bluuebunny/crossref_metadata_2025_split huggingface dataset:
TOTAL, UNCOMPLICATED, ANOMALOUS PULMONARY VENOUS CONNECTION
Authors: Sherman Frank E. , Bauersfeld S. Richard 
Published: December 2021

Anatomic observations on 13 necropsy specimens of total, uncomplicated, anomalous pulmonary venous connection are presented.
These cases accounted for 0.8% of all deaths and 3.9% of congenital cardiac deaths in a consecutive necropsy series.
Neill's embryologic classification is recommended because it is suitable for clinical purposes. The pulmonary venous return in one of the cases drained directly to the right atrium (type 1); in six it drained via a left superior vena cava (type 3A); in three it drained via the coronary sinus (type 3B); and in three the pulmonary venous return drained via the portal system (type 4A).
Findings common to all cases were: 1) interatrial communication; 2) enlarged right heart; 3) small left heart; 4) increased pulmonary circulation; and 5) normal aorta.
Anatomic findings are related to their surgical implication. The disproportion in size and implied functional capacities of the right and left sides of the heart is stressed, and the authors agree with previously recommended surgical correction in multiple stages.
Factors favoring surgical correction are: 1) The anomalous channel is so located that anastomosis with the left atrium is anatomically feasible. 2) The small left heart contains a reasonable, if not normal, number of myocardial fibers that should be capable of hypertrophy and increased function. 3) This anomaly is uncomplicated by other cardiac or extracardiac anomalies in most instances. All cases in this report were uncomplicated. 4) Pulmonary vascular changes in these infants are without scarring. 5) Myocardotomy in most instances can be limited to the atrial wall.
Factors unfavorable to surgical correction are: 1) Age at death in this series varied from 15 days to 14 months. The risk of cardiac surgery in infants is well-known. 2) The anomalous veins are scarred vessels, and may predispose to thrombosis. 3) The size of the anastomosis is limited by the small size of the left atrium.
Anomalous pulmonary venous connection must be excluded in all cases of left-to-right shunt at the atrial level. Anatomic variations that might lead to a proper diagnosis are summarized for the various types included in this study.
A STUDY OF 44 CHILDREN WITH THE SYNDROME OF RECURRENT (CYCLIC) VOMITING
Authors: Hoyt C. Sherman , Stickler Gunnar B. 
Published: December 2021

The case records of 44 patients less than 15 years of age seen at the Mayo Clinic from 1945 to May, 1957, who had the syndrome of recurrent vomiting, were studied. A questionnaire sent at the time of this study—from 2 to 14 years after the original examination—to determine if possible the prognosis and cause, elicited a response from 38 patients or their parents. Of the 38 patients, 30 had no cyclic vomiting at the time of follow-up. Of the remaining 8 patients, there was less than a 5-year follow-up in 7.
The cause of the syndrome of recurrent vomiting, while possibly psychogenic, is not known definitely. It usually terminates before puberty. There may be some relationship to migraine which also may be a syndrome and not a definite disease entity. Electroencephalographic study of 15 of the patients did not suggest any relationship to a convulsive disorder.
The Pediatric Residency
Authors: Kanof Abram 
Published: December 2021

While in the art gallery one may stoutly insist that he knows what he likes, it appears from the article of Deisher et al. (Pediatrics, 25:711, 1960) that in the practice of pediatrics one likes what he knows. I do not agree, however, that the fault is in the medical school training; rather, it lies in the inadequacies of the pediatric residency program.
What happens to the enthusiastic senior choosing pediatrics as his field, to change him after 10 years of practice into a physician nagging about the really petty complaints in Table V of Deisher's article?
RENAL TUBULAR DYSFUNCTION COMPLICATING THE NEPHROTIC SYNDROME
Authors: Stickler Gunnar B. , Hayles Alvin B. , Power Marschelle H. , Ulrich John A. 
Published: December 2021

Observations on two girls in whom an unusual type of chronic renal insufficiency developed many months after the onset of nephrotic syndrome are reported. Each patient became free of edema in spite of persistent massive proteinuria. Growth was retarded and rickets and attacks of tetany developed.
The chemical disturbances of the blood were characterized by hypocalcemia, hypokalemia, azotemia and metabolic acidosis. Hyposthenuria, proteinuria, amino-aciduria, and minimal erythrocyturia, cylindruria and glycosuria were present.
Healing of the rickets and cessation of attacks of tetany followed the administration of vitamin D and calcium salts. Prednisone was administered to one patient and thereafter proteinuria decreased and renal tubular function improved. Both girls are relatively asymptomatic 11 and 9 years after the onset of nephrotic syndrome, although they are rather small and still have evidence of renal disease.
It is possible that cells of the renal tubules have been damaged as a result of prolonged massive proteinuria.
ACTIVITY OF ACID PHOSPHATASE IN THE SERUM OF NORMAL INFANTS AND CHILDREN
Authors: Laron Zvi , Epstein-Halberstadt Batia 
Published: December 2021

Normal values for activity of acid phosphatase in the serum of infants and children are presented. The total acid phosphatase activity is high in the serum of newborn infants, declines slightly during the first 2 weeks of life, remains at a medium level up to the age of 13 and then further declines until it reaches a low level found in adults, around the age of 17 years.
The activity of tartaric acid-inhibited acid phosphatase in serum is similar in all ages.
A disparity between acid phosphatase activity in the serum of mothers and their infants is described.
THE RELATION BETWEEN CELL STRUCTURE AND CELL FUNCTION
Authors: Lowe Charles U. 
Published: December 2021

The Day is past when the cell can be considered a bag containing a nucleus and a host of enzymes swimming freely within the cytoplasm. It is now clear that the cell is a highly organized, carefully integrated and delicately controlled synthetic and catabolic organ with well defined particulate structures to which many specific functions may be assigned.
The nucleus contains two specialized structures, the genetic material or the chromosomes, and the nucleolus. The chromosomes are strands of desoxyribopolynucleotide (DNA) and histone-like proteins which are invisible as organized structures until mitosis is well established (Fig. 1). The DNA consists of double strands of polynucleotide with specific configuration wound in the form of a helix. The chromatin during mitosis can be visualized as multiple indented strips, which have sufficient individuality as to appear unique. Each chromosome strand is made up of many molecules; a locus on a chromosome with specific genetic potential has been termed a cystron, and a structurally related group of cystrons form a chromomere. The individual cystrons have not been clearly visualized but it seems reasonable to suppose that each represents a single molecule. Why particular genetic material is associated with specific chromosomes is not known.
The number of chromosomes appears to be characteristic of the species, and within a given organism all resting nuclei, except those of the germ cells, contain the same number of chromosomes and the same amount of DNA. Certain nuclei, for example a small number of hepatocytes, contain multiples of diploid DNA.
The lateral portion of each chromosome has in association with it a ribose polynucleotide (RNA or PNA), and that region is a site of rapid synthesis of this substance.
Physiology of Prematurity
Authors: DANCIS JOSEPH 
Published: December 2021

The Fifth Conference on Prematurity is reported in the manner already familiar to readers of publications of the Josiah Macy, Jr., Foundation. The editing succeeds again in maintaining clarity of expression without losing the feeling of spontaneity.
This conference is devoted to the premise that the best approach to the problem of prematurity is to eradicate it. Accordingly the stress is on factors leading to the termination of pregnancy with the inference that these may eventually be controlled. The major presentations are concerned with the effect of oxytocin on the activity of the pregnant uterus (Caldeyro-Barcia), the effect of progesterone on the isolated uterine muscle cell (Csapo), the role of the "incompetent cervix" in causing prematurity (Reid), and the relation of asymptomatic bacteriuria in the pregnant woman to prematurity and perinatal death (Kass).
ALLEGED ANAPHYLACTIC REACTIONS TO HUMAN GAMMA-GLOBULIN
Authors: Glaser Jerome , Wyss-Souffront William A. 
Published: December 2021

In the case of reactions following the injection of therapeutic agents, the possibility must be considered that the reaction may have occurred as a result of the contamination of the medication by some extraneous allergenic material. It is highly advisable that the manufacturers of biological products for injection avoid the possibility of contamination of these products by silk, penicillin and possibly other substances that may act as powerful sensitizers and allergens. All individuals sensitive to penicillin should receive injections from syringes not previously used for the injection of penicillin. It would be even better to set aside syringes and needles to be used only for the injection of penicillin and to be sterilized separately; if the sterilizing is done by boiling, a separate sterilizer should be used for that purpose only. If a patient dies suddenly following an injection, and the cause of death appears to be allergic shock, or if it is not obvious, blood should be drawn (most easily done by cardiac puncture) as soon as possible and the serum preserved under refrigeration for possible future passive transfer and other tests, as recommended by Lund and Hunt.
There is no incontrovertible evidence that acute anaphylactic reactions have occurred in man due to the injection of human gamma-globulin per se. The possibility that this may occur, however, cannot be completely excluded. It is of the utmost importance if such reactions are suspected that every effort be made to discover the responsible allergen.
CONGENITAL HEMOLYTIC DISEASE RESULTING FROM A-O ISOIMMUNIZATION
Authors: MITCHELL NATHAN , MOSS ARMAND H. , REDNER BERNARD , LEVY HAROLD , GREENBLATT I. J. 
Published: December 2021

Three instances of fatal hemolytic disease of the newborn have been observed in group A infants born of Rh positive mothers belonging to group O. Markedly elevated anti A agglutinins were demonstrated in the mother's serum following delivery of the child. (1:10,120 in Case 1, 1:5,000 in Case 2, and 1:6,000 in Case 3. All these titers fell within three weeks.) All infants were Rh positive and no Rh or Hr antibodies were found in the mothers' serum. Jaundice became apparent in all infants within 24 hours of birth. There was a moderate anemia, and varying numbers of nucleated red blood cells were found in the peripheral blood. One infant died on the third day of life, the second on the fifth, and the third on the sixth. In all cases the typical changes of hemolytic disease of the newborn were present at autopsy and in all extensive kernicterus of the basal ganglia, hippocampal nuclei, periventricular pontine nuclei, cerebellar dentate nuclei and medullary olives were found.
The finding of free circulating antibodies in the infant's blood obtained postmortem is of particular interest. These anti A agglutinins were active only in albumin-plasma dilutions. The retention of the agglutinating property of this antibody in both infant and mother even after addition with A and B blood group specific Witebsky substances indicate that it is probably an immune antibody.
It is believed that A-O isoimmunization has been proved in these three cases.
TRENDS IN HEALTH LEGISLATION AND ADMINISTRATION
Authors: WALL JOSEPH S. 
Published: December 2021

IN THIS column in April, we reported that a new School Health Services Bill was being drafted in the Health Sub-Committee of the Senate Committee on Labor and Public Welfare. On March 25, this Bill came out of Committee and was introduced into the Senate by Senator Thomas (Democrat, Utah) as S. 1411. Sponsoring this Bill with Senator Thomas was the entire membership of the Health Sub-Committee, with the addition of Senator Saltonstall, who introduced the School Health Service Bill (S.1290) a year ago in the Eightieth Congress.
In the opinion of several of those who are close to the Washington scene, this School Health Services Bill is one of the health measures most apt to meet with favorable and early action in the current session of Congress. While the battle rages over a comprehensive health program, a health measure which is less contentious may be enacted. Following all the electioneering promises it would be surprising if this session of Congress were to close without some health legislation which can be held up as accomplishment. S. 1411 is scheduled for early action in the Senate; in the House there have been several additions to the roster of the sponsors of School Health Services legislation. Indeed, this Bill, with some modifications, may have been acted upon favorably in both Houses by the time this report is published. If enacted, the measure will have farreaching influence upon health services for children of school age, and therefore warrants close attention by pediatricians, general practitioners, health officers and others specially concerned in this area.
Who Will Advise Mothers?
Authors: TERRELL C. O. 
Published: December 2021

Dr. John N. Kennell, in a Letter to the Editor, emphasized the findings of the study being conducted at Western Reserve on the emotional needs of mothers. He asks the question, "Who is going to give a mother the individualized quidance about child rearing that she wants? Do we pediatricians want to do this? Can we do this? All Pediatricians? A few pediatricians?"
These problems are not compartmented so that they can be taken in and out of pediatrics.
MISCELLANEOUS REVIEW
Authors: CLEMENT DAVID H. 
Published: December 2021

Some Practical Considerations of Economy and Efficiency in Infant Feeding. American Journal of Public Health, 52:125-142, 1962. (Reprinted for the U. S. Department of Health, Education, and Welfare; Children's Bureau.)
A Joint Committee of the Food and Nutrition Section and the Maternal and Child Health Section of the American Public Health Association has written this useful review. Compressed into its 17 pages is a great deal of pertinent information from man widely scattered sources and of special interest to physicians and nurses engaged in infant feeding practices among families where economy is important.
Infant feeding practices have been reviewed with special regard to cost, convenience, and safety. But there are many facts of interest to the private practitioner whose patients may be free of financial worry.
Impressive is the statement that in 1957 some 13,500,000 United States children were in families whose total income was less than $3,000 a year. In 1956, one of five dwelling units in small cities or rural areas had no running water inside the structure.
The cost of breast feeding in relation to bottle feeding depends upon the cost of the additional nutrients eaten by the mother. With a truly low-cost diet (which impressed this reviewer as so unpalatable as to be unrealistic the cost was calculated at 15ø a day, whereas with a moderate cost diet it was 40ø a day. An evaporated milk formula was estimated at 15ø a day and pasteurized whole milk at 25ø a day. The safety of breast milk was accepted as vastly superior to formulas.
Take Off Your Shoes and Walk
Authors: HAGGERTY ROBERT J. 
Published: December 2021

"Babies appear to have flat feet because of the thick layer of baby fat present in every infant's arch. . . ."
"Because of poor feet, countless of Americans have posture distortions, are usually fatigued and become prone to degenerative illnesses."
These two statements, taken from Dr. Wikler's book, suggest the dual aspects of this book—the eminently good, common-sense discussion on foot wear and normal development of feet and the extraordinary loose thinking about the relation of foot problems to general health.
PRESIDENT'S MESSAGE
Authors: Webb Clarence H. 
Published: December 2021

TWO MAJOR facets of the pediatrician's role in practice have been presented in previous messages: as a child's specialist and as family medical advisor and counsellor. The bases of these observations, previously detailed, are the author's experiences in practice and the reported experiences of a panel of 20 of his peers from various parts of this country.
A third characteristic of the pediatrician, less frequently recognized but all-pervasive, is that of teacher. The image immediately evoked by this term is of university connection, of medical school faculty. Indeed, pediatricians are justifiably proud of the rapid rise in status of pediatric teaching from a part-time or subsidiary position in most faculties 40 years ago to the present full-time status co-equal with surgery, medicine, and obstetrics. We are further gratified by the increasingly large corps of expert pediatric teachers throughout the country. Despite the fears sometimes expressed that the sudden outpouring of funds for research—long overdue—may shift the medical school emphasis away from the primary function of instruction, the probabilities are that a balance will be struck between teaching and research. Effective pediatric instruction will be likely to continue in the medical school and residency setting.
My thought, however, is of the teaching which the practitioner of pediatrics does, which extends pediatric thought to a widening circle. The attitude of instruction is inherent in all physicians, recognized from the earliest days of medicine and reflected in the Oath of Hippocrates. The pediatrician has an extra missionary zeal because he deals with the young impressionable individual and the developing family, wherein he seeks to establish attitudes and practices which will benefit the child.
FACTORS AFFECTING FOOD INTAKE
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

Emotional and cultural factors are of exceptional importance in determining food intake. The deeply ingrained pattern of three meals daily may be the cultural factor most open to criticism.
In experimental animals, and probably in the human, established nutritional habits are particularly potent factors in determining food intake. Proper nutritional education in early childhood may establish patterns of food selection that will be helpful in avoiding specific deficiencies and gross excesses in later life.
Appetite may prove adequate for selection of a nutritionally acceptable diet under certain circumstances but selection of food on the basis of nutritional principles is more reliable and is to be recommended.
A knowledge of normal variations in food intake in relation to age, sex, environmental temperature, and caloric expenditure is beneficial in interpreting the feeding behavior of children. Complaints by parents that their children have "poor appetites," are commonly based on a misconception regarding normal patterns of food intake.
Vitamins, iron, and other specific nutrients act as appetite stimulants only in the presence of deficiency of the particular nutrient.
ETIOLOGY OF RESPIRATORY INFECTIONS
Authors: Wulff Herta , Kidd Patricia , Wenner Herbert A. 
Published: December 2021

Sixty viruses were recovered from 58 of 114 infants and children ill of respiratory infections. Two outbreaks, one caused by RS and the other by influenza B viruses, occurred during the study period. RS and influenza B viruses totaled 55% of the virus yield. Other viruses recovered were parainfluenza types 1, 2 and 3 (14 strains), reovirus, type 1 (5 strains), adenovirus (5 strains), and mumps (1 strain). Two viruses were lost and remain unidentified.
Good correlation was obtained between viruses and development of specific antibody. A small fraction of infants had dual virus infections; heterotypic antibody responses were observed in 20% of the patients. These were considered to represent in part successive infections with specific viruses.
Fourteen of 18 RS viruses, 6 influenza, and all except one of the parainfluenza viruses (type 3) were associated with laryngotracheobronchitis, bronchiolitis, and pneumonia. None was associated with any single clinical category. RS was associated more often with pneumonia than bronchiolitis; influenza B was associated less often with these than with upper respiratory infection.
Analysis of virus-positive and virus-negative subgroups for bacterial "pathogens" and leukocytosis indicated that pneumonia of virus-negative infants was very likely bacterial in origin. Evidence was also obtained of concurrent bacterial infection in a fraction of patients yielding viruses.
ASSESSMENT OF THREE METHODS FOR MEASURING INTESTINAL FAT ABSORPTION IN INFANTS AND CHILDREN
Authors: Goldbloom Richard B. , Blake Roy M. 
Published: December 2021

Intestinal fat absorption has been measured in 22 infants and children with various forms of steatorrhea or growth failure, using four different techniques. Vitamin A absorption, I131-triolein absorption, butterfat absorption (as measured by alteration in serum turbidity), and 4-day fecal fat balance. The last of these was used as the reference standard, expressed both as gm/ day and as percentage of intake excreted over the 4-day period.
The measurement of Vitamin A absorption was unreliable as an index of the intestinal handling of lipid. I131-triolein absorption correlated well with fecal fat output, expressed as gm/day. A close relationship both to fecal fat balance and to quantitative daily excretion was attained by results of the serum turbidity method for butterfat absorption. The simplicity and special advantages of this technique are described.
Possible Idosyncrasy to Belladonna, Phenobarbital, or Paregoric
Authors: COHEN GEORGE J. 
Published: December 2021

With the thought that an unusual response to a common drug might be of interest, the following case is briefly reported.
A two-month-old girl with diarrhea for three days was given two teaspoons (as one dose) of Donnagel-PG; this dose contains the equivalent of 2 ml of paregoric, 0.0344 mg of hyoscyamine sulfate, 0.0063 mg of atropine sulfate, 0.0021 mg of hyoscine hydrobromide, and 5.4 mg of phenobarbital. Ten minutes later, because she became stiff and held her head to the left she was taken to the emergency room of a nearby hospital.
The Changing face of Childhood
Authors: CONE THOMAS E. 
Published: December 2021

Every so often one unexpectedly comes across a book which is so charmingly written and illustrated that one wishes everyone else could enjoy it too. This beautifully illustrated and skillfully narrated volume is just such a book.
The author has deftly selected over 150 illustrations ranging from prehistoric paintings to those of the present which show children at play, in school, at prayer, in the streets and at home; the pictures tell so much about the activities, the games they played, the toys and pets they loved, the food they ate, the books they read, the clothes they wore, and how they were taught.