bluuebunny/crossref_metadata_2025 huggingface dataset:
MEDIASTINAL AND SUBCUTANEOUS EMPHYSEMA COMPLICATING ATOPIC ASTHMA IN INFANTS AND CHILDREN
Authors: McGovern John P. , Ozkaragoz Kemal , Roett Katherine , Haywood Theodore J. , Hensel Albert E.
Published: December 2021

Only 20 case reports could be found in the available medical literature, for 100 years, concerning the incidence of mediastinal and subcutaneous emphysema complicating childhood asthma. The pathophysiology, clinical symptomatology, experimental data and therapy of this disease are discussed. A conservative, nonsurgical approach seems indicated. One new case, the youngest reported to date, is presented in detail.
RECURRENT BACTERIAL INFECTIONS AND DYSGAMMAGLOBULINEMIA: DEFICIENCY OF 7S GAMMA-GLOBULINS IN THE PRESENCE OF ELEVATED 19S GAMMA-GLOBULINS
Authors: Rosen Fred S. , Kevy Sherwin V. , Merler Ezio , Janeway Charles A. , Gitlin David
Published: December 2021

Two patients with recurrent bacterial infections associated with dysgammaglobulinemia are reported in whom there was a marked deficiency of 7S gamma-globulins in the presence of elevated concentrations of 19S gamma-globulins. Both patients lacked detectable beta2A-globulins. One of these patients had been known to have congenital agammaglobulinemia and had been followed for a number of years previously. The synthesis of 19S gamma-globulins in this patient was a transient phenomenon associated with renal and hepatic disease, and the ability to synthesize isohemagglutinins, Forssman antibody and anti-typhoid O antibodies. Plasma cells were not seen in the biopsy specimens of liver, spleen and lymph node from one patient, of lymph node from the other, or in bone marrow aspirates from both patients.
GROWTH DISTURBANCES AND VALUES FOR HORMONE EXCRETION IN VARIOUS FORMS OF PRECOCIOUS SEXUAL DEVELOPMENT
Authors: Ferrier Pierre , Shepard Thomas H. , Smith Elizabeth Knapp
Published: December 2021

Forty-two children with precocious sexual development have been classified according to: a) constitutional sexual precocity, b) premature adrenarche, and c) premature thelarche.

Constitutional sexual precocity and premature adrenarche are associated with excessive growth, advance in bone maturation, and elevation of the urinary 17-ketosteroids. In contrast, in premature thelarche growth, bone maturation and 17-ketosteroids were normal.

The presence of estrogenization of the vaginal smear was the most helpful laboratory finding in differentiating constitutional sexual precocity from the other two conditions.

The presence of detectable urinary gonadotropins in precocious puberty is of limited help.

Two patients with primordial dwarfism and associated precocious puberty are reported.

The occurrence of constitutional precocious puberty in a brother and a sister is described. This is apparently the first reported instance in which familial precocious puberty occurs in either sex.
PATHOLOGIC ANATOMY OF COMPLETE TRANSPOSITION OF THE ARTERIAL TRUNKS
Authors: Lev Maurice , Alcalde Victor M. , Baffes Thomas G.
Published: December 2021

A study was made of the pathologic anatomy in 147 cases of complete transposition of the arterial trunks. A classification was attempted, dependent upon the extent and nature of ventricular septation and the presence or absence of abnormalities in the atrioventricular orifices. Complete transposition with mitral stenosis or atresia or with common atrioventricular orifice are characteristically associated with pulmonic stenosis and atresia, while complete transposition with tricuspid stenosis or atresia, or with common ventricle, or single ventricle and small outlet chamber are more commonly associated with increased pulmonary flow. The two complexes, complete transposition with common ventricle and that with single ventricle and small outlet chamber, are very closely related pathologically.
CLINICAL CONFERENCE
Authors: Wishingrad L. , Elegant L. D.
Published: December 2021

Replacement transfusions via the umbilical vein may be carried out successfully in small premature as well as full-term infants. Many repeat procedures may be necessary to keep down the levels of free bilirubin. With great care, this can be done safely.
CONGENITAL INSUFFICIENCY OF THE PULMONIC VALVE
Authors: Ito Tomiko , Engle Mary Allen , Holswade George R.
Published: December 2021

The case of a neonate with isolated pulmonary valvular insufficiency resulting in heart failure and death is reported. Only two previous examples of symptomatic pure pulmonic insufficiency have been described: one similar case with intrauterine hydrops and death, 30 minutes after birth, and one adolescent with marked cardiac enlargement. Although this anomaly is usually considered to be a benign cardiac lesion, available experimental data and analysis of patients with additional lesions indicate that deleterious effects of pulmonary insufficiency may be anticipated if there is 1) little valve tissue and thus gross pulmonary regurgitation, 2) pulmonary hypertension, and/or 3) increased blood flow across the abnormal pulmonary valve.
CHRONIC POLYOSTOTIC PERIOSTITIS OF UNKNOWN ETIOLOGY
Authors: Altman Harry S. , Pomerance Herbert H.
Published: December 2021

A case of multiple bone pathology is presented. The clinical, laboratory, radiologic and pathologic aspects are discussed, without yielding any clues as to the true classification of the process. We therefore have applied a descriptive name: chronic polyostotic periostitis of unknown etiology.
LONG-TERM FOLLOW-UP OF 100 CHILDREN WHO RECOVERED FROM TUBERCULOUS MENINGITIS
Authors: Lorber John
Published: December 2021

IT IS MORE THAN 13 years since streptomycin became available for the treatment of tuberculous meningitis. Since then treatment has become progressively more efficient and much less complicated.1-7 Between 1947 and the end of 1955, 170 children were treated for tuberculous meningitis by the Department of Child Health of the University of Sheffield. One hundred of these survived for 5 years or more.

The purpose of this paper is to review the long-term results in these 100 survivors, 33 of whom have been followed for more than 10 years (Table I). Thirty children had been treated with streptomycin, 35 with streptomycin and aminosalicylic acid (PAS), and 35 with isoniazid, streptomycin and PAS. All had intrathecal treatment with streptomycin, although the length of the intrathecal therapy and the number of injections was progressively reduced as the newer antibiotics were introduced. No child had less than 20 intrathecal injections.

At the beginning of their illness 47 were less than 5 years of age, 43 between 5 and 9, and 10 between 10 and 14 years of age (Table II). Thirty-one survivors were in the early stage of disease, 53 were in the intermediate and 16 in an advanced stage on admission. After discharge from the hospital they were all followed at regular intervals. In the follow-up period much stress was laid on the assessment of their personality, their achievement, and their adjustment to life. During this period closer acquaintance with the parents and their siblings helped in placing the patients' achievements and problems in perspective.
SURGERY IN A HEMOPHILIAC CHILD WITH INTRACRANIAL HEMORRHAGE
Authors: Fuerth John H. , Teng Paul , Goldenberg Erwin
Published: December 2021

THE UNUSUAL bleeding tendency in hemophiliacs has been known since biblical times, and its hazards have been recognized in even such simple surgical procedures as circumcision.1 Perhaps the most dangerous complication of hemophilia is bleeding into the central nervous system.2 It therefore seems worthwhile to report the case of a 2-year-old hemophiliac who survived several intracranial hemorrhages, with two surgical interventions, but who 4 months later had a fourth and fatal hemorrhage.

CASE REPORT

History

D. H. was a 2-year-old hemophiliac with numerous admissions to the Kaiser Foundation Hospital, Los Angeles, for bleeding episodes. He was born at another hospital, was circumcised shortly after birth and had excessive bleeding following this. His first admission was at the age of 1 year for bleeding following a tongue bite. At that time he had an abnormal result of a prothrombin consumption test, with 55% residual prothrombin in the serum. The prothrombin consumption was corrected by fresh normal plasma and barium sulfate adsorbed plasma, but not by serum or plasma from a known hemophiliac type A. The diagnosis of hemophilia type A was thus established.

He had two brothers who were investigated and found to be normal. There was no abnormal bleeding tendency on his father's side, but two uncles of his mother and two first cousins were said to be "bleeders." No further details were known.

Physical and Laboratory Findings

The boy was admitted to the hospital on the evening of October 13, 1957, with a history of vomiting and progressive lethargy of 2 days' duration.
Determination of Blood Sugar in Newborn Infants
Authors: BAENS GLORIA S. , OH WILLIAM , LUNDEEN EVELYN , CORNBLATH MARVIN
Published: December 2021

To the Editor:

Recently, there has been a renewed interest in the level of blood sugar in the newborn period, with very low or zero blood sugars being reported1, 2 In some of these reports there is no mention of how the blood was collected, how long it was permitted to stand, how it was precipitated, or analyzed. As reviewed by Peters and Van Slyke,3 the disappearance of sugar from blood in vitro has been well documented since the time of Claude Bernard.
DIGOXIN DOSAGE IN PREMATURE INFANTS
Authors: Levine O. Robert , Blumenthal Sidney
Published: December 2021

An attempt has been made to determine a maximum safe digitalizing dose of digoxin for healthy premature infants. The experimental design has utilized a three-by-three Latin square, in which premature infants in three predetermined weight and age categories have been assigned at ran dom to each of three digitalizing dosages: 30, 50 and 75 µ/kg body weight of digoxin. The total scheduled dosage was administered intramuscularly in three equally divided doses at 8-hour intervals. Control electrocardiograms were taken, and tracings were obtained after two-thirds of the dosage had been given, 4 hours after digitalization was completed, and at 24-hour intervals thereafter. Digitalis intoxication was defined in terms of electrocardiographic criteria. Twenty-seven infants were tested with 30 µg/kg body weight of digoxin, 26 with 50 µg/kg and 27 with 75 µg/kg. The incidence of digitalis intoxication was 2.5% at the 30 µg/kg dosage level, 9.4% at 50 µg/ kg, and 33.3% at 75 µg/kg. The null hypothesis is rejected with a high degree of probability.

Insufficient data were available for statistical analysis of age differences in incidence of intoxication. The data indicates, however, that premature infants tested during the first 72 hours of life may have a diminished tolerance to the glycoside. Side-effects of glycoside administration were noted in only a few of the infants, were rarely severe and were short-lived.

The electrocardiographic manifestations of digitalis intoxication were widely varied. Sinus node depression with ectopic supra-ventricular beats and rhythms, and atrio-ventricular conduction disturbances were the most common arrhythmias observed. An irritable ventricular focus was observed in only 1 of the 12 intoxicated infants. In most cases a regular sinus rhythm had returned with 48 hours of full digitalization. However one infant still had evidence of arrhythmia 9 days later.

On the basis of the data presented, the following conclusions are reached: 1. The administration of 75 µg/kg body weight of digoxin, for the digitalization of healthy premature infants, in the manner described, incurs an excessive risk of digitalis intoxication. 2. Although 50 µg/kg represents a more reasonable risk among these infants, and 30 µg/kg a minimal risk, one must be alert to the occasional infant who may have an unusual intolerance to the drug.

It is recommended that digitalization be carried out under close electrocardiographic control, as no clinical criteria correlated well with the development of digitalis intoxication in these infants. Tracing of adequate length, in which the P waves are well defined, should be obtained during digitalization and at daily intervals until the infant is being given a stable maintenance dosage.
SIMPLIFIED MILLIPORE FILTER TECHNIQUE FOR CYTOLOGIC DIAGNOSIS OF CYTOMEGALIC INCLUSION DISEASE IN EXAMINATION OF URINE
Authors: Blanc William A. , Gaetz Russel
Published: December 2021

A simple and practical filtration technique, with small Millipore filters, has been used for cytologic examination of urine in children. It has proved useful in routine screening tests when generalized cytomegalic inclusion disease was suspected. It could lend itself to various diagnostic applications in the cytology of urine and of other body fluids.
ONSETS, COMPLETIONS AND SPANS OF OSSIFICATION IN THE 29 BONE-GROWTH CENTERS OF THE HAND AND WRIST
Authors: Stuart Harold C. , Pyle S. Idell , Cornoni Joan , Reed Robert B.
Published: December 2021

The film series of the right hands of 133 Boston children have been studied independently to obtain age equivalents for onset of ossification and completion of ossification in 29 bone-growth centers of the hand. Each of the intervals between onset and completion, namely, span of the osseous stage, has been calculated, and the means and standard deviations of each of the three variables are summarized.

The results show age equivalents and age-orders closely resembling the data in two preceding studies, where the assessment procedure was the same as that used in this study. An onset profile and a completion profile have been drawn from these mean and standard deviation values for each sex.

The data reported in this paper for the 29 centers of the hand and previously for 21 centers from five regions of the body, show the following: 1) The time-order of onset differs significantly from the time-order of completion. 2) The time-order onset profile reveals a characteristic clustering of onsets. 3) The correlations between onset and completion ages for the 133 children do not show that the time of completion can be routinely forecast by onset ages. However, the later the onset the better the prediction of completion time. 4) A developmental range graph constructed from assessments of skeletal age of the 29 centers of the hand reflects the schedules of onsets and completions for individual children. However, the "lifetime" of each of the onsets and completions is very brief and corresponds closely with the skeletal age curve during the first 4 years and during adolescence.
THE ASSOCIATION OF POSITION AT BIRTH AND HANDEDNESS
Authors: Churchill John A. , Igna Eli , Senf Rita
Published: December 2021

A statistically significant association between handedness of 2-year-old children and the position at birth was found. A larger number of left-handed children were born from the right occiput anterior position than could be accounted for by chance. An association of parental handedness and handedness of the children also was found. The evidence reveals a strong likelihood that there is an innate determinant for handedness.
Treatment of Rheumatic Fever
Authors: Illingworth R. S.
Published: December 2021

I should like to congratulate Dorfman et al. for their fine controlled trial of the treatment of rheumatic fever (Pediatrics, 27:692, 1961) and Feinstein for his critical commentary (Pediatrics, 27:819, 1961).

I disagree with Dorfman et al. when they conclude that "patients who show no evidence of carditis may be safely treated with salicylates in dosages sufficient to maintain a level of 20 to 30 mg/100 ml of blood," for the following reasons.

1. Although the majority of rheumatic children who are admitted without a significant murmur are discharged without one, whatever the treatment, some children treated other than by steroids develop a significant murmur while under treatment.
In Reply: Treatment of Rheumatic Fever
Authors: Feinstein Alvan R.
Published: December 2021

Because the interpretation of cardiac murmurs is the crucial feature of the evaluation of treatment in acute rheumatic fever, a scientific clinical study must arrange at least for (1) objective auscultation, (2) the use of specific, detailed, incisive criteria to differentiate physiologic and organic murmurs and heart sounds, and (3) the presentation of therapeutic results in subdivisions according to the initial auscultatory status of the patients. My recent paper in Pediatrics gave the reasons for these requirements and compiled data from the literature to show that the existing therapeutic trials were not really comparable and that the existing conflicts in therapeutic conclusions arose because the design or criteria of the studies had neglected some or all of the scientific requirements noted above.
Metabolic Bed
Authors: Fomon Samuel J. , Thomas Lora N. , Jensen Robert L. , Owen George M.
Published: December 2021

Several times each year we receive requests for information concerning the precise measurements of the metabolic bed we employ for use with infants. Since such beds are, to our knowledge, not commercially available, we have prepared the enclosed diagram that may prove helpful to individuals planning to construct metabolic beds for infants. Photographs of the bed, infant restraints, and collection equipment have been published previously (Pediatrics, 22:94, 1958).

See figure in the PDF.file
AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6
Authors: Karzon David T. , Hayner Norman S. , Winkelstein Warren , Barron Almen L.
Published: December 2021

The clinical features of 130 cases of aseptic meningitis syndrome associated with ECHO virus type 6 infection were studied. Characteristically, the onset was acute with the development of fever, headache, muscle pains, and vomiting. A biphasic course was present in 8% of the cases. The physical findings included mild to moderate stiffness or spasm of the neck, back, and posterior thigh muscles. Disturbance in sensorium, cranial nerve involvement, and bulbar signs were conspicuously absent. Absence of deep tendon and superficial reflexes occurred in 16% of the cases. Evidence of mild muscle weakness occurred in 39% of cases, more commonly in the axial rather than peripheral muscles. Most of these patients had bilateral weakness of the anterior neck muscles, but included in the group were five with bilateral weakness of the back or abdominal muscles and six with some involvement of the extremities. Neuromuscular changes were mild and frequently questionable. Where follow-up was available, the changes were usually found to be transient. The effect of age upon the clinical picture was analyzed. Only 3 of 130 patients were less than 4 years of age. Young children had a more acute onset and were admitted to the hospital more promptly than older children and adults. The incidence of pleurodynia was 38% in adults and only 5% in patients less than 20 years of age. The cerebrospinal fluid revealed pleocytosis, with lymphocyte counts ranging from a few cells to 930/mm3. The protein values exceeded 40 mg/100 ml in 48% of the cases, the highest value being 102 mg/100 ml.

An undifferentiated febrile illness in household associates of patients with aseptic meningitis, characterized by headache, vomiting and muscle pain, was associated with a high recovery rate of ECHO 6 virus. This is presumably the forme fruste of the fully developed aseptic meningitis syndrome.

ECHO 6 virus was recovered from four patients in whom there was evidence of neurologic involvement beyond that seen in the aseptic meningitis syndrome. ECHO 6 virus was the probable etiologic agent in two of these cases. A 15-year-old girl with mild encephalitis marked by disorientation, hallucinations, and weakness of the legs yielded ECHO 6 from her alimentary tract. ECHO 6 was recovered from the cerebrospinal fluid and alimentary tract of a 15-year-old boy with features of the Guillain-Barré syndrome.
In Reply: Materno-fetal Transfusion: A Common Phenomenon?
Authors: Mauer Alvin M.
Published: December 2021

Thank you for the opportunity of seeing letter submitted by Dr. Andrews. I have nothing that I can add to Dr. Andrews' letter, nor do we have any further information of our own about this phenomenon. We had hoped sometime soon to attempt to determine the possible incidence of materno-fetal transfusion in new-born infants, but as yet we have no figures available for publication. However, it would be my impression that an incidence as high as Dr. Andrews' letter would seem to suggest would not fit with our observations so far.
Twins in History and Science, Luigi Gedda, translated by Marco Milani-Comparetti. Springfield, Illinois, Thomas, 1961, 214 pp., $12.50
Authors: Benirschke Kurt
Published: December 2021

To some of us whose school Latin proved inadequate for the reading of Professor Gedda's 1951 book "Studio dei Gemelli" it was a great delight to see this recent English translation. This book surpasses most present-day medical books in its make-up, the printing, and particularly the color plates.

The original work of the renowned Italian gemellologist, we learn, was not translated until after the First International Congress of Human Genetics in 1956, in order to incorporate major difference from the original book.
EVALUATION OF THE STREPTOCOCCAL DESOXYRIBO-NUCLEASE B AND DIPHOSPHOPYRIDINE NUCLEOTIDASE ANTIBODY TESTS IN ACUTE RHEUMATIC FEVER AND ACUTE GLOMERULONEPHRITIS
Authors: Ayoub Elia M. , Wannamaker Lewis W.
Published: December 2021

Antibody titers for two recently described streptococcal antigens, desoxyribonuclease B (DNase B) and diphosphopyridine nucleotidase (DPNase) have been compared with antistreptolysin O (ASO) titers in patients with acute rheumatic fever, in patients with acute nephritis, and in normal controls. Like the ASO, elevated titers for the two new antibodies are commonly found in patients with complications of streptococcal infections. The titers for anti-DPNase tend to be higher in acute nephritis than in acute rheumatic fever. These two new anti-body tests are particularly useful in providing evidence of a preceding streptococcal infection in those patients with manifestations of acute rheumatic fever or acute nephritis who fail to show an elevated ASO titer.
STREPTOCOCCAL INFECTIONS IN FAMILIES
Authors: Meyer Roger J. , Haggerty Robert J.
Published: December 2021

Sixteen lower-middle-class families, comprising 100 persons, were intensively studied for one year, with systematic throat cultures for beta-hemolytic streptococci, periodic measurements of antistreptolysin O titer, and clinical evaluation of all illnesses; the results of those observations were compared to certain dependent variables of host, agent, and environment. The factors that seemed to play an important part in determining whether a given person acquired a streptococcus, became ill with this acquisition, or developed a subsequent increase in antistreptolysin O were age, season, closeness of contact with an infected person as measured by sleeping arrangements, acute or chronic family stress, and penicillin treatment. No relationship was found between streptococcal episodes and the number or type of streptococci present, sex of the patient, the presence or absence of tonsils, an allergic history, changes in weather, type of housing, or family size. Further evidence for the multiple causation of beta-hemolytic streptococcal disease has been obtained, although the mechanisms through which these factors exert their influence are not clear.
A NEW METHOD FOR STREAKING BLOOD AGAR PLATES
Authors: Kravitz Harvey
Published: December 2021

A NEW METHOD for the streaking of agar plates and the obtaining of isolated bacterial colonies on the agar surface is presented. The method involves the use of thin paper discs which are placed on the agar and cover the entire surface. The disc has linear slits of narrow width allowing optimum amounts of the specimen to be distributed through the paper and onto the agar surface when the paper is rubbed with a swab bearing the inoculum.

Robert Koch in his epochal publication of 18811,2 introducing the pure culture technique into bacteriology first described the use of solid gelatin media. In this publication he described the use of a platinum wire for the streaking of specimens onto the gelatin surface. Hesse in 1884, while working in Koch's laboratory, discovered the use of agar as a replacement for gelatin.3

Petri,4 in 1887, also working in Koch's laboratory, invented the culture dish which bears his name. It is notable that, with minor exceptions, the technique of streaking specimens onto agar plates by means of a wire loop has remained virtually unchanged to this date.

Throat cultures of patients in St. Francis Hospital, Evanston, Illinois; Lutheran General Hospital, Park Ridge; and the University of Illinois Hospital, Chicago, were studied. Studies were also made of throat cultures in the laboratories of the Evanston Board of Health. A total of 550 throat cultures was obtained. Cultures were made m 450 cases using the Iso-Disc technique only, and 100 cultures were studied in duplicate with the Iso-Disc method and the conventional wire loop method.
A GENETIC AND METABOLIC STUDY OF A FAMILY WITH HYPERLIPEMIA
Authors: Bialkin George , Zucker Saul , Sklarin Burton S. , Hirschhorn Kurt , Davidson Murray
Published: December 2021

A family consisting of a mother and father, heterozygous for idiopathic hyperlipemia, and their four offspring, one heterozygous and three homozygous for the disease, are described. In addition, a fifth child who is heterozygous, born of same mother but by another incompletely studied father, is presented. The genetics of the disease in this family, and also in the general population, with emphasis on diagnosis and prognosis in heterozygotes is discussed. The interrelationship of various lipid components in serum and their metabolism are briefly reviewed. The possible defective mechanisms in hyperlipemia, the techniques for deciding on the specific defect, and their application to the members of this family are reviewed. The effect of heparin, nicotinic acid, and fat-free diets in the homozygous members of the family are evaluated and their therapeutic applications are discussed. The symptomatology, possible pathologic physiology, relationship to lipid levels in serum and occurrence of abdominal crises in some of the homozygous members of this family are pointed out. The relationship of cholesterol and triglyceride levels in serum to, and the significance of, idiopathic hyperlipemia in the genesis of, atherosclerosis and coronary artery disease is elucidated.
CRYING IN INFANCY
Authors: Brazelton T. Berry
Published: December 2021

Eighty mothers of normal newborn infants kept daily records of their infants' fussing for the first 12 weeks. Twenty-eight babies were the firstborn in the family. An attempt was made to eliminate excessive environmental tension as an additive factor. Babies with underlying pathology were eliminated also. There was an average of 2¼ hours' crying in the first 7 weeks, with less each week thereafter. The time of day of its occurrence is summarized. Typical non-fussers sucked their fingers for longer periods each day. Babies who cried an unusual amount responded to manipulation of environmental tension. The possible innate reasons for crying in the infant are summarized. The hypothesis is made that a certain amount of crying is necessary. The reassuring aspect of this incidence of crying in "normal," emotionally secure, well-fed infants can be stressed by pediatricians for earnest parents who become anxious about a normal amount of unsatisfiable crying in their own neonate.
ERNST MORO (1874-1951)
Authors: Hoefnagel Dick , Lüders Dieter
Published: December 2021

"DAS ERSTE TRIMENON" was the title of a lecture given by Ernst Moro (Fig. 1) on May 7, 1918, before a meeting of the Society of Natural History and Medicine in Heidelberg; in this lecture the speaker discussed some features peculiar to the first 3 months of an infant's life.1 At the end of it "almost as an afterthought,"2 Moro described what he called "a small observation":

When a young infant is placed on the examining table and one taps with the hands on both sides of the pillow there follows a peculiar motor reflex: both arms are symmetrically extended and then approach each other again with slight shaking movements.
ACUTE CEREBELLAR ATAXIA IN CHILDREN ASSOCIATED WITH INFECTION BY POLIOVIRUS I
Authors: Méndez-Cashion Dolores , Sánchez-Longo Luis P. , Valcárcel Marta , Rosen Leon
Published: December 2021

Eleven cases of acute cerebellar ataxia are presented. The patients were observed during a period of 3½ months in the course of an epidemic of type I poliomyelitis in Puerto Rico. None had typical spinal poliomyelitis. There was evidence that infection with poliovirus type I could have been responsible for clinical findings in nine patients. In two, the symptoms were probably due to a different etiology. The findings suggest an association of acute cerebellar ataxia with infection by poliovirus I. This possibility deserves further investigation.
Frequency of Office Visits
Authors: Kennell John H.
Published: December 2021

In pediatrics (28:838, 1961) Dr. Samuel Wishik has commented on the findings of recent studies of health supervision of young children in California. This survey showed that "well care services . . . are reaching children but apparently are unable to hold them," in spite of the evidence that "ninety-one percent of the children under six years of age manifested behavior that caused concern to the mothers." He concluded that the report would help pediatricians "take stock of the effectiveness of their work and . . . their changing role in the protection of the health of children."
In Reply: Hazards of Radioactive Fallout
Authors:   Committee on Environmental Hazards, Farr Lee E. , Silverman Frederic N. , Lis Edward F. , Clifford Stewart H. , Yamazaki James N. , Zuelzer Wolf W. , Wheatley George M.
Published: December 2021

Dr. Chusid's concern over radioactive fallout, and particularly strontium-90, is shared by many people both as individuals and as responsible members of lay, professional, or governmental organizations. Because of this concern the AEC has since the beginning of its organization established, developed, and expanded a monitoring network which within the past 2 years has been further expanded by the Public Health Service monitoring network. The Sr90 removal process to which Dr. Chusid refers is one aspect of general attempts to meet and eliminate potential hazards.
AMERICAN BOARD OF PEDIATRICS
Authors:   The Examination Committee
Published: December 2021

Questions are often asked of the American Board of Pediatrics about content, nature, and objectives of its examinations. Two articles have previously been published which were intended to answer these queries.1,2

Candidates are expected to have sufficient factual knowledge and to have a sufficiently enlightened approach to children and their troubles to be able to handle problems encountered in a pediatrician's office and in hospitals where seriously ill children are cared for. The candidate should know how to diagnose and treat the medical illnesses which kill children, which cripple them, or which impair their physical or mental health. The pediatrician cannot be a psychiatrist, but he can advise parents in the problems of child-rearing. The pediatrician cannot be a school teacher, but he should know something of our schools and the problems of school children. He cannot be a geneticist, but he must understand the known mechanisms which lead to congenital and hereditary ills, so that he can give counsel to parents burdened with an abnormal child. He should understand the variations in physical and mental growth so that he can allay unnecessary fears or, if need be, take steps to manage significant deviations from normal. He should be able to assist the surgeon in preoperative and postoperative care of infants and children. He should know how to manage the premature infant, the normal newborn infant, the growing child, and the adolescent. Above all, he must recognize the seriously ill child and know how to treat him. He must be a useful consultant in the care of seriously ill children.
Hazards of Foods
Authors: Garrison Roy F.
Published: December 2021

Regarding the use of foods packed in glass jars for infant feeding (Pediatrics, 29:499, 1962), Dr. Coriell's remarks are pertinent. History of allergy was absent and subsequent intake of the same food caused no difficulty. I wonder if the shoe may not be on the other foot; that is, maybe some cases are diagnosed as allergy which are really staphylococcal toxin poisonings.

Does Dr. Coriell realize how long it would take in most cities to ship a food product to a State Department of Health?
Breast Feeding: Dr. Bates
Authors: Demy Nicholas G.
Published: December 2021

If anyone should feel sad about mothers who fail at breast feeding, it should be George Bates, M.D. (Pediatrics, 29:332, 1962). I am disinclined to leave that problem to an old practitioner who long ago found the theories and logic of Dr. William O. Jones (Pediatrics, 28:851, 1961) impractical.

I recall with shame and anger the obstetricians and pediatricians and nurses who discouraged capable mothers from nursing their babies. Breast feeding interfered with their and the hospital's routine, no doubt.
BURN THERAPY
Authors: Metcoff Jack
Published: December 2021

Elsewhere in this issue appears a paper by Meeker on management of extensive third-degree burns in 35 children. The paper is an extension of a previous report which describes use of an electric dermatome for preparing and obtaining skin grafts.1 Although early skin grafting (1 to 2 weeks after burn trauma) has been used by many surgeons for a good many years, the débridement and grafting technique entails certain difficulties which may be alleviated by skillful use of the electric (Brown) dermatome as described by Meeker. Early débridement and grafting within 1 to 3 weeks of the burn is a generally accepted surgical technique.
DERMATOME DÉBRIDEMENT, EARLY GRAFTING, AND MANAGEMENT OF EXTENSIVE THIRD-DEGREE BURNS IN CHILDREN
Authors: Meeker Irving A.
Published: December 2021

A method has been presented employing dermatome débridement and early grafting whereby it has been possible to reduce the period of hospitalization and the number of surgical procedures to one-third or one-fourth the figures for comparable cases treated by accepted standard methods of the past. In terms of economy to the hospital, and painful experience to the patient, approximately 6½ to 7 years of hospitalization have been saved in these 30 cases by employing the methods described in this paper.
Precocious Sexual Development—A Clinical Study of 100 Children. Erik Thamdrup; Springfield, Illinois, Charles C Thomas, 1962, 237 pp., $7.50
Authors: Talbot Nathan B.
Published: December 2021

This volume reports the author's clinical observations on 100 children with sex precocity seen in Denmark and compares these with the data of the literature. Those who are particularly interested in this subject will find some valuable information concerning the physical development of precocious children in the neatly designed tables and graphs. They will not find much in the line of physiologic explorations, new concepts or original opinions however. It is unfortunate, too, that chance failed to make available to the author examples of all the various types of sexual precocity known at this time such as the sodium-losing variety of congenital adrenocortical virilism, the incomplete type of central sex precocity in boys with development of the interstitial cells but not the tubules of the testes and others.
FAMILIAL BONE DISEASE RESEMBLING RICKETS (HEREDITARY METAPHYSIAL DYSOSTOSIS)
Authors: Stickler Gunnar B. , Maher Frank T. , Hunt James C. , Burke Edmund C. , Rosevear John W.
Published: December 2021

Familial metaphysial dysostosis has been described as it occurred among 18 members of a family in seven generations. The roentgenologic changes were very similar to those seen in vitamin D resistant rickets. No biochemical defect could be detected. Studies of renal function with special reference to tubular reabsorption of phosphorus gave normal values. The treatment of choice is osteotomy, after epiphysial closure has occurred, to correct the pronounced bowing of the legs. Administration of vitamin D in high doses has no effect on the course of this disease.
Mental Health in Modern Society
Authors: WORK HENRY H.
Published: December 2021

As another evidence of the emergence of psychiatry from the hospital and the new concept of its role in society, this book offers an excellent integration of mental health theory and practices in their relation to a multitude of social problems. Prompted, apparently, by the advances of psychiatry during the war period and including a thorough study of the mental health problems of the veteran, this book is a compendium of modern resources in the field with some thoughts on the varying usefulness of their application.

The first part deals with the lessons of the war itself and contains, in addition to a chapter on the psychiatric services in the armed forces and the emergency measure for dealing with the veteran, an excellent chapter on "The Psychiatric Disabilities of War: Dynamics and Motivation."
CYANOSIS IN INFANTS WITH NITRATES IN DRINKING WATER AS CAUSE
Authors: DONAHOE WILL E.
Published: December 2021

Five cases of idiopathic cyanosis in babies are reported. They cleared and did not recur when well water used for drinking and formula was changed, as a result of demonstrated contamination with Coliform organisms.

These cases substantiate the contention of Comly that the toxic, or nitrate-containing water, is the cause of the cyanosis. This cyanosis appears as a result of the oxidation of hemoglobin into methemoglobin by the nitrites derived from nitrates present in the well water used for drinking or formula.

Cyanosis cleared within a few days following removal of the infant to the hospital, away from the home water supply, but recurred within one to two weeks after returning home to the use of the contaminated water.

One infant strongly suggested that milk from cows which drank the contaminated water may be the cause of moderate cyanosis when the milk supply is restricted to the single herd.

One infant suggested that cyanosis may occur in a breast-fed infant, if the mother drinks the contaminated well water, or the milk from cows drinking water from that well.

Many cases of cyanosis in early infancy in farm homes have been and still are being incorrectly treated for hypertrophy of the thymus gland.

Cyanosis in early infancy, occurring particularly in babies living on farms one to three weeks after birth, can be cleared by using uncontaminated water.
PURE GRANULOMATOUS NOCARDIOSIS
Authors: WEIL MARVIN L. , CUTTINO JOHN T. , MCCABE ANNE M.
Published: December 2021

A case of an infectious granulomatous disease, in which the clinical picture resembled that of a retroperitoneal tumor, is presented. The etiologic agent is shown to be an hitherto undescribed organism, Nocardia intracellularis, n.sp. The clinical similarity of this rare disease to xanthogranulomata and neoplasms is emphasized. The diagnosis rests primarily upon histopathologic studies of the lesions, especially with reference to intra cellular organisms. The condition may be suspected if atypical acid fast organisms are found in the stools of patients with clinically similar pictures.
THERAPY AND PROGNOSIS OF FIBROCYSTIC DISEASE OF THE PANCREAS
Authors: ANDERSEN DOROTHY H.
Published: December 2021

The etiology of the respiratory lesion in fibrocystic disease of the pancreas is discussed with a summary of the congenital and nutritional hypotheses.

There is no morphologic evidence that a specific congenital abnormality exists in the bronchi or in their secretion. The microscopic appearance of the mucus does not resemble that of the contents of the pancreatic ducts but does resemble the mucus seen in some other clinical conditions, notably asthma. A physiologic congenital abnormality of the bronchi is possible but unproven.

Evidence is presented that dietary therapy improves the growth curves of infants diagnosed and treated prior to infection.

The absorption of vitamin A, and presumably of other fat-soluble specific substances, is affected by diet.

Twenty-two cases of fibrocystic disease without clinical evidence of respiratory infection are presented. Twenty-one of these were first seen after penicillin became available but only 11 have received it. The majority of the 22 patients were started on dietary therapy before a cough had been present for as long as two months. This record is presented as evidence in favor of a nutritional factor in the etiology of the respiratory infection.
BCG TUBERCULIN STUDIES
Authors: MAGNUSSON J. HENNING , LITHANDER A.
Published: December 2021

BCG tuberculin is prepared from BCG cultures grown as a matter of routine on Sauton's medium to obtain Calmette's vaccine. The BCG organisms are allowed to grow for 11 to 12 days prior to the preparation of the tuberculin.

In intradermal tests in BCG-infected guinea pigs this BCG tuberculin causes reactions at an earlier stage than equivalent amounts of commercial tuberculin. In those animals in which initially positive reactions had been caused by only BCG tuberculin, reactions to commercial tuberculin are also obtained in the majority of cases after a further few weeks.

In guinea pigs infected with a virulent strain of the tubercle bacillus no difference can be demonstrated between the two types of tuberculin. Already in the first tests reactions are equally frequent to commercial tuberculin and to BCG tuberculin.

In BCG-vaccinated newborn and older children, BCG tuberculin injected intradermally provokes reactions considerably more often than equivalent amounts of commercial tuberculin. The children sensitive only to BCG tuberculin in the first test after vaccination are subsequently sensitized to commercial tuberculin as well.
CENTRAL AUTONOMIC DYSFUNCTION WITH DEFECTIVE LACRIMATION
Authors: RILEY CONRAD M. , DAY RICHARD L. , GREELEY DAVID MCL. , LANGFORD WILLIAM S.
Published: December 2021

Five cases have been reported with symptoms and findings so similar as to constitute a clinical entity. The common features in this group are: 1. a deficiency of lacrimation; 2. an abnormal reaction to mild anxiety characterized by transient extreme elevation of blood pressure, excessive sweating, salivation to the point of drooling, and the development of sharply demarcated erythematous blotches on the skin, biliterally symmetric, and tending to recur in the same or similar configurations. The findings seem best interpreted as a central, possibly congenital, disturbance of autonomic function. An origin in the diencephalon has been suggested. The most difficult feature to interpret from a neurophysiologic point of view is diminished rather than excessive lacrimation.
Panel Discussion
Authors: JACOBSEN A. WILMOT , KOEPF GEORGE F. , TALBOT NATHAN B. , WILKINS LAWSON
Published: December 2021

The role of the adrenal cortex in resistance to stress and strain has been reviewed. Certain experimental data indicating increased secretion of the adrenal cortical hormone in acute and chronic stress has been presented and discussed in terms of Sayers' homeostatic theory of the acute stress mechanism and in terms of Selye's "Adaptation Syndrome." In addition, studies made on a patient with acute rheumatic fever were discussed. Changes in uric acid metabolism compatible with those that might be seen in an alarm reaction were noted in this patient. [SEE THE TABLE I IN SOURCE PDF].

In the adrenogenital syndrome there is increased protein anabolism due to excessive androgen, in Cushing's syndrome inhibition of protein anabolism due to excessive gluconeogenetic hormones. The manifestations of the adrenogenital syndrome differ according to the patient's sex and the age of onset. Congenital adrenal hyperplasia causes pseudohermaphroditism in the female. This can be differentiated from various types of genetic intersexuality by the evidences of excessive androgen from infancy on and by a fairly uniform type of heterosexual development with a persistent urogenital sinus. In the male congenital adrenal hyperplasia causes macrogenitosomia precox which is sometimes accompanied by Addisonian-like symptoms. This can be differentiated from other types of male precocity by the excessive excretion of androgen and lack of maturation of the testes. In postnatal life androgenic adrenal tumors or hyperplasia cause virilization in both sexes unaccompanied by embryonic abnormalities. Occasionally gynecomastia occurs in males. Most of the symptoms of Cushing's syndrome are probably caused by excess of the gluconeogenetic hormones. However, there is also usually an increased secretion of androgen and in some cases evidences of increased electrolyte-controlling hormones.
We, The Patients
Authors: PROVENCE SALLY ANN
Published: December 2021

This is a revised edition of a book first published in 1939 and written primarily for parents. It represents, in the author's words, "A point of view that has grown through the years." It deals with a variety of things with which parents are concerned in rearing their children—authority and freedom, punishment, discipline, truthfulness and lying, individual capacities and formation of attitudes. There is a section on the role of the home, school and community in the child's development. The radios, movies and comics are discussed in an unprejudiced manner.

Throughout the book the author reveals a sympathetic understanding of children and their parents. Her "point of view" seems to this reviewer for the most part wise and useful.
ANOMALOUS CHANNEL BETWEEN AORTA AND RIGHT VENTRICLE
Authors: BROWN RICHARD C. , BURNETT JOHN D.
Published: December 2021

The occurrence of a congenital vascular tract between the left posterior aortic sinus of Valsalva and the right ventricle in a 13 month old boy is reported. A group of cardiovascular anomalies which clinically resemble a patent ductus arteriosus is discussed, and the help which cardiac catheterization may give in confirming the diagnosis is indicated.
APICAL DIASTOLIC HEART SOUNDS IN ACTIVE RHEUMATIC FEVER
Authors: FRIEDMAN SIDNEY , HARRIS T. N.
Published: December 2021

Of 400 children under observation during active rheumatic fever, 115, or 29%, presented either an apical diastolic third sound or an early apical diastolic murmur. Of these, 54, or 49%, were found to have an apical diastolic third heart sound and an early diastolic apical murmur in some sequence.

The rapid flow of blood from auricles to ventricles during the early diastolic period of the cardiac cycle is thought to be the primary factor responsible for both the third heart sound and the early diastolic murmur. Factors which tend to increase intra-auricular pressure, such as regurgitation at the mitral valve, favor rapid blood flow through the auriculo-ventricular valves and production of these sounds.

The importance of the apical diastolic murmur as a sign of myocarditis per se is discussed.
PENICILLIN TREATMENT OF DIPHTHERIA CARRIERS
Authors: KARELITZ SAMUEL , SPINELLI VINCENT A.
Published: December 2021

Penicillin administered intramuscularly in doses of 30,000 u. every three hours and concurrently in the form of nose drops 1,000 u./ml. in each nostril every two hours effectively eliminated C. diphtheriae from seven carriers and one case of faucial diphtheria within 36 hours. One carrier required five days of therapy.

Penicillin is an effective agent in shortening the period of the carrier state of chronic diphtheria carriers.
HOMOLOGOUS SERUM HEPATITIS IN INFANTS AND CHILDREN
Authors: MOLOSHOK RALPH E. , KARELITZ SAMUEL , STRAUSS LOTTE
Published: December 2021

Eight cases of homologous serum hepatitis are reported as having occurred in seven infants under one year of age and in a child of 2½ years.

Five of these children died of acute hepatic degeneration.

Suggestive evidence has been presented for the implication of icterogenic plasma in five cases.

The clinical, laboratory and postmortem findings of serum hepatitis are described in detail.

Preventive measures have been reviewed and summarized.