bluuebunny/crossref_metadata_2025 huggingface dataset:
ACTIVITY OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE IN ERYTHROCYTES OF PATIENTS WITH VARIOUS ABNORMAL HEMOGLOBINS
Authors: Naylor Jean , Rosenthal Ira , Grossman Aaron , Schulman Irving , Hsia David Yi-Yung
Published: December 2021

In 99 patients with sickle cell anemia and 100 normal Negro children, the activity of glucose-6-phosphate dehydrogenase in erythrocytes was determined.

Hemoglobinopathies may be combined with reduced activity of glucose-6-phosphate dehydrogenase in the erythrocytes.

The two defects are inherited independently.

The incidence of the enzymatic defect in the erythrocytes of those with sickle cell anemia in this series does not differ from that of a similar Negro population having normal hemoglobin.

There appears to be no significant effect of the enzymatic defect in the erythrocytes on the clinical course of patients with sickle cell anemia or survival times of their erythrocytes.

Patients with sickle cell anemia and with normal stability of the glutathione in the erythrocytes have significantly higher levels of G6PD than controls or patients with sickle cell trait.
GLYCOGEN IN ERYTHROCYTES OF PATIENTS WITH GLYCOGEN STORAGE DISEASE
Authors: Sidbury James B. , Cornblath Marvin , Fisher Jean , House Evelyn
Published: December 2021

The erythrocyte glycogen concentration has been determined in 63 normal persons and 18 patients with glycogen storage disease. Erythrocyte glycogen from normal patients and from those with glycogenosis has been isolated and characterized by beta-amylase degradation and the iodine spectrum.

By these techniques patients with Type III glycogenosis could be distinguished both by the concentration of glycogen in the erythrocyte and characterization of the glycogen. One patient with amylo-1,4→1,6-transglucosidase deficiency (Type IV) was found to have a normal concentration of glycogen in the erythrocytes but the glycogen from the cellular elements of the blood was shown to be abnormal, being amylopectin-like in structure. The concentration of glycogen in the erythrocytes of Types I and II glycogenosis was found to be within the normal range.

The etiologic diagnosis can be made in approximately 50% of the patients with glycogenosis by assay of the concentration and characterization of erythrocyte glycogen, thereby obviating the necessity for biopsy. The erythrocyte glycogen in Type III glycogenosis offers another parameter which may be followed in evaluating the response of the patient to therapy.
ARGENTAFFIN CELL TUMORS (CARCINOIDS) OF THE APPENDIX IN CHILDREN
Authors: Oeconomopoulos Chris T.
Published: December 2021

Three cases of argentaffin cell tumors of the appendix in children are presented. The condition is rare in childhood.

The correct preoperative diagnosis of these tumors when located in the appendix has not been made. They appear to cause an obstructive appendicitis early in their course. This results in appendectomy and may account for lack of metastases in the reported cases.

The treatment of the appendiceal carcinoids consists of simple appendectomy and the prognosis is the same as for acute appendicitis.
TRIAMCINOLONE THERAPY IN THE ADRENOGENITAL SYNDROME
Authors: Green Orville C. , Cleveland William W. , Wilkins Lawson
Published: December 2021

Triamcinolone has the unique advantage that it is not a salt-retaining steroid, and therefore it has been found useful to physicians dealing with pharmacologic doses in serious diseases such as rheumatoid arthritis, lupus erythematosus, and the nephrotic syndrome. In the physiologic dosage ranges utilized in the adrenogenital syndrome, salt retention and other side effects are not complications of cortisone therapy. Our results would indicate that triamcinolone is 8 to 10 times as potent as cortisone when comparing adrenal suppressive ability. However, the increased potency of this compound is accompanied by a reduced margin of safety, and cortisone, hydrocortisone, or prednisone remain the drugs of choice in treatment of congenital virilizing adrenal hyperplasia.
SERIOUS INFECTIONS IN SPLENECTOMIZED CHILDREN
Authors: FINLAND MAXWELL
Published: December 2021

Splenectomy is now recognized as an essential part of the management of several types of hemolytic anemia, thrombocytopenic purpura, other hemorrhagic diseases and splenomegaly of diverse origin. It is now considered to be the only safe procedure for rupture of the spleen, which is usually, though not always, the result of trauma. In some of the congenital hematologic disorders, the manifestations may be severe enough at or soon after birth to require the operation early in infancy. In these and in the older children the operation usually, but not always, produces prolonged or permanent improvement or remissions that result in more nearly normal growth, development and general well being, reduces or eliminates the requirements for transfusions and, in many of the conditions, prolongs life.
TRANSMISSION OF POLIOVIRUSES
Authors: Wehrle Paul F. , Hagen Felicitas , Carbonaro Ory
Published: December 2021

An attenuated poliovirus Type III strain (Leon 12a1b) was fed to six members of a summer recreational school program in a small community in the central part of New York. Transmission of this virus occurred to only 3 of 25 family contacts of these six children and to only 1 of 13 close school associates. In addition, five more casual school and neighborhood contacts became infected during the study period. Thus, only 9 of 100 family and school contacts of these school children became infected during a 5-week study period.

The results have been interpreted to suggest that the attenuated poliovirus Type III strain (Leon 12a1b) is less invasive in open populations than the natural polioviruses previously observed. It is likely that the increased prevalence of Coxsackie B2 and B3 infections and perhaps other enteroviruses may have had some effect on the spread of the attenuated polioviruses. However, it seems unlikely that these latter two factors could have explained the striking differences observed.
PEDIATRICS IN THE PAST
Authors: Vignec Alfred J.
Published: December 2021

The New York Foundling Hospital, now located in a new, modern building (Fig. 1) has been in continuous operation for over 90 years. The New York Foundling Asylum, as it was originally known, opened its doors on October 11, 1869; it was the first institution in the United States devoted exclusively to the care of abandoned, neglected or dependent infants, regardless of race or creed. It preceded, by only 2 years, Chicago's Foundling Home, which was organized in 1871 by Dr. George Elias Shipman, a well-known New York physician who had migrated to Chicago.

The New York Foundling Asylum was founded by the Roman Catholic Order of the Sisters of Charity of St. Vincent de Paul; it had, as its primary objective, the reduction of the appalling rate of infanticide in New York City, most of these deaths being attributable to exposure. In the first year of operation, 61% of the infants admitted were in extremis. While it may be an exaggeration to say that the streets of New York were covered with dead and dying infants, it certainly would not be an exaggeration to say that it was commonplace. Indeed as late as 1892, according to Thomas Knox, 200 foundlings and 100 dead infants were found in New York City streets.

The first residence of the New York Foundling Asylum was a modest, 4-story brownstone building at 17 East 12th Street (Fig. 2). This building was situated on the north side of the street between Fifth Avenue and University Place—a site now occupied by the Aristocrat Garage. The adjoining building, No. 15, partially visible in the photograph, is still standing and in use.
Venotomy without Infection from Stitches
Authors: SPENCER D. C. , DERRICK JOHN R.
Published: December 2021

Surgery on patients of the pediatric age group requires an adequate venotomy for administering blood and fluid, not only during the procedure but also during the postoperative period. Since the advent of plastic tubing for venous catheterization, very few surgeons depend upon needles to remain in place without infiltrating during these critical periods. Though many techniques have been employed by various operators and various suture materials have been tried, all seem to occasionally result in stitch abscesses.
PULMONARY VASCULAR ADJUSTMENTS IN THE NEONATAL PERIOD
Authors: Rudolph Abraham M. , Auld Peter A. M. , Golinko Richard J. , Paul Milton H.
Published: December 2021

Pulmonary arterial or right ventricular pressures were measured repeatedly in 18 puppies and 2 goats, from 1 to 36 days of age; these pressures were measured with the use of indwelling catheters in unanesthetized animals.

In puppies the systolic pressure in the pulmonary circulation decreased rapidly to near adult levels in 5 to 10 days after birth, and then more slowly to adult levels by 5 to 6 weeks of age. In goats the pressures decreased more slowly, reaching near adult levels in about 12 to 14 days.

Acetylcholine produced a decrease in pulmonary arterial pressure in the puppy in the first 5 days of life, but an increase in pulmonary pressure after that time in the resting animal. In the hypoxic puppy, a reduction in pulmonary arterial pressure was induced by acetylcholine. These findings suggest that the pulmonary vessels in the young puppy are actively constricted but that relaxation occurs after the first few days of life.
HISTOPLASMOSIS AS A CAUSE OF ACUTE MYOCARDITIS AND PERICARDITIS
Authors: Crawford Stanley E. , Crook William G. , Harrison Walton W. , Somervill Blanche
Published: December 2021

A case of myocarditis and pericarditis due to histoplasmosis is presented. The similarity of this illness to rheumatic fever is cited. In endemic areas, the use of serologic diagnostic methods for the diagnosis of histoplasmosis should be considered in cases of myocarditis when other causes are eliminated.
TRACHEAL AND BRONCHIAL ADENOMAS IN CHILDHOOD
Authors: Weisel Wilson , Lepley Derward
Published: December 2021

Case histories of three patients are reported, in whom adenomas of the respiratory tract produced dangerous prolonged morbidity in children before correct diagnosis was made. In all children with ususual wheezing disorders or recurrent pulmonary infections, the possible diagnosis of adenoma should be entertained. The proper treatment of adenomas of the respiratory tract in children is surgical excision of the tumor and of the permanently damaged lung tissue. Early diagnosis will reduce the incidence of pulmonary destruction and the possibility of metastasis.
ELECTROENCEPHALOGRAPHIC FINDINGS IN JUVENILE DELINQUENCY
Authors: Low Niels L. , Dawson Shelton P.
Published: December 2021

One hundred juvenile delinquents were examined electroencephalographically in order to investigate the incidence and importance of obvious or previously unrecognized temporal lobe epilepsy. This correlation was not found to be significant. Twenty-nine patients were found to have 14 and 6 per second positive spikes. Inquiry also revealed that 13 of the 89 teenagers, for whom a good history could be obtained, had had breath-holding spells in earlier years.
SCHOOL PHOBIA IN OLDER CHILDREN AND ADOLESCENTS: DIAGNOSTIC IMPLICATIONS AND PROGNOSIS
Authors: Milman Doris H.
Published: December 2021

A series of 20 cases of school phobia in older children and adolescents was analyzed and categorized into three diagnostic groups: neurotic, organic and schizophrenic. Important differences were noted between neurotic and schizophrenic patients, particularly with respect to the malignant psychiatric symptoms, high intelligence and relapsing tendency of the schizophrenic group. The features common to all groups were pathological maternal attitudes, somatic complaints, anxiety and depression, rarity of prior history of significant anxiety about school, and favorable response to treatment. The symptoms most amenable to treatment were anxiety (both sexual and separation), depression, somatic complaints, and school phobia. With alleviation of these symptoms, there followed an improvement in physical health, school achievement, and social adjustment. Regular school attendance was achieved without coercion in 18 patients. A long-term follow-up averaging 5 years showed sustained improvement in 18 patients. School phobia in late childhood and adolescence is a different syndrome from that in early childhood, and it has graver diagnostic implications.
SPECIAL ARTICLE
Authors: Rose John A.
Published: December 2021

THE INCREASING USE of the diagnosis, "schizophrenic reaction," in the severe emotional disturbances of childhood is an evolutionary phenomenon. It is, in part, accounted for by the trend toward incidence of severe emotional disturbance in children at younger ages during the past 2 decades, which has eventuated in the current general problem of increasing severity in childhood mental health.

Prior to the 1940's there was little demand for mental hospital beds for children, while today most of the states are engaged in construction of facilities for children, with no end to the demand in sight.

Prior to the 1940's it was not believed that emotional disorders of early childhood could be severe enough to be identified as psychosis. In 1939, Kanner described a new syndrome of psychotic disturbance in childhood which he called "infantile autism." From this period on, a number of independent workers reported cases of similar nature.

Kanner saw in the behavior of these children a quality that had been considered by Bleuler to be typical of schizophrenic reactions, in his now classic treatise published in 1911. Autism referred to the withdrawal of the schizophrenic from the world of human relationships and values into a self-created world. Kanner described two modes of behavior as typical: 1) alienation from social relationship with persons and 2) preference for sameness in the environment. In addition he cited the fact that the children manifested confusion between self and other; the child might call himself "you," or "lie," and his mother or other caretaker "me."
REPORT OF COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

THE PRESENT REPORT concerns the nature and functions of natural vitamin K compounds and of some synthetic naphthoquinone derivatives, referred to as vitamin K analogues. The report emphasizes the use of these compounds in pediatrics, especially for prevention and treatment of hemorrhagic disease of the newborn. The demonstration that water-soluble analogues of vitamin K may be toxic for the newborn infant makes it imperative that these substances be used judiciously.

FUNCTIONS AND REQUIREMENT OF VITAMIN K

Table I provides information concerning characteristics, sources, available preparations and routes of administration of natural and synthetic compounds with vitamin K activity.

Functions

Vitamin K is required for synthesis of prothrombin and proconvertin (stable factor, factor VII), and it probably is involved also in synthesis of Stuart-Prower factor (factor X) and PTC (plasma thromboplastic factor, factor IX) since clotting defects due to deficiencies of these factors as well as to deficiencies of prothrombin and proconvertin occur in states of vitamin K deficiency.

Requirement and Usual Source of Supply

Available evidence indicates that vitamin K compounds cannot be synthesized by the animal organism. However, vitamin K1 is widely distributed in nature, being present in greatest concentrations in green leafy vegetables and in somewhat lesser concentrations in seeds, tubers and fruit. Although it has long been believed that bacterial synthesis of vitamin K2 in the intestine is another important source of the vitamin, recent studies with rats indicate that vitamin K2 formed in this manner is unavailable if coprophagy is prevented. Whether bacterial synthesis of vitamin K2 in the human intestine can contribute to satisfying the requirements for this vitamin is not known, and it is therefore uncertain whether suppression of growth of intestinal micro-organisms by prolonged oral administration of antibiotics or sulfonamides is of practical importance.
PRESIDENT'S MESSAGE
Authors: W. G. M.
Published: December 2021

ALTHOUGH at the moment the health of older people holds the politico-medical spotlight, there are indications that the health of children may soon be in this limelight. In fact, President Kennedy and the new administration have already taken several important actions to center more attention on the health and welfare of children. In the months ahead the Academy may, I expect, face its greatest opportunity yet to fulfill its purpose as an organization dedicated to the welfare of children.

At the Executive Board meeting on April 7, 1961, the Board, in a prepared statement, approved the proposed National Institute of Child Health and Human Development and offered the co-operation of the Academy in developing a program of basic research in child health. On July 18, Senators Hill and Kerr introduced into the Senate bill S.2269, which provides for the development of this new research Institute. Copies of the Board's resolution were sent to the Senators, together with the offer to appear before the appropriate Congressional Committee, in support of the bill. We believe this proposed Institute should emphasize the concepts of "the whole child" and "prevention" in research programs. We have also urged that research conducted through the presently constituted National Institutes of Health have the benefit of planning and participation by staff trained or oriented in pediatrics. These are matters that for some time have had the attention of your Executive Board.

Your officers have also been co-operating with the White House in connection with the President's Physical Fitness Program.
REPORT OF COMMITTEE ON FETUS AND NEWBORN
Authors:   COMMITTEE ON FETUS AND NEWBORN
Published: December 2021

ONE OF THE SIGNIFICANT FACTORS in decreasing mortality among children during the past century has been the recognition of the role that contaminated milk played in the production of various gastrointestinal disorders. For several decades it has been generally accepted that all milk-mixtures should be sterilized before being fed to infants. Recently, however, the question has been raised regarding the feasibility of preparing individual bottles of milk mixtures using clean but not sterilized ingredients and placing them in unsterilized equipment. Although there is no practical method of processing and preparing milk mixtures so that sterility is assured in every bottle, the increased susceptibility of infants to diarrheal diseases and the severity of diarrheas and dysenteries in early infancy make, it obligatory to take every effort to guarantee that all food fed to infants during the first months of life should be prepared by the safest possible method.

It has been shown that the terminal method of heating will destroy most pathogenic bacteria and viruses and is probably the best means now available for preparing milk mixtures for infant feeding, but even this method permits certain organisms (particularly spore-forming bacteria and a few viruses) to survive, especially when unclean equipment containing milk scum is used to prepare and store the mixture.

It has also been shown that most mothers can prepare milk mixtures satisfactorily at home by any of several different methods; the bacterial count in resultant mixtures varied inversely with the care and cleanliness exercised by mothers, so that the counts occasionally reached potentially unsafe levels.

The use of a technique of formula preparation that does not necessitate sterilization of equipment or ingredients might be a great boon to busy mothers.
STATEMENT BY COMMITTEE ON FETUS AND NEWBORN
Authors:   COMMITTEE ON FETUS AND NEWBORN
Published: December 2021

IT IS A BASIC PREMISE of pediatrics that physical size is not the most important difference between children and adults. There is increasing awareness that it is also necessary to make more than a quantitative distinction between infants and children. The fetus and the newborn infant often behave so differently as to warrant consideration as separate categories of the human species. This necessitates re-evaluation of the effects of drugs independently in each category of the human so that they may be used safely.

Existing drugs and agents that are developed in the future for use in the fetus and in infants must be subjected to more extensive preclinical investigation than is being carried out at the present time. The pharmacologic responses of the immature human may differ greatly both quantitatively and qualitatively from those of the adult. As a result, data obtained from tests in mature animals and human adults or older children cannot be accepted as a satisfactory basis for recommendations concerning the fetus and infant.

The pharmacologic properties of drugs should be studied in vitro and in vivo in the fetus and newborn animal and compared with those in the adult of the same animal species. Of particular importance would be a knowledge of the LD50, dose response, metabolism, and distribution and disposition of the drug.
CLINICAL CONFERENCE
Authors: Cornblath Marvin
Published: December 2021

These infants are remarkable not only because, like foetal versions of Shadrach, Meshach and Abednego, they emerge at least alive from within the fiery metabolic furnace of diabetes mellitus, but because they resemble one another so closely that they might well be related. They are plump, sleek, liberally coated with vernix caseosa, fullfaced and plethoric. The umbilical cord and the placenta share in the gigantism. During their first 24 or more extra-uterine hours they lie on their backs, bloated and flushed, their legs flexed and abducted, their lightly closed hands on each side of the head, the abdomen prominent and their respiration sighing. They convey a distinct impression of having had such a surfeit of both food and fluid pressed upon them by an insistent hostess that they desire only peace so that they may recover from their excesses. And on the second day their resentment of the slightest noise improves the analogy while their trembling anxiety seems to speak of intra-uterine indescretions of which we know nothing.

THUS Farquhar described the newly born infant of the diabetic mother. The purpose of this presentation is to review the information that is available concerning such infants and their difficulties. Dekaban and Baird, comparing 235 pregnancies in 48 diabetic mothers with 249 in paired nondiabetic controls, not only reaffirmed the increased intrauterine and neonatal mortality among these infants but also demonstrated an increased morbidity among the survivors. This morbidity included congenital malformations, retardation of development and epilepsy. Despite the increased morbidity and mortality, many of these infants are not sick and do well.
PSYCHOLOGIC AND NEUROLOGIC STATUS OF DIET-TREATED PHENYLKETONURIC CHILDREN AND THEIR SIBLINGS
Authors: Berman Phyllis W. , Graham Frances K. , Eichman Peter L. , Waisman Harry A.
Published: December 2021

The neurologic status and intelligence of 8 phenylketonuric children treated with a phenylalanine-low diet were compared with that of 11 unaffected children and 3 untreated siblings. The mean intelligence of the treated children was significantly higher than that of their untreated siblings. This was true both for the two children given a special diet at 2 years of age and for those treated earlier, but the children treated before 6 months of age were significantly more intelligent than those treated at 2 years. The one child for whom treatment was begun at 1 year had an intelligence level within the range of the five who were treated earlier.

Although intelligence was significantly higher in treated than in untreated children, and this was especially marked in the children treated early, all treated children were significantly less intelligent than their unaffected siblings. The loss in intelligence probably cannot be ascribed to poor chemical control, as treated children maintained phenylalanine levels within the normal range throughout treatment, with occasional brief exceptions.

Neurologic findings paralleled the results of intelligence testing. There were no suggestive or positive findings among the unaffected children. Children treated early had some relatively minor findings, while children treated late and those who were untreated had a higher percentage and more marked signs of neurologic defect.

Results of the present study considered together with results from other investigations, indicate that intelligence level, in phenylketonuric children, is a decelerating function of age. If this is true, the brain may be especially susceptible to damage in the first few weeks and months of life, and treatment should be instituted as early as possible.
GENERALIZED LYMPHADENOPATHY AND HEPATOSPLENOMEGALY INDUCED BY DIPHENYLHYDANTOIN
Authors: Bajoghli Mehdi
Published: December 2021

A 6-year-old child developed generalized lymphadenopathy and hepatosplenomegaly 2 weeks after diphenylhydantoin therapy was begun. The patient recovered 4 weeks after discontinuance of the drug therapy. There was eosinophilia in blood and in bone marrow, and a lymph node biopsy specimen showed reticulum and lymphoid hyperplasia.
MALIGNANT LYMPHOMA IN CHILDREN
Authors: Bailey Richard J. , Burgert E. Omer , Dahlin David C.
Published: December 2021

On the basis of observations made on 76 children with malignant lymphoma, of whom 28 had Hodgkin's disease (25 with Hodgkin's granuloma and 3 with Hodgkin's sarcoma) and 48 had lymphosarcoma, the following conclusions are drawn: Hodgkin's granuloma has a fairly prolonged course in childhood with a relatively good outlook for 5-year survival, but late recurrences are more common than in the lymphosarcoma group. Lymphosarcoma, excluding giant follicular lymphoma, has a more rapidly malignant course than does Hodgkin's granuloma, but long-term survival does occur in instances of localized disease involving the peripheral nodes on the small intestine. Chemotherapy and radiation therapy provide effective means for controlling Hodgkin's disease and giant follicular lymphoma, even when disease is widespread. Localized disease, when it occurs in malignant lymphoma, requires vigorous radiation treatment. In selected cases, radical surgical removal prior to radiation is indicated. The outlook for these patients is good.
THE RELATIONSHIP OF DERMATITIS HERPETIFORMIS TO INCONTINENTIA PIGMENTI IN NEWBORN INFANTS
Authors: Palmgren Bertil
Published: December 2021

A description is given of incontinentia pigmenti, with special reference to the various clinical stages and the theories of the causes of the condition. One case seen in a girl is described. The case was characterized by a very severe vesicular stage and marked eosinophilia in the blood as well as in the skin lesions. Herpes simplex virus could be regularly demonstrated in fluid from fresh vesicles. The neutralization test for herpes simplex showed no increase in the antibody titer of the patient, while during the following months an increase in titer was noted in the mother. At 2 years of age the child was normally developed, apart from a somewhat retarded eruption of the decidous teeth.
CONGENITAL DEFECTS OF THE CENTRAL NERVOUS SYSTEM ASSOCIATED WITH HYPERENDEMIC GOITER IN A NEOLITHIC HIGHLAND SOCIETY OF NETHERLANDS NEW GUINEA
Authors: Kidson C. , Gajdusek D. C.
Published: December 2021

Erythrocyte glucose-6-phosphate dehydrogenase activity was tested in 69 subjects from the Mulia region of Netherlands New Guinea, where a cretinoid, hypothyroid syndrome apparently affects the entire Dani-speaking population. The majority of results were in the normal range, but 11 values below this range were encountered. These findings, considered together with the results of other workers on hyperthyroid subjects, suggest that some influence of thyroid function on the activity of this enzyme may occur in vivo, although such an effect is absent in vitro. The key position of glucose-6-phosphate dehydrogenase in the hexose monophosphate shunt pathway suggests that alterations in carbohydrate oxidation via this route may be responsible for some of the metabolic changes in thyroid disease. In contrast to other areas of New Guinea, no cases of gentically controlled deficiency of glucose-6-phosphate dehydrogenase have been found in the Mulia region, a factor of possible assistance in determining the degree of genetic isolation of this population.
TWO BOOKS OF IMPORTANCE TO YOU
Authors: Fischer Carl C.
Published: December 2021

During the month of January you have received from the Central Office of the American Academy of Pediatrics, two books that we believe will be of great value to you if properly used.

The first of these is a Fellowship list for 1962, which gives the alphabetical and geographic listing of all of the Fellows of the Academy. It also contains a list of the officers, the District and State Chairmen and the National Committee Members, Liaison Representatives to National Organizations, and, at the end of the book, a copy of our Constitution and By-laws.

Since all the Fellows listed herein have met the basic requirements for Fellowship in the Academy, this directory may be used with confidence in the referring of patients who have moved from one area to another. The Central Office deserves great credit for the speed and accuracy with which it prepares this valuable list and places it in the hands of the membership.

The other book is entitled "Annual Reports of Committee and Liaison Representatives."

This compilation of the annual reports of all of our National Committees and of our Liaison Representatives was first made available to the membership in 1957 and has been sent out annually ever since.

In it you will find not only the usual succinct, factual, and extremely informative reports of the Executive Director and the Secretary but also the reports of 17 National Committees, 6 Section Committees, and 22 Liaison Representatives.

These reports are of importance and great inteest not only to the more than 250 Fellows of the Academy whose work as Committee members and Liaison Representatives made them possible, but also to the more than 6,000 others in whose name this work was done.
EXPERIMENTALLY INDUCED AUTOIMMUNIZATION DISEASE OF THE THYROID
Authors: Chandler R. W. , Kyle M. A. , Hung W. , Blizzard Robert M.
Published: December 2021

Studies were undertaken to determine whether cretinism could be produced in rabbits born to immunized does with autoimmune thyroditis. Although anti-thyroid antibodies crossed the placenta of the rabbit and disappeared from the serum of the neonates by 7 weeks of age, the growth curves and thyroid histology of the newborns were normal. Passive immunization of normal does at 20 and 21 days of gestation was not associated with placental transfer of antibodies although transfer occurred at 30 days gestation. The possibility that the short time interval of exposure of the fetal thyroid to antibodies accounted for the failure of thyroid damage to occur was investigated. The role of cellular antibodies was also investigated by injecting lymphoid cells from immunized adult rabbits into newborns. No thyroid damage or serum antibodies were produced. The possible explanations for failure to obtain thyroid damage by circulating antibodies in newborn rabbits are discussed.
THE SEIZURE AS A MANIFESTATION OF INTRACRANIAL TUMOR IN CHILDHOOD
Authors: Backus Reno E. , Millichap J. Gordon
Published: December 2021

The records of 291 children treated over a 10-year period for intracranial tumor were examined, with particular attention to patients with seizures. Seizures occurred in 17% of the total group—in 25% of patients with supratentorial tumors and in 12% of those with infratentorial tumors. They were the initial symptoms in 15% of patients with supratentorial tumors and in 1% of those with infratentorial tumors. The average age at onset was 4.9 years in the supratentorial group and 4.8 years in the infratentorial group. The diagnosis of supratentorial tumors was delayed for an average of 2 years, whereas infratentorial tumors were diagnosed within an average time of 3 months of the initial seizure. Eight patients continued to have seizures for periods between 3 and 8 years before a tumor was suspected.

The pattern of the initial seizure was of localizing value in 75% of patients with supratentorial tumors that involved the cerebral cortex and in 16% of patients with infratentorial tumors. In patients with seizures the electroencephalogram was of localizing value in 92% of tumors that involved the cerebral cortex, and abnormalities maximal in the occipital areas were compatible with the localization of 44% of infratentorial tumors. Spike, sharp wave, or spike and wave seizure discharges were present in 32% of patients with supratentorial tumors.
DEAFNESS FOLLOWING EPIDEMIC PAROTITIS (MUMPS)
Authors: SCOTT ROLAND B. , CRAWFORD ROBERT P.
Published: December 2021

COMPLICATIONS of epidemic parotitis are unusual before puberty. One of the least commonly reported complications in childhood is deafness. We wish to report such a case and briefly review part of the literature on the subject. [SEE TABLE I and II IN SOURCE PDF].

Case Report

E.J., a 10-year-old Negro female, was admitted to the medical pediatric service because of deafness. She was born after a normal gestation and delivery. She walked at 11 mo., talked at one year of age. She had attained Grade IV in school. Her past history included uncomplicated pertussis, uncomplicated measles, frequent colds, and occasional attacks of sore throat. Mother and father were living and well. There was no family history of syphilis or tuberculosis.

The present illness began two weeks previously with swelling of both parotid glands. Seven days later she complained of severe epigastric pain. This pain subsided by the next day when the patient vomited twice. Until this time hearing had been apparently normal. Impaired hearing was first noted eight days after the onset of swelling of the parotid glands, and gradually became worse until the patient could not hear the radio and responded only to loud speech. Subsequently, deafness became total and complete. The child complained of tinnitus with the early onset of deafness; and three days later, on getting out of bed, felt weak and had an ataxic gait.

As represented in Table I, four siblings developed uncomplicated clinical epidemic parotitis at about the same time as this patient.

Physical examination showed a tall, thin, poorly nourished female child, apparently deaf. Temperature was 37.2° C., pulse 108/mm., and BP 110/70 mm.Hg. The epitrochlear, cervical, and submandibular lymph nodes were slightly enlarged. The left parotid gland was slightly enlarged.
A PROGRAM TO FOSTER ADJUSTMENT IN YOUNG CHILDREN
Authors: ROBERTS KATHERINE E. , ALDRICH C. ANDERSON
Published: December 2021

WHEN a child living in Rochester reaches the age of 2½ years a letter is sent to his mother asking her to bring the child in to the office of the Rochester Child Health Institute for a check-up. The letter states that the child will be given a developmental test and instructs the mother to tell her child that he is coming to play with some toys. Both mother and child are thus prepared for a friendly visit and an effort is made to have it be a happy experience for everybody concerned.

This test is the first standardized one that is given any of our children, since the age of 2½ years is about the earliest age at which the Revised Stanford-Binet test can be used satisfactorily. The visit at this age is the first routine contact that the parent and child have with the psychologists on the Institute staff, although earlier conferences may be arranged in special cases. We hope by offering a routine psychologic service to all the children in the community that parents will learn that it is just as desirable, helpful and normal for their children to have a psychologic check-up as it is to have a physical check-up. We believe that our results will show that most Rochester parents are developing this attitude.

This program was started in July 1946 when the babies born in 1944 began reaching the age of 21/2 years. By July 1948, we will have had two years of experience with this program. From the point of view of cooperation, the results are heartening. The first year, 86% of the children on our list were brought in for a test, and on all but 5% we were able to carry out a fairly satisfactory test. During the first nine months of the second year 92% of the children came and a satisfactory test was completed on all but 4%. This acceptance of the psychologic part of the program is undoubtedly related to the fact that parents have had 2½ years of satisfactory contact with the Institute through the prenatal, neonatal and child health clinics and they think any service offered them is likely to be helpful. Another factor of importance is the routine nature of the test. Everyone in town who has a 2½-year-old—not just parents with dull children, problem children or atypical children of some kind—is invited to come. We find now that, if for some reason we miss a child in this age range, parents call up and ask when their child can come. We are probably justified in our belief that parents who come like the service and tell their friends about it.
ACUTE SEROUS MENINGITIS AND ENCEPHALITIS COMPLICATING SCARLET FEVER
Authors: SWEET LEWIS K.
Published: December 2021

The syndrome of acute serous meningitis complicating scarlet fever has been described. The condition has been found in approximately 1% of patients with scarlet fever. The onset usually is in the second half of the first week of illness. There is a recrudescence of fever with headache, toxemia, meningeal signs which may be minimal or absent, and a lymphocytic pleocytosis in the spinal fluid. The blood shows a polymorphonuclear leucocytosis in most instances. The condition ameliorates rapidly and recovery seems to be complete. The clinical manifestations of this syndrome are quite different from those of encephalitis complicating scarlet fever. The points in differential diagnosis have been outlined.
INFANTILE CEREBRAL PALSY CASES WITH SEVERE MENTAL DEFICIENCY
Authors: YANNET HERMAN
Published: December 2021

This is a report of a study of 157 cases of infantile cerebral palsy planned to demonstrate the correlation of etiologic diagnosis with neurologic residua. The average mental level of the group as a whole is represented by an intelligence quotient of 25, indicating the restricted distribution of the clinical material.

Birth trauma or postnatal central nervous system infections were found to be of etiologic importance in almost one third of the cases with asymmetric spastic involvement. On the other hand, these causative factors were not implicated in any of the hypotonic or ataxic group, nor in those spastic cases with symmetric involvement.
HEPATIC CARBOHYDRATE METABOLISM IN THE GENESIS OF NEONATAL HYPOGLYCEMIA
Authors: Mulligan Paula Bocsor , Schwartz Robert
Published: December 2021

Newborn infants delivered vaginally responded to glucagon and epinephrine plus glucagon within the first 8 hours of life with increases in the concentrations of blood sugar. The degree of responsiveness appears to be dosage dependent. Galactose is metabolized more slowly in the newborn than in older infants or adults, as judged by the half-time disappearance rate of galactose given intravenously. During administration of galactose the blood glucose concentration increases promptly. The hypoglycemia observed normally in the newborn infant at 4 to 8 hours after birth does not appear to be related to inadequate glycogen stores, immature hepatic enzymes, or hyperinsulinism. Some degree of generalized hepatic unresponsiveness, as yet undefined, seems of importance etiologically to explain the instability of blood glucose in the newborn infant.
THE SWEAT TEST
Authors: SHWACHMAN HARRY
Published: December 2021

AN INCREASED interest in the physiology of sweating was precipitated by the demonstration of markedly elevated electrolyte levels in sweat of patients with cystic fibrosis. Indeed, the determination of sweat electrolytes has become the most reliable single diagnostic test for cystic fibrosis, replacing the more difficult, time consuming, uncomfortable, and less reliable procedures of duodenal fluid aspiration and assay. The marked reduction or absence of proteolytic activity of duodenal fluid no longer serves as the cornerstone of diagnosis, since fully 15% of patients with cystic fibrosis have sufficient exocrine pancreatic function to yield normal or nearly normal enzyme values. Nevertheless, study of duodenal fluid is still of considerable value when dealing with cases difficult to diagnose, in instances of borderline sweat electrolyte levels, or for special study purposes.
DIPHTHERIA IN THE UNITED STATES, 1959-1960
Authors: Doege Theodore C. , Heath Clark W. , Sherman Ida L.
Published: December 2021

Diphtheria attack rates and cases, and to a much lesser extent case-fatality rates, have fallen steadily within the United States during the past 25 years. However, during 1959 and 1960 there was a halt in this long-term trend. Epidemiologic data on 868 clinical cases of diphtheria occurring in 1959 and 873 cases in 1960 were submitted to the Communicable Disease Center by 45 states. The cases and several major outbreaks tended to concentrate in the southern and southwestern states. Attack rates and deaths were highest for children under 10 years, and attack rates were more than five times greater for nonwhite children.

Analysis of 1960 immunization data shows that 72% of the patients had received no immunizations. Fifty-five per cent of carriers, but only 18% of persons with bacteriologically confirmed cases, had received a primary series. Only 1 person of 58 fatal cases occurring in 1960 had received a primary series. Certain problems for future investigation, disclosed by the surveillance data, are discussed.
FACTORS IN THE GROWTH OF CHILDREN WITH PATENT DUCTUS ARTERIOSUS
Authors: Umansky Richard , Hauck Anna J.
Published: December 2021

The preoperative and postoperative growth of 444 patients who underwent division of a patent ductus arteriosus prior to the age of 8 years at the Children's Hospital Medical Center in Boston has been investigated by means of review of hospital records and x-rays, and patient questionnaires. Information dealing with maternal height, additional developmental defects, rubella during the first trimester of pregnancy, "rubella syndrome," prematurity and birth weight, cardiac enlargement. and age of the patient at operation has been related to height and weight and the likelihood of acceleration in these parameters.
Pediatric Surgery, Vol. I & II
Authors: POTTS WILLIS J.
Published: December 2021

Pediatric Surgery, in two volumes, has just been made available to the medical profession. These volumes, made possible by the contributions of 79 qualified authorities in various branches of pediatric surgery, are especially appropriate at this time.

Although there are chapters which deal with anesthesia, genitourinary surgery, neurosurgery, and plastic surgery, the major portion of these two volumes represents what a qualified pediatric surgeon should know. The authors have exercised excellent judgment in holding each chapter to a reasonable length.
HYDROCEPHALUS AND MENINGOCELE: THE COURSE OF 100 PATIENTS
Authors: Merrill Robert E. , Isom John B. , Anslow Roberta M. , Pinkerton Joseph A.
Published: December 2021

A series of 100 patients with hydrocephalu or meningocele or both has been presented. Fifty-one of the patients have died, and the reasons for the deaths are listed. Seventeen of the patients are considered to have hopeless cases, and the reason these patients were so classified is listed. The remaining 32 patients were subclassified as noncompetitive if the I.Q. was found to be below 80. Seventeen patients were in this category, and the mean I.Q. was 63. The patients termed competitive numbered 15; this group had a mean I.Q. of 95. Only two patients in the group were entirely free of residual handicaps. This survey is offered as a baseline observation against which further attempts at therapy may be compared.
THE SUPPORTIVE ROLE OF PEDIATRICS IN AN INPATIENT PSYCHIATRIC UNIT
Authors: Cecil Henry S. , Cohen Richard L.
Published: December 2021

The experience with practice in a children's psychiatric hospital during the past 4 years has been used as the basis for some observations on the pediatric role. The evolution of this role has been related to direct care, but more and more utilized as a support resource for the staff. The application of pediatric care to the developmental potential in the child makes this use of the role possible. The need for this support derives from the fact that the heavy demands of disturbed children tax the resources of cartakers to a degree often beyond their capacity. As in private practice, the resultant anxiety of the caretaker about her capacity to nurture the child tends to appear as fears about the child's development. These concerns frequently are expressed in forms which are accessible to pediatric intervention. Several illustrations of this in children are given from daily practice. A model of care centered on child development is presented as a basis for understanding the dynamics of pediatric intervention. It is proposed that pediatric counselling is useful in providing emotional support to caretakers. Its effective use may be a factor in lessening the appearance of somatic symptoms in the child, thereby decreasing the need for direct symptomatic care.
T-3 Uptake in Infants and Children
Authors: MARKS JAMES F.
Published: December 2021

The values obtained by Kundstadter and associates vary rather markedly from those obtained by ourselves and others. They found elevated T-3-RBC uptake at various periods throughout childhood, while our results showed an elevation only in early infancy. Even there Kundstadter et al. showed a much greater change than we did.

Our work was in part misrepresented by the authors, when they stated that we did not distinguish among various age groups. We divided our infants under 18 months into a number of discrete groups. We grouped together children 1½ to 15 years of age because our data indicated these children represented a homogeneous group with respect to T-3 uptake. Indeed, observation of the authors' data for children 2 to 13 years suggests no real statistical difference among the three separate groups into which they have been divided.
Dressings which Conceal Hemorrhage
Authors: CANBY JOHN P.
Published: December 2021

The article in Pediatrics (29:907, 1962) on "Massive Hemorrhage in the Scalp in the Newborn Infant," by Pachman, is quite timely. However, I think a more common situation which may lead to the same result, i.e., hemorrhagic shock, is a neurosurgical procedure on the head of a young infant.

Having been stationed in various hospitals I had noticed that neurosurgeons tend to place a rather large bulky dressing on the scalp of the infant who has undergone craniotomy. Although a small amount of blood may be hidden under such a dressing it can be enough blood loss in a small infant to cause shock and ultimately death.
CARDIOPULMONARY CHANGES IN RESPIRATORY DISTRESS
Authors: AVERY MARY ELLEN
Published: December 2021

TWO PAPERS in this issue add to an impressive list of recent investigations of the pathophysiology of respiratory distress, presumably due to atelectasis with hyaline membranes, in newborn infants.

Such publications do not fully reveal the difficulties involved in getting this significant information. Perhaps first among these is the technical feat of collecting blood and gas samples and measuring pressure changes in critically ill infants. This requires a team accustomed to handling infants and apparatus, and available at all hours. A corollary of good technique is the achievement of these measurements without jeopardizing the condition of the infant. Of secondary importance, but nonetheless significant, is the creation of an enviornment favorable to the performance of investigations on sick infants.