bluuebunny/crossref_metadata_2025 huggingface dataset:
PULMONARY EMPHYSEMA AND OTHER CARDIORESPIRATORY LESIONS AS PART OF THE MARFAN ABIOTROPHY
Authors: Bolande Robert P. , Tucker Arthur S.
Published: December 2021

Seven cases of Marfan's syndrome are reviewed clinically, radiologically, and pathologically.

Six of the seven cases showed evidence of pulmonary dysaeration: (a) Two of the cases showed compression of the left main-stem bronchus by a giant left atrium with atelectasis of the left lung and compensatory emphysema of the right lung. (b) Two of the cases showed evidence of diffuse chronic pulmonary emphysema. Three cases had bilateral apical bullae. (c) One of the cases developed pneumothorax. The lungs of the children with the Marfan syndrome show precocious maturation of the elastic stroma of the alveolar septae. The pathogenesis of emphysema is discussed in relationship to the Marfan abiotrophy of connective tissue.
SYMPTOMATIC NEONATAL HYPOGLYCEMIA
Authors: Cornblath Marvin , Wybregt Susan H. , Baens Gloria S. , Klein Reuben I.
Published: December 2021

1. Symptomatic hypoglycemia occurs predominantly in male infants of low birth weight for the period of gestation.

2. Approximately 50% of the mothers had toxemia of pregnancy.

3. Low levels of glucose were found in the smaller of twins, with central nervous system pathology, and in the presence of polycythemia. On occasion, low levels of calcium were also present.

4. Therapy consists of intravenous glucose, plus ACTH or steroids as needed to relieve symptoms and maintain normal levels of blood glucose.

5. The pathogenesis may reflect intrauterine malnutrition with low stores of glycogen present at birth associated with an abnormally sensitive insulin release mechanism resulting in hypoglycemia and symptoms.
HOMOCYSTINURIA, AN ERROR IN THE METABOLISM OF METHIONINE
Authors: Gerritsen Theo , Waisman Harry A.
Published: December 2021

A new inborn error of metabolism was found in two mentally retarded children. The excretion of homocystine was accompanied in one boy by ectopia lentis, failure to thrive, poor developmental milestones, thrombo embolic phenomena, methioninuria, decreased excretion of taurine, and elevated plasma methionine. The second patient had normal plasma methionine levels, and a nearly normal amino acid pattern in the urine other than homocystine. Loading tests using methionine, serine, and homocystine failed to alter plasma amino acid levels and did not provide any information on the nature of the metabolic defect in sulfur amino acid metabolism. The two children had different abnormalities in methionine metabolism or they had the same metabolic defect but in different degrees of severity.
DISCOID LUPUS IN A NEWBORN INFANT OF A MOTHER WITH LUPUS ERYTHEMATOSUS
Authors: Jackson Robert
Published: December 2021

This is the third reported case of discoid lupus erythematosus in a newborn infant, the first reported with a positive L.E. cell test in the infant's blood. The mother had systemic lupus erythematosus. The two previously reported cases and the nine previously reported cases of circulating L.E. cells in newborn infants whose mothers had systemic lupus erythematosus were reviewed. The tentative conclusion is reached that the presence of L.E. cells in the newborn circulation with or without accompanying discoid facial lupus erythematosus is due to the passive placental transfer of the L.E. factor from the mother to the fetus.
Occurrence of Myeloma-Like γ-Globulin in C.S.F of A Four-Month Old Infant with Hydrocephalus
Authors: HOCHWALD G. M. , THORBECKE G. J.
Published: December 2021

Myeloma-like immune globulins present themselves as narrow bands upon paper electrophoresis, and usually show a characteristic appearance in immunoelectrophoresis. Two antigenically different groups of myeloma proteins have been described: groups I and II. Recently, 60% of normal γ-globulin, throughout the mobility range of γ-globulin, has been shown to possess the antigen characteristic for group I, and 30% that for group II myeloma.

Occurrence of myeloma-like proteins in the serum is not restricted to multiple myeloma. They may also be seen with other tumors, such as reticulum cell sarcoma, and various carcinomas. In addition, Sonnet and Milhaux have reported on the frequent occurrence of myeloma-like ("monoclonal") γ-globulins in the serum of adult Bantus with different diseases.

When large amounts of a myeloma protein are present in the serum, it may be found in a much lower concentration in the spinal fluid.
CHROMOSOME ANALYSES IN A CHILDREN'S HOSPITAL
Authors: Warkany Josef , Weinstein E. David , Soukup Shirley W. , Rubinstein Jack H. , Curless Mary C.
Published: December 2021

Chromosome analyses were performed in 227 persons, most of them pediatric patients. The majority of these were selected because of mongolism, other forms of mental retardation, congenital malformations, and sex anomalies. Some normal persons were also included in the study. Most of these were relatives of the patients.

Patients with Down's syndrome (mongolism) were selected because of low maternal age, familial recurrence, leukemia, and other reasons. Most of these patients had regular trisomy 21 mongolism but other cytogenetic types were also discovered and described.

No trisomy 13-15 syndrome was found but there were six trisomy 18 patients. Two children with multiple congenital malformations were examined and noted to be mosaics having in addition to normal cell lines, cells with trisomy 13-15 and trisomy 18 respectively.

Other patients with various congenital malformations including isolated congenital heart disease had normal cytogenetic patterns.

No typical Klinefelter's syndrome was encountered in a child. Several patients with Turner's syndrome, including one "male Turner's syndrome," and several cases of male pseudohermaphroditism were described.

Applications of the new cytogenetic methods and findings to clinical diagnosis and genetic prognosis were discussed.
Neonatal Infection and Premature Rupture of Membranes
Authors: JOHNSON KIT G.
Published: December 2021

As the article by Pryles, et al. entitled "A Controlled Study of the Influence on the Newborn of Prolonged Premature Rupture of the Amniotic Membranes and/or Infection in the Mother," Pediatrics, Vol. 31, pp. 608-622, has not yet received comment in your journal, perhaps it is not too late to ask the authors to fill three hiati which I felt existed in their presentation of this excellent study.

As antibiotics apparently were used (according to Table X) in some infants prior to the diagnosis of clinical sepsis, what were the comparative morbidity and mortality results in this group versus the group in which treatment was deferred until the diagnosis of clinical sepsis could be made?
New Hazards of Toys
Authors: JACOBZINER HAROLD
Published: December 2021

As it is well known some of the most severe and difficult to treat pneumonias in children are those caused by the aspiration of petroleum products, especially of the very light mineral oils.

At the present time there are on the market floating plastic nursery toys containing liquids, designed as playthings for the bath. Some of these toys containing very light mineral oils, develop cracks in use permitting the contents to escape slowly. These situations thus present a potential aspiration hazard and have resulted in complaints to us. The use of a vegetable oil in such toys would provide adequate buoyancy and eliminate the aspiration hazard. Some of these toys in the past contained kerosene. The manufacturers, in eliminating the fire hazard, create a new one by injudicious use of alternatives.
Nursing Your Baby
Authors: CONE THOMAS E.
Published: December 2021

These two books are a commentary on the physician's failure to promote breast feeding by the written word because both are written by mothers to offset the steady decline of breast feeding in the United States.

Mrs. Pryor's book is divided into two parts. The first is a survey of what we know about lactation and breast feeding; the second part is a day-to-day, month-by-month account of nursing a baby, from the first feeding in the hospital to a leisurely weaning months later.
DR. PARK AND THE GROWTH OF BONE
Authors: SILVERMAN FREDERIC N.
Published: December 2021

IN THE PREFACE to his monograph "Bone Growth in Health and Disease" Harris concluded with the following paragraph: "The romance of bone growth is not yet exhausted. The manifestations of disease in bone, the registration of lines of arrested growth in long bones, the phenomenal response of certain deficiency diseases to vitamins, the age changes in bone, and the extent to which the child can `grow out of' disease conditions still present fundamental problems in clinical research and biology. Gradually, but surely, we are passing from the vitalism of Ecclesiastes: `As thou knowest not what is the way of the wind, nor how the bones do grow in the womb of her that is with child' to the clinical certainty of Job: `His bones bear witness to the sins of his youth.'"
STUDIES ON FOLIC ACID IN INFANCY
Authors: Matoth Yehuda , Zamir Rina , Bar-Shani Shulamith , Grossowicz Nathan
Published: December 2021

Folic acid was assayed microbiologically in whole blood in a group of infants hospitalized for diarrhea, various infections, and malnutrition. Folic acid activity was decreased in the majority of cases. In some of the infants very low levels were observed. The value of the determination of folic acid in whole blood as a sensitive index of the folic acid status of an individual was confirmed by parallel observations on bone marrow morphology and the level of folic acid in serum. Folinic acid levels were within the normal range in most cases. Low folinic acid levels were common only when folic acid was extremely low. Many patients with low folic acid levels were not anemic, or mildly anemic. In the anemic patients a hypochromic microcytic blood picture was the rule. The effect of treatment with folic acid on the general condition of the patients was more striking than the hematological response.
INDICATIONS FOR EXCHANGE TRANSFUSION BASED UPON THE ROLE OF ALBUMIN IN THE TREATMENT OF HEMOLYTIC DISEASE OF THE NEWBORN
Authors: Waters William J. , Porter Eva
Published: December 2021

Maternal titer, history of previously treated sibling, positive Coombs, prematurity, cord serum bilirubin, and hemoglobin concentration do not by themselves indicate the need for immediate exchange transfusion in an infant who shows no signs of disease. The measurement of the reserve albumin binding capacity is a useful aid in determining the need for exchange transfusion in preventing bilirubin encephalopathy. A delay in treatment of infants who have an adequate reserve binding capacity does not increase the need for re-exchange and avoids unnecessary procedures. The rate of re-exchange among infants receiving added albumin and managed according to the criteria outlined was lower than in the conventionally treated series.
A CRITICAL EVALUATION OF THE MORO REFLEX
Authors: Parmelee Arthur H.
Published: December 2021

The conflicting statements relative to the proper stimulus for eliciting the Moro reflex and the response to be expected have been discussed and a historical review of the varying points of view presented.

The present study was done in three parts. In the first part, seven infants were studied by motion picture analysis at 0-4 days, 6 weeks, and 12 weeks of age. Four stimuli were used: (1) allowing the baby's head to drop back suddenly; (2) a pin prick to the baby's foot; (3) a loud noise; (4) slapping the examining table near the baby's head. The second and third stimuli were relatively ineffective at all ages tested. The first and fourth stimuli were equally effective throughout. The outward movements of the arms were dominant throughout but the secondary inward movements were prevalent in the neonatal period, but absent at 12 weeks of age. In the second part, 30 infants were studied by motion picture analysis, only in the neonatal period using four stimuli: (1) allowing the baby's head to drop back suddenly; (2) slapping the examining table near the head of the baby; (3) suddenly tilting downward a board to which the baby was fastened; (4) sudden jarring of the same board.

A scoring scale for arm and hand movements was devised as well as a scale for the state of arousal of the infant just prior to testing. The first, second, and fourth stimuli were equally effective and all were superior to the sudden dropping of the board. It was concluded that the stimulation of the semicircular canals of the infants was not enough for a good Moro response when neck movement was prevented by the board. Neck movement seems to be essential for significant Moro response. The scores for hand response were somewhat related to those for arm responses.

In the third part of this study, a detailed scoring technique for arm and hand movements and state of arousal of the baby was devised. Forty infants were studied in the neonatal period by direct observation. Interscorer agreement between five observers rating arm and hand movements was not good. This illustrates the difficulty of carefully observing and recording the Moro reflex response without the aid of motion pictures. The hand responses did not correlate strongly with the arm responses so that one could not rely on just hand observations.

In both Parts II and III of this study, no correlation could be found between the state of arousal of the infant just prior to the administration of the stimulus and the degree of response.
A New Development in Pediatric Education for the Practitioner and the Student
Authors: BRANTHAVER CHARLES A.
Published: December 2021

In view of the recurring criticism from practicing pediatricians directed in one way or another to the schism developing between themselves and the academic pediatrician, an ongoing program at the University of Minnesota might be of interest to pediatricians of either calling. This program was initiated on two premises that may not have been particularly unique fifteen years ago but do need reemphasis at this time. The first premise (and perhaps the more startling) was that the practicing pediatrician has a significant contribution to make to academic pediatrics.
A SYMPOSIUM: RECENT ADVANCES IN CARDIOLOGY
Authors: Griffiths Sylvia P. , Blumenthal Sidney
Published: December 2021

THE MEMBERS of the Section on Cardiology are particularly pleased with the opportunity presented by this symposium to share with you one of the major stated objectives of the Section "to promote understanding by pediatricians of established principles of diagnosis and treatment of cardiovascular diseases in children." The participants in this symposium are all active members of the Section with the exception of a close friend and colleague representing cardiovascular surgery, Dr. John W. Kirklin.

In order to examine the present and explore the future, one needs to review, however briefly, the past. A survey of pediatric journals and past programs of the American Academy of Pediatrics attests to the longstanding interest of pediatricians in diseases of the heart and great vessels in children. One of my prize personal possessions is a reprint of an article written by Dr. Murray H. Bass entitled "Heart Block and Congenital Heart Disease in Childhood" published on February 2, 1918, in the J.A.M.A., 70: 287-288. In addition, Dr. Bass was a pioneer in the development of phonocardiography. This dated back to the early 1930's and was stimulated by what he hoped would be a method of differentiating organic from insignificant murmurs. And yet, he would hardly have considered himself a pediatric cardiologist. His many contributions to the literature encompassed almost every facet of clinical pediatrics.

Here in Chicago, Stanley Gibson and Hugh McCullough might better be termed pediatric cardiologists with extremely wide pediatric interests. The contributions of Maude Abbott, Dorothy Andersen, and our own Helen Taussig need no recapitulation to this audience.
NEW DEVELOPMENTS IN DIAGNOSTIC METHODOLOGY
Authors: Adams Forrest H.
Published: December 2021

BECAUSE of the multiplicity of diagnostic techniques in pediatric cardiology, numerous skilled individuals will be required to participate in the patient's workup and it is essential that these work together as a team. The patient's physician still maintains the all important role of obtaining an adequate history and physical examination and making the referral to the pediatric cardiologist and participating in the resultant decisions about management of the patient.

Some of the newer techniques over the past decade extensively use x-rays and radioisotopes in the diagnosis of heart disease in infants and children. Most important, however, one should be aware of minimum radiation dose when employing these techniques. Fluoroscopic examination should be reserved for evaluating specific problems and more reliance placed on conventional x-rays of the chest as well as other parameters such as the electrocardiogram. An image intensifying unit for fluoroscopy or during cardiac catheterization should be used whenever possible. Optimal exposure factors which reduce radiation to a minimum during cardiac catheterization and angiography should be employed as well as gonadal protection devices during study. Yearly checks on radiation output of equipment should be carried out. When isotopes are used for indicator dilution studies to determine shunts and cardiac output, rapidly excreted ones should be employed with low activity and short half-life.

Recent developments in the recording of the electrical events of the heart beat include a battery-operated miniaturized radio broadcasting system which permits the recording of the electrocardiogram signal without the use of wires. The sender is attached to the patient and the receiver can be located as far away as 1,500 feet.
THE INFANT WITH HEART DISEASE
Authors: Rudolph Abraham M.
Published: December 2021

IN SPITE OF great surgical advances, congenital heart disease is still a major cause of death in children, and this is particularly true in the infant age group. The magnitude of the problem may be appreciated by viewing some data on mortality from congenital heart disease collected by Carlgren in Gotenberg, Sweden. He reviewed the history of all individuals born with congenital heart disease in a 10-year period in that city. Within 15 years after birth, 40% of these individuals had succumbed. The really important factor which emerged, however, is that 30% of these patients died in the first 6 months after birth. In reviewing the causes of death in this group, I have estimated that at least 50% of these infants died of lesions which can be cured or relieved by procedures presently available. It is thus obvious that it is incumbent on us, as pediatricians, to recognize and treat the child with heart disease at the earliest possible age.

Recognition of heart disease, and particularly of specific congenital lesions, is considerably more difficult in the infant than in the older child. One problem is that the lesions encountered in infancy may be much more complicated than in older children, because after the first year many of the infants with complicated lesions may have already succumbed. More important though, is the fact that many congenital heart lesions do not present the classical clinical features we have come to recognize with specific lesions in the older child. For example, the presence of only a systolic murmur or even an absence of murmur may occur in an infant with patent ductus arteriosus, rather than the typical continuous machinery murmur seen in the older youngster.
PARENTS' FEAR OF CONFLICT IN TOILET TRAINING
Authors: Spock Benjamin , Bergen Mary
Published: December 2021

Many mothers today have come to see training too exclusively as a conflict between mother and child, which only one can win; if the mother wins it will be only by arousing and then overriding the child's hostility. Dreading the conflict, they ignore signs of readiness. Thus training is postponed for months during which the mother is frustrated and the child develops feelings of inadequacy and guilt. Though a young child's possessive impulses may work against training at times, there are several other emotional drives ready to support training: the healthy child wants to master new skills, prefers to be clean, wants to wear grown-up clothes, likes to please and co-operate with his mother most of the time. If mothers can see that the balance is in favor of training, when conducted tactfully, they can go at it in a more assured and effective manner. By 18 months they should be encouraged to take advantage of whatever readiness the child shows and keep tactfully asking for his co-operation until training is achieved.
PITFALLS IN THE DIAGNOSIS AND TREATMENT OF IRON DEFICIENCY ANEMIA IN PEDIATRICS
Authors: Clement David H.
Published: December 2021

Errors in the diagnosis and treatment of iron-deficiency anemia involve several areas. In the history one may overlook anemia in the mother, loss of infant blood from the placental circuit or later as melena, as well as a diet high in milk and low in iron-rich foods.

In the physical examination pallor should not be estimated from facial color alone. In the laboratory a reticulocyte count should be determined before as well as during treatment.

Regarding treatment it is important to give enough iron (6 mg/kg/day) for long enough to replenish iron stores. An effective, oral preparation of ferrous iron alone in gradually increasing doses is preferred. Failure to respond suggests several possibilities discussed above.
BROKEN APPOINTMENTS
Authors: Alpert Joel J.
Published: December 2021

A survey of appointment breaking in the Medical Clinic of the Boston Children's Hospital Medical Center showed that approximately 20% of patients broke their appointments.

These patients were more likely to have shown evidence of social disorganization. Personal physician care appeared to lower the broken appointment rate although there appeared to be an irreducible minimum which in either the personal physician clinic or in the private office was a cancellation. Additional gaps in medical care noted in those who broke their appointments included inadequate immunizations, dissatisfactions with medical care, and ill-defined need to see a physician.
PROTEIN METABOLISM, CELL FORMATION, AND IMMUNITY
Authors: Gitlin David
Published: December 2021

Normally, a man can boast that some time during the first year of life he got up and stood on his own two legs. But it would be an idle boast indeed if modern man should ever claim that during his lifetime he actually stood alone. It is almost unnecessary to state, therefore, that the research for which this award has been given was not the product of one individual. It was based upon the works of those who searched before and it was accomplished through the efforts of many persons: among these were Dr. John Craig, whose knowledge of cells and tissues made most of these studies possible, Dr. Jesuś Kumate and his colleagues in Mexico, who brought our interests in the placental transfer of proteins to reality, and Dr. Charles Janeway, without whose support and encouragement all of our ideas would have been stillborn.

To review briefly our studies of the last seven years, as required by the rules governing this award, it has been necessary to select and discard. What has finally been chosen, for better or worse, are those studies dealing with natural developmental sequences in the metabolism of the plasma gamma-globulins and the antibody properties that these proteins manifest–or to be euphemistic, those studies concerned with the immunological ages of man.

The antibodies of normal human plasma represent four related groups of proteins. The largest of these groups in terms of quantity are the 7S gamma2-globulins which constitute 70 to 75% of the total gammaglobulins in the normal adult; these have a molecular weight of 165,000 and, as their name indicates, have an ultracentrifugal sedimentation coefficient of 7 Svedbergs, or 7S.1,2
BRAIN SWELLING WITH ACUTE PURULENT MENINGITIS
Authors: Williams Christopher P. S. , Swanson August G. , Chapman John T.
Published: December 2021

A fetal case of acute meningitis in a child is reported to illustrate the orderly sequence of neurological signs indicating progressive brainstem compression, leading to death. The similarity of this neurological pattern to that seen in patients with supratentorial mass lesions is emphasized.

Six cases of acute meningitis in infants and children are then reported who similarly showed signs of progressive brain swelling and herniation, in whom intravenous urea was used in treatment. In two children who were felt to be moribund with bulging anterior fontanel, coma, poorly reactive pupils, deteriorating respirations, and convulsions, the response to the infusion of urea was dramatic, with improvement in consciousness, respirations, and pupillary signs, and cessation of convulsions. Two other children had a less dramatic response to urea, but were definitely improved. Two were thought to have had possible benefit. No child showed deleterious effects from treatment with urea.

The mechanism of action of osmotic agents in the treatment of brain swelling is discussed. Hypertonic intravenous urea was felt to have been a safe and possibly valuable adjunct to the therapy of the patients of this study.
THE FACE PREDICTS THE BRAIN: DIAGNOSTIC SIGNIFICANCE OF MEDIAN FACIAL ANOMALIES FOR HOLOPROSENCEPHALY (ARHINENCEPHALY)
Authors: DeMyer William , Zeman Wolfgang , Palmer Catherine Gardella
Published: December 2021

Two patients with orbital hypotelorism, flat nose, and bilateral lateral cleft of lip and palate with a hypoplastic philtrumpremaxilla Anlage are described. Both patients had holoprosencephaly (arhinencephaly), a brain defect characterized by an arrest in prosencephalic cleavage with no or incomplete proplasia of frontal poles and olfactory bulbs. The two patients are an intermediate stage in a graded series of median facio-cerebral malformations which begins with cyclopia, and then, as face and brain transform toward normality, extends through ethmocephaly, cebocephaly, median cleft lip, and the two patients presented here. The facies of these patients are diagnostic of the type of brain malformation. Careful attention to face-brain relationships will significantly extend the number oif diagnostic facies which currently can be recognized. Physiological defects include poikilothermia, apnea, seizures, rigidity, and lack of psychomotor development.

Useful diagnostic studies include skull roentgenograms to show orbital hypotelorism and absent crista galli, electroencephalography, dermatoglyphics, chromosome studies, and sometimes pneumoencephalography.

Some holoprosencephalic patients, such as our first patient, who have few or no extracephalic malformations, have a 46 chromosome karyotype. Others, such as Patient 2, have many extracephalic anomalies. The literature suggests that the latter patients are apt to have 13-15 trisomy. The face predicts the holoprosencephalic brain irrespective of extracephalic anomalies or karyotype.
The Folic Acid Content of Milk: Revised Figures Based on an Improved Assay Method
Authors: Naiman J. Lawrence , Oski Frank A.
Published: December 2021

Using an improved assay technique with ascorbate-protected L. casei, the folate content of various milk preparations was determined. There was much variation among the different milk preparations, but in all cases the values were much higher than those previously reported. Problems in the interpretation of these data and their clinical significance are discussed.
NEONATAL LISTERIOSIS
Authors: Ray C. George , Wedgwood Ralph J.
Published: December 2021

Six cases of neonatal infection with Listeria monocytogenes occurring in Seattle, Washington, a previously unreported and apparently unsuspected endemic area are reported.

A review of the case reports in the United States and Canada are discussed and the manifestations of the disease in the pregnant mother and infant are characterized. An effort has been made to analyze mortality and its relation to specific antibiotic therapy and individual antibiotic disc sensitivities, as well as to the possible predisposing factors involved in the infection. The findings would suggest that the high mortality and morbidity in this disease might be lowered if a high index of suspicion is combined with adequate and prompt culturing techniques. Specific antibiotic therapy should be selected by sensitivity testing since it appears that standard therapy for unknown sepsis is not always adequate to significantly lower the mortality. Consideration should especially be given to the use of a tetracycline if Listeria is suspected in the very early neonatal period.
Observations on the Use of Triphenyl Tetrazolium for the Detection of Bacteriuria
Authors: ELIOT CHRISTOPHER R. , PRYLES CHARLES V.
Published: December 2021

A correlation of bacterial counts with results of Uroscreen tests was carried out on 350 clean-voided urine samples. Uroscreen was correct 61% of the time in detecting urines with greater than 100,000 organisms per ml. However, only 47% of the positive Uroscreen tests themselves were correctly positive.

The Uroscreen test is not considered reliable enough as a screening procedure for the detection of urinary tract infection and should be abandoned.
Will PSP Binding Technique Reduce Later Brain Damage?
Authors: ZOGER SEYMOUR
Published: December 2021

I was most interested in the paper by Dr. Waters in Pediatrics, 33:749, 1964.

Dr. Waters has presented cogent reasons for not doing an exchange transfusion for a bilirubin of 20 mg/100 ml. I should like to refer to an earlier paper by Dr. Byers (Pediatrics 1955, 15:248), in which 23 patients are presented with cerebral palsy and hearing loss following erythroblastosis. Dr. Byers states in this paper that only 2 of the 23 patients had clinically recognized kernicterus in the newborn. It is not always easy to be certain that our jaundiced newborns are not going to develop later complications. The PSP binding technique offers some promise in this regard.
ELECTRODIAGNOSIS OF NEUROMUSCULAR DISEASE
Authors: LAMBERT EDWARD H.
Published: December 2021

THE past decade has seen a number of the techniques of clinical neurophysiology come into common use in the diagnosis of neuromuscular disease. One of these is the measurement of conduction velocity of motor nerves. Conduction velocity of nerves was only of academic interest until 1948 when a simple method for making reliable measurements in man was described and proved useful as a test of nerve function. It is now a frequent subject of clinical investigation and in many laboratories measurement of conduction velocity has become a routine diagnostic procedure. A review and extension of this work by Dunn and his associates, published in this issue of Pediatrics, emphasizes the importance of such measurements to pediatrics wherein objective evidence of functional impairment of nerves is of particular importance because the clinical examination may be so unsatisfactory. Conduction velocity of peripheral nerves, measurable quickly and simply, should be standard practice in the study of neuromuscular disorders in infants and children.
STUDIES OF SMALL INTESTINE DURING DEVELOPMENT
Authors: Sterk Velimir V. , Kretchmer Norman
Published: December 2021

The data indicate that hydrolysis of lactose is maximal perinatally. The increase in activity of this enzyme is dissociated from intestinal growth by the time the rabbit is 21 days old. There is passive diffusion of the lactose across an intestinal sac which is related only to concentration and not the age of the animal. When lactose is administered to rabbits of different ages, lactosuria is observed mainly in older animals.
DIETARY TREATMENT OF PROTEIN LOSS IN INTESTINAL LYMPHANGIECTASIA
Authors: Holt Peter R.
Published: December 2021

A 2-year-old child with exudative enteropathy due to intestinal lymphangiectasia and an associated congenital lymphangiomatous malformation of the arm is presented. Treatment with medium chain triglyceride formula diet resulted in marked reduction in intestinal protein losses and disappearance of all symptoms. It is suggested that the enhanced lymphatic flow resulting from the thoracic duct transport of absorbed long chain fat results in increased leakage of lymph into the gut in intestinal lymphangiectasia.
PROTEIN-LOSING ENTEROPATHY SECONDARY TO CONSTRICTIVE PERICARDITIS IN CHILDHOOD
Authors: Plauth William H. , Waldmann Thomas A. , Wochner R. Dean , Braunwald Nina S. , Braunwald Eugene
Published: December 2021

A 6-year-old girl with anasarca, bilateral pleural effusions, and ascites was found to have severe hypoproteinemia secondary to gastrointestinal protein loss. This protein-losing enteropathy was originally felt to be idiopathic in origin, but re-examination some months later led to the recognition of chronic constrictive pericarditis. Pericardiectomy resulted in a complete relief of symptoms with a return of plasma proteins to normal and disappearance of the enteropathy. The 9 previously reported patients with protein-losing enteropathy and constrictive pericarditis are discussed briefly and the preoperative and postoperative data in our patient, including cardiac catheterizations and studies of protein metabolism, are presented.
MITRAL INSUFFICIENCY DUE TO ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY
Authors: Foster Harry R. , Hagstrom Jack W. C. , Ehlers Kathryn Hawes , Engle Mary Allen
Published: December 2021

An infant and a child with anomalous origin of the left coronary artery from the pulmonary artery have been presented. Each showed evidence of mitral insufficiency as a consequence of ischemic damage to the anterior papillary muscle and supporting myocardium. Changes in projected surgical approach necessitated by this combination have been discussed. Survival of the patient and his suitability for surgery are determined not only by the direction of blood flow in the coronary artery, which is influenced by the pressure in the pulmonary artery as well as by adequacy of collateral circulation, but also by the degree of endomyocardial and mitral valvular damage.
CONDUCTION VELOCITY OF MOTOR NERVES IN INFANTS AND CHILDREN
Authors: Dunn H. G. , Buckler W. St. J. , Morrison G. C. E. , Emery A. W.
Published: December 2021

The literature concerning the measurement of conduction velocity in human motor nerves and its clinical applications is reviewed. The chief value of the test to the clinician lies in the demonstration of a peripheral neuropathy and in its differentiation from myelopathy and myopathy. It is pointed out that this investigation is often particularly useful in infants and children as it is an objective and relatively painless test requiring little co-operation from the patient.

Starting from approximately half the normal adult value at birth in full-term infants the motor nerve conduction velocity normally increases to the full adult level during the first 3 to 5 years of life. In premature infants it begins at a still lower level. This increase is of clinical interest and can be studied serially. There is also a particular developmental aspect in infants in relation to possible delays or disturbances of innervation or myelination.

The results of measurements of conduction velocity, chiefly in the median nerves, are reported in 45 "normal" infants and children and in 100 others who had a variety of neurological disorders. The rate was normal in all but one of 33 children with miscellaneous cerebral disorders, including nonspecific mental retardation, Down's syndrome (mongolism), D1 trisomy, hydrocephalus, and organic convulsive disorders. There was a distinct reduction in metachromatic leucodystrophy (2 cases), infantile amaurotic idiocy (1 case), and recurrent and chronic polyneuropathy (3 cases). In 4 children with acute neuronitis there were no demonstrable gross changes in conduction velocity during the first 2 months, while the diminished voltage and increased temporal dispersion of the action potential were more helpful early diagnostic features. Normal results were obtained in benign congenital hypotonia (10 cases), phenylketonuria (3 cases), and ataxia-telangiectasia (1 case). Five children with Friedreich's ataxia were examined and 2 of these had marked clinical fluctuations in the extent of their weakness suggestive of peripheral neuropathy. One of the latter was seen during an acute exacerbation of his weakness when he had a distinctly reduced nerve conduction velocity, and prolonged terminal latency from wrist to thenar eminence. The other was tested during a phase of relative well-being and had a normal conduction velocity but even more prolonged terminal latency than the first. The remaining children had a slowly progressive illness; all of them had normal conduction velocity, but one had just significantly prolonged terminal conduction time.

Somewhat slow conduction rates for the age appeared to be present in 1 of 6 infants with arthrogryposis multiplex congenita and in 4 of 14 with clubfoot below the age of 2 years, but the statistical significance of these deviations cannot yet be indicated.

The results are discussed, with particular emphasis on developmental aspects and the involvement of the peripheral nervous system in "dysmyelination" and demyelination.
COMMITTEE ON ACCIDENT PREVENTION
Authors:   COMMITTEE ON ACCIDENT PREVENTION
Published: December 2021

A study of the flammability of fabrics involved in wearing-apparel fires was conducted co-operatively by the American Academy of Pediatrics Committee on Accident Prevention and the National Fire Protection Association Committee on Wearing Apparel. A total of 124 fabric samples from 84 accident cases were tested. Of the 124 samples, 94 were of cotton exclusively, bearing out the previously known, but widely unrecognized, fact that cotton is the most flammable of fabrics. All met the currently established standards of normal flammability for fabrics. Other data obtained in the study included age of patients (a total of 84, of whom 41 were children and 7 were aged persons); type of garment (40% were pajamas, nightgowns, bathrobes, or housecoats); and source of ignition (more than half were stoves, heaters, furnaces, or fireplaces).

The relative flammability of fabrics are discussed, with attention to the fiber and the weight and weave of the fabric. Other factors influencing wearing-apparel fires include the type and style of garment; the age of the person involved; and the availability of a source of ignition. Legislation concerning standards of acceptability for the flammability of clothing fabrics are outlined, as are the standards of the National Fire Protection Association. The need for a public education program about the hazards of clothing fires is delineated. Current research in the field of chemical flame retardants for fabrics is outlined.

Possible steps for reducing clothing fires are listed, with special attention to the pediatrician's role.
Keeping Pediatricians in Practice
Authors: HUCHTON PAUL , NICKEY LAURANCE N.
Published: December 2021

It seems that the topic "The New Pediatrics—Can It Be Practiced?" has become a very popular one for Letters to the Editor. We, who constitute a partnership composed of two young Board Pediatricians, would like to report our own happy experience, while taking exception to several statements made by Dr. Joel Berne of Brooklyn (Pediatrics, 34:297, 1964)

In the first place, we practice in an averagesized (350,000) city on the border, with an equal-sized sister city, Juarez, Mexico.
Hospitalization of Children
Authors: MEYER ROGER J.
Published: December 2021

In response to the reportorial account of the International Symposium on Hospitalization of Children (Pediatrics 34:1, 1964) there are several points which deserve mention.

It is quite doubtful that any sudden or universal resort to other solutions to the needs for children presently hospitalized would be acceptable in this country. It would appear, however, that the present firmly entrenched system, particularly evident in children's hospitals in the great teaching centers of the country, demands vigorous revision if physicians in training and the patients they care for are to be involved in optimal pediatric care rather than meeting the specialistic rituals of the hospital.
Pyelonephritis in Premature Infants
Authors: BIASINI G. CARLO , CENCIOTTI LEONIDA , MONTAGUTI AUGUSTO , VULLO CALOGERO
Published: December 2021

Dr. Wheeler's Commentary and the paper by Sweet and Wolinsky in the June Pediatrics which stress once more the problem of pyelonephritis in infants, prompt us to report the results [See Table in source PDF] of a survey on pyelonephritis incidence among premature infants discharged from our small nursery.

Our survey involves patients who were admitted to the nursery between March, 1962, and May, 1963; during this period we discharged 43 premature infants with birth weight ranging from 1,040 to 2,500 gm. One of these died at home owing to causes unknown to us; another one was not taken for control.
Letters to the Editor
Authors: SWEET AVRON Y.
Published: December 2021

To my knowledge Dr. Biasini et al. have presented the only data dealing with the relative frequency of urinary tract infections in full-term and premature infants. We too are engaged in prospective studies which may shed light on this question but the answer will be some time in coming. Until we know more, I would agree that prematures should be suspect and routinely investigated after the third week of life. Studies also are needed regarding the maternal role in this problem, although we have data which tend to incriminate the nursery rather than the mother.

The findings of Dr. Biasini and his colleagues again point out the late appearance of the illness. This time factor may be very important. Perhaps it reflects the decay of an immunological protective material gotten from the mother.
How to Keep Your Child Fit from Birth to Six
Authors: S. C. A.
Published: December 2021

This is an alarming book. Its author, a young mother, conducts a television program on physical fitness. She is said to command great attention among that large majority of women who somewhat wistfully seek to "keep slender and fit after thirty" by a conscientious program of exercising. Having established this large following, Miss Prudden (who uses her maiden name professionally) is now going after their children with what the book's jacket describes as "a step-by-step, day-by-day program to ensure a child's physical fitness from birth to six years of age."
The Early Diagnosis of Congenital Abnormalities
Authors: MCINTOSH RUSTIN
Published: December 2021

This is a gem of a book—small, compact, sparkling, a bit expensive for its size. It reflects the growing interest in congenital defects and the realization that early identification is the key to successful correction in an increasing number and variety of anomalies.

The author, consultant pediatrician to Alder Hey and Olive Mount Children's Hospitals in Liverpool, addresses himself to obstetrician and pediatrician alike, placing special emphasis on the conditions which can be recognized or suspected during the four weeks preceding birth and in the neonatal period.
Perceptual and Visuo-Motor Disorders in Cerebral Palsy
Authors: ROSENBERGER P. B.
Published: December 2021

The author's assignment in this monograph, as outlined in the preface, is "to find out exactly what is or is not known" in the field of concern; and as such it is a task as nobly executed as conceived. Mrs. Abercrombie has provided a concise distillation, with results in round numbers, of more than sixty of the most significant recent studies in this and related fields, together with intelligent commentary and criticism; and has summarized the conclusions of nearly a hundred others.
DEXAMETHASONE (16 ALPHA-METHYL, 9 ALPHA-FLUOROPREDNISOLONE) IN OBSTRUCTIVE RESPIRATORY TRACT INFECTIONS IN CHILDREN
Authors: Sussman Sidney , Grossman Moses , Magoffin Robert , Schieble Jack
Published: December 2021

A controlled study was undertaken to evaluate the effects of dexamethasone on obstructive respiratory tract infections in children. This drug in the dosage used did not alter the clinical course of patients with bronchiolitis or laryngitis in our limited series.
Diseases of Medical Progress
Authors: SISSMAN NORMAN J.
Published: December 2021

The material of this volume, subtitled "A Contemporary Analysis of Illness Produced by Drugs and Other Therapeutic Procedures," first appeared in print as one of the series, Medical Progress, in the New England Journal of Medicine in 1956. Dr. Moser then expanded it into a monograph published in 1959. Now, he has enlisted the collaboration of twelve of his specialist colleagues in the Army Medical Corps to produce a greatly enlarged treatise.

The book retains the format of the Medical Progress article.
Disorders of Language: Ciba Foundation Symposium
Authors: LENNEBERG ERIC H.
Published: December 2021

In this symposium "neurophysiologists, psychologists, phoneticians, linguists, a philosopher and an expert on information theory" (p. vii) were brought together in order to review the latest research on disorders of language. Relevant to the symposium were the problems encountered in "the aphasias due to focal lesions of the brain" (p. 2) and the speech of the demented; speech peculiarities in the psychoses and hysteria were also admissable topics. But entirely outside the scope of the symposium were "the disorders of articulation and of voice production due to causes within the peripheral organs of speech" (p. 3).
ON AN "IMPRACTICAL" PAPER
Authors: McKAY R. J.
Published: December 2021

The article on "Appearance and Localization of a Nerve Growth-Promoting Protein during Development" by Winick and Greenberg, which appears elsewhere in this issue of PEDIA-rRICs, is one of a type which tends to bring fire into the eyes of those of our readers who feel that there is an improper balance between "scientific" and "clinical" papers in this journal. As one who has defended the thesis that PEDIATRICS should consciously serve its readers who are practitioners as well as those who are academicians, it seems worthwhile to comment briefly on the reasons for recommending publication of this article.

First, I was favorably impressed by the merits of the manuscript from the purely editorial point of view:
CONGENITAL TOXOPLASMOSIS WITH PLACENTAL INFECTION IN MONOZYGOTIC TWINS
Authors: Glasser Lewis , Delta Basil G.
Published: December 2021

An instance of congenital toxoplasmosis affecting identical twin male infants is reported.

This is the first recorded prospective diagnosis of congenital toxoplasmosis discovered by chance histologic observation of the organisms in the placenta. The placental findings enabled an early detection of the disease through close follow-up of the asymptomatic infants. The disease became manifest in both infants simultaneously at the age of 7 months and had a similar course.

Placental toxoplasmosis means fetal infection. Prompt treatment of the infant, even though no symptoms are apparent, may prevent or reduce the degree of permanent oculocerebral damage.