bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDIES OF THE PHARYNX
Authors: Merritt W. H. , Nielsen M. , Bosma J. F. , Goates W. A. , Haskins R. , Ramsell C. , Lamb R. H.
Published: December 2021

An unusual occlusion of the mesopharynx is described in two patients with poliomyelitic impairment. This occlusion results from apposition of the lordotic cervical spine to the retrodisplaced structures of the mouth and face. The whole area of mouth, pharynx and larynx was immobilized by severe contracture of its musculature.

Methods of therapeutic mobilization and restoration of function to these structures of the bulbar area are described.
Paper Electrophoresis
Authors: FOMON SAMUEL J.
Published: December 2021

Although the book deals with both technique and applications of paper electrophoresis, the major emphasis is on methodology. The participants are of world-wide representation and are mainly individuals who have made important contributions to the development of the methods and apparatus.

The material presented includes opinions and presentation of evidence favoring the choice of buffers, filter paper, voltage, stain, etc., and of the identification and quantitative analysis of the separated materials. Paper-solvent interaction, paper-solute interaction and the influence of evaporation and diffusion are among topics of physicochemical interest.
CHILDHOOD PROBLEMS IN RELATION TO THE FAMILY
Authors: Kanner Leo , Eisenberg Leon
Published: December 2021

HISTORICAL

THE CHIEF focus in child psychiatry at the present time is on family relationships. It is of considerable interest that the concept of family relations did not really come into being until about the turn of the century and since then has come to occupy a position of increasingly greater emphasis in our thinking. This change in thinking took place mainly because of the efforts of Freud in Europe and Meyer in this country. It was in the first decade of the Twentieth Century that psychiatric history taking came to include a biography. However, even at that time, little attention was paid to children's behavior difficulties. It is of considerable interest that Freud's theories on infantile sexuality were published before Freud had ever seen a child professionally.

The greatest impetus came in the Twenties with the establishment of child guidance clinics at various places throughout the country and these began to study family attitudes and the relationships between various members of the family.

ATTITUDES

When we introduce the subject to medical students, we like to tell them that they have learned in medical school about various sets of agents which may be normally necessary for the proper body economy, may, on some occasions, be pathogenic, and may, under different circumstances, be remedial. Chemical substances, for example, are vitally important as foodstuffs, detrimental as toxins, and remedial as drugs. We have come to recognize that there is one other set of agents that is just as important and can have similar effects. These agents we choose to refer to as attitudes. In general, a person's feeling about himself and about the world in general will depend on the attitudes of the people who constitute his world. Certain attitudes provide an emotional climate that is ideal for the growing child and likely to provide for emotional stability. In summarizing the various attitudes that are necessary, we like to think of them in terms of the three A's: Affection, Acceptance, and Approval. It is certainly true that any child has a better chance of developing emotional security if he is surrounded by this attitudinal constellation.
Angiocardiographic Interpretation in Congenital Heart Disease
Authors: WHITTEMORE RUTH
Published: December 2021

This monograph on angiocardiography is one of the series, American Lectures in Pediatrics. The dissertation is divided into two parts, the first on general considerations, and the second on the diagnosis of specific anomalies.

The section on general considerations gives much useful information. In the introduction, some interesting historical background is presented followed by a discussion on technique and equipment. Here in the preliminary considerations, it is wisely stressed that the need for angiocardiography or aortography in each individual patient should be a group decision of the entire diagnostic team, and that the information to be obtained from the procedure should be thoroughly evaluated.
TREATMENT OF MEASLES ENCEPHALITIS WITH ADRENAL STEROIDS
Authors: Allen John E.
Published: December 2021

Ten cases of measles encephalitis treated with large doses of adrenal steroids are presented. Apparent complete recovery occurred in all 10 cases. In most of the cases clinical improvement was dramatic and prompt. There was no evidence of untoward reaction from the use of steroids combined with prophylactic antibiotic therapy. The results in this series are further substantiated by the report of Appelbaum and Abler who reported the recovery of 16 out of 17 patients with adrenocorticotropin.

It is to be emphasized that measles encephalitis is an extremely variable disease and that only prolonged experience with one form of therapy by different investigators and clinicians can determine the final efficacy of the treatment. Ten cases are not a great number from which to draw a definite conclusion in this disease, however, the results were so convincing to us that we felt an early publication of this information worthwhile in the hope that further trials will be undertaken by other groups. From our experience we recommend the treatment of measles encephalitis with steroid therapy as outlined.
THE EFFECT OF HUMIDITY ON SURVIVAL OF NEWLY BORN PREMATURE INFANTS
Authors: Silverman William A. , Blanc William A.
Published: December 2021

A controlled clinical trial was conducted to study the effects of two conditions of humidity upon respiratory symptoms, death rate and necropsy findings among premature infants in the first 5 days of life. Infants who were placed in environments of "80-90% relative humidity," which was achieved without the use of mist, had more rapid respiratory rates, higher body temperatures and a lower death rate than controls in "30-60% relative humidity." The nature of the mechanisms underlying the observed associations is a matter of conjecture which is under further study.
NOTE ON THE REPAIR OF CLEFT LIP AT THE TWELFTH HOUR AFTER BIRTH
Authors: Thoroughgood William C. , Fischer Carl C.
Published: December 2021

It is proposed that repair of cleft lip be undertaken during the first day of life. The advantages and disadvantages of such a procedure are discussed and the advantage of local anesthesia in repairing cleft lip is emphasized.

A report of the results in 12 patients is given.
EPIDEMIC SALMONELLOSIS
Authors: Szanton Victor L.
Published: December 2021

A 30-month study is reported of an epidemic of salmonellosis involving 46 newborn infants and 34 older individuals who were contacts and became carriers. A total of 80 persons was involved, all having positive stool cultures for Salmonella sp. (type Oranienburg). Of the total number of infants delivered during the epidemic, the 46 infected infants established an attack rate of 20%. The additional 34 older individuals who were carriers were contacts of the infected infants. The mechanics of contact or mode of pattern of spread could not be completely determined. In the newborn infants response to this infection varied. One infant died, 7 were acutely ill, 33 had symptoms of grossly abnormal stools, 5 had asymptomatic infection and were diagnosed by positive stool cultures alone. With one exception, the older individuals all were asymptomatic and were diagnosed by positive stool cultures. Serologic confirmation of the presence of this specific infection was established by determinations of specific antibodies. These were positive in 9 of 10 infants. In the older individuals, antibody agglutinations were positive in seven of eight so studied. Of the 33 infants followed, all became carriers and at the end of 30 months, cultures of stools of 30 of the total number had become negative for Salmonella sp. (type Oranienburg) and 3 remained positive. Of the 22 older individuals followed, all had cultures negative for Salmonella sp. (type Oranienburg) at the end of 13 months. Therapy was prescribed in six acute cases and all of these patients recovered. Experimental therapy for the carrier state resulted in failure in all cases. A comparison of the group of 20 infants not treated suggested that stools of the untreated patients cleared spontaneously more readily than those who were treated.
EDUCATION
Authors: Kanof Abram
Published: December 2021

More than half of American medical schools teach rehabilitation as part of the pediatric curriculum.

There is great variability in the quality and quantity of such teaching.

Three typical syllabuses are reproduced: One stresses the psychologic and parental aspects of rehabilitation in childhood; one stresses the physician's attitude and training requirements in this field; and one purports to be a short, practical introduction to rehabilitation together with a demonstration of its applicability to the care of children.
Bone Structure and Metabolism
Authors: PONSETI I. V.
Published: December 2021

Under the auspices of the Ciba Foundation 28 leading scientists met in London in July, 1955, to present papers and discuss current problems dealing with the structure and metabolism of bone. The proceedings of these meetings are compiled in a "Ciba Foundation Symposium." There were many important presentations.

Arne Engstrom applied his methods of quantitative roentgen microscopy to osseous tissues. The slowly mineralized structures in bone tissue are in a state of very rapid cxchange with body fluids and act as an effective ion-exchange column.
STERILIZATION AND PRESERVATION OF FORMULAS FOR INFANTS
Authors: Silver Henry K.
Published: December 2021

The "terminal" method of heating is the safest means of preparing artificial milk feedings for infants.

There is no practical method of processing formula so that sterility is assured in every bottle. Certain organisms (particularly spore-forming bacteria) may survive regardless of the method used.

Any departure from the usually recommended procedure for formula prepartion may be attended by the risk that the formula will become grossly contaminated. The term "terminal sterilization" as applied to the usual home method of preparation is a misnomer, since formulas may or may not be sterile even after "terminal" heating.

The "aseptic" method of preparing formula, although theoretically safe if performed correctly, has the hazard that breaks in technique may occur and pathogenic contamination may result.

Keeping terminally-heated formula at room or incubator temperatures for more than 6 hours may result in gross contamination of the formula by bacteria which were dormant in the milk-mixture.

Although it is common practice in the home to prepare the required formula every day, the present experiments indicate that terminally-heated formula which is prepared with clean equipment, and then cooled and refrigerated immediately thereafter is bacteriologically safe for at least 2 or 3 days. A new supply of formula need not be made daily.
DIFFERENCE IN COLOR OF HEMATURIA IN THE NEPHROTIC SYNDROME AND GLOMERULONEPHRITIS
Authors: Heymann Walter , Rothenberg Michael B. , Gilkey Carolyn , Lewis Mildred
Published: December 2021

Eleven grossly bloody urines were obtained from seven children with nephrosis; the color was bright red in nine and red with a brownish tinge in two. The supernate was yellow in 10 of the urines and slightly brownish in one. The sedimentation rate of the urinary sediment was slow. Seventy to ninety-six per cent of the erythrocytes were well preserved, with an average of 84%.

Thirty bloody urines were obtained from 24 children with acute nephritis and two with chronic nephritis; the color of 21 specimens was brown and of 4 was red. The supernate was brownish in 18 and yellow in 11. The sediment settled readily. The number of well preserved erythrocytes varied from less than 10% to 80%, with an average of 46%.

The conversion of hemoglobin from a red to a brownish pigment takes place in any acid urine whether obtained from a normal subject or from one with nephritis or nephrosis. The difference in color of hematuria of the nephritic and nephrotic subject lies in different rates of erythrocyte destruction, probably indicating differences in the intraglomerular lesions leading to hematuria in nephritis and in the nephrotic syndrome.

A practical implication of the described difference between the hematuria in nephritis and nephrosis is that a bright red urine suggests the nephrotic syndrome as an underlying disease, whereas a brown color points toward a nephritic renal disorder.
INCIDENCE AND PATHOGENESIS OF NEONATAL CANDIDIASIS
Authors: Kozinn Philip J. , Taschdjian Claire L. , Wiener Harry
Published: December 2021

Differences in the day of discharge, the size of the sample and methods of diagnosis largely account for the considerable variations in reports regarding the incidence of oral thrush at various institutions.

Factors commonly listed as contributory to oral thrush, such as debility, prematurity, and so forth, were not found to be operative in the series of cases studied. Preceding antibiotic therapy did not raise the incidence of neonatal oral thrush. The lack of resistance of the newborn infant to Candida albicans infection of the mucous membranes appears to be due to intrinsic defects in immunity which are not as yet understood.

Maternal vaginal candidiasis appears to be the primary source of neonatal candidiasis. The latter is most effectively prevented by adequate mycologic screening and therapy of the expectant mother.

Infants infected at birth harbor Candida albicans for several days before they develop clinical evidence of oral or cutaneous candidiasis. In view of these findings a reevaluation of public health measures for the prevention and spread of oral thrush in nurseries appears desirable.
RENAL (VASOPRESSIN-RESISTANT) DIABETES INSIPIDUS
Authors: Hillman Donald A. , Neyzi Olcay , Porter Philip , Cushman Anne , Talbot Nathan B.
Published: December 2021

It has been shown that the impact of an enduring limitation in homeostatic capacity on daily life can be defined in an objective manner. It is concluded that such information is of value in determining the patient's therapeutic needs, planning ways to fulfill them and in judging the efficacy of therapy.
PHENYLPYRUVIC OLIGOPHRENIA
Authors: Meister Alton
Published: December 2021

PHENYLPYRUVIC OLIGOPHRENIA is an inherited disease characterized by mental deficiency and urinary excretion of phenylpyruvic acid. Patients with this disorder are unable to carry out a particular enzymatic step in the metabolism of phenylalanine; this reaction is the conversion of phenylalanine to tyrosine:[see equation in source pdf].

These individuals therefore appear to be human mutants, analogous to mutants such as those which have been induced in Neurospora crassa and Escherichia coli. However, in contrast to the enzymatic defect in certain mutant microorganisms, which is often recognizable in terms of a specific nutritional requirement, the metabolic block in phenylpyruvic oligophrenia is associated with a relatively complex picture.

Phenyipyruvic oligophrenia is a recessive trait; it has been estimated that the gene is carried by approximately 0.5 to 1% of the population. Although most patients with this disease exhibit markedly reduced mental capacity, a few show only moderate retardation. A high percentage of patients with phenylketonuria have fair skin, blue eyes and blond hair. About 25% of patients with phenylpyruvic oligophrenia have experienced seizures, and many of these patients have been reported to show abnormal electroencephalograms. Several necropsies have revealed evidence of abnormal myelination; on the other hand, other postmortem studies have been described as essentially negative.

Patients with phenylpyruvic oligophrenia may excrete as much as 1 to 2 gm each of phenylpyruvic acid and phenyllactic acid per day; these compounds are not usually detectable in normal urine (Fig. 1). Urinary excretion of phenylalanine, normally no more than about 30 mg/day, may be as high as 1 gm/day in phenylpyruvic oligophrenia.
CONCENTRATIONS OF ACTIVE ISONIAZID IN SERUM AND CEREBROSPINAL FLUID OF PATIENTS WITH TUBERCULOSIS TREATED WITH ISONIAZID
Authors: Lanier Virginia S. , Russell William F. , Heaton Angeline , Robinson Arthur
Published: December 2021

Microbiologic assay for antimicrobially active isoniazid was performed on the serum of 57 children with tuberculosis. Comparisons were made with similar assays of serum from 344 adult tuberculous patients. Regardless of the basis for calculating equivalent dosage, the relative proportion of children and adults who were rapid inactivators of isoniazid was roughly the same.

Six hours after administration of isoniazid the concentrations in cerebrospinal fluid were equal to or greater than those of the serum.

The value of determining the concentrations of isoniazid in serum for individualization of dosage in children was discussed.
AMINONUCLEOSIDE NEPHROSIS IN RATS
Authors: Wilson S. G. F. , Hackel Donald B. , Horwood Sargent , Nash Gerald , Heymann Walter
Published: December 2021

The nephrotic syndrome produced in rats by administration of the aminonucleoside of Puromycin® appears after a latent period which can be shortened or lengthened by increasing or reducing the daily dose. Young rats which survive the initial course lose their proteinuria, but some relapse after 3 to 4 months. Upon re-administration of the nucleoside a chronic disease can be induced which causes death in 3 to 8 months from renal failure. Older rats given a single intravenous injection develop a chronic disease with a natural history the details of which are still not known.

It is unlikely that the pathogenesis is based on an antigen-antibody reaction, since ACTH, cortisone and inhibition of antibody formation by x-radiation fail to prevent the disease.

The nucleoside fails to produce a similar disease in dogs, rabbits, guinea pigs, and mice. Both 3-amino-3-deoxy-D-ribose, and and 6-dimethyl aminopurine, which in combination form the nucleoside, are inactive in producing renal disease individually. It is possible that dogs, rabbits, guinea pigs and mice are able to break down this compound while rats cannot.
ROLE OF COPPER IN INFANT NUTRITION
Authors: LAHEY M. E.
Published: December 2021

INTEREST in the role of copper in nutrition was first stimulated by observations indicating that this trace element in addition to iron was necessary for alleviation of the milk anemia occurring in weanling rats. While the counterpart of this deficiency state in the human infant has long been sought, proof of its existence is lacking.

Renewed interest in this problem has recently been aroused by the description of infants exhibiting microcytic hypochromic anemia, hypocupremia and hypoferremia, which manifestations are characteristic of copper deficiency in swine. The human subjects have, however, exhibited edema and hypoproteinemia, features not previously described in copper-deficient animals. It has been suggested by some that the subjects are copper deficient, by others that the basic defect involves the metabolism of protein. Indeed, there is evidence that both concepts may be correct and that two separate entities may be represented.
CYSTIC FIBROSIS OF THE PANCREAS: INTESTINAL ABSORPTION OF FAT AND FATTY ACID LABELED WITH I131
Authors: Reemtsma Keith , di Sant'Agnese Paul A. , Malm James R. , Barker Harold G.
Published: December 2021

Comparative studies of intestinal absorption utilizing test meals of I131-labeled neutral fat and fatty acid, administered on different occasions to the same individual, were performed in 10 patients with cystic fibrosis of the pancreas and in 13 control children. The results are compared with those previously obtained and reported in various groups of adults. Two of the patients with cystic fibrosis had normal tryptic activity in the duodenal aspirate.

The experimental data in the two patients with cystic fibrosis and normal tryptic activity of the duodenal contents are presented, but no conclusions are drawn therefrom. This series will have to be expanded before theories regarding underlying disturbances can be advanced.

All of the eight patients with cystic fibrosis and pancreatic achylia showed impairment of intestinal absorption of neutral fat, and to a lesser extent, of fatty acid. While the former result was expected, the impaired absorption of fatty acids was not, and is at variance with results in adults with acquired pancreatic deficiency. The hypothesis is advanced that an intestinal factor other than lack of pancreatic enzymes may be partially responsible for the defect in absorption in cystic fibrosis of the pancreas.
IDIOPATHIC HYPERCALCEMIA
Authors: Kowarski Avinoam
Published: December 2021

A case of idiopathic hypercalcemia with failure to thrive is described. A new form of diet employing milk treated with sodium sulfate was tried and proved effective.

Mechanism of action of sodium sulfate in lowering the absorption of calcium from the intestine is discussed.
SALMONELLOSIS IN A PREMATURE NURSERY UNACCOMPANIED BY DIARRHEAL DISEASE
Authors: Watt James , Wegman Myron E. , Brown O. Wharton , Schliessmann D. J. , Maupin Elizabeth , Hemphill Emmarie C.
Published: December 2021

Introduction into a large premature nursery of six apparently normal infants, who were later found to be infected with S. tennessee, led to epidemic spread of the infection over a 4-month period. No infant was ill at any time.

Original source of the infection could not be determined. Feedings, contact with other patients, and infected animals could be eliminated as modes of spread. Rectal-swab cultures of nurses and attendants were all negative.

Infection of air was demonstrated and positive cultures were obtained from bedside tables and recently changed cribs.

A positive culture was obtained from hands of one nurse immediately after washing. Evidence was found that increase in spread was associated with decrease in amount of nursing care. It is inferred that defective nursing techniques, particularly handwashing, was the chief mode of spread.
Poisoning of a Physician's Child by "Medical Samples"
Authors: GRIBETZ DONALD
Published: December 2021

The following case report, although of interest from the diagnostic point of view, may be of far greater importance to physicians personally and their families. It is being presented as a warning to doctors who may carelessly misplace "medical samples" in their homes.

A 21-month-ld female child, daughter of a physician, while taking an afternoon stroll with her parents, suddenly "tripped" and fell to the sidewalk. When picked up, she staggered repeatedly and was unable to regain normal balance.
THE DEVELOPMENT OF PREMATURELY BORN CHILDREN WITH BIRTH WEIGHTS OR MINIMAL POSTNATAL WEIGHTS OF 1,000 GRAMS OR LESS
Authors: Dann Margaret , Levine S. Z. , New Elizabeth V.
Published: December 2021

Seventy-three children, prematurely born, with birth or minimum weights of 1,000 gm or less, of 116 discharged alive from the Premature Nursery of the New York Hospital from 1940 through 1952, were examined between 1950 and 1957. Historic and social data, and findings on physical and psychometric examinations were evaluated.

With rare exceptions, physical health was good, with a marked paucity of neurologic defects.

They exhibited a tendency to catch up in height to normal standards for chronologic age, but often not until after 4 years of age.

The incidence of eye defects, especially strabismus and myopia, was high.

Intelligence quotients showed a wide range (59 to 142); the average I.Q., 94, was significantly below the I.Q. of 107 found in 34 full-term sibling controls. Twelve of the seventy-three prematurely born children had I.Q.'s below 80; among the 43 of similar birth weight but not available for examination, 19 were known to be mentally retarded and 5 of these were in institutions.

A number of variables, including birth weight, sex, race, and socio-economic status, were analyzed to see whether they bore any relationship to the outcome in terms of I.Q. A significantly higher proportion of the children with I.Q.'s above 100 was found among families of higher socio-economic rating. A suggestive advantage of girls over boys and of white over non-white patients was noted, though the latter is probably secondary to socio-economic factors.

A very high incidence of serious maternal complications existed and might well have influenced the outcome, but within the group no relationship was found between lower I.Q. and complications of pregnancy and delivery, with the possible exception of toxemia and cesarean section. There was no greater incidence of low I.Q. in patients with visual handicaps than in the total group.
ACQUIRED EVENTRATION OF THE DIAPHRAGM IN INFANCY
Authors: Bishop Harry C. , Koop C. Everett
Published: December 2021

Acquired eventration of the diaphragm due to injury of the phrenic nerve at the time of birth can seriously impair normal respiratory function and reserve and may produce associated gastrointestinal symptoms. Surgical plication of the involved diaphragm is a safe procedure which is accompanied by both immediate and long-lasting relief of the potentially fatal respiratory distress.
STUDIES ON PHYSIOLOGIC HYPERBILIRUBINEMIA OF NEGRO AND WHITE PREMATURE INFANTS
Authors: Holman Gerald H.
Published: December 2021

Serial determinations of the concentration of bilirubin in the plasma were obtained with 39 premature infants commencing with cord blood in 18 cases. The group consisted of 25 Negro infants and 14 white infants. Concentrations in the plasma were followed until the level fell below 2 mg/100 ml.

The hyperbilirubinemia exhibited by these prematures appeared to be due to so-called "physiologic processes" as all procedures to establish other causes were uniformly negative.

A definite inverse relationship between the degree of bilirubinemia and the maturity of the infant was shown in both white and Negro infants. Statistical significance was demonstrated when the mean peak concentrations of bilirubin in the plasma of the least mature infants were compared with those of the most mature infants, within each racial group.

There was a statistically significant difference between the concentrations of bilirubin in the plasma reached in the two racial groups in the most immature infants. The concentrations were lower in the Negro group. A similar trend was present in the more mature infants, but this was not statistically significant. These findings agree with the fact that the Negro infant is a more mature baby than a white child of the same weight. They also lend support to the thesis that the degree of bilirubinemia is a reflection of the functional maturity of the infant.

The possible causes of physiologic hyperbilirubinemia in full-term and premature infants were discussed. Several fields for experimental research are still unexplored. The role of the excretory capacity of the liver, particularly the functional activity of glucuronyl transferase, appears to be preeminent in the etiology of neonatal bilirubinemia. The sudden changes in the dynamics of hepatic blood flow which occur at birth may account, in part at least, for the hepatic immaturity.

That the premature infant can develop kernicterus in the presence of hyperbilirubinemia without evidence of isoimmunization is becoming more generally accepted. The incidence of kernicterus in this hospital and in this study is quite low. The possible role of racial groups and administration of vitamin K in this regard was discussed.

The bulk of the evidence indicates that premature infants exhibit jaundice and hyperbilirubinemia more frequently and to a greater degree than is reported in full-term infants.

The duration of this hyperbilirubinemia is related to fetal maturity, persisting longer in the most immature infants.

Because of the variability of concentrations of bilirubin in the plasma of premature infants, and because of the multitude of factors that play a possible role in determining the ultimate concentration of bilirubin, routine exchange transfusion for elevated concentrations of bilirubin does not seem warranted. The critical level over which exchange transfusion should be done cannot be stated on the basis of any available data.
INFANTILE SPASMS WITH MENTAL RETARDATION
Authors: Low Niels L. , Bosma James F. , Armstrong Marvin D. , Madsen Jack A.
Published: December 2021

The clinical syndrome of infantile spasms with mental retardation is described in detail in 10 children. Dietary experiments aimed at attempting to gain evidence for the existence of inborn errors of metabolism in these children did not yield positive information. It is suggested that these children may represent a group who suffer from related, but not yet discovered, metabolic abnormalities.
Tuberculosis, Every Physician's Problem
Authors: MIDDLEBROOK GARDNER
Published: December 2021

This book, written by one of America's most distinguished authorities on tuberculosis, clearly reflects, in particular, his views concerning the relative effectiveness of various methods of tuberculosis control. It documents the remarkable decline of the contagion during the past few decades. Dr. Myers reviews the very favorable trends which have occurred in the state of Minnesota largely as a result of his inspiration, guidance and remarkable drive. For many years he has been emphasizing the importance of the tuberculin test as the single most useful guide in any tuberculosis control program.
Diabetes as a Way of Life
Authors: CHUTE A. L.
Published: December 2021

Dr. Danowski has named his book Diabetes as a Way of Life very well. In addition to describing the manifestations of this disorder and accepted treatment procedures, he has pointed out the many ways in which the diabetic can meet successfully the problems presented in daily living.

The descriptions are clear and concise and the book is easy to read. Although it is factual and points out the problems, it is optimistic in its approach.

Dr. Danowski is obviously a "middle of the roader" in regard to dietary management and the control of glycemia.
Rehabilitation: A Community Challenge
Authors: BLUESTONE SEYMOUR S.
Published: December 2021

This volume collates knowledge accumulated, mainly during the past decade, by the many individuals and groups concerned with the provision of rehabilitation services. As one of the outstanding among these individuals, the author can speak authoritatively on the wide range of subjects covered. The book is well documented with references and is supplemented by an extensive classified bibliography.

Intended "to form a source of reference and guidance for all those interested in (rehabilitation), particularly those at the planning level of community activity," the book should be of even wider interest as a significant contribution to the basic understanding of rehabilitation by all thinking people.
Cerebral Palsy
Authors: KUGEL ROBERT B.
Published: December 2021

This monograph is an attempt to reduce a very complex subject to a simple summary. It is very difficult for the person less than sophisticated in matters pertaining to cerebral palsy to comprehend the exceedingly complicated nature of that symptom complex and the even more complicated efforts required for adequate management. In this volume there is an effort to provide a system of classification which is basic to the understanding of any aspect of this disease. The classification contains elements pertaining to etiology, degree of involvement, associated symptoms, specific type, and prognosis. In general, the usefulness of this monograph will be largely limited to those who wish to have a slightly greater appreciation for the problem.
OBITUARY
Authors: CHRISTOPHERSON E. H.
Published: December 2021

Henry F. Helmholz, M.D., of Rochester, Minnesota, ninth President of the American Academy of Pediatrics (1938-39) passed away at Rochester, Minnesota, on the evening of August 18, 1958. Dr. Helmholz would have been 76 years old on August 24.

Born in Chicago, he attended the University of Wisconsin and graduated from Johns Hopkins Medical School in 1906. Following a fellowship in pathology Dr. Helmholz studied pediatrics at the Universities of Berlin, Breslau and Vienna from 1907 to 1909. He returned to Chicago to marry Isabel C. Lindsay and to begin the practice of pediatrics. From 1909 to 1920 Henry Helmholz practiced in Chicago, but in 1921 accepted an appointment as Head of the Section of Pediatrics at the Mayo Clinic.
CYSTIC DISEASE OF THE LIVER AND KIDNEY
Authors: Lathrop Donald B.
Published: December 2021

The subject of cystic disease of the liver and kidneys has been reviewed.

A family has been studied in which at least four and probably six of seven children of normal parents have been affected by the disease, as shown by clinical study and biopsy, liver function and biopsy, and by pyelograms made after intravenous injection of radio-opaque material.

The prognosis of the condition usually depends upon the amount of renal involvement. In the patients studied here, however, the disease process in the liver has assumed even greater clinical importance, since two children have developed severe portal hypertension.
DIAGNOSIS AND TREATMENT OF ACUTE INTESTINAL INTUSSUSCEPTION WITH CONTROLLED INSUFFLATION OF AIR
Authors: Fiorito Eduardo S. , Cuestas Luis A. Recalde
Published: December 2021

Use of a new method for diagnosis and treatment of intestinal intussusception is described, termed "controlled insufflation." It consists of insufflation of the colon with air under fluoroscopic and manometric control. A simple attachment avoids higher intestinal pressures than desired. The apparatus, procedure, advantages and therapeutic results are briefly presented. Full reduction was achieved in 94% of 86 cases of intussusception.
Diagnostic Biochemistry
Authors: MAY CHARLES D.
Published: December 2021

This is a courageous book. It demands something of the student. The author has that rare maturity which leads him to arrange the text to involve the student in an active process of learning rather than egotistically exploiting him with a show of erudition that leaves the student passively impressed and unchallenged.

The essentials of important biochemical systems are clearly outlined, in a somewhat original manner, so as to enable one to understand the biochemistry behind diagnostic procedures.
EXPERIENCES WITH THE MANAGEMENT OF PLEXIFORM NEUROFIBROMA
Authors: Minor Charles L. , Koop C. Everett
Published: December 2021

Plexiform neurofibroma is a relatively uncommon manifestation of diffuse neurofibromatosis and is characterized by its unique gross appearance. Because of its tendency to involve peripheral nerves centripetally it must be vigorously treated surgically to prevent damage to vital areas, notably the brain and spinal cord, although the tumor is basically benign.

We have presented our experience with 11 children who had this disease, demonstrating that despite the propensity for the growth to crop up in several areas it can be eradicated locally, and the patient may have no further trouble for a long time.

We believe that resectable lesions should be removed even though this may require repeated operations over a period of several years.
CLINICAL CONFERENCE
Authors: Schulman Irving
Published: December 2021

Dr. Schulman: The patient I would like to discuss this afternoon demonstrates a problem which is quite common in pediatric practice, namely that of severe and recurrent epistaxis.

The patient is a 9-year-old boy who had manifested repeated episodes of epistaxis since the age of 2 years. The nosebleeds occurred most commonly during the night and more frequently during the winter than the summer months. They usually were not associated with trauma although, on occasion, they did follow sneezing. They seemed to occur more frequently when the child had a concurrent upper respiratory infection. In most instances the nosebleeds stopped spontaneously after a few minutes, but on at least three occasions they were so profuse as to require hospital attention and nasal packing.

At the age of 3 years, the child was seen by a physician who informed the mother that something was wrong with the child's platelets and that transfusions would be required each time the child had a nosebleed. During the subsequent 2 years the child was admitted to the hospital for transfusion on several occasions. When the child was 4 years of age the mother sought further advice from a hematologist and the patient was completely evaluated from the standpoint of hemorrhagic disease. No abnormality was found. However, the first physician insisted that a platelet defect was present and informed the mother that transfusions were still required with each nosebleed in order to prevent exsanguinating hemorrhage. Oven the succeeding 5-year period the child received numerous transfusions of whole blood, and in recent years with fresh frozen plasma. The nosebleeds had not increased in number or frequency during this period and the child was otherwise clinically well. Two weeks ago the child was brought to the Children's Memorial Hospital for further study.

The past history disclosed no evidence of a bleeding tendency apart from the nosebleeds. Specifically there had been no easy bruising, no bleeding following circumcision, or eruption of the teeth, and no development of hematomata after the usual immunization injections. Complete family history was likewise negative for any evidence of an abnormal tendency to bleed.
EXAMINATION OF THE URINE IN PYELONEPHRITIS
Authors: RUBIN MITCHELL I.
Published: December 2021

INFECTIONS of the urinary tract are second only to infections of the respiratory tract in frequency and, therefore, represent a very common pediatric problem. In most instances the infection involves the kidney substance (pyelonephritis). In recurrent or chronic infections, usually superimposed on a congenital anatomic defect, functional damage often results. Because of the serious consequences of untreated urinary infection, early diagnosis is imperative, particularly so where there is an associated urinary tract anomaly and where infection tends to persist.

Localizing clinical signs of infection in the urinary tract are too commonly absent to be relied on for a diagnosis, and pyuria, the usual indication of infection in the urinary tract, may be absent in the presence of infection. To date, the most reliable indication of infection in the urinary tract is obtained by finding bacteria in the urine in significant numbers.
ABDOMINAL EPILEPSY IN CHILDHOOD
Authors: Schade George H. , Gofman Helen
Published: December 2021

A complete family history as to the past seizures experienced by the patient or by members of his family may be revealing and helpful in establishing a diagnosis of abdominal epilepsy. In our study 19 of the 46 children revealed a past history of seizure state and 25 had experienced febrile seizures in infancy.

Detailed consideration of the type of pain, its site, and allied symptoms should be evaluated carefully. Disorientation during an episode of pain followed by exhaustion and sleep is suggestive of abdominal epilepsy.

Electroencephalography is usually helpful in supporting the clinical diagnosis of abdominal epilepsy.

Discussion with the child and his parents, when practical and possible, in regard to the diagnosis and therapy, is recommended. Clarification and definition of the regimen and of the condition are essential, as the term "epilepsy" still carries a stigma to the lay person. Consideration of the patient and parental feelings and attitudes leads to understanding, co-operation, and ultimate success in the control of symptoms.
Surface Area of the Body as a Basis for Calculating Dosages
Authors: DARROW DANIEL C.
Published: December 2021

Nathan Talbot and associates (Pediatrics, 24:495, 1959) have done much to make doctors realize that interpretation of many physiological phenomena of patients of different sizes is simplified by relating them to a variable function of body weight rather than directly to body weight. Essentially the variable function of body weight is weight raised to the two-thirds power times a factor, and called "surface area." One cannot quarrel with this practice as long as it leads to better understanding of physiological principles.
LEUKOCYTOSIS AS A COMPLICATION OF PREDNISONE THERAPY IN RHEUMATIC FEVER
Authors: Harris T. N. , Vandegrift Harvey N.
Published: December 2021

Three children under treatment with prednisone for acute rheumatic fever were found to develop leukocytosis, in the range of 16,000 to 20,000/mm3. In each case the leukocytosis began within a few days after the beginning of prednisone therapy, and ended within a few days after the termination of this therapy. Clinical observation and study failed to reveal any other infection which might have been the cause of the leukocytosis. It was concluded that the leukocytosis was an unexplained complication of prednisone therapy.
Roentgendiagnostik Beim Neugeborenen und Saugling
Authors: SCHWARZ GERHART S.
Published: December 2021

The author, an assistant at the Vienna University Children's Clinic and chief of its Roentgen Station undertook to publish this book 3 years after Swoboda, his predecessor, had brought out his book entitled "The Skeleton of the Child." The author stresses the great value of short simple radiographic procedures on newborns and infants which lead often to immediate clarification of the problem and result in useful surgery despite the fact that it is impossible to communicate with the patient at such an early age of life.
Anesthesia for Infants and Children
Authors: RACKOW HERBERT
Published: December 2021

This text is a welcome addition to the small number of books devoted exclusively to pediatric anesthesia. There have been many advances made in this field since Pediatric Anesthesia by Leigh and Belton (1948) and Stephen's monograph, Elements of Pediatric Anesthesia (1956), were published. Smith has collected much of this new information from widely distributed articles, organized it, and added from his own experience of many years at the Children's Medical Center, in Boston.

The book covers many aspects of pediatric anesthesia: basic science, patient preparation, general and special techniques, complications, mortality, etc.
THE EFFECT OF STRESS ON PATIENTS WITH CONGENITAL VIRILIZING ADRENOCORTICAL HYPERPLASIA
Authors: Rosenthal Ira M. , Gellman Vera , Hyde John S. , Bronstein I. Pat
Published: December 2021

The ability of a series of children with congenital virilizing adrenocortical hyperplasia to resist the effects of stress was studied. There were 31 cases in the group, of which 21 had a history of electrolyte disturbance. It was found that with prompt and adequate therapy these patients can withstand the effects of severe infections and of major surgical procedures. Therapy in the face of stress should include parenteral administration of cortisone and the provision of adequate amounts of sodium chloride daily, for those patients with a history of abnormalities in electrolyte homeostasis.
A Compendium of Research and Theory on Stuttering
Authors: RICHMOND JULIUS B.
Published: December 2021

Of the many speech impairments that handicap children and adults in the communicative process few have attracted as much attention as stuttering. Indeed, the empirical, experimental, and theoretical literature is so vast that it would require a lifetime to evaluate. The appearance of A Compendium of Research and Theory on Stuttering should, therefore, be a worthwhile contribution, but it suffers from its lack of a critical or integrating function. This results largely from the author's decision to present abstracts of articles in the literature.
OBSERVATIONS ON THE BACTERIOLOGY AND EPIDEMIOLOGY OF NURSERY INFECTIONS
Authors: Hardyment A. F. , Wilson R. A. , Cockcroft W. , Johnson Betty
Published: December 2021

THE STUDY of the control of skin infections of the newborn infants was started in the winter of 1948-49, when the incidence of pyoderma neonatorum in the nurseries of the Vancouver General Hospital reached a rate of 121 cases per 1000 live-births. At that time the nursery techniques were improved and there was a change from "dry" skin care to the application of 1% ammoniated mercury ointment. This did not prove to have a lasting beneficial effect. From January 1, 1948 until April 30, 1952, the incidence of pyoderma varied in a most unpredicted manner.

From May 1, 1952 until December 31, 1956, various methods of skin care were used experimentally to determine the effect of these on the pyoderma rate in the nurseries. During these observations, a study was made of various other aspects of the epidemiology of pyoderma neonatorum:

1. Studies of staphylococcal contamination of the environment.

a) Nasal carrier rate of infants, mothers, nurses and other personnel.

b) Nursery air.

c) The intact skin of normal infants versus infants with pyoderma.

d) Mothers' hands and bedding.

e) Nurses' hands and gowns.

f) Babies' tubs and bedding.

2. Identification by phage-typing and antibiotic resistance of the organisms isolated.

a) From pustules.

b) From nasal carriers.

3. Observation of the cytology of exudate from pustules (bacterial and nonbacterial).

THE NURSERIES

In the Women's Pavilion of the Vancouver General Hospital are six regular nurseries providing from 21.0 to 31.0 square feet per bassinet. The number of bassinets per nursery ranges from 12 to 22. The daily census shows that the per cent of occupancy ranges from 61 to 81.
A PHYSICAL SIGN USEFUL IN DIAGNOSIS OF ROSEOLA INFANTUM BEFORE THE RASH
Authors: Berliner Benjamin C.
Published: December 2021

I WISH to call attention to a physical sign, hitherto unremarked as far as I am aware, which is often useful in the preeruptive diagnosis of roseola infantum.

It has been my observation that early in the course of roseola, there develops a characteristics facies brought about by the presence of palpebral edema. As a matter of fact, it is often sufficiently evident to evoke comment from the parents, who will describe the child as having "heavy eyelids," or a "droopy" or "sleepy" appearance.

This facies makes itself evident early in the course of the disease, sometimes on the first day, rarely later than the third. It is unrelated to the degree of temperature elevation. It is unaccompanied by conjunctivitis, tearing or other evidence of ocular pathology. Periorbital edema is absent; the swelling is confined to the eyelids themselves. In most instances it disappears about 24 hours after the appearance of the rash.

One rarely will see a child with roseola who does not display this characteristic appearance. On the other hand, there is a small group of children, representing about 10% of instances, where unexplained palpebral edema occurs without evidence of roseola infantum. Most of these latter instances occur in the summer months.

The accompanying photographs of patients with roseola infantum illustrate this appearance (Fig. 1).
On the "Gray Syndrome" and Chloramphenicol Toxicity
Authors: GEME JOSEPH ST.
Published: December 2021

Some time ago North American pediatricians were introduced to the term "gray syndrome." This comprised abdominal distention, pallid cyanosis and vasomotor collapse, and was observed to appear within 2 to 3 days after institution of chloramphenicol therapy in newborn infants. This entity was not seen in neonates administered chloramphenicol in doses less than 50 mg/kg/24 hours. The alarming nature of this problem seems to have been corroborated by similar observations from several medical centers.

These afflicted infants were administered chloramphenicol as well as other antibiotics because of premature rupture of uterine membranes in most instances.