bluuebunny/crossref_metadata_2025_split huggingface dataset:
PATENT DUCTUS ARTERIOSUS IN INFANCY
Authors: LYON ROBERT A. , KAPLAN SAMUEL 
Published: December 2021

Patent ductus arteriosus produces symptoms in infancy which vary widely in kind and severity. Five patients observed during the past five years have been described briefly to illustrate these variations. One infant died at the age of one month with an aneurysm of the ductus. Another patient, with atypical signs, had a sevede degree of congestive failure until surgical treatment provided dramatic relief. In the other patients symptoms were limited to retardation of growth, frequent respiratory infections and atypical murmurs until the later months of infancy.
In spite of the variation of physical signs and of the radiologic and electrocardiographic findings, an accurate diagnosis can often be made early in life. When doubt exists, and especially in infants suffering from cardiac failure, cardiac catheterization, aortography or angiocardiography must be employed to secure information necessary for immediate surgical treatment.
Emphasis is placed upon the fact that patent ductus can be the sole lesion causing congestive failure in infancy.
RESUSCITATION OF THE NEWBORN INFANT
Authors: CHERNIACK R. M. , BOYD A. 
Published: December 2021

IN ORDER to initiate respiration, the newborn infant must be able to overcome a resistance to expansion of the lungs which is often as high as 30 cm. H2O. The lungs will remain atelectatic until an adequate respiratory effort is made. The infant may make one or two feeble attempts at respiration but then cease breathing, perhaps because these efforts are of insufficient magnitude to overcome the atelectasis. In such instances the force of the respiratory movements may be increased by external stimuli while intubation and removal of secretions from the tracheo-bronchial tree may reduce the resistance to expansion so that the infant's efforts are adequate. However, certain infants appear to require additional assistance in order to overcome this resistance. If the presence of initial atelectasis is a significant factor in preventing the onset of respiration, it would seem reasonable to make a strong effort to alleviate this condition.
Since the lungs offer a resistance to expansion of about 30 cm. H2O, any resuscitating device should exert pressures great enough to overcome this resistance. However, Wilson, Torrey and Johnson found that while a pressure of 24.4 cm. H2O did not cause expansion of the lung of the stillborn infant, it was great enough to cause gross pulmonary damage. Others have warned of alveolar rupture at even lower pressures and for this reason present-day resuscitators operate at low pressures.
Day et al. have recently pointed out the importance of time-pressure relationships in overcoming atelectasis and demonstrated that a pressure of 40 cm. H2O effectively overcame atelectasis of animal foetal lungs without producing lung damage if the pressure was applied for less than 0.25 seconds. It was therefore of interest to develop a resuscitator operating on a "timed-pressure" principle and to study the results obtained when it was used in the resuscitation of newborn infants with markedly depressed respiration.
EFFECT OF HIGH CONCENTRATIONS OF CARBON DIOXIDE AND OXYGEN ON THE RESPIRATION OF FULLTERM INFANTS
Authors: MILLER HERBERT C. 
Published: December 2021

Five percent carbon dioxide added to 20% oxygen is a more powerful stimulus to respiration of healthy fullterm infants than is 100% oxygen. Fullterm infants hypoventilating as a result of exposure to low concentrations of oxygen had their minute volumes restored more rapidly and to a greater extent when 5% carbon dioxide was added to oxygen concentrations varying from 12 to 95% than when 100% oxygen was administered.
The age of the infant appeared to have but slight effect on the response made to breathing 5% carbon dioxide or 100% oxygen. Infants under two or three hours of age were not tested.
The value of adding carbon dioxide to air or oxygen in the treatment of "asphyxia neonatorum" has been discussed. Too little is known concerning the chemical, physiologic and anatomic changes occurring in this loosely termed condition or even in healthy newborn infants to warrant a pessimistic attitude towards the use of 5% carbon dioxide added to air or oxygen in the treatment of newborn infants with respiratory insufficiency.
MECHANISMS OF ACTION OF VITAMIN D
Authors: HARRISON HAROLD E. 
Published: December 2021

EVER since the custom was inaugurated so brilliantly by Ashley Weech, the President of this society has been given the privilege of opening the meeting with a summary of some phase of his own research interests and since his paper is not open to discussion from the floor he can theorize a bit without the restraint of possible quick rebuttal. I have chosen to discuss the work on the "Physiology of Vitamin D" in which my wife and I have been engaged for a number of years. Since we have been in Baltimore we have been fortunate in having the benefit of Dr. Park's ideas and assistance, and the inspiration of his active interest in these studies.
Research activity in this field abruptly diminished when the practical applications of the discovery of vitamin D resulted in the virtual disappearance of rickets as a clinical problem. Many of the physiological problems remain unsolved, however, and our interest has been focused on the mechanism of action of the various sterols with vitamin D activity. In the following discussion many important contributions to this problem are omitted because of limitation of time.
We might first clarify certain quantitative aspects of vitamin D dosage. Figure 1 shows the Wide range of dosage over which vitamin D has been used in patients. A dose of 10 micrograms per day is adequate for the prevention of rickets in the normal infant whereas one to five milligrams per day or more have been required in the maintenance of patients with refractory rickets and hypoparathyroidism. It would seem possible that different biochemical systems might be involved at these extremes of dosage.
NITROGEN BALANCES ON LOW NITROGEN INTAKES IN INFANTS AND THE EFFECTS OF GELATIN SUPPLEMENTATION WITH AND WITHOUT VITAMIN B12 AND AUREOMYCIN
Authors: KAYE ROBERT , CAUGHEY RONALD H. , MCCRORY WALLACE W. 
Published: December 2021

1. A group of five male infants who received an average nitrogen intake of 98 mgm./kg./day, derived from cow's milk protein, retained an average of -2.0 mgm./ kg./day. Small positive balances were achieved at intakes of 110 mgm./kg./day in two subjects. An intake of 100 mgm./kg./ day in two subjects resulted in one instance of nitrogen equilibrium and one of negative nitrogen balance. In the subject given the lowest nitrogen intake, 70 mgm./kg./day a negative nitrogen balance was encountered. These data suggest that the lower limit of nitrogen intake for equilibrium in infants under the experimental conditions reported here is approximately 110 mgm./kg./day.
2. Two of these subjects received gelatin supplements providing 120 mgm. N/ kg./day, and responded with increased nitrogen retentions of 50 and 60 mgm. N/ kg./day.
3. Retention of the gelatin supplements was not further increased in either subject by the administration of 300 µg. of vitamin B12, and 200-300 mgm. of aureomycin daily.
4. The provision of a protein which does not contain all of the essential amino acids, as a supplement to protein of good biological quality permits real augmentation of nitrogen retention.
5. Certain implications of the data in regard to the nutritional value of sub-optimal intakes of nitrogen and total calories have been discussed.
LONGITUDINAL STUDY OF THE INCIDENCE OF CENTRAL NERVOUS SYSTEM DAMAGE FOLLOWING ERYTHROBLASTOSIS FETALIS
Authors: JONES MARGARET H. , SANDS RUSSELL , HYMAN CAROL B. , STURGEON PHILLIP , KOCH FREMONT P. 
Published: December 2021

One hundred unselected cases of erythroblastosis fetalis treated at Childrens Hospital in the newborn period have been followed from six months to five years in an effort to evaluate the relation of central nervous system signs in the newborn period to neuromuscular handicap and overall development later.
Of those showing no central nervous system signs in the newborn period 4% showed definite abnormality later.
Of those showing equivocal signs in the newborn period 33% showed definite abnormality later.
Of those having definite signs early, 100% continued to show abnormality in infancy and childhood.
There was no relation of the severity of the signs in the newborn period to the severity of the later handicap.
It is suggested, therefore, that one cannot be certain of the later normality of an infant showing no definite or equivocal central nervous system involvement in the newborn period. Careful following of all erythroblastotic infants until six to eight years of age or longer is advisable.
NUVARONES® IN THE TREATMENT OF CONVULSIVE DISORDERS (CLINICAL NOTE)
Authors: PETERMAN M. G. 
Published: December 2021

FOR the past six years a new hydantoinate, 3-methyl 5-phenylhydantoin. Nuvarone®, has been tried in selected cases of convulsive disorders. A preliminary report was made in 1952. This compound was being investigated simultaneously by others and two reports have appeared. The latter concerned 130 patients, 91 of whom were treated for one to 24 months. The results were reported as "good" in 44 and "fair" in 38 patients. The side effects were noted as "mild and transitory."
In the present series 72 patients under 16 years of age were treated for six months to six years. In nine patients Nuvarone® was the initial drug in treatment. In 38 patients Nuvarone® was gradually substituted for other compounds which had been inadequate. Nuvarone® was used in conjunction with other preparations such as phenobarbital or Gemonil® in 34 patients. It should not be used with other hydantoin compounds, Phenurone®, or the diones.
Complete blood counts, complete urinalyses (including urobilinogen tests), sedimentation rates, and electroencephalograms were done on all patients before and after Nuvarone® was started. The blood counts and urinalyses were repeated in two weeks and monthly thereafter with platelet counts in addition. Ieterus index and sedimentation rate were obtained every one to three months. No abnormal changes were noted. Two patients developed leucopenia but none developed thrombocytopenia. One patient had an allergic sensitivity to Nuvarone® and developed a generalized maculopapular erythema with leucopenia each of the three occasions the drug was instituted. Another developed leucopenia (to 3,200 w.b.c.) with no other blood changes and although the drug has been continued three years the leucocyte count has gradually increased to 7,500.
TREATMENT OF HEMANGIOMA OF THE SKIN IN INFANCY AND CHILDHOOD BY ROENTGEN IRRADIATION AND RADIUM
Authors: ABDULKERIM ANIS , BOYD JOSEPH A. , REEVES ROBERT J. 
Published: December 2021

A group of 323 cases of hemangioma of the skin were studied and follow-up results are given. The majority were of the cavernous and strawberry types. The classifications given are according to the relative sensitivity to irradiation. Various groups are separated depending on the type of treatment used.
The sites of predilection are the head and face. Complications are not frequent if treatment is given carefully.
SPECIAL ARTICLE
Authors:   THE EXAMINATIONS COMMITTEE
Published: December 2021

THE WRITTEN examination of January 15, 1954, was taken by 515 candidates, a larger number than in any previous year except 1953 when there were 607 candidates Grades ranged from a lowest mark of 32.0 to a highest mark of 89.5 Inspection of the range resulted in the decision to place the passing mark at 51. On this basis there were 32, or 6.2%, who failed and were therefore ineligible for oral examination.
The distribution of the grades earned by the 515 candidates is presented in the form of a histogram. As an aid to visual assessment of the nature of the distribution, a normal frequency curve computed from the mean and standard deviation of the data has been superimposed on the diagram. The distribution of the grades is clearly and impressively skewed to the left, that is, the scores tend to be massed at the high end of the scale and spread out at the low end. An examination of this type is relatively sensitive in the zone of poorer scholarship where the selection of failures is to be made and relatively insensitive in the range of higher scholarship.
The intrinsic reliability of the examination has again been assessed by comparing the grade made by each candidate on his odd-numbered questions with that earned on his even-numbered questions. The comparison reveals a "probable error of estimate," P.E.m, of 2.39, a lower figure and therefore a higher degree of reliability than yielded by any previous examination. The Committee is pleased that the increase in reliability was accomplished in spite of the fact that the length of the examination was decreased from 250 grading points in 1953 to 200 grading points.
CERTAIN ASPECTS OF THE RENAL REGULATION OF BODY COMPOSITION
Authors: COOKE ROBERT E. 
Published: December 2021

THE pH of extracellular fluid is determined by the ratio of the plasma concentrations of bicarbonate ion to carbonic acid, as given in the classical Henderson-Hasselbach equation. [See Equation in Source Pdf] The denominator the carbonic acid concentration, [H2CO3], is proportional to the carbon dioxide tension of the blood. The carbon dioxide tension (pCO2) is primarily dependent upon respiratory function, since metabolism (hence carbon dioxide production) is relatively constant.
The numerator of the equation—the bicarbonate concentration of extracellular fluid—is determined by the difference between nonvolatile cations and anions. Since there are almost limitless quantities of bicarbonate available to the organism from cell metabolism, [See Equation in Source Pdf] bicarbonate concentration must change whenever nonvolatile cation (largely sodium) is altered in relation to nonvolatile anion (largely chloride). Thus in most states extracellular bicarbonate concentration is dependent upon the ratio of sodium to chloride in extracellular fluid.
The quantity of water filtered at the glomeruli and reabsorbed by the renal tubules each day is approximately 15 times the extracellular volume. The quantity of sodium chloride filtered and reabsorbed daily is approximately 15 times that contained in the extracellular space and 150 times that usually ingested and excreted each day. Therefore, the ratio of plasma sodium to chloride in any steady state is determined by the composition of the renal tubular reabsorbate, as Cushny pointed over 30 years ago. In a sense the kidney perfuses the extracellular space with large quantities of tubular reabsorbate. Tubular reasorbate—the net quantity of materials reabsorbed by the tubules. This term is analogous to glomerular filtrate—the quantity of materials filtered by the glomeruli.
ANTIBODY RESPONSES TO NATURALLY OCCURRING POLIOMYELITIS INFECTIONS IN CHILDREN
Authors: MILLER C. ARDEN , WENNER HERBERT A. 
Published: December 2021

Thirteen of fourteen children with a clinical diagnosis of poliomyelitis showed high neutralizing antibody titers in tissue culture tests aganst prototype viruses, as early as two days after the first symptom, and persisting for as long as 18 months without significant change in titer. A significant increase in titer from that during the first week was occasionally encountered, but the initial titer was usually in the same range as that of the subsequent 18 months. The 14th child had antibodies against none of the prototype poliomyelitis viruses, though his clinical history was quite compatible with a non-paralytic infection. In the third month this patient's Type 2 antibody rose after six negative serums to 1:5120, possibly indicating an inapparent poliomyelitis infection several months after an erroneous diagnosis of poliomyelitis.
Stool specimens were available from seven of the 14 children. Six Type 1 poliomyelitis viruses and one Type 2 virus were recovered from these stools. Neutralizing antibody titers against the patient's own virus closely paralled those against the homologous prototype virus. When differences did occur, they were in favor of higher antibody titers against the patient's own virus.
Serums from 10 patients had antibodies against more than one prototype virus. With the exception of only two patients, antibodies against one of the prototype viruses were present far in excess of the others. Possible explanations for the heterotypic antibodies are discussed.
Neutralization tests, as performed, appear to be of value in ruling out a diagnosis of poliomyelitis, but not in establishing the diagnosis.
A TECHNIQUE FOR ROENTGENOGRAPHIC EXAMINATION OF NEWBORN, PREMATURE, OR ILL INFANTS WITHOUT REMOVAL FROM AN INCUBATOR
Authors: SILVER HENRY K. , NYHAN WILLIAM L. 
Published: December 2021

THE NECESSITY for roentgenographic examination as an adjunct to diagnosis and therapy during the neonatal period is well recognized. The indications for such examination and some of the difficulties encountered in its use are well known. The undesirable aspects of excessive handling of ill or delicate infants or of removing them from a source of constant oxygen, heat, and humidity may preclude examination when it is most needed. Certainly the hurry imposed by these difficulties often militates against satisfactory examination.
A technique is described which permits adequate roentgenographic evaluation without disturbance to the infant, cessation of oxygen therapy, or alteration of environmental temperature or humidity.
RAT MITE DERMATITIS IN CHILDREN
Authors: Haggard Carl N. 
Published: December 2021

DERMATITIS due to a specific etiologic agent, which responds immediately to therapy, is rather exceptional among eruptions in infancy.
Exploratory activities of toddlers often lead them to habitats and runways of rodents. Time belief that acariasis acquired by this direct manner may commonly be overlooked suggested that the present observations should be recorded.
CASE REPORT
A foundling home was being razed to make room for a new modern building. As portions of the house were torn down, occupants were moved to intact parts of the building. As the building proceeded, the need for rat extermination became increasingly great. About this time, adult occupants complained of itching rashes, and these failed to respond to a variety of common remedies.
REVIEW ARTICLE
Authors: Dawson Jean P. 
Published: December 2021

1) A case of hypoplastic anemia with multiple congenital anomalies (Fanconi's type) is reported. The patient exhibited pancytopenia associated with skin pigmentation, small stature and anomalies of the skeletal and genito-urinary systems.
2) The literature is reviewed and the characteristics of the disease discussed.
3) Management and therapy are discussed.
SPECIAL ARTICLE
Authors: Samuels Sidney S. 
Published: December 2021

THE DIAGNOSIS of non-suppurative, secretory otitis media has been made much more frequently in recent years than it was prior to 1950. This increase has been noticed in children many more times than in adults, as pointed out by Robison and Nicholas. The disease is much more commonly found because of increased vigilance some otologists believe, as does Suehs, since the entity was reviewed and clarified by the brilliant work of Hoople in that year.
However, there are undoubtedly other factors contributing to the greater incidence of this entity, such as the increased use of antibiotics in upper respiratory infections, including otitis media; an increase in the number of so-called virus infections; the greater prevalence of allergic diathesis; increased air travel; and, as Lindsay states, the swing of time pendulum toward extreme conservatism in recommending removal of tonsils and adenoids, a tendency resulting partly from a sense of security afforded by antibiotic therapy.
The condition has received more of the attention it merits lately from that group of practitioners who are first in contact with the patients, namely the pediatrician and general practitioner who attend the acutely ill child. For usually the actual onset of the illness is acute, an otitis media occurring during an acute upper respiratory infection or as an acute otitis media following such an illness. The former need not even reach the stage where it is definitely recognized, its progress being halted by the antibiotic treatment administered.
The attention of the attending physiciain is focused upon the middle ear in the younger child, either by the presence of pain in the affected ear, or by the abnormal appearance of the tympanic membrane, or both.
A COMPARISON OF ORAL BENZATHINE PENICILLIN G AND SULFONAMIDES FOR THE PREVENTION OF STREPTOCOCCAL INFECTIONS AND RECURRENCES OF RHEUMATIC FEVER
Authors: Markowitz Milton , Hemphill Woodrow 
Published: December 2021

1. The incidence of recurrences of rheumatic fever and streptococcal infections in 82 rheumatic subjects receiving a 200,000 unit tablet of benzathine penicillin G daily was compared with that in 64 rheumatic patients on a standard daily dose of a triple sulfonamide preparation, while both groups were followed for an average period of 13 months.
2. A total of 9 recurrences of rheumatic fever was noted, 4 in the group treated with penicillin and 5 among patients on sulfonamides.
3. The incidence of streptococcal infections as determined by a significant rise in the antistreptolysin O titer was essentially the same in both groups. Group A streptococci were found in the throat in about the same number of patients in each group.
4. Toxic reactions of a mild nature were noted in 7 patients (11 per cent) receiving sulfonamides as compared to 2 patients (2.5 per cent) on oral penicillin.
5. A single daily dose of 200,000 units of benzathine penicillin G is as effective a prophylactic agent as the sulfonamides for the prevention of rheumatic fever. Its chief advantage is the lower incidence of toxic reactions.
CONCENTRATION IN PLASMA AND RATE OF URINARY EXCRETION OF AMINO ACIDS IN PREMATURE INFANTS
Authors: Sereni Fabio , McNamara Helen , Shibuya Madoka , Kretchmer Norman , Barnett Henry L. 
Published: December 2021

Clearances of total and individual amino acids and of endogenous creatinine were measured in 2 groups of premature infants (less than 17 and more than 27 days of age), in full-term infants, children and adults. The results indicate that:
1) the concentration of total amino acids in plasma is higher in the premature infant; in the younger premature infant this higher concentration is due principally to higher concentrations of glycine, serine, threonine, glutamine, tyrosine and phenylalanine;
2) the clearances and rates of excretion of total amino acids and of most individual amino acids are higher in the older premature infants than in any other group of subjects; in the infants, but not in the children and adults, there appeared to be a direct relationship between rate of urine flow and rate of excretion of total amino acids, and
3) compared with the child and the adult, the higher rate of excretion of the amino acids in the older premature infant is due principally, not to the higher concentration in plasma, but to a lower rate of reabsorption of amino acids by the renal tubules. Although the rate of reabsorption of amino acids in the younger premature infant is also low, the very low rate of filtration results in a rate of excretion similar to that of the child and the adult.
It is concluded that, although a metabolic factor may be involved, the increased rate of excretion of amino acids in the older premature infant is due principally to a difference in the handling of amino acids by the kidney.