bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status of Exchange Transfusion
Authors: BOGGS THOMAS R. 
Published: December 2021

While respecting Dr. McKay's wisdom and judgment, I feel obliged to take issue with certain of the concepts he seems to champion in his article "Current Status of Exchange Transfusion in Newborn Infants" (Pediatrics, 33:763, 1964). I was pleased to read the Journal's "Introductory Note" carefully pointing out that such articles, while usually contributed by a member of the Editorial Board, reflect the author's own practice.
First, I cannot agree with Dr. McKay that it is currently possible to identify which infant with idiopathic hyperbilirubinemia and a serum bilirubin concentration of 18 mg/100 ml if premature, or 20 mg/100 ml if full term, is, and which is not, at risk as far as concerns kernicterus.
CHRONIC DIARRHEA AND ALKALOSIS
Authors: Tucker Virginia L. , Wilmore Douglas , Kaiser Carolyn J. , Lauer Ronald M. 
Published: December 2021

Three balance studies were carried out in a patient with severe diarrhea with alkalosis which had its onset in the neonatal period. The patient excreted frequent, profuse, watery stools containing large quantities of chloride, sodium, and potassium. The urine was quite hypotonic. When sufficient amounts of sodium, potassium, and chloride were provided in the diet and the child was not allowed to become dehydrated, body electrolyte and water could be maintained in a physiological range. This did not affect the volume, frequency, or content of the stools. This patient was considered to be similar to the two cases of "congenital alkalosis" with diarrhea originally described by Gamble and Darrow.
An investigation of causes of the metabolic abnormality of this patient which had not been previously studied were presented. An exploratory laparotomy failed to demonstrate an anatomical lesion which might explain the patient's basic problem. No abnormal endocrinopathy could be demonstrated. The child did fail to hydrolyze lactose in one out of three lactose tolerance tests. The absence of lactase activity in the duodenum was confirmed by a duodenal biopsy. Since a number of investigators have recently demonstrated a transient lactase deficiency in association with chronic or acute diarrhea, which resolved when the underlying problem was corrected, it was considered quite unlikely that this was the intrinsic defect in this child.
OPTIC ATROPHY IN CHILDHOOD
Authors: Schwartz James F. , Chutorian A. M. , Evans Robert A. , Carter Sidney 
Published: December 2021

An attempt has been made to determine the significance and outcome of optic atrophy as an apparently isolated entity in the pediatric age group.
A follow-up study was made of 48 children who presented in early childhood with optic atrophy with no known cause and no obvious systemic or neurological disease. It was found that the prognosis for useful vision is in general favorable in this group of cases. However, the significant incidence of mental retardation and other neurological impairment was noted for those children who had manifested severely impaired vision under one year of age. There was no correlation between specific symptoms and the outcome of vision. The patients with idiopathic optic atrophy were compared with other patients who presented with optic atrophy without signs of systemic or neurological disease on initial examination but who were later found to have underlying disease. X-ray findings of enlargement of the optic foramina, deformity of the sella turcica, and suprasellar calcification or hyperostitic changes in the region of the optic foramen were found to be important differential diagnostic features, as was the presence of proptosis or visual field defects, reflecting involvement of the optic chiasm or retrochiasmal visual pathways. By the use of these features and certain laboratory determinations it was possible to separate the idiopathic group from patients whose optic atrophy was secondary to optic nerve and chiasm gliomas, other intracranial neoplasms, fibrous dysplasia, congenital syphilis, and orbital neurofibroma. Problems in the diagnosis and differential diagnosis of optic atrophy have been discussed.
Unexpected Finding from a PKU Newborn Screening Program
Authors: COFFELT R. WENDELL 
Published: December 2021

We wish to draw attention to the unexpected finding of a maternal phenylketonuria case from our Guthrie PKU newborn screening program here in Burbank, California.
The first specimen taken from the infant involved was on the third day of life and registered 6 mg/100 ml phenylalanine content in the blood. This occurred very early in our program and at that time we did not feel an immediate follow-up should be done unless the result appeared above 6 mg/100ml. The next specimen was taken when the baby was 6 weeks old routinely in the doctor's office.
Neonatal Listeriosis, and the Problem of Retrieving Medical Information
Authors: DELTA BASIL C. 
Published: December 2021

I was most interested in the recent paper of Ray and Wedgwood which reported six cases of neonatal listeriosis, along with a review of the literature (Pediatrics, 34:378, 1964). In the article it is stated: "There are 63 welldocumented cases of neonatal listeniosis in the United States and Canadian literature."
It is surprising that in such a review article several recent reports have been omitted. Details of the additional cases of listeric infection in the newborn are being submitted in a summarized form (Table I) to complete the review for the benefit of the readers of Pediatrics.
Neonatal Hypoglycemia and Early Feeding
Authors: DAVIES PAMELA A. , SMALLPEICE VICTORIA 
Published: December 2021

Dr. Naeye (Pediatrics, 34:415) has much of interest to say about organ composition in newborn parabiotic twins and neonatal hypoglycemia. He suggests that gluconeogenesis from protein is the source of the glucose which must be necessary after hepatic glycogen is exhausted "since adequate alimentary carbohydrate is often not available for several days." We write only to put forward a practical point.
For the past two years we have conducted a trial of the immediate feeding with undiluted breast milk of infant weighing 1,000-2,000 gm at birth.
THE DEVELOPMENT OF THE LUNGS OF LAMBS
Authors: Orzalesi M. M. , Motoyama E. K. , Jacobson H. N. , Kikkawa Y. , Reynolds E. O. R. , Cook C. D. 
Published: December 2021

1. Lambs with estimated gestational ages from 55 to 154 days were delivered by cesarean section. Observations were made on animals in the fetal state and after the onset of respiration in lambs of more than 130 days gestation. Spontaneously born lambs were also studied.
2. Measurements of arterial blood gas tensions, pH, lactic acid concentration, and blood pressure showed that the animals were always in good condition.
3. Normal surface activity of lung extracts was first found in fetuses of about 126 days gestation and was present in the lambs of more than 130 days gestation which breathed.
4. Electron microscopy showed that cells containing osmiophilic inclusion bodies first appeared at about 120 days gestation and preceded by only a few days the appearance of normal surface activity of lung extracts. The number of cells containing osmiophilic inclusion bodies as well as the total number of inclusion bodies increased toward term. There was no apparent difference in the number of these cells or the total number of inclusion bodies in the lungs of lambs which breathed as compared to fetuses of comparable gestational age.
5. The water content of the lungs per unit of dry tissue decreased during gestation until about 95 days and then increased again until term. After the onset of respiration the water content rapidly decreased.
6. The blood content of the lungs per unit of dry tissue increased significantly during gestation and there was a further probable increase after the onset of respiration.
THIRTEEN BOYS WITH PROGRESSIVE SEPTIC GRANULOMATOSIS
Authors: Carson Merl J. , Chadwick David L. , Brubaker Charles A. , Cleland Robert S. , Landing Benjamin H. 
Published: December 2021

1. Thirteen boys are described who present a syndrome of chronic suppurative lymphadenitis, chronic dermatitis, chronic pulmonary disease, and hepatosplenomegaly, with an eventually fatal outcome.
2. The cases described appear to have the same basic disorder as those previously reported by Landing and Shirkey and by Bridges, Berendes, and Good.
3. Despite the frequent finding of hypergammaglobulinemia, no defect of antibody synthesis has been demonstrated.
4. The existence of an as yet unidentified physiological defect common to these patients is suggested.
PRELIMINARY REPORT
Authors: Chu J. , Clements J. A. , Cotton E. , Klaus M. H. , Sweet A. Y. , Thomas M. A. , Tooley W. H. 
Published: December 2021

HYALINE MEMBRANE DISEASE, or idiopathic respiratory distress syndrome, is the commonest cause of death in the newborn. Although it has been the subject of much investigation, its etiology and pathogenetic mechanisms have remained obscure. Accordingly, there are several theories about its causation and many opinions about its optimal therapy, some of these seemingly contradictory. As a result of recent studies, both our own and those of others, we believe that we have gained sufficient new insight into the functional basis of this syndrome to select therapeutic procedures more rationally than before and to suggest that the syndrome be renamed the pulmonary hypoperfusion syndrome.
We believe that the syndrome reflects the calling into action of reflex vasoconstriction which tends to centralize the circulation of the blood when the fetus or newborn infant is subjected to one or more of several stresses, such as hypoxemia, acidemia, hypothermia, and hypovolemia. This type of response has been observed in several animal species and tends to preserve blood flow to the brain, heart, and placenta at the expense of flow to other organs, especially the gut, the kidneys, and the lungs and has survival value in the presence of these stresses. Since the ductus arteriosus is patent in the fetus and newborn infant, however, blood flow to the alveolar capillaries may be virtually cxeluded by pulmonary vasoconstriction, and ischemic damage is more likely in the lungs than in other organs. It is for this reason that we prefer to emphasize the occurrence of pulmonary hypoperfusion in this syndrome.
THE BI-DIRECTIONAL PLACENTAL TRANSFER OF I131 3:5:3' TRIIODOTHYRONINE IN THE RHESUS MONKEY
Authors: Schultz Marvin A. , Forsander Jean B. , Chez Ronald A. , Hutchinson Donald L. 
Published: December 2021

The placental transfer of I131-labeled triiodothyronine has been studied in Rhesus monkeys. The majority of maternal to fetal placental transfer of radioactivity was in the form of iodide and a chemically unrecognized compound on chromatograms. Only traces of triiodothyronine or thyroxine were detected. In the fetal to maternal transfer studies, triiodothyronine was more readily transferred into the maternal circulation with small amounts of iodide and a similar unknown compound appearing. This substance may be sulfate conjugated triiodothyronine. There was a considerably higher concentration gradient used in the fetal to maternal transfers than in the reverse direction. The implications of this gradient difference are discussed.
The data from this study add further evidence to the clinical experience that maternal thyroid hormones are not readily available to meet all of the fetal needs during the latter part of pregnancy.
International Conference on Intrauterine Fetal Surgery
Authors: LUCEY JEROLD F. , FRIEDMAN EDWARD 
Published: December 2021

A NUMBER of research workers in obstetrics, pediatrics, physiology, hematology, pathology, internal medicine, immunology, aerospace medicine, and veterinary science are currently working on problems involving surgical approaches to the fetus in utero. To stimulate and facilitate communications between research workers interested in this new field, a small workshop conference was held in Stowe, Vermont, November 9-11, 1964. This conference was supported by a research grant (HD-01151-01) from the National Institute of Child Health and Human Development and was jointly sponsored by the University of Vermont College of Medicine and the Vermont State Health Department.
Three of the papers presented at this conference, and the discussion that followed their presentation, have been selected for rapid publication in this journal because of their immediate clinical interest.
The first step toward direct treatment of the human fetus has already been made. It can be anticipated that others will follow. The commonly held myth that one cannot study or treat the fetus without seriously jeopardizing survival will be examined much more critically in the future.
Who will be the physician for the fetus of the future remains to be determined. A successful answer will almost certainly require close co-operation between many specialties.
IMPAIRMENT OF INTESTINAL HYDROLYSIS OF LACTOSE IN NEWBORN INFANTS
Authors: Boellner Samuel W. , Beard Alice G. , Panos Theodore C. , Ross Ann 
Published: December 2021

A total of 122 oral lactose, glucose, glucose-galactose, and intravenous galactose tolerance tests were performed on 38 premature infants age 0-44 days and on 11 term infants age 0-3 days with the following conclusions:
1. Median fasting blood glucose levels were lower in premature infants than in term infants; values in premature infants rose steadily from 36 mg/100 ml in infants less than 3 days of age to 70 mg/100 ml in infants over 15 days of age.
2. Following orally administered lactose, 30- and 60-minute increments in blood glucose values were significantly less in premature and term infants younger than 3 days than in older infants. This was not true following oral administration of glucose.
3. In premature infants 0-3 days of age, 30- and 60-minute increments were significantly less following lactose than after either glucose or glucose-galactose. After 2 weeks of age, lactose tolerance tests were similar to glucose tolerance tests.
4. Intravenous galactose tolerance tests showed competent conversion of galactose to glucose in all age groups.
5. Significantly greater increments in blood glucose values were observed in premature and term infants less than 3 days of age when lactase was introduced into the duodenum prior to lactose administration.
From the present study, it appears that hydrolysis of lactose in the intestine of the newborn infant is relatively impaired during the first few days of life. Further studies with quantitative assays of lactase activity in the intestinal epithelial cells will be necessary to determine whether an absolute insufficiency of lactase exists at birth.
CARDIODYNAMIC STUDIES IN THE NEWBORN
Authors: Rudolph Arnold J. , Vallbona Carlos , Desmond Murdina M. 
Published: December 2021

Patterns of instantaneous heart rate were studied in 74 premature infants with idiopathic respiratory distress syndrome. Half (50.3%) of the recordings showed this finding during the course of the disease. It was found most frequently during the first 24 hours after birth. This finding is reversed in recovering infants.
Based on present data, persisting fixation of the heart rate in an infant with idiopathic respiratory distress appears to be indicative of a poor prognosis, whereas the presence or return of fluctuations in the recording of such an infant may permit a more favorable outlook.
ENDOGENOUS RENAL CLEARANCE RATES OF FREE AMINO ACIDS IN PRE-PUBERTAL CHILDREN (Employing an Accelerated Procedure for Elution Chromatography of Basic Amino Acids on Ion Exchange Resin)
Authors: Scriver Charles R. , Davies Eluned 
Published: December 2021

Six male and three female children in good health and between the ages of 3 and 10 years were studied. Fasting plasma concentrations and urine excretion rates of free amino acids were measured using automated ion exchange chromatography, utilizing a modified method for analysis of the basic amino acids. Endogenous clearance rates and net tubular absorption of plasma amino acids were also calculated.
The plasma concentration of free amino acids is generally slightly lower than in the adult subjects and renal clearance rates are slightly higher. Less than 5% of the filtered amino acid load is excreted in the urine. Intra-individual variation tends to be smaller than inter-individual variation.
WHOSE CHROMOSOMES TO COUNT IN MONGOLISM?
Authors: McKay R. James 
Published: December 2021

Every physician who must make decisions in the management of a child with Down's syndrome faces the problem of whether or not chromosomal analyses should be done and, if so, upon which members of the family. The purpose of such analyses is the identification of those individuals who may be expected to have an increased incidence of mongolism among their offspring as a result of a translocation of a 21 chromosome, a 21 isochromosome, mosaicism for 21-trisomy, or 21-trisomy itself. However, the high cost and difficulty of obtaining chromosomal analyses require that their number be kept to the minimum necessary, and that appropriate short cuts in the laboratory method also be applied whenever possible. The following paragraphs will attempt to lay a base for, and to outline, a logical and practical approach to the chromosomal screening of relatives of patients with Down's syndrome.
Table I lists various parental abnormalities involving the 21 chromosome, together with the theoretical proportion of cases of mongolism to total live births for each. In considering this table, the reader should keep in mind that it refers to an estimated 1 or 2% only of parents of patients with Down's syndrome. In an estimated 98-99% of instances, both parents are chromosomaliy normal.
Although the observed proportion of cases of mongolism to total live births approximates the theoretical ratio among the infants of mothers with the phenotype characteristic of Down's syndrome, the observed proportion is lower than the theoretical ratio among the children of parents with a normal phenotype and a chromosomal abnormality predisposing to mongoloid offspring.
A Case Report of "Cape Cod" Rocky Mountain Spotted Fever with Multiple Coagulation Disturbances
Authors: Atkin M. David , Strauss Herbert S. , Fisher George U. 
Published: December 2021

A case of "Cape Cod" Rocky Mountain Spotted Fever complicated by thrombocytopenia, circulating anticoagulant activity, and deficiency of Vitamin K-dependent clotting factors that responded to the intravenous administration of Vitamin K has been presented. To our knowledge, this is the first such case described.
Coagulation studies supported, in part, by grants from the Wimpfheimer Foundation and the John A. Hartford Foundation.
We are indebted to Dr. Sherwin V. Kevy of the Children's Hospital Medical Center for performing tests of fibrinolysis and to Dr. Edward S. Murray of the Department of Microbiology of the Harvard School of Public Health for his assistance in the isolation of Rickettsia and the performance of the serologic tests for diagnosis.
Genetics and Disease, Alfred G. Knudson, Jr. New York: McGraw-Hill Book Company, 1965, 294 pp., $10.50
Authors: Gerald Park S. 
Published: December 2021

The current interest in genetics has resulted in the recent appearance of numerous reviews and monographs on the subject. Many of these have been of such a general approach that hey are difficult for the clinician to translate no terms useful at the bedside. This condensed treatise by Dr. Knudson is one of the few which attempts to perform this translation.
Readers are guided systematically from the basic concepts of Mendel's "Laws of Inheritance" through almost the entire range of clinically applicable genetics, up to and including the regulatory models proposed by Jacob and Monod.
Red Urine (Continued)
Authors: Trimble George X. 
Published: December 2021

Dr. S. Levin of Johannesburg, South Africa, in his contribution "Red Urine: The Monday Morning Disorder of Children" (Pediatrics, 36: 134, 1965) remarked: "Over the past 20 years he Index Medicus does not list the phenomenon of red urine as a consequence of the ingestion of colored food."
Whether his statement is a reflection of inadequate survey of the medical literature by Index Medicus, or of the difficulty of making an accurate search by Index Medicus of the medical literature over a 20-year span, I am nable to say.
TOWARD A NEW DIMENSION IN HUMAN GROWTH
Authors: Forbes Gilbert B. 
Published: December 2021

It is with a deep sense of appreciation that I accept this honor, and proudly join the roll of distinguished Borden Awardees. In doing so, I should like to pay special tribute to two of my mentors—Dr. William Bradford and the late Dr. Alexis Hartmann—who stimulated and encouraged me in my work, and more importantly, gave me time in which to pursue it; and to Dr. John Hursh, of the University of Rochester Atomic Energy Project, for his most generous collaboration.
The measurement of human subjects in systematic fashion is a recent innovation, dating only to the early nineteenth century. This period also marked the rise of modern chemistry, and by mid-century von Liebig had found that sodium was the principal cation in body fluids while potassium was predominant in cells, and Carl Schmidt had analyzed blood serum in great detail.
The year 1857 saw the publication of one of the first attempts to analyze the body as a whole. The young author, Albert von Bezold*, analyzed the bodies of small animals for water, solids, and ash1, and announced as a result of his findings a fundamental concept in regard to tissue composition, namely, that animals possess water, organic matter, and ash contents which are characteristic of species and age. He found that growth was accompanied by a decrease in percentage of water and an increase in ash; and further that these changes occurred more rapidly in the early phases of the growth process. Similar trends in composition were predicted for man.
PRESIDENT'S ADDRESS
Authors: TOWSLEY HARRY A. 
Published: December 2021

IN Ancient Greece, the change of one generation of the Olympic games to the next was symbolized by the passing of a torch, the flame of which was never allowed to die.
We have a ritual in our Academy wherein the president, when he retires, passes on a report of the accomplishments of his presidential year and the new president catches the torch and carries forward the flame in what I hope will be a never ending ascension of our traditions.
My predecessors were men of dedication and experience in our profession, and they accounted for their stewardship in the final rite with words of grandeur and wisdom. Some of you have heard most, if not all, of the presidential addresses that have been given since our Society was founded in Detroit, 35 years ago. Knowing this, I approach this moment with some trepidation and with a humble spirit, but with the conviction that I must say the things to you that are in my heart and mind.
Before I go further, I must acknowledge that my ascension to this highest honor that may come to any pediatrician came unexpectedly because of the passing of our friend and colleague, who had been nominated to serve this year. The passing of Harold Flanagan and Frank Douglass, your last president, was a sad loss to the Academy, for in their lives they practiced the precepts of the Academy and its founding principles. We sincerely memorialize their many contributions to the cause of children's health and their love of humanity.