bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occurrence of Myeloma-Like γ-Globulin in C.S.F of A Four-Month Old Infant with Hydrocephalus
Authors: HOCHWALD G. M. , THORBECKE G. J. 
Published: December 2021

Myeloma-like immune globulins present themselves as narrow bands upon paper electrophoresis, and usually show a characteristic appearance in immunoelectrophoresis. Two antigenically different groups of myeloma proteins have been described: groups I and II. Recently, 60% of normal γ-globulin, throughout the mobility range of γ-globulin, has been shown to possess the antigen characteristic for group I, and 30% that for group II myeloma.
Occurrence of myeloma-like proteins in the serum is not restricted to multiple myeloma. They may also be seen with other tumors, such as reticulum cell sarcoma, and various carcinomas. In addition, Sonnet and Milhaux have reported on the frequent occurrence of myeloma-like ("monoclonal") γ-globulins in the serum of adult Bantus with different diseases.
When large amounts of a myeloma protein are present in the serum, it may be found in a much lower concentration in the spinal fluid.
CHROMOSOME ANALYSES IN A CHILDREN'S HOSPITAL
Authors: Warkany Josef , Weinstein E. David , Soukup Shirley W. , Rubinstein Jack H. , Curless Mary C. 
Published: December 2021

Chromosome analyses were performed in 227 persons, most of them pediatric patients. The majority of these were selected because of mongolism, other forms of mental retardation, congenital malformations, and sex anomalies. Some normal persons were also included in the study. Most of these were relatives of the patients.
Patients with Down's syndrome (mongolism) were selected because of low maternal age, familial recurrence, leukemia, and other reasons. Most of these patients had regular trisomy 21 mongolism but other cytogenetic types were also discovered and described.
No trisomy 13-15 syndrome was found but there were six trisomy 18 patients. Two children with multiple congenital malformations were examined and noted to be mosaics having in addition to normal cell lines, cells with trisomy 13-15 and trisomy 18 respectively.
Other patients with various congenital malformations including isolated congenital heart disease had normal cytogenetic patterns.
No typical Klinefelter's syndrome was encountered in a child. Several patients with Turner's syndrome, including one "male Turner's syndrome," and several cases of male pseudohermaphroditism were described.
Applications of the new cytogenetic methods and findings to clinical diagnosis and genetic prognosis were discussed.
Neonatal Infection and Premature Rupture of Membranes
Authors: JOHNSON KIT G. 
Published: December 2021

As the article by Pryles, et al. entitled "A Controlled Study of the Influence on the Newborn of Prolonged Premature Rupture of the Amniotic Membranes and/or Infection in the Mother," Pediatrics, Vol. 31, pp. 608-622, has not yet received comment in your journal, perhaps it is not too late to ask the authors to fill three hiati which I felt existed in their presentation of this excellent study.
As antibiotics apparently were used (according to Table X) in some infants prior to the diagnosis of clinical sepsis, what were the comparative morbidity and mortality results in this group versus the group in which treatment was deferred until the diagnosis of clinical sepsis could be made?
New Hazards of Toys
Authors: JACOBZINER HAROLD 
Published: December 2021

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

These two books are a commentary on the physician's failure to promote breast feeding by the written word because both are written by mothers to offset the steady decline of breast feeding in the United States.
Mrs. Pryor's book is divided into two parts. The first is a survey of what we know about lactation and breast feeding; the second part is a day-to-day, month-by-month account of nursing a baby, from the first feeding in the hospital to a leisurely weaning months later.
A CRITICAL EVALUATION OF THE MORO REFLEX
Authors: Parmelee Arthur H. 
Published: December 2021

The conflicting statements relative to the proper stimulus for eliciting the Moro reflex and the response to be expected have been discussed and a historical review of the varying points of view presented.
The present study was done in three parts. In the first part, seven infants were studied by motion picture analysis at 0-4 days, 6 weeks, and 12 weeks of age. Four stimuli were used: (1) allowing the baby's head to drop back suddenly; (2) a pin prick to the baby's foot; (3) a loud noise; (4) slapping the examining table near the baby's head. The second and third stimuli were relatively ineffective at all ages tested. The first and fourth stimuli were equally effective throughout. The outward movements of the arms were dominant throughout but the secondary inward movements were prevalent in the neonatal period, but absent at 12 weeks of age. In the second part, 30 infants were studied by motion picture analysis, only in the neonatal period using four stimuli: (1) allowing the baby's head to drop back suddenly; (2) slapping the examining table near the head of the baby; (3) suddenly tilting downward a board to which the baby was fastened; (4) sudden jarring of the same board.
A scoring scale for arm and hand movements was devised as well as a scale for the state of arousal of the infant just prior to testing. The first, second, and fourth stimuli were equally effective and all were superior to the sudden dropping of the board. It was concluded that the stimulation of the semicircular canals of the infants was not enough for a good Moro response when neck movement was prevented by the board. Neck movement seems to be essential for significant Moro response. The scores for hand response were somewhat related to those for arm responses.
In the third part of this study, a detailed scoring technique for arm and hand movements and state of arousal of the baby was devised. Forty infants were studied in the neonatal period by direct observation. Interscorer agreement between five observers rating arm and hand movements was not good. This illustrates the difficulty of carefully observing and recording the Moro reflex response without the aid of motion pictures. The hand responses did not correlate strongly with the arm responses so that one could not rely on just hand observations.
In both Parts II and III of this study, no correlation could be found between the state of arousal of the infant just prior to the administration of the stimulus and the degree of response.
A SYMPOSIUM: RECENT ADVANCES IN CARDIOLOGY
Authors: Griffiths Sylvia P. , Blumenthal Sidney 
Published: December 2021

THE MEMBERS of the Section on Cardiology are particularly pleased with the opportunity presented by this symposium to share with you one of the major stated objectives of the Section "to promote understanding by pediatricians of established principles of diagnosis and treatment of cardiovascular diseases in children." The participants in this symposium are all active members of the Section with the exception of a close friend and colleague representing cardiovascular surgery, Dr. John W. Kirklin.
In order to examine the present and explore the future, one needs to review, however briefly, the past. A survey of pediatric journals and past programs of the American Academy of Pediatrics attests to the longstanding interest of pediatricians in diseases of the heart and great vessels in children. One of my prize personal possessions is a reprint of an article written by Dr. Murray H. Bass entitled "Heart Block and Congenital Heart Disease in Childhood" published on February 2, 1918, in the J.A.M.A., 70: 287-288. In addition, Dr. Bass was a pioneer in the development of phonocardiography. This dated back to the early 1930's and was stimulated by what he hoped would be a method of differentiating organic from insignificant murmurs. And yet, he would hardly have considered himself a pediatric cardiologist. His many contributions to the literature encompassed almost every facet of clinical pediatrics.
Here in Chicago, Stanley Gibson and Hugh McCullough might better be termed pediatric cardiologists with extremely wide pediatric interests. The contributions of Maude Abbott, Dorothy Andersen, and our own Helen Taussig need no recapitulation to this audience.
NEW DEVELOPMENTS IN DIAGNOSTIC METHODOLOGY
Authors: Adams Forrest H. 
Published: December 2021

BECAUSE of the multiplicity of diagnostic techniques in pediatric cardiology, numerous skilled individuals will be required to participate in the patient's workup and it is essential that these work together as a team. The patient's physician still maintains the all important role of obtaining an adequate history and physical examination and making the referral to the pediatric cardiologist and participating in the resultant decisions about management of the patient.
Some of the newer techniques over the past decade extensively use x-rays and radioisotopes in the diagnosis of heart disease in infants and children. Most important, however, one should be aware of minimum radiation dose when employing these techniques. Fluoroscopic examination should be reserved for evaluating specific problems and more reliance placed on conventional x-rays of the chest as well as other parameters such as the electrocardiogram. An image intensifying unit for fluoroscopy or during cardiac catheterization should be used whenever possible. Optimal exposure factors which reduce radiation to a minimum during cardiac catheterization and angiography should be employed as well as gonadal protection devices during study. Yearly checks on radiation output of equipment should be carried out. When isotopes are used for indicator dilution studies to determine shunts and cardiac output, rapidly excreted ones should be employed with low activity and short half-life.
Recent developments in the recording of the electrical events of the heart beat include a battery-operated miniaturized radio broadcasting system which permits the recording of the electrocardiogram signal without the use of wires. The sender is attached to the patient and the receiver can be located as far away as 1,500 feet.
THE INFANT WITH HEART DISEASE
Authors: Rudolph Abraham M. 
Published: December 2021

IN SPITE OF great surgical advances, congenital heart disease is still a major cause of death in children, and this is particularly true in the infant age group. The magnitude of the problem may be appreciated by viewing some data on mortality from congenital heart disease collected by Carlgren in Gotenberg, Sweden. He reviewed the history of all individuals born with congenital heart disease in a 10-year period in that city. Within 15 years after birth, 40% of these individuals had succumbed. The really important factor which emerged, however, is that 30% of these patients died in the first 6 months after birth. In reviewing the causes of death in this group, I have estimated that at least 50% of these infants died of lesions which can be cured or relieved by procedures presently available. It is thus obvious that it is incumbent on us, as pediatricians, to recognize and treat the child with heart disease at the earliest possible age.
Recognition of heart disease, and particularly of specific congenital lesions, is considerably more difficult in the infant than in the older child. One problem is that the lesions encountered in infancy may be much more complicated than in older children, because after the first year many of the infants with complicated lesions may have already succumbed. More important though, is the fact that many congenital heart lesions do not present the classical clinical features we have come to recognize with specific lesions in the older child. For example, the presence of only a systolic murmur or even an absence of murmur may occur in an infant with patent ductus arteriosus, rather than the typical continuous machinery murmur seen in the older youngster.
PITFALLS IN THE DIAGNOSIS AND TREATMENT OF IRON DEFICIENCY ANEMIA IN PEDIATRICS
Authors: Clement David H. 
Published: December 2021

Errors in the diagnosis and treatment of iron-deficiency anemia involve several areas. In the history one may overlook anemia in the mother, loss of infant blood from the placental circuit or later as melena, as well as a diet high in milk and low in iron-rich foods.
In the physical examination pallor should not be estimated from facial color alone. In the laboratory a reticulocyte count should be determined before as well as during treatment.
Regarding treatment it is important to give enough iron (6 mg/kg/day) for long enough to replenish iron stores. An effective, oral preparation of ferrous iron alone in gradually increasing doses is preferred. Failure to respond suggests several possibilities discussed above.
BROKEN APPOINTMENTS
Authors: Alpert Joel J. 
Published: December 2021

A survey of appointment breaking in the Medical Clinic of the Boston Children's Hospital Medical Center showed that approximately 20% of patients broke their appointments.
These patients were more likely to have shown evidence of social disorganization. Personal physician care appeared to lower the broken appointment rate although there appeared to be an irreducible minimum which in either the personal physician clinic or in the private office was a cancellation. Additional gaps in medical care noted in those who broke their appointments included inadequate immunizations, dissatisfactions with medical care, and ill-defined need to see a physician.
PROTEIN METABOLISM, CELL FORMATION, AND IMMUNITY
Authors: Gitlin David 
Published: December 2021

Normally, a man can boast that some time during the first year of life he got up and stood on his own two legs. But it would be an idle boast indeed if modern man should ever claim that during his lifetime he actually stood alone. It is almost unnecessary to state, therefore, that the research for which this award has been given was not the product of one individual. It was based upon the works of those who searched before and it was accomplished through the efforts of many persons: among these were Dr. John Craig, whose knowledge of cells and tissues made most of these studies possible, Dr. Jesuś Kumate and his colleagues in Mexico, who brought our interests in the placental transfer of proteins to reality, and Dr. Charles Janeway, without whose support and encouragement all of our ideas would have been stillborn.
To review briefly our studies of the last seven years, as required by the rules governing this award, it has been necessary to select and discard. What has finally been chosen, for better or worse, are those studies dealing with natural developmental sequences in the metabolism of the plasma gamma-globulins and the antibody properties that these proteins manifest–or to be euphemistic, those studies concerned with the immunological ages of man.
The antibodies of normal human plasma represent four related groups of proteins. The largest of these groups in terms of quantity are the 7S gamma2-globulins which constitute 70 to 75% of the total gammaglobulins in the normal adult; these have a molecular weight of 165,000 and, as their name indicates, have an ultracentrifugal sedimentation coefficient of 7 Svedbergs, or 7S.1,2
BRAIN SWELLING WITH ACUTE PURULENT MENINGITIS
Authors: Williams Christopher P. S. , Swanson August G. , Chapman John T. 
Published: December 2021

A fetal case of acute meningitis in a child is reported to illustrate the orderly sequence of neurological signs indicating progressive brainstem compression, leading to death. The similarity of this neurological pattern to that seen in patients with supratentorial mass lesions is emphasized.
Six cases of acute meningitis in infants and children are then reported who similarly showed signs of progressive brain swelling and herniation, in whom intravenous urea was used in treatment. In two children who were felt to be moribund with bulging anterior fontanel, coma, poorly reactive pupils, deteriorating respirations, and convulsions, the response to the infusion of urea was dramatic, with improvement in consciousness, respirations, and pupillary signs, and cessation of convulsions. Two other children had a less dramatic response to urea, but were definitely improved. Two were thought to have had possible benefit. No child showed deleterious effects from treatment with urea.
The mechanism of action of osmotic agents in the treatment of brain swelling is discussed. Hypertonic intravenous urea was felt to have been a safe and possibly valuable adjunct to the therapy of the patients of this study.
THE FACE PREDICTS THE BRAIN: DIAGNOSTIC SIGNIFICANCE OF MEDIAN FACIAL ANOMALIES FOR HOLOPROSENCEPHALY (ARHINENCEPHALY)
Authors: DeMyer William , Zeman Wolfgang , Palmer Catherine Gardella 
Published: December 2021

Two patients with orbital hypotelorism, flat nose, and bilateral lateral cleft of lip and palate with a hypoplastic philtrumpremaxilla Anlage are described. Both patients had holoprosencephaly (arhinencephaly), a brain defect characterized by an arrest in prosencephalic cleavage with no or incomplete proplasia of frontal poles and olfactory bulbs. The two patients are an intermediate stage in a graded series of median facio-cerebral malformations which begins with cyclopia, and then, as face and brain transform toward normality, extends through ethmocephaly, cebocephaly, median cleft lip, and the two patients presented here. The facies of these patients are diagnostic of the type of brain malformation. Careful attention to face-brain relationships will significantly extend the number oif diagnostic facies which currently can be recognized. Physiological defects include poikilothermia, apnea, seizures, rigidity, and lack of psychomotor development.
Useful diagnostic studies include skull roentgenograms to show orbital hypotelorism and absent crista galli, electroencephalography, dermatoglyphics, chromosome studies, and sometimes pneumoencephalography.
Some holoprosencephalic patients, such as our first patient, who have few or no extracephalic malformations, have a 46 chromosome karyotype. Others, such as Patient 2, have many extracephalic anomalies. The literature suggests that the latter patients are apt to have 13-15 trisomy. The face predicts the holoprosencephalic brain irrespective of extracephalic anomalies or karyotype.
NEONATAL LISTERIOSIS
Authors: Ray C. George , Wedgwood Ralph J. 
Published: December 2021

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

A correlation of bacterial counts with results of Uroscreen tests was carried out on 350 clean-voided urine samples. Uroscreen was correct 61% of the time in detecting urines with greater than 100,000 organisms per ml. However, only 47% of the positive Uroscreen tests themselves were correctly positive.
The Uroscreen test is not considered reliable enough as a screening procedure for the detection of urinary tract infection and should be abandoned.
Will PSP Binding Technique Reduce Later Brain Damage?
Authors: ZOGER SEYMOUR 
Published: December 2021

I was most interested in the paper by Dr. Waters in Pediatrics, 33:749, 1964.
Dr. Waters has presented cogent reasons for not doing an exchange transfusion for a bilirubin of 20 mg/100 ml. I should like to refer to an earlier paper by Dr. Byers (Pediatrics 1955, 15:248), in which 23 patients are presented with cerebral palsy and hearing loss following erythroblastosis. Dr. Byers states in this paper that only 2 of the 23 patients had clinically recognized kernicterus in the newborn. It is not always easy to be certain that our jaundiced newborns are not going to develop later complications. The PSP binding technique offers some promise in this regard.