bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIABETES IN CHILDREN
Authors: Read Charles H. , Baer Paul E. 
Published: December 2021

EMPHASIS was placed on the primary objective of the physician in planning a therapeutic program for children with diabetes; the promotion of normal growth and development, including intellectual, moral, and social areas. To attain this objective, the physician must provide maximal simplification in his therapeutic plan, so that the pattern of life of the child with diabetes will deviate as little as possible from that of his normal contemporaries.
The relationship between level of "control" of diabetes (i.e., approximation to normoglycemia and aglycosuria) and the age of onset of the degenerative changes associated with this disease assumes paramount importance in governing the degree of simplification which can be safely permitted in any therapeutic program. While stressing the fact that such complications ultimately occur no matter what plan of management is pursued, and viewing the evidence on the true relationship between "control" and the appearance of degenerative changes as not yet entirely clear, Read nevertheless considers that all published experimental and clinical studies indicate that better "control" is directly correlated with later onset of degenerative lesions. He therefore believes that the aim of therapy should be to promote an essentially normoglycemic, aglycosuric state, with less than 5 per cent of the daily carbohydrate intake appearing in the urine.
With these objectives in mind, Read and Baer described the plan which they currently employ in the treatment of 110 diabetic children at the State University of Iowa, where an average of 1 new diabetic is admitted every 3 weeks. As they practice in a hospital center, they serve on a consultative basis, receiving patients by referral from doctors throughout Iowa. This means initiating regulation of the diabetes and subsequently re-evaluating progress by means of clinic visits 1 to 5 times yearly, at the discretion of the referring physicians.
THALASSEMIA-HEMOGLOBIN C DISEASE IN WHITE SIBLINGS
Authors: Erlandson Marion , Smith Carl H. , Schulman Irving 
Published: December 2021

Two white sisters of Italian parentage in whom thalassemia-hemoglobin C disease was found, have been presented. This is the third report of such cases and the first in white individuals. This disease produces a microcytic anemia which is usually mild but which may be severe. Splenomegaly may or may not be present.
The presence of large numbers of both microspherocytes and target cells in the blood smear should suggest the possibility of this diagnosis. Confirmatory evidence is found in studies of the blood of family members.
Growth at Adolescence
Authors: GALLAGHER J. ROSWELL 
Published: December 2021

Tanner need offer no apologies for this excellent book, which so clearly describes the changes in bodily form and function which occur during adolescence. We are in his debt for a succinct review of the major aspects of the physiologic changes of adolescence, clear illustrative material, hints for needed research and a bibliography which will prove invaluable to anyone interested in this field.
The phenomena of physical growth, its orderlines and its variability, are described in detail.
VASCULAR HEMOPHILIA
Authors: Schulman Irving , Smith Carl H. , Erlandson Marion , Fort Eleanor , Lee Richard E. 
Published: December 2021

The coagulation and vascular aspects of the von Willebrand syndrome have been studied in seven children.
Six of the children demonstrated a severe defect in the coagulation mechanism which was found to result from a marked deficiency in antihemophilic globulin. The latter deficiency was found in boys and girls, was familial, and apparently occurred in a manner distinct from the sex-linked recessive inheritance of classical hemophilia.
Morphologic capillary abnormalities were noted in the nail-beds of the fingers and in the bulbar conjunctivae of children with and without associated deficiency of antihemophilic globulin.
Administration of fresh plasma resulted in correction of both bleeding time and coagulation defects in a patient with the combined vascular-coagulation abnormality.
The vascular abnormality was found to be independent of deficiency of antihemophilic globulin or any of the known platelet factors.
Classification of the von Willebrand syndrome into at least two groups was recommended: patients with vascular defect plus AHG deficiency (vascular hemophilia), and patients with vascular defect and normal coagulation status (pseudohemophilia).
You and Your Child
Authors: BYERS RANDOLPH K. 
Published: December 2021

Dr. De Kok's book is a very comfortable discussion of the relations between mother, father, and a baby throughout the early years of life.
Its greatest strength, it seems to me, is the pointing out of the fact that all of the processes of growing up and education in the home and in school form a continuum in which a developmental pattern can be discerned. For instance, her chapter on sex education points out that sex education is not something that can abruptly be given by a parent at a certain age, but that sex education begins with the adorning consciousness of the child himself and continues until sexual maturity needing here and there a little guidance and a little information from home rather than an abrupt lecture on "the facts of life."
INCIDENCE OF ABNORMAL URINARY FINDINGS IN CHILDREN EXPOSED TO THE ATOMIC BOMB IN HIROSHIMA
Authors: Sullivan Margaret P. , Takahashi Yasushi 
Published: December 2021

Urinary abnormalities have been studied in 2,031 boys (1,039 exposed, 992 control) and 1,963 girls (985 exposed, 978 control) in Hiroshima, Japan, as a part of the continuing medical survey being carried on by the Atomic Bomb Casualty Commission from 1951 through 1953.
A history of nephritis was given by .28% of exposed boys, .49% of control boys, .20% of exposed girls, and .20% of control girls. Isolated abnormalities were found in 2.3% of exposed boys, 1.9% of control boys, 3.8% of exposed girls and 2.6% of control girls. Brief, transitory urinary changes without further evidence of urinary tract disease were found in 1.3% of exposed boys, .91% of control boys, 1.2% of exposed girls and .81% of control girls. Abnormalities were present for as long as 1 year in .48% of exposed boys, .40% of control boys, .81% of exposed girls, and .72% of control girls. There was no evidence of permanent damage in the 22 children in this group of 24 with adequate follow-up studies. Chronic renal disease, active or inactive, was suspected in .48% of exposed boys, .60% of control boys, 1.8% of exposed girls and 1.0% of control girls who showed urine abnormalities for longer than 1 year.
Case summaries have been presented in relation to six exposed children with histories of nephritis or with albuminuria and hematuria who had experienced one or more of the major radiation symptoms after the bombing.
There was no statistical difference in the incidence of nephritis or urinary abnormalities of a serious nature between the exposed and control groups. There was no statistical difference in the incidence of major radiation symptoms when the entire exposed group was compared with exposed children showing urinary findings of a serious nature.
The above data should be considered a progress report. The urinary findings in this study group should be reviewed in the future to determine whether or not renal damage has occurred in children exposed to the atomic bomb in Hiroshima.
VARYING DEVELOPMENTAL MECHANISMS IN TERATOLOGY
Authors: Patten Bradley M. 
Published: December 2021

The great variety of developmental mechanisms which may be involved in the genesis of abnormalities is emphasized. The following examples are presented: Too little growth; too little resorption; too much resorption; a resorptive process normal in character but occurring in an abnormal location; a growth process normal in character but occurring in an abnormal location and, finally, too much growth of some particular structure or tissue. With this variety of developmental mechanisms involved, the futility of expecting to find any blanket cause of congenital defects should be self-evident. Moreover, one would not expect to find the various causative factors even in the same category.
See figure in the PDF.file
In cases of too little growth, i.e., cases of the "developmental arrest" type, one would naturally look for deficiency factors, or for inhibiting factors-genetic or environmental.
In the case of too much or too little resorption as a secondary moulding process, or with growth or resorptive processes out of their normal territory, one would look for regulatory factors. So, also, with disturbances in timing, which were not discussed but which I believe we will find of great importance when we know more accurately the rate at which critical developmental process should normally progress.
See figure in the PDF.file
Finally, especial emphasis is placed on defects involving the overproduction of a tissue, or a structure, because the factors which might cause overgrowth must be of a different nature than the inhibiting or deficiency factors we have so long been accustomed to emphasize.
See figure in the PDF.file
I feel certain that in other papers in this conference there will be stressing of the multiplicity of etiologic factors, as well as similar emphasis on the variety of developmental mechanisms involved. I believe that we shall gain the conviction that each type of defect and each possible etiologic factor must be intensively studied on an individual basis if we are to make sound progress instead of bogging down in a morass of vague generalizations.
IS THERE SPECIFICITY OF ACTION IN EXPERIMENTAL TERATOGENESIS?
Authors: Wilson James G. 
Published: December 2021

Time-specificity has been well established in numerous experiments in which a teratogenic agent has been shown to cause different malformations when applied at different times in development. These time-specific effects are related to definite stages or events in embryonic development which might be regarded as periods of special susceptibility. Excessive doses tend to obscure time-specificity by causing teratogenic effects at times other than during periods of special susceptibility.
Recent experiments have indicated that, irrespective of time, many teratogenic agents seem to produce distinctive patterns of anomalies which differ qualitatively and quantitatively from those caused by other agents. The association of a particular group of malformations with a particular agent may be termed agent-specificity.
Agent-specificity is not always readily apparent for reasons such as: a) elimination of certain types of abnormalities by fetal death of affected individuals, b) fluctuations in the pattern resulting from variations in dosage of the agent, c) variable reactions to the same agent in different species or even different strains, and d) varying interests and methods of study on the part of the investigator. When due allowance is made for such variables, distinctive patterns of malformations can often be associated with particular teratogenic agents.
Although mechanisms of agent-specificity were not discussed in detail, it was suggested that each agent acts by interfering with a particular metabolic process in a specific way in the differentiating and growing embryo. Such action can be localized, generalized or selectively distributed, depending on the distribution within the embryo of the process concerned.
EXPERIMENTAL PRODUCTION OF CONGENITAL CLEFT PALATE: GENETIC AND ENVIRONMENTAL FACTORS
Authors: Fraser F. Clarke , Walker B. E. , Trasler Daphne G. 
Published: December 2021

Experimental studies and theoretic considerations on the problem of palate closure and the ways it may fail have led to the following conclusions:
The process of palate closure involves the delicate integration of a number of processes, each under the influence of genetic and environmental factors. These processes include the building up of a force within the palatine shelves enabling them to overcome the resistance of the tongue and meet in the mid-line, provided the width of the head and the width of the shelves are appropriate.
The process of palate closure can go wrong in a number of ways, each of which may result in a cleft palate: (a) the intrinsic shelf force may be impaired, e.g., by fetal and maternal genes and by cortisone; (b) the resistance of the tongue may be increased, e.g., by the mechanical stresses on the embryo following amniotic puncture; (c) the head may be too wide to allow the palatine shelves to meet in the mid-line; (d) the shelves may be too narrow to meet in the mid-line.
Obviously it is useless to argue about whether cleft palates are genetically or environmentally determined, or to attempt to find any one cause or cure that will account for all of them. Nevertheless our efforts to clarify the situation are justified, as each etiological factor that is understood may allow some reduction in the frequency of this defect.
ACUTE PANCREATITIS IN CHILDREN
Authors: Blumenstock David A. , Mithoefer James , Santulli Thomas V. 
Published: December 2021

Four cases of acute pancreatitis in children are presented. Thirty-six cases reported in the literature are briefly reviewed.
The diagnosis of acute pancreatitis is rarely made in children before operation or necropsy because the disease is confused with the more frequent causes of abdominal pain and vomiting in this age group. However, the clinical history and abdominal signs may be suggestive of acute pancreatitis. The diagnosis can be confirmed by demonstrating elevation of the concentration of amylase in the serum, provided mumps is not present.
In contrast to adult patients, acute pancreatitis in children is seldom related to disease of the biliary system.
Acute pancreatitis in children may be produced by trauma, acute infection and mechanical obstruction of the pancreatic ducts by round worms. The etiology of the majority of cases, however, remains unknown.
The complications of acute pancreatitis in children include diabetes mellitus, retroperitoneal hemorrhage, pseudocyst formation and hypocalcemic tetany.
Treatment of uncomplicated acute pancreatitis should be conservative if the diagnosis can be made without operation.
MAST CELL LEUKEMIA PRESENTING AS URTICARIA PIGMENTOSA
Authors: Waters William J. , Lacson Perpetua S. 
Published: December 2021

The concept of "urticaria pigmentosa" as a benign dermatologic syndrome needs revision. Generalized organ involvement may be present and in this case, with demonstration of the tissue mast cells in the peripheral blood and bone marrow, we chose to classify it as a form of leukemia.
The differentiation between tissue mast cells and blood basophils is emphasized.
Post-mortem examination revealed generalized infiltration of the body organs with tissue mast cells.
"Heparin" and histamine determinations on frozen, post-mortem specimens of liver showed a concentration of approximately 100-times normal.
Tissue mast cells were demonstrated in the peripheral blood.
The factors associated with the hemorhagic diathesis are reviewed.
STUDIES OF THE PHARYNX
Authors: Bosma James F. 
Published: December 2021

Performance of the hypopharynx was observed clinically and roentgenographically during oropharyngeal inflation, phonation, and swallow in a group of 20 normal subjects and 27 patients recovered incompletely from bulbar-pharyngeal poliomyelitis.
The varied disabilities of motor performance of the hypopharynx resulting from poliomyelitis have been classified, with indication of the particular muscular paralyses causing certain of these entities of disability.
Recent contributions to physiologic and clinical understanding of the motor event of swallow are reviewed. The total failure of swallow in poliomyelitis is not completely explained by familiar paralytic phenomena and possible alternative explanations of contracture or sclerosis of the sphincter muscles, distortions of afferent elements of the swallow reflex, disability of a swallow center, or of functional impairment must be considered.
SYSTEMIC LUPUS ERYTHEMATOSUS AND SYNDROMES POSSIBLY RELATED
Authors: Ogryzlo M. A. , Smythe H. A. 
Published: December 2021

Attention is drawn to the difficulties that may be encountered in the positive identification and classification of many patients suspected of suffering from systemic lupus erythematosus. Much of this is due to a lack of specific criteria, either clinical or pathologic, for the diagnosis of the disease. The problem has been made more difficult by the recognition of a number of other syndromes that bear a superficial resemblance to systemic lupus erythematosus, yet differ in clinical manifestations, natural course, prognosis and other respects.
A feature common to the group is the presence of the L.E. cell phenomenon. The related conditions differ from lupus enythematosus in that the L.E. phenomenon may only be demonstrable intermittently especially during severe exacerbations of the disease, while at the same time disturbances in the electrophoretic pattern of the serum proteins may be much more profound.
In systemic rheumatoid disease the prognosis without steroid therapy is better than in systemic lupus erythematosus, although the morbidity may be great.
The reactions which follow administration of certain chemotherapeutic agents are of considerable interest, particularly in view of the similarity to lupus erythematosus and rheumatoid arthritis, and the reversibility on withdrawal of the offending agent.
The relationship of these syndromes to each other and to classical systemic lupus erythematosus has not yet been resolved, and inclusion of them under the diagnosis of systemic lupus erythematosus at this time must be regarded as premature.
CYSTIC FIBROSIS OF THE PANCREAS
Authors: di Sant'Agnese Paul A. , Lowe Charles Upton 
Published: December 2021

IN THE COURSE of a review of all features of the disease, the following points were particularly noteworthy:
Incidence
This disease accounts for almost all cases of pancreatic insufficiency in children. The incidence in the population of the United States is between 1 in 600 and 1 in 10,000 live births, with a probable average incidence of 1 in 2,500. There is no sex predominance. There is, however, a difference in racial predilection, being rarely seen in the Negro and never in Mongolians. It is a familial disease, displaying the characteristics of a mendelian recessive gene. This means that in an affected family the disease may occur in approximately 25% of the offspring, that both parents must be carriers of the trait and that two-thirds of the non-affected children are also carriers. Birth order has no effect on the inheritance of this disease. The fact that it is usually a lethal disease indicates that the mutation rate for this gene must be very high; the frequency of the single gene in the population has been calculated to be approximately 1 in 50.
Pancreatic Insufficiency
Clinical evidence of poor digestion and absorption of protein and fat is seen in the increased quantities of these substances in the feces, which causes the feces to be bulky, foul smelling, foamy and greasy. Another clinical effect of malabsorption is seen in the failure of the newborn infant with cystic fibrosis of the pancreas to regain birth weight in the first 10 days of life. In the absence of other evidence of disease, this is a sign suggestive of pancreatic failure.
Letters to the Editor
Authors: REICHELDERFER THOMAS E. , NITOWSKY HAROLD M. 
Published: December 2021

We appreciate the opportunity of responding to the betters of Dr. Allan Bloxsom and Dr. R. B. Tudor, and we would like to make the following comments:
First, concerning the duration of exposure of infants in the air lock, this was selected because of three factors. The first of these was the experience cited in Bloxsom's report on the use of the air lock (J.A.M.A., 146:1120, 1951) where 98% of a group of 50 full-term infants and 58% of 50 premature infants (not 44%, as noted in his letter) who required resuscitation were kept in the air lock for 12 hours or less.
Letters to the Editor
Authors: QUICK ARMAND J. 
Published: December 2021

I wish to call your attention to a matter concerning the article of Fresh et al., "Blood Prothrombin, Proconvertin and Proaccelerin in Normal Infancy: Questionable Relationships of Vitamin K" which appeared in Pediatrics (19:241, 1957). On page 248 the following statement occurs: "Notwithstanding the insufficiently substantiated claims of Quick et al., that the simple `prothrombin time' determination is uninfluenced by an excess of factor V or factor VII,...."
I consider such a statement inexcusable. While they could have said that "we regard the claims to be insufficiently substantiated, etc.," they made their statement to appear as a fact, which is not justified.
Schönlein-Henoch Syndrome
Authors: GLASER JEROME 
Published: December 2021

The increased incidence of the Schönlein-Henoch syndrome in recent years has been commented upon by Diamond and Rubin (discussion, Am. J. Dis. Child., 90:544, 1955) and more recently by Derham and Rogerson (Arch. Dis. Childhood, 31:364, 1956). The latter authors suggest that this may be more apparent than real due to the interest aroused by Gairdner's valuable and exceedingly well written paper (Quart. J. Med., 17:95, 1948).
From the standpoint of the allergist another explanation which appears to be very logical may be offered which would account for an actual increase in the incidence of this disease.
Statistics
Authors: DAY RICHARD 
Published: December 2021

I wonder if it would be worthwhile to call the attention of readers of Pediatrics to an error which is made from time to time in the statistical analysis of clinical data, and which has escaped the eyes of editors more than once.
The error arises when an investigator has a large mass of facts, a punch card machine but no hypothesis. To illustrate, consider a clinical survey in which 100 different relationships are tested by the chi-square method.
Sweat Test for Cystic Fibrosis of the Pancreas
Authors: KUSHNICK THEODORE , BOFFA JOHN A. 
Published: December 2021

Following Barbero's report (Pediatrics, 18:189, 1956) concerning a simplified sweat test for the diagnosis of cystic fibrosis of the pancreas, it occurred to us that an even simpler modification might make the test available in small communities. With the aid of a private clinical laboratory (Elizabeth Biochemical Laboratory, Elizabeth, N.J.), Barbero's tube test was modified so that it might be done in the patient's home as well as in the hospital.
Method
The patient's back is thoroughly washed with soap and water, followed by thorough rinsing with tap water.
A Developmental Questionnaire for Infants Forty Weeks of Age: An Evaluation
Authors: STITT PAULINE G. 
Published: December 2021

This monograph is a detailed evaluation of a developmental questionnaire intended for use as a screening device to recognize abnormal behavioral development in infancy. It was one part of a long-term multiphasic study of premature infants, being conducted at the Johns Hopkins University School of Hygiene and Public Health, under the direction of Dr. Paul Harper.
The questionnaire used was based on Gesell's Developmental schedules and his thesis that functional tests of behavior can define central nervous system maturity and integrity.