bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CUTANEOUS REACTION TO EGGWHITE
Authors: London Richard L. , Glaser Jerome 
Published: December 2021

A study of 400 allergic patients of all ages, who were skin tested with eggwhite, is reported. The authors agree with those who believe that a positive reaction in infants who have in no known way been exposed to eggwhite after birth is in all probability due to intrauterine sensitization. There is a possibility, however, that some reactions to eggwhite may be due to a primary histamine or serotonin releasing substance present in the eggwhite which has no relationship to antigen-antibody reaction. The circumstances under which this takes place are not known.
In all age groups the family history was positive in about 65% of cases.
It was surprising to find, in view of previous opinions, that in the youngest age group (infants up to 2 years of age), the skin test was positive in less than half the patients (42%) in the presence of clinical sensitivity. It was also unexpected to find that the number of patients clinically sensitive to eggwhite but giving negative skin tests increased as age advanced. This justifies the common practice of eliminating egg as a trial measure in the diet of the first age group, regardless of the results of skin testing, and suggests that this should be done in any age group where food is considered a possible etiologic factor.
In the youngest age group somewhat more than one-third (34%) of the patients reacted positively to eggwhite but were not clinically sensitive. This finding was completely unexpected as it had been thought that in this age group a positive skin test to eggwhite was practically pathognomonic of clinical sensitivity.
In this study more positive reactions in children to eggwhite were obtained (70.5%) than in a somewhat comparable series where the incidence was much less (20%). We attribute this to the fact that in our series both scratch and intradermal tests were made while in the other series only scratch tests were done. This reflects the greater sensitivity of the intradermal test.
Only about half the patients of all ages who react to eggwhite are also clinically sensitive.
Attention is drawn to a theory which explains why a positive cutaneous test to a food, as eggwhite, may be clinically significant in atopic dermatitis even though the test (wheal reaction) does not reproduce the type of dermatitis being studied.
There was no definite evidence, because the number of cases studied is far too small, to indicate that the severity of asthma which may ultimately develop in infants not asthmatic at the time of skin testing is proportional to the strength of the initial reaction to eggwhite.
Pediatric Neurosurgery
Authors: RANSOHOFF JOSEPH 
Published: December 2021

This volume, consisting of the work of 24 individual physicians, was organized and edited by I. J. Jackson, M.D. and Raymond K. Thompson, M.D.
The book is directed mainly towards the neurosurgeon, and while certain sections may be of interest to the pediatrician, it is not basically oriented for their use. A number of sections of interesting statistics are available, however, for the pediatrician to peruse; this is particularly true of the sections on brain tumors by Lyle French, M.D., and the intracranial vascular malformations by Lester Mount, M.D. On the other hand, from a strictly neurosurgical point of view, there are certain sections in the book which leave a good deal to be desired.
ANTIBIOTICS IN THE TREATMENT OF BETA-HEMOLYTIC STREPTOCOCCAL PHARYNGITIS: FACTORS INFLUENCING THE RESULTS
Authors: Stillerman Maxwell , Bernstein S. H. , Smith Martha L. , Gittelson Stanley B. , Karelitz Samuel 
Published: December 2021

The effectiveness of penicillin V, penicillin V potassium, benzathine penicillin G, erythromycin and tetracycline in eradicating beta-hemolytic streptococci from the pharynx of 410 infected patients or carriers was studied. Penicillin V and penicillin V potassium were administered in daily oral doses of 375 to 750 mg (600,000 and 1,200,000 units), respectively, for 10 days. The benzathine penicillin G was injected once intramuscularly in similar doses. The broad spectrum antibiotics were given in daily oral doses of 30 to 50 mg/kg, up to 1 gm, for 10 days.
The bacterial cure rate was 84% for 224 patients treated with penicillin V and penicillin V potassium, and 86% for 129 patients treated with benzathine penicillin G in combined doses. Forty-eight percent of 23 patients treated with erythromycin and 38% of 34 patients treated with tetracycline were cured.
The majority of the clinical bacterial relapses developed 14 to 28 days after the onset of treatment with penicillin V orally and 24 to 32 days after benzathine penicillin G, 375 mg intramuscularly. Approximately half of the patients with bacterial relapses had clinical manifestations of pharyngitis.
Factors which might be responsible for the development of relapses and failures are discussed.
Complications consisted of one case of otitis media and one case of glomerulonephritis, developing 12 and 22 days, respectively, after the onset of treatment. No case of rheumatic fever was observed.
The data indicate that penicillin was definitely more effective than erythromycin and tetracycline in eradiating beta-hemolytic streptococci from the host, in the doses used. There was no significant difference in the effectiveness of penicillin V, penicillin V potassium and benzathine penicillin G.
Attention is drawn to the relapse-and-failure rate of 15% in these patients despite penicillin therapy.
THE ENZYMATIC EXPRESSION OF HETEROZYGOSITY IN FAMILIES OF CHILDREN WITH GALACTOSEMIA
Authors: Donnell George N. , Bergren William R. , Bretthauer Roger K. , Hansen R. G. 
Published: December 2021

Assay of galactose-I-phosphate uridyl transferase in erythrocytes has been applied to a study of 14 families in which a known case of galactosemia has occurred. Including normal controls, 278 individuals were involved.
The method employed was sensitive enough to differentiate between homozygous, heterozygous and normal individuals.
The results substantiate the conclusion that galactosemia is a genetic disease transmitted by simple autosomal Mendelian inheritance.
USE OF A FAT EMULSION INFUSED INTRAVENOUSLY IN INFANTS AND CHILDREN
Authors: Kaplan S. A. , Strauss J. , Yuceoglu A. M. 
Published: December 2021

One hundred and twenty-one intravenous infusions of fat were given to 47 subjects; 105 of these were given to infants and children below the age of 13 years.
Less than 10% of the infusions were followed by development of fever in excess of 101.5°F. Some of the patients who developed a febrile reaction had other possible causes for the development of fever, such as infection.
None of the subjects showed a hemorrhagic tendency, anemia, leukopenia or thrombocytopenia, or jaundice.
The indications for the intravenous use of lipid were: acute diarrheal disease, chronic caloric deprivation,"surgical" lesions of the gastrointestinal tract, acute renal failure, and certain diseases of the nervous system.
Chemical analysis of the total lipids, cholesterol and phospholipids in the plasma showed that there was an increase mostly in the fatty acid fraction of the serum lipids during an infusion and that there was a return to normal levels 24 hours after beginning the infusion. There was no striking change in the cholesterol concentration of the serum during or after the infusion. The phospholipid content of the serum increased slightly, but returned promptly to normal levels.
The dosage of lipid used intravenously was 30 ml/kg, infused over 6 hours. Since the emulsion supplies 160 cal/100 ml, this dosage provides 48 cal/kg.
Examination of the liver at necropsy or by biopsy showed an accummulation of black-brown pigment in some cases, which is similar to the pigment that has been observed previously in the livers of patients and experimental animals receiving fat intravenously. Microgranulomas were not seen. Using the dosage described, no lesions attributable to the intravenous use of lipid other than the development of pigment were observed.
It is suggested that Lipomul-I.V.® may be safely administered intravenously to infants and children providing the dosage used is not in excess of that recommended. A second infusion may be given safely 48 hours after the first infusion. If visual inspection of the serum shows that the milky opalescence has been lost, a second infusion may be given 24 hours after the first.
MARFAN'S SYNDROME (ARACHNODACTYLY)
Authors: Kohn Jerome L. , Strauss Lotte 
Published: December 2021

Close observation of a patient with Marfan's syndrome throughout the duration of his life (18 years) provided an unusual opportunity to study the clinical evolution of the syndrome from birth. The diagnosis was confirmed by necropsy which showed advanced structural alterations of the cardiovascular system unsuspected during life, as well as nonspecific skeletal changes.
Even in the absence of a familial history the syndrome should be suspected when arachnodactyly and excessive length are noted at birth or in the presence of accelerated longitudinal growth early in life.
Notwithstanding early recognition and restriction of physical activity, the evolution of the disease could not be modified, or fatal complications prevented. While it is understood that the prognosis varies in subjects with this affliction, experience with this patient emphasizes that even in a subject with minimal or no cardiovascular symptoms the prognosis must be guarded.
The Marfan syndrome may be a more common hereditary disorder than is usually realized. Present trends in research in this disease give hope that the underlying metabolic disorder may eventually be clarified. It is conceivable that a test may be developed which would not only offer a much needed diagnostic tool, but a valuable aid in genetic investigation of this disorder.
STUDIES ON SMALLPOX AND COMPLICATIONS OF SMALLPOX VACCINATION
Authors: Kempe C. Henry 
Published: December 2021

Introductory remarks the presentation of the E. Mead Johnson Award affords the recipient the honor of publicly acknowledging his debts to his teachers. I pay such grateful tribute to Dr. Grover Powers and Dr. Edward B. Shaw, my preceptors in academic pediatrics and to Dr. Joseph Smadel who introduced me to the pox viruses and urged me to take another look at the well-trodden field of smallpox. Helpful in his own way was the senior virologist who urged me instead to get involved in another, more fruitful field because "smallpox leaves no room for further work, having been well studied in the 1920's" and who, thereby, strengthened my resolve to re-examine current concepts in the field of smallpox and smallpox vaccination, a subject which has occupied us for the past 14 years. I also acknowledge my lasting debt to my associate, Dr. Henry Silver, who has been a critical colleague, supporter and friend over many years.
The WELL KNOWN clinical observation that it is sometimes difficult to vaccinate the very young chi'd against smallpox led to our early assessment of passive immunity as a modifying factor1 and this, in turn, resulted in the development of hyper-immune vaccinal gamma-globulin and its use in the prevention of smallpox after known exposure.2 The principal subject of this report will be our therapeutic experience with hyperimmune vaccinal gamma-globulin in over 300 patients suffering from serious complications of smallpox vaccination. Finally, we hope to show how basic immunologic studies can be of great value in the management of some of the unfortunate patients whose experience with the vaccinia virus has been a tragic one.
ACID MUCOPOLYSACCHARIDES IN URINE IN GARGOYLISM
Authors: Steiness Ib 
Published: December 2021

The present paper is a report on a study of a new screening test elaborated by Dorfman for the demonstration of mucopolysaccharides in small urine samples. The study comprised three patients with gargoylism, their parents and siblings and two control groups consisting of 57 children supposedly without any abnormalities in connective-tissue metabolism and 13 patients with more special diseases. Only the patients with gargoylism showed positive reactions, but a single negative reaction in a randomly selected urine sample does not rule out a diagnosis of gargoylism.
The results suggest that the screening test is a valuable diagnostic aid.
THE PIERRE ROBIN SYNDROME (GLOSSOPTOSIS, MICROGNATHIA, CLEFT PALATE)
Authors: Smith J. Lawton , Stowe Fred R. 
Published: December 2021

Thirty-nine cases of the Pierre Robin syndrome have been reviewed. In one-fourth of the cases, a history of an intrauterine disturbance in early pregnancy was noted. The entity appears to occur more frequently in offspring of elderly mothers. A positive family history was noted in two instances. The history is typical, with difficulty in swallowing and recurrent cyanotic episodes noted in the newborn. The child often reveals marked sternal retraction, excessive mucous secretion and stertorous respirations which appear quite alarming when in the supine position, but there is usually marked improvement when the child is placed in the prone position, allowing the ptotic tongue to fall forward. Physical examination reveals micrognathia (producing an "Andy Gump" appearance), cleft palate or other defects of the hard and soft palate, and various anomalies of the tongue, the most common being glossoptosis. The associated defects are discussed.
In the majority of cases the Pierre Robin syndrome is seen without other significant defects than the triad of micrognathia, cleft palate and glossoptosis. Medical and nursing care are considered. Attention is drawn to the occurrence of ocular disease in these children, e.g., congenital glaucoma and retinal detachment. It is recommended that all cases of the Pierre Robin syndrome have a thorough ophthalmologic examination under anesthesia, including dilatation for ophthalmoscopy and tonometry, prior to 1 year of age.
ANAPHYLACTOID PURPURA
Authors: Vernier Robert L. , Worthen Howard G. , Peterson Raymond D. , Colle Eleanor , Good Robert A. 
Published: December 2021

Forty-five children with anaphylactoid (Henoch-Schönlein's) purpura were studied.
Evidence of recent streptococcal infection, as determined by positive ASO titers, was found in 13 of 39 patients (33%), an incidence of positive ASO titers only slightly higher than that expected in children with nonstreptococcal illness. This observation suggests that streptococcal infection is not the major cause of anaphylactoid purpura.
Microscopic study of skin biopsy specimens from 12 children showed perivascular cellular infiltration of the dermis. Numerous leukocyte-platelet thrombi were observed in small dermal vessels.
Muscle biopsy specimens were usually normal.
Kidney biopsy specimens from 11 children with anaphylactoid purpura-nephritis of variable severity and duration were studied. The principal microscopic abnormality consisted of focal lesions of fibrinoid deposition and endothelial proliferation within scattered glomeruli. Renal biopsy specimens obtained during clinical recovery from anaphylactoid purpura-nephritis showed focal glomerular scars. The differences between the glomerular pathology of anaphylactoid purpura-nephritis and other forms of glomerulonephritis are discussed.
Clinical, experimental and pathologic data are reviewed which support the concept that anaphylactoid purpura is a form of diffuse vascular disease, probably caused by hypersensitivity to a variety of agents.
Gesundeit und Leistungsfahigkeit im Kindes- und Jugendalter
Authors: STERN PETER 
Published: December 2021

This book constitutes a valuable contribution to the problems of physical fitness of today's children and adolescents. According to the World Health Organization's definition, "health is a state of complete physical, mental and social comfort." The authors proceed to prove in a series of interesting statistical, sociologic and physiological studies, why the general state of health of West Germany's youth falls short of this goal. In spite of the great reduction of infant mortality and the increase of general life-expectancy in the past 80 years, the situation of the child in modern society is considered to be unsatisfactory.
One third of the West German population lives in big cities, believed to create a hostile environment to children, i.e. lack of security and "Lebensraum."
PROGRESSIVE MUSCULAR DYSTROPHY: AUTOSOMAL RECESSIVE TYPE
Authors: Jackson Charles E. , Carey Joshua H. 
Published: December 2021

A description is presented of the autosomal recessive type of childhood muscular dystrophy appearing in 14 members (9 males, 5 females) of one closely inbred kindred. The clinical description of these individuals is supplemented by data on values for proteins, protein-bound iodine, hexosamine and glutamic oxaloacetic transaminase in serum, and excretion of amino acids and creatine-creatinine. In comparing this autosomal recessive type with the more common sex-linked recessive type of childhood muscular dystrophy, the most reliable differentiating feature noted was the presence of dystrophy in a female within a family.
The muscle involvement in these two types of diseases was similar except for the preservation of the zygomaticus muscles of the face in the autosomal recessive type as compared with the involvement of these muscles and resultant flat smile in the sexlinked recessive type of dystrophy. Pseudohypertrophy of the calf muscles occurred in 4 of 14 affected individuals of this kindred and therefore cannot be considered a dependable differentiating feature. The patients with the autosomal recessive type of muscular dystrophy had a later age of onset (5 to 13 years), a slower progression and a possible longer life span than those having the sex-linked recessive type. The importance of differentiating muscular dystrophy into types based on mode of inheritance is emphasized.
VISCERAL LARVA MIGRANS
Authors: Snyder C. Harrison 
Published: December 2021

An analysis has been presented of the clinical features of visceral larva migrans based on the study of 20 cases seen during a 10-year period at the Ochsner Clinic. The disease is seen in small children who eat dirt and who thus ingest the ova of the canine roundworm, Toxocara canis. Larvae of the parasite invade the liver, causing hepatomegaly with extreme eosinophilia, and usually fever and anemia.
Migration of the larvae to other organs may result in pneumonitis, encephalitis or myocarditis. Lesions may also be seen in skin, kidneys and possibly in bone. Proof of diagnosis requires biopsy of liver or other infected tissue. Treatment with diethylcarbamazine (Hetrazan) may be helpful, but even without treatment, once pica is stopped most patients recover.
Serious sequelae are seen in the form of intraocular granulomata, sometimes causing blindness. These lesions, because they resemble retinoblastoma, have in the past led to unnecessary enucleation of the eye. Enucleation for suspected retinoblastoma, therefore, should not be performed without due consideration of the possibility of a benign granuloma caused by T. canis.
PRESIDENT'S MESSAGE
Authors: Wheatley George W. 
Published: December 2021

ABOUT 10 years ago when the Committee on Accident Prevention was created, the Academy focused national attention on accidents as the No. 1 cause of death in childhood and a major contributor to disability, disfigurement and crippling. One of the most spectacular features of this Committee's program is its efforts to prevent and treat poisoning in children, as demonstrated by the amazing growth of poison control centers. Through these community facilities, valuable data on the occurrence and frequency of childhood poisoning have been brought to light. This information has documented an impression held for a long time by many pediatricians: namely, that the creativeness of modern chemistry is both a boon and a bane, the latter all too often in the case of toddlers from about 1 to 4 years of age. Legislation has always been one of the most important means of accident prevention, including accidental poisoning. For example, an early and very effective law aimed at reducing lye burns and deaths from corrosive poisoning in children was the Federal Caustic Poisons Act of 1927, which was developed with the support of organized medicine, under the able leadership of Chevalier Jackson, Sr.
But as new products and new hazards increased, new legislation was required for greater protection. The Federal Hazardous Substances Labeling Act of July 1960 grew out of the concerted efforts of organized medicine and the industries concerned. This law now adds a new dimension to health protection from a wide variety of hazardous products found in or about the home, in addition to the 12 substances formerly labeled "Poison" under the old Caustic Poisons Act.
Hazardous products include those that are flammable, toxic by ingestion, inhalation or absorption, explosive, caustic, irritant or strong sensitizers. Because parents often are not aware of the danger of such products, the articles are readily available to young children for unsafe investigation. Jensen and Wilson reported, in a study of 100 cases of poisonings in children, that "in 53 cases the poison was not in its usual place, either because it was in use, because persons other than the parents had left it out, or because the parents themselves were careless."
Recent mortality data reveal that there are at least 1,400 deaths at all ages from solid and liquid substances, with about 450 deaths in children under 5 years. Last year 35,000 cases of accidental poisoning were reported to the National Clearinghouse from 182 centers in 37 States. The National Health Survey has estimated that 822,000 ingestions of toxic substances occur each year.
Both the householder and physician will benefit from the requirements of this new law. Information to prevent accidents from household products and to offer appropriate first aid when accidents occur must now be readily available to users and physicians. The hazardous substance must be revealed, together with such precautionary warnings and measures as are necessary for safe use and handling of such products.