bluuebunny/crossref_metadata_2025 huggingface dataset:
Heterogeneity of Rabbit Aortic Endothelial Cells, with Special Reference to Phagocytosis
Authors: Emura Sei , Masuko Sadahiko , Sunaga Toshiaki
Published: November 2007

Heterogeneity of aortic endothelial cells with regard to phagocytotic ability was examined by injecting India ink into normal rabbits. Light and electron microscopic analyses revealed that particles of India ink were phagocytosed in the endothelial cells, which in turn were localized at the distal side of the orifice of aortic branches, especially those of brachiocephalic, left calvicular, and dor sal intercostal arteries. No remarkable differences were found ultrastructurally between phagocytosing and nonphagocytosing endothelial cells. Ingested India ink particles were present within phagosomes of the endothelial cells for several hours after injection; the particles eventually accumulated in the subendothelial space twenty-four hours after injection.

These results indicate that an active transport system of large molecules via the phagocytotic processes is present in endothelial cells located at the distal sides of the orifice of aortic branches. These regions are known to develop initial atherosclerotic lesions in hypercholesterolemic animals. Thus, a possible corre lation between phagocytotic ability of endothelial cells and development of atherosclerosis is suggested.
Congenital Antithrombin III Deficiency Causing Mesenteric Venous Infarction: A Lesson to Remember—A Case History
Authors: Grewal Hani P. , Barrie William W.
Published: November 2007

Congenital antithrombin III deficiency is an uncommon but important cause of venous thrombosis, usually presenting with recurrent or atypical venous throm boembolism. Its importance lies in the fact that early recognition can lead to treatment in the acute stage, which can prevent propagation of the disease, and further prophylactic treatment may reduce the incidence of further episodes. The authors present a case of mesenteric venous infarction associated with congeni tal antithrombin III deficiency and briefly discuss the diagnosis, surgical impli cations, and treatment of this disorder.
Right-Sided Cardiac Thromboembolism and its Successful Treatment with Streptokinase: Case Report
Authors: Matana Ante , Mavrié Zarko , Fischer Fedor
Published: November 2007

A sixty-eight-year-old woman with a clinical diagnosis of pulmonary embolism and large right-heart embolus on echocardiography is presented. Because of the critical clinical condition of the patient and the inability to perform surgical intervention, thrombolytic treatment (streptokinase) was administered. The patient's condition improved, the right-heart embolus disappeared, and on the perfusion lung scan there was only one small perfusion defect in the right lung. The authors consider thrombolysis to be appropriate treatment for right-heart thromboembolism whenever surgical embolectomy is not possible.
Anticoagulant-Induced Shoulder Hematoma Producing Brachial Plexus Neuropathy—Case Reports
Authors: Frangides Christos , Kounis Nicholas G.
Published: November 2007

Hemorrhagic complications from anticoagulants are common and may manifest in any part of the human body. Skin discoloration, pain, tenderness, and soft-tissue swelling may be the main clinical features. The authors present 3 extraordinary cases of brachial plexus neuropathy associated with anticoagulant-induced hemorrhage. The signs, symptoms, important differentials, and clinical treatment are described with regard to the pathologic anatomy.
Immediate Anticoagulation for Intracardiac Thrombus in Acute Cardioembolic Stroke
Authors: Yasaka Masahiro , Yamaguchi Takenori
Published: November 2007

To assess the efficacy of immediate anticoagulation therapy on intracardiac thrombus formation in acute cardioembolic stroke, serial two-dimensional echocardiographic examinations were performed in 25 patients with acute cardioembolic stroke. Anticoagulation therapy was commenced within two days of onset in 7 patients (group A) but not in 18 patients (group B). Appearance or enlargement of intracardiac thrombi were not detected in group A but were noted in 7 patients (39%) of group B. Recurrence of systemic embolism was demonstrated in 3 patients (17%) of group B. There were no serious hemorrhagic complications in either group. Immediate anticoagulation could, therefore, be effective in preventing intracardiac thrombus formation and the consequent recurrence of systemic embolization in acute cardioembolic stroke. Because the study was preliminary and not randomized, further randomized study is desirable to establish the efficacy of immediate anticoagulation therapy.
Notes On Fifty Years of Pediatric Practice
Authors: Bass Murray H.
Published: November 2007

"What distinguished Murray Bass from many of his contemporaries in the past as well as in the present was the harmonious allotment of his professional interests and en dowments. At ward rounds and in the dis pensary he was stimulating, at times brilliant but always an instructive, inspiring teacher. His gift of keen observation made him an un- equaled diagnostician; his broad clinical ex perience a wise therapist.

"If one surveys the many scientific contri butions of Murray Bass covering a period of fifty years one is impressed by the wide range of his interests. Orthostatic albuminuria at tracted his attention in his first publications, probably as a result of his contact in Vienna with Jehle of the Childrens' Clinic. But sub sequently one can see how his scientific curi osity was stimulated by the problems arising from his own clinical experience. Observa tions of serious acute illness attracted his at tention to the dangerous idiosyncrasies of young children to metals and it was because of his penetrating analyses of cases of lead poisoning in nursing infants that the sale of nipple protectors containing this metal was prohibited in the State of New York. The clinical aspects of the Rh factor published jointly with Dr. Peter Vogel, vitamin A de ficiency in infants, periorbital edema as the initial sign of infectious mononucleosis, are relevant examples from the later period of his scientific activity.

"Murray Bass was a great physician, one of the greatest I have ever met. His was a God given gift of a rare personality which com bined qualities not often found together ; love, dedication to duty and intellectual curi osity. He utilized these qualities to the fullest and he was rewarded by the love and grati tude of thousands to whom he had been a comfort in times of anxiety with his compe tence and wisdom."—PAUL KLEMPERER, M.D., from J. Mt. Sinai Hosp. 21: 371, Sept.- Oct. 1962.
Congenital Pneumonia
Authors: Davies Pamela A.
Published: November 2007

The finding of polymorphs in the lung alveoli of fresh stillbirths and very early neo natal deaths is traditionally known as congenital pneumonia, though clear histological signs of pulmonary inflammation are lacking in most cases. An analysis of their clinical features is presented which supports the view that such pneumonia is a passively acquired condition due to asphyxial aspiration of maternal inflammatory cells.

True congenital pneumonia due to transplacental infection is rare, and is often but one manifestation of a generalized disease.
Treatment of Pulmonary Complications of Smoke Inhalation by High Pressure Oxygen
Authors: Gorman James F. , Rejent Marian M. , Lawrence William
Published: November 2007

Hyperbaric oxygenation was utilized successfully with a five-year-old child who developed a fulminating tracheo bronchitis and pneumonitis as a result of smoke inhalation. Analysis of this case, in addition to results from animal experiments, suggest an important sup pressive relationship between hyperoxia and the pulmonary inflammatory re sponse to injury.
Outpatient Practice
Authors: Freedman Alan R.
Published: November 2007

"You only see the rare problems in your pediatric residency training." "Residents are not being prepared for private pediatric practice." "They no longer teach you how to treat the common problems of children."

What resident in pediatrics at a teach ing institution has not heard these and related comments from visiting staff mem bers and from practitioners whom they meet ? Are these charges true, or are they, like so many other assertions in medi cine, opinions rather than facts ?
Menstrual Disorders in Adolescence
Authors: Widholm Olof
Published: November 2007

Papers on the gynecologic disorders of adolescence are being published in in creasing numbers, reflecting not only more medical knowledge of the problems of adolescence, but also increased enlighten ment and improved social conditions on the part of the public.
The Antipyretic Effect of Indomethacin: A Clinical Study of the Use for Fever States in Man
Authors: Walker Stuart H. , Hoffman Sumner H. , Silverstone Leslie , Dimoia Frank
Published: November 2007

This study is designed to demonstrate the antipyretic effect of Indomethacin in common febrile conditions of childhood. It also compares the effect of this new anti-inflammatory agent with that of acetylsalicylic acid in a controlled man ner.
Genetics Review : Modern Cytogenetic Technics
Authors: Destine Marie Louise , Monteleone Patricia L.
Published: November 2007

Chromosomal analysis is a valuable tool for diagnosis of anomalies, in pedigree analysis and interpretation, and in genetic counseling. In this report we review the findings in 600 patients studied over a one-year period at Cardinal Glennon Memorial Hospital for Children in St. Louis.
Urinary Tract Infection and Obstruction in Children
Authors: Leadbetter Guy W.
Published: November 2007

Management of recurrent urinary tract infections plagues pediatricians and many of their young patients. This urol ogist speaks out both clearly and elo quently about this problem, emphasizing the importance of a complete urologic investigation. He presents a step by step analysis of the possible etiology of in fection and presents a time-proven ap proach to what constitutes a thorough urologic evaluation.
Pediatric Practice in Eastern Saudi Arabia
Authors: McNiel James R.
Published: November 2007

This report describes pe diatrics as practiced with the Arabian-American Oil Company (Aramco) in Eastern Saudi Arabia by an American physician.

"Observations made dur ing approximately six years of pediatric practice with Aramco are presented, though with no attempt to cover every aspect of this practice or of life here."
Physical Fitness in Adolescence
Authors: Astrand Per-Olof
Published: November 2007

In a broad sense, a person's fitness and physical performance depends upon these factors:

1. Energy output ("motor power")— aerobic and anaerobic processes.

2. Neuromuscular functioning—strength and technic.

3. Psychologic factors.
Chlorphentermine as an Anorexigenic Agent In Adolescent Obesity
Authors: Rauh Joseph L. , Lipp Robert
Published: November 2007

Chlorphentermine proves to be a suc cessful anorexigenic agent in this study. When compared to a placebo, it produced a significant degree of weight loss and maintained its value for up to nine months of follow up. It has replaced all other drugs for the treatment of obese adoles cents in this busy clinic.
Atypical Manifestations of the Recurrent Pleurodynia Syndrome in Children and Adolescents
Authors: Nichamin Samuel J.
Published: November 2007

"This article represents the culmination of my practical experience over two dec ades with unusual aspects of enterovirus infections, encountered with a pleuro dynia-like syndrome. Such signs and atypical symptoms, not ordinarily found in textbook descriptions of the condition, can be of considerable help in the diag nosis of such a widely encountered mal ady."— From the author's letter which accompanied the manuscript.
Prognosis of Children with "Cerebral Palsy"
Authors: Thelander H.E.
Published: November 2007

What happens to children with cerebral palsy when they grow up?

What recuperative powers has the central nervous system?

Is everything being done that can be done to prevent these tragedies?
Delayed and Irregular Maturation Versus Minimal Brain Injury
Authors: Abrams Alfred L.
Published: November 2007

We are increasingly aware of the harm, both actual and potential, done to patient and parents from the designation of children with delayed and irregular maturation as "brain-damaged" or "suffering from brain dysfunction."

The terror and anxiety wrought by such diagnoses, despite the fact that they are based on no current evidence of actual brain disease, is the topic of this paper.
Primary Macroglossia
Authors: Shafer Alan D.
Published: November 2007

There is a clinical entity in which infants are born with large tongues as a consequence of idiopathic hypertrophy of the muscle fibers. Of nine such cases treated by this author, seven also had an omphalocele or an umbilical hernia—an association not well understood.

An anterior wedge resection of the tongue at approximately six months of age to pro tect against prognathism and speech defects seems advisable.
Respiratory Disease in Children Caused by Parainfluenza Viruses
Authors: Ramkissoon Ramdath , McDowall Milton F.
Published: November 2007

There was a sudden severe outbreak of acute respiratory disease in North Trinidad from October through December 1967. This affected all age groups, though particularly serious and widespread among children. in the first two years of life.

Parainfluenza viruses were isolated from many of the patients who were sick enough to be hospitalized.

The expressions of the infection, as here described, are on the whole distinctive.
An Analysis of Contemporary Prescribing Habits
Authors: Arnhold Rainer G. , Freedman Alan R.
Published: November 2007

Physicians in practice try in many ways to keep up with the rapidly expanding body of pediatric knowledge. We read the current literature to learn what researchers all over the world are doing. We attend national conferences, meeting colleagues from all parts of the United States. We attend lectures and staff conferences at local teaching hospitals and medical societies, to confer with and to listen to other physicians to whom we at times may refer patients.

Thus, we keep abreast in a general way of what may be termed the principles of prac tice in all parts of the world; but do we know anything at all about what's going on in the office down the street, the one around the corner or in any other office similar to ours in communities much like ours? How do our colleagues in practice handle certain prob lems ? Do they see the same kind of patients that we do? Are we prescribing too many antibiotics? Are we going overboard with drugs?

Clinical Pediatrics, a journal specifically oriented toward men and women engaged in the private practice type care of children, shares this curiosity. Articles about private practice are frequently featured. The following solicited study is an example.

R. G. Arnhold and Alan R. Freedman have individually contributed analytic articles in the past two years about their clinical observations.1 Inasmuch as prescription writ ing by doctors is a topic of perennial interest, Clinical Pediatrics asked these pediatricians at opposite ends of the country to survey and prepare a comparison of their prescription writing habits. This article presents a revealing synthesis of both sets of data.—Editor.
Blood Transfusion and Philately
Authors: Kyle Robert A. , Wolman Irving J.
Published: November 2007

A three-page article on "Stamps Against Cancer" was published in the May 1964 is sue of CLINICAL PEDIATRICS and was reprinted widely. The reprints were used to help persuade the Post Office De partment to issue the anti-cancer com memorative, which appeared in 1965.

Here is the start of another publicity campaign, directed this time toward pro motion of a blood-transfusion commem orative stamp for the United States.
Critical Review: Exercise as an Influence Upon Growth
Authors: Malina Robert M.
Published: November 2007

The scarcity of sound insights into the long-term effects of physical exercise upon the growth of children is amazing. Most of our knowledge has been derived by extrapolation from animal studies and from observations of adults and nerve-damaged patients. Much more research is necessary to enable us to identify the effects of physical activity on the growing child and to determine which sports and exercises are most likely to establish desirable effects.
Effects of Too-loud Music on Human Ears But, Mother, Rock'n Roll HAS to be Loud!
Authors: Rupp Ralph R. , Koch Larry J.
Published: November 2007

Constant or recurrent exposure to high intensity sound can permanently damage hearing. Pediatricians and otologists are becoming increasingly aware of this danger, especially to teenagers who listen to rock'n roll music and entertainment—"the louder the better."
Hemoglobin and Hematocrit Values of Adolescents
Authors: Daniel W.A. , Rowland Ann M.
Published: November 2007

Using height-weight and hemoglobin-hematocrit values to estimate nutritional status, 268 consecutive adolescent patients from low-income families were evaluated at the adolescent clinic of the University of Alabama Medical Center. Only four of the 123 boys and six of the 145 had hemoglobin values less than 11 Gm./100 ml. of blood, and in only one patient was the anemia due solely to iron deficiency. White boys and girls had higher hemoglobin and. hematocrit values than Negro boys and girls. The mean hemoglobin values from this group of low-income adolescents were similar to those from surveys of Minnesota farm boys and girls and caf adolescents attending a high-income private school in New York City.

A number of other observations of practical clinical value are discussed in the text.
Behavior Modification in Education and in the Clinic
Authors: Snelbecker Glenn E.
Published: November 2007

The merits of behavior modification are being debated with vigor and great emotion at conventions, in professional journals and in the mass media. Behavior modification procedures are being adopted or adapted in clinical psychology, education, psychiatry, special education in penal in stitutions, military and industrial training programs, remedial education, psychotherapy. Since pediatricians may be asked to advise or to work with those who are using behavior modification procedures, they should know what it is, how it originated, its current status and likely future.
Patients and Prescriptions
Authors: Arnhold R.G. , Adebonojo F.O. , Callas E.R. , Callas J. , Carte E. , Stein R.C.
Published: November 2007

How many children are given medicine in the way the physician pre scribes it? Several studies on this question have been published. This report evaluates both comprehension of medical instructions by par ents and their compliance with these instructions in a suburban setting.
Postnatal Alterations of Cardiac Rhythm
Authors: Välimäki I.
Published: November 2007

Knowledge of the clinical phenomena discussed in this paper should be at the listening end of every stethoscope used on a newborn baby.
Small Atrial Septal Defect associated with Physiologic Splitting of the Second Heart Sound
Authors: Pilapil Virgilio R. , Zipes Douglas P.
Published: November 2007

The importance of this brief presentation is to stress that dur ing evaluation of pulmonary ejection murmurs, normal splitting of the second heart sound may occur in patients with atrial sep tal defects, particularly if they are young or have small defects.
Remedial Reading in a Pediatric Clinic
Authors: Camp Bonnie W.
Published: November 2007

This paper describes a program which uses neighborhood tutors and other nonprofessionals to provide a pediatric clinic with a simple inexpensive remedial reading service for children with severe reading problems. Case illustrations exemplify some of the ways the program has been useful.
Trends in Accidental Poisoning in Childhood
Authors: Krain Lawrence S. , Bucher William H. , Heidbreder Gerald A.
Published: November 2007

A report of experiences in a large American city, with some suggestions for prevention.
Acquired Methemoglobinemia and Hemolytic Anemia Following Excessive Pyridium (Phenazopyridine Hydrochloride) Ingestion
Authors: Cohen Benjamin L. , Bovasso George J.
Published: November 2007

A case of accidental Pyridium (phenazopyridine hydrochloride) poison ing involving a 13-month-old white girl is presented along with its se quelae of methemoglobinemia, hemolytic anemia and transient hepatocel lular toxicity. The literature has been reviewed and the pertinent aspects of the pathophysiology, signs, symptoms, tests and therapy are reported.
Problems in the Diagnosis and Management of Acute Leukemia in Childhood
Authors: Evans Audrey E. , Wolman Irving J.
Published: November 2007

The early recognition of leukemia rests on a heightened awareness of the possibility of this disease in children with obscure symptoms. Once suspected, confirmation of the diagnosis is not difficult. The natural history of the disease has altered considerably in the past ten years due, in large part, to the increased survival. Problems of infection and localized collections of leukemic cells are now of major importance when trying to support patients in relapse.
How Frequent Is Bacterial Superinfection of the Pharynx in Infectious Mononucleosis?
Authors: Chretien Jane Henkel , Esswein John G.
Published: November 2007

Throat cultures from 133 patients with infectious mononucleosis were compared with cultures from 2,881 patients who were seen during the same period because of pharyngitis. Less than 3 per cent of the cultures from each group contained Group A beta hemolytic streptococci. The inflamed pharynx and necrotic tonsils of infectious mononucleosis are seldom subject to bacterial superinfection, either initially or during the course of the illness. There is no indication for routine use of antibiotics when infectious mono nucleosis is diagnosed. Should, however, a throat culture indicate presence of a bacterial pathogen, any appropriate antibiotic except ampicillin may be used without increasing the incidence of skin rash.
The Prognostic Significance of Fever in Childhood Urinary Infections
Authors: Woodard John R. , Holden Stuart
Published: November 2007

All infants and children with proven bacteriuria require urologic investiga tion and surveillance, but their prospects for developing chronic renal disease are variable. These differences are related to whether or not the bacteria have access to the kidneys. Such access correlates closely with the presence of an underlying congenital anomaly, particularly vesicoureteral reflux. Fever during an episode of active urinary infection is a strong indica tion that the patient has vesicoureteral reflux or some other significant uropathy and probably pyelonephritis.
Minocycline in the Antibiotic Regimen of Cystic Fibrosis Patients: Weight Gain and Clinical Improvement
Authors: Patterson Paul R.
Published: November 2007

Minocycline hydrochloride was given to 100 patients with cystic fibrosis of the pancreas for periods of 3 months over a broad-spectrum antibiotic drug rotation which lasted 2 years. Increased weight gain and some clinical improvement was seen during treatment with minocycline. Those patients with severe disease gained more weight than those with mild or moderate disease, and males gained more than females. When minocycline hydro chloride was not the drug in use, patients lost weight and their health declined.
The Value of Noise-Excluder Shells in Reducing Overreferrals from a School Audiometric Screening Program
Authors: Wall Lida G. , Tillis C.H.
Published: November 2007

Audiometric screening conducted in noisy environments can result in overreferrals to specialty clinics. A follow-up study, conducted to investi gate referral rates as related to the type of headset used in screening programs, showed that noise-excluding shells reduced overreferrals without increasing underreferrals.
Thanatophoric Dwarfism
Authors: Nissenbaum Mark , Chung Stanley M. K. , Rosenberg Henrietta K. , Buck Billy E.
Published: November 2007

Thanatophoric dwarfism is a severe form of short-limbed dwarfism in which cardiorespiratory failure uniformly results in death in the neonatal period. Its radiographic features include markedly flattened vertebral bodies with a typical U-shaped deformity, a flat squat pelvis, and short, bowed extremities with flaring and irregularity of the metaphyses. These char acteristic features distinguish this entity from the two other most commonly confused congenital short-limbed forms of dwarfism—achondroplasia and achondrogenesis. The distinctions are discussed in the text.
Accidental Bed Deaths in Infants due to Unsafe Sleeping Situations
Authors: Smialek J.E. , Smialek P.Z. , Spitz W.U.
Published: November 2007

Sixteen accidental deaths of infants occurred in Wayne County (Detroit) during 1974-1975 as a result of unsafe sleeping environments. Thirteen of these deaths resulted from different modes of asphyxia, two were due to falls, and one drowned. Differential diagnoses are pointed out.

It is estimated that over 600 infants die each year in the United States due to unsafe sleeping conditions. Despite the magnitude and importance of this problem, little has been provided to the public in the form of preventive education. Federal regulations, passed in 1974, control the manufacture of new cribs but do not affect the existing unsafe cribs.

Suggestions for the prevention of such fatal accidents are outlined, in cluding a safety check list for infant beds. The cooperation of all health professionals is required to educate the public of these dangers to their infants.
Caring for Parents of Sick Newborns
Authors: Arney William Ray , Nagy Jill N. , Little George A.
Published: November 2007

This paper is concerned with the care needed by parents who give birth to a "high risk" infant. Interviews with eight families demonstrate the diversity of responses to this anxiety-producing situation.
Appraising Children for Mental Retardation
Authors: Freeman B.J.
Published: November 2007

As a result of their unique relationship with families, pediatricians are often faced with the difficult task of counseling the parents of a mentally retarded child. For this reason it is imperative that he understand the nature of the tools used to evaluate the retarded. Since the IQ test is still the most commonly used tool to assess presence or absence of retardation, this paper has briefly reviewed the concepts of intelligence, the IQ, and their interrelationships and their usefulness when evaluating the mentally retarded child.
Corticosteroid Treatment of Cutaneous Hemangiomas : How Effective?
Authors: Bartoshesky Louis E. , Bull Marilyn , Feingold Murray
Published: November 2007

Twenty-four children with cutaneous hemangiomas were treated with corticosteroids. The indications for therapy included interference with im portant bodily functions by the hemangioma, thrornbocytogenia related to the hemangioma, or serious cosmetic effects secondary to the hemangioma. Five children had no improvement, twelve had possible improvement, five had probable improvement and two had definite improvement while on cortico steroids. One child had growth retardation as a complication of corticosteroids; this was reversed when the medication was discontinued.
Use of Balloon-Tipped Catheters in the Critically Ill Child
Authors: Weesner Kenneth M. , Rocchini Albert P. , Rosenthal Amnon
Published: November 2007

A retrospective study of our experience in the placement of 19 consecutive balloon-tipped catheters in the pulmonary artery of 18 children disclosed that the procedure can be performed with relative ease in the intensive care unit without the aid of fluoroscopy. Insertion of the catheters was not associated with any serious complications. Catheter malfunction, however, occurred in 9 of 18 patients: balloon rupture in 6 and clot formation in 3. Comparison of pulmonary capillary pressure through a balloon-tipped catheter and venous pressure through a central venous line indicates that, in the absence of significant pulmonary disease requiring high positive end expiratory pressure, or significant left heart dysfunction, a central venous pressure line is frequently adequate for monitoring right heart pressures and as a guidance to fluid therapy.
Multiple Renal and Splenic Infarctions in a Neonate Following Transfusion with Sickle Trait Blood
Authors: Novak Robert W. , Brown Robert E.
Published: November 2007

An infant with hydrops fetalis inadvertently received a large transfusion (35 ml/ kg) of apparent heterozygous hemoglobin S (sickle trait) blood. Massive splenic infarction and acute renal failure, secondary to multiple hemorrhagic renal in farctions, developed.
A Data Base Form for Pediatric Practice
Authors: Abrams Robert , Sigelman David
Published: November 2007

A data base form for the recording of information for pediatric practice is described. Its features include sections for anticipatory and safety guidance, a section for developmental data, and a problem oriented format, as well as the standard elements of a medical record system. This data base form has been effectively used by a five-pediatrician group for the past three years.
Management of Candida Peritonitis with Intravenous Amphotericin
Authors: Levin Robert M. , Jason Casey , Black Steve , Nickolai Dorothy , Potter Donald , Grossman Moses
Published: November 2007

The child presented in this report received intravenous amphotericin B 0.5 mg/ kg every 36 hours, for dialysis-associated Candida peritonitis. Just prior to her third dose of amphotericin B, the peritoneal fluid concentration of this drug was 0.1 mcg/ml, and the simultaneous serum level was 0.2 mcg/ml. An hour following the third amphotericin B dose, the peritoneal fluid and serum concentrations were 0.2 and 0.4 mcg/ml respectively. The minimal inhibitory concentration (MIC) of amphotericin B for the C. albicans isolated from this patient was 0.05 mcg/ml, and the minimal lethal concentration (MLC) was 0.1 mcg/ml. Treatment included concurrent 5-fluorocytosine, and catheter removal. This is the first time that mea surements of concentrations of amphotericin B in the peritoneal fluid have been reported in a child with peritonitis.
Prognostic Significance of Raynaud's Phenomenon in Children
Authors: Jung Lawrence K. L. , Dent Peter B.
Published: November 2007

Raynaud's phenomenon is a rare condition in the pediatric age group. Because of this, there is little information on the outcome of these patients. We have followed three patients in our clinic for extended period of time, and all remain well clinically despite the presence of im munologic abnormalities in two. This suggests that, while careful follow up is necessary, the presence of Raynaud's phenomenon and immunologic abnormalities in the pediatric age group are not necessarily of bad prognostic significance.
Enterovirus Infections in the Neonate
Authors: Krajden Sigmund , Middleton Peter J.
Published: November 2007

A chart review was made of 24 neonates less than one month of age with culture-proven enteroviral infection. The seasonal distribution was summer and fall. An antecedent illness was common in the mother or other family members. One patient had a mild gastroenteritis.

Three categories of severe disease were noted: (a) meningitis accounted for 50 per cent of the illnesses; (b) myocarditis for 25 per cent of the illnesses; and (c) the remainder presented with a severe sepsis-like illness.

High mortality rate was associated with low birth weight and low gestational age.
Effect of a Comprehensive Nutritional Program on the Growth and Ponderosity of Infants
Authors: Costom Bruce H. , Shore Donna
Published: November 2007

One hundred eighty-two consecutive newborns from a university-based private practice were enrolled in a comprehensive nutritional program in an attempt to lower the incidence of pon derosity in the group. The program emphasized an individualized approach in which the feeding instructions given to parents varied with the growth pattern of their child. Whereas specific modalities of feeding, such as breast vs. bottle and early vs. late addition of baby foods, appeared not to modify growth, the group as a whole exhibited a trend to lower weight-for-length index (WLI) and less ponderosity than in previous published reports. We propose that the individ ualized nutritional program may have resulted in this improvement, and that such attention to detail will likely be more rewarding than an approach which emphasizes only general nutritional information to the group as a whole.
The Adolescent with Spina Bifida
Authors: Blum Robert W.
Published: November 2007

We have made landmark strides over the past fifteen years in the medical management of infants and young children with spina bifida. Educational mainstreaming is national policy, and barrier-free physical environments are increasingly more common. Now we must direct our attention to the broader health and social needs of youth with spina bifida and their families, particularly in the areas of professional support and sexual and vocational counseling.
Gastroesophageal Reflux in Association with Congenital Heart Disease
Authors: Weesner Kenneth M. , Rosenthal Amnon
Published: November 2007

The clinical course of 19 infants with severe respiratory symptoms associated with the pres ence of both congenital heart disease and gastroesophageal reflux is described. Down Syndrome or central nervous system disease was present in 12 of the 19 infants. The identification of reflux as a major or additional cause of the respiratory complications was often overlooked. Medical therapy alone was successful in only one of the 19 patients. Early repair or palliation of the cardiac malformation with or without subsequent antireflux surgical procedure was as sociated with relief of the symptoms in 13 patients.
Trends in Medication Treatment of Hyperactive School Children
Authors: Safer Daniel J. , Krager John M.
Published: November 2007

In biannual school surveys from 1971 through 1981, it was found that the rate of medication treatment of hyperactive students increased two- to threefold over the decade. This increase applied similarly to parochial, public elementary, and public middle/junior high school stu dents. Other findings over the decade include the following: methylphenidate use increased from 40 per cent to 91 percent of all the medication prescribed for hyperactivity, administration of medication for hyperactivity in the school increased from 61 per cent to 87 per cent of the total, and the number treated with medication prescribed by the family doctor decreased from 98 per cent to 59 per cent. Noteworthy fandings in 1981 were as follows: 19 per cent of public elementary school students in special education classes were treated with medication for hy peractivity ; hyperactive students in middle/junior high school had received medication treat ment for an average of five to six years; the most common school period of medication use was grades one through four; entrance into first grade and secondary school corresponded to an increased use of medication for hyperactivity; and female, relative to male, students were treated with medication for hyperactivity less often than would be expected in teacher surveys of class room hyperactivity, a finding particularly striking in middle/junior high school.
Citrobacter Ventriculitis in a Neonate Responsive to Trimethoprim-sulfamethoxazole
Authors: Greene Gerald R. , Heitlinger Leo , Madden John D.
Published: November 2007

There are increasing reports of citrobacter central nervous system infections in neonates. These organisms cause brain abcesses in a high percentage of pa tients. They may be resistant to commonly used antibiotics. We report a term male infant with underlying meningo-myelocoele and hydrocephalus in whom Citrobacter diversus meningitis and ventriculitis developed. Initial antibiotic ther apy including intraventricular amikacin failed to sterilize the ventricles or alter a deteriorating clinical course. Adding intravenous trimethoprim-sulfamethox azole to the therapeutic regimen resulted in reversal of a progressively worsening condition and eventual recovery. Trimethoprim-sulfamethoxazole should be con sidered as a potentially useful alternative antibiotic for susceptible central ner vous system infections.
An Analysis of Physician-Parent Communication in Pediatric Prenatal Interviews
Authors: Sprunger Lewis W.
Published: November 2007

Thirty-three prenatal interviews done in the offices of four practicing pediatricians were audio-recorded, transcribed, and analyzed for content by two separate methods. Interviews with the individual pediatricians varied markedly in length and were significantly longer if the father was present. Pediatricians took charge of the interviews by asking more questions than parents and by talking twice as much as parents. A relatively small number of topics (medical care of the infant, infant feeding, business aspects of the pediatrician's practice, and history of the current pregnancy) occupied a majority of the interview time. Although interviews with indi vidual pediatricians tended to include a standard set of topics, any given visit was individualized to address parents' issues. Follow-up interviews with mothers showed that they were highly satisfied with the visits and perceived the doctors as having been warm and friendly. Mothers' highly favorable reactions were achieved in spite of the fact that interview style was generally doctor-active/parent-passive, indicating that, in some medical settings, this approach may be quite appropriate.
Neonatal Lead Poisoning
Authors: Sensirivatana Rajanee , Supachadhiwong Orawan , Phancharoen Suwannee , Mitrakul Chulee
Published: November 2007

A case of lead encephalopathy in a 2-month-old child is reported. Modes of poisoning are discussed and the unusual clinical manifestations of metallic brownish discoloration of nails and subdural effusion are presented. The pos sibility of lead poisoning as a cause of convulsions in neonates should be con sidered by doctors caring for these patients. Detailed history of lead exposure in prenatal and postnatal periods aids in early diagnosis and treatment which, thus, prevent severe neurological sequelae.
PKU and Temperament
Authors: Schor David P.
Published: November 2007

Parents of children with PKU completed behavior rating forms for their children three through seven years old. The 25 completed forms represented 79 percent of the families con tacted ; 16 of the children had PKU and 9 were siblings of children with PKU. Of the 16 children with PKU, 15 were on phenylalanine-restricted diets at the time of the study. The children with PKU were rated as significantly more rhythmic, more intense, and less persistent than the siblings without PKU. When ratings were compared with those obtained from a private pedi atrics practice, children with PKU were significantly less persistent and the siblings were sig nificantly less rhythmic and less intense. There was a significant correlation between blood phenylalanine levels and persistence ratings, with children having higher blood levels tending to be rated as less persistent than children having lower blood levels.
Computer Software Design for Pediatric Practice
Authors: Williams Thomas H.
Published: November 2007

Practical applications for using computers in everyday medical practice have not kept pace with the technical developments that now make this tool available to the pediatric practitioner. A modular approach to user-developed applications software is presented as a model for com puterizing the pediatric oflice. Benefits have included lower cost, greater data reliability and validity, standardization of office and medical procedures, and automation of jobs formerly requiring much personnel time. Some patient services have improved, and other new services have become possible, through the application of computer software designed in accordance with our practice philosophy.
Chlamydia trachomatis Infection in Infants Delivered by Cesarean Section
Authors: La Scolea Leonard J. , Paroski John S. , Burzynski Lorraine , Faden Howard S.
Published: November 2007

This report describes a well documented case of Chlamydia trachomatis pneumonia in a child delivered by cesarean section. The case indicates that infants delivered by cesarean section are still at risk of developing chlamydial infection. Various routes of infection are discussed, with a review of chlamydial disease in infants born by cesarean section.
Retinoblastoma Metastatic to Bone Marrow
Authors: Friedman Henry S. , Kurtzberg Joanne , Croker Byron , Falletta John M. , Kinney Thomas R.
Published: November 2007

A 28-month-old white male, 7 months status postenucleation for retinoblastoma, presented with lethargy, irritability, anemia, and thrombocytopenia. Bone marrow examination revealed almost total replacement of marrow elements with clumps of small round basophilic cells. Electron microscopic study of the marrow revealed clumps of cohesive tumor cells with intermediate junctions, establishing a diagnosis of metastatic retinoblastoma.
Survival in Infants with Anencephaly
Authors: Baird P.A. , Sadovnick A.D.
Published: November 2007

There is little available literature on survival data in the form of lifetables for babies born with anencephaly. These data would be valuable in advising parents, who often request very specific information on the length of time their child might survive. Survival is examined for a cohort of anencephalic infants in a well-defined population. Sex-specific survival tables are given, since these are the most practical to use for counselling purposes. These data show that over 40 percent of liveborn anencephalic infants (51 % males; 34% females) survive longer than 24 hours, and of these, 5 percent are still alive on the seventh day. Data also are presented on the types of mal formations observed in addition to anencephaly.
Campylobacter Enteritis
Authors: San Joaquin Venusto H. , Welch David F.
Published: November 2007

Campylobacterjejuni was isolated from 135 infants and children seen at the Oklahoma Children's Memorial Hospital over a 3-year period. The comparative frequency of isolation of C. jejuni, Salmonella, and Shigella were 1.5 percent, 2.2 percent, and 3.1 percent, respectively. Campylobacter enteritis was most prevalent during the warm months from May to October, peaking in July. Seventy percent of the afflicted children were 2 years old or younger; only 13 percent were older than 5 years. There were the usual clinical presentations (acute onset of diarrhea, fever, abdominal pain, and bloody stools) of Campylobacter enteritis, but other, less common, patterns also were seen. These included chronic diarrhea without significant systemic manifestations; asymptomatic bloody stools, particularly in neonates; and fever and abdominal pain without diarrhea. Severe complications included hemolytic-uremic syndrome, sepsis associated with septic arthritis and osteomyelitis, and failure to thrive.
Emergence of Beta -lactamase-prod uci n g Aerobic and Anaerobic Bacteria in the Oropharynx of Children Following Penicillin Chemotherapy
Authors: Brook Itzhak , Gober Alan E.
Published: November 2007

The acquisition of beta-lactamase-producing aerobic and anaerobic bacteria was investigated in 21 children treated with penicillin for otitis media or pharyngitis and in 18 untreated control children. Beta-lactamase-producers were isolated in three children before and in ten children after treatment (p = 0.04). Although the variety of bacterial species isolated did not change following treatment, beta-lactamase-producing Bacteroides melaninogenicus, B. orulis, and Branhamella ca tarrhalis were encountered only after therapy, while some beta-lactamase-producing Staphylococcus aureus and Hemophilus influenzae were found before treatment. The incidence of beta-lactamase- producers did not increase in the control children. Spread of beta-lactamase-producers to household contacts by 12 treated and 13 normal control children also was studied. Ten of the treated children and 15 of 33 of the household contacts harbored beta-lactamase-producers, while none were found in normal control children and only two were found in 27 of their household contacts (comparison of the two household contacts, p < 0.01).
Kyphosis and Pulmonary Function in Cystic Fibrosis
Authors: Logvinoff Marie-Martine , Fon Gerald T. , Taussig Lynn M. , Pitt Michael J.
Published: November 2007

Spine deformity and chronic pulmonary disease are commonly seen in patients with cystic fibrosis (CF). In order to assess the prevalence of kyphosis, a retrospective evaluation of all initial standing chest radiographs of our CF patients matched with our "reference" population was undertaken. We also studied the possible correlation between the degree of kyphosis and the pulmonary function tests (PFTs), consisting of thoracic gas volume and maximal expiratory flows. In our population, the study canfirmed an increased prevalence of kyphosis in CF patients (p < .01), which occurred mostly in girls after 12 years of age (p < .018). The kyphosis appeared to be, in most instances, of mild degree and was not related to any of the PFTs. No measurable increase of kyphosis was observed over a 3-year period in the group. Longer prospective study and the relationship of kyphosis to endocrine function in CF at puberty should be undertaken.
Childhood Osteomyelitis
Authors: Okoroma Edwin O. , Agbo Daniel C.
Published: November 2007

During the years 1976 through 1980, 118 children with osteomyelitis were seen at our hospital, an incidence of almost 24 cases per year. Twenty-eight of these had sickle cell disease. Males were more commonly affected than females, with a ratio of 2.1 to 1, and bones of the lower extremities were more commonly involved, than those of the upper extremities with a 2 to 1 ratio. Seventy patients were anemic, with hemoglobin levels of 10 g/dl or less. Staphylococcus aureus was the most common organism isolated from patients with sickle cell disease, as well as those with normal genotype.
Pediatric Aerosol Therapy Guidelines
Authors: Alderson Sheila Horan , Warren Robert Hughes
Published: November 2007

Delivery of medication in aerosol form to the pediatric population is an important therapeutic module. Aerosol therapy allows rapid medication effects, reduces systemic side effects, and provides uniform results in comparable clinical presentations if preparation techniques and dosages are appropriate. The effectiveness of aerosol therapy is dependent upon several key factors, and techniques developed to emphasize these factors will maximize aerosol delivery into the tracheo bronchial tree. Indications for medical aerosol therapy are specific for children, and individualized treatment can be structured for a wide variety of pulmonary disorders. Proper and successful administration of aerosol therapy to the infant or child requires a comprehensive amount of skill and knowledge on the part of the respiratory therapy practitioner. Guidelines discussed in this paper will assist the respiratory care practitioner in achieving optimal results in treating airway disease in the pediatric patient.
Presumed BCG Infection in a Boy with Chronic Granulomatous Disease
Authors: Kobayashi Yohnosuke , Komazawa Yoshitaka , Kobayashi Masao , Matsumoto Takahiko , Sakura Nobuo , Ishikawa Kayoko , Usui Tomofusa
Published: November 2007

A male child with chronic granulomatous disease (CGD) developed protracted axillary lymphadenopathy with liquefaction following a bacille Calmettle-Guérin (BCG) immunization. Except for phagocytic dysfunctions characteristic of the un derlying disease, immunological examinations were normal. The literature dealing with CGD cases with disseminated BCG infection was reviewed. It is concluded that the possibility of CGD should be considered in those who develop such adverse reactions to BCG immunization.
A Case Report of Lingual Lymphangioma Presenting as Recurrent Massive Tongue Enlargement
Authors: Rice James P. , Carson Stephen H.
Published: November 2007

Lymphangiomas are benign congenital tumors that frequently result in ma croglossia. Tongue involvement may lead to airway obstruction, swallowing difficulties, mandible-dental deformities, and speech disturbances. This case report demonstrates the many difficulties in diagnosis and management. Reduction in tongue size with preservation of motor and sensory function is best accomplished by wedge resection of the tip of the tongue.