bluuebunny/crossref_metadata_2025_split huggingface dataset:
IN-VITRO EVALUATION OF EFFECT OF ENZYMES ON TRACHEOBRONCHIAL SECRETIONS FROM PATIENTS WITH CYSTIC FIBROSIS
Authors: Chernick Warren S. , Barbero Giulio J. , Eichel Herbert J. 
Published: December 2021

A standard procedure was established for the in-vitro screening of potentially therapeutic enzymes in cystic fibrosis. The procedure involved the use of two criteria for the evaluation of the effectiveness of a given enzyme, i.e., the release of components from the tracheobronchial secretions absorbing at 270 mµ and the change in viscosity of the secretions.
Of various proteolytic, fibrinolytic and nucleolytic enzymes subjected to the screening procedure, pancreatic dornase had the most marked action on a 1% homogenate of the secretion in saline solution. Trypsin and chymotrypsin were considerably less effective, and the other enzymes had little or no effect.
Tracheobronchial secretions from cystic fibrosis were found to inhibit the activity of trypsin when assayed with casein, but not that of pancreatic dornase when assayed with deoxyribonucleic acid.
A direct correlation has been shown between the degradation of deoxyribonucleic acid and the decrease in viscosity of the tracheobronchial secretions from cystic fibrosis, when acted upon by pancreatic dornase.
Cytochemical smears of the secretions from cystic fibrosis exhibited dissolution of the fibril structure after treatment with pancreatic dornase.
The data afford further evidence for the contention that the fibrous network observed in the tracheobronchial secretions of patients with cystic fibrosis consists primarily of deoxyribonucleoproteins which contribute to the over-all viscosity of these secretions.
INTRACELLULAR ORGANIZATION OF ENZYME SYSTEMS
Authors: Villee Claude A. 
Published: December 2021

A review is presented of the morphologic picture made available by recent advances in electron microscopy and of the biochemical localization of enzymes made possible by ultracentrifugation, which have led to a picture of the segregation of function accompanying a segregation of structure within the cell. The localization of enzymes in certain parts of the cell provides additional methods of controlling enzyme rates and insures that reactions will occur in a certain sequence. The product of one reaction is made directly available as the substrate for the next reaction in the sequence, and the enzyme for this next step is located immediately adjacent in the membrane. The localization of enzymes within lipoprotein membranes may permit reactions to occur in a nonaqueous phase, reactions that could not be carried out in a completely aqueous system.
Although much remains to be done in this rapidly developing field, it is now clear that catalysts are organized spatially within the cell and that the fine structure of this organization extends to molecular dimensions, paralleling the intricate morphologic fine structure that has been revealed by electron microscopy.
TRANSMISSION OF POLIOVIRUSES
Authors: Wehrle Paul F. , Reichert Ralph , Carbonaro Ory 
Published: December 2021

A partially immunized recreational school population in central New York has been studied during the course of an outbreak of poliovirus Type I infection. The data indicate that some increased resistance to poliovirus Type I infection occurred following immunization but that the effect was limited to extra-household contact and was not apparent within households where infection occurred regardless of the immunization status of either the presumptive source or contact.
Relatively poor antigenicity of the vaccine used seems the best explanation for the lack of demonstrable effect on prevalence of pharyngeal polioviruses among infected persons. The present study emphasizes the need for universal immunization if clinical poliomyelitis is to be effectively controlled with Salk-type poliomyelitis vaccine, and it further provides a base-line for studies with attenuated polioviruses in this population.
MEASLES ENCEPHALITIS
Authors: Karelitz Samuel , Eisenberg Melvin 
Published: December 2021

The histories of 42 patients with measles encephalitis were reviewed to evaluate the treatment, in particular to determine whether adrenal corticosteroids or adrenocorticotropin were helpful, beyond the results with usual supportive therapy.
There were no fatalities, but 13 patients had central nervous system sequelae on discharge; 9 of these had been treated with, and 4 without ACTH and/or corticosteroids.
Re-examination of 20 of the 42 cases 2 to 7 years after discharge from the hospital revealed that of 14 children treated during the acute phase of encephalitis with ACTH and/or corticosteroids, 12 had central nervous system sequelae, while only 6 of these 12 had manifested complications on discharge. Four of 6 untreated patients among the 20 followed-up had central nervous system sequelae, as compared to 4 of 22 at the time of discharge from the hospital.
The patient's condition on discharge from the hospital did not accurately indicate the future course; some sequelae became manifest later, others disappeared, some became milder and others worse.
Adrenal corticosteroids and ACTH administered to these patients did not prevent central nervous system complications.
The advisability of the use of these hormones in the management of measles encephalitis is questioned.
The survival of 42 consecutive patients indicates that some fatalities may be prevented by constant supervision and intensive supportive therapy.
EDUCATION
Authors: Badgley Robin F. 
Published: December 2021

Three conclusions are deduced from the results presented.
First, attendance by patients at this pediatric clinic is highly selective by social class and racial backgrounds. Negroes and lower class whites are significantly over-represented. The ratio of Negroes attending the clinic to their expected representation is seven to one. One suspects Negroes may find this clinic more accessible than they do community practitioners. Although the patients attending the clinic are not representative of the community in which they reside, nevertheless they do provide the student with an excellent "testing ground" for future practice. Thus one of the main objectives of the clinic has been achieved.
The second conclusion focuses upon the types of diseases and the utilization of hospital services. Diseases, as would be expected, vary from one service to another. Two per cent of the pediatric ward patients and 4% of the emergency room patients were given diagnoses of psychobiological and psychoneurotic disturbances. In contrast, 25% of the pediatric clinic patients were in these categories.
Dr. Milton Senn believes that pediatric outpatient departments constitute a realistic testing ground for community practice. If this is so, and the prevalence of psychoneurotic disturbances in the community is but a fraction of the figure reported for the clinic, then this finding has broad implications for the treatment of such patients by pediatricians. Referring to the treatment of mentally ill children by pediatricians, Dr. Senn states:
The ordinary paediatric staff, even with some psychologic insight, is usually not trained well enough to cope with these children. In order to deal with them properly, psychiatric rather than paediatric hospital services are needed.
PRESIDENT'S MESSAGE
Authors: Wheatly George W. 
Published: December 2021

Much thought is being given these days to the content of pediatric education for the future. Indeed, it has been under serious consideration for the past several years. Representatives of the American Board of Pediatrics, the American Pediatric Society, the Society for Pediatric Research, the Pediatric Section of the American Medical Association, and the American Academy of Pediatrics, constituting an ad hoc committee organized in mid-1960, have recommended the formation of a Joint Committee on Pediatric Education, Practice and Research, and have outlined a program to explore and study the various problems. Details of this report will be found in the report of our Committee on Medical Education, October, 1960. Your Executive Board has accepted this report and is prepared to do its full part in implementing the Committee's recommendations. This includes staff help, space at the Evanston headquarters, and sharing in the cost. I consider this a subject not only important but urgent.
Whenever a question as fundamental as the education involved in a specialty is raised, many points of view must be considered. In a democratic society, this is as it should be. It is essential that those most concerned, namely, those who must do the teaching and those who apply this education by direct service to the public, be heard. For this reason I have proposed that the regional meetings of our Medical Education Committee deal with the question and invite practitioners, as well as heads of pediatric departments, to these sessions. Too often the voice of the practitioner is not raised or perhaps not heard or heeded when professional education is under consideration. I hope that these meetings will get under way this year under the aegis of our Committee on Medical Education.
One of the points of view on the nature and future of our specialty which has been publicized, and thus perhaps over-emphasized, is that pediatrics has become debased by over-production of pediatricians and the simplicity of the service involved in taking care of children. To preserve the value of our specialty, it has been proposed that pediatricians should turn over "routine office care" to physicians less highly trained in child care, leaving "problem cases" to the true specialist. Aside from the fact that "routine office care" often presents an opportunity to the pediatrician to turn up incipient difficulties of many kinds, this concept is unrealistic, defeatist and unimaginative. It is unrealistic because medical practice in a free society, so long as the public has free choice of physician, will be determined by what the public wants and is willing to pay for.
STATUS OF SULFONAMIDES IN THERAPY OF INFECTIONS
Authors: Daeschner C. W. , Yow E. M. 
Published: December 2021

MANY physicians will recall clearly the great enthusiasm that greeted the introduction of the sulfonamides into clinical medicine in 1935. For the first time the physician carried to the bedside a broadly effective chemotherapeutic agent for the management of bacterial infections. As new sulfonamide derivatives appeared, the pneumococcus, staphylococcus and streptococcus could be inhibited, and the common childhood infections—pneumonia, impetigo, otitis media, and tonsillitis—were managed effectively. Problems of urosepsis, bacterial meningitis and bacterial arthritis were often dramatically improved. Though drug toxicities were encountered, these were readily accepted by a grateful profession as a small price to pay for such an effective approach to the control of infectious diseases.
During the next 10 years sulfonamides of greater efficacy and lower toxicity continued to appear and rapidly expanded the clinical use of chemotherapy. With the introduction and widespread use of sulfadiazine in 1941-1942, sulfonamides reached a peak of popularity. This same period saw the introduction of the first antibiotic.
Procedures in Vascular Surgery
Authors: VOOREES ARTHUR B. 
Published: December 2021

In the preface the author outlines the origin of this excellent, useful book. Starting as a guidance outline for residents at the Peter Bent Brigham and West Roxbury Veterans Administration Hospitals, it has had, since its inception, the advantage of constant critical review.
The text contains a remarkable amount of crisp information of a technical and practical nature, which is of considerable value to the student of vascular surgery at any level. Since no attempt is made by the author to cover cardiac surgery, the book is of somewhat limited pediatric interest.
The author has avoided encrusting his outline text with discussions of controversial practices.
CAUSES OF DEATH IN INFANTS WITH HEMOLYTIC DISEASE OF THE NEWBORN (ERYTHROBLASTOSIS FETALIS)
Authors: Van Praagh Richard 
Published: December 2021

In a series of 882 infants with hemolytic disease, there were 82 fatalities, for which 74 necropsies were performed. In general, death resulted from severity of hemolytic disease in 59%, from delay in treatment leading to kernicterus in 18%, from profound late anemia in 3%, and from conditions unrelated to hemolytic disease in 20% of the cases in which necropsy was performed. Significant clinical and pathologic findings in the 74 infants were: anemia in 70%; aspiration of amniotic sac content in 55%; pulmonary hemorrhage in 54%; heart failure in 51%; with anascarca in 42%; death during or soon after the exchange transfusion in 32%; pneumonia in 19%; kernicterus in 18%; pulmonary hyaline membranes in 12%; rupture of the spleen in 5%; and cerebral intraventricular hemorrhage in 4%.
The risk of death during or soon after the exchange transfusion was 2% per patient and per procedure, if infants with hydrops or fatal lesions are excluded. The total risk was 4% per patient and 3% per exchange transfusion. Approximately one-third of all fatalities occurred during or soon following exchange transfusion. In approximately one-third of infants who died at this time, no adequate cause of death was found pathologically. Pulmonary hemorrhage did not differ significantly in incidence or in degree between kernicteric infants, nonkernicteric infants with hemolytic disease, and a control series. Rupture of the spleen occurred significantly more frequently in infants with severe hemolytic disease than in the control series. The important problems of death during or soon following exchange transfusion, and of hemorrhage in infants with hemolytic disease, merit further study.
IMPORTANCE OF AGE, SEX AND BODY HABITUS IN THE DIAGNOSIS OF LEFT VENTRICULAR HYPERTROPHY FROM THE PRECORDIAL ELECTROCARDIOGRAM IN CHILDHOOD AND ADOLESCENCE
Authors: Walker Colin H. M. , Rose Raymond L. 
Published: December 2021

The electrocardiographic records of 849 normal individuals between the age of 1 and 16 years were studied, and the arithmetic sum of the voltages SV2 and RV5 were calculated. Values considerably in excess of those usually quoted were found to exist in this age group, the mean being 38.0 mm ± 9.7 and the range 15 mm to 65 mm. A new set of means and standard deviations for this index have been prepared.
Variations in these values are evident with advancing age, and these appear to be related to sex. Whereas there is no difference in voltages between the sexes in children under the age of 11 years, over this age the females present values which become progressively smaller with the advance of puberty (both in relation to their previous values and to the values found in males), reaching a mean level 17 mm lower than that of the males by the age of 16 years. The males show no significant difference in voltage after and before the age of 11 years, while the females do. The possible causes for these trends have been briefly discussed.
As a result of this study and in contradistinction to adult experience it is considered unwise to rely on precordial voltage alone as an index of left ventricular hypertrophy unless the SV2 + RV5 value is greater than 60 mm in children less than 11 years of age, or greater than 55 mm in females and 65 mm in males past 11 years of age.
CLINICAL CONFERENCE
Authors: Rozenfeld Irving H. 
Published: December 2021

WE HAVE recently seen two youngsters whose presenting complaints were highly suggestive of spinal cord disease but whose lesions were far removed from this area. We believe this deserves emphasis.
CASE REPORTS
Case 1
The first patient was seen initially when he was 14½ years old, complaining of vague pains in his night knee and thigh. This pain was intermittent, slightly worse at night, but did not interfere with the patient's activities. Physical examination was entirely negative. There was no local tenderness, limitation of motion or limp. Roentgenograms of the knee, thigh and hip were interpreted as negative, and the patient was advised to limit activity temporarily.
Although he was subsequently seen for minor respiratory infections, there was no further mention of pain. Eighteen months later, the patient's mother called to say that she had just noticed that the right leg was thinner than the left.
When seen, however, the patient, now 16 years old, reported that pain in the leg had continued during the 18-month period. There was no specific localization of the pain; it was worse at night and responded to heat, massage and aspirin. He had pain occasionally during the day and had limped for the preceding several months. This however did not stop him from playing football and baseball. He reported further that he first became aware of the thinness of the right leg about 4 months previously but had not told anyone. Furthermore, he reported an 11-lb weight loss during this 4-month period.
On examination, there was marked atrophy of the entire right leg, as shown in Figure 1.
On Feeding at the Breasts
Authors: JONES WILLIAM O. 
Published: December 2021

To the Editor:
A decreasing percentage of new mothers and their newborn babies are experiencing the pleasurable opportunity of breast feeding. It seems apparent that this once-universal method of furnishing our young with their nutritional and sucking needs will become less common as time moves on. It is my conviction that the mother who is interested in breast feeding her nextborn child should be given proper encouragement as well as the best advice in the implementation of the desire.
Gamma-globulin in Prevention of Hepatitis
Authors: STOKES JOSEPH 
Published: December 2021

To the Editor:
In Pediatrics, 28:514-515, 1961 are a letter from Sydney S. Gellis, M.D., and James A. McComb, D.V.M., and a reply from the Committee on the Control of Infectious Diseases, which appear to be contradictory, concerning previous recommendations in earlier studies on the control of epidemic hepatitis. I should agree with the major points made by Gellis and McComb: "We firmly believe that 10 years experience should not be abruptly discarded on the basis of a single clinical trial."
A CHILD-ORIENTED APPROACH TO TOILET TRAINING
Authors: Brazelton T. Berry 
Published: December 2021

Results of toilet training obtained from the records of 1,170 children in pediatric practice over a 10-year period are summarized. The suggested method stressed the child's interest and compliance in developing autonomous control. This was instituted at about 2 years of age and depended on his physiologic and psychologic readiness.
Initial success was achieved simultaneously in both bowel and urinary control in 79.5% of the cases, 12.3% in bowel control alone, and 8.2% in urinary control. This first accomplishment was reached at an average age of 27.7 months. Daytime training was completed between 2 and 2½ years of age in 80.7% of this group. The average age for day training was 28.5 months; males and females showed no significant difference; first children were 1.2 months slower than their siblings. Night training was accomplished by 3 years in 80.3% of cases. The average age for completion of all training was 33.3 months. Males took 2.46 months longer for complete training. First children were delayed 1.7 months in complete training in relation to their siblings.
Of the children who had chronic difficulties in this area, 76 (6.5%) were untrained at 4 years, and 16 (1.4%) were failures by the age of 5 years. The value of such a child-oriented program in preventing residual symptoms is stressed.
THE ACADEMY 1960-61
Authors: Wheatley George M. 
Published: December 2021

This will be a brief report about some important national programs and actions since our annual business meeting a year ago. While they help demonstrate the Academy's influence and breadth of interest in child health affairs, these developments also are a challenge to our leadership. How to keep pace with this broadening public interest and also maintain a private practice is the dilemma of most pediatricians. It can be done, it must be done, and it will be done, if each of our members takes seriously the obligation of Fellowship.
As an organization we continue to grow at an impressive rate. In the past 10 years our membership in the United States has more than doubled. Altogether there are slightly more than 7,000 members in the Academy. Of these, more than 5,700 are in the United States, 231 in Canada and 940 in Latin America. With greater size comes a greater problem in communication. The annual business meeting—though it serves an important purpose in this respect—is not enough. Our News Letter is becoming increasingly useful as a means of reaching all our members. The brochure "An Introduction to the American Academy of Pediatrics," published this year, fills the need for a brief description of the purpose, organization and program of the Academy. A new publication, Careers in Pediatrics, soon to be issued will give young people some better understanding of pediatrics and show them that as a specialty it has many inviting possibilities. This all helps.
But for the Academy of fulfill its purpose to improve the health of all children, it must mobilize the ideas and efforts of all its members.
CHOLECYSTITIS AND CHOLELITHIASIS IN CHILDREN
Authors: Sorge Dominick V. 
Published: December 2021

Four cases of gallbladder disease in a young age group are presented. Etiologic factors are discussed. Although gallbladder disease in children is uncommon, it should be ruled out in patients who present with abdominal complaints, especially with symptoms consistent with gallbladder disease.
A good medical, economic and family-racial history is, as always, very important. There may be a female preponderance for cholelithiasis, even in children. A higher index of suspicion in the differential diagnosis of abdominal complaints may lead to a higher percentage of pre-operative diagnoses.
Hyaline Membranes in Lebanon
Authors: Younozai M. K. 
Published: December 2021

Because of recent interest in the geographical incidence of hyaline membrane formation in the lungs of infants dying in the newborn period, the following observations are reported.
Between July 1, 1948, and June 30, 1958, there were 7,131 live births at the American University Hospital in Beirut, Lebanon. There were 117 known deaths during the first month of life. Autopsies were performed on 91 infants (78%). With use of the criteria of Potter,1 sections of the lungs of the 63 infants who died during the first 3 days of life were reviewed.
CONGENITAL DEFECTS OF THE CENTRAL NERVOUS SYSTEM ASSOCIATED WITH HYPERENDEMIC GOITER IN A NEOLITHIC HIGHLAND SOCIETY OF NETHERLANDS NEW GUINEA
Authors: Gajdusek D. Carleton 
Published: December 2021

A recently discovered, isolated, and still neolithic population in the interior Highlands of Netherlands New Guinea has been studied, in which most, and perhaps all, of the members suffer from varying degrees of congenital central nervous system damage. This damage ranges from subtle degrees of mental subnormality to severe feeble-mindedness often associated with deafness or deaf-mutism. In this region about one-fourth of the males and two-thirds of the females are found to have goiter. In some hamlets the incidence reaches 100% among the adult females. Many of these goiters are among the largest reported in world literature.
The extreme isolation and the high incidence of this congenital goitrous cretinism of varying degrees of severity make this region ideally suited for studies of both the genetic and environmental factors which determine the defects in this population. Similarly, they offer an unprecedented opportunity to investigate the etiology and pathogenesis of central nervous system defect associated with endemic goiter. The possibility that an unusual use of sweet potato leaves as a dietary staple in a region wherein the total nutritional balance is marginally adequate may play a role in the medical situation is under investigation. Metabolic and biochemical studies will be reported in subsequent papers in this series. Other medical problems of the area are briefly discussed and the distribution of goitrous areas in New Guinea is reviewed.