bluuebunny/crossref_metadata_2025_split huggingface dataset:
ENZYMATIC PATTERNS DURING DEVELOPMENT
Authors: Kretchmer Norman 
Published: December 2021

I would like to express my gratitude to you, the American Academy of Pediatrics, for selecting me for an E. Mead Johnson Award. I accept the honor with humility because no scientific work is accomplished without inspiration from teachers and other investigators, and without actual participation of many colleagues. I appreciate this opportunity to acknowledge publicly those individuals who have been and are particularly influential in my progress.
Dr. Jean Oliver, the man to whom I owe my entry into medicine and pediatrics, with great effort instilled in me an everlasting appreciation for the inseparable relationship between structure and function. Fortunately, I have remained in close contact with Dr. Oliver throughout the years, continually reaping benefits from his advice and influence.
I conceived of function as only cellular and molecular until Dr. Henry L. Barnett introduced me to organ function, especially in relation to the young individual. In addition, he fostered in me an interest in the broader aspects of pediatrics, amid since that time has been available constantly for intimate exchange and crystallization of ideas.
I am indebted particularly to Dr. S. Z. Levine for leading me into the field of biologic development and insisting that my time be divided between clinical pediatrics and the laboratory. Dr. Levine has always emphasized that ideas, philosophies and problems originating in the ward or clinic can and should be considered in the laboratory.
AN INBORN ERROR OF LIPID METABOLISM
Authors: Bigler John A. , Mais Roland F. , Dowben Robed M. , Hsia David Yi-Yung 
Published: December 2021

The present report concerns a new clinical syndrome characterized by hepatomeggaly, retardation of physical and mental growth, and a disturbance of lipids in the plasma.
The abnormalities are present in two siblings born of parents who are second cousins. As far as can be determined, none of the six other siblings is affected.
The disturbance of lipids is characterized by an increase in the concentrations of triglycerides and phospholipids in the plasma with relatively little increase in the concentration of total cholesterol. By means of paper and agar gel electrophoresis, the disturbance has been found to involve primarily an increase in the concentration of alpha2-lipoproteins. Using zone electrophoresis on starch medium, we have shown that there is an increase in concentration of phospholipids and triglycerides in the alpha2-lipoproteins and of triglycerides in the alpha1-lipoproteins. Analytic ultracentrifugation revealed an increase in each of the fractions, but was most marked in the lipoproteins with Sf 20-400.
It would appear that this represents a new third "inborn error of lipid metabolism" in man.
TREATMENT OF THE NEPHROTIC SYNDROME WITH TRIAMCINOLONE
Authors: Hellman Leon , Zumoff Barnett , Minsky Arnold , Kretchmer Norman , Kramer Benjamin 
Published: December 2021

In this report, only acute remissions of the nephrotic syndrome following triamcinolone therapy are considered. No conclusions are drawn regarding the effects of this treatment on the ultimate fate of these children. With these reservations kept clearly in mind, this experience with 15 children with the nephrotic syndrome indicates that triamcinolone is a highly effective therapeutic agent.
With the 20 mg/day dose employed for 30-45 days in this series, side-effects were absent except for the occasional appearance of slight moon facies.
The incidence of complete remission in the entire series was 10 out of 15 patients (67%). Of patients whose disease was less than 12 months in duration, and who did not have hypertension, eight out of nine patients (89%) had a complete remission. These results compare favorably with the experience reported in the literature with other steroids.
The mere induction of acute remissions, no matter how readily or reproducibly, should not be the chief concern in therapy of nephrosis. The ultimate prognosis is still pessimistic, despite regimens of therapy with currently available steroids. A recent report suggests that the long-term results of steroid therapy in the nephrotic syndrome might be improved by earlier, more intensive, and more prolonged treatment. It is the present authors impression that triamcinolone is a useful steroid for such a program, because of its high potency and minimal side-effects. The doses employed did not cause hypertension or retention of sodium.
UTILIZATION OF PARENTERALLY ADMINISTERED NITROGEN BY INFANTS RECEIVING SUBOPTIMAL CALORIES
Authors: Calcagno Philip L. , Rubin Mitchell I. , Mukherji P. K. 
Published: December 2021

The parenteral administration of 100 mg of amino-acid nitrogen/kg of body weight/ day given within 4 hours to infants who are underfed (40 cal/kg of body weight/day) and protein-starved can change the nitrogen balance from negative to positive or greatly reduce the degree of negative balance.
The retained nitrogen is not degraded to urea or excreted as amino acids in the urine in the after-period. It is postulated that the retained amino-acid nitrogen is utilized for synthesis of tissue.
Even when the total caloric intake is suboptimal, the administration of a protein hydrolysate during prolonged protein starvation in infants who are unable to ingest protein seems desirable.
LYMPHOPNEUMATOSIS CYSTOIDES INTESTINALIS WITH EOSINOPHILIA IN THE INFANT
Authors: Gagnon Jacques , Rheault Marcel 
Published: December 2021

A study of five infants with lymphopneumatosis cystoides intestinalis and a review of the literature is presented.
There is an association between lymphopneumatosis cystoides and eosinophilia.
Lymphopneumatosis seems to result from the association of several factors, namely, gastrointestinal disturbances (generally accompanied by infection and followed by wasting and avitaminosis) and acidification of the gastrointestinal content. Nevertheless, the exact pathogenesis is obscure.
Eosinophilia does not seem to be produced by the gases in the cysts.
USES AND ABUSES OF ANTIPYRETIC THERAPY
Authors: Done Alan K. 
Published: December 2021

FEVER is undoubtedly the most common symptom confronting the physician who treats children. It is fought as though it were the patient's primary disease, and its mere presence is often accepted as being sufficient indication for the institution of antipyretic therapy. It is not surprising, therefore, that therapeutists and pharmaceutical concerns have energetically sought new and better drugs for the control of fever. In the past few years there has appeared on the market a number of new formulations which are purported to offer distinct advantages in terms of antipyretic potency, acceptance by children, and/or reduced toxicity.
It is axiomatic that virtually any claim regarding a drug can be supported by published data, if the proper study is selected and interpretation is sufficiently influenced by conviction. Particularly is this true of antipyretic-analgesic drugs, where such factors as lability in the case of fever and lack of objectivity in the case of pain, make evaluation difficult. The claims and counterclaims which have been made concerning antipyretic drugs have led to considerable confusion and misunderstanding on the part of clinicians in general. The purpose of this presentation is to attempt to provide some clarification of this problem.
IS ANTIPYRESIS INDICATED?
More critical than the choice of an antipyretic is the question of whether or not such therapy is indicated in the individual case, for there is little doubt that these drugs are grossly overused, at times to the detriment of the patient. Therefore, before discussing the antipyretics themselves, it seems appropriate to review briefly a number of points which deserve consideration before one elects to use an antipyretic.
DuBois summarized a lifetime of study on fever and the regulation of body temperature with the statement: "Fever is only a symptom and we are not sure that it is an enemy. Perhaps it is a friend." The literature concerning the possible role of fever in body defenses is extensive and inconclusive.
THE USE AND ABUSE OF DRUGS IN THE TREATMENT OF ASTHMA IN CHILDREN
Authors: Ratner Bret 
Published: December 2021

ASTHMA is among the serious manifestations of allergic disease for which patients require immediate relief. Because of its chronicity and tendency to recur there has been a continuous search for more effective symptomatic treatment.
A large number of drugs have been developed which are purported to relieve the symptoms of asthma. They are used and often abused to an extent which may actually endanger the life of the patient.
For some diseases, in which only one effective remedy is available, a calculated risk is justified to save the life of an individual. Under these circumstances the value of such treatment outweighs its danger. This situation should not often arise with asthma, for which the choice of remedies is wide enough to make it possible to avoid any one which may be hazardous in a particular patient. Let us, therefore, take stock of the measures used in the treatment of asthma and evaluate their respective merits.
We will begin with an example of a child who died from bronchial asthma after a surgical operation and whose case was presented at a hospital conference:
Post-mortem examination disclosed that the entire bronchial tree was completely filled with thick, gelatinous fluid. A discusser at the conference quite rightly criticized the use of atropine and stated that bronchoscopic aspiration, postural drainage and nasotracheal intubation should have been instituted. He added that adrenal steroids had also been indicated. To my astonishment he went on to recommend antihistaminics, aminophylline and epinephrine before, during and after anesthesia.
This discussion leaves one dismayed, for with a plugged bronchial tree many of the drugs suggested by the critic are as contraindicated as was the atropine. Antihistaminics, for example, with their drying, atropine-like action, are specifically contraindicated.
Art Therapy in a Children's Community
Authors: VOLLMER HERMANN 
Published: December 2021

Edith Kramer is an excellent artist, has a sound knowledge of psychoanalytic theory and has had 7 years of experience as an art therapist with disturbed children. This rare combination probably explains the unusual qualities of her book, not shared by any other on this subject. Mainly the psychoanalytic training seems to be indispensable for a meaningful interpretation of artistic creations or their use in a therapeutic program.
Prinzhorn, whose book, The Art of the Insane, was a sensation when it appeared in 1922, had artistic sensitivity and psychiatric knowledge but failed utterly in his interpretations. Freud's writings were at hand but Prinzhorn, as many others, rejected Freud's dynamic psychology in favor of speculations, comparisons and mysticisms which left all basic questions about his unique collection unanswered. Subsequently, psychoanalytic thinking has influenced many fields besides psychiatry and led to Psychoanalytic Explorations in Art, culminating in Ernst Kris's masterful book with this title in 1951. Edith Kramer seems to continue this productive development with her present book.
CONGENITAL ANOMALIES ASSOCIATED WITH GONADAL APLASIA
Authors: Haddad Heskel M. , Wilkins Lawson 
Published: December 2021

The congenital anomalies associated with the syndrome of gonadal aplasia were reviewed in 55 cases. All patients in this group were short in stature. Almost half of the group had webbed neck, 13 of whom were of the Bonnevie-Ullrich type. Seven of the latter, however, changed into the Turner's type of neck in early childhood. Edema of the extremities, aortic coarctation and cutis laxa seemed to be associated with the group of neck webbing. Other somatic anomalies, on the other hand, especially shield-like chest, cubitus valgus and abnormal facies and nails, occurred with almost equal incidence among the two groups: those with and those without webbed neck. All patients with webbed neck tested for chromosomal sex showed a male pattern, whereas, of 11 patients with normal necks whose chromatin pattern was studied, 4 had female patterns.
A high incidence of bone rarefaction ("osteoporosis") of unexplained nature, moderate hypertension of unknown etiology and multiple intestinal telangiectases was noticed. Several other anomalies, mostly of mesodermal origin, were found to be of a higher incidence in this group than the general population.
The embryogenesis and the pathogenesis of this syndrome are discussed. Diagnosis and treatment are briefly mentioned.
NECROTIZING ARTERITIS OF THE CORONARY VESSELS IN INFANCY
Authors: Munro-Faure Honor 
Published: December 2021

A case of necrotizing arteritis of the coronary vessels in a 4-month-old infant is described. Death was due to thrombosis of the aneurysmally dilated coronary arteries. A review of the literature yields a total of 19 cases of necrotizing arteritis in infancy, 12 of whom showed a similar gross pathology. Of these 12 at least 8 have presented with a similar symptomatology.
Etiologic theories are discussed, and suggestions are made as to the possible management of infants presenting a similar diagnostic problem.
OCCURRENCE OF CHRONIC DIARRHEA IN THREE PATIENTS WITH GANGLIONEUROMAS
Authors: Green Morris , Cooke Robert E. , Lattanzi William 
Published: December 2021

The occurrence of celiac-like symptoms in three patients who had either a ganglioneuroma or a ganglioneuroblastoma is reported.
The possibility of a causal relationship in these cases is suggested, and an hypothesis regarding this relationship is presented.
ACUTE SUBDURAL EFFUSIONS AND LATE SEQUELAE OF MENINGITIS
Authors: Platou Ralph V. , Rinker Andrew , Derrick Joseph 
Published: December 2021

In a group of 343 consecutive patients under 36 months of age with acute purulent meningitis, survival rates were encouraging but neurologic sequelae were disturbingly frequent. Fifty-five infants had subdural collections during the acute phase of their disease. An attempt was made to evaluate the prognostic significance of these.
It appears clear that the frequency and severity of neurologic sequelae are related to the presence of early subdural collections, but these could not be specifically correlated as to volume, character, on time at which they occurred. Subdural collections are most frequent in the youngest patients, for whom early recognition of meningitis may be difficult or delayed.
It is assumed, but not proved, that factors similar to those responsible for production of the subdural collections also caused many of the evidences of brain damage that appeared concomitantly or developed later.
INCIDENCE OF INFECTION IN CHILDREN AFTER SPLENECTOMY
Authors: Laski Bernard , MacMillan Angus 
Published: December 2021

Eighty-one cases of splenectomy and 94 cases of appendectomy that were carefully followed are reviewed in relation to subsequent infections.
One child in each group developed purulent meningitis and four cases of aseptic meningitis were observed in the appendectomized group.
It would appear from this series that the incidence of serious infection in children after splenectomy is no higher than in a somewhat similar group after appendectomy.
THE RESPIRATORY DISTRESS SYNDROME OF PREMATURITY
Authors: Usher Robert 
Published: December 2021

A study of 59 premature infants with respiratory distress syndrome has revealed the presence of severe increase in concentration of potassium with electrocardiographic changes. Thirty-six of 37 of these infants examined serially between 12 and 60 hours of age developed electrocardiographic abnormalities. Concentrations of potassium in serum of over 7.0 meq/l were associated with these prolonged conduction times. Concentrations of over 9.0 meq/l occurred in 12 infants, 11 of whom died. Parenteral administration of glucose, insulin, and bicarbonate produced a fall in the concentration of potassium in the serum and a correction of the electrocardiogram.
Control premature and full-term infants had concentrations of potassium between 4 and 7 meq/l and never showed electrocardiographic disturbances.
Evidence is produced that premature infants with the respiratory distress syndrome develop a toxic degree of hyperkalemia which is reversible.
COMPARATIVE STUDY OF HUMAN MILK AND A SOYA BEAN FORMULA IN PROMOTING GROWTH AND NITROGEN RETENTION BY INFANTS
Authors: Fomon Samuel J. 
Published: December 2021

Four infants, 4 to 6½ months of age, were studied for periods of 38 to 73 days while receiving ad libitum feeding of a formula in which the protein was derived from soya bean. No other source of calories was provided. The content of protein in the formula was 1.14 gm/100 ml (6.8% of the calories supplied by protein) and the mean intake of protein by the infants was 1.7 gm/kg/ day. The amounts of methionine (mean intake, 38 mg/kg/day) and tryptophan (mean intake, 14 mg/kg/day) supplied by the formula were slightly less than currently accepted minimal requirements for infants.
The rate of gain in weight of the infants was normal and retentions of nitrogen (15 metabolic balance studies) were at least as great as those of normal full-term infants of similar ages fed human milk. This finding may be of value in consideration of protein allowances for children in technically underdeveloped areas of the world in which soya beans, but not animal protein, are available.
THE WOLFF-PARKINSON-WHITE SYNDROME IN INFANTS AND CHILDREN
Authors: Schiebler Gerold L. , Adams Paul , Anderson Ray C. 
Published: December 2021

It is the belief of the authors that the Wolff-Parkinson-White syndrome, although frequently misinterpreted, is not an uncommon finding in infants and children. This electrocardiographic pattern occurred approximately once among every 200 children (0.5%) referred for cardiac evaluation.
Twenty-eight infants and children with the Wolff-Parkinson-White syndrome, 19 (68%) of whom were males, were arbitrarily classified into five general groups: 1) "traditional—9 cases; and those associated with 2) congenital heart disease–13 cases; 3) rheumatic heart disease–1 case; 4) familial cardiomegaiy–2 cases; and 5) disease of the central nervous system–5 cases. Only two patients were placed in more than one category.
The small number in the "traditional" group (9 of 28 cases) is striking. About half of the cases studied had associated congenital heart disease, particularly Ebstein's anomaly of the tricuspid valve. A review of reported cases with the Wolff-Parkinson-White syndrome and congenital heart disease appears to show that this syndrome may be associated with many congenital malformations of the heart, but particularly with dextrocardia and anomalies of the tricuspid valve (Ebstein's malformation and tricuspid atresia).
The association of the Wolff-Parkinson-White syndrome with diseases of the central nervous system and with congenital anomalies in other areas of the body is noted.
Fourteen of the patients (50%) had episodes of tachycardia, and paroxysms of tachycardia were suspected in two others.
Digitalis preparations have proved to be efficacious in terminating the bouts of tachycardia in children.
The prognosis in those individuals without any other congenital anomaly is usually good.
On the basis of this study, the authors consider that every child with this electrocardiographic pattern should be investigated for additional abnormalities.
New Diagnostic Test for Neural Tumors of Infancy: Increased Urinary Excretion of 3-Methoxy-4-hydroxymandelic Acid and Norepinephrine in Ganglioneuroma with Chronic Diarrhea
Authors: GREENBERG ROBERT E. , GARDNER LYTT I. 
Published: December 2021

Green et al. (Pediatrics, 23:951, 1959) reported the occurrence of chronic diarrhea with abdominal distension and wasting as presenting symptoms in three children who had either a ganglioneuroma or ganglioneuroblastoma. Since all symptoms abated after removal of the tumor, they postulated the secretion of a chemical substance by the tumor, affecting gastrointestinal motility or water reabsorption or both.
We have made studies in an additional child, age 2½ years, who manifested a similar syndrome with a ganglioneuroma. The findings in this patient indicate that the ganglioneuroma was a functioning endocrine tumor, involved in the overproduction of 3-methoxy-4-hydroxymandelic acid, norepinephrine and perhaps two other compounds of unknown structure.
AN EVALUATION OF THE TREATMENT OF PHENYLKETONURIA WITH DIETS LOW IN PHENYLALANINE
Authors: Knox W. Eugene 
Published: December 2021

Essentially all cases of phenylketonuria treated with a low phenylalanine diet and published up to December, 1959, were reviewed and evaluated. All untreated individuals with phenylketonuria with an I.Q. above 60 that have been recorded were tabulated. The number of these (20) verifies as reasonable the incidence of 2.5% of 466 untreated cases of phenylketonuria that have an I.Q. above 60. This figure was used as one basis of evaluation of the treatment.
Forty-four patients with phenylketonuria, over 3 years of age, have been treated without impressive change in mental or neurologic status. These were not considered further.
Forty-three patients with phenylketonuria, treated before 3 years of age, were tabulated and evaluated in detail. The mean age at start of treatment was 16.2 months, and the mean duration of treatment was 16.8 months.
The treated group had 18 times as many with an I.Q. above 60 and twice as many with a normal electroencephalogram as the untreated group. These differences were highly significant. The treated group also had fewer seizures.
Those treated before 16 months of age, compared with those treated between 16 months and 3 years of age, had four times as many with an I.Q. above 60 and fewer (none) with seizures. These differences were highly significant. The early treated group also has more with normal electroencephalograms.
For the whole group the final I.Q. was negatively correlated with age at the start of treatment in a highly significant manner (r = -0.67, P &lt; .01). Over the 3-year period studied, a minimal loss of nearly 5 points in the I.Q. occurred each 10 weeks that treatment was delayed.
The low phenylalanine diet started in the early months of life is therefore effective as a preventative of mental deficiency and neurologic abnormalities. The diet is less effective in reversing changes which have already developed.