bluuebunny/crossref_metadata_2025 huggingface dataset:
OBSERVATIONS ON A TRIP TO RUSSIA
Authors: Senn Milton J. E.
Published: December 2021

In May of 1958 I visited Russia for the purpose of learning about child care and child rearing practices. Although up to that time about 25 scientists had visited Russia in order to make various studies, no pediatrician had been there with the specific purpose that I had in mind. Some of the visitors had been social scientists, and there had been a few social workers. These persons were interested in the behavior of the Russian people, particularly the family life and the manner of educating and rearing children. My purpose was also to visit Professor Nicholas Krasnogorski in Leningrad, who is an honorary member of the American Pediatric Society. I will begin this account with the story of my visit to his laboratory and apartment.

I had met Professor Krasnogorski in 1932 when the American Pediatric Society met at the Mayo Clinic. At that time he presented a paper on the treatment of enuresis by feeding children salty foods at bedtime. I remember him very well, and before leaving for Russia I had written him of my plan to visit Leningrad, with the date set at about May 12. I arrived in Leningrad a day late, but after checking in at the Ministry of Health of that city, I was given a message from Professor Krasnogorski saying that he was expecting me. The following day I arrived at his laboratory at 11:00 A.M., as he had suggested. This was housed in a building of two or three stories, a plain stucco exterior badly in need of paint, and approached by a road which was deeply rutted and worn, and which had never been paved. At the doorway of this institute I was greeted by a woman member of the staff and taken at once to Professor Krasnogorski's laboratory. He greeted me cordially. He is now 76 years old, frail in appearance, but clear in mind. He spoke English very well and understood me perfectly.

I was impressed with the smallness of the rooms of his laboratory and with their overcrowding. There was much electronic apparatus as well as kymographs and conditioning apparatus. He showed me graphs that he had made of infants beginning to speak, and told me that his great interest now was in trying to learn more about the development of human speech, and by use of pavlovian methods to try to understand the workings of the higher nervous centers. He spoke with great enthusiasm, and believed that he had finally overcome some of the obstacles in our understanding of speaking processes. He credited his success to the pavlovian method, which he had first learned from the master, and whose colleague he had been for 26 years.
PEDIATRICS AND SOCIETY
Authors: Richmond Julius B.
Published: December 2021

A recent editorial entitled "Can the new pediatrics be practiced?" raised many significant issues which deserve elaboration. The "new" pediatrics has been developing over a period of years and it might be advantageous, therefore, to view the development of current pediatric practice and education in the somewhat broader historical perspective of social process. Since each person views social process from the vantage point of his own background and experience, these observations are not presented with the thought that they are a consensus of pediatricians generally. I should emphasize at the outset, however, that I am not presenting value judgments, but rather that I am making an effort to record certain trends of which we should take note. For if we are aware of social process, we are in a better position to direct it in the interests of progress rather than to drift randomly.
ANTIMICROBIAL AGENTS
Authors: Lepper Mark H. , Riley Harris D.
Published: December 2021

Hyperacute infections, i.e., infections which are often fatal within 24 hours from the onset of symptoms, and resistant strains of organisms, account for the vast majority of failures in the use of antibiotics. A few cases cannot be classified into either category and remain as unexplained failures.

The magnitude of the problem of hyperacute infections can be judged by the fact that in a contagious disease hospital about a third of the fatalities from nontuberculous, bacterial infectious diseases occur within the first 24 hours from the onset of symptoms. Meningitis due to meningococcus or pneumococcus, or meningococcemia, are most commonly encountered in this group. In Dr. Lepper's experience, those patients who will die within 24 hours from onset of symptoms can be predicted early from clinical observations, and they command "heroic therapy."

A lively discussion of the use of adrenal corticosteroids as pant of "heroic therapy" in hyperacute infections ensued. Dr. Riley pointed out that they are useful agents but have serious side effects and definite hazards. They are known to decrease the resistance of the host to infection. (The effect of cortisone on streptococcal infections in the rabbit was cited: 58 out of 66 rabbits pretreated with cortisone died; 5 of 60 control animals died.) Instances of empyema developing during treatment of pneumococcal pneumonia with both antibiotics and ACTH were described. The discussants agreed that at no time should adrenal corticosteroids be used in the treatment of infectious processes without simultaneous administration of adequate amounts of appropriate antibiotics.
Letters to the Editor
Authors: POLHEMUS DONALD W.
Published: December 2021

The perceptive comments of Dr. Miller are basically correct and we are only too aware of the many sources of possible bias in compiling and interpreting data such as these. Perhaps a few of the problems which he raises can be clarified by the following additional information.

Questionnaires were given to parents of normal control children when they left the hospital; they were usually mailed to parents of leukemic children. Except to clarify doubtful information and to secure quantitative data on deep radiation therapy the parents and physicians were not further contacted. The questionnaires were returned by parents of 79% of leukemic children and 67% of healthy control children. We feel that these rates are adequate to exclude bias on the basis of type of patient returning the data.
Methods for Research in Human Growth
Authors: FALKNER FRANK
Published: December 2021

In his admirable Foreword to this book, Professor Ashley Weech describes how he would reply, somewhat nettled, to those remarking that growth investigators had first to chart normal seas before paediatricians could spot the abnormal. His laudable reply was that doctors must describe what must be considered abnormal. He goes on to say what a pleasure it is in this volume to find a joining of minds. Indeed there has been.

The authors state, in an excellent introduction that each chapter could be expanded into a separate monograph but that the book is expressly modest. It is noteworthy that in spite of truly voluminous data collected and published on growth and development in the past, rarely has method been described, critically, educationally, or in detail.
CARDIORESPIRATORY SYNDROME OF OBESITY IN A CHILD
Authors: Jenab Morteza , Lade Roswith I. , Chiga Masahiro , Diehl Antoni M.
Published: December 2021

A 6-year-old child with the cardiorespiratory syndrome of obesity is presented. No definite evidence of intrinsic pulmonary disease could be demonstrated at necropsy. A review of the medical literature reveals no previously reported cases in children.
Ciba Foundation Colloquia on Endocrinology, Volume XII
Authors: VAN WYK JUDSON J.
Published: December 2021

The Ciba Colloquia on Endocrinology continue to provide the most penetrating discussions available on specific endocrine topics. Volume XII of this series is devoted exclusively to a consideration of functional tumors of the endocrine glands.

The volume contains 20 formal presentations of work carried on by leading American and European investigators. Each report brings together in a meaningful way observations which are scattered throughout various technical journals. Each paper is followed by a verbatim transcript of the discussion which ensued. Frequently the discussion proved to be more illuminating than the original presentation.

Secreting tumors of the endocrine glands occur spontaneously with considerable frequency in laboratory animals.
THE RESPIRATORY DISTRESS SYNDROME AND ITS SIGNIFICANCE IN PREMATURE INFANTS
Authors: Bauman William Allen
Published: December 2021

THE RESPIRATORY distress syndrome of the newborn period is recognized as a clinical entity predominantly afflicting newborn premature infants. Although disorders of the cardiovascular and central nervous systems as well as metabolic derangements are capable of causing a newborn infant to have dyspnea, in those who die the pathologist more frequently finds pulmonary disease. Microscopic examination of the premature infant's lung often discloses atelectasis, emphysema, edema, pneumonia, hemorrhage, aspiration of amniotic debris and the presence of hyaline membrane. In a previous study a significant relationship between respiratory difficulty in early life, pulmonary roentgenographic abnormalities, and the presence of pulmonary hyaline membrane at necropsy was demonstrated.

Curtis has most recently reviewed much of the literature relating to etiology and treatment of "hyaline membrane disease." The clinical manifestations of the syndrome, however, have been infrequently recorded. Miller and Jennison in a survey of more than 4,000 births indicated that the infants who died with hyaline-like material in the lungs had had symptoms characterized by marked respiratory difficulty including retraction of the lower chest wall on inspiration. Parmelee stated that dyspnea was frequently associated with retractions of the rib margins and lower sternum and that there also was grunting and cyanosis to a varying degree. Blystad showed that 15 of 25 dyspneic newborn prematures who died had hyaline membrane formation in the lungs. It is the purpose of this paper to present a clinical appraisal of the respiratory distress syndrome and further to demonstrate its relationship to the presence of pulmonary hyaline membrane at necropsy.

CLINICAL DIAGNOSIS

The newborn premature infant may manifest the respiratory distress syndrome by several physical findings. Characteristically he breathes as if he has glottic obstruction; intercostal retractions accompany strong inspiratory movements.
Staphylococcus Pyogenes and Its Relation to Disease
Authors: SPRUNT KATHERINE
Published: December 2021

This is a lengthy review of the current state of our information on the "Staphylococcus pyogenes." As the author points out in his preface, workers in quite unrelated fields writing in many different tongues in journals of varied disciplines have all contributed to this pool of information, but the pool has become so vast and subspecialization therein so minute that there is real need for a monograph to help in the "merging of ideas."

The book goes a long way toward filling that need. There could not be much work that the author has not at least noted and his references are clearly documented. If for no other reason, his book would be valuable for its collection of about 200 pages of references which fortunately include titles.
RESPIRATORY ILLNESS IN CHILDREN SIMULTANEOUSLY INFECTED WITH HEMADSORPTION VIRUS TYPE I AND A NEWLY RECOGNIZED HeLa ENTEROVIRUS (HE)
Authors: Cramblett Henry G. , Kasel Julius A. , Utz John P.
Published: December 2021

An outbreak of undifferentiated respiratory illness among children in a convalescent hospital is described. The illness was characterized by fever of short duration, erythema of the palpebral conjunctivae, rhinorrhea, cough, pharyngeal erythema and rhonchi.

Serologic and virologic evidence is presented indicating simulanteous infection in the involved children with type 1 hemadsorption virus and a newly-recognized HeLa enterovirus (HE virus).
GENETIC ASPECTS OF PEDIATRIC ENDOCRINOLOGY
Authors: Gardner Lytt I. , Rosenthal Ira M. , Feinberg Richard J.
Published: December 2021

Dr. Gardner: Historically pediatricians have been in the vanguard of the social and scientific forces improving the health and well-being of their patients—the children of this country. Indeed, we have the heavy responsibility of carrying on the proud tradition of our professional great-grandfather, Dr. Abraham Jacobi, who came to these shores in the aftermath of the German Revolution of 1848, and who eventually rose to the presidency of the American Medical Association. As the pioneer in American pediatrics, Jacobi never failed to let his position be known on controversial issues. His intuitive Jeffersonian grasp of the democratic process facilitated his rôle in the early development of pediatrics here. Jacobi's coat has, in a sense, fallen upon our shoulders, and American pediatrics must continually be on the alert to live up to what he would have expected of us.

Therefore let me come directly to the problem at hand. As we know, the relative number of children with congenital defects in our hospitals is very much greater than 25 years ago. Recently in our hospital we tabulated the cases over a 5-month period, and found that 30% of the pediatric inpatients were there because of congenital defects. This apparent increase is almost certainly due in large part to the reduction in patients with infectious disease, but the figure of 30% still must remind us that the care of children with congenital defects is a field of major importance in modern pediatrics. How many of these defects are genetically determined is not known for sure, but certainly a considerable part of this group of patients represents inherited disease. As is obvious from the syndromes we will take up in this endocrine round table, nearly every one of these conditions is genetically determined, that is to say, the result of a mutation which has taken place in the human hereditary material.
Pediatric Neurology
Authors: PRICHARD JOHN STOBO
Published: December 2021

It is generally considered that a good textbook should be either very complete or relatively short and readable, describing the most important clinical conditions in some detail and briefly mentioning the rest. This book is certainly not a comprehensive account of the neurologic diseases of childhood. Neither is it very short. But it does contain some useful material. In particular there is a practical account of the problems of cerebral palsy, and the cerebral infections are covered in some detail.

Some people will disagree with a number of statements in the book.
DELAYED NEUROPATHY AFTER INJURY TO THE CERVICAL SPINE IN CHILDREN
Authors: Zike Kenneth
Published: December 2021

Two young children with severe, progressive, delayed neuropathy after trauma to the cervical spine were studied. The syndrome has not been reported previously in this age group. One patient succumbed 3 years after the injury, and the other is totally and permanently disabled 5 years after the injury by a spastic quadriplegia.

The danger of delayed neurologic disability after cervical trauma may be minimized by the following diagnostic and therapeutic considerations:

The possibility of cervical injury after trauma must be recognized and appropriate caution exercised in moving the patient, in planning diagnostic study and in assuring persistent close follow-up, even in young children.

When a patient is first seen with neuropathy after a silent interval, diagnostic suspicion is no less essential. Probing inquiry may be necessary to disclose the original injury. Careful attention to physical findings may localize the injury, suggest its nature and possible mechanism of occurrence.

Apparently normal routine roentgenograms of the cervical spine should not be allowed to exclude the diagnosis, particularly if they are incompatible with historic and physical information.

Whether the case is acute or chronic, no diagnostic path should be neglected until a firm diagnosis is clearly established.

Persistent follow-up is essential, even during periods of apparent remission.

Consultation should be undertaken freely with pertinent specialists whose particular skills may assist or be essential to a favorable outcome.
Pathophysiology in Surgery
Authors: SANTULLI THOMAS V.
Published: December 2021

In this period of heavy and bulky multiauthored textbooks with the uneven degrees of excellence in the large number of subjects contained between their widely separated leaves, it is refreshing to read through one of single authorship which is concise and uniform in its approach. Doctor Hardy is to be congratulated on cramming the essentials of surgical physiology into 644 well written pages which most surgeons and pediatricians will find worth reading.

In preparing this book the author compiled material which encompasses the common physiologic problems that are encountered in general surgery. His major effort seems to have been directed to presenting this material in relation to actual patient care and in this he has been successful.
MESENTERIC CYSTS IN INFANCY AND CHILDHOOD
Authors: Arnheim Ernest E. , Schneck Herman , Norman Alex , Dreizin David H.
Published: December 2021

The pathologic, clinical and radiologic features, diagnosis and treatment of mesenteric cysts in infancy and childhood, based upon a study of 82 cases in the literature, are discussed. An additional case of mesenteric cyst is presented.

Mesenteric cysts were usually noted in male children from 2 to 10 years of age, presenting with abdominal enlargement and abdominal pain, and revealing characteristic roentgenographic findings.

Excision of the cyst was often complicated by adhesions to the intestinal wall; simultaneous resection of the involved intestine has become a safe procedure, with an operative mortality of 7% in recent years.
THE SEARCH FOR KNOWLEDGE OF THE CHILD AND THE SIGNIFICANCE OF HIS GROWTH AND DEVELOPMENT—EXAMPLES FROM THE HARVARD LONGITUDINAL STUDIES
Authors: Stuart Harold C.
Published: December 2021

First, I wish to express my deep appreciation for the Borden Award of the American Academy of Pediatrics and the recognition which it conveys, not only for my studies over the past 30 years but for the work of my associates who have contributed to them in many ways.

Before discussing the studies for which I have been responsible I wish to emphasize that search for knowledge of the child has been undertaken by many people at different periods in many places and that pioneering in this particular field was underway in several places before I became interested in it. Also, several groups have been pioneering concurrently with us in the same or closely related fields. The Academy has already conferred a Borden Award on Washburn, who has been conducting most extensive longitudinal studies of children. That project and the one at the Fels Foundation, Antioch College, Ohio, under the direction of Sontag, were started at about the same time and are still continuing and expanding under the original direction. Time does not permit even naming the other projects which have been in operation over recent years in this and related fields.

During the first two decades or more of the present century various cross-sectional studies were made and norms were developed to describe populations of children by age, supposedly to help to distinguish the abnormal from the normal child. The concept gradually emerged however, that to fully understand the significance of a child's developmental status it was necessary to follow his progress periodically and to obtain concurrently information as to the major features of his life experiences.

I had the good fortune in 1928-1929 through two chance occurrences to be brought into this field of inquiry and to have close contacts with several leaders in it.
COPPER AND PROTEIN DEPLETION COMPLICATING HYPOFERRIC ANEMIA OF INFANCY
Authors: Schubert William K. , Lahey M. E.
Published: December 2021

Fourteen infants are described with a syndrome consisting of iron-deficiency anemia, hypocupremia and hypoproteinemia. Significant retardation of growth was noted in one-half of the patients. Evidence is presented to indicate that the hypocupremia is due to copper depletion and is not secondary to the hypoproteinemia. Abnormalities in the absorption and utilization of iron were not observed. Study of an additional 54 infants with iron deficiency anemia and normal or elevated levels of copper in the serum reveals a significant degree of growth retardation and hypoalbuminemia, both of which correlate well with the severity of the anemia.

Hypotheses consistent with the results obtained are discussed. The possibility is proposed that initial severe deficiency of iron, resulting in marked anemia, led to protein depletion, and this in turn to impaired copper retention and consequent development of the complete syndrome.
CONCENTRATION OF GAMMA-GLOBULIN IN THE SERUM OF INFANTS DURING THE FIRST 3 MONTHS OF LIFE
Authors: Trevorrow Virginia E.
Published: December 2021

Studies of gamma-globulin on 16 infants at ages 3 days, 1, 2, and 3 months show a drop in concentration which results primarily from dilution in an expanding plasma volume. The total circulating gamma-globulin remains relatively constant from age 3 days through the first 3 months of life. As degradation of protein is probably taking place, it is concluded that the normal loss is being replaced by synthesis by the infant.
Krankheiten Der Neugeborenen (Disease of the Newborn)
Authors: ULICH KONRAD
Published: December 2021

A short compendium for students and physicians interested in the treatment of disease of the newborn period coming from behind the "Iron Curtain." The book shows an extensive knowledge of the "Free-World" medical literature on such subjects as erythroblastosis fetalis, cytomegalic inclusion disease, toxoplasmosis and other diseases of recent interest.

A chapter on infant mortality is extensive and shows a similar decline of the death rate over the last decades as in the United States. The over-all mortality during the first year of life per 1,000 live-born in 1954 shows 49.6 deaths/1,000 in East Germany and 42.2 deaths/ 1,000 in West Germany. Infant mortality in the United States amounted to 26.4 deaths/1,000 in 1955.
Letters to the Editor
Authors: ANDERSON DAVID W. , HOWARD HARTLEY W.
Published: December 2021

Van Wyk et al. have reported a case of goiter and hypothyroidism in an infant maintained 8 months on a diet of soybean milk (Mull-Soy®). Their studies of this case and comparison with apparently normal individuals have led them to infer the presence in soy of a goitrogen which, in susceptible persons, modifies thyroid metabolism.

We are studying the effect of soybean products on thyroid activity in rats and it seems desirable to present certain preliminary observations at this time.

Rats, housed in individual wire-screen cages, were fed diets simulating soybean milk in composition and fortified with vitamins and iron to meet the known requirements. Water, ion-exchanged to remove traces of iodine, was provided ad libitum.
Simplified Fixation and Staining for Delineation of Nuclear Chromatin by the Barr Technique
Authors: ROBINSON A.
Published: December 2021

Examination of smears of the buccal mucous membrane for nuclear chromatin has become a useful clinical tool in the evaluation of conditions involving questions of chromosomal sex. Although actual delineation of the complete chromosomal constitution of the patient's somatic cells yields more information than the nuclear chromatin determination alone. the latter test is extremely useful because of its simplicity. This makes it readily available for use on any patient and applicable to large populations as a screening procedure for detection of certain kinds of anomalies. Hence, it seems worthwhile to call attention to the following modification of the Barr test for nuclear chromatin, which is more rapid than the original procedure, but appears to be every bit as reliable.
TRANSIENT SYNOVITIS OF THE HIP JOINT IN CHILDREN
Authors: Spock Alexander
Published: December 2021

A clinical review of 47 eases of transient synovitis of the hip joint occurring in patients less than 14 years of age is presented.

Evidence from clinical, bacteriologic and serologic data is presented to show that in four patients acute streptococcal infection was associated with the development of transient synovitis. In one other patient clinical and serologic data disclosed a similar parallelism with an infection by the Coxsackie B virus. These findings suggest that these agents may be among those etiologically responsible for this syndrome.

An obese or stocky physique probably predisposes a child to this disease.

Patients with transient synovitis do not have any diagnostic abnormalities which can be detected by roentgenographic examination.

Prevention of weight bearing by bed rest until the patient is completely asymptomatic provides the best form of therapy, and failure to follow such treatment results in prolongation of the illness. Antibiotics do not appear to influence the course of the disease.

Three patients in this series developed Legg-Perthes disease within an interval of 3 to 17 months after convalescing from transient synovitis of the hip.
IN PURSUIT OF THE STREPTOCOCCUS
Authors: Hollinger Nell F. , Rantz Lowell
Published: December 2021

Two new laboratory techniques for recovery and identification of beta-hemolytic streptococci are reviewed. One of these is an augmented culture medium containing nucleic acid, maltose and neomycin in addition to the classic agar base. Increased use of throat culture has followed a field trial of this augmented medium, with which pediatricians experienced no difficulty in distinguishing beta-hemolysis in the recognition of streptococci. The other technique, identification of streptococci with fluorescent antibody, affords a rapid means of grouping and typing on direct throat smears in those locations in which the equipment and specific fluorescein-tagged antisera are available.

Results are reported on the recovery of beta-hemolytic streptococci after transport on inert material (a Dacron-tipped throat swab in a tube with desiccant and on a Filter Paper Strip in a kit). Field trials in pediatric clinics and offices resulted in recovery of 90.5% of all positives using the Filter Paper Strip and 50.5% of the positives when swabbings were plated as controls from paired throat cultures on 1,017 children. The Filter Paper Strip technique is recommended as a reliable means of bringing the laboratory to the pediatrician. Similar trials of the Dacron swab with desiccant accounted for 80% of the positives from paired throat cultures on 552 children, with 73% positives from control cultures. The Dacron-tipped swab with desiccant technique was ready for reference laboratory study.

In the field trials of the Filter Paper Strip and Dacron-tipped swab techniques, the beta-hemolytic streptococci were isolated and classified by group and type. Of 193 positives, 82% were Group A, the rest were Group B, C or G; one-fifth were Group A, type 12. Percent by group and type is essentially the same as that reported in an earlier study of the same population. The proportion of Group C and G streptococci is high, one-seventh of the total. The proportion of Group A, type 12 organisms appears to warrant study of possible association between streptococci and glomerulonephritis in these population groups.

The new augmented culture medium, the rapid grouping and typing with fluorescent antibody, and the recently developed technique for transport on inert material enhance the value of laboratory aids to the clinician in recovery and in the identification of beta-hemolytic streptococci from throat cultures.
TRANSMISSION OF HOSPITAL STAPHYLOCOCCI AMONG NEWBORN INFANTS
Authors: Hurst Valerie
Published: December 2021

The rate and sequence in which various body areas of the newborn infant acquire coagulase-positive staphylococci was studied in two hospitals at a time when nursery infections were not occurring. The infants became colonized rapidly on numerous body surfaces in one nursery, and more slowly and less extensively in the other. Skin and rectal cultures usually became positive before those from the nose, throat, and eye. The groin and axilla of infants in one nursery tended to become colonized before the umbilical cord; in the other nursery, colonization of the umbilical cord often preceded that of the groin or the axilla. Different body sites of an individual infant often became colonized with different strains of staphylococci, as determined by phage typing, and two strains sometimes were detected in a single site.

The carrier state of the newborn infant can be assessed accurately only by culturing many body sites and by phage typing many colonies. Cultures of skin, rectum, and umbilical cord are likely to be more informative than nasal cultures, because the nose is often the last site to become colonized. The culture procedure which is most likely to portray the carrier state may have to be determined independently for each hospital nursery to be studied.

It may be difficult to prevent acquisition of hospital strains by applying bacteriostatic substances to the umbilical cord stump or portions of the skin because of the extent to which staphylococci multiply upon the skin, mucous membranes, and perhaps within the intestinal tract.
EPIDERMOLYSIS BULLOSA LETALIS
Authors: Roberts Maureen H. , Howell Denis R. S. , Bramhall James L. , Reubner Boris
Published: December 2021

Three cases of epidermolysis bulbosa letalis are described. The infants were born within 10 miles of one another and the three mothers were related, but showed no evidence of the disease. The fathers also were apparently healthy.

At birth all the infants had bullous skin lesions. These progressed in spite of meticulous nursing care, massive doses of antibiotics, corticosteroid therapy and increased dietary protein. The babies became pyrexial and the levels of serum albumin decreased markedly. At necropsy none of the infants had any significant lesions apart from the skin. It therefore seems that loss of serum albumin and electrolytes, and dermal sepsis were responsible for the deaths. Corticosteroid therapy appeared to be of no value. Replacement of lost fluids, on the other hand, would seem to be logical in such cases and should probably be a routine procedure.

Abnormalities were observed in the histology of the skin. The earliest lesion was a vesicular degeneration of the basal cells of the epidermis, followed by cleavage at the dermoepidermal junction. In the opinion of the authors, these early lesions produce a diagnostic histologic picture differing from other bullous dermatoses, except possibly some of the other variants of epidermolysis bullosa. A study of the epidermis in future cases of this disease by histochemistry or electron microscopy is likely to elucidate further the nature of the congenital defect in the basal part of the epidermis.
PITUITARY GONADOTROPINS IN GONADAL DYSGENESIS
Authors: Grossman Elmer R.
Published: December 2021

Four prepubertal girls with gonadal dysgenesis whose urine contained pituitary gonadotropin have been studied at various ages at the University of California Medical Center; considerable variation in urinary gonadotropin has been noted in three.

Urinary gonadotropin levels should be determined in each case where the diagnosis of gonadal dysgenesis is entertained. More than a single 24-hour specimen of urine should be tested, as a single negative specimen may be followed by one containing a diagnostically significant amount of gonadotropic activity. [See FIG. 1. in Source Pdf.]
Neurological Complications of Lymphomas and Leukemias
Authors: CRAMBLETT HENRY G.
Published: December 2021

In a retrospective study, the authors have reviewed the hospital records of 5,778 patients with Hodgkin's disease, lymphosarcoma, multiple myeloma, and leukemia. A total of 795 neurobogic complications occurring in 745 patients were discovered which represented a patient incidence of approximately 13%. The complications which were encountered included spinal cord compression, infiltration of intracranial structures, compression and infiltration of peripheral and cranial nerves, intracranial hemorrhage, infiltration or invasion of the pituitary by tumor cells, and central nervous system infections occurring in association with the various malignancies.
A CONTROLLED TRIAL OF EDATHAMIL CALCIUM DISODIUM IN ACRODYNIA
Authors: McCoy James E. , Carré Ivo J. , Freeman Mavis
Published: December 2021

A small controlled trial of edathamil calcium disodium in acrodynia (pink disease) showed no statistically significant effect on the progress of the disease nor was there any evidence that elimination of mercury from the body can be accelerated by the use of this chelating agent.

Some comments are made on the role of mercury and of therapy in acrodynia.
Ciba Collection of Medical Illustrations, Volume 3, Part I. Upper Digestive Tract
Authors: BARBERO GIULIO J.
Published: December 2021

This volume of the magnificent series of the major anatomy and pathology of the systems of the human organism illustrated by Dr. Netter is a fine example of the high quality of this series. The illustrations are beautifully reproduced with great clarity. The drawings attempt the difficult task of illustration of the relationship between form and function and succeed well in graphically portraying present concepts of upper gastrointestinal physiology. The charts on mastication, vomiting, hunger and deglutition are particularly excellent examples of the graphic arts in the explanation of such complex processes. The text accompanying the illustrations is succinct, precise and well written.
Prediction of Growth
Authors: ANDERSON MARGARET , GREEN WILLIAM T.
Published: December 2021

We should like to be among the first to congratulate Stuart and Reed and their associates for their very significant contribution to child development research, which appeared in the November Supplement to Pediatrics (24:875, 1959). All who have dealt with the difficult problem of handling unwieldy, longitudinal data will particularly appreciate the careful organization and presentation of this valuable material and the original method here employed for its analysis.

Of especial interest to us was the section on "Patterns of skeletal development in the hand." At the meeting of the Society for Research in Child Development, April 5, 1957, we discussed some of our experiences with patterns of skeletal development and we quote from this report:
A Visit to the Soviet Union
Authors: KALB MARVIN L.
Published: December 2021

In his article in the July, 1959 issue of Pediatrics (24:113, 1959) Dr. Stokes makes an immensely valid point. Russia is changing, and changing quickly. There's no question, I feel, that Moscow's booming rates of economic growth have finally begun to be translated into more shoes, more dresses, and more apartments, and the Russian people seem to be pleased, and rather proud of their recent material progress.

It's a good thing that the American people are refocusing their thinking about the Soviet Union. The Russian people are not barbarians; they're rather nice, in fact. They don't all wear threadbare shawls—though many peasant women still do—and they're not swaddled so inhibitingly that they all develop perverted personalities, as some of our top sociologists would still have us believe. The fact is the old walls of distortion and preconception have begun to crumble under the impact of increasingly intelligent reporting about Russia and the Russians.
RUBELLA AS A CAUSE OF THROMBOCYTOPENIC PURPURA
Authors: Ferguson Arthur W.
Published: December 2021

Case histories are presented of two children in whom thrombocytopenic purpura followed rubella, and a third case is described in which purpura may have been secondary to a modified rubella infection. The serum of two of the children appeared to contain platelet agglutinins. The clinical features of these 2 and 17 other published cases of post-rubella purpura are summarized and discussed.

Some clinical and pathologic aspects of acute thrombocytopenic purpura in childhood are discussed, and it is suggested that infections mild enough to pass unrecognized, such as rubella, may precipitate the disease more frequently than is suspected.
CONSERVATIVE MANAGEMENT OF ACUTE RENAL FAILURE
Authors: Kaplan S. A. , Strauss J. , Yuceoglu A. M.
Published: December 2021

The observations during treatment of three children with acute renal failure by a conservative regimen of therapy are presented. One patient died. The regimen has also been applied to six adults with renal failure; one died.

The urine in the early stages of renal failure may be iso-osmotic with plasma and may represent unmodified fluid from the proximal tubules.

Cardiac failure associated with hyperkalemia or administration of excessive quantities of fluids is the most frequent cause of death in this disorder.

A regimen of therapy is described which embodies the following principles:

a) Limitation of daily fluid intake to insensible loss plus the urine volume of the previous day.

b) Restriction of sodium intake from the beginning to anticipate the development of acidosis.

c) Use of cation exchange resins to prevent excessive increase in the concentration of potassium in the serum.

d) Provision of adequate caloric intake through the administration of emulsified fat intravenously.

e) Treatment of hyperphosphatemia and hypocalcemia when they occur.

f) Continuation of careful supervision and therapy, even after the diuretic phase begins, since renal function continues to be severely restricted for several days afterwards.
Mechanisms of Hypersensitivity. Henry Ford Hospital International Symposium
Authors: HARRIS T. N.
Published: December 2021

This book represents an ambitious effort to collect recent information in a wide area of immunology. There are 48 individual papers divided among 12 different sections. Thus, although the title of the symposium refers only to hypersensitivity, there are sections not only on the specific reactions of the delayed and immediate types of hypersensitivity and on mechanisms which may be involved in these, or may modify them, but also on peripheral areas such an autoantibodies, and tolerance and rejection of transplanted tissue. There are also a number of groups of papers on humoral antibodies, on the detection and measurement of these, on the heterogeneity of antibodies, and on immunologic unresponsiveness. Although this book does not purport to represent current developments in the entire field of immunology, its coverage is quite broad.
Differentialdiagnose Neurologischer Krankheitsbilder
Authors: ZELLWEGER HANS
Published: December 2021

Bodechtel and his group approach the task of writing a differential diagnosis in two ways. They devote a small section of the book to describing a few important signs and symptoms, such as headache, unconsciousness and cerebral paroxysms, as separate topics, giving their clinical significance, diagnostic value and special attributes in the various diseases and conditions. The subject matter in the remaining divisions of the book is organized nosologically and the different neurologic diseases are discussed.

Etiology and pathogenesis are mentioned but briefly. A thorough discussion of therapeutic problems is not within the scope of this book. Emphasis is given to clinical symptomatology and course and laboratory findings with special reference to their diagnostic significance.
INFECTIONS AND VIRILIZING ADRENAL HYPERPLASIA
Authors: VOORHESS MARY L. , GARDNER LYTT I.
Published: December 2021

PHYSICIANS who treat children with virilizing adrenal hyperplasia frequently question the proper course of therapy that should be followed when these patients are exposed to infectious diseases. Misconceptions have developed because of a tendency to confuse these patients, who need adrenocorticosteroids only for replacement therapy, with patients having other syndromes who are receiving suppression therapy.

Children with virilizing adrenal hyperplasia are given long-term treatment with physiologic amounts of adrenocorticosteroids to replace those steroids which their adrenal glands are unable to produce. It is hoped that their abnormally large adrenal glands can thus be reduced to a normal size. This is replacement therapy.

Children with asthma, leukemia, nephrosis, etc., may be given large doses of steroids in an empiric effort to induce remissions in these diseases.
Tumors of the Pancreas
Authors: BLANC WILLIAM A.
Published: December 2021

Like most of its predecessors, this new fascicle of the Atlas of Tumor Pathology will be a standard and practical reference work. Save for fibrocystic disease, pancreatic lesions are rare in the pediatric age group. There is, however, something of interest for the pediatrician in many chapters of this booklet, as for instance, a table of the 14 reported cases of carcinoma of the pancreas "in infancy and youth" (from 7 months to 19 years of age), or a brief account of idiopathic hypoglycemia in children. Every physician shall appreciate also, the compact presentations of "extrapancreatic tumors associated with hypoglycemia," "familial adenomatosis of endocrine glands" (Wermer) and Strøm-Zollinger-Ellisoin syndrome (insuloma associated with peptic jejunal ulcer).
Rheumatic Fever: Epidemiology and Prevention
Authors: RAMMELKAMP CHARLES H.
Published: December 2021

The 36 papers included in this symposium vary greatly in both length and manner of presentation. The book will be disappointing to the expert, since few data are presented and many of the contributions are merely abstracts or opinions. There are several notable exceptions. McCarty's review on the relationship of group A streptococci to rheumatic fever is excellent, as is the review of the epidemiology of these infections by Hedlund. The pediatrician will be interested in the data of Jersild which shows that sulfonamide treatment of hospitalized cases of scarlet fever did not reduce the incidence of this disease in the nurses, whereas since 1947, when these patients received penicillin no cases have developed among the nursing staff.
MUMPS VIRUS INFECTION SIMULATING PARALYTIC POLIOMYELITIS
Authors: Lennette Edwin H. , Caplan Gerald E. , Magoffin Robert L.
Published: December 2021

Eleven cases clinically considered to be mild paralytic poliomyelitis are reported in which there was clearcut serologic evidence of mumps virus infection. Poliomyelitis viruses were not isolated from the stools and complement-fixing and neutralizing antibodies to poliomyelitis were either absent (4 cases) or did not significantly change in titer between the acute- and convalescent-phase specimens of serum.

Clinically, fever, headache, vomiting, nuchal rigidity, stiff back, muscle pain and slight to moderate weakness of several muscle groups were prominent manifestations. The cerebrospinal fluid uniformly contained over 100 leukocytes and commonly over 300, predominantly lymphocytes. Only 2 of the 11 cases developed evidence of parotitis, and in these, parotitis did not antecede the central nervous system manifestations. Electroencephalograms were abnormal in 3 of 8 cases.

All 11 cases had evident muscle weakness at the end of the acute phase of illness, and four had slight residual weakness on convalescent examination 2 to 5 months after onset. There was no significant predilection for any muscle group.

These observations emphasize that central nervous system involvement with the virus of mumps may be manifested as a syndrome of meningomyelitis and be erroneously diagnosed as paralytic poliomyelitis. Weakness is usually highly transitory but residual involvement may persist for some months. As the incidence of paralytic poliomyelitis is reduced by widespread immunization mumps virus may assume increasing relative importance as a cause of "poliomyelitis-like" disease.
COMPARISON OF ACTIVITIES OF ISOCITRIC DEHYDROGENASE AND GLUTAMIC-OXALACETIC TRANSAMINASE IN SERUM IN INFECTIOUS HEPATITIS
Authors: Bodansky Oscar , Schwartz Morton K. , Krugman Saul , Giles Joan P. , Jacobs A. Milton
Published: December 2021

Activities of isocitric dehydrogenase (ICD) and glutamic-oxalacetic transaminase (GOT) in serum were determined concurrently and sequentially in 42 patients exposed to hepatitis virus.

In nine patients who developed clear clinical evidence of the disease, the maximal values for both enzymes were attained on the same day, but the relative rise in GOT was substantially greater. Considerations are presented for the preferential use of the latter enzyme as an aid in diagnosis of hepatitis.
A SIMPLE SOLVENT-PARTITION METHOD FOR MEASUREMENT OF FREE AND CONJUGATED BILIRUBIN IN SERUM
Authors: Eberlein Walter R.
Published: December 2021

A relatively simple solvent-partition method is described for the spectrophotometric measurement of free and conjugated bilirubin in serum. Experience with the method has demonstrated its empirical value in the routine study of jaundice in infants and children. The limitations of the method are emphasized.
THE HAZARD OF INDUCTION OF SWEATING IN CYSTIC FIBROSIS OF THE PANCREAS
Authors: Gorvoy Jack D. , Acs Hedda , Stein Martin L.
Published: December 2021

A fatality in a 2-year-old child with cystic fibrosis of the pancreas, which resulted from an attempt to collect sweat using a plastic bag to enclose the patient, is described. It is reported as a reminder of the potential danger of this procedure and of the need for caution in its performance.

This method should not be used in infants less than 3 months of age, because they produce so little sensible sweat.

A child to be subjected to this procedure should have a normal temperature, good hydration and little pulmonary involvement. The addition of external heat should be avoided.

The duration of time the patient is kept in the plastic bag should rarely exceed 1 hour, and the temperature of the child should be determined repeatedly during the procedure. There should be constant close supervision by medical personnel.
PROSPECTIVE EXPERIENCE WITH MATERNAL RUBELLA AND THE ASSOCIATED CONGENITAL MALFORMATIONS
Authors: Michaels Richard H. , Mellin Gilbert W.
Published: December 2021

The Fetal Life Study (1946-1959) recorded 25 instances of rubella infection during pregnancy. Exposure to rubella occurred during 95 other pregnancies. The results of these pregnancies and the follow-up of the infants is reported.

A summary of other prospective studies reported in the literature is also presented. The incidence and number of malformations per live-born child are discussed in relation to the time of maternal rubella during pregnancy. There appeared to be a decreasing risk of malformation in live-born infants from 47% (8/17) in the first 4 weeks, 22% (8/36) in the fifth through eighth weeks, to 7% (3/46) in the ninth through twelfth weeks. Although the trend appears to be definite, the Fetal Life Study and the six other studies summarized are quite diverse and the samples are small.

It is suggested that prospective observations be more completely reported and control observations also be made. There is dire need of objective laboratory techniques for the diagnosis of rubella.
SUGGESTED USE OF RECTAL BIOPSY IN THE DIAGNOSIS OF NEURAL LIPIDOSES
Authors: Nakai Hisayo , Landing Benjamin H.
Published: December 2021

The histochemical properties of nerve cells of the myenteric plexus in five forms of neural lipidosis (Tay-Sachs infantile amaurotic idiocy, Hurler's disease, Niemann-Pick disease, Jansky-Bielschowsky early juvenile amaurotic idiocy, and Spielmeyer-Vogt late juvenile amaurotic idiocy) are presented. These data, in conjunction with clinical features and other histologic properties of the colonic wall, provide a basis for the use of rectal biopsy in tile diagnosis and differential diagnosis of tile neural lipidoses.