American journal of diseases of children

SMITH, CLEMENT A.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010011001

THE FACT that representatives of two specialties, obstetrics and pediatrics, are at this meeting indicates the interest of us all in every stage of the period that begins with an intrauterine fetus and ends with an extrauterine baby. Therefore, both the fetus and the newly born infant will be dealt with in this review of the fundamental principles of anoxia and cyanosis. In conclusion, an attempt will be made to describe briefly the beginning of extrauterine respiration. ANOXIA Although anoxia is the subject of a vast literature, the facts have not changed since Means in 19241 clarified them by the diagrams presented, in somewhat modified form, in figure 1. It will be noted from the scheme of each diagram that in passage through the capillaries blood gives up a certain amount of its oxygen and simultaneously undergoes a decline in its oxygen tension. The amount of oxygen is expressed

ROSS, VICTOR; CLAPP, FRANCES L.; PARSONS, C. H.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010020002

A NUMBER of reports dealing with reactions following immunization against tetanus have appeared in recent years.1 The elimination of Witte's® peptone from the medium in which the bacillus is grown seemed to reduce the frequency of disturbing reactions. Nevertheless, it appears desirable to improve on the fluid toxoids being used, as well as on the product obtained by the simple addition of relatively large amounts of alum to such crude toxoids. Several methods of purifying crude toxoid or toxin have been described in the literature. Boivin and Izard2 used trichloroacetic acid to precipitate the toxoid and thereby obtained a considerable removal of inert substances. Eaton and Gronau3 precipitated tetanus toxin with cadmium chloride, after a previous treatment with calcium chloride. Toxin was then eluted and reprecipitated with ammonium sulfate and the latter removed by dialysis. Pickett, Hoeprich and Germain,4 following the same procedure and applying it

SCHONFELD, WILLIAM A.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010027003

IN ORDER to understand the psychologic disturbances of pubescence and adolescence, it must be borne in mind that the transition from childhood to full physiologic and psychosexual maturity is a particularly trying period.1 Knowledge is still limited with respect to the interplay of psychologic, organic and growth factors which during the second decade of life have an effect on personality development and may lead to psychosomatic disorders both during adolescence and later in life.2 The observations in this report are based on a psychosomatic study of 256 boys whose ages ranged from 9 to 16 years at the initial visit. In all these patients, either the child or a parent expressed concern over the sexual inadequacy of the patient's physique, although there was no evidence of gross congenital defects or endocrine dysfunction and all the boys were capable of eventual development of spontaneous puberty. Some of the somatic

LEVITIN, MILTON; ZELMAN, MORRIS

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010040004

PNEUMONECTOMY, or resection of the diseased lung, in the treatment of pulmonary tuberculosis in adults is now an accepted procedure, although indications for its employment remain controversial. While pneumonectomies have been performed in children, mainly for bronchiectasis, we were unable to find, in a review of the literature, cases of pulmonary tuberculosis treated in this manner. There are, however, brief references to lobectomies in the treatment of this disease in persons in the growing age period, with apparent success.1 As the disease in children usually does not progress to the stage that makes this form of therapy necessary, reports can be presented on only 4 patients in whom pneumonectomy was performed since November 1946 for pulmonary tuberculosis. The children ranged in age from 3 to 13 years at the time of operation. The operation in children presents problems not encountered in adults. Obliteration of the residual "dead space" created

KHALIL, A.; SAFWAT, A.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010052005

IN SPITE of the large amount of clinical research on whooping cough, no curative treatment of the disease has yet been discovered. Special serum therapy, although definitely beneficial in the early stages, is less so as the disease progresses.1 Sulfonamide compounds, as well as penicillin, have no influence on the progress of the disease, their value being mainly against secondary infections.2 The use of streptomycin seems to be promising as far as can be judged from the results of observations in vitro and of experiments on rats, but its use in human subjects is still under trial.3 The recently suggested high altitude treatment is also as yet in the stage of investigation.4 The present day treatment of the disease, once it has reached the paroxysmal stage, is, therefore, mainly symptomatic. The commonest and, until now, probably the most beneficial treatment consists, in addition to ordinary nursing

FISHER, JOHN H.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010060006

PEPTIC ulcers in infants were described about one hundred and twenty years ago by Cruveilhier,1 whose writings clearly illustrated 3 cases of gastric ulcers in infants, 1, 2 and 4 weeks old, respectively. It is commonly believed that this disease rarely occurs in infants and children. Therefore, its possibility has not received the consideration it justly deserves in cases of feeding difficulties, anemia, gastrointestinal disturbances and marasmus of obscure nature. Judging from reports in the literature, it appears that the disease is commoner in the United States and on the European continent than it is in Great Britain. Paterson2 stated that only 3 British cases had been reported prior to 1922 and that in the twenty years previous no case had been encountered at the Great Ormond Street Hospital, in London. As attention has been drawn to this condition, more and more cases are being recognized and reported.

JAWORSKI, ALEXANDER A.; FARLEY, JOHN E.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010069007

THE PURPOSE of this paper is to establish further the usefulness of hyaluronidase, a relatively new agent in facilitating administration of fluids in pediatric practice, and to present results of numerous studies on toxicity performed to insure the relative safety of alidase,®1 the commercial hyaluronidase product used in this clinical investigation. Duran-Reynals2 and McClean3 were the first to note a spreading factor, hyaluronidase, present in testicular extract aiding spread of subcutaneously injected dye and fluid. This factor has since been obtained from many sources, including snake venom, leech, spider and bee extract, spermatozoa, some carcinomas and many bacteria. Chain and Duthie4 identified the spreading factor as a mucolytic enzyme which acts on hyaluronic acid,5 a mucopolysaccharide which in its native form is a gel or mucin clot not bound to protein. By use of histochemical methods such as metachromic reactions of certain dyes, acid mucopolysaccharides

VÉGHELYI, PETER V.; KEMÉNY, TIBOR; SÓS, JOSEPH

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010075008

IN 1945, an unusual change was observed in the pancreas of an infant who had died from dysentery associated with nutritional edema resulting from a diet lacking animal protein. The change consisted in cystic atrophy of a small part of the acinar tissue. Other parts of the excretory system and the islets seemed to have remained intact. Reproduction of the change experimentally was attempted by the use of various deficient diets and toxic agents. Trials to induce the lesion by dietary means were successful.1 However, chronic poisoning by small doses of carbon tetrachloride brought about regular production of this change in our series. EXPERIMENTAL METHOD Male albino rats of the same strain, ranging in weight from 160 to 190 Gm., were used. They were fed a well balanced stock diet, with a liberal supplement of water-soluble vitamins and cod liver oil with added vitamin A. The daily amount of

ABBOTT, O. D.; TOWNSEND, RUTH O.; FRENCH, R. B.; AHMANN, C. F.

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010079009

IN 1940, a study of the effectiveness of the school lunch in improving the nutritional status of the children in one rural school was begun, and in 1946 the first report was published.1 During this study, special attention was given to skeletal development as shown by roentgenograms of the carpal bones and epiphyses of the distal portion of the radius and ulna. The report herein presented deals with carpal and epiphysial development as another index of the nutritional status of these children. Ossification of these centers begins soon after birth and continues to maturity, thereby furnishing a continuous measure of skeletal progress. Moreover, the carpal bones and epiphyses are so easily evaluated by roentgenograms and have been used by so many investigators in the study of skeletal development that standards and norms are available for comparison. While the worth of roentgenography in the study of pathogenic and traumatic conditions

KUNSTADTER, RALPH H.; MILZER, ALBERT; WHITCOMB, FRANCES

1950 American journal of diseases of children

doi: 10.1001/archpedi.1950.04040010092010

THE INCREASED interest in fungous diseases of the lung is attested by the large number of articles appearing in the literature during the past few years. This impetus apparently was initiated during World War II because of the numerous cases of benign coccidioidomycosis that developed in certain troop units. Smith1 suggested that histoplasmosis also may occur endemically in a benign form. Subsequently, many surveys and studies were undertaken throughout the United States and the relationship of nontuberculous pulmonary calcifications to benign histoplasmosis has been established. While studying coccidioidomycosis in the military service, one of us (R. H. K.) observed a case of bronchopulmonary mycosis which roentgenologically resembled tuberculosis and coccidioidomycosis, but which was proved to be caused by Geotrichum, a related fungus.2 According to Dodge,3 only 12 cases of Geotrichum infection had been reported by 1935, 8 of which were infections of the respiratory tract. In 1933,