SERUM IN MUSCULAR DYSTROPHY
Authors: Pearson Carl M. , Chowdhury Sudhir R. , Fowler William M. , Jones Margaret H. , Griffith Wendell H.
Published: December 2021

Progressive muscular dystrophy is one of the relatively few chronic diseases in which an increase of various enzymes in serum is of diagnostic value. In the presence of muscular weakness high levels indicate a primary myopathic process. It has previously been shown that elevated values for enzymes in serum are most pronounced in childhood dystrophy, are highest early in the disease, and taper toward normal several years later.

This study involves a clinical and biochemical analysis of several families in which dystrophy is known to exist. An elevation of the enzymes studied (two transaminases, aldolase, two dehydrogenases) was found in several young boys who were at the time clinically asymptomatic. In one family the youngest of these children was 4½ months of age. Three of his brothers developed clinical dystrophy at about 3 years of age. In another family clinical follow-up for 3 years after the finding of elevated levels of enzymes in serum has shown the development of early muscular weakness in two male cousins of a known dystrophic person. Muscle biopsy in the preclinical stage has shown dystrophic changes in each of five cases.

The diagnostic and prognostic significance of enzyme levels in serum in families of dystrophic persons is impressive. It appears that in some forms of dystrophy the time of onset of the disease is very early in life, or even in the prenatal period. The enzyme studies have provided the first objective evidence that this may be the case.
BONE, MUSCLE AND FAT MEASUREMENTS
Authors: Maresh Marion M.
Published: December 2021

The widths of the bone, muscle and fat shadows were measured at specific locations on 14 seriatim roentgenograms of the extremities of 25 boys and 25 girls between the ages of 2 months and 6 years. Mean values for each of these measurements were presented and demonstrate the changes with age that have been presented by other workers. Interesting individual differences were found in the relative widths of the same tissue measured at different locations as well as changes in relative level of bone, muscle and fat widths with increasing age.

Coefficients of correlation between these measurements and weight were all reasonably good, but the height:muscle widths and height:fat widths were considerably lower than the height:bone widths correla tions for both sexes. The bone:fat and muscle:fat correlations were low (-0.1 to 0.2) for both sexes, but a surprising difference which has not been reported by previous workers was found in the bone: muscle correlations for boys (over 0.5 after 1 year of age) and for girls (0.1 to 0.2).

For these 50 children, assessments of skeletal age at the chronologic age of 5 years were also available. The correlations with height and weight at this age were 0.32 and 0.38 for the boys and 0.47 and 0.52 for the girls.

A superficial examination of the nutritional data of these children and of their records of basal metabolism for this 6-year period has not revealed any obvious relationships between either of these sets of data and the bone, muscle and fat measurements in this study.

Accepting these measurements as less consistent than those made from roentgenograms taken for soft tissue delineation, and also accepting that these measurements are but one dimension of the tissue mass in the total body, they do seem to be a useful supplement to the clinical and anthropometric data in the study of the body composition of the child.
CONGENITAL ABNORMALITIES OF PULMONARY VESSELS AND THEIR RELATION TO MALFORMATIONS OF THE LUNG
Authors: Ferencz Charlotte
Published: December 2021

The common embryologic origin of various pulmonary malformations has been reviewed. Reported cases have been discussed with reference to the pulmonary and/or cardiovascular consequences of the malformations. Available hemodynamic data have been tabulated and analyzed. A plea is made for the accurate observation and careful recording of anatomic, clinical and physiologic data that will permit a better understanding of the nature and course of congenital malformations of the lung.
CONSTRICTION OF BODY IMAGE IN CHILDREN WITH CONGENITAL HEART DISEASE
Authors: Green Morris , Levitt Eugene E.
Published: December 2021

The body self-image was determined by means of the drawing of the human figure in a group of children with congenital heart disease, in normal controls and in children who were emotionally disturbed or intellectually retarded The data and analyses indicate that children with congenital heart disease tend to depict them selves graphically smaller than do normal children. It may therefore be inferred that children with congenital heart disease, in general, have a constricted view of their bodies.
EXPERIMENTAL SALICYLATE INTOXICATION
Authors: James J. A. , Kimbell Lewis , Read William T.
Published: December 2021

Exchange transfusion, hemodialysis and peritoneal dialysis with albumin and conventional dialysis solutions was carried out in dogs following the administration of a standard dose of sodium salicylate intravenously. Hemodialysis was the most efficient method of removing salicylate, about 50% of the dose injected being removed during a 4-hour period. Exchange transfusion and peritoneal lavage were considerably less efficient. Peritoneal lavage with 5% albumin solution was more effective than lavage with an equal volume of conventional dialysis solution, but absorption of albumin from the peritoneum took place unless additional dextrose was added to the solution. The amount of salicylate excreted in the urine during the period of study sometimes exceeded that removed by peritoneal dialysis or exchange transfusion. Some clinical implications of these studies are discussed.
In Reply: Hazards of Foods
Authors: Coriell Lewis L.
Published: December 2021

The syndrome described by Dr. Garrison is consistent with the ingestion of enterotoxin produced by staphylococci or to acute allergic constitutional reaction to ingested foods (Pediatrics, 29: 129, 1962). The short incubation period, type of gastrointestinal symptoms, accompanied by prostration, evidence of circulatory shock, followed by recovery, could be produced by either. To confirm the staphylococcal enterotoxin diagnosis it is most important to save the suspected food—test it for the presence of staphylococcal enterotoxin or other toxic products and to identify all organisms present.
Potassium Toxicity Due to Intravenous Penicillin Therapy
Authors: Moss Malcolm H. , Rausen Aaron R.
Published: December 2021

Extremely large doses of penicillin given intravenously are regularly used by many in the treatment of severe bacterial infections. Attention has been called to the possibility that potassium toxicity might result from the rapid infusion of large doses of the potassium salt of penicillin, which is the commonly used preparation.1,2 In mice, the toxicity of intravenously injected penicillin has been shown to be due to the cation used in the preparation with the potassium salt being the most toxic form.3,4
REPARATIVE PHENOMENA IN LUNGS OF NEONATES WITH HYALINE MEMBRANES
Authors: Boss Jochanan H. , Craig John M.
Published: December 2021

Destructive changes have been described by others in the respiratory bronchioles, alveolar ducts, and alveoli associated with hyaline membranes in the lungs of infants who died in the first few hours of life. After 24 hours of extra-uterine life, cellular proliferative phenomena appear in these same areas and are almost always present after 48 hours of extra-uterine life. It is suggested that these represent a reparative process related to the early destructive changes associated with the formation of the hyaline membrane, rather than a purely reactive phenomenon associated with the formation of phagocytes involved in the removal of the membranes.
MAGNESIUM DEFICIENCY IN CELIAC DISEASE
Authors: Goldman Armond S. , Van Fossan Donald D. , Baird Elwood E.
Published: December 2021

Balance studies were performed on a 16½-year-old white girl with hypomagnesemia due to celiac disease. During the initial phase of the study, a great magnesium loss in feces was demonstrated, with decreased magnesium excretion in urine and increased sodium and potassium retentions. Following the elimination of gluten in the diet, all mineral balances were restored to normal.
REVIEW OF CARCINOIDS IN CHILDREN
Authors: Field Jack Lavyrl , Adamson Lucile Frances , Stoeckle Harry E.
Published: December 2021

A review of the literature revealed 19 cases of nonfunctioning gastrointestinal carcinoid tumors reported in the pediatric age group, with the primary site in the appendix in 15 of these. A case of functioning carcinoid in a 15-year-old white male is reported. Classic signs and symptoms of increased circulating serotonin were observed, except those of the cardiac system.
AN EPIDEMIC OF INFECTIOUS LYMPHOCYTOSIS WITH DIARRHEA
Authors: PETERMAN M. G. , KASTER J. D. , GECHT ELI A. , LEMBERT G. L.
Published: December 2021

An epidemic of infectious lymphocytosis which occurred in the Milwaukee County Home for Dependent Children and Milwaukee County Hospital Pediatric Service has been reported. There was a total of 28 cases. Two of these cases occurred in children who were hospitalized for other reasons, and were from the population at large.

The most prominent presenting symptom was diarrhea, which was noted in 16 cases.

The leukocyte counts ranged from 18.9 thousand to 147 thousand/cmm. and the lymphocytes ranged from 64 to 94%.

The total apparent time for the epidemic was from November 1947 to March 1948.
PRESIDENT'S MESSAGE
Authors: Fischer Carl C.
Published: December 2021

REGARDLESS of how we, as individual physicians, may feel about the role of the federal government in the individual practice of medicine, the time has long since passed when we can afford the luxury of ignoring it.

In past years the influence of the government on medicine has been mostly in general areas and perhaps least of all in that of pediatrics; but under the present administration there has been a decided change.

For this reason it seems necessary to me to call to the attention of all Fellows of the Academy the particular items in President Kennedy's message of February 26, 1962, which relate specifically to the practice of Pediatrics.

These may be considered to be three in number: The first of these dealt with the subject of immunization.

On this topic President Kennedy said:

I am asking the American people to join in a nationwide vaccination program to stamp out these four diseases (whooping cough, diphtheria, tetanus, and poliomyelitis) encouraging all communities to immunize both children and adults, keep them immunized and plan for the routine immunization of children yet to be born. To assist the states and local communities in this effort over the next 3 years, I am proposing legislation authorizing a program of federal assistance. This program would cover the full cost of vaccines for all children under 5 years of age. It would also assist in meeting the cost of organizing the vaccination drives begun during this period, and the cost of extra personnel needed for certain special tasks.
A DIFFERENCE IN THE INCIDENCE OF HYPERBILIRUBINEMIA AMONG PREMATURE INFANTS IN TWO HOSPITALS
Authors: Lucey Jerold F. , Phillips Carol L. , Utterback James G. , McKay R. James
Published: December 2021

A difference in the incidence of hyperbilirubinemia among premature infants in two hospitals has been reported. This difference could not be explained by difference in any of the usual factors which are known to affect neonatal hyperbilirubinemia. Investigation disclosed that the method of preparation of the bilirubin standard and standard curve created the difference in the incidence of hyperbilirubinemia. Correction and subsequent control of this variable resulted in a decrease in the incidence of hyperbilirubinemia in the hospital with a high incidence. Attention is called to the fact that this variable may account for some of the difficulties encountered in judging the value of exchange transfusions for hyperbilirubinemia of the newborn.
CONGENITAL HEART BLOCK WITH FATAL ADAMS-STOKES ATTACKS IN CHILDHOOD
Authors: Molthan Marian E. , Miller Robert A. , Hastreiter Alois R. , Paul Milton H.
Published: December 2021

Congenital heart block may be associated with Adams-Stokes attacks in children with slow heart rates and QRS complexes of prolonged duration. The attacks are almost always associated with upper respiratory infections. The mechanism in two of three cases was ventricular tachycardia, or ventricular tachycardia followed by ventricular arrest. At autopsy, moderate endocardial fibrosis was found in two cases. A small atrial septal defect was present in one. These and other reported fatal cases of congenital heart block in infancy and childhood suggest that the clinical course is not as benign as previously suggested.
ABNORMAL OCCURRENCE OF THE ULNAR NERVE—HYPOTHENAR MUSCLE H-REFLEX IN SYDENHAM'S CHOREA
Authors: Hodes Robert , Gribetz Irwin , Hodes Horace L.
Published: December 2021

Six patients, 8 to 14 years of age, were examined for abnormal H-reflex activity by means of an electrophysiological technique, and the findings were compared with the clinical examination, in Sydenham's chorea. Four of the patients were examined at the stage of the disease in which purposeless, involuntary movements were present in the upper extremity. In all four patients an aberrant H-reflex was elicited from the hypothenar muscles by weak, painless, percutaneous, electrical stimulation of the ulnar nerve. The H-reflex declined pari passu with the reduction of movements noted clinically. Two of the patients, studied electrophysiologically when abnormal movements were present, were re-examined long after disappearance of choreiform activity. At this time H-reflexes were either minimal or absent. Two patients who presented unilateral choreiform movements showed H-reflexes only on the affected side. Two patients who were studied only once, after the choreiform movements had disappeared, showed minimal H-reflexes, or complete absence of the abnormal response. The locus of disturbance in the central nervous system in this disease is discussed and the need for further investigation noted.
KLEBSIELLA-AEROBACTER PNEUMONIA IN INFANTS
Authors: Thaler Manning Michael
Published: December 2021

Klebsiella pneumoniae and Aerobacter aerogenes organisms are indistinguishable by standard laboratory methods and should be grouped under the single name Klebsiella-Aerobacter in clinical discussions. Though serotypes 1, 2, and 4 are usually implicated in severe respiratory disease in adults, any type may prove pathogenic in infants. A case of Klebsiella-Aerobacter pneumonia in a 7-week-old infant in which a Type 16 organism was lethal is presented. The disease took a fulminating course, characterized by copious secretion of thick purulent mucus, in which a great number of Klebsiella-Aerobacter were found. These diminished rapidly following antibiotic therapy, but the patient died from the flooding of her respiratory passages with secretions.

The 36 cases of this condition reported in the world literature are discussed, with particular emphasis on early diagnosis and effects of antibiotic therapy. The mortality in sporadic cases is four times that reported during epidemics. The diagnosis is seen to be particularly elusive and is complicated by the use of drugs prior to culture. The significance of throat carriers, especially during periods of increased incidence is difficult to interpret. Gram stains of tracheal secretions are singled out as a simple procedure helpful in making a quick diagnosis and in following the effect of antibiotic therapy. A combination of streptomycin and chloramphenicol is suggested as the antimicrobial combination of choice, effective in over 90% of in vitro studies.
ACUTE IDIOPATHIC RENAL VEIN THROMBOSIS IN INFANTS
Authors: Miller Harry C. , Benjamin John A.
Published: December 2021

A case of acute renal vein thrombosis diagnosed preoperatively on the fourth day of life and cured by nephrectomy is recorded. It is believed that this is the youngest survivor of surgical therapy for this condition. In this case, a hydrocele on the side of the renal lesion appears to be a newly observed associated finding, possibly related to irritation and serositis of the peritoneum overlying the affected kidney. The reports of surviving patients recorded in the literature since 1900 are reviewed and discussed.
Manual of Practical Micro and General Procedures in Clinical Chemistry
Authors: O'BRIEN DONOUGH
Published: December 2021

This is a thoroughly workmanlike production which could with advantage be added to the library of any chemical pathology laboratory providing services for children. The book is profusely and well illustrated, with the text set out in sections, the first being concerned with the general principles of microchemistry with details on such matters as blood collecting and equipment. A wide spectrum of routine methods is offered, and there are additional sections for special procedures such as for VMA, amino acid chromatography, serum mucoproteins, serum copper, etc., as well as for a useful series of appendices on references, source of equipment, standards, and normal values.
THE ALVEOLAR LINING LAYER
Authors: Avery Mary Ellen
Published: December 2021

The alveoli of the normal lung are lined by a substance which exerts surface tension at the air-liquid interface. In the expanded lung the tension is high and operates to increase the elastic recoil of the lung. In the lung at low volumes the surface tension becomes extremely low. This confers stability on the airspaces and thus prevents atelectasis. This lining layer is a lipoprotein film, which is not found where alveoli are still lined by cuboidal epithelium. Its time of appearance coincides with the appearance of alveolar lining cells. Electron microscopic evidence of secretory activity in alveolar cells suggests that they may be the source of the surface-active film. The normal alveolar lining layer is not present in lungs of infants who die from profound atelectasis and hyaline membrane disease. Whether its absence is a failure of development or due to inactivation is not established.
Taking Care of Physicians children
Authors: WESSEL MORRIS A.
Published: December 2021

The articles, "The Physicians Children as Patients" by John H. Kennell and Willard D. Boaz, and "Should not Physicians' Families be Allowed the Comfort of Paying for Medical Care?" by Benjamin M. Spock, in the July, 1962, issue of Pediatrics call attention to an important medical problem.

Doctor-parents do indeed need help in establishing a definite, well-defined relationship with their pediatricians. The physician who accepts this professional role should describe clearly for the doctor family, as for any other family, his plans for carrying out his professional responsibilities and his desire to be of service to his patients.
THE ETIOLOGY OF HYPOPROTEINEMIA IN A PATIENT WITH CONGENITAL CHYLOUS ASCITES
Authors: Rosen Fred S. , Smith David H. , Earle Ralph , Janeway Charles A. , Gitlin David
Published: December 2021

An infant with congenital chylous ascites and Milroy's disease, as well as two patients with Milroy's disease of the lower extremities, have been studied with regard to the turnover of I131-labeled human serum albumin. The children with Milroy's diease had a normal turnover of radioiodinted albumin, whereas the child with congenital chylous ascites had a markedly increased turnover due to loss of serum protein into the gastrointestinal tract. The hypoproteinemia which is a characteristic finding in congenital chylous ascites may be due to such gastrointestinal loss of protein in serum.
EPIDEMIOLOGY OF ASTHMA IN CHILDREN, WITH PARTICULAR REFERENCE TO WIND SPEED AND WIND DIRECTION
Authors: Newell Guy René , Swafford Lida Inge
Published: December 2021

There are many reports relating air pollution to asthma. Specific agents have been implicated, although not always concretely demonstrated. This study of 2,400 pediatric emergency visits for asthma compares its epidemiology in children and adults, particularly as to effects associated with wind speed and wind direction.

Outbreaks of asthma in children were not nearly as conspicuously related to wind speed and direction as were those in adults. The severity of attacks, as judged by emergency visits for relief, increased in the fall and fell off during the summer. More boys than girls were affected; the frequency of visits gradually built up with age, except for a drop at the immediate prepubertal ages, followed by a sharp peak at age 14 years. Thus "duration of exposure" could not be clearly related to the frequency of attacks. These observations have raised questions and speculations which we hope will lead to further studies.
Letters to the Editor
Authors: CONNELLY JOHN P. , CRAWFORD JOHN D. , WATSON JOHN
Published: December 2021

The four stumbling blocks to truth invented by the Anglican sage, Brother Roger Bacon, O.F.M., are: (1) the influence of fragile or unworthy authority, (2) custom, (3) the imperfection of undisciplined senses, and (4) the concealment of ignorance by ostentation of seeming wisdom. We are guilty of a violation of number three but would like not to extend our guilt by trespassing the fourth stumbling block.

In preparing a response to Dr. R. Rapkin's letter regarding our recent article, "Neonatal Hyperphosphatemia," we uncovered two errors: a minor one in Table II and a more serious one in Table III, which alters the findings. In Table II the mean serum phosphorus value on day three should read 0.09 mg/ml.
Pediatric Visiting Hours and Policies
Authors: GEPPERT LEO J.
Published: December 2021

It is obvious from even a cursory investigation of visiting regulations in children's hospitals that the people involved have a schizophrenic attitude. Like politics and religion, this is an explosive subject about which almost everyone seems to have very fixed opinions and they differ vehemently. Most of what has been written about this subject has been published in lay magazines, hospital management publications, and journals directed to the nursing profession. The subject has rarely been mentioned in pediatric journals.
HUMAN GROWTH HORMONE IN INFANT MALNUTRITION
Authors: Mönckeberg Fernando , Donoso Gonzalo , Oxman Sergio , Pak Nelly , Meneghello Julio
Published: December 2021

Human growth hormone was used in the treatment of six malnourished infants who had previously failed to respond or gain weight, in spite of a diet adequate for their growth requirements. The hormone was administered, by intramuscular injection, in a dosage of 2 mg weekly for 4 consecutive weeks. During the administration of the hormone a significant gain in weight and proportionally increased nitrogen, phosphorus, and potassium retention was produced. After discontinuation of the hormone, the increased rate of weight gain and the increased positive balances for these elements was not sustained. Our findings suggest that a decrease in all hormones produced by the adenohypophysis in the child suffering from severe malnutrition may serve as an important adaptation mechanism which may increase his chances of survival.
MEASURES OF BODY FAT AND HYDRATION IN ADOLESCENT BOYS
Authors: Heald Felix P. , Hunt Edward E. , Schwartz Robert , Cook Charles D. , Elliot Orville , Vajda Beno
Published: December 2021

A study of total body fat by simultaneously performing a variety of measurements of adiposity on each of 66 adolescent boys is described. Estimates of total body fat by densitometry indicate a 50% loss of body fat's contribution to total body weight from 12 to 18 years. Total body water, as measured by deuterium oxide, increases from 61% at age 12 years to 65% at age 18 years. Fat loss from this measurement closely parallels the fat changes estimated from densitometry. Lean body mass, hydration and adiposity appear to reach adult values at the sixteenth year. Subcutaneous fat measured by soft tissue x-rays films of the arm shows a similar fat loss, and of the same magnitude, when compared to densitometry and total body water estimates of fat. The triceps skinfold has a high correlation in estimating losses in fat during adolescence. The skinfold technique at this site provided a practical and accurate estimate of adiposity in adolescent boys.
Burn Therapy: Commentary on a Commentary
Authors: CHAMBERLAIN JOHN
Published: December 2021

In his Commentary on burn therapy in the June issue of Pediatrics (29:861, 1962), Dr. Metcoff deplored the use of "rather arbitrary formulae" to simplify the prevention of shock in burned patients, yet stated they were based on careful study by Evans et al. and the Brooke Army Group—and on certain assumptions. He says that use of these formulae results in the administration of too much water, sodium, and protein, yet he admits that "the most important cause of death after severe burns is the development of infections in the second post-burn week," not shock or poorly treated shock.
Treatment of Severe Spell Syndrome in Congenitial Heart Disease
Authors: RUDOLPH ABRAHAM M. , DANILOWICZ DELORES
Published: December 2021

An infant with pulmonary atresia with a ventricular septal defect, developed a severe prolonged spell associated with a possible gastrointestinal hemorrhage of unknown etiology. Arterial blood studies revealed an extremely low oxygen tension, a markedly reduced pH and slightly reduced carbon dioxide tension. Intravenous infusion of sodium bicarbonate solution was associated with dramatic improvement of the child's condition, and a return of arterial blood pH to normal levels although arterial oxygen tension had improved only slightly.
Sweat Electrolytes in Glycogen Storage Disease, Type I
Authors: SHWACHMAN HARRY
Published: December 2021

This correspondence is stimulated by the article by Doctors Harris and Cohen which appeared in Pediatrics, 31:1044, 1963.

I am indeed pleased to learn that some patients with glucose-6-phosphatase deficiency (von Gierke's disease) have elevated sweat electrolytes. We recall one patient tested by us with this deficiency and he showed the following values: at 5 10/12 years of age, sodium 18.8 meq/l, chloride 23.9 meq/l, potassium 7.3 meq/l. I consulted Dr. Paul di Sant-`Agnese, who is an authority on both glycogen storage disease and cystic fibrosis.
PULMONARY FUNCTION IN PECTUS EXCAVATUM
Authors: Polgar George , Koop C. Everett
Published: December 2021

Pulmonary function studies were essentially normal in 12 children with pectus excavatum. The deviations from the predicted values were slight, inconsistent, and had no correlation with the degree of the deformity. These findings present no basis for a physiological indication for corrective surgery of funnel chest. Predictions cannot be made concerning the ability of the patient with pectus excavatum to withstand acute or chronic pulmonary disease in later life. Prolonged follow-up studies on a group of patients such as this, as well as on a post-operative group, would seem to be indicated.
Prophylactic Vitamin D Dosage after Infancy
Authors: BAKWIN HARRY
Published: December 2021

In the report of the Nutrition Committee, American Academy of Pediatrics on the "Prophylactic Requirement and the Toxicity of Vitamin D" (Pediatrics, 31:512) the same prophylactic dose of vitamin D is recommended for children and adolescents as for infants. This seems to me unrealistic.

Before the introduction of widespread vitamin D prophylaxis, all the babies over 3 or 4 months on the infant's ward at Bellevue Hospital had rickets during the late winter and spring. The only variation was in degree. Rickets was never seen after the first year or two except for an occasional case of "renal rickets" and "coeliac rickets."
Problems of Translation
Authors: LIBER A. F.
Published: December 2021

Among the many virtues of the article by Lamy et al., "Congenital Absence of Betalipoproteins" (Pediatrics, 31:276, 1963) is the generally excellent English, with virtually no translationese. But the reader unversed in French may be puzzled by the legend of Figure 11, page 286: "Gelosis immunoelectrophoresis." "Gelosis" is clearly intended to render gélose, the French word for agar, or, in the current usage when referring to electrophoresis, agar-gel. The ending -sis is doubtless derived from the French -se, as in nephrosis for nephrose, analysis for analyse. A different law of transliteration applies to chemical substances, in whose names -ose is used in both French and English, as in glucose, identical in the two languages. Indeed, Dorland's Medical Dictionary gives gelose "a carbohydrate, (C4H10O5)n, from agar."
MILK ALLERGY
Authors: Saperstein S. , Anderson D. W. , Goldman A. S. , Kniker W. T.
Published: December 2021

The examination of sera from milk allergic children, children allergic to substances other than milk, and normal children, revealed no significant differences relative to coated tanned cell hemagglutinin titer or the presence of precipitating antibody as measured by gel diffusion for milk components.

The passive cutaneous anaphylaxis test revealed a high percentage of positive responses with sera from milk allergic individuals only.

The presence of milk hemagglutinins could not be demonstrated in the cord sera from 30 newborns.

The results of this study suggest that the passive cutaneous anaphylaxis technique deserves further evaluation as a laboratory method for the confirmation of milk allergy.
PERTHES AND PARENTS; THE CARE OF YOUR CHILD WITH LEGG-CALVÉ-PERTHES DISEASE, V. W. Rosar, Springfield, Illinois, Charles C. Thomas, 1963, 94 pp., $4.75
Authors: Trott Arthur W.
Published: December 2021

This is a comprehensive small volume which deals with problems of a crippling disease and it was written by a parent, who had to deal with this problem in her own child, for the benefit of parents whose children may be similarly afflicted. Consequently, the language used is that which the layman can understand. The description of the disease and its etiology, which opens the book, is certainly concise and up to date. The various types of treatment which can be performed as well as the prognosis are explained in detail.
"THE CIRCULATION OF BLOOD THROUGH SKELETAL MUSCLE"
Authors: Hyman Chester
Published: December 2021

MOVEMENT, that most grossly apparent manifestation of life, results from skeletal muscle contraction. Energy for contraction is ultimately obtained from the external environment so that fuels for transformation in the muscle cell must be brought from the gut or liver by the circulation. Continuing activity clearly depends on adequate tissue perfusion which maintains constant the environment of the cell and assures each tissue its necessary nutrients. In skeletal muscle, the vast range of potential activity would require either a constant blood flow adequate for the maximum demand, or, a rapidly and accurately adjusting circulation to meet the immediate needs of the tissue. Since the principle of parsimony rules most biological systems, instead of the prodigal maximum blood flow to resting muscle to provide for the occasional burst of activity, the variable blood flow system is the more logical and the actual solution. However, at times the maximum needs of active muscle may exceed the blood supply to incur a blood flow debt which must be repaid after the contraction. These general concepts are supported by numberless casual observations and many careful scientific studies performed over the past centuries. Specific information of the mechanisms regulating the circulation in skeletal muscle has accumulated during the past half century and several new concepts have been proposed in the past two decades. What follows is a summary and personal evaluation of our present knowledge of these mechanisms.

Traditionally, a description of the morphologic stage prefaces the examination of any physiologic mechanism; in this case, we must examine the arrangement of tubes which carry the blood through skeletal muscle.
Counseling in Medical Genetics
Authors: SMITH DAVID W.
Published: December 2021

Dr. Reed has presented genetic counseling in a manner which should be easily understood. He assumes the reader knows little genetics and he utilizes only the most common and essential genetic terminology. The material is presented in an open, often lighthearted fashion, and the necessary facts are interlaced with philosophical and personal commentary. The simple points are stressed along with the pitfalls, resulting in a very practical text for the clinician of today.
PERICARDITIS IN JUVENILE RHEUMATOID ARTHRITIS
Authors: Lietman Paul S. , Bywaters E. G. L.
Published: December 2021

Pericarditis was diagnosed clinically in 20 of a series of 285 cases of juvenile rheumatoid arthritis (7%). Of 11 postmortem studies in patients with juvenile rheumatoid arthritis, pericarditis was found in 5 (45%). In a patient with juvenile rheumatoid arthritis pericarditis may occur at any age, and its occurrence is unrelated to sex or age of onset of arthritis. Pericarditis usually follows arthritis and is usually associated with fever, leukocytosis and an elevated erythrocyte sedimentation rate. A patient who develops pericarditis is also prone to develop a skin rash, lymphadenopathy, splenomegaly, pulmonary disease, and amyloid disease. The presence of pericarditis is unrelated to the severity of the arthritis but may be related to a more severe course because of its relation to amyloid. The pericarditis may be asymptomatic. The usual physical findings consist of friction rub, tachycardia and tachypnea. X-ray and electrocardiographic changes are frequently useful in its detection. The clinical course of pericarditis is usually short and benign. No cardiac residua were detected. There is no evidence for the necessity nor for the efficacy of adrenocortical steroids.
International Opportunities for Experience
Authors: SIEBENTHAL B. J.
Published: December 2021

This letter is sent in order to point out to all pediatricians that there is an important place in the international medical picture for the "short-term" specialist. This I suspected for several years, and, after spending four months in Lahore, Pakistan, during the past winter, I am convinced more than ever that this is true. I am also convinced that the specialties, including pediatrics, have a real international obligation as well as a national one.
STUDIES OF CARBOHYDRATE METABOLISM IN THE NEWBORN INFANT
Authors: Cornblath M. , Wybregt S. H. , Baens G. S.
Published: December 2021

The rate of disappearance of an exogenous load of glucose (1 gm/kg) administered rapidly intravenously is reduced in premature infants under 3 days of age as compared to infants over 7 days of age, children, and adults. Premature infants are not leucine sensitive and respond to tolbutamide with less of a hypoglycemia under 3 days of age than after 7 days. Galactose (1 gm/kg) is cleared more slowly in the premature infant than the adult, but is rapidly converted to glucose. After intravenous fructose (1 gm/kg), there is a transient drop in blood glucose and an immediate rise in lactic acid in the premature infant. Subsequently, a hyperglucosemia occurs. Glucagon and glucagon plus epinephrine produce a hyperglycemic response in the premature infant; the hyperglycemia being greater after 7 days of age as compared to that between 3 to 7 days. In the premature infant, the metabolic needs of the relatively large brain, which is glucose dependent and is not insulin sensitive, may exceed the capacity of the liver to produce glucose during fasting. This may explain the relatively low levels of glucose in the blood of these infants.
ATTENUATED POLIOVIRUS INFECTION IN INFANTS FED COLOSTRUM FROM POLIOMYELITIS IMMUNE COWS
Authors: Gonzaga Antonio J. , Warren Robert J. , Robbins Frederick C.
Published: December 2021

The ingestion of bovine colostrum, containing poliovirus neutralizing antibody, before the administration of 105.5 TCID50 of Sabin Type 2 vaccine prevented viral infection of the gastrointestinal tract in 8 of 11 3-day-old infants during a 16-day period of observation. The ingestion of colostrum after as short an interval as 2 hours following administration of the vaccine did not affect the incidence of infection, but it did appear either to delay the establishment of infection or to interfere temporarily with the isolation of virus from the feces. The ingestion of colostrum that did not possess poliovirus neutralizing antibody did not influence the incidence of infection.
REPRODUCTIVE FAILURE IN FAMILIES OF PATIENTS WITH IDIOPATHIC DEVELOPMENTAL RETARDATION
Authors: Tips Robert L. , Smith George , Meyer Donald L.
Published: December 2021

1. The family histories of 30 patients with idiopathic developmental retardation were analyzed with respect to pregnancy records of nonaffected female kindred. Comparison was made with data from the family histories of 27 similarly ascertained control patients.

2. The mothers and maternal aunts of retardates were found to have abnormal pregnancy records, i.e., a markedly decreased reproductive rate and increased fetal loss (reproductive failure). Similar findings were not noted in the histories of the maternal grandmothers or other females in the families.

3. The comparison study suggests genetic factors as an influence on reproduction in the maternal families of retardates but their nature remains unknown.

4. The utilization of these findings in clinical genetic counseling is briefly discussed.
PHENYLKETONURIA
Authors: Kleinman David S.
Published: December 2021

The dietary regimen is a difficult one; it must be closely controlled by the physician if complications are to be avoided. Although effective in limiting pathology, if administered early and maintained, evidence is not yet presented as to whether it is fully protective.

Estimates of the incidence and prevalence of phenylketonuria are not well established. There are indications that, although rare, the incidence may be considerably higher than the 1 in 20,000 to 25,000 births previously estimated. Discrepancies in the estimates should be explored for possible explanation. These may relate to different population frequencies, definitions of mental retardation, and screening and testing procedures.

The degree of variability in the manifestations (or expressivity) of phenylketonuria in mental retardation and other effects has not been adequately examined. Investigation of the factors relating to this variability may provide information regarding the mechanics of pathology and lead to improved screening and therapeutic measures.
Oesophageal Atresia—Critical Study of the Literature and Report on Sixteen Cases
Authors: SWENSON ORVAR
Published: December 2021

Oesophageal Atresia, by A. P. M. Rutten, is a short paper-back book which exhaustively reviews the literature on esophageal atresia and tracheoesophageal fistula. A minor section of the book gives the author's experience with sixteen cases. The material is well arranged and clearly presented. Many interesting facts are included in this work, such as the incidence of anomalies in relation to the position of the esophageal fistula in the tracheobronchial tree. For example, when the esophageal fistula enters the trachea at the carina or below, the incidence of associated anomalies is greater than when the fistula enters above the carina.
ERYTHROCYTE ACETYLCHOLINESTERASE ACTIVITY IN ABO HEMOLYTIC DISEASE OF THE NEWBORN
Authors: Kaplan Eugene , Herz Fritz , Hsu Ku Shin
Published: December 2021

Erythrocyte AChE is reduced in ABO hemolytic disease of the newborn. This enzyme alteration is not present in all infants with ABO disease, nor in all erythrocytes of affected infants. Treatment of erythrocytes with anti A or B antibodies has not resulted in AChE decrease, but such decrease regularly follows erythrocyte treatment by proteolytic enzymes. While AChE is normal in Rh hemolytic disease of the newborn it is decreased in one infant exhibiting features of both ABO and Rh disease.

The measurement of erythrocyte AChE activity provides a simple colorimetric test to confirm the diagnosis of ABO hemolytic disease of the newborn. The reduced activity of this surface located erythrocyte enzyme in ABO disease and in paroxysmal nocturnal hemoglobinuria suggests that a similar extracorpuscular mechanism could be involved in both conditions. The demonstration of an enzymatic abnormality in erythrocytes associated with an immune hemolytic anemia may yield a model system for further study of cellular reactions in immune diseases.
THE SPIDER NEVUS IN INFANCY AND CHILDHOOD
Authors: Wenzl James E. , Burgert E. Omer
Published: December 2021

At the Mayo Clinic 711 children, ranging in age from birth to 15 years, were examined for the presence of spider nevi. The children were divided into three groups: normal controls, patients with chronic illness and patients with disease of the central nervous system. In the normal children, the incidence of spider nevi increased rapidly after 2 years of age to reach a plateau at about the time of puberty for both sexes. In children more than 13 years of age the incidence appeared to be decreasing, presumably toward the stated incidence of 12 to 15% in so-called normal adults. In normal children, spider nevi appeared to occur more frequently in pubertal females than in pubertal males. The incidence was increased in both sexes in patients more than 4 years of age with disease of the central nervous system. In patients with chronic illnesses, there was no significant increase in spider nevi, but the ratio of pubertal females to pubertal males was reversed. The anatomic distribution in all groups differed from that of adults, the dorsum of the hands and forearms being the sites of predilection in children. In view of the frequency of these lesions in childhood, it appears that the presence of spider nevi in otherwise healthy children is an insignificant stigma.
ADRENAL FUNCTION IN ALLERGY
Authors: Siegel Sheldon C. , Heimlich Ernest M. , Richards Warren , Kelley Vincent C.
Published: December 2021

Dexamethasone aerosols were studied in asthmatic children to determine their effectiveness and whether they produced suppression of adrenocortical function. In a double-blind cross-over study of 32 subjects, 24 children were definitely improved by the active material, 4 subjects did better on the placebo, and in 4 asthmatics no difference between the active and placebo aerosol could be detected. Adrenocortical function was measured by an ACTH-17-hydroxycorticosteroid response test and by measuring total 24-hour urinary excretion of 17 hydroxycorticosteroids. Both methods demonstrated statistically significant suppression of adrenocortical function. Thus, though aerosols of dexamethasone are effective in controlling asthma in children they do not avoid the side-effect of adrenocortical suppression.
FREE AMINO ACIDS OF CORD PLASMA AS COMPARED WITH MATERNAL PLASMA DURING PREGNANCY
Authors: Ghadimi H. , Pecora P.
Published: December 2021

The free amino acids of cord blood as compared with maternal blood taken within a few minutes were studied by the use of ion-exchange column chromatography.

Twenty-two paired plasma samples from immature, premature, and full-term caesarean sections and vaginal deliveries were studied. The material also included three cases of advanced maternal diabetes. In addition bloods from four healthy women after parturition were also analyzed to compare with blood obtained at the end of pregnancy.

The results indicate that (a) all the ratios of free amino acids of cord to maternal blood are above 1 and mostly about 2, (b) the discrepancy is brought about by decreased maternal and increased fetal values, (c) the ratios obtained from blood taken at the second trimester of pregnancy are somewhat higher than those of full-term, (d) an active transport mechanism responsible for the transfer of amino acids against a concentration gradient is in operation probably during the entire pregnancy, (e) essential and nonessential amino acids are transported across the placental barrier indiscriminately, and (f) maternal diabetes and the route of delivery do not affect the concentrations of free amino acids on both the fetal and maternal side.
ORAL POLIOVIRUS VACCINATION IN CHILDREN: A STUDY SUGGESTING ENTEROVIRUS INTERFERENCE
Authors: Feldman Roger A. , Holguin Alfonso H. , Gelfand Henry M.
Published: December 2021

Monovalent oral poliovirus vaccine type 1 was fed to two groups of children comparable in all respects except that in one group there was a high rate of naturally occurring infections with Coxsackie B4 and poliovirus type 3. Approximately 30% of the children in the latter group were found to have "wild" enteroviral infections during the two-week period beginning with vaccine feeding, and 38 of 128 of them (30%) who were "serologically susceptible" failed to show serologic evidence of vaccine "take" eight weeks after vaccination. In the other group, with no documented "wild" enteroviral infections during the two-week period, only three of 70 susceptibles (4%) failed to show a serologic response. This difference was attributed to the interfering effect of concurrent enterovirus infection on infection (and successful vaccination) with the OPV strain.

Community vaccination programs scheduled in the cold months of the year should avoid the possibility of enterovirus interference.
Pancreatitis in Childhood Associated with Ascariasis
Authors: GILBERT MICHEL G. , CARBONNELL MANUEL L.
Published: December 2021

Two cases of pancreatitis secondary to infestation with Ascaris as a rare disorder in infants and children are reported. Diagnosis of this disease can be made earlier and more frequently if a serum amylase, gastrointestinal series, and stool examination for ova and parasites are done in all children with acute, undiagnosed upper abdominal pains. Active medical treatment for the pancreatitis followed by antihelminthic therapy should be instituted as soon as the diagnosis is made. If medical therapy is not effective surgical extraction of the offending parasite from the pancreaticobiliary system may be necessary.
On Natal Teeth, by a Doubly Qualified Expert
Authors: MONCRIEFF ALAN
Published: December 2021

As (probably) the only Fellow of the Academy of Pediatrics to be born with a tooth (lower incisor), I feel the urge to write a short comment on the article on "Natal and Neonatal Teeth" in your December, 1963, issue. First, let me say that in accordance with the view of "some people" I claim to have been "especially favored by fate" and judge myself lucky to have escaped the polysyllabic syndromes mentioned on p. 1091.
THE MODERN MORBIDITY OF PERTUSSIS IN INFANTS
Authors: White Robert , Finberg Laurence , Tramer Arnold
Published: December 2021

Seventy-five children who had pertussis during early infancy and survived from a group having less than 1% mortality were recalled and examined, along with controls, for evidences of chronic pulmonary disease, neurological impairment, intellectual performance, and current behavior.

The data show no incidence of chronic pulmonary disease and no significant neurological sequelae in this small sample.

There was a statistically significant reduction in performance on the Wechsler Intelligence Scale for Children for the Negro group who had pertussis, compared to the controls, but not for the white pairs.

These observations give renewed justification for urging comprehensive immunization programs against pertussis.
The Development of the Infant and Young Child—Normal and Abnormal
Authors: HAGGERTY ROBERT J.
Published: December 2021

Pediatrics has been called the study of the upward slope of the curve of life. As such it has become widely accepted that detailed knowledge of the development of the infant and child as he progresses up this slope is essential for all pediatricians—and yet all too few pediatricians gain such knowledge and skill. Professor Illingworth has for some time espoused the point that such skills are necessary for pediatricians and also that a book about this topic should be written by a pediatrician.