bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL CONFERENCE
Authors: Krugman Saul , Ward Robert 
Published: December 2021

Dr. Krugman: Since 1953 approximately 400 cases of infectious hepatitis with jaundice have been observed at the Willowbrook State School on Staten Island. The studies to be described were carried out in collaboration with Dr. Robert Ward and Dr. Joan Giles of our staff, Dr. A. Milton Jacobs of Willowbrook State School and Dr. Oscar Bodansky of Sloan-Kettering Institute. I should like to present a progress report of our investigations which have been concerned with the prevention and natural history of infectious hepatitis at Willowbrook. (A report of these studies has recently appeared in the New England Journal of Medicine (248:407, 1958) to which the reader may refer for further details.)
It had been previously reported by Stokes and associates that the administration of gamma-globulin was followed by not only a lower incidence of hepatitis but also a prolongation of the protective effect. Stokes postulated that "passive-active" immunity was responsible for this phenomenon. The epidemic of hepatitis at Willowbrook provided us with an opportunity to test this hypothesis.
Effect of Gamma-globulin on the Frequency of Infectious Hepatitis. Figure 1 illustrates the course of the outbreak at Willowbrook beginning in January, 1955. As can be seen, hepatitis continued to occur at a rate of about two to three cases per week. The cases, predominantly in children, occurred in 18 buildings in the institution. In June of 1956 gamma-globulin, 0.01 ml/lb, was administered to approximately a third of the inmates of each building. The control and inoculated groups were comparable as to age and time of admission to Willowbrook.
THE INFLUENCE OF THE THERMAL ENVIRONMENT UPON THE SURVIVAL OF NEWLY BORN PREMATURE INFANTS
Authors: Silverman William A. , Fertig John W. , Berger Agnes P. 
Published: December 2021

The influence of two contrasting environmental temperatures upon time survival rates of premature infants in the first 5 days of life was studied. Infants who were placed in incubators with an air tamperature of 31.7°C (89°F) had a higher survival rate than controls who were in incubators maintained at 28.9°C (84°F).
In this clinical trial a sequential, matched-pairs plan was used to evaluate the differences in survival under the two study conditions.
THE TREATMENT OF ALLERGY WITH EXTRACT OF TOXICODENDRON QUERCIFOLIA: A CONTROLLED SERIES
Authors: Kamin Sheldon H. , Nastasi Leo , Westlin William , Kline Allen H. 
Published: December 2021

A controlled study, using the doubleblind placebo method, has been utilized to evaluate the effects of administration of an extract of Toxicodendron quercifolia in the treatment of allergic patients. Thirty children received the extract and 26 received comparable injections of normal saline. Six weeks after the onset of treatment the children were re-evaluated. No statistically significant difference between the groups could be ascertained.
A most important corollary to this study has been the number of patients who improved while receiving placebo. Attention is called to the great "healing powers" inherent in the positive attitude of the doctor treating allergy, above and beyond the mode of treatment being used.
THE EFFECTS OF ANOXIA ON THE METABOLISM OF HUMAN FETAL TISSUES
Authors: Villee Claude A. , Hagerman Dwain D. , Holmberg Nils , Lind John , Villee Dorothy B. 
Published: December 2021

The problem of any organism surviving under anaerobic conditions is to convert the potential energy of its substrate molecules into biologically useful energy without having to use molecular oxygen. The resistance of the fetal and newborn mammal to hypoxia might depend upon some unique chemical reaction, upon quantitative differences in the rates of certain enzymatic reactions common to fetal and adult tissues, or upon a lower rate of cellular metabolism in fetal tissues. These experiments with human fetal tissues favor the second of these three possibilities.
Tissue slices of human liver, cerebral cortex, brain stem, heart, lung, kidney and skeletal muscle were incubated in a medium containing C14 labeled glucose, fructose, pyruvic acid or acetic acid. These experiments showed that there is a fourfold greater rate of glycolysis in fetal liver midway through gestation under anaerobic conditions than under aerobic conditions. In contrast, the rate of lipogenesis under anaerobic conditions was only one-tenth as great as the rate under aerobic conditions. Experiments revealed that after a slice of liver or cerebral cortex had spent a full hour in complete anoxia, its ability to synthesize fatty acids and to oxidize substances by way of the Krebs cycle was essentially unimpaired. All of the experiments were designed to test the maximal activity of the enzyme systems involved. An excess of substrate was provided so that the activity of the cellular enzymes, and not the concentration of the substrate, was the ratelimiting factor. These experiments provide an estimate of the upper limit of the metabolic activity of the tissue in oxygen and in nitrogen. They do not provide an estimate of metabolic rates in vivo. Observations on human tissues near term showed that the rate of aerobic lipogenesis was much less than that observed in tissues of younger fetuses. This was equally true with labeled glucose, pyruvate and acetate as substrates. The pattern of lipogenesis is comparable to that in the liver of a rat 24 hours after parturition and not to the pattern which obtains in the rat just before birth. The rate of anaerobic lipogenesis is substantially less than that under aerobic conditions. These observations may be correlated with the idea that the newborn rat is more immature than the newborn human. These experiments indicate that lipogenesis is of no significance in the ability of the human fetus one half way through gestation to withstand hypoxia, for under anaerobic conditions lipogenesis is decreased whereas glycolysis is increased.
SPECIMENS OF URINE OBTAINED FROM YOUNG GIRLS BY CATHETER VERSUS VOIDING
Authors: Pryles Charles V. , Steg Nina L. 
Published: December 2021

The pertinent literature on bacteriologic study of the urine has been reviewed in brief.
Bacteriologic studies, including cultures, Gram stains and colony counts, of catheterized and voided specimens of urine from girls aged 2 to 12 years, were carried out in three groups: Group I: paired specimens (catheter and clean voided). Group II: clean voided specimens. Group III: random non-clean voided specimens.
There was a 96.5% positive correlation between catheter and clean voided specimens obtained by a standardized technique from the same patients; the time interval between the two types of examinations was less than 1 hour.
Colony counts provide a valid means of differentiating infection from contamination in both clean voided and catheter specimens from female children. The data suggest that urines containing less than 1,000 colonies/ml are indicative of contamination; urines containing between 1,000 and 100,000 colonies/ml are to be suspected of infection, and urines containing more than 100,000 colonies/ml of urine are indicative of infection.
Clean voided specimens are valid only if the patient is prepared before collection of the specimen as carefully as for catheterization.
Where doubtful results are obtained, the study of more than one specimen of urine is absolutely necessary. In our experience, follow-up studies resolved doubtful findings in every instance.
Under certain circumstances, catheterization must remain a necessary procedure in the diagnosis and management of infection of the urinary tract, with the full realization that the use of this instrumentation may involve the risk of introducing infection.
Our results confirm previous findings that the presence of organisms in Gram stains in the absence of epithelial cells from catheter or clean voided specimens of urine is of diagnostic significance.
HYPERBILIRUBINEMIA OF NEWBORN INFANTS ASSOCIATED WITH THE PARENTERAL ADMINISTRATION OF A VITAMIN K ANALOGUE TO THE MOTHERS
Authors: Lucey Jerold F. , Dolan Robert G. 
Published: December 2021

Seven cases of marked hyperbilirubinemia occurring among premature infants within the first 40 to 72 hours of life are reported. The mothers of these infants had received 72 mg of a vitamin K analogue (Hykinone®) intramuscularly or intravencusly from 2 to 112 hours prior to delivery. The evidence presented indicates that this medication predisposed the infants to hyperbilirubinemia.
The hypothesis is presented that the vitamin K analogue passed through the placenta and exerted a hepatotoxic effect upon the newborn infant. Because of possible serious consequences to the infant, new drugs should be used with caution when administered to pregnant women or to newborn infants, and medications should be given in doses no larger than necessary to obtain a desired and proven therapeutic or prophylactic effect.
REDUCTION OF METHEMOGLOBIN BY ERYTHROCYTES FROM CORD BLOOD
Authors: Ross Jean D. , Desforges Jane F. 
Published: December 2021

Studies were made of the ability of erythrocytes from 18 cord bloods to reduce methemoglobin in vitro. Erythrocytes of cord blood reduced significantly less methemoglobin than did those of adult controls in the presence of lactate, lactate and methylene blue, or glucose. These findings are interpreted as evidence of a transient deficiency of either DPNH-dependent methemoglobin reductase or of one of the enzymes responsible for the generation of DPNH in the erythrocyte. The severity of this defect was highly variable.
In contrast, TPNH-dependent reduction of methemoglobin by erythrocytes of cord blood in the presence of glucose and methylene blue was only infrequently deficient. Evidence is presented to suggest that this deficiency, when present, is due at least in part to deficiency of generation of TPNH.
The frequency of deficient DPNH-dependent reduction of methemoglobin may explain the ease with which young infants develop methemoglobinemia.
PRESIDENTIAL ADDRESS
Authors: Clifford Stewart H. 
Published: December 2021

IT IS Academy tradition that your outgoing President be afforded this opportunity to render to the Fellows his evaluation of present Academy activities and his recommendations as to the future. It is a healthy experience for any organization to pause for a moment to reflect on the path it has come and take fresh bearings on the course to be charted toward the Academy's goal of improving the total health and welfare of all children.
The routine business of the Academy is being efficiently carried out by the central office staff at the Academy headquarters in Evanston under the able leadership of our Executive Secretary, E. H. Christopherson. We have been very fortunate in having the loyal services of our Business Manager, W. J. Becker, whose department is the increasingly complex business and financial affairs of the Academy as well as attention to many of the details of our Annual and Spring Meetings.
The Executive Board is the authoritative group having control over all Academy activities. Every effort is made to keep their load of routine business as light as possible that full attention can be directed toward committee activities and to decision on Academy policy. Between Board meetings, the Executive Secretary represents the Board on matters of established Academy business. An Executive Committee has been created to act jointly for the Board in areas where no established policy exists and where prompt action is required.
The productive activities of the Academy having to do with children originate in the Board and in the various special and standing committees. The standing committees are in general of two types—one is concerned with functions and conditions that may affect all age groups; the other is concerned with the broad problems that may occur in specific age groups. The problems encountered in any age group may involve the applied activities and thinking of many disease or function oriented committees.
Pseudo-pseudo-hypoparathyroidism
Authors: SMYTH FRANCIS SCOTT 
Published: December 2021

It is my understanding that the term pseudo-pseudo-hypoparathyroidism is applied to those patients who are similar in every way to the pseudo-hypoparathyroid except that the blood chemistry is normal.
In the March issue of Pediatricas (23:520, 1959), Ray and Gardner have reported what they contend is the youngest patient with pseudo-pseudo-hypoparathyroidism. The physical characteristics of round face, stubby fingers (short phalanges), wide finger nails, soft-tissue calcification and the failure to respond to intravenous panathyroid extract are typical of both syndromes. However, the authors report that the serum inorganic phosphorus ranged from 6.9 to 7.8 mg/100 ml.
The writer finds it difficult to accept these as normal concentrations for a 7½-year-old girl. He is strongly of the opinion that this patient represents pseudo-hypoparathyroidism.
THE NATURE OF SCARLATINAL ARTHRITIS
Authors: Crea Maria A. , Mortimer Edward A. 
Published: December 2021

In order to determine the relationship of scarlatinal arthritis to rheumatic fever, 18 patients who experienced joint symptoms early in the course of scarlet fever were interviewed and examined 1 to 20 years later to establish the incidence of subsequent rheumatic symptoms.
Two patients experienced definite pancarditis during the original illness, and the course of the arthritis in two additional cases was highly suggestive of rheumatic fever. Subsequent stigmata of rheumatic fever appeared in six other patients. Thus, the episode of scarlatinal arthritis probably represented rheumatic fever in eight instances, and possibly in two more.
It is concluded that scarlatinal arthritis is most likely a manifestation of rheumatic fever.
GENERALIZED TUBERCULOUS ADENITIS IN BANTU CHILDREN IN SOUTH AFRICA
Authors: Harris L. C. 
Published: December 2021

Fifteen cases of generalized tuberculosis in Bantu children are described. Though this condition is not uncommon in the Bantu, it is rare in white people and the literature on the subject is relatively scanty.
The superficial glands may be markedly enlarged, especially cervical and axillary glands, but occasionally inguinal as well; hilar, paratracheal and intra-abdominal glands may all be involved. In three patients in this series the primary focus was roentgenographically demonstrable in the lungs. There was no evidence in any patient of multiple primary foci.
Two patients had miliary tuberculosis and tuberculous meningitis and died, but in uncomplicated cases the response to chemotherapy with isoniazid and paraaminosalicylic acid is good. In the course of healing, some glands may suppurate, requiring surgical drainage and irrigation with a solution of streptokinase and streptodornase.
The condition is believed to result from lymphohematogenous spread but the reason for this phenomenon is unknown. The condition appears to be generally more common among Negroes.
GROUP DISCUSSIONS WITH MOTHERS OF HOSPITALIZED CHILDREN
Authors: Glaser Kurt 
Published: December 2021

Many articles have been written about the trauma of hospitalization to the child, but only little has been published about parents' reactions to the hospitalization of their children.1,2
The following observations concerning group discussions with parents of hospitalized children may suggest a three-fold approach to alleviate some of the trauma to the parents: directly through the anxiety-relieving effect of the discussions and indirectly through the experience gained from these group sessions when applied to the training of staff as well as to the setting up of administrative policies.
The present study was undertaken with five objectives in mind:
1) Imparting of information, correction of misinformation, ventilation and clarfication of feelings, and the supportive effect of group interaction are aimed at relieving the anxiety of the parents and improving the interrelationships between parents, children, the hospital and its personnel.
COMPARATIVE STUDY OF ADEQUACY OF PROTEIN FROM HUMAN MILK AND COW'S MILK IN PROMOTING NITROGEN RETENTION BY NORMAL FULL-TERM INFANTS
Authors: Fomon Samuel J. 
Published: December 2021

Eight normal full-term infants have been studied during ad libitum ingestion of a formula (Formula 1257) containing 60 calories/100 ml and providing 7% of the calories as protein from cow's milk, 50% from a mixture of vegetable oils and 43% from lactose. The mean concentration of nitrogen in this formula was slightly less than the mean concentration in human milk in a previous study.4
Growth of the infants is interpreted as within normal limits.
The mean concentration of urea nitrogen in the serum was 6.0 mg/100 ml. Between 1 and 6 months of age the mean concentration of total protein in the serum was 5.7 gm/100 ml.
Both the mean volume of intake and the mean concentration of nitrogen in the feeding were slightly less than those of the infants fed pasteurized human milk. Consequently, in 44 of 60 metabolic balance studies with infants receiving Formula 1257, intakes of nitrogen were less than the mean intakes of infants of similar age receiving pasteurized human milk (Fig. 3). Similarly, retentions of nitrogen in 37 of the 60 metabolic balance studies fell below the regression calculated for infants fed pasteurized human milk (Fig. 4). The retentions of nitrogen were generally in the range of those of infants fed pasteurized human milk and it is concluded that the two feedings have similar abilities to promote retention of nitrogen by infants.
VITAMIN B6-DEPENDENCY AND INFANTILE CONVULSIONS
Authors: Scriver Charles R. 
Published: December 2021

Another patient with the rare convulsive disorder termed "vitamin B6 (or pyridoxine) dependency" is presented. The case of a deceased sibling, suspected of having had the same disorder, is also presented. The characteristic features of the syndrome, as illustrated in these patients, are discussed.
The unusual daily requirement for 10 or 11 mg of pyridoxine supplementation has persisted during the first 20 months of the surviving child's life. The response to pyridoxine is specific and impressive, suggesting a biochemical lesion underlying the convulsive disorder.
The probable nature of this biochemical disorder, the significance of a peculiar pattern of urinary excretion of vitamin B6 and related products, and the sequence of vitamin B6 dependent enzyme involvement, are discussed; the disease may be an inborn error of metabolism involving an enzyme of the brain.
Nothing can be lost, and perhaps much will be gained, if a diagnostic trial with pyridoxine therapy produces impressive improvement in any "idiopathic" convulsive disorder of infancy and childhood.
The apnea monitor business
Authors: Bergman Abraham B. , Beckwith J. Bruce , Ray C. George 
Published: December 2021

Perhaps the most fruitful dividend from research into the sudden infant death syndrome (SIDS) in the past decade has been its establishment as a distinct disease entity. Though this knowledge is still not universally distributed throughout the medical profession, at least some of the veil of mystery and superstition has been lifted, and authoritative guidelines for the recognition and management of SIDS have been issued.
Among the characteristics of SIDS, four deserve special emphasis, and serve as the basis for most of the research currently being conducted: (1) Most cases of SIDS occur between 4 and 16 weeks, suggesting some physiologic vulnerability during this age period.
The Needs of Foster Children
Authors: Seidel Henry M. , Daniel William A. , Davis Joseph H. , Harris Ruth C. , Sherry S. Norman , Tillman Mary A.T. , Karelitz Samuel , Lewos Donald , Work Henry H. 
Published: December 2021

Approximately 350,000 children live with 150,000 foster families in the United States during any given year. These children are in foster homes because the degree of social disorganization in their natural families has led to a societal decision to separate them from their natural families. Significant basic causes include unemployment, poor education, poor housing, and bias. There are also more subtle factors which may, in part, lie beyond our present understanding.
Foster children comprise a population at high risk. At the time of placement, most of them have not had access to sufficient physical and emotional nourishment and necessary medical care. One recent study revealed handicaps in some 40% of the children studied; of these, 15% had multiple handicaps, 33% had emotional and behavioral problems, 19% were mentally retarded, and 13% had various physical ills. Twenty percent had not been evaluated at all. Indeed, there are many kinds of handicaps. Thirty percent of foster children have not seen their natural parents within six months. The average placement has been longer than five years; 68% of placements range from four to eight years, with frequent movement of a child from one family setting to another.
The community, with the process of foster care, assumes or accepts the responsibility for a child's care through the mechanism of count order and/ or voluntary agreement with natural parents. The implied promise of such a move is the satisfaction of apparently unfulfilled needs. The implication is that a period of planned substitute family care can serve as a positive rehabilitative force.
Benign Rheumatoid Nodules
Authors: Estelle F. , Simons R. , Schaller Jane G. 
Published: December 2021

Fifteen asymptomatic children with benign rheumatoid nodules, followed up to 12 years, are described. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression, and frequent recurrence. Granuloma annulare was present in two patients. All 15 children were healthy and free from rheumatoid arthritis, rheumatic fever, or any other recognizable systemic disease at followup and none had positive tests for antinuclear antibodies or rheumatoid factors.
Histologically the nodules closely resembled those seen in adult-onset rheumatoid arthritis. Though biopsy may be useful for confirmation of the clinical diagnosis of benign rheumatoid nodules, wide surgical excision, skin grafting, and treatment with medication are unnecessary in this selflimited syndrome.
Psychological Preparation for Surgical Pediatric Patients: The Effect on Children's and Parents' Stress Responses and Adjustment
Authors: Visintainer Madelon A. , Wolfer John A. 
Published: December 2021

This clinical experiment tested variations of psychological preparation and supportive care designed to increase the adjustment of children (and their parents) hospitalized for elective surgery. Eighty-four children, aged 3 to 12, admitted for tonsillectomies were randomly assigned to one of three treatment conditions or to a control group: (1) a combination of systematic preparation, rehearsal, and supportive care conducted prior to each stressful procedure; (2) a single-session preparation conducted after admission; and (3) consistent supportive care given by one nurse at the same points as in the first condition, but including no systematic preparation or rehearsal.
The children's hospital adjustment was measured by blind ratings of behavioral upset and cooperation during the blood test, medication injection, transport to surgery, induction, and postoperative fluid intake and by recovery room medications and pulse rates and time to first voiding. Post-hospital adjustment was assessed with Vernon et al.'s Post Hospital Behavior Inventory. Parent outcome measures included self-ratings for anxiety and satisfaction with information and care. As hypothesized, the results demonstrated that children who received condition one showed significantly less upset and more cooperation and their parents reported significantly greater satisfaction and less anxiety than did children or parents in the other groups. Younger children were significantly more upset and less cooperative than older children.