bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ENZYMIC AND MORPHOLOGIC ORGANIZATION OF THE MITOCHONDRIA
Authors: Lehninger Albert L. 
Published: December 2021

In This Paper I shall describe some of the information we have recently obtained regarding the enzymic and molecular organization of the mitochondria, which as you know are very small particulate organelles in the cytoplasm of all aerobic cells. These bodies have been found to catalyze one of the most fundamental activities of the cell, namely, the transformation of the energy yielded by oxidation of foodstuffs into the so-called phosphate-bond energy of adenosine triphosphate. This process of respiration and phosphorylation is extremely complex and involves the interaction of at least seventy different enzymes and coenzymes in an integrated fashion.
The mitochondria have a characteristic ultrastructure in which these enzymes are embedded, and it is now possible to consider in some detail the intramitochondrial location and function of these important energy-transforming molecules.
First, let us consider the organization of oxidative metabolism in purely biochemical terms. Figure 1 shows the usual text-book representation of the final common pathway of biologic oxidation in animal tissues. You will recall that all three of the major foodstuffs of the cell (carbohydrate, fat and protein) ultimately are degraded in the tissues to a two-carbon unit, namely, acetylcoenzyme A. The acetate group then undergoes oxidation by the Krebs citric acid cycle, and in this process the two carbon atoms of acetate become oxidized to carbon dioxide. The oxidation of acetate is finally completed when pairs of hydrogen atoms are removed from certain of the intermediates of the Krebs cycle by dehydrogenases. These hydrogen atoms, or their equivalent in electrons, pass along the respiratory chain via the cytochromes until they meet molecular oxygen and reduce it to form water.
Congenital Adrenal Hyperplasia Associated with Polycythemia
Authors: Michael Alfred F. , Gold Arnold P. 
Published: December 2021

We reported (Pediatrics, 23:727, 1959) a male infant with congenital adrenal hyperplasia complicated by marked polycythemia during the newborn period. This child died at 29 months of age. The purpose of this communication is to relate his further course and the necropsy findings.
He was admitted to the hospital at 1 day of age to be investigated for adrenal hyperplasia, as his sibling was known to have this disease. The diagnosis was confirmed by finding an increased 24-hour urinary excretion of 17-ketosteroids.
A COMMUNITY APPROACH TO JUVENILE INTRACTABLE ASTHMA
Authors: Bernstein I. Leonard , Allen John E. , Kreindler Louis , Ghory Joseph E. , Wohl Theodore H. 
Published: December 2021

Rehabilitation of children with refractory asthma utilizing the existing facilities of a local institution has proven successful in Cincinnati. A complete description of the origins, aims and services of this program is presented. The local nature of such a program has some distinct advantages over a national institution doing the same kind of work, chief among which is the opportunity for long-term clinical observation and laboratory studies of discharged children. In general this preliminary presentation of our clinical results in 47 patients corroborates the good results previously reported by other centers involved in long-term rehabilitation of children with asthma. Specific factors which may influence or produce clinical remissions in these patients are under current investigation.
In our opinion, it is not only feasible, but also highly desirable, for other urban areas to develop similar treatment centers. It is conceivable that some type of federation, either formal or informal, would be mutually beneficial to all who are involved in this gratifying work, in both local and national centers.
BLOOD CULTURES FROM THE UMBILICAL VEIN IN THE NEWBORN INFANT
Authors: Lipsitz Philip J. , Cornet JoAnn M. 
Published: December 2021

A study was done to investigate the routine use of blood obtained from the umbilical vein for blood cultures in newborn infants. It was found that 45% of such samples will be contaminated with the same organisms as are found on the umbilical stump.
The pathogenesis of the bacteremia indicated by positive cultures from samples of blood obtained from the umbilical vein is discussed.
Positive cultures from the blood samples obtained at the start of exchange transfusions do not necessarily indicate either bacteremia or septicemia.
EFFECT OF SPLENECTOMY ON THALASSEMIA
Authors: Wolff James A. , Sitarz Anneliese L. , Von Hofe Frederick H. 
Published: December 2021

The effects of splenectomy in 18 children with thalassemia (Mediterranean anemia) are evaluated.
The subjects varied in age at the time of splenectomy from 1½ to 18½ years and have been followed for 5 months to 28 years since operation. One death occurred at the time of splenectomy, during induction of anesthesia.
All patients, even those who later died, benefited initially from splenectomy. They required fewer transfusions and maintained higher hemoglobin levels subsequently for varying periods of time.
Of the 18 patients, 7 have died; all but 2 of these developed chronic congestive heart failure late in the course of the disease. Pericarditis was suspected in life and proven at necropsy in three subjects. No definite proof of the relationship of splenectomy to the incidence of penicarditis has been shown.
In this small series of patients no significantly increased incidence of severe infection was observed postoperatively.
Lack of Inhibition of Choline Esterase in Serum by Nupercaine in Cystic Fibrosis
Authors: Weber Ione , Hayden George A. , Kim Ih Chin , Barbero Giulio J. 
Published: December 2021

When it was reported1 that a genetic factor was involved in the degree of inhibition of choline esterase activity in the serum by Dibucaine (nupercaine), a study was undertaken to determine whether or not this familial characteristic could be demonstrated in patients with cystic fibrosis and their relatives, as contrasted with the general population.
The ages of the 31 patients with cystic fibrosis ranged from 18 days to 9 years. The relatives comprised: 28 mothers, ages 20 to 49 years; 23 fathers, ages 23 to 54 years; 10 siblings, ages 2½ to 20 years; and 43 other relatives, ages 5 to 72 years.
MORTALITY OF EXCHANGE TRANSFUSION
Authors: Boggs Thomas R. , Westphal Milton C. 
Published: December 2021

We have presented the experience of an exchange transfusion service in performing 1,139 procedures over a 7-year period. The design and practices of this service have been described in order to provide the background necessary for a critical analysis of our results. Since no definition exists for "Mortality of Exchange Transfusion," we have suggested one.
The outstanding features of this experience were:
1. The umbilical vein approach proved to be an extremely easy technique by which to initiate an exchange transfusion.
2. The great majority of the procedures were completed as planned.
3. In all but a very few exchange transfusions, a volume of donor blood at least 1.5 times the infant's blood volume was infused. We could show no correlations between the volume of donor blood employed in an initial procedure and the need for a repeat exchange.
4. Most of our exchange transfusions were completed in less than 1 hour; many in less than 30 minutes. We were unable to demonstrate a higher morbidity or mortality in infants being subjected to a faster as opposed to a slower procedure.
5. The best definition of the mortality rate of exchange transfusion appears to be the number of infants dying during or within 6 hours of a procedure expressed as a percentage of the number of infants transfused and again as a percentage of the number of exchange transfusions performed.
6. The incidence of death during or within 6 hours of an exchange transfusion appeared to be more closely related to an infant's clinical status at the beginning of a procedure then to the procedure itself. Most of the deaths occurred among critically ill infants with Rh-hemolytic disease. Vigorous infants, full-term or premature, regardless of diagnosis, tolerated exchange transfusions well. Our mortality rate in vigorous infants was very low.
HYPOGAMMAGLOBULINEMIA
Authors: Dolan Thomas F. , McCullough Norman B. , Gibson Lewis E. 
Published: December 2021

An unusual patient, characterized by recurrent infections, hepatosplenomegaly, low levels of gamma-globulin in the serum (400 mg/100 ml) and lymphocytosis, is described.
The patient had pneumonia due to Nocardia asteroides followed by chronic Salmonella newport infection of 16 months' duration, kept in check by continuous antibiotic therapy. No antibodies were produced against specific antigenic challenges. The relationship of this case to those of congenital and acquired agammaglobulinemia is discussed.
THE PRACTICE OF PEDIATRICS
Authors:   The Editor
Published: December 2021

Early in 1959 an editorial in Pediatrics (23:253, 1959) entitled "Can the new pediatrics be practiced?" referred to some obstacles facing pediatricians now entering general practice. It seemed that the scope of pediatrics and the knowledge of children had been extended enough in recent years to justify the term new pediatrics, and that these advances were becoming difficult to apply in a hurried general pediatric practice. The question was raised as to whether it was not somewhat urgent to take more deliberate steps to make it easier and more inviting to practice pediatrics as a truly sophisticated specialty—to take cognizance of the improved capabilities of pediatricians and to foster recognition of the comprehensive service they can render when the working conditions are favorable. Furthermore, it was emphasized that there appeared to be need for concern about the future appeal of the practice of pediatrics rather than with the fate of pediatrics as a branch of medical science, and that this distinction was fundamental to intelligent discussion.
Now we have an opportunity to consider the opinions of leaders within the American Academy of Pediatrics in the following series of papers. These were presented at the 1960 Spring Session of the Academy in a panel discussion organized by a prominent official of the Academy to deal with the question posed by the editorial a year previously.
Some of the participants took serious exception to the term new pediatrics. Less seriously, one gains the impression they might have preferred Ye Olde Pediatrics to describe the prevailing practice, to go with their suggestion it simply needs to be made "better."
INTRODUCTORY
Authors: Fischer Carl C. 
Published: December 2021

In A Final act of what I can only interpret as retribution for the tasks imposed upon them, your Program Committee drafted its chairman to set up the concluding program of this session in a form of a panel on the topic, "Can the New Pediatrics be Practiced?"
Fortunately, no restrictions as to content or participants were given and for this, at least, my thanks to the committee.
Periodic episodes of self-examination by various segments of the medical profession have been among the more salutary advances of Medicine for generations, but increasing emphasis upon the change in pediatric practice seems to date back only about 3 years to a Letter to the Editor of the Journal of Pediatrics by Dr. Frank L. Tabrah in December, 1957. This letter quoting an article of the November, 1956 issue of Medical Economics, stated among other things that "1/3 of the pediatricians in practice were dissatisfied" and contained such challenging statements as, "well-babies still frequent the pediatrists' office, but it is inconceivable that any physician with intelligence and interest in the unusual, can long survive the routine of playing grandmother for years on end in a well-baby practice. Few men will knowingly accept such a career—in time the specialty may lose the top quality men it has attracted in past years, pediatric medical office practice is not enough; there are too many private pediatric practices being started today that will be abandoned from sheer boredom." Dr. Tabrah's letter was followed by a reply by one of our panelists, Dr. Lee Hill, and in the same issue by an article entitled "Pediatric Rewards" by Dr. A. H. Parmelle, Sr.
REPORT OF SUBCOMMITTEE ON ACCIDENTAL POISONING
Authors:   Subcommittee on Accidental Poisoning, Press Edward , Adams William C. , Chittenden R. F. , Christian Joseph R. , Grayson Robert , Stewart Colin C. , Everist Bruce W. 
Published: December 2021

BACKGROUND MATERIAL
Boric acid (H3BO3, boracic acid, orthoboric acid) is a colorless and odorless compound occurring as crystals, granules or a white powder. It is usually prepared by action of sulfuric acid on borax (sodium borate).
Boric acid is used medicinally in ophthalmic solutions, and the powder or solution as an acidifying agent in treating the irritation produced by ammonia from the urine in diapers of infants, and in dermatology in ointments either alone or in combination with other medicinal agents. It has also been employed in gargles, mouth washes and as a preservative.
Commercial uses of boric acid are varied, but often include its use in the preparation of face or body powders in which it is added to tale. It is stated that boric acid has a suppressant effect on molds or mildews, or assists in enabling the powder mixtures to flow more freely from the containers.
The usual ointment contains 10% boric acid; the standard medicinal solution contains not less than 4.25% boric acid.
The United States Food and Drug Administration, on January 30, 1954, issued a statement to the effect that borated talcum powder containing 5% or less of boric acid is safe for use as a dusting powder on babies. The implication here is that powder using more than 5% boric acid would not be safe.
Fatalities among adults from the ingestion of boric acid have been reported from as little as 1 teaspoonful of boric acid. Another report indicates that 2 ounces of a 5% solution of boric acid were fatal to an infant.
Tooth Discoloration in Cystic Fibrosis
Authors: Zegarelli E. V. , Denning C. R. , Kutscher A. H. , Tuoti F. , di Sant'Agnese P. A. 
Published: December 2021

In recent years, attention has been focused on grossly observable, often severe discoloration of teeth of a gray-black or brown character in patients with cystic fibrosis of the pancreas. Quite often, this discoloration appears to be localized, but not definitively, to the middle and cervical thirds of the clinical crowns of teeth.
In order to document and analyze data concerning this peculiar tooth discoloration. a study of a group of patients with cystic fibrosis was undertaken.
A PEDIATRIC CLASSIC
Authors: M. C. D. 
Published: December 2021

It is not from a desire to be tantalizing that only three pages of this classic of pediatric investigation are shown here (Figs. 1-3). The title page reveals it was so lengthy a paper (actually 62 pages) that a "Contents" was believed to be necessary. Although the article is based on observations from only four subjects, the studies are known to have extended over 2 years.
The investigations were so thoughtfully planned that they have served as models to subsequent generations of workers in the field. The data are presented within the framework of a clear exposition of concept and subjected to a searching analysis and logical interpretation. It would be a reckless editor who would seek to improve on the characteristic style or dare to strike out a single paragraph.
The first public appearance of one of Gamble's famous diagrams is shown on the page 633 of his paper; that it is the product of his own draftsmanship is easily recognized by those who ever watched him prepare charts for lectures or papers in his laboratory study.
Dr. Gamble was 40 years old when this paper appeared, but it was his first important contribution. There was still time for a long series of equally fundamental papers. Take heart you despondent quartogenerians and stir among the scoffing youngsters!
THE EFFECT OF ALTERATIONS IN EXTRACELLULAR FLUID ON THE COMPOSITION OF CONNECTIVE TISSUE
Authors: Weil William B. , Wallace William M. 
Published: December 2021

Variations in the volume and composition of the extracellular fluid were produced by adrenal insufficiency, dehydration and intraperitoneal perfusion with a chloride-free solution. Direct analysis of blood, skin and tendon were performed to determine the extent to which loose and dense types of connective tissue varied with the changes in the plasma ultrafiltrate. Less than 10% of the sodium and chloride in tissue is associated with connective tissue solids in such a way as not to be readily diffusible.
On the basis of these studies, a structure for connective tissue has been postulated with three divisions: A rapidly-equilibrating phase, a noncellular connective tissue solids phase and an intracellular phase. The noncellular solids, acting as polyelectrolytes, could bind ions to a variable extent depending on acid-base and fluid tonicity changes.
The reduced rate of equilibration of dense connective tissue with extracellular fluid produces a phenomenon which would appear as "storage" in certain situations.
Thus by binding and by delayed equilibria, connective tissue has a small capacity to act as a storage area for extracellular electrolyte, but in general, the fluid and salt of connective tissue is in direct diffusion equilibrium with plasma ultrafiltrate.
THE EFFECT OF POTASSIUM DEFICIENCY ON THE KIDNEY
Authors: Holliday Malcolm A. , Segar William E. , Bright Nancy H. , Egan Thomas 
Published: December 2021

Evidence is presented that the histologic lesion and the defect in urinary concentrating capacity seen in potassium deficiency are a consequence of the potassium deficiency per se and their progression is a function of the duration of the potassium deficiency, not of its severity.
Prolonged potassium deficiency results in irreversible scarring of the kidney and in an irreparable defect in the urinary concentrating capacity.
Dilution of urine in potassium deficiency is minimally impaired at a time when a defect in urinary concentrating capacity is present.
A relation between the histologic lesions in the collecting tubules of the potassium deficient animals and the defect in the urinary concentrating capacity of these animals is discussed.
RELATIONS OF INTRACELLULAR IONS TO METABOLITE SEQUENCES IN MUSCLE IN KWASHIORKOR
Authors: Metcoff Jack , Frenk Silvestre , Antonowicz Irena , Gordillo Gustavo , Lopez Elizabeth 
Published: December 2021

A biopsy was obtained at the time of admission and subsequently from eight children with severe kwashiorkor. The biopsies were analyzed for electrolyte content and for the quantities of certain intermediates (pyruvate, lactate, citrate and alphaketoglutarate). The results in five children who recovered are compared with those from three children who died. Significant reductions occurred in intracellular potassium, phosphate, magnesium and pyruvate, but lactate and alpha-ketoglutarate were increased.
When the intracellular electrolytes were related to a specific intermediary metabolite (on the premise that the ion served as an activator or inhibitor in an enzymatic sequence leading to the production or the utilization of that intermediate) the changes assumed greater significance. A more dynamic interpretation of the data was provided by comparing ion:metabolite ratios of the initial with those of the second biopsy in patients who either recovered or died. Death from kwashiorkor was associated with a marked reversal in the sodium: pyruvate ratio and the apparent inorganic and organic phosphate to pyruvate ratios within the cell. These changes are consistent with some defect in the formation of pyruvate from phosphoenolpyruvate in a potassium-, magnesium-, phosphorus-dependent system. The citrate, magnesium and "true" inorganic phosphate to alphaketoglutarate ratios also were reversed in children who died compared to those who recovered. Such changes indicate a possible inhibition in the usual citric acid cycle pathway along which alpha-ketoglutarate is metabolized.
Preliminary data on concentrations of phosphoenolpyruvate, isocitrate and oxalacetate within the muscle cell and on the activities of pyruvic kinase also are presented.
The data are consistent with the hypothesis that the cellular swelling (in muscle) often characteristic of kwashiorkor leads to reduction in concentration of essential intracellular ions with inhibition of intermediary energy metabolism, thus leading to death. Since intracellular ions may function as activators or inhibitors for specific enzymes, it is suggested that changing quantities of a particular ion may be referred to the quantity of metabolite forming substrate or product of the specific enzymatic sequence. Altered ratios of ions to appropriate metabolites emphasize the possible significance of intracellular electrolytes in the biological system.
Anomalien der Harnwege im Kindesalter und Ihre Chirurgische Behandlung
Authors: McGOVERN JOHN H. 
Published: December 2021

This is a well-illustrated review of various congenital genitourinary anomalies. The details of the urologic investigation as presented in the first chapter would more likely interest radiologists and urologists than pediatricians. Cystourethrography is not sufficiently emphasized. Not only is the examination rather easily performed but abnormalities are frequently so disclosed: for example, 10 to 15% of children with recurrent infection have shown vesicoureteral reflux and hydronephrosis, often when the intravenous pyelogram was normal.
Some of the etiologic concepts suggested are at variance with current knowledge; for example, vesicoureteral reflux is said to be normal under some circumstances; also, megaureter is alleged to be secondary to aganglionic segments of the ureter.
STUDIES ON THE CIRCULATION IN THE NEONATAL PERIOD
Authors: Rudolph A. M. , Drorbaugh J. E. , Auld P. A. M. , Rudolph A. J. , Nadas A. S. , Smith C. A. , Hubbell J. P. 
Published: December 2021

Hemodynamic measurements by means of cardiac catheterization were obtained in 38 infants in the first 30 hours after birth. Nineteen of these infants were considered to have normal circulatory and respiratory systems. Nine had mild respiratory distress, and 10 had severe respiratory distress.
The circulatory systems of infants with mild respiratory distress did not appreciably differ from the normal. Some infants in both these groups showed evidences of patency of the ductus arteriosus with a small left-to-right shunt for the first 10 to 15 hours after birth.
The infants with severe respiratory distress had widely patent ducti, with large left-to-right shunts and, in some instances, right-to-left shunts. The pulmonary arterial and systemic arterial pressures were lower in these infants as compared to the normal and those with mild respiratory symptoms. These characteristics of the severely distressed infants could be related to the disease process, but may be due to prematurity alone.
The possible role of left ventricular failure associated with a large left-to-right ductal shunt is discussed. A generalized lack of vasoconstrictor tone could possibly be responsible for systemic and pulmonary arterial hypotension as well as for the widely patent ductus arteriosus.