bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACIDIFICATION OF THE URINE BY INFANTS FED HUMAN MILK AND WHOLE COW'S MILK
Authors: Fomon Samuel J. , Harris Dorris M. , Jensen Robert L. 
Published: December 2021

Acidification of the urine was studied with two groups of infants, each group consisting of four infants between 2 and 6 months of age: Group I received fresh or pasteurized human milk and Group II received whole cow's milk on evaporated milk and water without additional carbohydrate.
The mean titratable acidity of the urine of infants of Group I was 3 meq/m2/12 hr compared with 35 meq/m2/12 hr for infants of Group II. The rates of excretion of ammonia were 7 and 28 meq/m2/12 hr by infants of Group I and II, respectively. After administration of ammonium chloride (4 gm/m2/day) for 2 days, the titratable acidity increased to 6 meq/m2/12 hr in Group I and to 34 meq/m2/12 hr in Group II. The mean rates of excretion of ammonia increased to 21 and 36 meq/m2/12 hr, respectively.
The greater titratable acidity of the urine of infants of Group II is attributed primanly to the greater amounts of phosphate in the urine (mean, 35 mmol/m2/12 hr excreted by infants of Group II compared with 3 mmol/m2/12 hr by infants of Group I). The greater rate of excretion of ammonia by infants of Group II is attributed jointly to the prolonged administration of a diet with relatively great residue of anions and, perhaps, to the greater availability of glutamine and other precursors of ammonia.
EQUIPMENT FOR CATHETERIZATION OF FEMALE INFANTS
Authors: Storts B. P. 
Published: December 2021

THE IMPORTANCE of examining the urine of infants, especially females, cannot be overemphasized. It is getting a fresh specimen that sometimes presents the problem. This is true for the pediatrician making a home call and sometimes in office work. The apparatus to be described offers a sort of one-man catheter set that can be used in the home or office. Figure 1 shows that the apparatus can be carried in a medical bag; the 4-ounce, wide-neck bottle makes a small package. The equipment consists of a 4-ounce, wide-neck, Americantype bottle; a two-hole rubber stopper; two pieces of glass rod and a No. 8 soft rubber catheter. The apparatus is assembled, wrapped in a towel and autoclaved. Several of these sets can be kept ready.
It is not often necessary to catheterize male infants. The catherization of female infants can be done in the home with the mother as the only assistant. The vaginal area is cleansed with soap, preferably Phisoderm®. The apparatus does not allow for the escape of the first few drops of urine before collecting; our experience has led us to believe that this is not necessary, if proper cleansing and inspection has been done.
It is well to remember that the urethra of the female infant baby is "C" shaped. The meatus represents the bottom end of the "C." The catheter should be started downward. The thighs should be widely abducted but held fully extended, not flexed on the abdomen. This position will not angulate the "C" curve of the urethra. The specimen is collected in the stoppered bottle which does not require holding. This allows free use of both hands. The specimen is collected in a closed apparatus and offers a fresh specimen for study and culture.
STUDIES IN FEBRILE SEIZURES
Authors: Millichap J. Gordon 
Published: December 2021

In mice, rats, guinea pigs and kittens and in 51 children with recurrent febrile seizures, the height of the body temperature was the important determinant in the induction or occurrence of seizures with hyperthermia. Both clinically and in animal studies, the body temperature at the onset of the convulsion may be used as a measure of the threshold to febrile seizures.
The pattern of the experimental febrile seizure was principally clonic in type. It varied with the height of the temperature and with the age and maturity of the animal. Also, the febrile seizure threshold varied with age and maturity. It was independent of the basal temperature of the body. In rats, the threshold was lowest at 3 to 8 days and highest in the adult animal; a small but significant elevation in threshold was observed at birth. In the newborn guinea pig, the threshold convulsive temperature was equal to that of the 20-day-old rat.
The rapidity of rise in body temperature was not a predisposing factor. In animals which convulsed, the susceptibility to febrile seizures was independent of the rate of temperature rise and the severity of the pyrogenic stimulus.
A measure of the febrile seizure threshold as demonstrated in this study has been found of value in studies of the mechanism and prevention of seizures with hyperthermia. Its clinical importance is discussed.
TREATMENT OF DISSEMINATED INFANTILE HISTOPLASMOSIS WITH AMPHOTERICIN B
Authors: Little Joseph , Bruce James , Andrews Harry , Crawford Kenneth , McKinley George 
Published: December 2021

Four cases with disseminated histoplasmosis are reported; three were in children under 12 months of age.
All responded gratifyingly to amphotericin B therapy given intravenously.
The value of Heiner's agar-gel technique for histoplasmin precipitin as a diagnostic tool was substantiated.
Further therapeutic trial of amphotericin B in disseminated infantile histoplasmosis seems warranted.
EOSINOPHILS IN THE THYMUS IN HYALINE MEMBRANE DISEASE (RESPIRATORY DISTRESS SYNDROME)
Authors: Black Maurice M. , Baldi Aldo G. 
Published: December 2021

An examination was made of the prominence of perivascular aggregates of eosinophilic leukocytes in thymic septa of cases of respiratory distress syndrome (hyaline membrane disease). Similar examinations were also made in cases of stillbirth and perinatal death unassociated with hyaline membrane disease. Moderate or marked thymic eosinophilia was found in more than 70% of 27 cases of hyaline membrane disease. This degree of eosinophilia was encountered in less than 10% of the control group.
Numerous eosinophils were also found in the axillary lymph nodes of four of eight cases of hyaline membrane disease, but in only 2 of 20 control cases.
The data are considered in terms of their relationship to adrenocorticoid levels in the fetus and the pathogenesis of hyaline membrane disease.
OBSERVATIONS ON GROWTH OF FINGERNAILS IN HEALTH AND DISEASE
Authors: Sibinga Maarten S. 
Published: December 2021

Using a modification of the Babcock photographic technique, it has been possible to make measurements of the day to day growth of the fingernail in human subjects.
There are marked individual variations in the rate of growth at all ages, but for the same individual and the same nail the rate of growth is relatively constant and can be used to study the effect of various physiologic and pathologic disturbances.
Preliminary observations indicate that nail growth is unfavorably affected in certain disease states, notably measles and nephrosis. Malnutrition and certain dietary restriction were not found to affect this parameter appreciably. Growth of the nails was followed for 10 days after death and was found to be measurable, the rate exceeding that noted during a severe attack of measles.
PROCEEDINGS
Authors: Barclay William R. 
Published: December 2021

THE PURPOSE of this presentation is to review very briefly some of the history of the controversial BCG vaccine. This is a living, attenuated, bovine strain of tubercle bacilli. This strain was first isolated in Paris as a very virulent organism for animals, and it was attenuated by serial passage in artificial media for a period of 13 years.
By 1921, Calmette and Guérin were satisfied in their own minds that they had produced an attenuated bacillus, but they delayed the announcement and the distribution of cultures to other laboratories until about 1924. From 1921 to 1928, large numbers of experiments were conducted to try and revert this attenuated bacillus to its original virulent characteristic. All experimental attempts in this direction failed.
In 1930 the vaccine received a setback from which it has never fully recovered, when 240 children received it as an orally administered vaccine at Lubec and 72 of them died. 2 A full-scale investigation subsequently revealed that the BCG strain was not the cause of the disaster. A contaminating strain of bacilli in the culture administered was positively identified by growth and color-producing characteristics.
I think it is improper to speak of "a BCG vaccine." Just as the original vaccine was able to mutate from a fully virulent strain of organisms to an attenuated form, mutations continue to go on producing relative degrees of infectivity or invasiveness. There is no such thing as absolute virulence and absolute avirulence. Rather, there is a continuous spectrum of invasiveness which an organism may exhibit, and an organism may change its characteristics of invasiveness from one culture to another.
Therefore, one may read in the literature that a BCG vaccine given in Scandinavia has produced a certain amount of immunity and a certain amount of hypersensitivity, but one cannot expect to exactly reduplicate the same result here; because you just cannot get the same Scandinavian vaccine here and reduplicate that experience. In this country there are several sources of BCG vaccine that a laboratory may acquire or a physician may use.
RADIOLOGIC AID IN REGIONAL AND GENERALIZED EMPHYSEMA OF THE LUNGS IN INFANTS
Authors: Liebner Edwin J. 
Published: December 2021

Normally, the bronchi dilate rapidly in inspiration and contract slowly in expiration, thus effecting a form of check-valve mechanism. Intra-and extra-bronchial occlusion, pulmonary infection, developmental bronchopulmonary malformations and pleural communications are pathologic processes which can disturb the check-valve mechanism and produce increased aeration. [See Figure in Source Pdf.]
The main bronchus and artery may be obstructed separately, or as a unit. Angiocardiograms should be analyzed for abnormal patterns, especially obstruction or atresia. A lack of vascular markings in the lungs can suggest pseudo-increased aeration.
On a regional basis, roentgenographic study of the vascular and air patterns can lead to recognition of certain entities. An angiogram in congenital lobar emphysema contrasts the vascular pattern in the involved and the remaining normal and unaffected lobes with pneumatocele, cystic disease, and atelectasis.
Reasons for support of the deficient-cartilage theory as a cause of lobar emphysema are cited, with emphasis on the localization of the emphysema to the anterior or upper lobes.
Bronchiolitis can give total compensatory emphysema, and the reasons given will help to understand the roentgenographic findings. Regional compensatory emphysema of the remaining lung, after total or partial collapse of a lobe by intrinsic or extrinsic factors, is illustrated. Basal pneumothorax is indicated to be a significant postoperative complication.
Although at times great similarity may exist in the appearance of plain films in conditions producing increased aeration of infants' lungs, it is hoped that this review will stimulate deeper analyses and wider recognition of the fundamentals.
PUBLIC HEALTH
Authors: Fleck Andrew C. , Klein Jerome O. 
Published: December 2021

On the basis of present knowledge, the various sources and accompanying pathways by which effective contacts between susceptible infants and the staphylococcus take place in the nursery outbreaks are as follows: 1) Direct contact with infective lesions; 2) direct and indirect contact spread from the asymptomatic infant carrier to the susceptible infant within the nursery, particularly under conditions of overcrowding and poor nursery technique.
Personnel carriers, fomites and air-borne droplet nuclei and dust, as sources of outbreaks, do not command a body of convincing epidemiologic evidence at this time.
The epidemiologic investigation of nursery-acquired disease requires that each infant at risk be followed for a minimum of 15 days. The most probable source and route of transmission of the causative organism can be identified. Control efforts should be based on the epidemiologic diagnosis.
PEDIATRICS AND SOCIETY
Authors: Gardner Lytt I. 
Published: December 2021

THIS is a progress report to the readers of Pediatrics on the status of Senator Lister Hill's "Health for Peace" bill (Senate Joint Resolution 41). This measure, which would have set up an international institute of medical research, passed the Senate May 20, 1959 with flying colors but finally was snagged in a House subcommittee through the summer of 1959.
The legislation received resounding approval by the Senate, with a vote of 63 to 17. The bill proposed to organize an Institute of International Medical Research within the framework of the National Institutes of Health. A $50,000,000 annual appropriation was planned. Evidence of widespread public support for the measure was observed in the statements of authorities who spoke at the Senate hearings concerning the bill. It is of interest that no one appeared to testify against S.J. Res. 41 during the 6 days of hearings.
At lease two persons participating in the hearings were members of the American Academy of Pediatrics: Dr. Martha M. Eliot, Head, Department of Maternal and Child Health, Harvard School of Public Health and Dr. Sidney Farber (Honorary Associate Member), Professor of Pathology, Harvard Medical School.
Many witnesses pointed out the importance of providing support for the research activities and the training of promising scholars in other lands. On this subject, Dr. Farber had this to say:
In many countries, such as Italy, the amount of research support available is so small that men of great skill and intellect are compelled to carry on only token research concerning problems which are selected because they do not require manpower, equipment, or modern research facilities.
MAPLE SYRUP URINE DISEASE: BRANCHED-CHAIN KETO-ACIDURIA
Authors: Dancis Joseph , Levitz Mortimer , Westall Roland G. 
Published: December 2021

A case of maple syrup urine disease is presented. The patient lived for 20 months, the longest survival so far reported.
There were increased amounts of leucine, isoleucine and valine in plasma and urine, indicating a block in the metabolic degradation of these amino acids.
There was an accumulation in the urine of the respective keto acids, but not of the aldehydes or of the simple acids. This locates the block at a step common to all three amino acids, that of oxidative-decarboxylation.
The alpha-hydroxy-acid derivatives of these amino acids are probably present, but the evidence is still incomplete.
Animal experiments indicate that oxidative decarboxylation of the branched-chain amino acids is a metabolic step which is found generally in tissues, including leukocytes but probably not erythrocytes.
Immunity and Virus Infection
Authors: PLOTKIN STANLEY A. 
Published: December 2021

This volume is a collection of papers given at a symposium on immunity and virus infection held in May, 1958 by the Vanderbilt University School of Medicine on the occasion of a visit by Sin MacFarlane Burnet.
The book opens with a thought-provoking discussion by Burnet of three theories of antibody production: the direct template theory of Haurowitz and Pauling; the indirect template theory of Burnet and Fenner; and the clonal selection theory of Jerne as modified by Burnet. The direct template theory states that antibody is formed by moulding against antigen; the continued production of antibody, therefore, depends on the persistence of the antigen.
THE REDUCTION OF INTUSSUSCEPTION BY HYDROSTATIC PRESSURE
Authors: SANTULLI THOMAS V. 
Published: December 2021

THE ARTICLE by Robins and Plenk which appears in this issue of Pediatrics is representative of the experience on the operative and non-operative forms of treatment of intussusception in childhood which is being reported by many others. Although the series is too small to draw any valid conclusions, the authors have attempted to show that reduction by barium enema will save about a half of these patients a surgical procedure, and they have called our attention to the advantages and disadvantages of hydrostatic reduction.
The treatment is still controversial and there is uncertainty regarding the proper role, if any, of hydrostatic reduction of intussusception. Some of the proponents of the surgical treatment still maintain that operation is the only form of treatment for all cases of ileocolic intussusception, while other authors are equally adamant in the use of hydrostatic pressure as the primary method of reduction.
CYCLIC VOMITING
Authors: BARBERO GIULIO J. 
Published: December 2021

RECURRENT vomiting in children has always been a difficult problem for diagnosis and treatment. The syndrome termed "cyclic vomiting", defined by Gee in 1882 as recurrent bouts of unexplained vomiting in children, has lacked careful documentation of clinical course and eventual prognosis. The report by Hoyt and Stickler on cyclic vomiting in this issue of Pediatrics presents a long-needed retrospective follow-up of patients previously labeled with this term.
It is encouraging to learn that this syndrome usually terminates by puberty. It is also helpful to obtain specific information concerning the incidence of migraine and headaches in these children, since a prevailing impression among many clinicians has been of the very high frequency of migraine in the families of such children and of the eventual development of migraine in the later life of these children.
COMPARISON OF THE IN-VITRO METABOLISM OF TETRAHYDROCORTISONE IN THE LIVER OF THE FETAL, NEWBORN, PREGNANT AND NON-PREGNANT ADULT RAT
Authors: Greenberg Robert E. , Gardner Lytt I. 
Published: December 2021

In the study of corticosteroid metabolism means must be utilized to separate the initial sequential process of reduction of the A ring of the phenanthrene nucleus from the subsequent conjugation mechanism at the 3-hydroxyl position. Utilizing the in-vitro system described by Brown et al., the metabolism of tetrahydrocortisone by liver slices from adult female, pregnant, post-partum fetal and newborn rats was studied.
Liver slices from premature and newborn rats exhibited an intact although quantitatively reduced ability to metabolize tetrahydrocortisone, when compared to the normal adult rat. Liver slices from pregnant and post-partum rats similarly metabolized less tetrahydrocortisone, suggesting that similar factors might be affecting the conjugating mechanism in all four groups.
It is probable that incomplete development of enzymatic mechanisms in the young animal might be anticipated to be more pronounced and significant in terms of the highly specific enzymes and hydrogen donors involved in the initial reduction of the A ring of the steroid nucleus.
IMMUNOLOGIC RESPONSES OF PREMATURE AND FULL-TERM INFANTS TO INFECTION WITH CERTAIN VIRUSES
Authors: Eichenwald Heinz F. , Kotsevalov Olga 
Published: December 2021

Observations are reported on a number of newborn and premature infants naturally infected with adenovirus types 1, 2, and 3, and ECHO virus types 9, 18, and 20 during their first few weeks of life.
Serial serologic studies revealed that these babies generally responded promptly with antibody formation and that this was independent of age and birth weight, but did vary with the particular type of virus involved. The presence of homologous passively acquired antibody did not appear to interfere with the formation of active immune bodies. However, the response to the various viruses differed sufficiently that it was not possible to arrive at general conclusions on the basis of information derived from any single agent.
PRIMARY HYPEROXALURIA
Authors: Shepard Thomas H. , Krebs Edwin G. , Lee Lou-sein W. , Johnson Mary Louise 
Published: December 2021

Dietary and metabolic studies carried out on a patient with primary hyperoxaluria are reported. There was no appreciable change in the urinary excretion of oxalate when he was given a diet low in oxalate, or ascorbic acid, magnesium or riboflavin. A diet high in protein and low in carbohydrate was associated with increased excretion of oxalate, whereas increased catabolism of protein induced by cortisone and the postoperative state did not appreciably change the urinary excretion of oxalate.
Evidence that the source of increased accumulation of oxalate might be related to the glycine-glyoxylate-oxalate pathway is the observation that the increased urinary excretion of oxalate in the mother was slightly depressed by the administration of sodium benzoate. Glycine (10 gm) did not cause an appreciable increase in oxalate in the urine but may have been associated with formation of bladder stones in the patient.
The ratio of oxalate to nitrogen in the urine remained relatively constant during wide fluctuations in excretion of nitrogen.
CHANGING CONCEPTS IN OTOLARYNGOLOGY FOR THE PEDIATRICIAN
Authors: Ferguson Charles F. 
Published: December 2021

DURING the past two decades since the advent of chemotherapeutic and antibiotic drugs, the field of otolaryngology has undergone tremendous changes. This is true not only of the specialty as a whole, but also particularly of that portion in which the pediatrician is primarily concerned. It behooves him, as well as the otolaryngologist, to become increasingly aware of formerly hopeless congenital anomalies now amenable to treatment. In addition he must still maintain a high diagnostic acumen and not allow it to become dulled by the promiscuous use of the newest medications for every minor symptom. Too often there is the temptation today to over-treat a simple illness, only to find that a new complication has arisen, which may prove of more concern than the original, self-limited condition. Although it should be axiomatic even today, it must again be emphasized that accurate diagnosis should always precede therapy.
The average present-day physician, whatever his field of endeavor, unfortunately is becoming increasingly strong on therapy, and too often weak in diagnosis. The constant barrage of beautifully colored propaganda from highly competitive drug houses does not help to relieve this growing imbalance, and constantly tempts him to give every medication an early trial before a careful diagnosis can be established. The effect of such a situation, particularly in the field of otolaryngology, cannot be denied.
According to Hansel whose contributions to our understanding of obscure conditions of the nose and throat are monumental, the three most important problems in otolaryngology today are allergy, infection and immunity.
POST-SPLENECTOMY INFECTION IN INFANTS AND CHILDREN
Authors: Robinson Tom W. , Sturgeon Phillip 
Published: December 2021

Fatal or life-threatening infection occurred in 13 members of a post-splenectomy population of 110 individuals followed for a median period of 6 years. Division of the population into two groups, one group predisposed to infection by the basic disease and/or the treatment which led to splenectomy and another non-predisposed group, revealed a distinct difference in the hazard.
The non-predisposed group of 63 individuals had only one severe infection; this experience does not suggest risk of a very high order.
Our Experience combined with that of others reporting cases in this category, provides a total splenectomy population of 205 with but two severe infections. It is evident that splenectomy carries a very low risk of post-operative infection when done over the age of 6 months for the generally accepted indications of splenic rupture, congenital spherocytic anemia, and idiopathic thrombocytopenic purpura.
In the 47 individuals in this study predisposed to infection by their underlying disease, the incidence of severe post-operative infection was approximately 25%. No relation to age at time of splenectomy was evident. Ten of the 12 infections occurred within 12 years of operation. No attempt has been made to assess how great an increase, if any, this represents over a non-splenectomized control population similarly predisposed to infection.
Our Experience, in addition to that of others, in the group predisposed to infection by their underlying disease, makes a total splenectomy population of 85; 23 (27%) of this group suffered severe post-operative infections.