bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHONDROECTODERMAL DYSPLASIA (ELLIS-VAN CREVELD SYNDROME)
Authors: Smith Harris L. , Hand Albert M. 
Published: December 2021

Two cases of chondroectodermal dysplasia (Ellis-van Creveld syndrome) in infants are reported. The four major features of the syndrome (chondrodysplasia, ectodermal dysplasia, polydactylism, and congenital defect of the heart) were present in each of the infants. One of the cases (Case 1) is believed to be the first published instance of this syndrome in the Negro race. The clinical course of both infants was marked by progressive dyspnea and cyanosis, leading rapidly to death in the newborn period.
Detailed gross and microscopic pathologic findings are included. The cardiac malformation in one case was cor triloculare and in the other was cor biloculare with transposition of the great vessels. The thoracic cage of each infant was extremely narrowed anteriorly and flared inferiorly. Chondro-osseous junctions of ribs were in the anterior axillary line. Death was attributed to the congenital malformation of the heart, pulmonary hypoplasia, and diminished capacity of the thorax due to chondro-osseous dysplasia. The severe chest deformities together with serious congenital cardiac lesions distinguish these cases.
The literature is briefly reviewed, and the clinical and radiographic features of the syndrome are discussed.
PREVALENCE OF SENSITIVITY TO TUBERCULIN AND HISTOPLASMIN AMONG HIGH SCHOOL STUDENTS IN MONTGOMERY COUNTY, MARYLAND
Authors: Edwards Lydia B. , Peeples William J. , Berger Anne G. 
Published: December 2021

Skin testing with tuberculin and histoplasmin was combined with the annual roentgenographic examination of high school students in Montgomery County, Maryland, during the spring term of 1957. More than 3,200 students participated in the program. The tests were given by intracutaneous injection of a 5 TU dose of standardized tuberculin and a 1:100 dilution of histoplasmin H-42. Reactions were read in 48 to 72 hours by measuring the transverse diameter of induration. Photofluorograms of the chest were read without knowledge of the results of the skin test.
The prevalence of tuberculin sensitivity was found to be very low among white students throughout the county. It was estimated that only about 3% of the students had reactions indicative of a tuberculous infection. Histoplasmin sensitivity was many times more prevalent than tuberculin sensitivity and, moreover, showed striking differences in sections of the county no more than 20 miles apart, ranging from about 14% in the suburban schools in the southeast to more than 60% in the rural northwest. Pulmonary calcifications were most frequently associated with sensitivity to histoplasmin, occasionally with sensitivity to both histoplasmin and tuberculin and in no instance with sensitivity to tuberculin only.
Partial Masculinization of the Female Fetus by the Administration of Oral and Intramuscular Progestins During Gestation
Authors: WILKINS LAWSON , JONES HOWARD W. 
Published: December 2021

The purpose of this letter is to bring rapidly to the attention of pediatricians and obstetricians a type of sexual abnormality which, if recognized early, is of relatively little importance or can be readily corrected, but which if wrongly diagnosed or treated may be disastrous to both child and parents. During the past month, three infants have been born in Baltimore with this condition which is of iatrogenic origin.
We have studied 17 female patients showing, at birth, partial masculinization of the external genitalia consisting of an enlarged phallus, with or without varying degrees of fusion of the labioscrotal folds.
Letters to the Editor
Authors: FELDMANN FLOYD M. 
Published: December 2021

Dr. Vollmer is quite right in pointing out that the references quoted in my article are selected. The number of published studies of patch tests which were done with simultaneous intracutaneous tests, using measured doses of standardized PPD, is small. I preferred to use those which seemed to me to demonstrate conclusively the variability in the dose of tuberculin delivered by the patch—for that is its most serious shortcoming.
Control studies such as these with results unfavorable to the patch are not rare or unique, but tend to be unreported for various reasons.
SYMPOSIUM: IATROGENIC DISEASE
Authors: Chute A. L. , Deamer William C. 
Published: December 2021

THE MOST obvious physician-caused trouble in the field of allergy is the immediate constitutional reaction caused by the injection of an overdose of antigen during the course of desensitization treatment. Such a reaction can take several forms, including itching of the palms of the hands and soles of the feet, urticaria, angioedema, as well as asthma or hay fever—especially if the latter were the patient's clinical complaints. Shock can also occur and, in addition, there may be flushing of the face, headache, or vomiting and diarrhea. These symptoms, or any combination of them, are usually associated with a large local redness and swelling at the site of injection.
The more sensitive the patient and the greater the overdose, the more severe the reaction is likely to be, and the sooner it will occur after injection. Under these circumstances it may resemble anaphylactic shock and, like it, may be fatal. The number of such fatalities is certainly few; I personally can recall only one instance in which such a serious outcome was even in question. However, the patient who experiences a full-blown constitutional reaction is not in a position to take much comfort from statistics and would much prefer that his physician avail himself of all the means at his disposal to anticipate such an occurrence and thereby avoid it. These precautions include observance of the size of the local reaction 10 or 15 minutes after each injection so long as increases in dosage are being made, informing the patient and his parent that malaise, or occurrence of minor symptoms within an hour or two after treatment should be reported, and recognition of the patient initially as being very sensitive from the large size of the skin tests and the degree of severity of symptoms.
Lehrbuch der Kinderchirurgie
Authors: PICKETT LAWRENCE K. 
Published: December 2021

This volume represents a composite of information on almost every conceivable aspect of pediatric surgery. To review such a volume in detail is far too great a problem for the present purposes. Suffice it to say that the presentation of the book is more complete in its coverage than any comparable text in this reviewer's experience.
The book is written in German but is so well illustrated with photographs and drawings that one need not be a master of the language to understand the message.
A FAMILIAL METABOLIC DISORDER WITH STORAGE OF AN UNUSUAL POLYSACCHARIDE COMPLEX
Authors: Craig John M. , Uzman L. Lahut 
Published: December 2021

A metabolic disease, characterized by the accumulation of a mixture of complex polysaccharides in liver, spleen, lung, kidney and reticuloendothelial system, is described in three patients. Its familial nature is indicated by the fact that two of the cases were siblings. The salient clinical features included hepatosplenomegaly, anemia, failure in physical development and susceptibility to respiratory infection. The disease simulates glycogen storage disease in the response in the epinephrine tolerance test, and in an inability to call on glycogen stores.
Histochemical tests on the tissue containing the storage cells indicated that the material was not glycogen, even though polysaccharide in nature. The storage material was isolated from the liver of one of the cases. This isolated material proved to be a complex consisting of two major moieties. The first appeared to possess a high molecular weight, was insoluble in organic solvents, and contained glucose, galactose, glucosamine and hexuronic acids as constituents. A small amount of peptides were associated with this fraction. The second major moiety of the storage material was soluble in ethanol and contained glucose, galactose, glucosamine, fatty acids, hexuronic acids and neuraminic acid as main constituents (hence a lipopolysaccharide).
Attention is drawn to the fact that the storage material would have been considered an "abnormal glycogen" if the customary procedures for the isolation of glycogen had been applied to the tissue. It is suggested that caution be exercised in future studies involving storage diseases where storage of an "abnormal glycogen" with an abnormality in side-chains is suspected.
STUDIES OF RESPIRATORY PHYSIOLOGY IN CHILDREN
Authors: Helliesen P. J. , Cook C. D. , Friedlander L. , Agathon S. 
Published: December 2021

Determinations of lung volumes (residual volume, functional residual capacity, vital capacity, and total lung capacity) in 82 "hospital normal" and volunteer children are reported. These values correlated best with the individual's height, but almost as well with weight and surface area.
Values for lung compliance and flow resistance obtained from 77 children are also presented. Lung compliance correlated most closely with functional residual capacity and vital capacity. Resistance had a negative correlation with the height of the individual.
End-expiratory intrapleural pressures as measured with an intra-esophageal balloon were found to average -6.3 cm of water for 41 of the children.
Where data were available, relationships of lung volume, compliance and resistance were compared on the basis of height for infants, children and young adults, and found in most instances to be similar for all three groups.
CONTINUOUS SPLENIC-GONADAL FUSION WITH ECTROMELIA: TERATOGENESIS
Authors: Sommer Jaochim R. 
Published: December 2021

A case of continuous splenic-gonadal fusion with ectromelia is reported.
The teratogenesis of the anomaly is discussed. A mesenteric attachment of the splenic cord is described, and the blood supply of the splenic cord was studied in serial sections.
The findings lend strong support to the theory that the splenic and gonadal-mesonephric structures fuse by means of the caudal limiting fold rather than across the coelomic epithehium.
THE AIMS OF Pediatrics: LOFTY BUT NOT AIRY
Authors:   The Editorial Board
Published: December 2021

What is Pediatrics trying to accomplish in the field of medical literature? This is a question continuously before the Editorial Board and one which should be considered occasionally with those for whom it is published. Note that a sweeping reference is not made to "the readers" as though the journal was meant to serve some homogeneous group. Preservation of health and treatment of disease during childhood and adolescence are the avowed objectives of pediatricians, but their fulfillment depends on the contributions of a vast and varied array of persons with related interests. It would be impossible for Pediatrics or any other medical journal to include all things for all men at all times.
An important step in determining the nature of a medical journal is to choose an appropriate place among the welter of printed material directed to the profession. This ranges from lively medical newspapers and gaily colored magazines and brochures, resembling the products of lay journalism, to staid uncompromising collections of scholarly papers.
A SIMPLE METHOD FOR OBTAINING VENOUS BLOOD FROM SMALL INFANTS
Authors: Anke Wolfgang 
Published: December 2021

OBTAINING samples of venous blood from small infants presents a problem even to the experienced pediatrician. A method providing least trauma for baby and doctor is always desired. A simple technique for obtaining samples of venous blood from premature and small infants was described by Banus in 1957. A modification of his technique has been adopted in the present technique which employs simpler equipment and easily allows obtaining volumes of blood from 5 to 10 ml.
EQUIPMENT (Figs. Ia and Ib)
Polyethylene catheter with attached No. 23-gauge needle (modified Murphy-Gardner set). Plastic needle-adapter. No. 20-22 gauge needle. Hemostat. Vacuum test tube.
PROCEDURE
The polyethylene catheter is connected to [See Fig. 1a,1b in Source Pdf] the plastic needle-adapter and the latter to a No. 20-22 gauge needle (Fig. lb). The catheter is clamped with the hemostat, which will maintain a good vacuum, and the needle inserted through the center of the rubber plug of the vacuum-containing test tube. A scalp vein is entered against the blood flow. As this is done the blood will flow several millimeters into the catheter. The hemostat is then released, permitting blood to flow through the polyethylene catheter into the test tube by means of the vacuum existing in the system. The polyethylene catheter and needle may be rinsed with heparin before assembling, in order to prevent clotting when large volumes of blood are required. Scalp veins are preferred to other peripheral veins, because the needle can be held firmly while in such a superficial vein, assuring a good flow of blood.
COMMENT
This technique has several distinct advantages over the more commonly used methods of venipuncture. Minimal equipment, which for the most part is inexpensive and disposable, is needed. There is less trauma to the infant than by standard procedures for blood-letting. With very little experience the technique can be performed with facility. Because suction is evenly controlled, the plasma obtained is usually free of hemolysis. There is almost no exposure to air with this system, so that blood for determination of carbon dioxide can be collected with accuracy, providing oil is added to the tube immediately after collecting the blood. The polyethylene catheter can be clamped during the procedure, and the collecting tubes can be changed, should both clotted and non-coagulated specimens be desired.
THE PHYSICAL ENVIRONMENT AND THE PREMATURE INFANT
Authors: Silverman William A. 
Published: December 2021

I AM MOST grateful to the Academy for naming me as the recipient of an E. Mead Johnson Award for 1958 and pleased beyond measure by this great honor. I cannot allow this moment to pass without acknowledging with pleasure my debt of gratitude to Dr. Richard Day, who first awakened in me a curiosity about the meaning of proof for a clinician and to Dr. John W. Fertig for his patience as teacher, critic and collaborator.
This decision of the Awards Committee has given me cause for reflection. I interpret it to signal approval of and benevolent interest in the use of the planned trial as a device to help answer questions at the clinical level. I am encouraged to think that the rules of evidence that have applied in the laboratory are now increasingly consulted on ward rounds. Mr. John W. Gardner, president of the Carnegie Corporation, recently commented upon the difficulties that result from the acceptance of a double standard of excellence at different levels of human activity; he stated that, ". . . The society which scorns excellence in plumbing because plumbing is a humble activity and tolerates shoddiness in philosophy because it is an exalted activity will have neither good plumbing nor good philosophy. Neither its pipes nor its theories will hold water."
F. H. K. Green has recently been quoted as saying, ". . . when the value of a treatment, new or old, is doubtful, there may be a higher moral obligation to test it critically than to continue to prescribe it year-in, year-out with the support merely of custom or of wishful thinking." I am encouraged to believe that we have arrived at a point in time when this moral obligation may be included as one of our clinical responsibilities.
We were required to consider our responsibility very closely in this regard about 8 years ago when confronted with the challenge of retrolental fibroplasia. As we watched the early vascular changes of this condition develop, we reasoned that these proliferating vessels might be halted by the then newly available hormone, adrenocorticotropin (ACTH). We gave this substance to an infant when, from the appearance of the ocular fundi, it was clear that the disease was progressing. The fundi of this infant returned to normal. This sequence of events was repeated following the treatment of many infants during the next year.
ANTIBODY RESPONSE TO INFLUENZA-VIRUS VACCINE IN CHILDREN WITH NEPHROSIS: EFFECT OF CORTISONE
Authors: Kunin Calvin M. , Schwartz Robert , Yaffe Sumner , Knapp John , Fellers Francis X. , Janeway Charles A. , Finland Maxwell 
Published: December 2021

Polyvalent influenza-virus vaccine was administered to 55 children; 44 of these children were in various stages of nephrotic syndrome, including 17 under treatment with adrenocortical hormones; 5 were children with the adrenogenital syndrome receiving replacement cortisone therapy, and 6 were normal controls.
Antibody response, as measured by the hemagglutination-inhibition test 2 weeks following a single subcutaneous dose of vaccine, was not significantly different in children with active or inactive disease, and appeared to be similar in those receiving hormone therapy and in those who were not.
The serum levels of gamma-globulin were lower in children with active nephrotic syndrome, but this did not affect either the prevaccination levels of influenza A prime antibody or the response to the vaccine.
No change in the status of activity of nephrosis occurred during the period of immunization or immediately thereafter, even in patients who had moderate febrile reactions to the vaccine.
The failure of any of the groups to respond serologically to the Asian strain component of the vaccine is discussed.
ADMINISTRATION OF GLUCURONIC ACID TO ICTERIC NEWBORN INFANTS
Authors: Jeliu Gloria , Schmid Rudi , Gellis Sydney 
Published: December 2021

Fourteen icteric newborn infants were treated with varying amounts of glucuronic acid or sodium glucuronate, administered by oral or intravenous routes. No significant change in concentration of bilirubin in the serum was observed.
Experimental evidence and biochemical considerations do not suggest that the administration of glucuronic acid enhances the formation of bilirubin glucuronide.
It is the authors' opinion that at present the use of glucuronic acid should not be considered as an alternative for exchange transfusion in the treatment of newborn infants with high concentrations of bilirubin in the serum.
ON THE TEACHING AND PRACTICE OF THE NEW PEDIATRICS
Authors: MAY CHARLES D. 
Published: December 2021

AN EDITORIAL in the February issue posed the question, "Can the New Pediatrics be Practiced?" The point was made that the answer may depend partly on economics—on the value placed on pediatricians' services. Because of a full realization there are other aspects of the matter, the readers were invited to share their thoughts.
Judging from the comments in recent Letters to the Editor, some ideas about the teaching and practice of the "new pediatrics" seem prevalent:
1) Group practice and health insurance plans may be ways to cope with the economics.
2) There is widespread discontent with the discrepancy between the emphasis in pediatric training and the nature of the experiences encountered in practice.
3) One type of training is not apt to be equally suitable for all the broad groups of pediatricians (academicians and consultants, general practitioners, and public health administrators).
RESPONSE OF THE NEWBORN INFANT TO MAJOR SURGERY
Authors: Colle Eleanor , Paulsen Elsa Proehl 
Published: December 2021

Balance data for sodium, potassium, chloride, nitrogen, and water were obtained postoperatively in 15 newborn infants operated upon in the first 4 days of life and in 5 control newborn infants.
The infants showed a response in terms of electrolyte and water balances which is significantly different from that reported in adults:
The volumes of urine were equal to or greater than those in normal infants of a comparable age. The data suggest a diminished capacity of the newborn to conserve water postoperatively, but a normal capacity to dilute the urine. No evidence of retention of water was observed.
The urinary excretion of sodium and chloride was equal to or larger than that of normal infants. The infants who had losses postoperatively from gastrointestinal suction showed no capacity to reduce renal excretion of these ions while they suffered these large extrarenal losses.
The concentrations of sodium and chloride in the serum remained normal or became slightly elevated postoperatively.
Losses of potassium and nitrogen in the urine were of the same relative magnitude as those in adults.
The observed responses are discussed in terms of the function of antidiuretic and adrenocortical hormones in the newborn infant.
The application of these data to practical considerations of fluid and electrolyte therapy in the postoperative management of the newborn infant are discussed briefly.
TREATMENT OF SHIGELLOSIS WITH TETRACYCLINE IN INFANTS UNDER 2 YEARS OF AGE
Authors: de la Torre Joaquin A. , Olarte Jorge , Joachin Alicia 
Published: December 2021

Ninety-eight infants under 2 years of age, hospitalized with gastroenteritis due to a shigella infection (92 Shigella flexneri and 6 Shigella boydii) were studied in order to investigate the effectiveness of tetracycline in their treatment.
During the first 60 hours of hospitalization, clinical recovery was induced in 28 of the 98 cases using only intravenous fluids and a period of fasting, but no antibiotic. Eleven infants died in the same period. Of the 28 who recovered, 3 had clinical relapses.
The remaining 59 infants were divided at random in two groups: one, with 26 cases, received tetracycline; the other, formed by 33 patients, received a placebo. From the 26 who were given tetracycline there were 14 recoveries (53.8%) and 12 failures (4 deaths [15.3%] and 8 cases [30.7%] that required a change from tetracycline to another drug). In the 33 control patients, there were 11 recoveries (33.3%) and 22 failures (7 deaths [21.2%] and 15 cases [45.4%] that became worse and needed an antibiotic).
The cases that recovered, and had a sufficient number of stool cultures after treatment, are too few to permit conclusions on the usefulness of tetracycline from the bacteriologic point of view; nevertheless they show, as has been previously reported, that a certain number of patients who recovered, with or without antibiotic, continued to have stool cultures positive for shigella.
OCCURRENCE OF PSEUDOTUMOR CEREBRI (BENIGN INTRACRANIAL HYPERTENSION) DURING TREATMENT OF CHILDREN WITH ASTHMA BY ADRENAL STEROIDS
Authors: Dees Susan C. , Mckay Hamilton W. 
Published: December 2021

The development of pseudotumor cerebri (benign intracranial hypertension) is described in three young boys with asthma, who were receiving small doses of adrenal steroids during a stage of withdrawal of treatment. These patients had received continuous steroid treatment for several years, beginning in late infancy. They had acquired the appearance of Cushing's disease.
The mechanism by which pseudotumor cerebri developed in these three children was not determined. Various hypotheses are discussed.
Attention is called to the sequence of events in these children with asthma as another possible complication of prolonged use of steroid therapy.