bluuebunny/crossref_metadata_2025 huggingface dataset:
THE HEART AND PULMONARY CIRCULATION IN CHILDREN AT HIGH ALTITUDES
Authors: Peñaloza Dante , Arias-Stella Javier , Sime Francisco , Recavarren Sixto , Marticorena Emilio
Published: December 2021

Physiologic and anatomic changes have been demonstrated in healthy children born and living at high altitudes. Electrocardiographic and vectorcardiographic studies indicate that after birth the right ventricular preponderance remains throughout infancy and childhood. Anatomic observations have confirmed the presence of right ventricular hypertrophy in healthy children of high altitudes. Cardiac catheterizations reveals mild pulmonary hypertension associated with increased pulmonary vascular resistance, the degree of pulmonary hypertension being higher under 5 years of age. The increased pulmonary resistance is principally related to structural changes of the pulmonary vasculature, while arteriolar vasoconstriction and polycythemia are secondary factors. Pulmonary hypertension and right ventricular hypertrophy are not associated with any kind of symptoms in high-altitude children, and we must understand these changes as related in some way to the mechanisms of natural acclimatization.

Patent ductus arteriosus is more frequent at high altitudes than at sea level, and the incidence augments gradually as altitude above sea level increases, the relationship following a curve of parabolic type. It is probable that at high altitude hypoxia and pulmonary hypertension, which remain as chronic conditions after birth, are factors related to the patency of ductus arteriosus.

High altitude pulmonary edema may occur in healthy children returning to altitude after being at sea level for a few days or weeks. Rapid improvement of the clinical condition is obtained after continuous oxygen administration; however, death may occur if early treatment is not given. Cardiac catheterization reveals a normal pulmonary wedge pressure and a degree of pulmonary hypertension two or three times greater than that corresponding to healthy children of high altitude. The mechanism of high altitude pulmonary edema is discussed.
The Neurological Examination of the Full Term Newborn Infant
Authors: PAINE RICHMOND S.
Published: December 2021

This monograph is one of the excellent series of "Little Club Clinics" published as an extension of the journal, Developmental Medicine and Child Neurology. It outlines in detail, test item by test item, the method for examination of the nervous system of full-term newborn infants of Dr. Prechtl, who is one of the world's leading authorities on this. The method has been tested on some 1,500 babies, most of whom had abnormal obstetrical histories, and little exception would be taken to any of it by those most experienced in neonatal neurology in this country.
ISOLATED SUBCUTANEOUS RHEUMATIC NODULES
Authors: Altman Robert S. , Caffrey P. R.
Published: December 2021

1. A 2 11/12-year-old white male with isolated rheumatic nodules is reported. No evidence of systemic disease was present.

2. Reported cases in the literature are reviewed.

3. A possible direction for etiologic investigation is proposed.
The Baby Doctor's Behavior
Authors: CODDINGTON R. DEAN
Published: December 2021

I want to congratulate you, as well as Dr. Lawrence Ross, for the publication of his most delightful article, "Understanding Your Baby Doctor's Behavior" in the October issue of Pediatrics, 34:564, 1964. As a pediatrician who returned to the W.O.M.B. during the stage of the tranquil 5's, I can lend my support to his developmental scheme. Although my personal bias results in a slightly different interpretation of some of his later development stages, I agree in principle and I'm sure that Dr. Ross did not mean the scheme to be all inclusive and without normal variations.
FATAL MYOCARDITIS IN AN ADOLESCENT CAUSED BY COXSACKIE VIRUS, GROUP B, TYPE FOUR
Authors: Sanyal Shyamal K. , Mahdavy Mehdy , Gabrielson Mary O. , Vidone Romeo A. , Browne Marie J.
Published: December 2021

A fatal case of myocarditis apparently due to Coxsackie virus, group B, type 4, occurring in a 13-year-old girl has been presented. This is the first reported fatal case beyond 2 years of age. Isolation of the virus from the pericardial fluid and the presence of a high homologous serum neutralizing antibody titer strongly suggested the diagnosis. Although generally considered to be a benign entity in older children and adults, myocarditis due to Coxsackie virus may be fatal.
HOMOCYSTINURIA
Authors: Brenton D. P. , Cusworth D. C. , Gaull G. E.
Published: December 2021

From a series of studies on autopsy brains, the concentration of cystathionine has been found to vary in different areas. In the brains of two homocystinuric children, however, the concentration was found to be extremely low in all the areas examined. In the autopsy tissues of a patient with cystathioninuria the concentrations of cystathionine have been confirmed to be high. These findings are consistent with the view that the biochemical defect in homocystinuria is a deficiency of cystathionine synthetase and that the defect in cystathioninuria is a deficiency of the cleaving enzyme. Investigation of the activity of betaine-homocysteine transmethylase, thetin-homocysteine transmethylase, and glutathione-homocystine transhydrogenase by in vitro techniques revealed no differences between homocystinurics and controls.
NEONATAL STAPHYLOCOCCAL INFECTION
Authors: Simon Harold J. , Allwood-Paredes Juan , Trejos Alfonso
Published: December 2021

The dynamics, consequences, and prevention of neonatal staphylococcal colonization were studied in San Salvador, El Salvador. The results indicate that:

All untreated infants who resided in the hospital for more than 48 hours became colonized. Umbilical preceded nasal colonization in this group.

An antiseptic skin care program effectively prevented colonization among treated infants in the hospital. Colonization in this group did occur in the first 3 months of life, but never to the extent found among the controls. Nasal preceded umbilical colonization in the treated group.

Staphylococcal disease occurred four times as frequently in the control group as in the treated group and four times as often in males as in females.

Initial staphylococcal colonization in mothers and family members of the two study groups and the non-staphylococcal disease experiences of both populations were essentially identical. Therefore, the differences in colonization rates and staphylococcal disease among the infants were probably due to the infant care program.

Studies on the epidemiology of neonatal staphylococcal infection and disease in San Salvador were carried out from birth through the first 3 months of life.

The phage-types and antibiograms of hospital- and community-derived strains differed widely from each other. The excess morbidity encountered in untreated infants was traceable almost entirely to hospitalacquired infections.

The first strain acquired by an infant was not necessarily the disease-producing strain, and multiple sequential colonizations occurred among the infants and their mothers. All hospital-acquired strains persisted and declined at approximately the same rate throughout the study.
CARDIAC PROBLEMS IN THE GLYCOGENOSES WITH SPECIFIC REFERENCE TO POMPE'S DISEASE
Authors: Hohn Arno R. , Lowe Charles U. , Sokal Joseph E. , Lambert Edward C.
Published: December 2021

In 4 of 16 patients having glycogenoses other than Pompe's disease electrocardiographic abnormalities were found. These abnormalities could not be related to the type of glycogenosis present and were limited to changes in the T wave and the QT interval. No other evidence of heart disease was found in these patients.

Hemodynamic and cineangiographic evidence of muscular obstruction to cardiac outflow from both right and left ventricles was documented in a case of Pompe's disease. The obstruction was confirmed by postmortem findings. In one other case not investigated by cardiac catheterization, similar autopsy findings were found. This alteration is probably more widespread than is generally known, and has important therapeutic implications.
FRANK H. DOUGLASS, M.D. 1899-1965
Authors: CHRISTOPHERSON E. H.
Published: December 2021

FRANK H. DOUGLASS, M.D., of Seattle, Washington, thirty-fourth President of the American Academy of Pediatrics (1963-64) and the immediate past President, died unexpectedly in Seattle on the morning of January 22, 1965, at the age of sixty-five years.

Born in Sedro Woolley, a small community about 65 miles north of Seattle, a son of a pharmacist and one of a family of ten children, Dr. Douglass graduated in Pharmacy from Washington State University in 1919.
THE GROWTH AND MATURATION OF HUMAN GLOMERULI AND PROXIMAL CONVOLUTIONS FROM TERM TO ADULTHOOD
Authors: Fetterman George H. , Shuplock Nancy A. , Philipp Frederick J. , Gregg Helen S.
Published: December 2021

A quantitative study of dimensions of immature human glomeruli and proximal convoluted tubules has been made by means of microdissection. Normal kidneys from 23 subjects varying in age from full term to 18 years were utilized in this study.

The proximal convoluted tubules in the normal kidney of a full-term infant are small in relation to their corresponding glomeruli. With the rapid growth of the proximal tubules in the first few months of life, a correspondingly rapid shift in anatomic glomerulotubular balance occurs.

The final dimensional change in the maturation of a proximal convoluted tubule is an increase in its volume.

The extreme heterogeneity of nephrons at term is recorded, along with their rapid attainment of relative homogeneity at an early age.

The best anatomic correlates for glomerulotubular balance in immature human kidneys were found to be glomerular surface area and proximal tubular volume.

The small proximal tubular mass shown to exist in early infancy may well account for the low Epah, TmPAH, and TmG values which have been demonstrated during this age period.
Health and the School Child
Authors: CHIPMAN SIDNEY S.
Published: December 2021

This book representing the views of twenty contributors, the majority of whom are physicians, is intended as a reference book for teachers, school administrators, nurses, and other professional people working with school children. Their material is clearly presented and readily comprehended. A glossary which has been included should be useful to teachers and school administrators. The bibliography is very spotty and incomplete.

The twenty-one chapters deal with many of the subjects pertinent to the health of schoolage children and to school health services.
CONTINUOUS RECORDING OF SWEATING BY RESISTANCE HYGROMETRY
Authors: Segar William E. , Hancock Charles J. , Sawyer Thomas , Bullard Robert W.
Published: December 2021

A method is described for the continuous recording of sweating rate by the use of resistance hygrometry. The data indicate the chloride concentration of sweat collected under a vapor pressure barrier is not different from the chloride concentration of sweat collected during experiments permitting normal evaporation of water from the surface of the skin.

Sweating is a cyclic process, and two rates of cyclic activity can be demonstrated. The major cyclic activity is probably regulated by the central nervous system.

In a constant environment, sweating rate is inconstant and not directly related to size or age. Sweating rate is not proportional to the number of functioning sweat glands in the skin area studied.

Children with fibrocystic disease did not differ in sweating rate or cyclic activity from normal children and adults.
THERAPEUTIC PRINCIPLES FOR STREPTOCOCCUS VIRIDANS INFECTIONS: RECURRENT BACTERIAL ENDOCARDITIS IN A CHILD WITH CONGENITAL HEART DISEASE
Authors: Gersony Welton M. , Nadas Alexander S.
Published: December 2021

A case of recurrent bacterial endocarditis due to a relatively resistant alpha streptococcus is reviewed. The following general principles of treatment are recommended:

1. Intravenous penicillin therapy should be instituted in all instances.

2. Should serum bactericidal levels indicate the organism to be extremely sensitive (< 0.1 units/ml) oral phenoxymethyl penicillin (Penicillin-V) may be substituted after 3 weeks.

3. In cases infected with organisms sensitive to greater than 0.1 units/ml, intravenous therapy should be continued for 6 weeks and streptomycin added for 2 weeks.

4. When facilities for studying penicillin sensitivity and serum bactericidal activity are not available, the intravenous penicillin-streptomycin regime is recommended.
Leucine-Sensitive Hypoglycemia Treated with Long-Acting Epinephrine
Authors: GRIESE GEORGE G. , WENZEL FREDERICK J.
Published: December 2021

A case of leucine-induced hypoglycemia in an infant is reported. The only successful method of treatment in this case was administration of long-acting epinephrine. This may be a simple, practical, and inexpensive method of treating certain cases of infantile hypoglycemia.
Benzalkonium Chloride Solution as a Source of False Proteinuria
Authors: ROBINSON JOHN C. , CONNELLY JOHN P.
Published: December 2021

A source of false proteinuria was recently discovered when two female children were noted to have heavy "proteinuria" in clean voided urine specimens obtained in the Children's Service Ambulatory Clinic. The girls were admitted to the hospital a few days later. Repeated urine specimens were negative for protein in the hospital.

In an effort to explain this discrepancy, 5 drops of 10% sulfosalicylic acid were added to benzalkonium chloride solution which is routinely used to clean the genitalia in the [See Table I in Source Pdf.] Children's Clinic but not used on the wards. The benzalkonium chloride-sulfosalicylic acid mixture gave a 4+ precipitate indistinguishable from the 4+ protein reaction.
MATERNAL, CORD, AND SERIAL VENOUS BLOOD: PROTEIN-BOUND IODINE, THYROID-BINDING GLOBULIN, THYROID-BINDING ALBUMIN, AND PREALBUMIN VALUES IN PREMATURE INFANTS
Authors: Perry Ralph E. , Hodgman Joan E. , Starr Paul
Published: December 2021

1. P.B.I. and thyroid-binding protein levels in mothers delivering premature infants of varying weights are the same as those reported for mothers delivering at term. The maternal T.B.G. is from 50-60% greater than the T.B.G. of the cord blood.

2. The cord P.B.I. in the smallest infants is significantly lower than their mothers' and is lower than that of the babies weighing over 1,500 gm.

3. The characteristic newborn P.B.I. pattern of abrupt rise in the 48 hours after birth followed by a more gradual fall has been established for the premature infant. The magnitude of rise is less in the smallest prematures. The increase in P.B.I. following delivery is found in all weight groups and does not appear to be associated with the gestational age.

4. T.B.G. levels in prematures are the same as those reported in term infants, and are stable throughout the first 10 days. The rise in P.B.I. cannot be attributed to a change in T.B.G.

5. A pattern of alterations in T.B.A. and T.B.P.A. has been described.
The Paradoxical Effect of Alcohol on Carbohydrate Metabolism in Four Patients with Liver Glycogen Disease
Authors: LOWE CHARLES U. , MOSOVICH LUIS L.
Published: December 2021

Oxidation of ethanol to acetaldehyde, the first step in alcohol metabolism, is catalyzed by the enzyme alcohol dehydrogenase and resuits in the reduction of DPN to DPNH. In a coupled reaction, pyruvate is converted to lactate with regeneration to DPN. There are a number of consequences of these reactions when alcohol is consumed. Lactate levels in blood rise; DPNH produced by the reaction inhibits the enzymatic steps involved in the conversion of UDP galactose to UDP glucose and glutamate to alpha keto glutarate. As a result of these inhibitions, galactose removal from blood is markedly delayed and gluconeogenesis from amino acids is inhibited.
The Maltreated Child–the Maltreatment Syndrome in Children
Authors: PICKERING M. R.
Published: December 2021

This slim volume is an easy-to-read, concise, thought-provoking review of the multiple aspects and current status of the Maltreatment Syndrome in Children. A brief historical survey of society's increasing concern about the welfare of children sets the stage for a detailed description of the problem and its implications. Following discussion of many aspects of the syndrome, a number of case reports and illustrative photographs are presented, effectively enhancing the impact of the text.

The Maltreatment Syndrome in Children, a term coined by the author, includes manifestations ranging from deprivation of food, shelter, or love to actual physical trauma.
Asian Pediatrics: The Scientific Proceedings of the First All-Asian Congress of Pediatrics, New Delhi, 1961
Authors: CONE THOMAS E.
Published: December 2021

This is a book of historic importance because it records the scientific proceedings of the First All-Asian Congress of Pediatrics held in January, 1961, in New Delhi. Delegates from twenty-three countries heard nearly one hundred and fifty original papers on a wide range of child health and care. Ninety of these papers are published in this book, although a few are in the form of a short abstract.

The participants covered the broad areas of pediatrics which are of particular interest to those involved in child care in Afro-Asia.
CONGENITAL SPINAL ANOMALIES IN INFANTS OF DIABETIC MOTHERS
Authors: Rusnak Stuart L. , Driscoll Shirley G.
Published: December 2021

Three similar cases of agenesis of the lower spine in infants of diabetic mothers are presented with a discussion of associated skeletal and systemic anomalies. These cases are compared with 7 similar cases reported previously. A specific pathogenetic relationship to maternal diabetes mellitus is suggested, in light of the rarity of these anomalies in the general population. Possible etiologic factors have been considered in a review of animal experiments and clinical observations in human patients.
PERCUTANEOUS BLADDER ASPIRATION AND OTHER METHODS OF URINE COLLECTION FOR BACTERIOLOGIC STUDY
Authors: Pryles Charles V.
Published: December 2021

IN THE PAST FEW YEARS, a great deal of interest has been focused on the problem of distinguishing true bacteriuria from contamination. The normal urethra is known to harbor bacteria which may contaminate specimens obtained either by voiding or by catheterization. The latter method of obtaining samples may well be the means of introducing organisms that might not have been present before or of replacing sensitive with resistant organisms. Moreover the risk of producing such an infection is greater with the incompletely emptying bladder of lower urinary tract obstruction It has been suggested that percutaneous needle aspiration of the bladder urine may not only be safer than catheterization in some circumstances, but would also obviate contamination of samples during voiding or catheterization.

Elsewhere in this issue, Nelson and Peters relate their experience with suprapubic percutaneous aspiration of the urinary bladder in premature and full-term neonates. Aspiration of bladder urine for bacteriologic purposes was first reported in 1956 by Guze and Beeson, who compared colony counts in urine samples obtained both by bladder aspiration and catheter in a small group of women free from urinary tract infection. The following year a comparison of bacterial counts of the urine obtained by needle aspiration of the bladder, catheterization, and midstream collection was described by Manzon and her associates. In 1959 we obtained samples of urine by percutaneous needle aspiration of the bladder and compared the quantitative cultures with those obtained immediately thereafter by catheterization; all these samples were from infants and children prior to elective laparotomies.
Red Urine: The Monday Morning Disorder of Children
Authors: LEVIN S.
Published: December 2021

It is passing strange that probably the commonest urinary disorder in children gets scant mention in some of the largest standard textbooks on pediatrics or urology. Over the past 20 years the Index Medicus does not list the phenomenon of red urine as a consequence of the ingestion of colored food.

A frequent telephone complaint on a Monday morning concerns the distressing observatio that a 2-or 3-year-old child is passing red urine. Commonly there has been a children's party on the preceding Saturday afternoon or Sunday and in addition to red sweets there have been available red cool drinks and jellies,pink wafer biscuits, red icing sugar, and cakes.
Adrenal Cortical Adenoma Arising in a Girl with Congenital Adrenogenital Syndrome
Authors: DAESCHNER GEORGE L.
Published: December 2021

The following report concerns au adrenal cortical adenoma in a girl of 13 years in whom the diagnosis of virilizing adrenal hyperplasia was made shortly after birth. An explanation of the etiology of the tumor is suggested by the unusual clinical course.

Past History

A. A., a Caucasian infant was born September 8, 1950, to a 31-year-old mother. Birth weight was 8 lb 12 oz (3.8 kg) and the immediate neonatal course was uncomplicated. The house physician recorded the child as a male with hypospadias and discharged it at the age of 3 days without further studies. Eleven days later the infant began to have episodes of vomiting with mild diarrhea.
COMPARATIVE INCIDENCE OF BIRTH DEFECTS IN NEGRO AND WHITE CHILDREN
Authors: Altemus Leonard A. , Ferguson Angella D.
Published: December 2021

Studies made during the last 20 years indicate that in mixed, but predominantly [SEE TABLE VI IN PDF SOURCE] Caucasian, racial groups, birth defect occurs in approximately 1 to 4% of all live births. To supplement the scanty information on the incidence of birth defects among North American Negro children the birth records were reviewed for a ten-year period at two hospitals in the District of Columbia. Approximately 60% of all Negro children born in the District of Columbia are delivered in these hospitals. Among these children representing a cross section of the socioeconomic groups of the Negro community, the incidence of birth defects was approximately 6%. There were significant differences in the frequencies at the two hospitals, the hospital with the largest number of births from mothers in the lower socioeconomic group had approximately three times as many defects as the hospital utilized by the higher socioeconomic group.

The ten congenital malformations occurring most frequently in a group of predominantly Caucasian Boston children were compared with the ten commonest defects in the District of Columbia group. Six defects, namely, polydactyly, clubfoot, hypospadias, congenital heart disease, mongolism, and cleft palate were among the commonest ten in both groups; the frequencies of these varied. The five congenital malformations occurring most frequently at the two hospitals in the District of Columbia were similar in type and in incidence. Multiple defects were rare in both racial groups and no grouping of defects seemed to occur together more frequently than others.
RADIOISOTOPE RENOGRAPHY IN CHILDREN
Authors: Wenzl James E. , Tauxe W. Newlon , Burke Edmund C. , Hunt James C. , Stickler Gunnar B.
Published: December 2021

Radioisotope renograms with orthoiodohippurate-I131 were obtained for 41 children who had known renal or renovascular disorders. (Two patients had hypertension but no evidence of renal disease.) Values determined for various components of the renogram curves were considered abnormal when they exceeded two standard deviations from the mean values for normal children of similar body surface area or when time B (from injection to the point of maximal radioactivity) exceeded 6.5 minutes or differed from the contralateral kidney by more than 1 minute.

The renogram was clearly abnormal in all 17 patients who had unilateral or predominantly unilateral renal disorders. Abnormalities associated with bilateral renal disorders varied with the disease and its severity. The clinical severity of impairment of renal function could be estimated from the renogram.

The isotope renogram proved to be a simple, reproducible technique for determination of function of the separate kidneys.
HYPERMETHIONINEMIA: A METABOLIC DISORDER ASSOCIATED WITH CIRRHOSIS, ISLET CELL HYPERPLASIA, AND RENAL TUBULAR DEGENERATION
Authors: Perry Thomas L. , Hardwick David F. , Dixon Gordon H. , Dolman Clarisse L. , Hansen Shirley
Published: December 2021

Three infants in one sibship are described, each of whom died during the third month of life after illnesses characterized by irritability and progressive somnolence, and terminally by a tendency to bleed and hypoglycemia. Each infant had a very peculiar odor for several weeks before death. Autopsy disclosed almost identical pathological changes in each infant, consisting of hepatic cirrhosis, renal tubular dilatation, and pancreatic islet hypertrophy.

Biochemical investigation of the third infant demonstrated, besides a generalized aminoaciduria, a very marked elevation of methionine in serum, and a disproportionately high excretion of this amino acid in urine. Normal brain cystathionine concentration, and absence of excessive amounts of homocystine and cystathionine from urine, indicated that the major known pathway of methionine degradation was intact. α-Keto-γ-methiolbutyric acid was found in the infant's urine and may have been responsible for the patient's odor.

It is suggested that an alternative pathway of methionine breakdown, in addition to that leading through cystathionine, exists in man, and that an enzymatic block, possibly in the oxidative decarboxylation of the alpha keto acid of methionine, might conceivably have accounted for the disease found in these infants.
Accidental Strangulation in Infancy
Authors: GREENDYKE ROBERT M.
Published: December 2021

Six infant deaths due to accidental strangulation are presented. The hazards presented by certain restraining devices are emphasized and a plea is made for recognition of the potential risk of strangulation of babies in high chairs or crib.
STUDIES IN ACUTE IRON POISONING. I. DESFERRIOXAMINE IN THE TREATMENT OF ACUTE IRON POISONING: CLINICAL OBSERVATIONS, EXPERIMENTAL STUDIES, AND THEORETICAL CONSIDERATIONS
Authors: Whitten Charles F. , Gibson George W. , Good Mary H. , Goodwin Jesse F. , Brough A. Joseph
Published: December 2021

1. Thirteen children who had ingested iron salts were treated with a combination of enteral and parenteral Desferrioxamine. Although all recovered, a review of the literature indicates that criteria are not available to determine whether the treatment was responsible for their survival.

2. Three of 9 dogs recovered when treated with enteral and intravenous [See Table XII. in Source Pdf.] Desferrioxamine, which was started 1 hour after the administration of a L D.100 dose of ferrous sulfate.

3. Desferrioxamine does not prevent the absorption of the quantities of iron involved in acute iron poisoning.

4. Further studies are essential to: (a) establish criteria for determining the quantity of Desferrioxamine to use in individual cases so that maximum effectiveness will be achieved without producing serious toxicity, and (b) to determine whether toxicity from the iron-desferrioxamine complex can be prevented.
Review of Child Development Research, Volume I
Authors: VALADIAN ISABELLE
Published: December 2021

Sponsored by the Russell Sage Foundation, the Society of Research in Child Health and Development has undertaken the much needed task of presenting to the professional persons of various disciplines working with children a selective and interpretive review of child development research.

The present volume, which is the first of an announced series, deals predominantly with the social and psychologic aspects of child development. It covers a great variety of topics from infant care, parental separation, parental discipline, early group experience, effects of mass media, acquisition of sex typing and sex role identity, and development of moral character, to the genetic and neurophysiologic aspects of behavior.
Sex-Linked Neurodegenerative Disease Associated with Monilethrix
Authors: BRAY PATRICK F.
Published: December 2021

A family in which two male infants died with spastic dementia, seizures, and defective hair development is described and is compared with a very similar family reported recently. Despite the marked similarity in the clinical findings and the pattern of inheritance in the two families, the biochemical findings differed, providing the impetus for this report. Whereas previously Menkes, et al, found elevated levels of glutamic acid in the blood of two of five affected boys, all of the plasma and urinary amino acid values in the patient reported here were normal. Whether observations reported here amid those of Menkes should be interpreted to indicate the existence of two different diseases with very similar clinical features, or whether the glutamic acidemia is an inconsistent epiphenomenon in a single inborn error of metabolism must be considered.
Pulmonary Venoconstriction and the Pharmacology of Respiratory Distress
Authors: IVANHOE FRANCIS
Published: December 2021

I have read with great care the preliminary report on hyaline membrane disease which Dr. J. Chu and collaborators have published in your May issue. It is indeed a pleasure to see the mention of reflex pulmonary vasoconstriction by other members of the profession as the "crucial functional abnormality" involved in this condition. The following considerations are made with a view to criticizing in a constructive way some of the interpretations elaborated by the authors in explaining their data.
THE USE OF COTTON-TIPPED SWABS AS A SIMPLE METHOD OF TRANSPORTING CULTURES OF BETA HEMOLYTIC STREPTOCOCCI
Authors: Breese Burtis B.
Published: December 2021

Almost 100% of beta hemolytic streptococci isolated from cases of streptococcal disease will remain viable on untreated cotton swabs for 1 week and over 90% for periods up to a month when dried and sealed in ordinary pill envelopes. Knowing this fact, the practicing physician can transport cultures for this organism without haste by mail or in his bag reliably, cheaply, and simply.
Your Allergic Child, Herman Hirshfeld. New York: ARC Books, 1964, 142 pp., $1.45
Authors: Mueller Harry Louis
Published: December 2021

The author covers the field of clinical allergy with a good introduction in the first two chapters to the general problems of the allergic child and then takes up specific allergic diseases under appropriate chapter headings. Throughout the book, there is an underlying theme that each patient differs, that there are no "pat" answers, and that the parent should consult his physician for the final analysis. No fads or fancies are plugged and the general tone is conservative.
Drug Addiction in Youth International Series of Monographs on Child Psychiatry
Authors: GALDSTON RICHARD
Published: December 2021

This monograph edited by the Editor of the excellent International Series of Monographs on Child Psychiatry, contains 17 articles by 14 different authors. These chapters include detailed descriptions of the clinical and pharmacological effects of glue sniffing, marihuana, heroin, and paint thinner. The social and economic characteristics of the population from which the typical young drug addict emerges are well developed in these chapters. The addict's habits, attitudes, and practices are described and his relative resistance to a variety of treatment and rehabilitation techniques is eloquently emphasized.
TRANQUILIZER POISONING: AN EXAMPLE OF CHILD ABUSE
Authors: Dine Mark S.
Published: December 2021

A case of deliberate perphenazine poisoning by a parent is presented as an example of child abuse. The symptoms of poisoning included prolonged sleep, convulsions, and hyperpyrexia. The correct diagnosis was delayed because the mother denied that the child had received any drug. Suggestions for making the diagnosis include a high index of suspicion on the part of the physician and routine testing for phenothiazines and other psychotropic drugs in patients with convulsions of undetermined etiology.
Renal Arteriography in Infancy
Authors: PUYAU FRANCIS A.
Published: December 2021

A description has been made of a simple method of obtaining renal arteriograms in small infants.
Prenatal Treatment of Erythroblastosis
Authors: REWALD ENRIQUE
Published: December 2021

I was most interested in the papers published from the International Conference of Intrauterine Fetal Surgery held in Stowe, Vermont, November 9-1l, 1964 (Pediatrics 35: 813, 1965).

The current interest in this subject induced me to request publication of the following commentary: I think that intrauterine exchange transfusion, as performed by Karlis Adamsons, Jr., et at., where the femoral artery was cannulated in order that the arterial pressure should permit the withdrawal of blood, seems to be an unnecessary risk since, until birth, the mother is perfectly able to withdraw the excess of fetal bilirubin.
Adopting A Child Today
Authors: WESSEL MORRIS A.
Published: December 2021

The author of this book possesses strong motivation to improve circumstances surrounding the creation of families through the adoptive process. This aim is praiseworthy for there is great need for better understanding of the various professional responsibilities which the law, social work, and medicine should offer in this area.

The initial chapter, entitled "Agency Adoption," states that couples seeking to adopt should gain through their contacts with a caseworker "new insights into themselves, their feelings about adoption, and the ways in which they will handle the special problems of adoption with the child in the years ahead."
ANNUAL SUMMARY OF VITAL STATISTICS—1964
Authors: Wegman Myron E.
Published: December 2021

Each year as the vital statistics of the United States are reviewed,* the key question asked by pediatricians is "What has happened to infant mortality?" This year, in 1964, it is gratifying to note that a new low was achieved. While preliminary results for 1965 suggest that a retrogression may be in store, the 1964 record is the best the country has yet seen.

The year 1964 was also characterized by continuation of the downward trend in births, a tendency of the marriage rate, which had been climbing over the previous two years, to level off, and a slight over-all decline from the preceding year in general mortality.
Group Therapy in Childhood Psychosis
Authors: BULLARD D. M.
Published: December 2021

Clinical research in childhood psychosis is one of the most difficult tasks facing child psychiatry today. The unstable nature of the clinical observations is matched by the ambiguities of the available theoretical models. Of all the aspects of this complex disorder the effectiveness of psychotherapy is singular in its importance and elusive in its demonstration.

This monograph describes a research study of the response of a small group of psychotic children to group psychotherapy over a period of four years.
Pierre Robin Syndrome
Authors: WARD WILLIAM W.
Published: December 2021

Doctor Wallace M. Dennison's excellent discussion of "The Pierre Robin Syndrome," Pediatrics, 36:336, did not mention a very effective and easy method of preventing airway obstruction. Oeconomopoulos described the placement of a heavy silk suture through the base of the tongue and through the anterior alveolar ridge. We have found this to be most effective.
Mumps Skin Tests and Skin Sensitivity
Authors: HOLTZ ALBERT I.
Published: December 2021

In the note published by Drs. Aronson and Lepow, "The Effect of Repeated Mumps Skin Tests on the Skin Sensitivity to Mumps Antigen" (Pediatrics, 36:422), the 3 injections of skin test antigen were not followed by skin sensitivity. In an attempt to produce immunity within the incubation period of mumps infection, one intradermal skin test followed by 10 cc. of mumps vaccine injected intramuscularly produced a skin-test conversion in only 7 out of 18 children, of these only 2 developed neutralizing antibody.
THE EFFECT OF ACTIVITY ON THE CONCENTRATION OF BLOOD LACTATE IN NEWBORN INFANTS
Authors: Graven Stanley N. , Criscuolo Dominic , Holcomb Thomas M.
Published: December 2021

The effect of 5 to 20 minutes of mild to moderate activity on the concentration of blood lactate in 9 infants was measured. During activity the concentration of blood lactate increased 0.4 to 1.8 mM/L. The maximum increase in the concentration of blood lactate after vigorous activity was 2.9 mM/L.

Based on the results of these studies, the following conclusions are drawn:

1. Activity, even if mild, can increase significantly the concentration of blood lactate in the neonate.

2. During vigorous activity, lactate can accumulate at rates (0.14-0.34 mM/L/min) approaching those observed during total asphyxia.

3. Following activity, neonates may metabolize lactate at a slower rate than human adults.

4. The effect of activity must be considered in the interpretation of any studies which involve the concentration of blood lactate in the neonate.
FAMILIAL NATURE OF CONGENITAL HEART DISEASES
Authors: Nora James J. , Meyer Thomas C.
Published: December 2021

A two-year investigation of 517 families selected through a proband having a congenital heart disease suggests a higher frequency of familial congenital disease than has been reported before. Many previously undiagnosed parents and siblings of the probands were discovered by the simple method of listening to their hearts. Although figures of 3.4% affected sibs and 1.8% affected parents are presented, it is emphasized that these figures are used only to call attention to the high frequency of familial congenital heart diseases. The figures are not suggested as empiric risks because "congenital heart disease" is more appropriately a category of diseases than a discrete disease. An awareness that familial congenital heart diseases are perhaps not as uncommon as previously reported places a responsibility on the examining physician to other members of the family as well as to the patient.
Thrombocytopenia in Rocky Mountain Spotted Fever
Authors: STRYKER WINIFIELD
Published: December 2021

The case of Rocky Mountain Spotted Fever with multiple coagulation disturbances reported in Pediatrics (36:627, 1965) was similar to a recent patient's.

This was a 2½ year old girl with a 9 day history of fever and rash. She was comatose and had papular lesions, many of which were hemorrhagic, involving the whole body (including palms and soles) plus many small flat petechiae. A sibling had died 2 days before with an identical history.
INTRAUTERINE GROWTH OF TWINS AS ESTIMATED FROM LIVEBORN BIRTH-WEIGHT DATA
Authors: Naeye Richard L. , Benirschke Kurt , Hagstrom Jack W. C. , Marcus Cyril C.
Published: December 2021

Percentile curves representing intrauterine growth of monochorionic and dichorionic twins were constructed from the birth weights of liveborn infants at gestational ages ranging from 24 to 42 weeks. The median weights of twins were progressively lower than median weights for single-born infants during late gestation. Monochorionic twins were both smaller and had a greater intrapair variation in birth weight than dichorionic pairs. Intrauterine growth charts prove useful in studying factors influencing twin growth during both the prenatal and postnatal periods.
HEART FAILURE IN CONGENITAL THYROTOXICOSIS
Authors: Farrehi Cyrus , Mitchell Marvin , Fawcett David M.
Published: December 2021

Congenital thyrotoxicosis, or Graves' disease of the newborn, may be complicated by cardiac decompensation. Both the disease and its complication are self-limited, but they may become severe and endanger the life in the neonatal period.

Failure of the heart may be related to interference with formation of high-energy phosphate bonds in the myocardial mitochondria by high levels of thyroid hormone. This phenomenon depletes the source of energy for myocardial contraction.

The treatment should be primarily directed toward the hyperthyroidism.

The enhanced rate of growth of the hyperthyroid fetus may lead to a developmental state where a small, apparently premature infant has well-formed and well-functioning organs, some aged far in advance of the relatively short intrauterine life. The term "accelerated maturity" is suggested to describe this state.
Beta-1C-Globulin in Glomerular Nephritis
Authors: KLEMPERER MARTIN R. , GOTOFF SAMUEL P. , ALPER CHESTER A. , ROSEN FRED S.
Published: December 2021

It was previously reported that hemolytic activity was restored to the serum of an individual with acute glomerulonephritis upon the addition of purified beta-1C-globulin (Ć3). At the time it was known that this preparation of beta-1C-globulin was contaminated with two other complement components, beta-1F-globulin (Ć5) and Ć62 though the latter complement component has not been immunochemically characterized. Recently a method has been described by Nilsson and Müller-Eberhard for the separation of these proteins, so that immunochemically pure beta-1C-globulin can be obtained which is free of beta-1F-globulin, Ć6 and beta-1H-globulin, another contaminant which is not a complement component.
Letters to the Editor
Authors: BONGIOVANNI ALFRED M.
Published: December 2021

Basically what Dr. Klein says is in no way contradictory to what I happen to believe. Nonetheless, in a commentary read widely by practitioners it is necessary to pick an age for a number of reasons. First of all, within our own city I have a pretty good idea of what is going on in other hospitals. There is a great deal of surgery being done in the first year or two of life and I do not like this.
Management of Emotional Problems of Children and Adolescents
Authors: HARRIS HERBERT I.
Published: December 2021

This book is a comprehensive treatise of the subject matter but is happily couched in such a simple prose that it is a pleasure to read. After a thorough-going discussion of the normal aspects of childhood and adolescence the author elaborates upon the usual adjustment problems encountered in these years. He inclines to be somewhat gingerly in his treatment of adolescent sexuality and its problems, which actually compose a much larger area of adolescent concern that one would surmise from this book.
Management of Juvenile Diabetes Mellitus
Authors: GROSSMAN ELMER R.
Published: December 2021

Doctors Traisman and Newcomb cover the usual subjects of the cause, diagnosis and treatment of juvenile diabetes, leaving about one-third of the text for a detailed description of diet therapy. The book is designed as a how-to-do-it guide, and should be judged accordingly.

In these modest terms, it is a reasonably useful book. A few omissions, however, are worthy of note. For example: the four-page discussion of differential diagnosis omits postconvulsive and acute febrile glycosuria—two well-known though uncommon entities.
THE EFFECT OF ROOMING-IN ON THE ACQUISITION OF HOSPITAL STAPHYLOCOCCI BY NEWBORN INFANTS
Authors: Mortimer Edward A. , Wolinsky Emanuel , Hines Donna
Published: December 2021

The effect of rooming-in of infants with their mothers on the acquisition of hospital staphylococci was studied by comparing rates of acquisition with a control group of infants cared for on the same division in standard fashion. Thirty-one percent of 75 rooming-in babies and 40% of 224 control infants acquired strains identical to organisms carried by personnel or other infants. The reasons for the lack of a more striking effect are not clear, but the results suggest that rooming-in as practiced in this study is of little benefit in preventing nursery cross infection.
CONGENITAL NONSPHEROCYTIC HEMOLYTIC ANEMIA ASSOCIATED WITH ERYTHROCYTE GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY IN A NEGRO FAMILY
Authors: Grossman Aaron , Ramanathan K. , Justice Parvin , Gordon Joan , Shahidi Nasrollah T. , Hsia David YI-Yung
Published: December 2021

This paper describes a Negro family with congenital nonspherocytic hemolytic anemia associated with glucose-6-phosphate dehydrogenase deficiency.

All four affected males in this family showed a hemolytic anemia characterized by low hemoglobin, reticulocytosis, and jaundice. There was no detectable G-6-P D in the red cells and about a tenth of normal enzyme activity in the white cells. By starch gel electrophoresis, the G-6-P D was present as a single band which migrated at the rate of 104% of normal. Physico-chemical studies revealed a marked increase of the Michaelis constant for both G-6-P and TPN, a marked lability of the enzyme upon heating at 40°C and 48°C, and a single narrow peak at pH 9.0. Most of these features were similar to those seen in the Oklahoma I variant.

Four of the females in the family were studied (two sisters, the mother, and a maternal aunt of the propositus); all showed a lesser degree of anemia and reticulocytosis but no jaundice, except in the mother. There was a decrease of haptoglobins and both the mother and one sister showed a decrease of erythrocyte survival time as measured by chromium-51. The female members had between 11 and 26% of normal G-6-P D activity in the red cells and between 35 and 63% of normal enzyme activity in the white cells. Starch gel electrophoresis in the mother and aunt showed a single band which migrated at 110% of normal with a trail at the position of the affected males.

The presence of a milder degree of hemolysis in the heterozygous carriers of the gene for G-6-P D deficiency associated with congenital nonspherocytic hemolytic anemia provides further support for the Lyon hypothesis in man.
RESUSCITATION AND TREATMENT FOLLOWING SUBMERSION
Authors: Redding Joseph S.
Published: December 2021

In resuscitation from drowning it must be remembered that when breathing movements are absent no time must be wasted in attempts to drain the lungs. Reoxygenation must be started immediately with exhaled air. Positive pressure ventilation with oxygen should be substituted as soon as possible. It should be continued in victims of sea water submersion until a blood specimen can be examined and any plasma deficiency corrected. In fresh water drowning intermittent positive pressure ventilation combined with closed chest cardiac massage is a preliminary to external electrical defibrillation. Prevention of delayed death depends upon the management of massive hemolysis, hypervolemia, electrolyte imbalances, aspiration pneumonitis, and myocardial failure.
Congespirin: Distribution, Composition, Advertising
Authors: ALPERT JOEL J.
Published: December 2021

An advertisement in the November, 1965, Pediatrics (page cix) advertises "The First and Only Pediatric Cold Tablet Recommended Even for Three Year OldsmNew Congespirin." This product has been extensively advertised on television. In addition, it has been distributed through the mails and sample packets containing tablets distributed in residential areas so that one 3-year-old collected for his mother, but fortunately did not ingest, some 20 packages containing 80 tablets.

I wish to protest not only this method of advertising, which is a potential source of accidental ingestion, but also the product itself.
The Individual, Society, and Health Behavior
Authors: HAGGERTY ROBERT J.
Published: December 2021

This is a mind stretching book. It presents a broad picture of studies from the behavioral sciences—especially social psychology—of relevance to public health practice. If there is any criticism of the book it would be the exclusive use of the public health model to show the relevance of this knowledge to medicine. This is not to say that there is not a great deal of value in this book for the practitioner dealing with individual children and their families.