bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL CONFERENCE
Authors: Wolff James A. 
Published: December 2021

Dr. Wolfe: I shall discuss two cases of methemoglobinemia which we have seen in the past 2 years produced by the application of benzocaine ointment. These are, as far as I have determined, the first reported cases of methemoglobinemia due to benzocaine (ethyl aminobenzoate), and indeed the first cases of methemoglobinemia due to the application of an ointment.
The first of these patients was admitted in 1954 at the age of 7 weeks. Birth and neonatal history were normal. Eczema began at the age of 4½ weeks. The baby was treated with a variety of ointments and dietary changes without improvement.
The infant was admitted to the Babies Hospital at 7½ weeks of age on the day the parents had been given an ointment, which they were told contained coal tar. At 7 o'clock that evening the ointment was applied widely to the baby's skin. Approximately 45 minutes later the mother heard the baby screaming. On entering the infant's room she found that the color of his skin was black. She rushed the baby to the hospital where the diagnosis of methemoglobinemia was suggested. Blood was obtained and was found to appear chocolate brown. The baby was given 3 ml of a 1% solution of methylene blue, intravenously. This brought about a prompt change in the color; within 10 minutes the baby was no longer cyanotic.
Marked tremors had been noted on admission. These continued throughout most of the evening but by the next morning had entirely disappeared. The baby was discharged home the following morning without further laboratory investigation. Neither the concentration of methemoglobin in the blood nor any other laboratory data were obtained.
SOLITARY TUBERCULOMA OF THE MEDULLA OBLONGATA
Authors: Tegeris Andrew S. 
Published: December 2021

The incidence and clinical manifestations of intracranial tuberculomata are discussed, with special reference to those in the medulla oblongata.
A case of tuberculoma in the medulla is presented. The tuberculoma is believed to have resulted from hematogenous dissemination of tubercle bacilli from the right lung.
The pathogenesis, pathology, complications and course of intracranial tuberculomata are reviewed.
EXTRACORTICAL CEREBROSPINAL FLUID IN NORMAL HUMAN FETUSES
Authors: Lanman Jonathan T. , Partanen Yjrö , Ullberg Sven , Lind John 
Published: December 2021

A layer of cerebrospinal fluid surrounds the developing brain of normal human fetuses. The layer was found to occupy 13 to 26% of the intracranial space. Convolutions appeared in the hemispheres while this layer was still present.
Neither growth of the skull nor the appearance of cortical convolutions is secondary to pressure from growth of the brain into a confined cranial space.
THE ISLETS OF LANGERHANS IN PANCREATIC FIBROSIS
Authors: Larsson Yngve 
Published: December 2021

A survey is given of earlier views on the occurrence of diabetes and decreased glucose tolerance in cystic fibrosis of the pancreas, as well as on the structure of the islet tissue in this disease and in experimental fibrosis of the pancreas.
Intravenous glucose tolerance tests were performed in three patients with cystic fibrosis. of the pancreas, and normal glucose tolerance curves obtained.
Fibrosis of the pancreas was produced experimentally in rabbits by ligation of the pancreatic duct. In eight of nine such animals, the glucose tolerance was normal. Histologically, the pancreas exhibited total acinar atrophy, with cystic dilatation of the ducts, between which numerous small islets of Langerhans of fetal type were compressed. The general picture was similar to that seen in the fetus and in cystic fibrosis of the pancreas. Quantitative determinations of the islet volume showed a great reduction in size of the islet tissue, due chiefly to a marked decrease in area of the individual islets. The alpha-to-beta cell relations were, however, normal.
The results are discussed, and compared with those in alloxan-diabetic animals and with animals with experimentally produced hypertrophy of the pancreas. In the latter the islet tissue hypertrophies as well (Fig. 7).
The prenatal relations between the exocrine and endocrine tissues of the pancreas may also exist postnatally. The resistance to the diabetogenic effect of alloxan present in animals with the pancreatic duct ligated seems to be associated with the immature, fetal structure of the islet tissue in acinar fibrosis.
MINOR MOTOR EPILEPSY
Authors: Livingston Samuel , Eisner Victor , Pauli Lydia 
Published: December 2021

The diagnosis, treatment and prognosis of minor motor epilepsy, based on study of 698 children, are discussed; 622 were followed for intervals ranging from 3 to 22 years.
Minor motor seizures begin most often between 3 and 12 months of age.
Brain damage is prominent in the general clinical manifestations of patients with minor motor epilepsy.
Hypsarhythmic abnormalities are present in the electroencephalograms of most patients.
Minor motor seizures rarely recur after 5 or 6 years of age.
These spells are exceedingly difficult to control with anticonvulsant drugs. A ketogenic diet is the most effective therapy.
The most serious aspect of minor motor epilepsy is the associated mental retardation.
Presumptive etiologic factors are discussed.
CHRONIC ASTHMA IN CHILDHOOD: DOUBLE-BLIND CONTROLLED STUDY OF TREATMENT WITH GAMMA-GLOBULIN
Authors: Abernathy Rosalind S. , Strem Edward L. , Good Robert A. 
Published: December 2021

To evaluate the effect of injections of gamma-globulin upon the course of asthma, observations were made with 22 asthmatic children ranging in age from 1½ to 5½ years. They had suffered from asthma from 1 to 13 years and were selected as subjects because they had not made satisfactory improvement under allergic management over an average of 2.4 years. They were placed in two groups by random assignment, one of which received injections of gamma-globulin.
Without knowledge of the treatment being given, one author examined each child at the time of each injection and one month after the last injection. Roentgenograms, vital capacity, complete blood counts and chemical determination of the blood proteins were performed at the initial and final visits.
Fifteen of the twenty-two patients improved clinically, eight in the treatment group and seven in the control group. No significant differences between the groups were noted in the amount of asthma, physical growth, hemoglobin value or eosinophilia. The concentration of gamma-globulin in the serum increased in the treated patients. Nevertheless, there was no difference in the incidence of infection in the two groups and in both it was equal to that in a normal population.
This double-blind controlled study offers no evidence to support the view that treatment with gamma-globulin has a beneficial effect on the course of chronic asthma in children.
PUBLIC HEALTH, NURSING, MEDICAL SOCIAL WORK
Authors: James J. A. 
Published: December 2021

A study has been made of the number of deaths and admissions to the hospital of similar groups of premature and full-term Negro infants between 1 and 24 months of age. About twice as many ex-prematures died or required admission to the hospital; in this population ex-prematures may account for 25% of admissions during the first 2 years of life. Lower respiratory tract infections and diarrheal disease accounted for the majority of admissions to the hospital and deaths. Illness was commoner in babies of low birth weight, and in those under 6 months of age.
It seems probable that more intensive surveillance of the premature infant after discharge from the nursery might decrease this high incidence of sickness. Special attention should be paid to the early detection and treatment of infections, which are the principal cause of major illness. Some possible lines of approach to the investigation of this problem are discussed.
STUDIES ON THE BIOCHEMISTRY OF CONNECTIVE TISSUE
Authors: Dorfman Albert 
Published: December 2021

The nature and diversity of acid mucopolysaccharides of connective tissue have been discussed. It is probable that these substances play a variety of physiologic roles.
Insulin affects the rate of synthesis of acid mucopolysaccharides in skin. There is a striking decrease in concentration in the skin of diabetic animals. This is restored toward normal by the administration of insulin.
Acid mucopolysaccharides are excreted in the urine of patients with Hurler syndrome. At least two different polysaccharides are involved. The amount of each in the tissues and urine vary in different patients.
BACTERIAL ENDOCARDITIS IN CHILDREN WITH HEART DISEASE
Authors: Cutler Joseph G. , Ongley Patrick A. , Shwachman Harry , Massell Benedict F. , Nadas Alexander S. 
Published: December 2021

A series of 24 cases of bacterial endocarditis occurring in younger individuals, with either congenital or rheumatic heart disease, is presented. A recovery rate of 83% was obtained.
The clinical features, bacteriology and therapy are discussed along with complicating factors arising during therapy.
In the group with cyanotic congenital heart disease, bacterial endocarditis occurred most commonly in those with tetralogy of Fallot. In the acyanotic group there was a slight predominance of those with ventricular septal defect and coarctation of the aorta. In the patients with rheumatic heart disease, mitral insufficiency was the predominant lesion.
PRIMARY XANTHOMA TUBEROSUM IN CHILDREN
Authors: McCleary Jack E. , Brunsting Louis A. , Kennedy Roger L. J. 
Published: December 2021

A brief classification of xanthomatoses is presented. In an attempt to remove some of the confusion contributed by the several different meanings for the term "hyperlipemia," the term "hyperneutralipemia" is introduced to indicate an elevation of the concentrations of neutral fat in the serum. The term "hyperlipemia" is retained to mean an elevation of values for any of the blood lipids. The term "primary xanthoma tuberosum" designates the classic idiopathic form of xanthoma tuberosum associated with hypercholesteremia and without hyperneutralipemia.
The primary purpose of this paper is to review the outcome of 11 cases of primary xanthoma tuberosum in children seen at the Mayo Clinic. Five of the eleven are known to be dead from cardiovascular disease, and one other is presumed to be dead. In five of the six patients angina pectoris developed before death. Two patients who are still living have angina pectoris, one having suffered myocardial infarction.
Necropsy of four patients showed atheromatous involvement of the coronary blood vessels to be a prominent finding. Three of the patients died before they reached the age of 15 years.
Two of the patients were brother and sister. Of the remaining nine patients, four gave a family history of cardiac disease occurring in a close relative early in life and five patients had relatives with cutaneous xanthomas. In the one family studied, all five members had hypercholestenemia.
CLINICAL CONFERENCE
Authors: Miller Robert A. 
Published: December 2021

In recent years there has been growing interest in pulmonary disease in infancy, especially in the newborn period. Therefore, it has become more important to try to differentiate primary pulmonary disease as a cause of cyanosis in the newborn period, from congenital heart disease as a cause of the same symptoms.
Since recognition of such clinical entities as hyaline membrane disease, plasma cell pneumonia and some types of interstitial fibrosis of the lung is occurring in younger and younger patients, one may get the impression from the literature that it is fairly easy to separate primary pulmonary disease from pulmonary disease secondary to congenital heart disease.
I woud like to show you two children, one of whom was considered to have congenital heart disease and was found at postmortem examination to have primary pulmonary disease. In the other case the child was considered to have primary pulmonary disease and then was found to have pulmonary disease secondary to heart disease.
The first case is that of a girl who was first seen in this hospital as an infant because of a mild degree of cyanosis. She had been getting along quite well, but had been noted to breathe a little harder than the other children.
Aside from the cyanosis there was no abnormality on examination of this baby except that the second heart sound was very loud. There was no distinct cardiac murmur during the period of infancy. However, as the child was followed, a systolic murmur became audible. This was a soft, Grade II to Grade III pansystolic murmur and was maximum in the third left interspace medial to the apex. The second sound was narrowly split, fixed and was quite sharp. The electrocardiogram showed right ventricular hypertrophy. The roentgenogram at the time showed that the heart was only slightly enlarged and that there was a prominence in the pulmonary artery area. This was a number of years ago, and at that time, the clinical diagnosis was Eisenmenger syndrome; that is, a ventricular septal defect with pulmonary vascular obstructive changes and high pulmonary artery pressure.
This child was followed for a number of years, and finally, at the age of 8 years, came to this hospital in extremis. She was quite cyanotic. She still had a faint systolic murmur, and a loud snapping second heart sound.
Roentgenograms showed that the heart was now quite large. The pulmonary artery was still quite prominent, and the major branches of the pulmonary artery also seemed to be somewhat enlarged. The vascular markings in the lung fields were essentially normal, and the most important clinical impression one got of this child was that she was in right heart failure and was cyanotic.
All About You
Authors: WINTER WILLIAM D. 
Published: December 2021

Parents for years have been keeping personal record books of their children's progress from birth to maturity; the present publication is the first such book designed specifically for the adopted child, beginning with the day he enters his permanent home. All the elements of the usual "baby book" are present, but nowhere need a page be left blank just because the child did not enter the family until months or years after birth.
A most important feature is a removable booklet addressed to adoptive parents, stressing the need and the means of acquainting the child with his adopted status from the very beginning.
CONGENITAL DEFICIENCY OF FACTOR VII ASSOCIATED WITH HEMORRHAGIC DISEASE OF THE NEWBORN
Authors: Rabiner S. Frederick , Winick Myron , Smith Carl H. 
Published: December 2021

Early diagnosis of congenital abnormalities of coagulation may be masked by the clotting defects associated with the newborn period and mistaken for hemorrhagic disease of the newborn. A case is presented which illustrates this problem.
To exclude a congenital defect, a careful family history should be obtained and a complete coagulation study performed on all infants with severe hemorrhagic manifestations. The diagnosis of hemorrhagic disease of the newborn should not be assumed in such cases. If there is evidence to support the diagnosis of a congenital abnormality, either from the family history or from the coagulation studies, or should there be a lack of response to vitamin K in an infant with severe bleeding, replacement therapy with plasma or serum should be instituted immediately. Repeated coagulation studies will eventually demonstrate the congenital abnormality and should be performed in suspected cases.
TRIMETHADIONE (TRIDIONE®) NEPHROSIS IN RATS
Authors: Heymann Walter , Hackel Donald B. , Hunter Janet L. P. 
Published: December 2021

Doses of 38 to 57 mg of trimethadione (Tridione®) were given by stomach tube daily for 4 to 18 months to 22 rats. Eleven of these developed a nephrotic syndrome characterized by proteinuria (without hematuria), hypoproteinemia, hyperlipemia and histologic lesions in the kidneys.
The disease began usually 5 to 6 months after trimethadione administration was started. It was mild in 3 rats, moderately severe in 6, and marked in 2. Renal failure was noted in three animals after proteinuria had been noted for 4 to 9 months.
Spontaneous remissions after the administration of trimethadione had been discontinued were not noted. The administration of cortisone in two animals was without detectable beneficial effect.
Complement activity in sera of 13 animals was normal, and no agglutinating antibodies could be detected in 10 sera obtained at the time of death.
In 11 rats given trimethadione for 6 to 17 months without development of proteinuria, less marked, but definite, histologic alterations were noted. Four of these had some azotemia and in five, slight degrees of hyperlipemia were noted.
These findings make it imperative to evaluate the renal status of human patients receiving dione derivatives as long-term treatment for petit mal seizures.
THERAPY OF CYSTIC FIBROSIS OF THE PANCREAS
Authors: Shwachman Harry 
Published: December 2021

GENERAL CONSIDERATIONS
I SHOULD like to open my remarks concerning therapy of cystic fibrosis of the pancreas by pointing out that some of the things we do are based on sound physiologic principles, such as salt and pancreatic enzyme replacement. Other therapeutic measures are based on prevention, e.g., the use of water-miscible vitamin A to prevent vitamin A deficiency, the use of vitamin K to prevent prothrombin deficiency, or the use of gamma-globulin to prevent measles in the exposed patient. A number of therapeutic measures have been employed in the management of patients with cystic fibrosis that require further evaluation, as unfortunately the effects produced in many instances are based on the judgment of anxious parents and enthusiastic physicians. Examples of this kind may include the use of trypsin by intramuscular or aerosol routes or the use of adrenal steroids. It is important to keep a proper perspective. We must not discard any form of therapy that offers relief, and on the other hand, we must avoid the use of harmful agents and needless operative procedures.
The first point I should like to make is the importance of being certain of the diagnosis. In the case of equivocal laboratory findings with a clinical picture that is consistent with the disease, I believe therapy should be instituted and the laboratory tests repeated, until the diagnosis can be established or discarded. Figure 1 shows a 9-week-old baby who was first seen about 10 years ago. He had the typical pulmonary picture of cystic fibrosis, yet the duodenal fluid contained adequate proteolytic activity and showed increased viscosity.
Letters to the Editor
Authors: TALBOT NATHAN B. , RICHIE ROBERT H. , CRAWFORD JOHN D. 
Published: December 2021

We note with interest that Drs. Hurst and Darrow agree that body fluid requirements of patients of differing sizes bear a simpler relation to weight raised to the two-thirds power than to weight directly.
"Surface area" is directly proportional to the two-thirds power of weight, being closely equal to weight in kg⅔ X 0.1. We have used "surface area" thus defined as a basis for describing limits of tolerance and related physiologic data and for expressing dosages simply because this familiar body dimension has been found empirically to give reasonably satisfactory results.
TRANSPLACENTAL TRANSMISSION OF BUSULFAN (MYLERAN®) IN A MOTHER WITH LEUKEMIA
Authors: Diamond Israel , Anderson Mary M. , McCreadie Samuel R. 
Published: December 2021

A female infant, born of a mother with leukemia who received 6-mercaptopurine and x-ray therapy early in the pregnancy and Myleran® throughout most of the pregnancy, showed severe stunting of growth, congenital anomalies of the eyes, palate and ovaries, and cytomegaly involving most of the organs and tissues of the body.
Evidence is cited to implicate Myleran® as the agent responsible for the defects and cytomegaly.
THE COPPER CONTENT OF INFANT FOODS
Authors: Hughes Gertrude , Kelly Vincent J. , Stewart Robert A. 
Published: December 2021

A method of measuring the copper content of processed baby foods is described. More than 2,600 randomly selected samples of 86 baby food items packed at four widely separated areas were assayed for copper content. Strained beef liver and the cereals, particularly high-protein cereal, showed the highest levels, followed by fruits and vegetables. In general, the values were found to be consistent with other published data. With very few exceptions the copper content did not differ significantly in products packed in widely separated areas.
It is concluded that the copper intake provided by "average" diets containing processed baby foods meets or exceeds the estimated daily requirement of 0.05 mg/kg of body weight/day. The conditions under which an inadequate copper intake might obtain have been discussed.
CONCENTRATIONS OF I7-HYDROXYCORTICOSTEROIDS IN THE BLOOD OF DIABETIC MOTHERS AND IN BLOOD FROM THE UMBILICAL CORDS OF THEIR OFFSPRING AT THE TIME OF DELIVERY
Authors: Migeon Claude J. , Nicolopoulos Demetrios , Cornblath Marvin 
Published: December 2021

Concentrations of 17-hydroxycorticosteroids were determined in plasma from maternal venous blood of 13 diabetic mothers and in cord venous blood of their infants at the time of elective cesarean section.
No significant differences were found between plasma levels of 17-hydroxycorticosteroids when compared with normal controls.
From the limited data available, no correlation between concentrations of blood sugar, 17-hydroxycorticosteroids, clinical course or outcome was apparent.
BRONCHIAL OBSTRUCTION IN CYSTIC FIBROSIS: RHEOLOGICAL FACTORS
Authors: Denton Robert 
Published: December 2021

Rheological studies of the respiratory secretions from patients with cystic fibrosis and from controls are presented. The apparent viscosities of mucous secretions were obtained in five patients with cystic fibrosis and in seven control subjects. The viscosity values for cystic fibrosis mucus after shearing were found to be about 5 times that of controls.
The structure of the mucous molecule is discussed, and the various factors affecting its viscosity and flow characteristics are described.
The effect of 0.5 molar NaCl solution in dispersing cystic fibrosis mucus is presented. This effect suggests the theory that the high viscosity of mucus in cystic fibrosis is due to a decreased concentration of sodium ions in the structure of the mucous molecule. A link between the high concentration of salt in the sweat and the high viscosity of mucus of patients with cystic fibrosis could thereby be provided.