bluuebunny/crossref_metadata_2025_split huggingface dataset:
FURTHER OBSERVATIONS ON THE CORRECTED BROMIDE SPACE OF THE NEONATE AND INVESTIGATION OF WATER AND ELECTROLYTE STATUS IN INFANTS BORN OF DIABETIC MOTHERS
Authors: Cheek Donald B. , Maddison T. G. , Malinek M. , Coldbeck J. H. 
Published: December 2021

The present study extends previous observation on the extracellular volume and total body chloride of infants in the neonatal period. It is shown that the decrease in the corrected bromide space is most rapid in postnatal life during the first 2 weeks when 40 ml/kg are lost. By the end of the second week, body weight approaches birth weight. Hence by that time there is a gain of 40 gm/kg, and mainly of protein and cell water. Growth processes are in full progress. The values obtained by other workers for the chloride space of muscle in premature, full-term and 6-month-old infants do not vary considerably from the corrected bromide space for the whole body at these age periods.
Nine infants born around the thirty-sixth week of gestation, and of diabetic mothers, were investigated concerning composition and distribution of water and electrolytes, mainly on the third day of postnatal life. It was found that total water was reduced on a weight basis by 37 ml/kg, and this reduction can be explained on the basis of increased body fat, as demonstrated by other workers. The corrected bromide space (on the basis of weight, not age) was reduced by 50 ml/kg of weight, and it was considered that part of this reduction was not due to body fat increase. As much as 40 ml of water/kg of lean body weight probably shifts from the extracellular to the intracellular phase. There is a reduction of extracellular sodium and chloride in infants born of diabetic mothers. This finding was supported by muscle analysis of one infant who died of the respiratory distress syndrome. No change was found in the plasma osmotic pressure or in the concentrations of sodium and chlorides in plasma. The urea content of plasma was elevated, due perhaps to the reduction in extracellular volume.
UROLOGICAL EMERGENCIES IN NEWBORN INFANTS
Authors: Lattimer John K. , Uson Aurelio C. , Melicow Meyer M. 
Published: December 2021

Children who do not void after birth should be recognized as being in great danger. Where obstructing urinary lesions are found, drainage by nephrostomy is always safer than by a suprapubic cystostomy or a urethral catheter, which is necessarily small, and might lead to lethal sepsis in this situation. The treatment of obstructions of the bladder neck is surgical. Patent urachus may result from obstructions of the bladder outlet. The treatment is surgical and the obstruction should be relieved before the urachus is closed. Children born with deficient abdominal musculature, even when partial, usually have an accompanying severe obstruction of the bladder neck, dilation and infection of the urinary tract. They are also prone to have undescended testes and other extraurinary anomalies, such as club foot. Obstructions must be relieved and a corset prescribed.
Neurogenic bladders in children are troublesome and must be assumed to be present when meningoceles, sacral defects and neurologic deficits of the perineum and legs are found. Urological studies may be deferred, but for a few weeks only. Masses in the abdomen must be considered to be Wilms tumors or sympathocoblastomas until proven otherwise by pyelograms or even exploration. The kidney is by far the most common organ to cause a surgical mass in the abdomen, whether it be enlarged from tumor, cystic disease or hydronephrosis.
The treatment of undescended testes can usually be put off until the age of 5 or 6 years, unless a large hernia is present, whereupon operation can be done at once. A trial of hormone therapy is advised before age 6; if it is unsuccessful, orchidopexy should be done before age 7. Exstrophy of the urinary bladder may now be treated by functional closure in most cases, and every child should be offered at least one good chance at this anatomic restoration, either at birth or at the age of 3 months. Traumatic torsion of the genitalia, if severe, usually requires surgery. The contralateral testis should be fixed in place, to forestall its possible torsion at some future date.
Thromboses of the renal vein with dehydration and omphalitis can be treated hopefully with anticoagulants and chemotherapy and other supporting measure. Surgery may be considered, but is precarious. Salt-losing tendencies in newborn children with congenital adrenogenital syndrome and dehydration can be treated medically and successfully if recognized in time.
Fistulas between rectum and urethra, accompanying imperforate anus, can be treated surgically after the child is several months old and better able to tolerate anesthesia. Masses presenting at the vulva, with or without urinary obstruction, may be prolapsing ureteroceles or imperforate hymens with mucocolpos. Large teratomas are sometimes seen attached to the perineum causing urethral obstruction, and they must be removed.
CLINICAL AND LABORATORY ASPECTS OF THYROID FUNCTION
Authors: Pickering Donald E. 
Published: December 2021

It is an honor to have been selected as a recipient of the E. Mead Johnson Award for Research in Pediatrics; more specifically, for research in thyroid gland function. At mid-century it seemed reasonable to explore quantitatively the role of thyroid in the developing primate and thus, hopefully, to provide a more secure base whereby therapeutic criteria could be ascertained.
The gross effects of thyroid ablation and their general elimination following administration of crude thyroid gland were known before the turn of the century, and thyroxine was identified as the primary thyroid gland hormone and was chemically characterized and synthesized during the first two decades of this century.
At the turn of the century the late Sir William Osler,1 in a classic presentation reviewing sporadic cretinism on this continent, in all optimism made the following statement.
Not the magic wand of Prospero or the brave kiss of the daughter of Hippocrates ever effected such a change as that which we are now enabled to make in these unfortunate victims, doomed heretofore to live in hopeless imbecility, an unspeakable affliction to their parents and to their relatives.
Unfortunately, the optimism expressed in this statement has not come to fruition. Mental retardation remains the most significant sequella of thyroid deficiency in the pediatric age group and is of high incidence in sporadic cretinism, without regard to clinical classification; i.e., whether the dysfunction represents athyrosis or an inborn error of hormonogenesis or is of some other origin.2,3
It has been the opinion of our group, both clinically and experimentally, that most cases of thyroid deficiency are treated too late and with far too little hormone.
BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA
Authors: Clapp Wesley M. , Butterfield L. Joseph , O'Brien Donough 
Published: December 2021

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth.
See Table in the PDF file
THE PHYSICIAN'S CHILDREN AS PATIENTS
Authors: Kennell John H. , Boaz Willard D. 
Published: December 2021

THE LACK OF ATTENTION—in the medical literature—to the care of physicians' families is in sharp contrast to the degree of concern and controversy about this subject. Medical writers may have hesitated, as have the present authors, to report their observations, because of uneasiness about revealing confidential material or their fear that they would seem critical of their colleagues. Because the authors' experience with physicians' children as patients has convinced them that the management of illness and the fostering of health in the families of physicians present very special problems, this report is presented.
The authors have reviewed their experiences with more than 100 physicians' families in preparation for this report. They found deplorable gaps and variations in their records. These difficulties highlight some of the unusual features of medical care for physicians' families. Physicians move frequently while they are in medical school, residency training, fellowships, and military service. There is a great variation among physicians' families in the use they make of their pediatrician and in the frequency of their visits. Some records are distressingly abbreviated because so much of the medical discussion has taken place in corridor consultations.
In this paper names and personal details have been changed to preserve the anonymity of the subjects. The examples come from different cities, states, and countries.
THE PHYSICIAN-FATHER'S ANXIETIES
Every physician, no matter what his training and practice, has accumulated a storehouse of anxieties about disease. These often make minor illnesses take on major significance. The pediatrician must always keep in mind that the physician consulting him about a family health problem may well have many more serious concerns and a higher degree of anxiety than other parents, no matter how well he covers this with jokes.
SHOULD NOT PHYSICIANS' FAMILIES BE ALLOWED THE COMFORT OF PAYING FOR MEDICAL CARE?
Authors: Spock Benjamin M. 
Published: December 2021

THE TRADITION that doctors give care to each other and to each other's families without charge is an ancient and honorable one. It demonstrates in action some of the noble aspirations of man—generosity, loyalty to his profession, pride in service, devotion to an ideal.
Every physician is touched when a colleague turns to him for care. Even the doctors' doctor, who is already carrying an excessive share of such service, feels honored by each new request, for it is a tribute from a particularly discriminating patient.
But this is only one side of the relationship—the donor's. I am convinced that in a majority of medical situations (particularly those in the areas of pediatrics and internal medicine) the recipient physician's family is receiving insufficient care, not through any fault of the donor but because the recipient is so inhibited in asking for it. It is hard to say whether the recipient physician or his wife is in the more uncomfortable spot. The physician, when he or a member of his family develops a symptom, particularly a minor one, is promptly involved in a conflict of feelings. He cannot, unless he is a most unusual person, detach himself emotionally while he takes a history and does a physical examination. His natural anxiety tends to make him vacillate between exaggerating and minimizing the significance of the symptom. From the start he is debating in his mind whether it would be appropriate to call the proper physician. Consciously or unconsciously he is wondering how that colleague would view the request for help.
Prenatal Influences
Authors: REID DUNCAN E. 
Published: December 2021

This book, which comprises a discussion of the factors concerned with fetal development, is written evidently with the design of capturing both medical and lay readers. Hence, some of the statements that appear throughout the book might seem a bit trite and obvious to the physician.
In a somewhat dramatic form, the book opens with a factual account of the development of the conceptus. This is followed by most complete chapters on placental transport and nutrition.
The Consumers Union Report on Family Planning
Authors: RYAN KENNETH J. 
Published: December 2021

This short publication covers the subject of family planning with regard to both the use of contraceptive methods for preventing pregnancy and the infertility evaluation for those who cannot conceive. A short introductory chapter is devoted to a discussion of the physiology of ovulation and fertilization. The material is well organized and reasonably comprehensive for the lay reader. In addition, it is a fair and accurate summary of our present state of knowledge. The book has a pleasing format and is executed with taste.
While this material is suitable for the educated layman, there is, as yet, no completely satisfactory source book for the physician.
Neonatal Hyperphosphatemia
Authors: RAPKIN RICHARD H. 
Published: December 2021

Connelly et al., in their recent article on neonatal hyperphosphatemia (Pediatrics, 30:425, 1962), came to the conclusion that "an effect of the hormone was evident on day three, the clearance of the treated infants being significantly greater than that of the controls. . . ." They go on to say: "The increase in approximately four liters in filtration attributable to hormone effect is quite adequate . . . to explain the entire difference . . . between the phosphate excretion of the treated and control infants. . . ."
I believe that these conclusions cannot be justifiably made from the available data. The creatinine clearance of control infants on day three varies from 6.48 to 30.09 liters/24hours/ 1.73m2, a fivefold variation.
Letters to the Editor
Authors: EICHENWALD HEINZ F. 
Published: December 2021

I have been informed that some objections have been voiced to the recommended space allowance in newborn nurseries of 30 square feet per infant. Since I feel very strongly that 30 square feet represents in fact the minimum safe and efficient space requirement, I believe it might be worthwhile to review the evidence which has led us to this recommendation.
As you know, we were able in the past several years to construct a series of experimental nursery units in which it was possible to conduct controlled observations while the units were in regular use.
Dissatisfaction with Pediatrics
Authors: HUDSON PHOEBE 
Published: December 2021

I cannot resist a letter to you concerning the booklet "Careers in Pediatrics" which was published in The New Physician and sent to members of the Academy.
I am compelled to take issue with the article by Dr. McKay entitled Dissatisfactions With Pediatrics. First of all, I feel the selection of Dr. McKay (a fine fellow and excellent doctor) is wrong. His subject deals with the practice of pediatrics in which he is not engaged—much as he might wish to have us think so. It's always the same.
GROWTH RETARDATION: USE OF SULFATION FACTOR AS A BIOASSAY FOR GROWTH HORMONE
Authors: Kogut Maurice D. , Kaplan S. A. , Shimizu C. S. N. 
Published: December 2021

A bioassay for measurement of human growth hormone based upon the observation that normal human serum, in vitro, will favor the incorporation of S-35 into immature rat cartilage is described. The factor in serum is called "sulfation factor." Sulfation factor determinations were performed on 27 normal children, 15 with hypopituitarism, 26 dwarfs without demonstrable endocrine or other diseases, 11 children with a variety of non-pituitary diseases causing dwarfism, and 1 adult with acromegaly.
The mean activity (± S. E.) of sulfation factor was 0.84 ± 0.057 S. F. units in the normal children, 0.45 ± 0.024 S. F. units in idiopathic hypopituitary patients (p &lt; 0.01), 0.95 ± 0.054 S. F. units in dwarfs without evidence of endocrine or other recognizable diseases, 0.82 ± 0.057 S. F. units in dwarfs with well recognized nonpituitary disease, and 2.2 S. F. units in one adult with acromegaly.
There was an excellent correlation between sulfation factor and other laboratory determinations of pituitary function. Hypophysectomized rats receiving bovine growth hormone showed substantial increase of sulfation factor as compared to control hypophysectomized rats. Sulfation factor activity appears to be a valid and useful indicator of growth hormone activity in serum.
A Philosophy of Infant Feeding
Authors: BARNESS LEWIS A. 
Published: December 2021

This is a delightful book.
In the author's introduction it is stated: "There are so many books on the feeding of infants. Whatever its faults, at least this little book is different." This book is especially different in that infant feeding is covered in a very painless fashion with a minimum of tables and figures. The writing is excellent, and one hardly realizes that he is reading a textbook of fact.
The author uses a paleocentric approach to infant feeding. In his evolutionary study he finds for example, "In modern cultures it is no longer a case of survival of the breast fittest." In addition to many bon mots the book is replete with helpful practical advice.
LEUKEMIC INFILTRATION OF MENINGES AND SPINAL NERVE ROOTS
Authors: Sullivan Margaret P. 
Published: December 2021

Three of 32 children with leukemic infiltration of the central nervous system have shown symptoms caused by involvement of the spinal meninges and nerve roots. The case reports demonstrate the use of radiation and intrathecal chemotherapy in combination and in sequence in management of this complication of leukemia. Intrathecal Methotrexate was used for the meningeal infiltrations and radiation therapy was employed for the infiltrations of the nerve roots and nerves which would be contacted poorly or not at all by intrathecally administered medication. Two of the children showed relief of symptoms caused by involvement of spinal structures. The central nervous system infiltrations of the third child were resistant to therapy.
The incidence of infiltration of spinal meninges and nerve roots is probably higher than indicated by this report. This type of involvement should be suspected in the child who complains of pain in the legs and ceases walking, particularly if there is a previous history of leukemic involvement of the nervous system.
CERVICAL MASSES IN INFANTS AND CHILDREN
Authors: Moussatos George H. , Baffes Thomas G. 
Published: December 2021

Two hundred sixty-seven patients with tumors in the neck, observed at the Children's Memorial Hospital, have been reviewed. Forty-seven of these patients had malignancy. The most common malignancy was lymphosancoma or Hodgkin's disease (20 cases). The highest incidence of malignant degeneration in tumors of a specific organ occurred in the thyroid (50%). The over-all malignancy rate in neck tumors in this series was 15.7%.
This study was undertaken primarily to evaluate clinical patterns and diagnostic methods. It was of great interest to find that tumors of the neck are not as deadly as one might suppose. At least 84% of the lesions were benign and responded well when accepted methods for their treatment were carried out. Moreover, it was fascinating to find that, aside from certain organspecific carcinomas (e.g., thyroid and parotid glands), most cervical neoplasms arose from mesodermal tissues and, when malignant, offered a very poor prognosis. Yet, most lesions arising in the neck manifested themselves before metastasizing beyond the region, so that, if they were localized, surgical excision offered excellent opportunity for adequate containment. Certainly, the backbone of treatment of neck tumors, regardless of type, was surgical ablation, wherever possible.
A few neck tumors were metastatic in nature, but adequate study and evaluation of the patient usually demonstrated the distal primary before operation was undertaken.
Another interesting point, not entirely foolproof but fairly reliable, is the observation that malignant tumors generally were located in the posterior cervical triangle. This applied almost universally, except for lesions in the thyroid gland. Although biopsy is the only way to be certain, it is comforting to have some assurance preoperatively that a solitary mass in the anterior cervical triangle probably is benign. The probability that a cervical tumor is malignant increases in the following order: (1) multiple tumors located in the anterior triangle of the neck; (2) tumors, single or multiple, located in the posterior cervical triangle; (3) multiple tumors located both in the anterior and posterior cervical triangles. Tumors of the thyroid gland represent a class unto themselves. When they are present the malignancy rate is very high, and in this series represented approximately 50%.
VALUE OF LONGITUDINAL STUDIES OF EXERCISE FITNESS TESTS
Authors: Sexton Alan W. 
Published: December 2021

THE TERM "longitudinal study" implies observation or experimentation over a considerable period of time. Just what this period of time will be depends upon the phenomenon and the organism being studied. If, for example, one is interested in the growth rates of long bones in mice, a few months is sufficient. In human beings fifteen to twenty years would not be out of line since, wanting to know how the individual arrives at his ultimate length, one must measure him periodically during his entire growing period. To be worthwhile, therefore, the longitudinal study must be designed to answer questions which cross-sectional data cannot answer.
In order to discuss intelligently the value of longitudinal studies of exercise fitness tests, one must at the outset define what the objectives are in such studies. Consider the following questions:
1. What are the effects of growth, of sex, and of aging on the fitness of the individual?
2. In the absence of conditioning programs, is the level of fitness of an individual a rapidly-changing measurement, or does it demonstrate relative constancy?
3. When conditioning programs are considered, what is the effect of their onset, duration, and cessation on the individual level of fitness?
4. What are the immediate and longterm results of illness on the individual level of fitness?
5. What, if anything, can one say about the effect of fitness levels on the longevity of the individual?
The answers to these and related questions are the principle goals of longitudinal fitness studies. How successfully, then, have such longitudinal studies been carried out?
EFFECT OF AMNIOTIC FLUID ASPIRATION ON THE LUNG AND CIRCULATION
Authors: Colebatch H. J. H. , Halmagyi D. F. J. , Starzecki B. 
Published: December 2021

The administration of 1-2 ml/kg body weight of human amniotic fluid into the trachea of anesthetized sheep caused a gross fall in lung compliance, an increase in resistance to air flow and severe hypoxemia, but only a slight rise in pulmonary arterial pressure. The changes in lung mechanics, and the hypoxemia, were not affected by forced inflation of the lungs; but after atropine sulphate, adrenaline, or aerosol isoproterenol, forced inflation produced marked improvement.
The effects of amniotic fluid aspiration resemble some of the features of the respiratory distress syndrome of the newborn. However, whether sheep amniotic fluid introduced into newborn lamb lungs would have an entirely similar effect remains to be proven.
LAWSON WILKINS 1894-1963
Authors: SCHAFFER ALEXANDER J. 
Published: December 2021

IN THE death of Lawson Wilkins world Pediatrics has lost an outstanding leader. But this is only half the story. Pediatric endocrinology has lost its Dean and one of the builders of its foundations. Pediatric endocrinologists have lost their chief, their adviser, their teacher, and their constant friend. Pediatric practitioners have lost a delightful companion, as well as one who spared no pains to translate for them the complicated language of endocrinology into intelligible and usable clinical information.
Lawson was a scientist, to be sure, but he lived in no ivory tower. He was first and last a warm physician.