bluuebunny/crossref_metadata_2025 huggingface dataset:
OBSERVATIONS ON GENERALIZED GLYCOGENOSIS WITH EMPHASIS ON ELECTROCARDIOGRAPHIC CHANGES
Authors: Caddell Joan L. , Whittemore Ruth
Published: December 2021

Clinical, laboratory, and postmortem studies on two cases of generalized glycogenosis diagnosed, and studies during life, and the family history of a third case are presented. An instance of consanguinity and of an afflicted brother and sister are noted in this small series. Serial electrocardiograms of both infants showed progressive left ventricular hypertrophy and variability in P, Q, S-T, and T waves over a period of months. Tracings of one patient revealed shifting atrial foci, ventricular coupling, and slight aberration in some of the ventricular complexes. Unexplained mild fructosuria was noted in one patient. Staining of circulating leukocytes for glycogen appears to be an unreliable diagnostic test.
INTERSTITIAL PNEUMONIA DUE TO PNEUMOCYSTIS CARINII, CYTOMEGALIC INCLUSION DISEASE AND HYPOGAMMAGLOBULINEMIA OCCURRING SIMULTANEOUSLY IN AN INFANT
Authors: Kramer Robert I. , Cirone Vincent C. , Moore Halcuit
Published: December 2021

A fatal case of Pneumocystis carinii pneumonia associated with generalized cytomegalic inclusion disease and hypogammaglobulinemia in a 6 month-old-infant has been presented. The differences between this case, typical of those that have been occurring in sporadic form, and the cases that occur in epidemic form have been discussed. It is the authors' belief that the hypogammaglobulinemia, directly related to the absence of plasma cells in the bone marrow and pulmonary parenchyma, was the predisposing factor in the pathogenesis of the Pneumocystis carinii pneumonia, and that the cytomegalic inclusion disease occurred because of the debilitated state of the patient brought about by the Pneumocystis carinii infection. Necropsy findings with electron-microscopic pictures of both the Pneumocystis carinii organism and and the cytomegalic inclusion disease virus have been presented. There is no specific therapy for Pneumocystis carinii pneumonia, although spontaneous recovery from the disease in its epidemic form may occur. In its sporadic form this disease has been universally fatal.
FEMALE PSEUDOHEMAPHRODITISM WITH DELIVERY OF A NORMAL CHILD
Authors: Avin Joseph
Published: December 2021

A typical case of congenital adrenocortical hyperplasia with a persistent urogenital sinus has been followed for 9 years from the initiation of steroid therapy at 12 years, through surgical correction of the genital anomalies, a ruptured tubal pregnancy, and finally to the delivery of a normal female infant. The literature is briefly reviewed.
An Atlas of Detailed Normal Pneumoencephalographic Anatomy, Giovanni DiChiro, M.D. Springfield, Illinois, Thomas, 1961, 328 pages, $19.00
Authors: Neuhauser Edward B. D.
Published: December 2021

For many years a number of excellent texts of normal pneumoencephalographic anatomy have been available. In this atlas, Dr. DiChiro, who is head of the section of Neuroradiology of the National Institutes of Health, Bethesda, Maryland, admirably supplements these previous studies. Utilizing 283 LogEtron reproductions of roentgenograms obtained during fractional pneumoencephalography, the detailed anatomy is clearly demonstrated. Most of the reproductions are accompanied by simple line and stipple sketches that are helpful as are identifying numbers and arrows placed, with a few exceptions, on the sketches alone, so that the excellent roentgenograms are unmarred by numerous reference marks.
SULFOBROMOPHTHALEIN SODIUM METABOLISM IN NEWBORN INFANTS
Authors: Sussman Sidney , Carbone J. V. , Grodsky G. , Hjelte V. , Miller Phebe
Published: December 2021

With the use of a standard dose of sulfobromophthalein sodium (BSP), the metabolism of this substance was studied in a group of full-term and premature infants (normal, hypoxic, and hyperbilirubinemic). Elevated total BSP and BSP conjugate at birth in normal full-term and premature infants approached normal adult levels toward the end of the third week of life. There was no significant difference between the rate of decrease of total or conjugated BSP in the full-term and premature infant. During the first 20 days of life the decrease in total BSP levels proceeded at a faster rate than the decline in BSP conjugate in both normal groups. The mean concentrations of total BSP and BSP conjugate were higher in infants with hypoxia, hyperbilirubinemia, and hemolytic disease of the newborn than in normal infants, but the difference was not statistically significant.
MASSIVE HEMORRHAGE IN THE SCALP OF THE NEWBORN INFANT
Authors: Pachman Daniel J.
Published: December 2021

A newborn infant with massive hemorrhage within the fascial planes of the scalp has been described. The bleeding was above the periosteal layer of the scalp and was therefore a hemorrhagic caput succedaneum rather than a giant cephalhematoma. Massive hemorrhage in the scalp of an infant should be treated as a medical emergency, and fresh whole blood should be given to prevent severe anemia and posthemorrhagic shock.
PRESIDENT'S MESSAGE
Authors: TOOMEY JOHN A.
Published: December 2021

TWO things have disturbed our members: first is the appeal for Federal Aid; second, the dictatorial manner in which the appeal for Federal Aid was presented. 1st. All must realize by now that there exists an acute financial situation in many medical schools. This has had the earnest thought of the Committee on Medical Education of the AMA and the deans of the Association of Medical Colleges who met just two weeks ago.

The educators are fully apprized of the reasons against such a move which would eventually mean the loss of their liberty and State Medicine; they realize that the Supreme Court has ruled that subsidies imply control; they know that Government operation is wasteful, inept and graft-ridden; they see the Army build unnecessary hospitals, the Navy, the Public Health Service and Veterans and some sub-departments likewise, and then they cry for more competent men to run ill-conceived and duplicating projects; they see full Army Camps open and unnecessary staffs on duty; they note the senseless unnecessary demand for more medical schools and for more medical students; they note government dispensaries are kept open—and to prove the need for their existence count every visitor that enters; they wonder how one could justify the purchase of a yacht for the study of fish and wildlife; they have not forgotten the WPA nor the relief measures for schools handled by Federal Agencies during the war; they have not forgotten the PWA, the NYC, The Lanham Act, the GI Bill and the CCC's; they know it will be more costly in taxes for any community to get funds through the Federal Government; they know that once they accept subsidies they cannot turn back; they feel that in the end one will have a "Police State," and we pediatricians will have a Pediatric W.P.A.
Junior Speaks Up
Authors: MCCULLOCH HUGH
Published: December 2021

Noteworthy for its style of presentation in the form of characters, speaking somewhat as those in an Elizabethan play or movie. Terse, crisp, pungent erudite discussions in dialogue of common problems concerning a growing child. The author is to be congratulated on the introduction of "Shadow" a character foil for "Junior" to reason out his own thinking and approach to these problems. It is here that the author shows his skill in opening up a child's mental processes and probable reactions, reflexes and response to the many environmental influences that are thrown, thrust and imposed on him.
THYMOL TURBIDITY VALUES IN THE SERA OF NEWBORN AND PREMATURE INFANTS AND OF MOTHERS AT TERM
Authors: DESMOND MURDINA MACFARQUHAR , ZIMMERMAN HYMAN J. , SWEET LEWIS K. , THOMAS LAWRENCE J.
Published: December 2021

The sera of 108 infants (premature and full term), 65 pregnant women at term, and 28 adult normal controls were studied with the thymol reagent. The mean degree of thymol turbidity of infant sera (0.77 ± 0.55 units) was found to be significantly lower than that of adult normals (1.65 ± 1.15 units) and pregnant women at term (2.1 ± 1.00 units).

No correlation could be demonstrated to exist between the absolute globulin level or albumin-globulin ratio on the one hand, and the degree of thymol turbidity in the serum of either infants or mothers at term on the other.

In the newborn group of premature and full term infants, no correlation could be found between the degree of thymol turbidity and the level of blood bilirubin as found in physiologic jaundice.

It is suggested that the low thymol turbidity values obtained in infants may be related to low blood lipids or low beta-globulin concentration as described by other authors.
THE USE OF CARONAMIDE IN PEDIATRICS
Authors: PERRY THOMAS L.
Published: December 2021

Twenty-one infants and children received combined intramuscular penicillin and oral caronamide therapy for periods ranging up to 8 weeks. Marked increases in the maximal and minimal serum penicillin levels were regularly obtained when caronamide was given in a daily dosage of from 0.4 to 0.8 gm./kg. body weight. No relation was observed between the height of serum caronamide levels and serum penicillin levels. Caronamide was found to inhibit reversibly the tubular excretion of phenol red. No serious toxic effects of the drug were observed. Several successfully treated patients are described briefly, and a suggestion is made as to the type of pediatric case in which the use of caronamide is indicated.
SPECIAL REVIEWS
Authors: GLASER JEROME
Published: December 2021

The management of the child with chronic asthma is discussed. The importance of possible prophylactic measures is mentioned. Environmental control is emphasized with special reference to the avoidance of house dust, feathers, wool, animal pets and strong odors. Change of climate is not always successful and it is important to do all that one can to relieve the child in his own community before this is considered.

The asthmatic child must be protected against respiratory infections. The usual measures of prophylaxis in pediatric practice must not be omitted but are all the more urgently indicated in the case of asthmatic children.

Recurrent lymphadenoid tissue in the nasopharynx following adenotonsillectomy is discussed in its relationship to bronchial asthma.

The possible use of physiotherapeutic measures for the prevention of asthmatic chest deformities and for assisting in the relief of chronic bronchial asthma is mentioned.

Psychosomatic factors are important and consist chiefly in giving the child a sense of security by means of a thorough understanding by the parent of the symptomatic treatment of asthma; the avoidance of coddling or rejection of the child; and teaching the child to excel in some special field so as to experience a feeling of superiority in competition with non-asthmatic children.

The asthmatic child should be aided in the selection of a career in which, if asthma persists or recurs, the earning of a living will not be impossible.

It is pointed out that the nature of the asthmatic problem is such that special facilities should be made available for research in all phases of the problem.
THE PEDIATRICIAN AND THE PUBLIC
Authors: HARPER PAUL
Published: December 2021

THE problem of health services for children of school age is particularly timely in view of current interest in such services. The editors of this column have asked several authorities in this field to state their opinion of the objectives of a school health service and to describe practical methods of attaining these goals. The first two letters in the current issue deal with this subject; other letters on health services for children of school age will be published in subsequent issues. Dr. James L. Wilson is professor of pediatrics at the University of Michigan; Dr. Jessie M. Bierman is professor of maternal and child health at the University of California School of Public Health; and Dr. Dorothy B. Nyswander is professor of Public Health Education in the same school, and the author of "Solving School Health Problems, the Astoria Demonstration Study," the Commonwealth Fund, 1942.

The last two letters are from Dr. Albert D. Kaiser, health officer of Rochester, New York. Dr. Kaiser has described the program of the Council of Rochester Regional Hospitals for improving medical care in the 11 counties served by the member hospitals in the June issue of this column. His first letter in this issue describes how these services might be extended if additional funds were available. His second communication serves to make clear what was meant by "institutes conducted for . . . governing boards" as described in the eighth paragraph of his first letter.
Congenital Malformations
Authors: MILLER HERBERT C.
Published: December 2021

Dr. Murphy has attempted to answer two very important questions: what causes congenital defects and what are the chances confronting porspective parents, particularly if they have already had one defective child? The first edition of his book published in 1940 set forth the genetic factors as they occurred in a group of nearly 900 defective children studied by him and his collaborators. The second edition is not an extension or revision of these former observations, but simply adds two chapters dealing with two environmental factors responsible for congenital defects. These added chapters deal with the effects of pelvic irradiation and maternal rubella on the fetus.
RENAL CLEARANCES OF SODIUM PENICILLIN G, PROCAINE PENICILLIN G, AND INULIN IN INFANTS AND CHILDREN
Authors: BARNETT HENRY L. , MCNAMARA HELEN , SHULTZ SELMA , TOMPSETT RALPH
Published: December 2021

Reports of unexpectedly high serum concentrations of procaine penicillin G suggested the possibility that, in addition to the major factor of slow absorption, the renal clearance of procaine penicillin might be lower than that of the sodium salt.

Measurements of inulin clearances and clearances of either sodium penicillin G or procaine penicillin G in 10 children and four premature infants showed no significant difference between the clearances of the two penicillin salts. A reduced clearance of procaine penicillin, therefore, does not explain the apparent occurrence of unexpectedly high serum concentrations of penicillin in normal subjects.

Critical evaluation of data on the maintenance of drug levels with a particular preparation of procaine penicillin requires consideration of the limits imposed by the clearance data presented.

Penicillin clearances in premature infants suggest that if penicillin is given to small infants in dosages proportionate to their surface area, the duration of drug concentrations in the blood should be six times as long as in children and adults and three times as long if the dosage is proportionate to body weight.
STUDIES IN THE RELATION OF THE HEMOLYTIC STREPTOCOCCUS TO RHEUMATIC FEVER
Authors: HARRIS T. N. , HARRIS SUSANNA , NAGLE RUTH L.
Published: December 2021

Titrations of antibodies to four streptococcal antigens have been carried out in the sera of patients with rheumatic fever and of convalescents from streptococcal infections. These antigens are the hyaluronidase, the hemolysin, and two somatic fractions, the cytoplasmic particles and supernate proteins.

Mean titers to all of these antigens were elevated in both rheumatic and streptococcal infection. The mean titer was somewhat higher in rheumatic than in streptococcal infection in the case of three of these antibodies. In the case of the fourth, antihyaluronidase, this difference was considerably greater.

The antihyaluronidase titer showed better correlation with changes in the activity of the rheumatic infection than did the other tests. There was, however, no striking correlation between this titer and the severity of the illness.

Application was made of these findings to the problem of laboratory diagnosis of rheumatic fever by streptococcal serology. A method is presented for assessing the relative usefulness of such tests in terms of the, distribution of their titers in this disease and in health. By this method the antihyaluronidase test was found to be most useful of the four.

The comparative diagnostic value for rheumatic fever was studied in the case of the antihyaluronidase test, the antistreptolysin test, and of combinations of both tests.
Round Table Discussion
Authors: ELEY R. CANNON
Published: December 2021

Chairman Eley: It is advisable to state the proper title of the discussion, should read, "Therapeutics of Tuberculosis in Infancy and Childhood with Special Reference to Chemotherapy." As you will see, this immediately enlarges the field of discussion and does not necessarily limit it to streptomycin.

The U. S. Public Health Service has been conducting a cooperative study on the evaluation of antituberculosis chemotherapeutic agents in juvenile tuberculosis. These studies are being made in several pediatric centers throughout the country and especially in those localities where teaching hospitals are available. Dr. Floyd Feldman of the U. S. Public Health Service is the medical director and coordinator of this huge undertaking. Dr. Ralph Platou is the director of this work at Tulane University, Louisiana, and Dr. William Berenberg has charge of the program at the Childrens Medical Center, Harvard Medical School, Boston.

During the past decade amazing progress has been made, both in the control and treatment of diseases resulting from bacterial invasion. It would naturally follow therefore that these same measures might be applied to the treatment of tuberculosis. The in vitro results obtained by the use of the sulfonamides and their related compounds (i.e., promin, diasone and promizole) suggested their trial in the treatment of tuberculosis in experimental animals. These studies showed that in the hypersensitive guinea pig a deterrent effect on the infection could be demonstrated, but that the infection was not eradicated. When these agents were applied to man, the results were even less favorable as no regression of the disease, quiescence or cure was demonstrated.

Studies have also been made with agents that might prove effective by altering the metabolism of the organism. For example, benzoic and salicylic acids were studied with the possibility that the growth of the organism might be inhibited by interference with its oxidization. None of these substances has as yet proved satisfactory for the treatment of human tuberculosis.

To date streptomycin has been more effective in the treatment of this disease than any other antibiotic agent employed. However, it has its disadvantages as illustrated by (1) the development of resistance of the organism to the agent after its administration over a given period of time, and (2) the appearance of labyrinthine disturbances following prolonged or massive therapy. It is, however, believed that sufficient evidence has been obtained to justify the therapeutic use of streptomycin in certain tuberculous conditions such as: (1) Miliary tuberculosis. (2) Acute tuberculous pneumonia. (3) Tuberculous meningitis. (4) Extra-pulmonary tuberculosis.
THE PEDIATRICIAN AND THE PUBLIC
Authors: HARPER PAUL
Published: December 2021

WE ARE publishing two additional letters in the series devoted to the health problems of children of school age. The first is from Mr. John L. Bracken, Superintendent of Schools, Clayton, Missouri, who has been recently elected President of the American Association of School Administrators. Charles C. Wilson, M.D., is Professor of Education and Public Health at Yale University.

The letter from Dr. Caroline A. Chandler is self-explanatory. The editors wish, however, to take this opportunity to note that Dr. Chandler's letter has called attention to an incomplete quotation in their statement as published in the January issue of this column in answer to the letter of Dr. John K. Glen; the resolution which is quoted in the third from the last paragraph of the statement was passed by the Academy in the form given in Dr. Chandler's letter.
TRENDS IN HEALTH LEGISLATION AND ADMINISTRATION
Authors: WALL JOSEPH S.
Published: December 2021

THE 81st Congress continues to receive an increasing number and variety of health bills. Among this growing list, we wish at this time to draw attention to the following:

National Child Research Bill

In February we published in this column a preliminary draft of "The National Child Research Bill." This bill, with few but significant changes, was introduced into the Senate by Senator Douglas on February 10 as S.904. In preliminary draft form this bill provided for a National Child Research Institute to be established in the Children's Bureau. Thus it was intended that there should be created within the Children's Bureau a separate institute comparable to the National Institutes of Health of the U.S. Public Health Service. In S.904 there is no mention of a separate institute; it is proposed that the Children's Bureau itself be "authorized to establish and carry out a program of research in child life and development" with such additional quarters as may be necessary to enable the Bureau to discharge its functions provided for in this bill. In other respects S.904 is identical to the draft bill previously published.

The School Health Services Bill

This bill, preliminary draft of which was also published in this column in February, became entangled in legislative strategy from which it has not emerged as of present date (February 23, 1949). In late January there arose within the Senate Committee on Labor and Public Welfare a proposal to add school health services to S.246, a bill calling for $300,000,000 a year in Federal aid to elementary and secondary schools. An additional annual appropriation of $25,000,000 to be used for school health services was suggested as an amendment to S.246 with a formula to be worked out for the distribution of the funds through the state education agencies. (The School Health Services Bill proposed by Senator Saltonstall in the 80th Congress, S.1290, called for an appropriation of $10,000,000 for the first year and $15,000,000 for the second year.)
The Parathyroid Glands and Metabolic Bone Disease
Authors: WILKINS LAWSON
Published: December 2021

About 25 years ago Fuller Albright became interested in disorders of the parathyroid glands and other conditions disturbing calcium and phosphorus metabolism. It was in 1925 that the first parathyroid adenoma was removed in Vienna and in 1924 and 1925 that Hanson and Collip independently extracted the active principle of the parathyroid glands. Since this time Albright and a long retinue of coworkers have turned out a large number of classic papers clarifying the understanding of the actions of parathyroid hormone, vitamin D and dihydrotachysterol, the effects of various renal disorders upon phosphorus and calcium, and the nature of bone diseases such as osteitis fibrosa generalisata, osteoporosis, osteomalacia, Paget's disease and polyostatic fibrous dysplasia. The new monograph presents in clear and concise form the accumulation of a quarter century of investigations and gives Albright's views as they stand today.
Voluntary Medical Care Insurance in the United States
Authors: HARPER PAUL
Published: December 2021

The author has brought together in this book a great mass of factual data. Medical care insurance is defined as a device for pooling risks and resources against the economic hazards of sickness, injury and maternity. Pooling of risks is feasible only for people able to make regular contributions; even under optimum conditions of employment and income there is a segment of the population who have to depend upon public aid for maintenance and for medical care. There is a larger group of self-supporting individuals and families with many children who can pay only a limited amount toward the full cost of adequate medical care insurance. In periods of depression this group is bound to increase.
SOCIAL ADJUSTMENT OF SIX PATIENTS WITH HEMOPHILIA PRIOR TO AND DURING PROPHYLACTIC TREATMENT
Authors: COHEN ETHEL , HERRMANN ROSALIND L.
Published: December 2021

A study has been made of six patients treated for hemophilia by repeated frequent infusions of plasma.

Prior to beginning treatment these patients were semi-invalids, hospitalized frequently for periods of weeks and months and handicapped in their adjustment to normal social life. Since treatment they and their families have gained a feeling of confidence, without fear of hemorrhage "hanging over their heads." They know that if a hemorrhage occurs, it probably will not incapacitate them, but that even if it does, the period of incapacitation will be comparatively short. Our observations indicate great improvement in the lives of the patients studied, Whatever the future may hold for these patients, they have acquired a new outlook on life and many positive experiences. Also, from this study some insight has been gained into the social component of this disease and of the problems both solved and created by effective treatment.
INTESTINAL ABSORPTION OF VITAMIN A FROM OILY AND AQUEOUS MEDIA IN PATIENTS WITH THE CELIAC SYNDROME
Authors: DANIELSON WAYNE H. , BINKLEY EDWARD L. , PALMER HAROLD D.
Published: December 2021

The absorption of vitamin A from oily and aqueous media has been studied in infants and children with cystic fibrosis of the pancreas and idiopathic celiac disease.

Patients with cystic fibrosis of the pancreas can absorb vitamin A acetate and vitamin A alcohol when it is given to them in an aqueous dispersion. The vitamin A acetate curves rose above the vitamin A alcohol curves in three of four patients on whom absorption curves were obtained.

Vitamin A is absorbed by patients with idiopathic celiac disease only slightly better from an aqueous dispersion of the alcohol than from an oily concentrate of the naturally occurring esters. The poor absorption from an aqueous media by these patients supports the suggestion that the defect in absorption in this disease lies within the intestinal mucosa.

The use of the differences in response to oily and aqueous concentrates in the differential diagnosis of the entities of the celiac syndrome is suggested.
THE PEDIATRICIAN AND THE PUBLIC
Authors: HARPER PAUL
Published: December 2021

The keynote of a good school health program is cooperation. Effective working relationships among parents, school staff, and health personnel are essential. Continuous education on the growth and development problems of children and active participation on the part of all concerned with the health of children are basic.

A good school health program is a dynamic program. It is bent on determining the changing needs of many individuals and on meeting these needs in the most effective way possible with all the variety of physical facilities and human resources to be found in the school and community.

The pediatrician has a unique contribution to make in meeting the objectives of the school health program and in interpreting them to the community.
INTERNATIONAL NEWS AND REPORTS
Authors: CRAIG W. S.
Published: December 2021

A lecturer in Diseases of Children was first appointed in 1921 and later given the status of part-time professor in 1927. Some 19 years later (1946) the part-time chair in Diseases of Children was replaced by a whole-time chair in Pediatrics and Child Health. The formation of a university department began with the establishment of a whole-time chair. Departmental staff, other than secretarial, consists of the professorial head, his deputy, who has the status of lecturer, and three tutors. Of the tutors, one holds a resident appointment in a maternity hospital.
Psychopathology and Education of the Brain-Injured Child
Authors: SARASON SEYMOUR
Published: December 2021

As the title indicates this book is divided into two parts: the psychopathologic and educational aspects of brain-injury in children. The following is the definition of the brain-injured or exogenous child given by the authors: "A brain-injured child is a child who before, during, or after birth has received an injury to or suffered an infection of the brain. As a result of such organic impairment defects of the neuromotor system may be present or absent; however, such a child may show disturbances in perception, thinking, and emotional behavior, either separately or in combination.
Rheumatic Fever, Nursing Care in Pictures
Authors: MCCULLOCH HUGH
Published: December 2021

This has been written primarily for parents to supplement the services of the public health or visiting nurse in the home of a family with a rheumatic fever patient. It shows through the text and through many photographs, the course of an 11 year old child with rheumatic fever; first in bed at rest, then the successive stages of recovery back to full activity, pointing out the physical, emotional, mental and social care needed at these stages. The photographs are excellent and illustrate the application of the written material in the text.
OVARIAN TUMORS IN CHILDHOOD
Authors: DARGEON HAROLD W.
Published: December 2021

Data on 14 cases of ovarian tumors occurring in children have been discussed in this presentation.

Ovarian neoplasm is uncommon during childhood. It should be considered however in the differential diagnosis of several conditions observed not infrequently by the clinician in girls from infancy through adolescence. These conditions are: lower abdominal pain of acute, subacute or chronic nature; abdominal or pelvic masses; precocious puberty and vaginal bleeding.

The treatment is surgical.

The prognosis in the malignant varieties is usually serious, but there are exceptions to this generalization. The prognosis in the benign types is good.
ACUTE ISOLATED MYOCARDITIS
Authors: WEBER MORTIMER W. , BALDWIN JANET S. , HALL JOHN W.
Published: December 2021

A brief review of the literature on acute isolated myocarditis is presented. The age incidence of reported cases is predominantly in two groups, adults and infants or children under the age of three years. A case of a 10 year old child who ran a rapid, six day course terminating in death is reported with postmortem findings. Diagnosis of acute isolated myocarditis may be suspected clinically but can be made with finality only with postmortem examination.
BRAIN TUMORS IN CHILDREN
Authors: KEITH HADDOW M. , CRAIG WINCHELL MCK. , KERNOHAN JAMES W.
Published: December 2021

Twenty-four per cent of brain tumors of children aged less than 15 years were found to be astrocytomas, 20% were medulloblastomas and 11% were ependymomas. If the astroblastomas (3%) and ependymoblastomas (3%) are added to these, these groups of tumors comprise 61% of all brain tumors of children. Gliomas constituted 84% of all the tumors in children.

Six tumors were found in infants 1 year of age or less. The youngest infants were 2 months old.

Astrocytomas were slightly more common in children aged 5 years or less than in the older group. Medulloblastomas and ependymomas were distinctly more common in the younger group than in the older group.

Seventy-one per cent of tumors in the age group from birth through 5 years of age were infratentorial; 28% were supratentorial; 1 tumor (1%) was both infratentorial and supratentorial. In the group 6 through 14 years of age, 64% were infratentorial and 36% were supratentorial. Thirty per cent of infratentorial tumors were astrocytomas and 30% were medulloblastomas. Sixteen per cent of supratentorial tumors were craniopharyngiomas, 12% were astrocytomas and 12% were glioblastoma multiforme.

Under present conditions at the Mayo Clinic, 54% of all children who undergo operation for tumor of the brain survive for six months or more. Of 256 patients observed for five years or more after operation, 13.3% survive for at least five years. The longest survival period was 20 years after operation. This patient had had an astrocytoma removed in 1926.
Obstetric Analgesia and Anesthesia
Authors: YANNET HERMAN
Published: December 2021

This book is an excellently developed presentation of the present status of pain-relieving drugs in obstetrics. It is divided into two sections: The first is devoted to (1) detailed analysis of clinical and experimental data referrable to fetal respiration, and (2) pathologic pulmonary conditions in the fetus and newborn that might be causally related to the labor inhibiting and respiratory depressive effects of many, if not all, the pain-relieving drugs used during delivery. The scope of the section is indicated by some of the chapter headings, i.e., incidence of respiratory injury before birth; respirations before birth; intrauterine pneumonia; atelectasis; asphyxia.
PILOMATRIXOMA (CALCIFYING EPITHELIOMA) IN CHILDREN
Authors: Bingul Ozdemir , Graham James H. , Helwig Elson B.
Published: December 2021

A clinicopathologic analysis of 92 pilomatrixomas in 84 children was made. The diagnosis is seldom made clinically, since the lesions are not distinct and are referred to most often as some variety of cyst. The common locations are the face, neck, and arms. The lesion is benign and is cured by excision. In our patients the diagnosis was always established by pathologic study. There are similarities between pilomatrixoma and pilar structures. The tumor probably originates from a primitive cell of the primary epithelial germ and differentiates toward hair-matrix cells. The name "pilomatrixoma" is acceptable, since it conveys the histogenesis of the lesion and avoids the word "epithelioma," which generally indicates a malignant neoplasm and should not be used for this benign tumor.
INTRAPULMONIC NEUROGENIC TUMOR
Authors: Lee B. Y. , Tchertkoff V.
Published: December 2021

A case of primary, solitary intrapulmonic tumor of nerve sheath origin in a 7½-year-old child is presented. The case is apparently the first one in this age group and should be considered in the differential diagnosis of chilhood lung tumors. Therapy is surgical removal, and results are excellent.
Digoxin Dosage in Newborn Animals and Infants
Authors: MARINI ANTONIO , SERENI FABIO , BOTTINO DOMENICO
Published: December 2021

Please do not think that, after our recent letter in Pediatrics (29:500, 1962), we wish to monopolize the column of Letters to the Editor. However, the paper by Levine and Blumenthal on "Digoxin Dosage in Premature Infants" (29:18, 1962) touched us so heartily that we must write of our experiences.

For reasons similar to those of Levine and Blumenthal, we devised in 1961 a series of experiments to test whether the responses of newborns to digitalis and ouabain differ from those of adults.
Modern Problems in Pediatrics, The Growth of the Normal Child during the First Three Years of Life
Authors: ILLINGWORTH R. S.
Published: December 2021

This volume is devoted to the proceedings of an international seminar in Zurich organized by the International Children's Centre, and attended by about 112 experts from 26 countries. The seminar was devoted to the growth of the normal child in his first three years.

The subjects discussed include the assessment of physical growth, including the growth of fat, body density, muscle, and bone; the assessment of skeletal maturation; the chemistry of growth and development; the early diagnosis of mental deficiency, and the value of developmental tests; and psychological development.

It is almost invidious to pick out a few contributions as being of especial value; they would include the papers on "the influence of environment on growth" by Marcel Graffar of Belgium, "nutritional growth" by Dean of Kampala, "the accurate prediction of growth and adult height" by Nancy Bavley of Bethesda, "the growth of fat tissue" by Harold Stuart and co-workers, and "the biochemistry of the child during the first three years" by Tanner of London.
NASAL POLYPOSIS IN PATIENTS WITH CYSTIC FIBROSIS
Authors: Shwachman Harry , Kulczycki Lucas L. , Mueller Harry L. , Flake Carlyle G.
Published: December 2021

Among 742 patients with cystic fibrosis studied during the past 4 years, 50 (or 6.7%) were found to have nasal polyposis. Polyps were noted in patients of all ages, the youngest being 2½ years of age. Roentgenograms of the sinuses showed evidence of paranasal sinusitis in each case studied. An allergic investigation was conducted in each of the 50 patients with nasal polyposis. Twenty-four patients presented no evidence of allergy. The clinical severity of the basic disease (cystic fibrosis) was the same in both the allergic and nonallergic group.

A brief description of the clinical course of the patient with nasal polyps is presented. The polyps are often multiple, may cause complete nasal obstruction, and tend to regrow. Their course is beneficially influenced by the administration of broad-spectrum antibiotics or systemic steroids. However, polyps did appear in many patients while on constant broad spectrum antibiotic therapy. Conservative management is suggested. Simple polypectomy is carried out when nasal obstruction is complete. In a small number of patients, repeated polypectomies have been necessary over a number of years. The severity of the pulmonary lesion is not reflected by the degree of alteration of the mucosal linings of the paranasal sinuses. Patients with nasal polyposis, regardless of the presence or absence of allergy, should be examined for evidence of cystic fibrosis, including family history, pulmonary evaluation, and appropriate laboratory tests.
Care of the Newly Born Infant
Authors: SILVERMAN WILLIAM A.
Published: December 2021

This book is addressed principally to midwives and family doctors involved in the care of newborn infants born at home and maternity hospitals in Great Britain. Many terms (e.g., "posseting," "breaking wind," etc.) and proprietary names (e.g., "Lethidrone," "Belcory Feeder," "Jacques Catheter," etc.) are probably unfamiliar to most readers in the United States. American pediatricians will be interested in the profusion of photographs (many in color) illustrating neonatal conditions and in the detailed discussion of every aspect of the technique of breast feeding. If the breasts of American mothers are ever called back to active duty, one could turn to this volume for useful information of the lost art.
THE TREATMENT OF THE PIERRE ROBIN SYNDROME
Authors: Goldberg Marvin H. , Eckblom Roger H.
Published: December 2021

The diagnosis of the Pierre Robin Syndrome, cleft palate, micrognathia, and golssoptosis is re-emphasized. The clinical symptoms are discussed. The treatments advocated in the literature are described. A simple traction device, employing a horizontal suture through the mid-body of the tongue and an elastic traction system, is explained. Five cases of the syndrome are reported. In one the condition was mild; in the other four the tongue traction device was employed. In one sick infant with a congenital heart disease a tracheotomy had to be performed. Much difficulty was experienced following this, and the operation is only recommended when traction alone does not control the handling of the profusion of mucus and bouts of apnea. A removable acrylic palatine obturator was used as an adjunct to nipple feedings in three patients, with excellent results. The method of production of this "false palate" is described.
Medical Education; A New Pattern
Authors: BAKER HARRY
Published: December 2021

What are the aims of present day grade school and secondary school education? This demanding question has been raised by many people deeply concerned with the future of education. With the ascendency of science and technology there has been a great deal of stress on the teaching of factual material, with much less organized thought as to what this will do to the children receiving this education. The emphasis is on the "what" rather than on the "why." Medical education is faced with the same problem.
Diagnostic Tests in Infants and Children
Authors: LUCEY JEROLD F.
Published: December 2021

This book is advertised as being aimed at a wide audience of students, pediatricians, pathologists, and general practitioners. As a result of this approach the book falls far short of satisfying the needs of any one of these groups. It is a mixture of the old and new, neither of which is critically appraised. Many of the laboratory tests included are of purely historic interest. Dr. Behrendt utilizes 39 pages to discuss tests of basal metabolism rate, even though he acknowledges that such procedures have "outlived their usefulness."
RETROPERITONEAL XANTHOGRANULOMA
Authors: Krugly Melvin , Emanuel Benjamin , Smallberg William , Veiga Secundino
Published: December 2021

A second case of a retroperitoneal xanthogranuloma in a child is presented. The tumor is very rare, and its retroperitoneal location is characteristic. The importance of this tumor is its possible relation to the other known histiocytoses, such as eosinophilic granuloma, Hand-Schüller-Christian disease, and Letterer-Siwe disease. Long-term follow-up is needed before a patient can be considered cured by surgery and x-ray therapy.
Breast Feeding
Authors: BATES GEORGE
Published: December 2021

Without any intention of imposing upon these columns with a prolonged and inconclusive discussion of breast feeding, I should like to reply to the communication of Dr. Nicholas Demy (Pediatrics, 29:1030, 1962). It might also be of interest to hear current opinions of other practicing pediatricians on this subject.

My previous communication (Pediatrics, 29:332, 1962) meant to express the thought that there is no superiority attributable to breast feeding that can be clinically observed in breast fed infants as compared with infants nourished by proper artificial feeding regimens.
Payment for Pediatric Care
Authors: COHN BRAD
Published: December 2021

I most respectfully beg to differ quite vehemently with the sentiments expressed by Dr. Spock et al. in the August, 1962, issue of Pediatrics The principle of "professional courtesy" as expressed by rendering medical services to our colleagues and their families without charge is a fine tradition quite worthy of preservation. The idea epitomized herein implies we are receiving from our colleagues the most cherished privilege, compliment, and reward; namely, the trust and confidence placed in us to render our highest skills and very finest efforts in behalf of the physician and his loved-ones. I, for one, believe in expressing my gratitude to the physician and his family for according me this privilege, and simultaneously, I inform them I do not intend to take the responsibility lightly, and will insist on being called for the slightest question or problem.
THE RELATIONSHIP OF THE SODIUM, POTASSIUM, AND CHLORIDE CONCENTRATION OF THE FEEDING TO THE WEIGHT GAIN OF PREMATURE INFANTS
Authors: Goldman Herbert I. , Karelitz Samuel , Acs Hedda , Seifter Eli
Published: December 2021

One hundred four healthy premature infants, of birth weight 1,000 to 1,800 gm, were fed one of five feedings: (1) human milk; (2) human milk plus 13 meq/l of sodium chloride; (3) human milk plus 13 meq/l of sodium chloride and 18 meq/l of potassium chloride; (4) a half-skimmed cows milk formula; and (5) a partially-skimmed vegetable oil, cows milk formula. The infants fed any of the three human milk formulas gained weight at a slower rate than the infants fed either of the two cows milk formulas. Infants whose diets were changed from unmodified human milk to the half-skimmed cows milk gained large amounts of weight, and at times were visibly edematous. Infants whose diets were changed from the human milks with added sodium chloride, to the half-skimmed cows milk, gained lesser amounts of weight and did not become edematous. The infants fed the two cows milk diets gained similar amounts of weight, although one diet provided 6.5 gm/kg/day, the other 3.1 gm/kg/day of protein.
Laboratory Manual of Pediatric Micro-and Ultramicro-Biochemical Techniques
Authors: HOLLIDAY MALCOLM A.
Published: December 2021

This book has much to recommend it. It is a summary of almost all laboratory procedures a clinical chemistry laboratory might be called upon to do, even in the most research-orianted univensity hospitals. The style of the text is particularly appealing, for it is direct, simple, and free of pedagogy. The methods described for the frequently used tests are well selected in general (one important exception in the reviewer's opinion is the omission of the simple techniques devised by Seligson for measuring urea nitrogen, ammonia, etc.).
MYOCARDIAL INFARCTION AND MULTIPLE THROMBOSES IN A CHILD WITH PRIMARY THROMBOCYTOSIS
Authors: Spach Madison S. , Howell Doris A. , Harris Jerome S.
Published: December 2021

The first case of primary thrombocytosis, with myocardial infarction and multiple thromboses, in childhood has been described. Despite persistent elevation of platelets, the patient has had no recurrence of thrombotic phenomena for 8 years following her original episode. The electrocardiographic abnormalities of inferior myocardial infarction which were present following the patient's acute episode gradually disappeared. Although the electrocardiogram was normal 5 years after the infarction, the vectorcardiogram revealed changes consistent with the diagnosis of an old diaphragmatic myocardial infarct.
Genetics
Authors: CONNEALLY PATRICK M. , STEINBERG ARTHUR G.
Published: December 2021

The interest in genetics among medical men has increased greatly in the last decade, as is evident from the fact that genetics has become a required course in many medical school curricula. A major requirement to keep pace with this development is an adequate genetics textbook.

Dr. King presents a well-written textbook, and the illustrations are excellent, especially those on mitosis and meiosis. It is written, however, mainly from a classical viewpoint; some areas, especially cytology, are discussed in considerable detail, while others, notably human genetics and some of the more recent advances in genetics, are given scant coverage.
EXTERNAL CARDIAC COMPRESSION
Authors: Thaler Manning Michael
Published: December 2021

External cardiac compression is now the accepted method of treating sudden cardiac arrest. The technique is described, with particular emphasis on the steps which can cause serious trauma, if not properly performed. Ventilation of the lungs is of paramount importance.

The incidence of cardiac arrest seems to be increasing and appears to be higher in infants, perhaps because of the large proportion of cardiac surgical procedures in this age group. Survivals depend on several factors, the most important of which are the time elapsed before treatment is begun, the location of the patient at the time of cardiac arrest, and the primary disease of the patient. Use of external cardiac compression diminishes delay, makes the location of the patient less important, and produces less trauma in a critically ill patient. Blood pressures achieved by the external method are comparable to levels reached by direct massage of the heart. The myocardium is not traumatized by the external method, which is also less fatiguing to the operator.

The complications of external cardiac compression are traceable to excessive pressures and to pressure over wrong areas of the chest, and are therefore avoidable. Pressure should be applied to the sternum in the mid-line only, just above the xyphoid process. Two cases of ruptured liver in children are mentioned, and reports of other injuries are discussed in connection with specific errors in technique.
Human Milk—Protein—Prematurity
Authors: OMANS WALTER B. , BARNESS LEWIS A. , ROSE CATHERINE S. , GYÖRGY PAUL
Published: December 2021

Sometimes, in order to make an article brief, authors quote others, but the interpretations of the new authors may not reflect the context of the original observers. This has occurred in the quotation of several of our papers in a recent article by Pincus et al.

First we are quoted as agreeing "that small infants where fed isocaloric diets gain weight more rapidly on a diet having a higher protein content" (author references 12 and 16). In reference 12,2 we state that infants fed 3.0 to 8.0 gm of protein per kilogram gained equally well. Only when the protein intake was below 2.0 gm/kg did the weight curve not rise as well. Indeed, in this paper, we noted a few babies taking more than 8 gm/kg protein who gained very poorly.