bluuebunny/crossref_metadata_2025_split huggingface dataset:
VINCRISTINE IN THE TREATMENT OF ACUTE LEUKEMIA IN CHILDREN
Authors: Heyn Ruth M. , Beatty E. C. , Hammond D. , Louis J. , Pierce M. , Murphy M. L. , Severo N. 
Published: December 2021

Vcr induced complete marrow remission in 43% of children with all types of acute leukemia who were refractory to other antileukemic therapy. The median duration of disease before Vcr treatment was 13.5 months. The marrow response in those patients achieving an A marrow was rapid with a marked clearing of the blasts by 14 days and a complete remission by 28 days. The median duration of complete remission with and without maintenance therapy was 63.5 and 59 days, respectively.
Drug toxicity occurred in about half the patients, limiting the total dose of drug that could be given. Leukopenia, alopecia, gastrointestinal symptoms, and neurotoxicity were the most common problems seen. These were reversible on withdrawal of the drug.
Remissions were not improved by increasing the dose of Vcr to 0.1 mg/kg for two or more doses after 4 doses of 0.075 mg/kg. The reduction in dose necessitated by drug toxicity was not detrimental to a good response since the children attaining complete remissions experienced the greatest number of alterations in dose prior to the onset of remission.
THE PLACENTA
Authors: Dancis Joseph 
Published: December 2021

I AM greatly indebted to the Borden Award Selection Committee for inviting me here today. I am also grateful for the opportunity to acknowledge another debt, the one that I owe to Dr. L. Emmett Holt. Last night was passed pleasantly in the company of several old friends. As has become common on such evenings, our talk turned to Dr. Holt, because all of us there felt that he had exerted a strong influence on the course of our lives. It was Dr. Holt that made it possible for me to enter the field of research, and then provided me with an example of a teacher who is not above being taught, of an inquirer who doesn't resent being questioned, of a tireless worker capable of concentrated effort but with broad interests.
Pleasant as these reminiscences are, I realize that I have been invited here to talk about the placenta, and that is what I intend to do. An occasion such as this offers the speaker the opportunity of summarizing experiences and concepts that have developed over an extended period of preoccupation with a subject. This is particularly pleasurable if one can discern a continuity that spans the years and provides a unifying theme for the countless details and apparently isolated observations involved in research. Now that teleology is becoming more respectable it is no longer quite as improper to seek to interpret experimental results in terms of a harmonious design obeying a logic of selection for survival. It is in that context that I would like to review the results of some of our studies of placental function.
INCREASING PULMONARY VASCULAR RESISTANCE DURING INFANCY IN ASSOCIATION WITH VENTRICULAR SEPTAL DEFECT
Authors: Hoffman Julien I. E. , Rudolph Abraham M. 
Published: December 2021

Three children with big ventricular septal defects, large pulmonary blood flows, and pulmonary hypertension were catheterized at the ages of 3, 6, and 6 months. Pulmonary vascular resistance was low in two and slightly raised in the other. Recatheterization at the ages of 9, 16, and 26 months, respectively, showed increases of pulmonary vascular resistance in all, and the ventricular septal defects were successfully closed by open-heart operation soon thereafter. In the one child who was recatheterized only after there was clinical evidence of a raised pulmonary vascular resistance, postoperative catheterization showed a progressive rise in pulmonary vascular resistance indicating progressive pulmonary vascular disease. The other two children who were clinically well were recatheterized specifically to try and detect early pulmonary vascular changes and, in contrast, in both of these children pulmonary arterial pressures and vascular resistances have returned to normal after operation.
These patients demonstrate that in those at risk of developing pulmonary vascular disease (big ventricular septal defect with high pressures and flows), pulmonary vascular resistance can rise rapidly in early life. In these patients progressive pulmonary vascular disease could be prevented if surgery to lower pulmonary arterial pressure and blood flow is done early enough. Even in patients who appear to be improving, recatheterization is necessary to demonstrate a moderate rise in pulmonary vascular resistance, since a moderate rise is not detectable by current clinical techniques.
VINCRISTINE SULFATE THERAPY IN CHILDREN WITH METASTATIC SOFT TISSUE SARCOMA
Authors: Sutow W. W. , Berry D. H. , Haddy T. B. , Sullivan M. P. , Watkins W. L. , Windmiller Joan 
Published: December 2021

Sixteen children with metastatic or recurrent lesions from soft tissue sarcoma, mostly rhabdomyosarcoma, were treated with vincristine sulfate in a protocol-controlled cooperative study. Complete, though not permanent, regression of tumor occurred in two patients. Significant partial control of disease was achieved in three other children. Gastrointestinal or neurologic side-effects resulted in alteration of drug dosage schedule in 4 of 15 patients. The degree of antitumor activity in several of these cases was such that the further study of the effectiveness of the drug, particularly in combination with surgical and radiation therapy, in children with soft tissue sarcoma seems indicated.
Generic and trade names of drugs: vincristine sulfate—Oncovin; cyclophosphamide—Cytoxan; chlorambucil—Leukeran; dactinomycin—Actinomycin-D.
KERNICTERUS: REVISED CONCEPTS OF PATHOGENESIS AND MANAGEMENT
Authors: DIAMOND IVAN 
Published: December 2021

BILIRUBIN ENCEPHALOPATHY occurs almost exclusively in newborn infants with severe unconjugated hyperbilirubinemia. When these babies succumb to this condition the brain usually shows localized yellow staining (kernicterus) which is due in part to accumulation of unconjugated bilirubin. There is strong circumstantial evidence that bilirubin is responsible for the neuropathologic changes characteristic of kernicterus but the factors governing the entry of the pigment into the central nervous system have long been a matter of speculation.
In the plasma, most of the bilirubin is transported firmly bound to albumin. However, whether the pigment enters the brain bound to albumin or only after being detached from its albumin carrier has not been established.
JEJUNAL BIOPSIES IN INFANT MALNUTRITION: WITH SPECIAL REFERENCE TO MITOTIC INDEX
Authors: Brunser Oscar , Reid Alejandro , Mönckeberg Fernando , Maccioni Alejandro , Contreras Iván 
Published: December 2021

The histological aspect and the mitotic index of jejunal biopsies were studied in 8 normal infants, in 18 marasmic infants, and in 10 infants with kwashiorkor. The mucosa of the marasmic infants was similar to the normal controls, although thinner. In kwashiorkor the mucosa was similar to celiac disease.
In marasmic infants fed on the same diet, the mitotic index is significantly lower in infants who do not show weight increase when compared with those who do increase in weight. In kwashiorkor the mitotic index is closer to, although also significatively lower than, normal.
It is suggested that these differences are due to the low caloric intake in marasmus where the energy supply is not sufficient to maintain the rate of cell proliferation; a hormonal mechanism governed by the pituitary gland is also suggested. In kwashiorkor the histological aspect similar to celiac disease seems to indicate a common pattern of reaction of the jejunal mucosa due to different causes.
DENSITY AND SECRETORY ACTIVITY OF ECCRINE SWEAT GLANDS IN PATIENTS WITH CYSTIC FIBROSIS AND IN HEALTHY CONTROLS
Authors: Huebner Dorothy E. , Lobeck Charles C. , McSherry Nona R. 
Published: December 2021

The number of active sweat glands was observed in patients with cystic fibrosis and healthy, age-matched controls following stimulation of sweating on the inner forearm surface by pilocarpine iontophoresis. Though gland density appeared to be higher and more variable in cystic fibrosis, statistical analysis of this relationship was inconclusive but did not allow a rejection of the hypothesis that patients have higher gland densities at a given age than controls.
The amount of sweat produced in cystic fibrosis was related to the number of active glands; this was not true of controls. The parameter of gland density, added to the previously described sweat test procedure, has allowed calculation of the average sweat output per gland on the forearm. This output increased with increasing age in both controls and patients with cystic fibrosis.
Should Additional Training be Required for Board Certification?
Authors: VAN LEEUWEN G. 
Published: December 2021

As a young academician I hesitate to be critical of the Board of Pediatrics' recommendation that additional training be required for certification. (Pediatrics, 37:861, 1966). The points I wish to raise were certainly discussed and were likely omitted from publication for the sake of brevity.
However, the addition of an entire year of training in problems of behavior, school-life, etc., as recommended, may well be patchwork of old problems rather than insight into the future.
COMMITTEE ON NUTRITION
Authors: LOWE CHARLES U. , COURSIN DAVID B. , HEALD FELIX P. , KAYE ROBERT , O'BRIEN DONOUGH , OWEN GEORGE M. , SCRIVER CHARLES R. , SWEENEY MICHAEL J. 
Published: December 2021

WITH A note of sadness, the Committee on Nutrition of the American Academy of Pediatrics wishes to call to the attention of the membership the death of Robert Ramapatnam Williams. A noted chemist and scientist, Dr. Williams obtained world renown for his work on the isolation, identification, and synthesis of vitamin B1. He died at his home in Summit, New Jersey, in October 1965.
Born in Nellore, India, February 16, 1886, of American missionary parents, he began teaching in the Philippines in 1908 and considered the Islands his second home.
Williams never found time to earn a doctorate, although he attended Ottawa University (Kansas) and the University of Chicago for undergraduate and postgraduate work. He earned a B.S. in 1907 and an M.S. in 1908 and received honorary LL.D. and D.Sc. degrees from numerous universities.
The story of his work with beriberi is one of the most exciting in the field of nutrition. While working in the Philippines in 1910 with the Chemical Division of the Bureau of Science, he became interested in the disease. He assisted in treating an infant dying of beriberi with brown-rice bran syrup. The child's dramatic recovery stirred the synthesis of thiamine chloride. His work culminated in extensive field trials, again in the Philippines, shortly after World War I. For this study, the Bataan peninsula was divided into two parts. In the western area the inhabitants ate plain white rice; those in the eastern area received plain white rice enriched with rice coated with vitamin B1, concentrate. Within weeks the death rate from beriberi dropped dramatically in the eastern area. It remained high in the western area until smugglers began "running in" the treated rice.
PLASMA VOLUME STUDIES IN LOW BIRTH WEIGHT INFANTS
Authors: Cassady George 
Published: December 2021

An average plasma volume of 46.8 ± 7.1 ml/kg and blood volume of 87.9 ± 13.6 ml/kg was found in 69 true premature infants studied during the first 12 hours of life. Respiratory distress syndrome in these infants was not associated with an altered plasma or blood volume. However, the degree of maturity, estimated by either birth weight or gestational age, was found to be inversely related to the plasma volume.
Intra-uterine growth retardation, defined on the basis of disproportionately low birth weight in relation to gestational age, was associated with an elevated average plasma volume (52.0 ± 7.8 ml/kg) during the 4 hours after birth. Despite rapid adjustment of this volume to normal between 4 and 12 hours of age, the average blood volume in this group of infants was significantly elevated (102.0 ± 18.7 ml/kg).
These studies reveal direct, objective and measurable differences between growth-retarded and true premature low birth weight infants and represent an attempt toward more accurate definition and understanding of intra-uterine growth retardation.
Pediatric Practice
Authors: FISCHER CARL C. 
Published: December 2021

The articles by Drs. Bergman, Dassel, and Wedgwood, "Time-Motion Study of Practicing Pediatricians," and by Drs. Breese, Disney, and Talpey, "The Nature of a Small Pediatric Group Practice" as well as Dr. Ross's pertinent commentary on these two reports all attest to the increasing interest in the economic and service aspects of pediatric practice.
Academy Fellows should know that for the past several years the Academy has had a Council on Pediatric Practice created to study such problems and give every possible guidance to our membership in these areas.
CYTOMEGALIC INCLUSION DISEASE OF INFANCY
Authors: Emanuel Irvin , Kenny George E. 
Published: December 2021

Clinical, laboratory, and virological data are presented for a series of seven infants with cytomegalic inclusion virus disease who have milder and more varied clinical features than were found in other series. These babies were born within a 15-month period in the Seattle area.
Only one patient had the typical picture of fulminant neonatal disease. All patients had jaundice which tended to be prolonged, but in most cases this appeared to be associated with mild hemolytic anemia rather than with obstructive hepatitis. Hepatomegaly was seen in six patients and splenomegaly in four. Thrombocytopenic hemorrhagic phenomena occurred in three patients. Two babies had Rh incompatibility associated with obstructive hepatitis, suggesting that cytomegalovirus infection may be an occasional factor in the liver disease in such patients.
These patients have been followed for from 2½ to 19½ months. Six patients have been chronic excretors of virus. One patient has microcephaly and spastic hemiparesis, and another is definitely retarded. There were no cases of choroidoretinitis, intracranial calcifications, or seizure disorders.
FAMILIAL RETICULOENDOTHELIOSIS: CONCURRENCE OF DISEASE IN FIVE SIBLINGS
Authors: Miller Denis R. 
Published: December 2021

A fatal syndrome characterized by failure to thrive, eczema, recurrent skin, ear, and respiratory tract infections, lymphadenopathy hepatosplenomegaly, pulmonary infiltrations, and terminal peripheral pancytopenia and hypergammaglobulinemia is described in a complete sibship of five girls. Histologically, there was diffuse reticulum cell infiltration in the lungs, liver, spleen, lymph nodes, bone marrow, gastrointestinal and genitourinary tracts, and central nervous system. The lymphoid architecture was obliterated and there was a marked plasmacytosis. Death occurred between the ages of 20 months and 4 9/12 years and was associated with pulmonary insufficiency, septicemia, and candidiasis. Attempts to identify an etiologic agent were unsuccessful.
Although similar to other reviewed cases of familial reticuloendotheliosis, the involvement of a complete sibship appears to be a unique occurrence.
Dangers of Hydrogen Peroxide in Enemas or Lavage
Authors: SHAW ANTHONY , DANIS RICHARD 
Published: December 2021

We wish to bring to the attention of pediatricians the danger of using hydrogen peroxide for colon lavage in infants. Since Olim described its use combined with saline, various dilutions ranging from 0.75% to 1.25% have been recommended by increasing numbers of authors for infants who have meconium plug syndrome or those with meconium ileus.
We have seen lethal and near lethal complications resulting from the use of such dilutions of hydrogen peroxide in the small and large bowel of infants, and we have first hand information of similar complications in the hands of other pediatric surgeons.
SUDDEN, UNEXPECTED DEATH IN INFANCY
Authors: Geertinger Preben 
Published: December 2021

THE PROBLEM of sudden, unexpected death in infancy (SUD) has become increasingly important in recent years in forensic medicine. Mortality in infancy from well defined causes has rapidly decreased, and the proportion of SUD of unknown cause has, therefore, been still more evident. Today SUD cannot be considered a problem for forensic medicine only; many other branches of medicine have an interest in this problem.
In the past SUD has been attributed to suffocation by overlaying, by aspiration of vomitus, or by bedclothes. During the last 10 years it has widely been presumed that SUD is due to an overwhelming viral infection. Although much effort has been spent in an attempt to demonstrate the possible viral agent, the results have mainly been negative. Hypogammaglobulinemia as a possible cause of SUD was indicated by Harboe and Gormsen, and more recently it was suggested that SUD results from an anaphylatic reaction to cow's milk inhaled into the larynx or trachea. Many authors have pointed out that SUD might be connected with rickets or some more obscure kind of disorder in the calcium metabolism, and in 1962 Maresch demonstrated a significantly low content of calcium in heart musculature in these infants and presumed that one and the same basal disorder of metabolism might lead to rickets and spasmophilia as well as to SUD.
However different the theories, two facts seem to be generally accepted by all authors in this field. Nearly all claim that SUD is significantly most frequent at the age of about 3 to 4 months.
LIPID METABOLISM IN THE NEWBORN. I. PHOSPHOLIPIDS IN CORD AND MATERNAL SERA
Authors: Zee Paulus 
Published: December 2021

Lecithin, sphingomyelin, lyso-lecithin and cephalins were determined in the cord serum of ten newborns and in the serum of their respective mothers, drawn just prior to their delivery. Significant differences were found in the amount and distribution of serum phospholipids, as well as in the fatty acid pattern of serum lecithins, between newborn and mother.
The findings were interpreted to mean that at parturition a placental barrier exists between maternal and fetal serum phospholipids.
The mothers, at the conclusion of their pregnancy, showed characteristic differences in their serum phospholipid concentrations and in the fatty acid distribution of serum lecithin from non-pregnant women.
SKIN INFECTIONS AND ACUTE NEPHRITIS IN AMERICAN INDIAN CHILDREN
Authors: Anthony Bascom F. , Perlman Lawrence V. , Wannamaker Lewis W. 
Published: December 2021

Serial observations were obtained over an 18-month period of 270 Indian children with pyoderma. Beta-hemolytic streptococci, predominantly group A, and coagulasepositive staphylococci were recovered from the majority of lesions (80% and 70%, respectively), both on the initial and on subsequent cultures. The predominant agglutination patterns of streptococcal strains were similar to those described in other studies of superficial skin infections. Another agglutination pattern, 17/23/47, not previously observed to be prevalent in streptococci from skin lesions, was identified in a significant number of skin cultures. In addition, the hitherto undescribed association of M-types, including type 41 and a new M-type, with strains of T-agglutination pattern 3/13/B3264 was found. In striking contrast to the streptococcal strains, established "impetigo" strains of Staph. aureus (type 71 or other group II strains) were in the minority. Throat cultures of children with pyoderma suggested a limited relationship between infection or colonization of the pharynx and infection of the skin, while nasal streptococci were more closely correlated with and possibly derived from the flora of the skin lesions. Titers of ASO were not often elevated over control values in children with pyoderma, while anti-DNAse B titers were more commonly increased.
Group A streptococci isolated from skin lesions prior to or at the time acute nephritis was recognized included type 12 (M and T) and strains classified by T-agglutination as 5/27/44, 11 and 4. The role of infection or colonization of the upper respiratory tract in the relationship of pyoderma to nephritis was not clarified in these studies. Moreover, in view of the frequency of change of group A streptococcal strains in skin lesions, as shown in serial observations in this study, the nephritogenic significance of streptococci recovered from skin lesions at the time of recognition of nephritis must remain in some doubt. Questions concerning the pathogenesis of endemic nephritis associated with pyoderma can probably be most reliably answered by frequent, prospective observations of a normal population with significant occurrence of streptococcal skin infections.
IN UTERO EXPOSURE TO THE HIROSHIMA ATOMIC BOMB
Authors: Wood James W. , Johnson Kenneth G. , Omori Yoshiaki 
Published: December 2021

A study was made by Miller in 1954 of children who were in utero and within 2,200 meters from the hypocenter at the time of the atomic bomb in Hiroshima. These earlier observations have with few exceptions been validated by this follow-up of the subjects at 20 years of age and the value and accuracy of clinical evaluation in early childhood is clearly indicated. The following conclusions are made.
Both small head size (circumference minus 2 SD or more) and mental retardation are most closely related to (1) maternal exposure within 1,500 meters from the hypocenter, and (2) a gestational age of less than 15 weeks.
The heads of infants with either small or normal circumferences at birth increase thereafter in circumference at the same rate and stop growing at the same age, thereby maintaining the same size relationships throughout childhood into adult life.
Mortality in the mentally retarded group as a whole exceeds mortality in normal children. For the group of all subjects exposed within 1,500 meters the mortality rate is higher than for the subjects located beyond 1,500 meters.
Spinal Fluid Glucose in Neonatal Meningitis
Authors: NOGEN ALAN G. 
Published: December 2021

Drs. Winterbauer, Fortuine, and Eickhoff detail under "Experience and Reason" in the October issue two patients in whom Group B streptococci were isolated from spinal fluid.
In the second patient they note a spinal fluid protein of 24.5 mg/100 cc while the glucose is 79 mg/100 cc. Are these values reversed or was a glucose infusion running? If these values are correct, I would appreciate a comment by the authors.