bluuebunny/crossref_metadata_2025_split huggingface dataset:
DELAYED EFFECTS OCCURRING WITHIN THE FIRST DECADE AFTER EXPOSURE OF YOUNG INDIVIDUALS TO THE HIROSHIMA ATOMIC BOMB
Authors: Miller Robert W. 
Published: December 2021

Thirty-three children who were exposed while in utero to the Hiroshima atomic bomb have head circumferences 2 or more standard deviations below normal. Twenty-four of these were between the seventh and fifteenth week of gestational age at the time of detonation of the bomb. The incidence and the severity of microcephaly increases as the distance from the hypocenter decreases. Mental retardation occurred in 15 of the 33 patients. The incidence of this defect was also related to distance from the hypocenter and gestational age. No other embryologic effects of exposure to the atomic bomb have been detected to date.
In 6 years ending in December, 1954, 19 persons who were within 2100 meters of the hypocenter have developed leukemia before attaining the age of 19 years. The annual incidence of this disease among those who were within 1500 meters and who were younger than 10 years of age at the time of exposure is 1:1000.
There are no cataracts that impair vision among the present pediatric group. An increased incidence of a mild visual disability, the cause of which is thus far indefinite, has been found among those now 16 through 19 years of age who were within 1800 meters of the bomb center. The incidence of chronic otitis media is the same for the 2 exposure groups, as are the means of the hematologic values for the patients with this ailment. There is no increase in the tumor incidence of the exposed children as compared with the nonexposed. There are no data to prove it, but the impression is that among the survivors the fear of late effects may be common and potentially disabling. Of those 19 years of age and younger, there were 2771 within 3000 meters of the hypocenter at the time of detonation of the bomb who were examined in 1954. Twenty-four of these had sequelae of the blast or thermal effects of the bomb other than well-healed scars. No other abnormalities related to atomic bomb exposure have been identified.
The review of the literature and the data presented in this report describe the late effects of exposure of young subjects to ionizing radiation or to nuclear weapons as known in the early part of 1955. The new information may be useful in the further definition of the tolerance of humans to ionizing radiation.
CURRENT PROBLEMS IN DIABETES
Authors: Klein R. , Laron Z. 
Published: December 2021

THE PREVENTION of the vascular disease accompanying long-term diabetes mellitus is the most important problem in diabetes at the present time. The importance of this problem is dramatized by the following statistics from the Metropolitan Life Insurance Company Policy Holder Statistics and those of the Joslin Clinic for 1954. Diabetic coma accounted for 4.8% of all deaths in diabetic patients among the Metropolitan Life Insurance Company policy holders and 0.7% amongst the deaths of diabetics in the Joslin Clinic group. Eighty-three per cent of the deaths in diabetics in the Metropolitan Life Insurance Company group were due to vascular changes. The comparable figure for the Joslin Clinic group is 72%. Table I shows the figures in tabular form. It has been shown that, whatever other factors there may be in the causation of the vascular components of diabetes, these degenerative manifestations do increase with increasing length of survival with diabetes mellitus. There seems to be general agreement on this fact. Therefore, [SEE TABLE I IN SOURCE PDF.] the increase in vascular manifestations associated with diabetes would be expected in association with the decline of deaths from coma and the survival of diabetics for an appreciable period of time.
The emotionalism aroused in the proponents of the various regimens to prevent vascular changes in diabetes mellitus makes it difficult to ascertain the facts about this problem but at the same time emphasizes its importance.
An impartial review is needed of what is known about the etiology and prevention of these dread manifestations of diabetes mellitus. That is the main purpose of this article. To do this properly will require consideration of many factors related to the disease.
THE PEDIATRICIAN AND THE PUBLIC
Authors: de Silva C. C. 
Published: December 2021

Ceylon is a small island, the economy of which is almost wholly agricultural based as it is on tea, rubber and coconut. It grows only half its requirements of its staple food, rice, and hence its rapidly growing population gives great cause for anxiety. The state of child health of such a country, where the per capita income is less than $100 a year, is naturally related very closely to the general economic standard of the nation and this is dependent largely on the population pressure. Unless we can increase our wealth by increasing production and productivity by opening virgin land, of which there are 3¼ million acres, and by industrialization, our standards will go down rather than up. Since independence in 1948, however, in spite of a rapidly growing population, one can say that the standard of living has risen, except among the underemployed and unemployed section of the urban dwellers who comprise 15% of the total population. This is reflected by the rise in the expectation of life at birth which was 42.8 years in 1946 to 59.3 years in 1954, and the marked lowering of the infant mortality rate which has already been referred to.
A very large proportion of deaths in children occur from acute disorders such as nutritional deficiencies, pneumonias and diarrheas. Nearly two-thirds of the total deaths in the hospital are caused by such preventable illnesses. Forty-five per cent of the total deaths occur in children under 5 years and 49% under 10 years. Quite apart from any superior consideration, this is sheer economic waste because such a high proportion of our man power dies before any measure of productivity can be achieved. For this reason, if for no other, the state must provide more care to the forgotten generation of children between the ages of 1 and 5 years.
Though environmental sanitation is important, and should by no means be neglected, it appears that as far as children are concerned nutrition must receive first priority in any public health measures. Until we can increase the consumption of more calories, more protein and more vitamins A and B, it is futile to expect much improvement in the present state of child health in Ceylon. This is not merely an economic problem but needs attack at the educational, social and cultural levels.
Though the number of admissions to the Children's Hospital, Colombo, has increased rapidly year by year, the fatality rates for almost every common condition have fallen equally, and in some instances more rapidly. There is, therefore, reason for happiness as well as for tears, for hope as well as for depression but not for despair.
CONGENITAL DEFECTS OF THE LYMPHATICS IN INFANCY
Authors: McKendry J. B. J. , Lindsay W. K. , Gerstein M. C. 
Published: December 2021

Congenital defects of lymphatics in infancy are manifested by chylous ascites, chylothorax and lymphedema.
One case of congenital chylous ascites and two cases of congenital chylothorax, are added to the literature. Eight cases of [See FIG. 11. in Source Pdf.] congenital lymphedema are reviewed from the hospital records with a follow-up study.
No mention of combinations of these manifestations was found in the literature. A case report of chylous ascites with lymphedema is presented and some experimental work is presented in a case of lymphedema with chylous ascites and chylothorax.
Numerous large lymphatic spaces were present in the intestinal mesentery, serosa and bowel villi. The subcutaneous tissues of the involved limbs showed many dilated lymphatic channels. The uninvolved limbs showed similar, but less extensive, changes.
The pathologic picture is one of multiple dilated lymphatic channels, with failure of peripheral channels to communicate with the larger lymphatics.
Experimental evidence is provided to show that the chyle in the thoracic and abdominal cavities can be explained by a back pressure phenomenon of parietal and visceral lymphatics rather than small breaks in the thoracic duct which we were unable to demonstrate.
In the past, hypoplasia and absence of the thoracic duct, has been postulated in cases of chylothorax. This work does not support that view.
PHEOCHROMOCYTOMA IN CHILDREN
Authors: Cone Thomas E. , Allen Marvin S. , Pearson Howard A. 
Published: December 2021

Three additional children under 12 years of age with functionally active pheochromocytomas are presented.
These three children are of further interest becaues of the familial nature of the pheochromocytomas.
Two of the cases are the first to be reported in sisters less than 10 years of age.
These two sisters demonstrate that children may have multiple pheochromocytomas, located both within the abdomen and in the chest. The older of the two sisters had an intrathoracic pheochromocytoma as well as pheochromocytomas of both adrenal glands. The younger sister had a pheochromocytoma of the right adrenal gland and another in the region of the aortic bifurcation.
Of striking interest was the finding of bilateral pheochromocytomas in the mother of the two girls. This is the first report in which a mother and her children had functionally active pheochromocytomas.
The literature is reviewed and the characteristics of these tumors as well as the laboratory diagnosis are discussed.
HEMOPHILUS INFLUENZAE TYPE b CELLULITIS
Authors: Green Morris , Fousek Mildred D. 
Published: December 2021

Six cases of cellulitis associated with infections due to H. influenzae type b are reported. In four instances the etiologic relationship was proved by blood cultures while in the other two cases the etiologic relationship was suggestive.
Cellulitis of the face due to H. influenzae type b presents a characteristic clinical picture which should suggest the possibility of this specific etiology.
EFFECT OF PENICILLINS V AND G ON CARRIERS OF VARIOUS GROUPS OF STREPTOCOCCI IN A CHILDREN'S HOME
Authors: Wehrle Paul F. , Feldman Harry A. , Kuroda Kenzo 
Published: December 2021

Penicillin V satisfactorily eliminated Group A streptococci from the nasopharynx of carriers when used in a total daily oral dose of 400,000 units administered in two divided doses, morning and evening during a 10-day period. Half this dose for a similar 10-day period was considerably less effective. These results were entirely comparable with those observed with penicillin G administered in single or double doses of 250,000 units daily for 10- day periods under the conditions of this study.
The need for daily doses of at least 400,000 units of penicillin V or 500,000 units of penicillin G for effective eradication of streptococci from carriers has been demonstrated.
A high incidence of infection with streptococci of Group G was observed but did not appear to be associated with clinical disease. No increased prevalence of Group G organisms was apparent among any age group or in any of the apartments studied in contrast with Group A infections.
NEUROLOGIC MANIFESTATIONS OF LEUKEMIA
Authors: Gilbert Enid F. , Rice E. Clarence 
Published: December 2021

Three cases of acute lymphocytic leukemia with neurologic manifestations are presented in which the clinical signs, together with the findings in the spinal fluid, closely resembled those of acute bacterial meningitis.
Review of the literature reveals an infrequent occurrence of neurologic symptoms in leukemia. When present, they usually represent a terminal phenomenon.
The occurrence of a low content of sugar in the cerebrospinal fluid in association with meningeal infiltration of the brain in patients with leukemia has been reported. The relation of this phenomenon to the glycolytic activity of leukemic cells is discussed.
CONCENTRATION OF PYRUVIC ACID IN THE BLOOD OF THE NEWBORN INFANT
Authors: Gonzales Romulo F. , Gardner Lytt I. 
Published: December 2021

THERE are several aspects of carbohydrate metabolism in the newborn infant which are peculiar to that age group. The normal, full-term newborn exhibits concentrations of glucose in the blood between 15 and 120 mg/100 ml.1 Concentration of glycogen in the liver may be as high as 10 gm/100 gm wet-weight immediately after birth and then there is a precipitous decrease.2 There is a relative resistance of the fetus and newborn to anoxia.3-4 This phenomenon has been attributed to the preponderance of anaerobic over aerobic metabolism in the tissues of the newborn.5 Further data seemed desirable concerning the concentrations of intermediates in the blood, other than glucose, in the carbohydrate metabolism of the newborn.
Accordingly a study was made of the normal concentration of pyruvic acid in the newborn for the first 5 days of life. Data on concentration of pyruvic acid in the blood have also been obtained in normal adults, pregnant and parturient women, and on venous and arterial blood from the umbilical cord.
PATIENT MATERIAL AND METHODS
The control or normal adult group was predominantly composed of white females and consisted of hospital employees and student nurses in the reproductive age period. Previous studies by others showed no significant difference between males and females6 or between whites and Negroes.7 The controls were divided into a group which supplied venous blood and another group which supplied capillary blood. Minimal squeezing proximal to the site of puncture was applied during all collections. The group of pregnant women consisted of both private and clinic patients, while the parturient group consisted of clinic patients only.
GRANULAR CELL MYOBLASTOMA IN CHILDHOOD
Authors: Bishop Harry C. , Wagner Bernard M. 
Published: December 2021

The granular cell myoblastoma is a rare tumor of childhood with only 10 cases previously reported. The occurrence of the tumor in the vulva of a 6-year-old child is presented.
No authentic case of this tumor in its malignant form has been recorded in childhood. The granular cell myoblastoma should be considered in the differential diagnosis of soft tissue tumors in children and offers an excellent prognosis.
STUDIES OF THE PHARYNX
Authors: Bosma James F. 
Published: December 2021

THE INCREASING relative and absolute incidence of bulbar poliomyelitis1-34 has provided a valuable opportunity for the study of neurologic impairment of the pharynx. The varied distribution of impairment within the musculature of the area of the pharynx is appropriate to the typical pathologic finding in this disease of discrete and focal necrosis irregularly distributed in nuclear areas.21 This variety of impairments has been utilized to evaluate the contribution of specific elements of the musculature in this area to its general motor performance. Over the period of the past 7 years, a succession of patients having poliomyelitic disability in the area of the pharynx has been observed clinically, with supplementary cinema studies of the visible pharynx and the external neck27 and fluoroscopic and rapid-sequential roentgenographic studies, in which visualization of the pharynx was facilitated by radiopaque media. A useful classification of poliomyelitic impairments of the pharynx has been derived, with recognition of the compensatory and alternative maneuvers which they invoke.
This report is particularly concerned with related impairments of swallow and of speech which results from deficient motor control of the oropharyngeal and the palatopharyngeal orifices. The observations are related to general anatomic, physiologic, and neurologic studies of the pharynx.35 Normal motor function of the lower pharynx and function impaired by poliomyelitis are considered in a succeeding report.36
PATIENT MATERIAL
The normal subjects include 9 children, 7 to 13 years of age, and 11 young male adults, in each of which subject an examination of the area of mouth, pharynx, and neck was performed to obviate anatomic and neurologic abnormality.
HEREDITARY AND ENVIRONMENTAL FACTORS IN THE PATHOGENESIS OF RHEUMATIC FEVER
Authors: Diamond Eugene F. 
Published: December 2021

A study of cases of rheumatic fever admitted to La Rabida Sanitarium over a 5-year period was carried out to evaluate heredity and environment as etiologic factors in rheumatic disease. The incidence of rheumatic fever was shown to be higher in families where one or both parents were known to have a positive family history of rheumatic fever. The incidence of rheumatic fever was compared in environmental groups. A totally unfavorable environment was shown to increase the incidence of rheumatic fever. No single unfavorable environmental factor changed the incidence of rheumatic fever.
The incidence of rheumatic fever in each environmental group was higher when there was a positive family history for rheumatic fever, indicating an hereditary factor in the family incidence of rheumatic fever. Analysis of the various mating types in the families with a positive rheumatic trait was carried out. Agreement with a simple autosomal recessive gene inheritance was obtained in families where both parents had a definite family history, but no agreement was obtained in cases where only one parent gave a positive family history.
IMMUNOLOGIC AND BIOCHEMICAL STUDIES IN INFANTS AND CHILDREN WITH SPECIAL REFERENCE TO RHEUMATIC FEVER
Authors: WILSON MAY G. 
Published: December 2021

CERTAIN individuals are more susceptible than others to many conditions. In recent years it has become clear that in rheumatic fever, susceptibility of the host is an important factor in the pathogenesis of the disease. It was concluded from genetic and epidemiologic studies that susceptibility to rheumatic fever is on a genetic and age basis. Although the susceptible child cannot be identified at the present time, the number of children expected to be susceptible in a group of families of known genotype may be determined on the basis of recessive inheritance. It may, therefore, be postulated that distributed among a group of families of known hereditary background are children who are susceptible and insusceptible to the acquisition of rheumatic fever.
As a direct result of long term observation of rheumatic families over a period of 30 years, a second generation of children of known hereditary background is available to us for exploratory studies. This group includes children from families in which one or both parents are rheumatic, or in which neither parent is rheumatic. In this group there are normal (insusceptible), susceptible and rheumatic children.
The nature of the hereditable factors which may be responsible for susceptibility is obscure. Recent advances in biochemical genetics have provocative implications in rheumatic fever. Of particular interest are the observations which demonstrate that such biochemical reactions as enzyme and protein specificities are gene determined.
As a working hypothesis it seemed reasonable to postulate that in a susceptible child, abnormal physiologic, chemical, immunologic or hormonal responses might be found.
Differences might then be observed in certain reactions between the normal group and a group containing a high proportion of genetically susceptible children.
This approach does not conflict with the concept that exogenous factors, irrespective of their nature, may also be operative. If the nature of the endogenous factors were known, the role of possible exogenous agents would be clarified.
THE RESPONSE OF YOUNG INFANTS TO INGESTION OF AMMONIUM CHLORIDE
Authors: GORDON HARRY H. , MCNAMARA HELEN , BENJAMIN HELEN R. 
Published: December 2021

The results of observations of the effect of ingestion of ammonium chloride on the acid-base excretion of three premature and three full term infants are presented. Two of the three premature infants showed a definitely diminished ammonia and increased sodium excretion as compared with the full term infants. The results suggest that some premature infants may have a renal tubular disability.
One of the two infants with diminished ammonia formation and the third premature infant, the two smallest in the series, became listless, refused their feedings, and developed depressed fontanelles and diminished elasticity of the skin. This could not be correlated with changes in serum CO2 content or chlorides or with the presence or absence of an adequate urinary formation of ammonia and conservation of sodium. Since the infants who became dehydrated gained weight while doing so, shifts of water and electrolytes from extracellular to vascular or intracellular compartments must have occurred. It is suggested that the tendency of young infants to disturbances of acidbase balance may be conditioned by disabilities in intracellular metabolism as well as by renal dysfunction.
The implications of the limitations and variability in homeostasis for therapy are discussed.
Special ReportFROM THE COMMITTEE ON SCHOOL HEALTH AND THE COMMITTEE ON RHEUMATIC FEVER
Authors:   Committee on School Health,   Committee on Rheumatic Fever
Published: December 2021

This joint report of the Committees on School Health and Rheumatic Fever of the American Academy of Pediatrics has been prepared as a guide to school authorities in determining what can be done about this disease through the schools.
The school occupies a unique position in relation to rheumatic fever control. Rheumatic fever causes more deaths than any other disease in children of school age. A first attack usually occurs in children at the age when they are in the first or second grade and recurrences are most common up to the age when children are leaving high school. The insidious onset of so many cases during the school years suggests that teachers and others in daily contact with school children should be aware of early signs and symptoms which may mean acute rheumatic fever.
The periodic school health examination when done hastily without removal of clothing may miss children with rheumatic heart disease. On the other hand, children may be labeled with the diagnosis of a rheumatic heart because a heart murmur Was wrongly interpreted. This serves to emphasize the opportunities as well as the difficulties of discovering rheumatic fever and rheumatic heart disease in school children.
Improvement of School Medical Procedures
The American Academy of Pediatrics believes the problem of what to do about rheumatic fever through the schools is an integral part of what should be done about the health of all school children. The following recommendations, while pointed towards case-finding and health supervision of the rheumatic child, will, if applied, lead to better health service for all school children.
The periodic school medical examination should be improved:
1. By obtaining a health history of the child from the parent and the teacher, if possible, at the time of the child's examination.
2. By being performed without haste and with the child disrobed.
3. By the employment of physicians trained in pediatrics, if possible. Where this is not feasible, arrangements should be made for giving physicians who make school medical examinations additional clinical training in normal child growth and development as well as in children's medical problems including rheumatic fever and heart disease.
4. By allowing time for the physicians to plan with the nurse and parent for medical attention. The examination is then more likely to be of greater aid in getting medical care for school children who need it.