bluuebunny/crossref_metadata_2025 huggingface dataset:
THYMIC ALYMPHOPLASIA AND CONGENITAL ALEUKOCYTOSIS
Authors: Gitlin David , Vawter Gordon , Craig John M.
Published: December 2021

Thymic alymphoplasia has been found to be a part of the histopathological picture of congenital aleukocytosis. As in children with congenital agammaglobulinemia who have thymic alymphoplasia, the thymic anomaly is accompanied by lymphopenia and a marked generalized paucity of lymphocytes in the tissues or lymphocytic hypoplasia. The patient described in this report, a girl who succumbed at 15 days to overwhelming bacterial infection, also had agranulocytosis and no granulocytes or granulocyte precursors could be discerned in her bone marrow; megakaryocytes were present in the marrow in normal numbers and hematocytoblasts, normoblasts, and monocytes were present as well. Hence, the defect in this syndrome, whether intracellular or conveyed humorally, would appear to be highly selective. On the basis of the normal development of the human thymus and other lymphoid tissues including the bone marrow, it would seem that the defect in the development of the lymphocyte was manifest at or before the 10th week of gestation. The possible relations between lymphocytes, plasma cells, and granulocytes are discussed.
Somatic and Psychiatric Aspects of Childhood Allergies,
Authors: KORSCH BARBARA MARIA
Published: December 2021

In his introduction to the collection of essays on the Somatic and Psychiatric Aspects of Childhood Allergies, the editor, Ernest Harms, makes the statement that the larger size of this monograph will permit "intensive treatment of each problem." The contents of the collection certainly bear out this introductory statement. The volume to be discussed includes a series of most extensive discussions on all aspects of childhood allergy, ranging from straightforward clinical presentation of somatic facts concerning childhood allergies to the most theoretical discussion of possible psychiatric and psychoanalytic problems that may have a bearing on the symptomatology prognosis and treatment of the allergic child.
TREATMENT OF A CASE OF NONTUMOROUS CUSHING'S SYNDROME WITH o,p'DDD
Authors: Bar-Hay J. , Benderly A. , Rumney G.
Published: December 2021

A case of a nontumorous Cushing's syndrome in a 10-year-old girl is presented. The diagnosis was based on the clinical picture, the high levels of urinary steroids and plasma 17-OH corticosteroids, the results of ACTH stimulation tests, and finally by the histology of the left adrenal.

Therapy with o,p'DDD had a dramatic effect on the patient's condition. The typical signs of Cushing's syndrome disappeared, and the girl is developing normally. The urinary steroids and the plasma 17-OH corticosteroids returned to normal levels. The ACTH stimulation tests gave results indicative of a normally functioning adrenal gland.
Symptoms from Milk
Authors: INGALL MANUEL
Published: December 2021

In the excellent, precise article on Milk Allergy by Goldman et al. that appeared in Pediatrics, 32:425, 1963. I believe an addition should be made to their clinical diagnosis of milk allergy (p. 426). Thus, in patients with pure gastrointestinal symptoms, especially diarrhea, should not such diagnoses as galactosemia and lactase or other disaccharide enzyme deficiencies be ruled out by appropriate tolerance tests, etc., since these conditions as well as cow's milk allergy will subside following milk elimination, and recur after milk introduction?
The Prenatal Pediatric Visit
Authors: MENDELSOHN ROBERT S.
Published: December 2021

Dr. Morris Wessel's article, "The Prenatal Pediatric Visit" (Pediatrics, 32:926) is in general helpful. However, certain aspects of his presentation lead me to think that his experience may be derived chiefly from an academic environment. For example, while in some cases it may be all right to ask prospective parents about their housing and occupation, many may regard this as an attempt by the pediatrician to "size them up" financially. This potential source of resentment should be carefully considered in this type of interview.
THE CORRECTION OF PROLONGED BLEEDING TIMES IN TWO BROTHERS BY PLATELET TRANSFUSIONS DESPITE NORMAL IN VITRO PLATELET TESTS
Authors: White James G. , Yunis Edmond , Colliander Marian , Krivit William
Published: December 2021

1. Two children with congenital disorders have been presented.

2. Laboratory evaluation of their problem revealed only prolonged bleeding times and positive cuff tests.

3. The transfusion of normal platelets, but not plasma, corrected their abnormal bleeding times.

4. The use of blood product transfusion as a means of establishing diagnosis was useful in our patients and is recommended in the study of all difficult bleeding problems.
New Information Available on Hazards of Fallout: Useful Work of a New Jersey Academy Committee
Authors: CHARLES SEYMOUR
Published: December 2021

Our Committee, for the past two years, has concerned itself with the potential hazard of fallout to the health of the infant, child, and fetus. In May, 1963, we initiated a survey of the countermeasure programs within the individual states. Countermeasures are possible methods of controlling exposure to fallout which might be used by government or private health facilities.

Our studies form the basis for testimony to a Sub-Committee on Atomic Energy of the Congress.
Current Pediatric Therapy
Authors: S. C. A.
Published: December 2021

One person cannot review a book of nearly 700 text pages written by almost 250 authors. He can scarcely hope even to describe it. But he can, in this case, note that if such a book can be written, the editors have chosen a group of contributors who should be able to write it with authority. Drs. Gellis and Kagan have been broad in their selection of subjects to be considered, including not only everything to be expected but also some welcome surprises like the list of Poison Control Centers in the United States and Canada, and some frightening ones like the suggestions for supersonic transport travel.
Outline of Electrocardiography
Authors: HUGENHOLTZ PAUL G.
Published: December 2021

This book is based on the experience of the author in teaching courses of electrocardiography and therefore reflects a rather dogmatic, but at the same time limited, discussion of the principles and facts of electrocardiography. Undoubtedly, the book is clearly written, systematic in its organization, reads easily, and is quite well illustrated. It has derived most of its information from other sources and the best illustrations from these publications in the literature have been reproduced to the advantage of the reader who now finds essentials of other people's work.
The Allergic Child
Authors: BURGIN LEO B.
Published: December 2021

As is frequently the case, texts produced by multiple authors may vary considerably in degree of excellence. In this opus, while there are variations, one would classify the chapters as excellent in most instances, good in a few. This same multiple authorship leads to some duplication of material which adds to the length of the book. Since this book is aimed at the practicing physician shortening of the text would be welcome.

In general the various aspects of pediatric allergy are presented in a clear and precise manner. Controversy is avoided and for the most part middle of the road methods are recommended.
CONGESTIVE HEART FAILURE AND RHEUMATIC ACTIVITY IN YOUNG PATIENTS WITH RHEUMATIC HEART DISEASE
Authors: Spagnuolo Mario , Feinstein Alvan R.
Published: December 2021

Ninety distinct episodes of congestive failure have been analyzed in 40 children and adolescents with rheumatic heart disease. The cause or precipitating factor of each episode was sought by careful clinical evaluation. Without regard to laboratory tests, the episodes were classified as "active" when associated with other major features of the Jones diagnostic criteria for rheumatic fever, and as "inactive" when such features were absent, with the congestive failure presumably due to mechanical or pharmaceutical causes, pulmonary infarctions, or nonstreptococcal infections.

Associated values for the erythrocyte sedimentation rate and CRP were remarkably consistent in both the "active" and "inactive" groups. These tests were often specific enough to be useful in deciding the cause and treatment of the episodes. The ESR was at its highest and was almost always elevated in untreated "active" patients; it usually remained within normal limits in those "inactive" episodes not associated with pulmonary infarctions or nonstreptococcal infections. The CRP results followed the same pattern.

It is currently believed that every episode of congestive failure in young patients with rheumatic heart disease is due to "rheumatic activity" and that the low values frequently found for ESR are due exclusively to the failure itself. The present results contradict these concepts. Congestive failure can often occur in this age group without rheumatic activity; it does not significantly lower an ESR elevated by inflammation. Low ESR values in patients not receiving anti-rheumatic therapy suggest that the congestive failure is due to causes other than rheumatic activity.
Physiology and Morphology of Bronchiolitis
Authors: ROBBINS J. J.
Published: December 2021

I was very much interested in Dr. Ingeborg Krieger's excellent study of pressure-flow-volume relationships in acute infantile bronchiolitis, published in Pediatrics, 33:45, 1964.

I am wondering if Dr. Krieger is acquainted with the recently published studies by Engel of the anatomy of the bronchiolar tree in infancy and childhood which might well provide an explanation for the seemingly paradoxical lack of rise in outflow resistance and prolongation of expiratory phase as is characteristic of other obstructive lung disease as bronchial asthma.
Hyaline Membranes and Pulmonary Blood Pressure
Authors: BROWN R. J. K.
Published: December 2021

The aetiology of the syndrome of respiratory distress in the premature infant remains unsolved. As I know to my cost, theories based upon mere speculation rarely prove correct. However, when new facts are discovered it is inevitable that we should try to fit them into the clinical picture.

In the December issue you have published a most exciting article (32:1094, 1963) which provides an important clue to the pathogenesis of the syndrome. One feels it should provide the complete answer, but this finding, like so many others, is capable of different interpretations because of the complexity of the respiratory and haemodynamic factors involved.
MASS IMMUNIZATION OF CHILDREN WITH ORAL, TRIVALENT POLIOVIRUS VACCINE (LEDERLE STRAINS)
Authors: Serpa-Florez Fernando , Maldonado-Romero Dario , Arguello-Pinzon Alvaro , Bahamon-Soto Alberto , Pineros-Bernal Hector
Published: December 2021

A campaign against poliomyelitis in Bogota, Colombia, utilizing an orally administered trivalent poliovirus vaccine (Lederle strains) demonstrated its particular value in public health campaigns, as well as its effectiveness and safety. A single dose of vaccine, administered to more than 187,000 children under 7 years of age within a 2-month period by personnel limited in number and without previous similar experience, greatly reduced both the number of children susceptible to poliomyelitis and the incidence of the disease in the community. Estimated reductions in the number of seronegative children among those vaccinated were from 47% to 7% for Type I poliovirus, from 37% to 20% for Type II, and from 46% to 3% for Type III, with even greater reductions in the number of seronegative children under 4 years of age. In addition, the vaccine viruses apparently spread to unvaccinated members of the community with no increase in virulence, resulting in a sharp reduction in the incidence of paralytic poliomyelitis during the following year and in an unprecedented 4-month period without a single case between 7 and 12 months after the mass vaccinations. Although four cases of poliomyelitis occurred among the vaccinated children, all originated at about the time of the vaccination and two of them must have been caused by wild polioviruses or other enteric viruses, which may also have been responsible for the other two cases. In any event these two cases represent only 0.01% of all the children vaccinated.
STROKE VOLUME AND RELATED HEMODYNAMIC DATA IN NORMAL CHILDREN
Authors: Sproul Ann , Simpson Ellen
Published: December 2021

1. Catheterization data on 21 children between the ages of 6 and 16 years with no demonstrable hemodynamic abnormality were analyzed in order to establish normal values for blood flow in children.

2. The findings are: (a) Body surface area is a reliable standard of size for predicting cardiac output, stroke volume, and oxygen pulse. (b) Stroke volume is less variable than cardiac output or oxygen pulse since it is less affected at rest by minor variance from the basal state. (c) Cardiac index of 4.1 1/min/ m2 is valid within the surface area range of 0.7 to 1.2 m2. (d) Stroke index of 42 ml/beat/ m2 is valid within a surface area range of 0.7 to 1.5 m2.

3. Oxygen pulse is proposed as a sensitive index of the variance from basal state and as a useful flow measure for outpatient cardiac function studies.

4. A nomogram is presented for predicting cardiac output, stroke volume, and oxygen pulse from surface area.
SULFATE METABOLISM DURING MAMMALIAN DEVELOPMENT
Authors: Percy Alan K. , Yaffe Sumner J.
Published: December 2021

The developmental pattern of activities of several enzymes in mammalian (mouse) liver concerned with sulfate cleavage and transfer is presented. Maximum arylsulfatase activity occurred at 14 days of age, while sulfokinase activity was greatest at 28 days of age. The similarity of the results for both enzymatic functions suggests a common regulatory factor.
THE NATURAL HISTORY OF CERTAIN CONGENITAL CARDIOVASCULAR MALFORMATIONS
Authors: Nadas Alexander S.
Published: December 2021

INFORMATION on the "natural history" of congenital cardiac malformations is difficult to obtain and may have very little meaning for the statistician. One is aware that the facts obtained may yield a profile only of those patients with heart malformations who have signs and symptoms significant enough to bring them to a cardiac center. The others, either not sick enough to come to a center, or too sick and even dying before they can be brought to the specialist, or living too far from the medical center, therefore, will not be included in any survey. The only way the entire congenital heart disease population may be caught in the net of the investigator is by following up carefully a large group of newborns.

Though information gathered may not be statistically significant it is none the less important as a frame of reference in making recommendations to patients and their families. Also it is of necessary historical import that we document the course of patients with malformations as yet unaltered by the hand of the surgeons. The effect of surgery on patients with certain malformations is far reaching and changes the course of their natural history. Another reason why we should try to find out what happens without operation to certain patients is that there will be a tremendous advance in cardiovascular surgical techniques for many lesions yet in the future. Nobody questions the fact that cardiac surgery, in many, if not most, areas will be better tomorrow than it is today.

The notable exceptions to improvement of surgical techniques include repair of patent ductus arteriosus, coarctation of the aorta, secundum atrial septal defect, and pulmonic stenosis.
CURRENT CONCEPTS IN PEDIATRIC CARDIOVASCULAR SURGERY
Authors: Kirklin John W.
Published: December 2021

AMONG the many interesting congenital cardiac malformations amenable to surgery today, four will be discussed, namely, coarctation of the aorta, ventricular septal defect, Tetralogy of Fallot, and transposition of the great vessels. Recommendations for surgical therapy are based on the experience at the Mayo Clinic.

Coarctation of the aorta continues to be most satisfactorily treated by operation and the hospital mortality risk is extremely low. In general, the optimal age for surgery is about 10 to 12 years. Unusually severe systemic hypertension or cardiac enlargement constitute an indication for somewhat earlier surgery. When infants with isolated coarctation of the aorta show severe cardiac failure, and this certainly occurs although uncommonly, operation should be advised at that age. The risk even then is very low, but few cases may require reoperation at age 12 because of failure of adequate growth of the anastomosis.

The indications for repair of ventricular septal defect must take into account the estimated size of the lesion and its hemodynamic effects. Patients with small ventricular septal defects who have normalsized hearts and normal electrocardiograms, that is, those without clinical evidence of significant hemodynamic derangement, are not advised by us to undergo repair of the defect at present. Patients with ventricular septal defect and mild or moderate pulmonary artery hypertension (that is, patients whose pulmonary artery pressure is less than 75% of systemic artery pressure) can be operated upon at essentially no hospital risk. Operation is clearly advisable in all of these patients. Patients with ventricular septal defect who have severe pulmonary artery hypertension associated with a large pulmonary blood flow (and thus with only mild elevation of pulmonary vascular resistance) can be operated upon with a low hospital mortality rate, in the neighborhood of 5%.
COMMITTEE ON ENVIRONMENTAL HAZARDS
Authors:   Committee On Environmental Hazards
Published: December 2021

IN A REGENT REPORT on water resources, it is estimated that at the present rate of increasing population growth and industrial use by the end of this century it will be necessary to withdraw from streams and ground sources one billion acre-feet or approximately 75% of stream flow. This represents a threefold increase over the proportion now used, and reflects population increase, greater urbanization with associated increases in water consumption, and increased industrial usage proportional to present trends. That this presents serious problems for the future is readily appreciated when one considers the enormous load of waste, both human and industrial, that these streams are presently carrying. Of the over 500,000 organic chemicals known and described, many are finding their way into streams and thus into our water supplies. Only a small fraction of those presently in water would be acceptable to the Food and Drug Administration as proper additives for food and beverages for human consumption. Although waterborne outbreaks of acute communicable disease traced to established municipal water supplies are rare at the present time, the possibly harmful effects of various chemical additives are much more difficult to determine and trace. This problem is likely to become considerably more severe, since it seems likely that the present rate of industrial development will continue and our water usage is expected to reach one thousand billion gallons of water per day within this century.

This Committee was provided an opportunity recently to review the present status of water pollution in this country with the staff of the Robert A. Taft Sanitary Engineering Center.
Earlier Follow-up Studies of Premature Infants
Authors: KUNSTADTER RALPH H.
Published: December 2021

In the article "A Long-term Follow-up Study of Small Premature Infants," Dann et al. (Pediatrics, 33:945, 1964) the authors neglected to cite and recognize significant early studies on this subject. In 1934, Hess, Mohr, and Bartelme published the first comprehensive study on The Physical and Mental Growth of Prematurely Born Children (University of Chicago Press). Twenty years later, Dr. Julius H. Hess wrote "A Development Study of Prematurely Born Infants Weighting 1250 Grams or Less at Birth, with Particular Reference to Those 18 Years of Age and Older" (Pediat. Clin. N. Amer., 679, August, 1954).
Importance of Vaccination against Measles
Authors: LEWAK NORMAN
Published: December 2021

The February, 1964, issue of Health News (a publication of the New York State Department of Health) contains an advertisement addressed to "Dear Physician" which asks the doctor to remind his patients to continue vaccination against "Diphtheria, Whooping Cough, Polio, Tetanus, and Smallpox." My question is, "What happened to measles?"

All of us cheered the announcement last year that a measles vaccine would soon be available to the public. Last autumn we contemplated a spring free of miserably sick children with cough, conjunctivitis, coryza, and rash complicated by respiratory distress or encephalitis.
Positive Cultures of H. Pertussis
Authors: JAFFE VITA R.
Published: December 2021

In the article by White, Finberg, and Tramer on "The Modern Morbidity of Pertussis in Infants" I noted with interest one sentence in which the authors stated, "Positive cultures for H. pertussis were so rare that a negative culture was not a useful criterion for exclusion." In my article on pertussis in the Journal of Pediatrics of December, 1955, I listed one hundred cases of pertussis, all of which had a positive cough plate. These cough plates were examined by Dr. J. B. Holland of the District of Columbia Department of Public Health and further confirmed by Dr. Margaret Pittman of National Institutes of Health.
Understanding Your Baby Doctor's Behavior
Authors: ROSS LAWRENCE S.
Published: December 2021

A young mother comments to her friend, "He doesn't seem to listen to me!" "Mine just won't come when I call him!" the other woman replies. Are they talking about their children? No!! They are discussing their pediatricians or "Baby Doctors."

Are Baby Doctors really as unhappy as some writers claim they are? Do they really hate all mothers? Here at last is a guide to help and reassure parents in their unending search for better understanding of their Baby Doctor.

Although there is a general pattern in the development of his behavior, it is always important to remember that your baby doctor is an individual and therefore may vary considerably in his rate of growth.
Preventing latrogenic Aspirin Poisoning
Authors: SETLEIS HOWARD
Published: December 2021

Accidental poisoning in infancy and childhood is often preventable. The thirteenth edition of Pediatrics by Holt, McIntosh, and Barnett points out:

". . . of particular importance in salicylate poisoning is the high incidence of therapeutic over-dosage which in all instances is probably avoidable. When aspirin is recommended, the exact dose and duration of therapy should be specified, and parents should be emphatically advised not to exceed the amount prescribed. . . ."

Such advice and caution must be directed not only to parents but also to those responsible for published material of physicians who would advise other physicians in the use of acetylsalicylic acid or any other medication.
Homocystinuria
Authors: DENT C. E.
Published: December 2021

The report of two cases of homocystinuria by Gerritsen and Waisman (Pediatrics, 33: 413, 1964) raises an important clincal point. The two cases reported by myself and others (Arch. Dis. Child., 38: 425, 1963) both had bilaterally dislocated lenses and this abnormality has been present in all other cases seen by us since then. Gerritsen and Waisman do not make entirely clear statements with respect to eye abnormalities in their patients. For case K.T. we are only told "There was no complaint of any visual difficulty" (p. 415), and nothing is said about the examination of the eye.
Sulfadiazine-Resistant Meningococcus
Authors: ABLER CHARLES
Published: December 2021

Lest some unwarranted doubts may arise regarding the therapeutic efficacy of sulfadiazine in the treatment of meningococcal infections (excluding the fulminans type) or the emergence recently of resistant strains, from the article "Meningococcal Disease Due to a Sulfadiazine Resistant Strain" which appeared in Pediatrics, 34:124 (1964), I hasten to point out that both in this article and the reference that it draws upon heavily (J.A.M.A., 186:139, 1963), the only warranted deduction from the data detailed is that Group B meningocci are relatively more resistant or less sensitive to sulfadiazine compared to Group C meningococci on testing in vitro.
Diagnostic Procedures in Pediatric Ophthalmology
Authors: LEPARD CECIL W.
Published: December 2021

Twenty-seven qualified authors have contributed to make this 300-page volume a valuable aid to the examination of infants and children and therefore important to the treatment of pediatric disease. Some contributions present an entirely new approach. After reading Dr. David O'Harrington's excellent chapter, every ophthalmologist will have a new stimulus to uncover a previously uncovered area of perimetry. Dr. Harry E. Thorpe, as always, has something new for biomicroscopy in children. Some authors, perhaps because of limited space, have been too brief. Dr. Marshall M. Parks's section on Ocular Motility, on the other hand, is particularly comprehensive.
From the Pan American Medical Association
Authors: CALDWELL GEORGE W.
Published: December 2021

With regard to the letter from Dr. Horace L. Hodes, which appeared in Pediatrics, 34: 434, the Pan American Medical Association, through the undersigned, apologizes for the secretarial error which resulted in the letter mentioned by Dr. Hodes.
An Old Pediatrician Looks in the Mirror
Authors: BRUCE JAMES W.
Published: December 2021

A am 78 years old and have been engaged in active doorbell-ringing pediatric practice since 1920–44 years. Doctors do not ring as many door bells as they once did because we have finally convinced most people that we can do a much better job in our offices where we have nurses to help us and where we can get laboratory work done quickly. Whereas in 1920 practice was about 70% house calls, 25% office, and 5% hospital, it is now about 85% office, 10% hospital, and 5% house calls.
Hospitalization vs. Home Care of Children
Authors: LEVIN S.
Published: December 2021

I write with regard to the Commentary in Pediatrics (34:1), July, 1964. Whatever the reasons, in South Africa the care of sick children is much more home centered than what I have observed in England and especially America and Canada. Here there is no alternative such as "If he is too sick to be brought to the office then he is sick enough to be in hospital." I rarely find it necessary to confine a child to hospital, and would like to present my experiences in this regard with respect to gastroenteritis and dehydration.
Modern Problems in Pediatrics VIII
Authors: S. C. A.
Published: December 2021

This book exemplifies certain problems of those publications which originate in international conferences, and even in important conferences such as this one. The printed products of such gatherings are useful, but one regrets that they are not much more so. This book was made available after a shorter interval than separates many a conference and its publication—nevertheless, more than two years elapsed. And the reader will get (and will retain) less information than did the listener who participated in these sessions, and in the informal discussions, not transcribed, in the Conference Room.
CONGENITAL HORNER'S SYNDROME AND HETEROCHROMIA IRIDUM
Authors: Robinson Geoffrey C. , Dikrainian D. A. , Roseborough G. F.
Published: December 2021

This paper reports an infant with anomalies of the cervical vertebrae, left-sided enterogenous cyst, congenital Horner's syndrome, and heterochromia iridum, also on the left side. The various causes of congenital Horner's syndrome and heterochromia are reviewed.
Parabiotic Twins and Neonatal Hypoglycemia
Authors: CORNBLATH MARVIN
Published: December 2021

The article by Dr. Naeye, "Organ Composition in Newborn Parabiotic Twins with Speculation Regarding Neonatal Hypoglycemia" in Pediatrics 34:415, 1964, is interesting, but his speculations are irrelevant. The only similarity between the parabiotic syndrome and neonatal hypoglycemia is that the former always occurs in twins, and the latter may occur in the smaller of discordant twins. Parabiotic twins have a high mortality, discordant twins do not. The smaller donor twin is anemic and pale; the smaller hypoglycemic twin is often polycythemic (3/7)1 and plethoric.
Thallitoxicosis
Authors: OLSON ROBERT L.
Published: December 2021

The article by Drs. Smith and Doherty, entitled "Thallitoxicosis," appearing in Pediatrics, 34:480, 1964, certainly is a very excellent description of three cases of poisoning occurring in school-age children in one family.

However, I diligently searched through the article to find how these children could have gotten this poison into their systems and was disappointed that I could find no mention or supposition as to how these children received this poison. It was stated that the family did have a poison in the home that contained thallium.
III. PULMONARY DIFFUSION
Authors: DeMuth George R. , Howatt William F.
Published: December 2021

1. Equations describing the normal variation and changes with size of the diffusing capacity (rebreathing technique) for boys and girls have been obtained from 230 observations on 139 children.

2. The use of covariance analysis on the longitudinal data reduces the residual variance by about half, indicating that in children the diffusing capacity for carbon monoxide, Dco, grows along growth lines. This aids in finding significant deviations from the predicted in children who are followed with repeated examinations.

3. The Dco increases with growth in a manner very similar to that of the lung volumes, not only in respect to height, but also in respect to age, weight, and surface area. The ratio Dco/TLC expresses a relationship which does not vary with body size, age, or sex in these healthy individuals. Although boys and girls have the same mean values, the correlation between each individual's values from the two series is significant for boys but not for girls.

4. The constancy of the Dco/TLC during growth supports the hypothesis that the lung grows between the ages of 5 and 18 years by the addition of new air spaces rather than by enlarging the pre-existing ones.
Travel Health Guide for Infants and Children
Authors: WEBB CLARENCE H.
Published: December 2021

This is a handy, reliable, and inexpensive travel guide for the millions of parents who now take their children on trips, especially by automobile. It is written interestingly, is in an attractive format, and is well illustrated. An especially valuable feature is a page of Do's and Don'ts at the end of each chapter, which are eye catching and emphasize the salient points of each topic.

Chapters cover such topics as General Planning, Feeding Suggestions, Clothing and Laundry, Common Respiratory Diseases, Digestive Disorders, Common Contagious Diseases, First Aid, Swimming, Traveling with Pets, and Recreational Activities.
The Differential Diagnosis of Diarrhea
Authors: HOLT L. EMMETT
Published: December 2021

This monograph, one of the Medical Extension Series prepared by the University of California at Los Angeles, is a collection of essays largely by members of the medical staff of U.C.L.A. on various agents causing diarrhea and their recognition. There are chapters on parasitic fungal, rickettsial, bacterial and viral diseases, on neoplastic and toxic diarrheas, on psychogenic diarrhea, on non-specific inflammatory disease, on non-abdominal occult diarrheas, on malabsorption syndromes in adults and in children, and on the special problems of diagnosis in infants and children.
EXTROPHY OF THE CLOACA
Authors: Zwiren Gerald T. , Patterson Joseph H.
Published: December 2021

A case report of an infant with extrophy of the cloaca treated surgically has been presented. The literature has been reviewed and the embryology, pathology, and previous surgical approaches have been described. As illustrated by this case report, a more hopeful prognosis can be expected for at least some of these infants with this complex anomaly.
Measles Vaccine
Authors: HARVEY N. A.
Published: December 2021

Formerly, the pediatrician was faced with the problem of many diseases for which he could offer no preventive measures. Now he is faced with the problem in reverse: there are so many preventive vaccines available that he has difficulty scheduling them all. He may even have to "sell" the newer agents to some mothers (already wincing inwardly at the prospect of numerous painful shots to be administered on the baby's tender bottom!).

The principle of parsimony therefore ranks high among immunization guidelines favored by many pediatricians.
Letters to the Editor
Authors: KRUGMAN SAUL
Published: December 2021

In the introduction to our article (Pediatrics, 34:795, 1964) it is clearly stated that one inoculation of live measles vaccine is the immunization of choice for infants over 9 months of age. This regimen has obvious advantages over the combined inactivated-live measles vaccination procedures which entail multiple inoculations. On the other hand, live vaccine is not consistently immunogenic for younger infants because of the potential suppressive effect of residual passive antibody.

Passively acquired measles antibody may disappear as early as 3 months or as late as 11 months.
The Full-Time Child
Authors: SETLEIS HOWARD
Published: December 2021

Having read "Correlates of Low Birth Weight: Psychological Status at Six to Seven Years of Age" by Weiner et al. in the March, 1965, issue of Pediatrics, perhaps the psychological stage was set for pseudo-psychological hypophesizing.

I know for a fact that many individuals reading the Summary of the article completely misread the second line. This sentence is printed as: ". . . weight children and 415 full-time children ..." Could the words "full-time" really have been an error? Could the authors, editors, and printers of Pediatrics have forgotten the use of the words "full-term"? Obviously not! "Full-term" as a descriptive classification of infants is used throughout the paper.
Purpura Fulminans
Authors: TOLENTINO PAOLO
Published: December 2021

I was very interested reading the article "Purpura Fulminans" by Dr. J. D. Bouhasin in Pediatrics, 34:264, 1964. In 1962 I observed a case of purpura fulminans after scarlet fever, which demonstrated a typical hyperfibrinolysis, with dissolution of the coagulum one hour after blood coagulation in vitro, and healed after administration of epsilon-aminocaproic acid. I think this was the first case in the literature in which such a defect could be demonstrated and such therapy was administered. My lesson to the students was published in Minerva Medica, 53:2087, 1962.
Nutricia Symposium on the Adaptation of the Newborn Infant to Extra-Uterine Life
Authors: AVERY GORDON B.
Published: December 2021

This book is composed of papers on newborn physiology presented at a symposium held at the State University in Groningen, The Netherlands, under the leadership of Dr. J. H. P. Jonxis. Both the original papers and the discussion by the participants are included. The contributers are international in their origin and outstanding in their professional competence. Although no pretense is made to discuss all the clinical problems of newborn infants, particular subjects are covered in a scholarly and relatively exhaustive manner.
ABO HEMOLYTIC DISEASE OF THE NEWBORN: A FAMILY STUDY WITH EMPHASIS ON THE STRENGTH OF THE A ANTIGEN
Authors: Grundbacher Fred J.
Published: December 2021

Thirty-one Caucasian families characterized by having one or more infants with ABO hemolytic disease of the newborn were ascertained and investigated. All the mothers were blood type O. Of a total of 47 affected type A infants, 2 were subtype A2 and the rest A1. Thirty-three of the affected infants were female and 14 male, revealing an obvious effect of sex. No association was found between secretor status and ABO hemolytic disease. Within subtype A1 the relative strength of the paternal antigen was not significantly different from that of a control sample of males. Some aspects of the complex etiology of ABO hemolytic disease have been discussed.
REDUCTION OF RADIATION EXPOSURE OF CHILDREN DURING UROLOGIC DIAGNOSIS
Authors: Amar Arjan D. , Chabra Kamla
Published: December 2021

Four methods used in the urologic diagnosis of children are presented as examples of methods developed to offset hazards of radiation exposure: (1) limited area radiographic study, (2) double dose of contrast medium in excretory urography, (3) new, non-radiographic technique for demonstrating vesicoureteral reflux, (4) ciné techniques.

The development of similar types of modification to reduce radiation exposure of children is advocated for other specialties relating to the pediatric age group.
HEREDITARY RENAL DYSFUNCTION AND DEAFNESS
Authors: Cassady George , Brown Kenneth , Cohen Maimon , DeMaria William
Published: December 2021

For the past six years we have been engaged in the study of 476 members of seven families with hereditary renal disease and deafness. We have been profoundly impressed with the commonness of the syndrome and by the wide spectrum of clinical findings with which the disorder may present. We have often uncovered the syndrome successfully mimicking acute and chronic nephritis and pyelonephritis in university hospitals and schools for the deaf, and we suspect a much greater frequency than is generally recognized.

The clinical features of families with this disorder are remarkedly similar in spite of the broad clinical spectrum of the disease in individual patients. This had led us to consider the syndrome as a single disease state.

Males with deafness in the first two decades of life have more severe renal impairment, and risk of early death is much higher in this group. A significant number of males were found to have little hearing impairment early in life and, although urinary sediment abnormalities were present, to run a more chronic course. Late in life this group has unequivocal evidences of renal disease and progressive hearing impairment, but a shortened life span does not seem to be characteristic. Urinary sediment in both groups of males is characterized by red cells; proteinuria and (less frequently) pyuria are sometimes associated with the hematuria, and on rare occasion isolated pyuria may be present. Otitis media is suggestively but not significantly increased in our affected males; eye defects, particularly myopic refractive errors, are significantly increased in the affected females.

No single, simple diagnostic test has been found. The importance of a careful history and repeated urine examination and a high index of suspicion when these techniques reveal abnormality has been shown, and certain clinical criteria for diagnosis which have proven of value have been offered.
DIAGNOSIS AND TREATMENT: RESPIRATORY DISTRESS AND CARDIAC DISEASE IN INFANCY
Authors: Rudolph Abraham M.
Published: December 2021

THE commonly recognized causes of respiratory distress during infancy are pulmonary or tracheobronchial pathology, cardiac failure, and cerebral disease. The various mechanisms by which cardiac disease may produce increased respiratory effort are not, however, generally appreciated, with resultant confusion in the management of the underlying problem.

The major pathological physiologic disturbances producing respiratory distress (in association with heart disease) are pulmonary edema and severe metabolic acidosis. Pulmonary edema occurs either in left ventricular failure or in association with lesions resulting in an obstruction of the pulmonary venous return. Metabolic acidosis is related to severe hypoxia which is the major manifestation of several types of cardiac anomaly.

The respiratory pattern associated with pulmonary edema is that of tachypnea to rates of 60-100/min, with initially only mild increased effort. Rales are not usually heard until a considerable amount of fluid has entered the alveoli; thus absence of this clinical sign does not exclude the diagnosis. In advanced pulmonary edema, marked air hunger appears and in young infants head retraction with gasping respiration may occur, presenting an appearance of an obstructed airway. Cyanosis is usually only of mild degree unless associated with cyanotic congenital heart disease.

Left ventricular failure and pulmonary venous congestion are far more frequently observed in heart disease in infancy than right-sided failure. It is surprising that most descriptions of heart failure in infancy stress hepatomegaly as one of the earliest signs of failure. However, respiratory distress as manifested by tachypnea and dyspnea is usually the first evidence of cardiac failure in infancy, and hepatomegaly and other evidences of right-sided failure occur much later.
THE ADVANCE OF CHROMATOGRAPHY
Authors: HOLT L. EMMETT , SNYDERMAN SELMA E.
Published: December 2021

THE advances in pediatrics, like those in medicine as a whole, can usually be traced to some new development in technique, the significance of which is often appreciated only in retrospect. The discovery of the microscope was not heralded as the prelude to the study of microbiology or microscopic anatomy and pathology. The pediatrician who today gives DPT routinely to his young patient seldom stops to think of the debt he owes to Pasteur, the father of immunology. It is the same with advances in chemistry, and one can think of many other examples in which a new technique has proved immensely useful in the understanding and treatment of disease.
A Defective Extra Chromosome Associated with Clinicial 17-18 Trisomy Syndrome
Authors: MILLER JAMES Q. , ROSTAFINSKI MICHAEL J. , HYDE MARGARET S.
Published: December 2021

A male infant was found to have many clinical features typical of 17-18 trisomy. However he had an unusual chromosome defect which has not previously been reported, an additional medium chromosome with arms of equal length. Its structure is compatible with that of a 17-18 long-arm isochromosome.

His clinical features and postmortem findings are compared to those associated with usual 17-18 trisomy, and support the thesis that he possessed a defective additional 17 or 18 chromosome.

Reports of such defective extra chromosomes are rare. Additional studies are needed to confirm or to disprove an association between such clinical and chromosome defects.
"Neonatal Hepatitis" in Twin Pregnancy
Authors: WONG PAUL W. K. , BURNSTINE RICHARD C. , HSIA DAVID YI-YUNG
Published: December 2021

The familial nature of "neonatal hepatitis" has been known far some years. The present paper reports on the occurrence of this condition in one of dizygotic twins.

Case Report

A.B., a white female, was first admitted to the Children's Memorial Hospital at the age of 2 months with a history of persistent jaundice. She was the first born of a twin pregnancy with a birth weight of 5 lb (2.3 kg). Jaundice was first noted within a few hours after birth and increased in intensity as the child grew older. The stools were light and the urine dark. Despite a good appetite, the weight gain had been poor.
Importance of Vaccination Against Measles
Authors: MUSIKER SEYMOUR B.
Published: December 2021

In Pediatrics for September (34:438, 1964) Dr. Lewak presented a problem to the Academy and to pediatricians throughout the country. I have patiently waited for a response either by comment or letter. There has been none. I served with Dr. Lewak along with some 35-40 other house officers and shared in his experience.

Gentlemen, in 1963, more than 400 people died from measles. In 1964, the figure was close to 500. Dr. Terry, Surgeon General of the United States, reports that this is the leading killer of the infectious diseases.
Letters to the Editor
Authors: LEWAK NORMAN
Published: December 2021

A letter of mine printed in this column in September, 1964 (p. 438) outlined my experience with the unnecessary measles epidemic of 1964. In that letter I urged that a national campaign be instituted to convince the public that measles is a deadly disease and to inform them that a vaccine is available.

Since September I have written many letters to organizations and news media and the response has been poor. Everyone is interested but no one thinks the public can be moved.
CORE TEMPERATURE IN INFANTS UNDERGOING CARDIAC CATHETERIZATION
Authors: Baum David , Mullins Gay
Published: December 2021

A study of "deep rectal temperature" was performed in 25 unwarmed infants less than 2 years of age undergoing cardiac catheterization. All 13 children (including 3 unsedated infants) whose body temperature fell 2° C or more were 6 months of age or less. Temperatures dropped 1.1° C or less in the remaining 12 patients, all of whom were 6 months of age or more. In general, those children who suffered the greatest falls were smaller, less well nourished and had larger surface areas relative to body mass. In addition, arterial desaturation was found more often in these patients.

Hypothermia and its complications have been prevented in 16 infants undergoing cardiac catheterization with the assistance of a safe, simple warming device. The young patients warmed were similar to the 13 unwarmed infants found to develop hypothermia in environmental conditions comfortable for laboratory personnel.

Not only is hypothermia in infancy a hazard per se, it is without apparent metabolic advantage. Furthermore, the alterations in oxygen consumption that occur with cold in these small patients may invalidate any calculations that assume stable oxygen consumption. Therefore, it is concluded that hypothermia should be avoided in the young infant studied in the cardiovascular laboratory. The warming system presented in this report is suggested as a method with which this undesirable condition may be prevented.
THE TRICEPS SKINFOLD AS A PREDICTIVE MEASURE OF BODY DENSITY AND BODY FAT IN OBESE ADOLESCENT GIRLS
Authors: Seltzer Carl C. , Goldman Ralph F. , Mayer Jean
Published: December 2021

The relationship of body density to skinfolds, anthropometric measurements, and indices is studied in a series of 32 obese adolescent girls. The possibility of using various skinfolds as predictors of density was tested. Triceps skinfold is suggested as the best simple predictor of body density (and hence percentage total body fat) in obese adolescent girls. For this population, the following regression equation is recommended for the prediction of body density from the triceps skinfold measurement.

body density = 1.1516 - 0.09256 log triceps skinfold

In recognition of the need for a more objective definition of obesity as well as for a simple, reasonable precise method for estimating the degree of obesity of the individual based on actual fat content, it is proposed that adolescent girls with triceps skinfold thickness 25 mm and over should be characterized as obese; and a conversion table is presented for the direct estimation of body density and percentage body fat from triceps skinfold thickness in obese adolescent females ages 12-18.
RESPONSES TO INFUSED METHACHOLINE IN FAMILIAL DYSAUTONOMIA
Authors: Smith Alfred A. , Hirsch Jacob I. , Dancis Joseph
Published: December 2021

Methacholine was infused into six control subjects and into five patients with familial dysautonomia. In the control group blood pressures were well maintained and a tachycardia was observed. In contrast, the blood pressures among the dysautonomic subjects usually fell and the heart rate did not increase. Parasympathetic responses such as tearing and coughing were far more marked and occurred in the dysautonomic at dosages lower than in the normal. In two cases the knee jerks, characteristically missing in dysautonomia were temporarily restored. Increased pain and normal axon flares in response to intradermal histamine were observed in two other patients indicating an improvement in sensory function. The enhanced responses to infused methacholine in dysautonomia suggest an insufficiency of parasympathetic function with effector supersensitivity. The basis for the improvement in sensory function is unknown. The simplest explanation of the observations is a deficiency in neurohumoral transmission. However, an objection to the quick acceptance of this simple hypothesis is also presented.