bluuebunny/crossref_metadata_2025 huggingface dataset:
CHILDHOOD TUBERCULOSIS: CLINICAL VALUE OF THE ELECTROPHORETIC PATTERN OF THE SERUM PROTEINS
Authors: Nemir Rosa Lee , Zitrin Charlotte Marker , Tsouros Paraskevi , Melly Enriqueta
Published: December 2021

The blood serum protein fractions of 138 children with tuberculosis were analyzed by paper electrophoresis serially over a period of many months. Many manifestations of tuberculous infection were studied. The group was divided into 11 categories ranging from healed or arrested tuberculous disease to various stages of activity. The serum protein fractions were evaluated in terms of prognosis, type of tuberculous disease, effect of intercurrent infection and age of patient. It was found that the greatest changes occurred in the gamma-globulin and albumin fractions in reciprocal relation. With the exception of tuberculous meningitis, the increase in gamma-globulin usually corresponded to the severity of disease. Albumin was correspondingly decreased, and was low even in tuberculous meningitis. Both fractions approached normal levels as the patients improved. Relatively normal readings were found in patients with tuberculosis observation or arrested tuberculosis. The greatest deviation from normal was seen in patients with miliary tuberculosis and those with pleurisy with effusion. Here, the gamma and alpha2-globulins were very high and the serum albumin was low. The alpha2 fraction was elevated in the children with more severe disease, including tuberculous meningitis; with clinical improvement it returned to normal more rapidly than the gamma. A rise in the beta-globulin fraction suggests caseation. Confirmatory evidence was obtained in patients with endobronchial disease, tuberculous adenitis and from the only necropsy in the series. The significant changes in the various fractions are further described and discussed.
ISONIAZID TREATMENT FOR TUBERCULIN REACTORS
Authors:   COMMITTEE OF SECTION ON DISEASES OF THE CHEST
Published: December 2021

THE EFFECTIVENESS of isoniazid in preventing the extrapulmonary complications of primary tuberculosis in infants and young children has now been established. Considering the severely damaging and often fatal forms the complications can take, such as meningitis and skeletal tuberculosis, this treatment is indeed a welcomed discovery.

The large control study by the Public Health Service that established the efficacy of this treatment was developed at the urging of pediatricians who had observed that children whose tuberculosis was treated with isoniazid did not develop meningitis or other sequelae. Through the participation of 33 pediatric clinics throughout the United States, 2,750 children with asymptomatic primary tuberculosis were entered in the study. The principal criterion for selecting children for the study was a reaction to the intermediate dose (5 TU) of tuberculin of induration in diameter of at least 5 mm. Children, 3 years of age or older, had in addition, roentgenographic evidence of primary tuberculosis.
GENETIC STUDIES ON THE CONGENITALLY HYPOTHYROID
Authors: Neel James V. , Carr Edward A. , Beierwaltes William H. , Davidson Ruth T.
Published: December 2021

THE IMPORTANCE of congenital hypothyroidism as a cause of human disability varies greatly from one part of the world to another, bearing a well-known relationship to the availability of dietary iodine. However, even in areas where the iodine supply is adequate, or in areas of endemic cretinism where iodized salt has been introduced, severe hypothyroidism remains one of the important endocrine disorders of childhood. The present report is concerned with the genetic aspects of an attempt to obtain a comprehensive picture of congenital hypothyroidism in the state of Michigan at the present time.

Recent advances in techniques for the study of thyroid disease, as well as the even earlier recognition and treatment of congenital hypothyroidism, have rendered obsolescent, in nonendemic areas, the traditional division of cretins into goitrous and nongoitrous or athyrotic. Thus, current techniques permit the recognition of minute or ectopic thyroid glands in the former "athyrotic" group while prompt recognition and treatment of congenital hypothyroidism may forestall, at least temporarily, the development of a goiter in a potentially "goitrous cretin," and even conceivably, in the face of long continued therapy, lead to the degeneration to a small remnant of a thyroid which in the absence of treatment would have assumed immense proportions. Further, as brought out in the summary of Wilkins et al. the goiter of a "goitrous cretin" not infrequently fails to appear before the second decade; a study at the age level of the present one accordingly cannot rely on physical examination alone for a classification. There is thus the need for an extremely careful use of both terms and techniques in any over-all approach to congenital hypothyroidism such as this purports to be.

SUBJECTS

The present report stems from genetic studies on 54 index cases (propositi) with severe hypothyroidism, representing 50 sibships. These persons were located in the following manner:

1) Through a review of the charts of all patients on whom the diagnosis of congenital hypothyroidism was made at the University Hospital between 1930 and 1959. This review yielded a total of 54 diagnosed cases, of whom 28 in 26 sibships are included in the present series. The remaining 26 cases are not included in the study for the following reasons: a) laboratory and other studies not yet complete on 14 patients, b) 5 patients either live out of state or cannot be located, c) diagnosis not confirmed in 2 cases, d) 2 patients deceased, and e) family unable to cooperate in 3 cases.
BEHAVIORAL EFFECTS OF PRENATAL DRUG ADMINISTRATION IN THE WHITE RAT
Authors: Werboff Jack , Gottlieb Jacques S. , Havlena Joan , Word Thomas J.
Published: December 2021

Pregnant albino rats received daily injections of reserpine, iproniazid, 5-HTP, BAS, or sterile water during the second trimester of pregnancy. Offspring of these animals were evaluated on a battery of behavioral measures.

There were no uniform effects of the administration of drugs to pregnant mothers. These drugs did have generally adverse effects on maternal mortality and total resorption of the litter. Iproniazid appeared to be most toxic.

Significant neonatal mortality occurred in all experimental groups, with 100% mortality of the offspring of mothers receiving iproniazid. Weight of the experimental offspring was less than that of the control offspring, with differences becoming more apparent as the animals grew older. No effect on motor maturation was observed. Activity on the small open field test yielded inconclusive results. However, activity on the inclined plane revealed that offspring of mothers that had been treated with 5-HTP and BAS were significantly faster than control offspring.

Increased activity and increased emotionality was observed in the experimental offspring on the open field test. Greater susceptibility to seizures produced by audiogenic stimuli was also found in the experimental animals. In contrast, there were no defects in learning ability in the experimental offspring in either the maze learning or conditioned avoidance behavior situation.
ENZYMES IN SERUM IN KWASHIORKOR
Authors: Edozien J. C.
Published: December 2021

Amylase, alkaline phosphatase, pseudocholinesterase, GOT, GPT and ICD concentrations have been determined in the serum of healthy Nigerians and in children with kwashiorkor.

The activities of amylase, alkaline phosphatase and pseudocholinesterase in serum are significantly reduced in kwashiorkor.

GOT, GPT and ICD activities in serum are increased in approximately 50% of cases of kwashiorkor. The excess enzymes are derived principally from skeletal muscle but also from liver.

In 7.5% of kwashiorkor patients the enzyme changes in serum resemble the pattern in acute hepatic cell necrosis. This type of case will probably progress to liver cirrhosis if the patient survives.
CLINICAL EXPERIENCE WITH THE RADIOACTIVE IODOPYRACET (DIODRAST) RENOGRAM IN PEDIATRIC SUBJECTS
Authors: Feitel Morris , Oliver William J.
Published: December 2021

The procedure for performing the radioactive iodopyracet renogram in children has been described. Confirmation of the test as a useful method for detection of unilateral renal disease has been demonstrated for children, as previously reported for adults.

At the present stage of development, the major use of the procedure relates to its advantage as a screening test for subjects with hypertension, either with known renal disease or in those in whom renal abnormalities are not defined by the usual kidney function studies.
An Introduction to Embryology
Authors: BLANC WILLIAM A.
Published: December 2021

This book is written for the college student or for the young university student. It presents an integrated approach to embryology, combining descriptive morphology, biochemical, physiological and experimental embryology and some elements of genetics. This text is of little practical use in reference to human embryology, but it reads, 20 years after one's embryology course, like a modern and refreshing version of an old story. It is a clear, lucid and agreeable, although unequal, compilation and presents together much material usually dispersed in various works.
EPIDEMIC PLEURODYNIA (BORNHOLM DISEASE) DUE TO COXSACKIE B-5 VIRUS
Authors: Bain H. W. , McLean D. M. , Walker Selma J.
Published: December 2021

During the months of July to October, 1958, a widespread outbreak of epidemic pleurodynia (Bornholm disease) occurred in Southern Ontario. In this epidemic three main disease entities were encountered: epidemic pleurodynia, acute benign pericarditis and aseptic meningitis, alone or in combination.

Sixty-nine patients were studied at the Hospital for Sick Children, Toronto, and viral studies were carried out for many of them. Five of seven patients with pericarditis had associated pleurodynia, and seven patients had associated pleurodynia and aseptic meningitis. The clinical features of each of the three major entities encountered are presented.

Viral studies point to Coxsackie B5 virus as the common etiologic agent in the various disease entities encountered in this outbreak. It seems likely that the Coxsackie B viruses may be important etiologic agents in acute benign pericarditis.

Chronic constrictive pericarditis occurred as an end-result in one of the patients with acute benign pericarditis.
Neonatal Exchange Transfusions
Authors: SAND RICHARD E.
Published: December 2021

A recent review of the charts of the last 100 consecutive neonatal exchange transfusions done at our hospital has uncovered some pertinent findings which were not presented in the article by Boggs and Westphal (Pediatrics, 26:745, 1960).

The original purpose of the survey was to attempt to demonstrate a direct correlation between "early exchanges" and fewer exchanges in controlling hyperbilirubinemia, especially in Rh incompatibility. It soon became evident that this could not be shown in a retrospective study, the most obvious reason being that earlier initial exchange transfusions are indicated in the more severe cases, which are also likely to require repeated transfusions.
Hazards of Edathamil (EDTA) Therapy in Lead Intoxication
Authors: ANDREWS B. F.
Published: December 2021

It occurred to me when reading the Report of the Subcommittee on Accidental Poisoning, "Statement on Diagnosis and Treatment of Lead Poisoning in Childhood" (Pediatrics, 27:676, 1961), that mention of the potentially severe toxic effects of intravenously given CaEDTA should have been made. Five fatalities ascribed to CaEDTA have been reported from Germany and one from the United States in recent years. Also, fatalities have been associated with NaEDTA in the treatment of hypercalcemia. Pathologic examination of renal tissue from these patients revealed lesions of the proximal tubules.
VENTILATORY FAILURE AND RIGHT-TO-LEFT SHUNT IN NEWBORN INFANTS WITH RESPIRATORY DISTRESS
Authors: Strang Leonard B. , MacLeish M. Heather
Published: December 2021

Infants with severe respiratory distress were investigated by analysis of gases in arterial and venous blood during the breathing of pure oxygen. The results indicated that the infants suffered from a reduced alveolar ventilation and from right-to-left shunt. Possible mechanisms for these disorders are discussed.
ANGIOMATOSIS (HAMARTOMATOUS HEM-LYMPHANGIOMATOSIS)
Authors: Koblenzer Peter J. , Bukowski Martin J.
Published: December 2021

A case is described of a diffuse, possibly generalized, abnormality of a hamartomatous nature of the peripheral vascular system. A number of cases from the literature, which also appear to belong in this category, are summarized. Histologic examination shows that lymph and blood vessels may both be involved, though this may be essentially an abnormality of the lymphatic system in which extensive venolymphatic communications occur.

The clinical manifestations vary according to the site of involvement and the extent of dissemination and also according to whether the lesions are predominantly hemangiomatous or lymphangiomatous.

The main features are osteolytic lesions, visceromegaly, cutaneous hemangiomas or lymphangiomas and massive effusions into any body cavity. The effusions are usually chylous, sanguineous or a mixture of both. Any or all of these features may be present in any one case.

The disease frequently has its onset in childhood or adolescence and tends to be progressive. If the lesions are widely disseminated or an effusion into a body cavity is present the outlook is grave.

Treatment so far has been unsuccessful. Surgery may occasionally have a place.

The term angiomatosis is employed to denote this condition not only to underline its potentially extensive nature but also to avoid debate as to whether it is essentially hemangiomatosis or lymphangiomatosis.
WRINGER INJURIES
Authors: Chamberlain John W. , Soltes Maury
Published: December 2021

During the 5½ years from January 1, 1955, to August 1, 1960, 116 children with wringer injuries were admitted to the Boston City Hospital. Of these, 56 were treated with, and 60 without, pressure dressings. There was no significant difference in the percentage of cases requiring skin grafting and other operative procedures. It is concluded that the application of pressure dressings in the treatment of these lesions is illogical and a waste of time and materials.
NITROGEN BALANCE STUDIES WITH NORMAL FULL-TERM INFANTS RECEIVING HIGH INTAKES OF PROTEIN
Authors: Fomon Samuel J.
Published: December 2021

Nitrogen balance studies were performed with 12 normal full-term infants, 8 boys and 4 girls, during the first 4½ to 6 months of life. Three high-protein feedings were employed, supplying approximately 20% of the calories as protein from cow milk. Growth of the infants is interpreted as within normal limits. The concentration of total protein in the serum was not greater than that recorded in previous studies employing lesser dietary intakes of protein. The mean concentration of urea nitrogen in the serum was 21.8 mg/100 ml between 1 and 6 months of life and somewhat greater during the first month of life. A close relation between mean intake of protein in various studies and mean concentration of urea nitrogen was demonstrated. Intakes of protein were generally between 4.5 and 6 gm/kg/day, and retentions of nitrogen were, with few exceptions, between 200 and 300 mg/kg/day in the first 2 months of life and between 130 and 200 mg/kg/day from 4 to 6 months of age. The major sources of error in calculation of body content of protein on the basis of metabolic balance studies are mentioned. Metabolic balance studies are believed unsuitable for prediction of body composition.
CLINICAL CONFERENCE
Authors: Lerner Herbert I.
Published: December 2021

The patient was a 11½-month-old white female infant, whose mother was gravida III, para III. The pregnancy was entirely normal, with no virus infections or irradiation during the first trimester. The patient had edema of the dorsa of the hands and feet at birth. When she was first seen at 2½ months the edema of the hands had subsided and the skin was very lax. The dorsa of the feet still exhibited pitting edema. In addition, she had a short neck, low set ears, cutis laxa in the neck region, a shield-like chest with widely separated, hypoplastic nipples, a high arched palate, telangiectasia of the cheek and forehead, and hypoplasia of fingernails and toenails. The blood pressure was normal and femoral pulses were palpable. The external genitalia were normal. She was in the third percentile for height and weight on the Stuart growth curve, in contrast to her two older siblings, who had always been in the ninetieth percentile.

Buccal smears revealed a negative sexchromatin pattern. A diagnostic pneumoperitoneum at 5½ months of age revealed an indication of a small uterus with no demonstrable ovaries. There were no detectable levels of urinary gonadotropins at 4½, 5 and 6 months of age, but at 10 months between 0 and 5 mouse units were reported. Although these patients usually develop increased urinary gonadotropins at puberty, an investigator has reported three patients with gonadal dysgenesis who excreted increased amounts of gonadotropins in urine before puberty, the youngest being 2 years 8 months old.

Between 2 and 4 months of age the patient developed an infection of the urinary tract that indicated the possibility of a renal anomaly. Intravenous and retrograde urograms revealed normal findings, except for a bifid renal pelvis. A chromosomal count revealed five cells, with a diploid number of 45. Buccal smears from the parents were normal.
PARA-INFLUENZA 2 (CA) VIRUS: ETIOLOGIC ASSOCIATION WITH CROUP
Authors: Kim Hyun Wha , Vargosko Andrew J. , Chanock Robert M. , Parrott Robert H.
Published: December 2021

During October, November and December, 1959, para-influenza 2, or croup-associated (CA), virus was recovered from 7 of 28 patients with croup. Three additional patients were infected with this agent, as indicated by serologic tests. The incidence of virus recovery from patients with croup was many times greater than from comparable control infants and children, regardless of the attribute compared. These findings constitute the first evidence from controlled epidemiologic studies that para-influenza 2 virus has an etiologic relationship to the croup syndrome. They also indicate the variable prevalence of para-influenza 2 virus, which differs from the almost constant presence of para-influenza 3 virus and para-influenza 1 virus in the pediatric population under study.
DIAGNOSIS OF KERNICTERUS IN THE NEONATAL PERIOD
Authors: Van Praagh Richard
Published: December 2021

In a series of 882 infants with hemolytic disease of the newborn (erythroblastosis fetalis), 31 infants developed kernicterus. In the neonatal period the diagnosis of kernicterus was established firmly in 65%, remained uncertain in 19% and was not suspected in 16%. This diagnosis was established firmly in the neonatal period when spasticity was moderate to marked. The diagnosis of kernicterus remained uncertain when spasticity was mild and short-lived. This diagnosis was not suspected when spasticity was not observed.

Characteristically, a progression of three distinct clinical phases was observed in infants with kernicterus during the neonatal period. A fourth clinical phase appeared later in infancy. The first clinical phase was characterized by hypotonia, lethargy and a poor sucking reflex; the second by spasticity, opisthotonos and fever; the third by the diminution or disappearance of spasticity; and the fourth by the progressive appearance ance of the relatively permanent signs of post-kernicteric extrapyramidal cerebral palsy.

The hypotonia, lethargy and poor sucking reflex of the first phase of kernicterus appeared highly significant because of the great importance of this phase concerning the infant's neurologic prognosis. But these critical signs were nonspecific, being associated also with major pulmonary, cardiovascular and other central nervous system pathology in non-kernicteric infants with hemolytic disease. The spasticity of the second phase indicated with great accuracy that kernicterus had occurred in the first clinical phase. The diagnostic reliability of spasticity was not related to its intensity or duration. A kernicterus-like syndrome related to hemorrhages within the basal ganglia was the only observed exception to the otherwise complete diagnostic reliability of spasticity. The true absence of any spasticity throughout the first week of life appeared to indicate with great reliability in the neonatal period that kernicterus had not occurred. The lessening or disappearance of spasticity in the third clinical phase erroneously led to diagnostic uncertainty in the neonatal period concerning the presence or absence of kernicterus.

It is hoped that accuracy in the diagnosis of the presence or absence of kernicterus in the neonatal period may be increased by an understanding of the three neonatal clinical phases, their cardinal signs, their progression and the diagnostic problems of each phase.
THE EPIDEMIOLOGY OF ACUTE RESPIRATORY DISEASES
Authors: Wenner Herbert A. , Christodoulopoulou Georgia , Weston Jean , Marsh Alice , Liu Chien
Published: December 2021

In a study on the natural histories of infection from viruses associated with respiratory infections, answers were sought for two principal questions: a) when, during the life history of individuals, and b) how often was primary infection with each virus acquired? In 1957, 25 infants, 6 weeks of age, and in 1958, 107 family associates were entered into a study that lasted 2½ years and that was principally designed to measure seropositive and seroconversion rates for 19 respiratory viruses, and the primary atypical pneumonia agent.

During an epidemic of influenza type A" the entire population was at risk; 75% of infants, and all adults converted. Other respiratory viruses associated with high conversion rates during infancy and often continuing into childhood were HA types 1 and 2, Sendai, ECHO type 11, RS, CA, and adenovirus types 1, 2 and 5. For many of these viruses all, or a majority, of members of families were seropositive. Influenza types B and C viruses were associated with sporadic family outbreaks during 1958-1959. Other viruses, namely, influenza types A and A, Coe, ECHO virus types 10, 20, 25 and 28, and the agent of primary atypical pneumonia were associated with low conversion rates at any specified age. The risk of acquiring infection from adenoviruses indicated gradual recruitment of susceptibles at discrete intervals; adenoviruses (types 1 and 5) were present in the oropharynx of seropositive children; their presence was not always associated with appearance of demonstrable antibodies.
CLINICAL AND BIOCHEMICAL OBSERVATIONS ON AN APPARENTLY NONFATAL VARIANT OF BRANCHEDCHAIN KETOACIDURIA (MAPLE SYRUP URINE DISEASE)
Authors: Morris Manford D. , Lewis Bernard D. , Doolan Paul D. , Harper Harold A.
Published: December 2021

A previously healthy female child first developed episodes of ataxia, lethargy and semicoma following otitis media at the age of 16 months. Subsequently she had a convulsion, and ventriculograms were taken. The attacks, lasting 1 to 4 days, recurred several times over a 12-month period. During these attacks, it was noted that the urine of the patient had an odor resembling that of maple syrup. Biochemical studies revealed that at intermittent intervals she excreted abnormally large amounts of keto acids. However, when the patient was asymptomatic, the urinary pattern of keto acids was indistinguishable from that of the control subjects. The late onset and the episodic nature of the disease, as well as the fact that the physical and mental development of the child have progressed normally to the present age of 41 months, indicate that this case may represent the first reported variant of the previously reported cases of maple syrup urine disease.
CAPACITY OF THYROXINE-BINDING GLOBULIN TO BIND TRIIODOTHYRONINE AND THYROXINE IN MATERNAL AND CORD BLOOD
Authors: Michener William M. , Tauxe W. Newlon , Hayles Alvin B.
Published: December 2021

Normal values for the measurement of thyroidal function using the erythrocytic uptake of I131-labeled triiodothyronine and the thyroxine-binding capacity of the inter-alpha globulin were established. Paired maternal and cord blood samples collected at the time of delivery were studied with these methods. The erythrocytic uptake of labeled hormone was increased in cord blood as compared to maternal blood. Cord blood apparently binds exogenous triiodothyronine in a different manner than it does exogenous thyroxine. Whether this is a qualitative or quantitative difference was not shown in this study.
AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6
Authors: Karzon David T. , Barron Almen L.
Published: December 2021

An epidemic of aseptic meningitis occurred during the summer and fall of 1955 in the western part of New York State. A total of 305 cases of central nervous system disease and 40 cases of other illness were studied. ECHO virus type 6 was the predominant enterovirus associated with aseptic meningitis, as demonstrated by virus isolation and neutralizing antibody studies. In addition to the predominant type, other enteroviruses played a minor role. In those cases with viral isolates, 85% were ECHO 6, 2.2% were ECHO 14, 1.4% were ECHO 2, 0.7% were ECHO 18, 2.8% were Coxsackie viruses (A9, B3, B4), 4.3% were unidentified viruses and only 4.3% were polioviruses. Aseptic meningitis associated with the variety of enterovirus serotypes could not be clinically differentiated. Stool was the best source of virus, with a recovery rate of 74%. Rectal swabs yielded 34%, throat swabs 50% and cerebrospinal fluid 8% virus recovery. Cases of paralytic poliomyelitis, as defined by the presence of residual asymmetric paralysis, were associated with poliovirus infection and not with Coxsackie or ECHO viruses. Other central nervous system syndromes, such as encephalitis, were infrequently associated with enteroviruses.
Food Allergy
Authors: Josephson Barry M.
Published: December 2021

In the January issue of Pediatrics, there appeared two papers which dealt with the problem of food allergy: "Food Hypersensitiveness?" by Morishima and Kessler, and "Gastrointestinal Food Allergy in Infants," by Rosenblum and Matheson.

In the first paper, Drs. Morishima and Kessler adeptly presented two cases of reactions to foods generally considered to be hypoallergenic. They made a good point of the protein nature of food hypersensitivity and the difficulty in detection of the offending food, when the "violent" reaction is delayed in onset.
In Reply: Food Allergy
Authors: Morishima Akira , Kessler Walter R.
Published: December 2021

Dr. Josephson in his letter notes that direct skin testing might have given positive reactions in the patients presented in our report. The infant who was clinically reactive to squash was tested with squash extract but failed to react. The baby who was fed sweet potato in the hospital with such dramatic sequellae was not tested directly. We hesitated to perform direct tests because these may be associated with systemic, constitutional reactions, as was true for the case presented by Park and quoted in our paper.
SURGICAL EXCISION OF PULMONARY METASTASES
Authors: White James G. , Krivit William
Published: December 2021

Two patients who had had pulmonary metastatic lesions treated by surgical excision 6 and 11 years ago have been reported as cured. The majority of patients with pulmonary metastases die despite the implementation of roentgen therapy and chemotherapeutic agents. A more aggressive approach would include pulmonary metastasectomy.

The application of this technique to selected patients in whom the primary tumor has been controlled, and the metastases are limited to the lungs, should be considered before hope for a cure is abandoned.
RECOVERY FROM COMPLETE HEART BLOCK IN DIPHTHERIA
Authors: ENGLE MARY ALLEN
Published: December 2021

Six patients who recovered from complete heart block in diphtheria have been reported. Four of these had intraventricular conduction disturbances as well. All but one of these patients had massive glandular and periglandular edema of the neck: a "bullneck." The shortest duration of the conduction disorders was two days. The longest was six weeks.

Two of the patients who recovered showed evidence of both cardiac decompensation and peripheral vascular collapse. Three of the patients were digitalized without untoward effect and with prompt improvement in at least two of them. Four of the six patients developed peripheral paralyses during convalescence.
ADENOTONSILLECTOMY AND POLIOMYELITIS
Authors: FABER HAROLD K.
Published: December 2021

THE danger that adenotonsillectomy performed in the presence of an epidemic may instigate an attack of poliomyelitis, usually although not exclusively bulbar, has now been generally recognized for several years, and the avoidance of the operation during epidemics is now almost universally adopted as an important preventive measure. It is, therefore, disturbing to find the actual existence of a relationship between operation and disease called in question. The doubt has been raised almost exclusively by otolaryngologists who have, of course, a vital interest in the matter. One of their principal organizations, The American Laryngological, Rhinological and Otological Society, has for the last two years conducted a questionnaire-survey under the leadership of Daniel S. Cunning of New York City based mainly on the number of cases of poliomyelitis in which tonsillectomy (and other operations) had been performed two months or less before the onset of the disease. The last of these reports based on data for 1947 has recently been published. In it Cunning states his conclusion that "I am more than ever convinced that there is no causal relationship between the two, and that when a bulbar poliomyelitis follows a tonsillectomy it is coincidental."
Give Them a Chance to Talk
Authors: METRAUX RUTH W. , AMATRUDA CATHERINE S.
Published: December 2021

This is a small cardboard covered handbook in photo-offset print, designed mainly for the speech therapist working with children handicapped by cerebral palsy. It contains a brief description of cerebral palsy (athetoid, spastic and ataxic), classification and description of the common speech disorders, an outline of the sequences of speech development together with a guide to the assessment of speech (articulatory) maturity, and a description of speech and sound discrimination tests.

A detailed outline of the methods of speech therapy used in the athetoid, the spastic, and the ataxic child follows.
PRENATAL AND NEONATAL NUTRITION
Authors: Smith Clement A.
Published: December 2021

MOST AWARD RECIPIENTS have made carefully planned and masterfully executed investigations of some unexplored nutritional territory, which they could fully describe at such a time as this. I can report only a few disconnected explorations which discovered some useful points of view and uncovered some awkward pitfalls for future travellers. While thanking the Borden Company for the honor of being here, I should like also thank the many colleagues who did most of the work of our explorations, the Boston Lying-in Hospital, which has been such a comfortable base camp, and the Association for the Aid of Crippled Children, whose financial backing has been so necessary and so generous.

PRENATAL NUTRITION

Our thinking about unborn and newborn babies seems to have dealt so much with other problems than their nutrition and growth that prenatal nutrition was often studied not by first intention but because of some special opportunity. Perhaps the most fortunate of these came when a maternal blood volume study by our medical and obstetrical colleagues provided us with babies whose prenatally acquired iron molecules could be identified throughout infancy, but that was an interesting side trip on a trail we have not pursued further.

Another journey began with Mrs. Bertha Burke's investigations of maternal dietary histories, which afforded the chance to examine a series of infants with much special information attached. The results of our attempts to correlate particular deficiencies in what mothers had eaten during pregnancy with the condition of their infants at birth were disappointing to those so recently stirred by the demonstrations of Dr. Warkany, that specific malformations of newborn animals resulted when maternal diet was restricted in certain nutrients at critical periods of fetal life.
THE THYROID IN CHILDREN
Authors: Kunstadter Ralph H. , Buchman Harvey , Jacobson Morad , Oliner Leo
Published: December 2021

The in vitro erythrocyte uptake studies of radioactive 1-triiodothyronine in 70 normal children, ranging in age from newborn infants to 13 years, are presented. The data reveal elevated uptake values in these children as compared to adults, indicating alteration in binding capacity of thyroxin-binding serum protein carriers, in all probability a reduction in thyroxin-binding prealbumin capacity.
THE PARENTS' REACTION TO THE BIRTH AND EARLY CARE OF CHILDREN WITH CLEFT PALATE
Authors: Tisza Veronica B. , Gumpertz Elizabeth
Published: December 2021

From the beginning the life experiences of the baby born with cleft palate and cleft lip are different from those of normal infants. Following a discussion of the nature of the initial feeding difficulties, some parental anxieties related to the babies' malformation are enumerated. The birth of a congenitally damaged baby is experienced as a grievous loss by the mother. The length, depth, and nature of the resolution of her mourning reaction influences significantly the mother-child relationship. The key position of the medical doctor in relieving parental anxieties and alleviating grief is emphasized. His emotional understanding and continued support play an important part in the development of a relaxed and accepting parent-child relationship.
PATERNAL DEPRIVATION—A DISTURBANCE IN FATHERING
Authors: Green Morris , Beall Patricia
Published: December 2021

A disturbance in fathering has been observed in 19 cases in a pediatric diagnostic clinic. This disturbance, referred to as the paternal deprivation syndrome, is characterized by the finding that the father, to a notable degree, is psychologically uninvolved with his son and, in addition, is physically absent from the home much of the time. The presenting symptomatology is discussed, along with a description of family inter-relationships. Management of these cases is reviewed and the prophylactic role of the pediatrician is emphasized.
Radiographic Atlas of Skeletal Development of the Foot and Ankle
Authors: GARN STANLEY M. , ROHMANN CHRISTABEL
Published: December 2021

The now-familiar "Radiographic Atlas of Skeletal Development of the Hand and Wrist" opened an important chapter in the systematic evaluation of skeletal status. Unlike its predecessor, Todd's "Atlas," it was based on the clinically-normal, middle-class Brush Foundation children. Like Todd's radiographic atlas, it provided age and sex-specific photographic standards. And for those workers interested in more than flip-through appraisal, the series of maturity indicators in the Greulich-Pyle "Atlas of the Hand" offered remarkable reliability in the hands of a careful evaluator.
GIANT BULLOUS EMPHYSEMA OCCURRING IN TUBERCULOSIS IN CHILDHOOD
Authors: Kress Milton B. , Finkelstein A. H.
Published: December 2021

An unusual case of giant bullous and cystic lesions, occurring during the healing process of pulmonary tuberculosis of the adult type in a 7-year-old child is presented. The unusual characteristics of the lesions are discussed. This case represents the first to be reported in which giant bilateral bullous lesions developed during the treatment of pulmonary tuberculosis in a child whose sputum and gastric washings were positive for tubercle bacilli on smear and culture.
PROTEIN LEVELS IN SERUM OF PREMATURE INFANTS FED DIETS VARYING IN PROTEIN CONCENTRATIONS
Authors: Pincus Joseph B. , Gittleman Isaac F. , Schmerzler Emanuel , Brunetti Norma
Published: December 2021

The concentration of the protein of the diet of artificially fed infants influences the concentration of the total protein and the albumin fraction of the serum. The composition of the protein of the diet, i.e., the lactalbumin: casein ratio, may also influence the plasma protein levels. The globulin fraction decreases significantly in the artificially fed groups but not in the group receiving human milk. The gamma-globulin decreases significantly in all groups studied, but globulins alpha1, alpha2, and beta do not change significantly from day 1 to day 21.
Letters to the Editor
Authors: AISENSON MILTON R.
Published: December 2021

The articles by Drs. Kennell and Boaz and by Dr. Spock in the July issue of Pediatrics are interesting and provocative. One often hears that physicians' families get inadequate medical care, but I wonder if this is really true. And though I have had experiences such as those cited, I think it only proves that physicians are people. I, too, may be generalizing, but I feel that physicians are more likely to get optimum care than the average patient.
ANNUAL SUMMARY OF VITAL STATISTICS—1961
Authors: Wegman Myron E.
Published: December 2021

THIS year's summary of provisional vital statistics for the United States in 1961 indicates that over-all birth and death rates are essentially unchanged from 1960. Each year the National Vital Statistics Division, a unit of the Public Health Service, publishes estimated rates that, except when specifically noted, are provisional and based on a 10% sample of reported births and deaths. Experience has shown, however that final national figures agree closely with these estimates, which are derived from monthly reports on certificates filed in registration offices around the country. The rates for 1961 are published in Volume 10, No. 13, April 30, 1962 (Part 1) and July 31, 1962 (Part 2), of the Monthly Vital Statistics Report.
CLIFFORD G. GRULEE SR. M.D. 1880-1962
Authors: HILL LEE FORREST
Published: December 2021

WITH THE DEATH of Dr. Grulee on October 24, 1962, there came to an end the career of one of America's most noted pediatric personalities. His earlier role as an academician in Chicago's medical schools, his productivity as an author of pediatric writings, his membership on numerous national and local committees concerned with child health and welfare, and his years in the practice of pediatrics are somewhat overshadowed by his later achievements in the founding and development of the American Academy of Pediatrics. Selected as Executive Secretary at the First Annual Meeting of the Academy on June 12 and 13, 1931, he served continuously in this post until his retirement on June 30, 1951.
GAMMA-GLOBULIN DETERMINATIONS IN ALLERGIC CHILDREN WITH USE OF A GEL DIFFUSION MICROMETHOD
Authors: Huntley Carolyn C. , Lyerly Anne
Published: December 2021

Gamma-globulin determinations were carried out on the sera of 49 normal and 52 allergic children, with use of a quantitative immunologic method. No significant difference was found between the two groups. There was likewise no difference between the gamma-globulin concentrations in serum of the girls and boys.
Letters to the Editor
Authors: GELLIS SYDNEY S. , SILVERBEG MERVIN
Published: December 2021

Dr. Scheinberg's suggestion is of course entirely appropriate, and his screening test deserves much more attention and use. It will be difficult, however, to convince physicians to employ it routinely in all infants, inasmuch as Wilson's disease at most will be found in 8 to 10 of 1,000,000 persons tested. The rarity of the disorder does not argue against routine screening, for the detection of a case prior to the onset of symptoms and signs might spare grief and expense which would amply justify the time and effort involved in its detection.
ERYTHROMYCIN PROPIONATE AND POTASSIUM PENICILLIN V IN THE TREATMENT OF GROUP A STREPTOCOCCAL PHARYNGITIS
Authors: Stillerman Maxwell , Bernstein Stanley H. , Smith Martha , Gorvoy Jack D.
Published: December 2021

The relative effectiveness of erythromycin propionate and K penicillin V in two dosage schedules was evaluated in the treatment of 261 cases of acute pharyngitis from which Group A hemolytic streptococci were recovered from December, 1958, to June, 1959. Erythromycin propionate, in a daily dose of 30 mg/kg up to 1.0 gm, and K penicillin V, in daily doses of 375 mg and 750 mg, were administered orally for 10 days. The adjusted bacterial cure rate was 78% among 86 patients treated with erythromycin, 72% among 102 patients treated with K penicillin V, 375 mg, and 88% among 73 patients treated with K penicillin V, 750 mg. The data indicate that K penicillin V was more effective in eradicating Group A streptococci from the pharynx in a daily dose of 750 mg than 375 mg, and suggest that erythromycin propionate in the dosage used, was less effective than K penicillin V, 750 mg, but equally as effective as K penicillin V, 375 mg daily. The incidence, time of occurrence, and results of retreatments of bacterial relapses are presented, and two possible causes of relapses are considered.
HARTNUP DISEASE
Authors: Halvorsen Karin , Halvorsen Sverre
Published: December 2021

Two cases of Hartnup disease in a Norwegian family with four children from unrelated parents are described. They have the typical pellagra-like rash and the H-pattern of aminoaciduria. The urinary indole excretion was markedly increased in both. Neomycin treatment prior to tryptophan loading prevented the usual increase in indolic acids. A third sibling had the same urinary indole chromatogram but neither clinical symptoms nor the H-pattern of aminoaciduria. In both proven cases there were hair anomalies, in Case 1 pathological electroencephalographic findings, and in Case 2 a hypoglycemic reaction during a glucose tolerance test. On the basis of a review of the literature and our own experiences, it is concluded that nicotinamide or combined vitamin B preparations have a definite value during acute exacerbations, and that they probably improve the photosensitivity of the skin. The vitamin therapy does not influence the abnormal excretion of amino acids.
A QUANTITATIVE MICROMETHOD FOR THE DETERMINATION OF PHENYLALANINE AND TYROSINE IN BLOOD AND ITS APPLICATION IN THE DIAGNOSIS OF PHENYLKETONURIA IN INFANTS
Authors: La Du Bert N. , Howell R. Rodney , Michael Patricia J. , Sober Eva K.
Published: December 2021

A simple enzymatic spectrophotometric method has been described which permits the quantitative determination of phenylalanine and tyrosine in 0.10 ml of whole blood. For elevated levels of phenylalanine and tyrosine, the method is rapid, specific, and precise. The method should be of value in establishing the diagnosis of phenylketonuria in infants and in following the blood levels of phenylalanine of those on the low phenylalanine diet.

Analysis of heel-prick samples of premature and term infants has shown that normal infants have a broader range of blood phenylalanine values than adults, and that the levels of tyrosine may be as high as 20 mg/100 ml in older infants and premature babies.

The fact that transient elevation of blood phenylalanine may occur in normal newborn infants must be appreciated in making a diagnosis of phenylketonuria in early infancy.
CHROMOSOMAL ABERRATION IN AN INFANT FOLLOWING THE USE OF DIAGNOSTIC X-RAYS
Authors: Conen P. E. , Bell A. G. , Aspin N.
Published: December 2021

Chromosome studies were performed on an infant with congenital anomalies, since abnormal karyotypes have been found associated with certain patterns of anomalies. The only chromosome abnormalities found were structural changes, including some of the type seen following exposure to ionizing radiation. A detailed investigation was made of the roentgenographic studies made in this case. A dose of only 0.825 rads total body radiation may have caused the chromosome aberrations detected in the cultured leukocytes, although there are alternative explanations in this malformed child. Infants and small children are more likely to receive a higher dose of irradiation than adults during roentgenographic examinations because of the difficulty in maintaining correct position and shielding small areas.
THE ETIOLOGY, SYMPTOMS, AND TREATMENT OF URETHRAL STRICTURES IN MALE CHILDREN
Authors: Leadbetter Guy W.
Published: December 2021

The cases of eight patients are presented in whom urethral stricture developed in childhood. Two of these were adults. Surgical treatment of urethral strictures in children is urged after an adequate trial of dilatation has failed. The results have been satisfactory.
EFFECT OF ORAL POLIOVIRUS VACCINE IN NEWBORN CHILDREN
Authors: Sabin Albert B. , Michaels Richard H. , Ziring Philip , Krugman Saul , Warren Joel
Published: December 2021

Twenty-one infants who received Type 1 oral vaccine at birth, and six infants from an unvaccinated control group observed since birth, were fed 105.9 TCD50 of Type 1 oral vaccine at 6 months of age. Among the 11 infants with evidence of infection at birth, 6 (55%) failed to excrete Type 1 poliovirus a second time and 5 excreted only for 7 to 10 days. This complete or partial resistance to reinfection obtained also for the eight infants in this group, who after the first dose of vaccine excreted virus without developing enough antibody to be detected at 3 months. Among the 10 vaccinated infants who exhibited no evidence of infection after the first dose because they had no demonstrable virus in the single specimen tested during the first week after birth and at 3 months did not fulfill the criteria for development of antibody, there were, nevertheless, 3 who did not excrete poliovirus after the second dose and 2 who excreted for only 7 to 10 days, while the remaining 5 excreted for 20 days or longer. The serologic data on the response of these infants to Salk vaccine prior to the second feeding also suggested that a few infants in this group may have been infected after the first dose.

The serologic tests indicated that immunologic tolerance does not develop in orally vaccinated newborn infants in whom the virus multiplies with insufficient antibody formation. On the contrary, their antibody mechanism is so sensitized that a subsequent dose of Salk vaccine calls forth a booster type of response only for the type of virus that multiplied shortly after birth. While oral poliovirus vaccine is not maximally or optimally effective when given during the first few days after birth, there may be administrative or public health indications for use of the Type 1 vaccine shortly after birth in poliomyelitis eradication programs in certain parts of the world.
For Parents Only: The Doctor Discusses Discipline
Authors: LOW MERRITT B.
Published: December 2021

This is a small, "folksy" book on advice to parents, and belongs in the series of Dr. Richardson's books along similar lines for boys, girls, mothers and fathers, teenagers, grandparents, and others involved in the raising and growing of children. Almost condescending at times, it falls in the category of "common sense" books, chatty, shy of techniques. Even though modernized to the extent of having TV, P.T.A., and teenage sections and overtones, it perhaps assumes too little knowledge if not too little intelligence in our present day adults. Did not Dr. Aldrich cover Clara Davis' famous eating experiments, and the problem of putting children to bed, some 25 years ago? There are other inadequacies in modern child-nutrition besides "forcing."