American journal of diseases of children

TOOMEY, JOHN A.; KELLER, ROBERT A.

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400002001pmid: 20241867

CUTANEOUS testing for susceptibility to diphtheria and scarlet fever has been a widespread practice for many years. The reliability of the former is generally accepted. To immunize against diphtheria three antigens are now in use. Immunization of certain groups of persons, especially nurses and physicians, against scarlet fever is practicable,1 but the reactions encountered in giving Dick toxin have been such that it has never become officially recommended as public health procedure. The following report is a survey of twenty years of cutaneous testing and immunization of student nurses at the contagious department of Cleveland City Hospital. Since 1925, all student nurses who entered contagious service have been given Schick and Dick tests routinely. Those who had positive reactions were immunized against the antigen to which they were susceptible. For about ten years all tests and injections for our own and for nurses from other hospitals affiliated with City Hospital

KRAMER, BENJAMIN; SOBEL, ALBERT E.; GOTTFRIED, SIDNEY P.; Besman, Lottie

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400014002pmid: 20241868

BLACKFAN and Wolbach1 have reported that "histologic evidences of A avitaminosis may occur in infants who are receiving an amount of vitamin A in their diet usually accepted as meeting the minimal protective needs of the body." Similar histologic changes have been observed by one of us (B. K.) in children with chronic diarrhea and cystic fibrosis of the pancreas who received amounts of vitamin A much larger than the considered adequate dose. It has been shown by May and his colleagues2 and Chesney and McCoord3 that impaired intestinal absorption of vitamin A exists in children with celiac disease, cystic fibrosis of the pancreas, obliteration of the bile ducts and cretinism. In an effort to circumvent this barrier to the absorption of vitamin A, the latter was administered by intramuscular injection.4 Although McCoord and Breeze5 obtained an elevation of the vitamin A level in the

HOYNE, ARCHIBALD L.; SLOTKOWSKI, EUGENE L.

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400025003pmid: 20241869

ALTHOUGH sporadic reports of measles encephalitis are found in the literature prior to the year 1923, it is only in the last two decades that encephalitis as a complication of measles has seemed to occur in epidemic proportions. It is difficult to determine the exact incidence of this condition, as not all cases of measles are reported and many cases of mild encephalitis may be missed. Stimson1 stated the opinion that this complication usually develops in less than 1 per thousand cases. Table 12 discloses the incidence in previously reported epidemics of measles and also in our series. There were 10 additional cases at another contagious disease hospital which are not included. From January through June of 1946, 307 patients were admitted to the Cook County Contagious Hospital with the diagnosis of measles. Table 2 divides these cases into three separate age groups, showing the number of cases

WAGNER, RICHARD

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400030004pmid: 20241870

GLYCOGEN storage disease (von Gierke's disease) is a rare condition in childhood, and little is known about its pathologic chemistry. In a recent study on 2 cases of glycogen storage disease Bridge and Holt1 called attention to the glycogen content of whole blood. The occurrence of an increase in the level of glycogen in the blood had been reported by previous investigators.2 Bridge and Holt identified the polysaccharid present in blood of glycogen storage disease as glycogen by its chemical properties. Since 97 per cent of the total glycogen has been found in the blood cells, they calculated from whole blood glycogen a concentration of from 6 to 10 per cent of this carbohydrate in the white blood cells. The assumption was made that all the glycogen is concentrated in the leukocytes with none in the erythrocytes. The present study deals with direct glycogen determinations on isolated white

CLARKE, GENE H.

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400036005pmid: 20241871

IN 1942, Jorgensen and Greely1 demonstrated that sulfadiazine can be administered subcutaneously in a 5 per cent aqueous solution without deleterious local effects. Since then others2 have used this method of administration with some variations regarding dosage and interval between injections but, in general, following the plan which has been widely adopted for oral administration of the drug, namely, 50 to 75 mg. per kilogram (⅓ to ½ grain per pound) of body weight as an initial dose, and approximately twice this amount per day divided into three, four or six doses.3 Glaser and Lawrence2c reported studies of the levels obtained in the blood when the drug was administered by the subcutaneous route. Aside from this study, little attention has been given to the pediatric aspects of subcutaneous administration of sulfonamide drugs. The following report presents the results of a study of blood levels obtained in

McNEIL, MELBA

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400044006pmid: 20241872

WHILE not unheard of, congenital diaphragmatic hernia on the right diagnosed in infancy is believed rare enough to warrant the report of a single case. This child was observed by me at regular intervals from birth until the seventh month, at which time symptoms referable to the abnormality first developed. HISTORY OF THE CASE J. L. H. III was born Oct. 10, 1946, being the first child of a 17 year old mother. During the second month of gestation a positive Wassermann reaction had been obtained, and intensive antisyphilitic treatment was carried out during the entire pregnancy. At the time of delivery both the mother's Wassermann reaction and the Wassermann reaction of the cord were negative. The infant breathed spontaneously at birth, and his color was good at all times. Breast feeding was supplemented with a Dryco formula. At four weeks the infant's gain was insufficient and he seemed hungry.

GOLDSTEIN, LOUIS S.

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400046007pmid: 20241873

TO date, no case of congenital essential thrombopenic purpura in twins has been described in the literature, which contains reports on 19 cases. The literature up to 1936 was reviewed by Sanford, Leslie and Crane,1 who listed 12 cases. Since then cases have been reported by Davidson,2 Whitney and Barritt,3 Urbanski and Hutner,4 Schefrin and Schechtman5 and Morrison and Samwick.6 The latter proposed the following criteria for a diagnosis of thrombopenic purpura: (1) purpura, with petechiae and ecchymoses; (2) increase in bleeding time; (3) increase in clot retraction time; (4) decrease in platelets; (5) no change in coagulation time; (6) no change in prothrombin time; (7) either normal or increased number of megakaryocytes and/or immature megakaryocytes; (8) normal vitamin C content; (9) positive response to tourniquet test; (10) normal or slightly enlarged spleen; (11) absence of adenopathy; (12) leukemoid reaction with leukocytosis and polynucleosis,

PETERSON, J. CYRIL

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400049008pmid: 20241874

IN A RECENT article1 a colleague and I reviewed the literature relating to pernicious anemia in childhood and reported the first authenticated case1a from America. In this postscript I wish to show the responses of the patient to folic acid. The patient, A. A., has been followed continuously since November 1940. Throughout she has shown gastric achlorhydria and can be maintained in a state of health only when she is continuously treated for anemia with liver extract or an equivalent. She has been observed through five relapses, some specifically induced by withdrawal of treatment. Erythropoiesis has shown consistently with each relapse an arrest of maturation at the megaloblastic level. She responds in a characteristic way to the administration of liver extract (chart 1). On Feb. 6, 1946, she received her last injection of liver extract2 but continued until March 25, 1946, to receive orally 4 cc. of

SNYDER, C. HARRISON; VICK, EDWARD HOGE

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400052009pmid: 20241875

HYPERTENSION of long duration and serious degree is seldom encountered in pediatric practice, but when it does occur it may offer a most fascinating problem in differential diagnosis. Most cases are due to renal disease, others to coarctation of the aorta, acrodynia, lead poisoning, Cushing's syndrome, hyperthyroidism and rare types of brain tumor involving the hypothalamus. A few cases, by elimination, have to be labeled "essential hypertension," but only after thorough study has failed to reveal the cause. For most cases of hypertension there is no effective therapy. But there is one further group, illustrated by the 3 cases to be reported here, in which surgical intervention may effect the immediate cure of an otherwise progressive and fatal hypertension. These are the cases due to pheochromocytoma or paraganglioma—tumors of chromaffin tissue which secrete epinephrine. Such tumors usually arise from the adrenal medulla (where they are called "pheochromocytoma"), but occasionally develop

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400073010

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400106011

GENERAL NEWS Fund for Investigations Having Therapeutic Interest.—The Committee on Therapeutic Research of the Council on Pharmacy and Chemistry has a fund made available by the American Medical Association to be expended in the promotion of investigations that have therapeutic interest. Applications for grants in this general field, which is conceived very broadly, are invited. An adequate description of the research proposed should be incorporated in the application. As the grants from the Council may well be small in relation to the total cost of investigations aided, information is requested as to whether the proposed research is a continuation of investigation which has been previously supported by some research fund and as to whether the work is to be supported in part by a grant or grants from other sources. Applications should be in the hands of the Secretary of the Council, 535 North Dearborn Street, Chicago 10, Illinois,

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400107012

There are over 20,000 voluntary health agencies in the United States, with at least 300,000 rather exceptional citizens serving on boards or committees of these agencies. The number of volunteer workers giving some of their time and effort outside board meetings would exceed a million, and this does not include the millions of Red Cross workers. Exclusive of that spent by the Red Cross, the money spent annually throughout the country approaches $50,000,000. It is obvious, therefore, that a critical evaluation of the purpose, function and prospects of these voluntary health agencies is of great importance to the future growth of organized health work in this country. The present study was launched under the auspices of the National Health Council in 1941 aided by a fund from the Rockefeller Foundation. The volume is well worth reading by pediatricians, many of whom are, no doubt, on the boards of these voluntary

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400108013

To dispel the possible impression that the reviewer has been too critical when reading this book, he will say at the outset that Professor Patten is to be congratulated highly for his excellent achievement. He has fulfilled admirably his endeavor to narrate in simple and readable form the phases of human embryology which are of special interest to medical students and physicians. The reader is impressed with the style of the text and the freshness of its approach. The developmental processes are presented as a story of dynamic events, and emphasis is placed on the functional significance as they unfold in sequence. The topics are well organized and clearly set forth. He has been skilful and especially successful in the way in which he has correlated human embryologic and adult structures and has portrayed the basis for the explanation of developmental anomalies. Special thought has been given to expounding those

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400110014

This volume thoroughly discusses a form of therapy which is not often used by the practicing clinician. The book opens with excellent chapters on the history and technic of pneumoperitoneum. Special chapters are alloted to the complications of this procedure before the clinical applications are presented. The major portion of the text deals with tuberculosis of the peritoneum, the digestive tube and the lungs. The chapter on tuberculous enterocolitis devotes a number of pages to clinical symptoms and laboratory and roentgenologic diagnosis, which the reviewer feels is unnecessary in a volume primarily dedicated to a therapeutic procedure. The inclusion of 44 reports of cases in this chapter does not add to the value of the text. One hundred and twenty-nine pages are devoted to the treatment of pulmonary tuberculosis. The physiologic aspects of pneumoperitoneum on the apicobasal diameter, the volume and the surface of the lung are discussed. The author

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400111015

Dr Gesell and Dr. Ilg, with their collaborators, have written a monograph on the development of children from 5 to 10 years of age, which carries on their work with younger children into the school years. It therefore extends their observations on the development of children through half of the span of growth. Part 1 is concerned with the picture of the entire cycle of development with emphasis on mental growth and the effect of environment on it, particularly that of parents and teachers. Part 2 gives first a series of cross sectional studies of children from 4 weeks to 4 years of age. This is followed by studies of each of the years from 5 to 10. In each chapter the authors describe their behavior "profile" of the child, followed by a picture of individual traits at each age listed under ten headings: motor characteristics, personal hygiene, emotional expression,

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400112016

While this book is planned for nurses, it should be of interest to pediatricians because of the large part played by nurses in school health services. It not only gives a good interpretation of what a school health program is and the principles involved but offers valuable suggestions to the school nurse. It stresses the philosophy that "the schools can do a better job in health education than they are now doing, but if they are to do this work well, it will have to be as health education and child protection and not by actually supplying health services which the community should provide." With this point of view the whole program is considered to indicate how the nurse functions, the problems she faces and her relation to the responsibilities of teachers, principals, parents, physicians and many others who serve children. Appropriate emphasis is given to using the findings of

1947 American journal of diseases of children

doi: 10.1001/archpedi.1947.02020400113017