A.M.A. Journal of Diseases of Children

HAGGERTY, ROBERT J.;MARONEY, MARGARET W.;NADAS, ALEXANDER S.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030529001pmid: 13372046

Abstract Introduction Essential hypertension is the principal cause of persistently elevated blood pressure in adults.1 In children, by contrast, essential hypertension is rare; renal diseases, diseases of the central nervous system, coarctation of the aorta, and endocrine disturbances are the commonest etiological factors.*In view of the paucity of reported cases of essential hypertension in the pediatric literature, it seemed worthwhile to present the cases with this condition encountered at the Children's Medical Center, Boston. We shall emphasize the salient points in differential diagnosis and discuss the therapeutic approaches. References 1. White, P. D.: Heart Disease , Ed. 4, New York, The Macmillan Company, 1951. 2. McCrory, W. W., and Nash, F. W.: Hypertension in Children: Review , Am. J. M. Sc. 223: 671, 1952.Crossref 3. Hughes, J. G.: Symposium on Hypertension: Hypertension in Infancy and Childhood , J. Tennessee M. A. 45:469, 1952. 4. Griffiths, A. L.: Hypertension of Renal Origin in Childhood , Arch. Dis. Childhood 25:81, 1950.Crossref 5. Faber, H. K., and James, C. A.: The Range and Distribution of Blood Pressures in Normal Children: Clinical Application of Statistical Methods to Interpretation of Deviation from Normal Average , Am. J. Dis. Child. 22:7, 1921.Crossref 6. Woodbury, R. A.; Robinow, M., and Hamilton, W. F.: Blood Pressure Studies on Infants , Am. J. Physiol. 122:472, 1938. 7. Robinow, M.; Hamilton, W. F.; Woodbury, R. A., and Volpitto, P. P.: Accuracy of Clinical Determinations of Blood Pressure in Children with Values Under Normal and Abnormal Conditions , Am. J. Dis. Child. 58:102, 1939.Crossref 8. Day, R.: Blood Pressure Determination in Children: Effect of Width of Cuff , J. Pediat. 14: 148, 1939.Crossref 9. Graham, A. W.; Hines, E. A., and Gage, R. P.: Blood Pressures in Children Between the Ages of 5 and 16 Years , Am. J. Dis. Child. 69: 203, 1945. 10. Allen-Williams, G. M.: Pulse-Rate and Blood Pressure in Infancy and Early Childhood , Arch. Dis. Childhood 20:125, 1945.Crossref 11. Downing, M. E.: Blood Pressure of Normal Girls from 3 to 16 Years of Age , Am. J. Dis. Child. 73:293, 1947. 12. Butler, A. M.: Chronic Pyelonephritis and Arterial Hypertension , J. Clin. Invest. 16:889, 1937.Crossref 13. Smith, H. W.: Hypertension and Urologic Diseases , Am. J. Med. 4:724, 1948.Crossref 14. Pickering, G. W., and Heptinstall, R. H.: Nephrectomy and Other Treatment for Hypertension in Pyelonephritis , Quart. J. Med. 22:1, 1953. 15. Howard, J. E.; Berthrong, M.; Gould, D. M., and Yendt, E. R.: Hypertension Resulting from Unilateral Renal Vascular Disease and Its Relief by Nephrectomy , Bull. Johns Hopkins Hosp. 94:51, 1954. 16. Fomon, S. J.; Kaplan, S. A., and Brodsky, W. A.: Malignant Nephrosclerosis Without Retinal Edema in a Child.: Long-Term Observations and Renal Function Studies , A. M. A. Am. J. Dis. Child. 83:493, 1952. 17. McDowell, F. H., and Plum, F.: Arterial Hypertension Associated with Acute Anterior Poliomyelitis , New England J. Med. 245:241, 1951.Crossref 18. Riley, C. M.; Freedman, A. M., and Langford, W. S.: Further Observations on Familial Dysautonomia , Pediatrics 14:475, 1954. 19. Derbes, V. J., and Weiss, T. E.: Untoward Reactions to Cortisone and ACTH , Publication No. 131, American Lecture Series, Monograph in American Lectures in Internal Medicine, edited by Roscoe L. Pullen, Springfield, Ill., Charles C Thomas, Publisher, 1951. 20. Daeschner, C. W.; Moyer, J. H., and Able, L. W.: Pheochromocytoma in a 4-Year Old Child: Renal Hemodynamic, Pharmacologic, and Radiographic Studies , J. Pediat. 45: 141, 1954.Crossref 21. Gifford, R. W., Jr.; Roth, G. M., and Kvale, W. F.: Evaluation of New Adrenolytic Drug (Regitine) as Test for Pheochromocytoma , J. A. M. A. 149:1628, 1952.Crossref 22. Roth. G. M., and Kvale, W. F.: Tentative Test for Pheochromocytoma , Am. J. M. Sc. 210: 653, 1945.Crossref 23. Goldfarb, P. M.: Pheochromocytoma: Report of a Case in a 9-Year Old Negro Boy , J. M. A. Alabama 23:70, 1953. 24. Goldenberg, M.; Serlin, I.; Edwards, T., and Rapport, M. M.: Chemical Screening Methods for the Diagnosis of Pheochromocytoma: Nor-Epinephrine and Epinephrine in Human Urine , Am. J. Med. 16:310, 1954.Crossref 25. Byers, R. K.; Maloof, C. A., and Cushman, M.: Urinary Excretion of Lead in Children: Diagnostic Application , A. M. A. Am. J. Dis. Child. 87:548, 1954. 26. Warkany, J., and Hubbard, D. M.: Adverse Mercurial Reactions in the Form of Acrodynia and Related Conditions , A. M. A. Am. J. Dis. Child. 81:335, 1951. 27. Wolff, H. H.: Mechanism and Significance of Cold Pressor Response , Quart. J. Med. 20:261, 1951. 28. Hines, E. A.: Hereditary Factor in Essential Hypertension , Ann. Int. Med. 11:593, 1937.Crossref 29. Hines, E. A., Jr.: Range of Normal Blood Pressure and Subsequent Development of Hypertension , J. A. M. A. 115:271, 1940.Crossref 30. Levy, R. L.; Hillman, C. C.; Stroud, W. D., and White, P. D.: Transient Hypertension: Its Significance in Terms of Later Development of Sustained Hypertension and Cardiovascular-Renal Disease , J. A. M. A. 126:829, 1944.Crossref 31. Sobel, I. P.: So-Called Essential Hypertension in Childhood , Am. J. Dis. Child. 61:280, 1941. 32. Siegel, A. E., and Thomas, P. C.: Primary Hypertension in Childhood: The Influence of Hyperadrenalism , Arch. Pediat. 47:473, 1930. 33. Hoyle, C.: Case of Adolescent Hypertension with Excretion of an Adrenalin-like Substance in the Urine , Lancet 2:230, 1933.Crossref 34. Taussig, H. B., and Remsen, D. B.: Essential Hypertension in a Boy 2 Years of Age , Bull. Johns Hopkins Hosp. 57:183, 1935. 35. Reyersbach, G. C., and Butler, A. M.: Symposium on Recent Advances in Medicine: Treatment of Hypertension in Children by Sympathectomies , M. Clin. North America 33:1283, 1949. 36. Bos, S. E.; Kho Lien Keng; Velzeboer, C. M. J., and De Vries, S.: Essential Hypertension in a 12-Year Old Girl Treated with Hexamethonium Compounds , Acta pædiat . 42:570, 1953.Crossref 37. Schwartz, H.: Malignant Hypertension Nephritis , Am. J. Dis. Child. 27:233, 1924.Crossref 38. Bell, E. T., and Clawson, B. J.: Primary (Essential) Hypertension: Study of 420 Cases , Arch. Path. 5:939, 1928. 39. Amberg, S.: Hypertension in the Young , Am. J. Dis. Child. 37:335, 1929. 40. Murphy, F. D., and Grill, J.: So-Called Malignant Hypertension, Clinical and Morphological Study , Arch. Int. Med. 46:75, 1930.Crossref 41. Klemperer, P., and Otani, S.: "Malignant Nephrosclerosis" (Fahr) , Arch. Path. 11:60, 1931. 42. Court, D.: Malignant Hypertension in Childhood , Arch. Dis. Childhood 16:132, 1941.Crossref 43. Sieber, H. A.; Grimson, K. S., and Orgain, E. S.: Newer Drugs in the Treatment of Hypertension: Use of Hexamethonium Salts , Circulation 8:840, 1953.Crossref 44. Livesay, W. R.; Moyer, J. H., and Miller, S. I.: Treatment of Hypertension with Rauwolfia Serpentina Alone and Combined with Other Drugs , J. A. M. A. 155:1027, 1954.Crossref 45. Wilkins, R. W., and Judson, W. E.: The Use of Rauwolfia Serpentina in Hypertensive Patients , New England J. Med. 248:48, 1953.Crossref 46. Corcoran, A. C.; Dustan, H. P.; Taylor, R. D., and Page, I. H.: Management of Hypertensive Disease , Am. J. Med. 17:383, 1954.Crossref 47. Hoobler, S. W.: Treatment of Hypertension , Am. J. Med. 17:259, 1954.Crossref 48. Schroeder, H. A.: Management of Arterial Hypertension , Am. J. Med. 17:540, 1954.Crossref 49. Perry, H. M., Jr., and Schroeder, H. A.: Syndrome Simulating Collagen Disease Caused by Hydralazine (Apresoline) , J. A. M. A. 154:670, 1954.Crossref

SASLAW, MILTON S.;STREITFELD, MURRAY M.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030544002pmid: 13372047

Abstract Because of the etiological relationship attributed to group A beta hemolytic streptococci in rheumatic fever, the pattern of infection with these organisms is presented for greater Miami (Dade County), Fla., an area where rheumatic fever is uncommon. In school children 6 to 9 years of age 25% to 40% of those studied by monthly throat swabbings have group A organisms in their throats at least once each 8-month school year. Groups and types of streptococci isolated are the same as in the North. Approximately 50% of children with such organisms show definite antistreptolysin O rises. Children from whom group A beta hemolytic streptococci (typable or nontypable) are recovered have higher average antistreptolysin O titers and indices than do those children from whom no beta hemolytic streptococci, or only groups of streptococci other than group A, are isolated. The postulate that 3% of group A beta hemolytic streptococcal infections proceed to References 1. Saslaw, M. S.; Ross, B. D., and Dobrin, M.: The Incidence of Rheumatic Heart Disease in Native School Children of Dade County, Florida , Am. Heart J. 40:760, 1950.Crossref 2. Paul, J. R., and Dixon, G. L.: Climate and Rheumatic Heart Disease: Survey Among American Indian School Children in Northern and Southern Localities , J. A. M. A. 108:2096, 1937.Crossref 3. Quinn, R. W., and Kincaid, C. K.: Rheumatic (Valvular) Heart Disease in Madison, Wisconsin: Survey of Seventh Grade School Children , Am. J. M. Sc. 223:487, 1952.Crossref 4. Wedum, B. G.; Wedum, A. G., and Beaghler, A. L.: Prevalence of Rheumatic Heart Disease in Denver School Children , Am. J. Pub. Health 35:1271, 1945.Crossref 5. Sampson, J. J.; Hahman, P. T.; Halverson, W. L., and Shearer, M. C.: Incidence of Heart Disease and Rheumatic Fever in School Children in Three Climatically Different California Communities , Am. Heart J. 29:178, 1945.Crossref 6. Paul, J. R.: Tabulated by Wedum and co-workers (Reference 4). 7. Quinn, R. W.: Incidence of Rheumatic Fever and Heart Disease in School Children in Dublin, Georgia, with Some Epidemiological and Sociological Observations , Am. Heart J. 32:234, 1946.Crossref 8. Packard, J. M.; Graettinger, J. S., and Graybiel, A.: Incidence of Heart Disease in School Children of Pensacola , Florida, U. S. Naval Air Station, Pensacola, Florida, Project No. NM 001 057. 02.01, (Oct. 25) , 1951. 9. Rammelkamp, C. H.; Wannamaker, L. W., and Denny, F. W.: The Epidemiology and Prevention of Rheumatic Fever , Bull. New York Acad. Med. 28:321, 1952. 10. Saslaw, M. S., and Streitfeld, M. M.: Group A Beta Hemolytic Streptococci and Rheumatic Fever in Miami, Fla. , Pub. Health Rep. 69:877, 1954.Crossref 11. Kleinman, H.: Epidemic Acute Glomerulonephritis at Red Lake , Minnesota Med . 37:479, 1954. 12. Updyke, E. L.; Moore, M. S., and Conroy, E.: Provisional New Type of Group A Streptococci Associated with Nephritis , Science 121:171, 1955.Crossref 13. Reinstein, C. R.: Epidemic Nephritis at Red Lake, Minnesota , J. Pediat. 47:25, 1955.Crossref 14. Saslaw, M. S.; Streitfeld, M. M., and Williams, E. H., Jr.: Use of an Antistreptolysin O Index for Comparison of Large Samples: Experience in Miami, Florida , Clin. Res. Proc. 3:77, 1955. 15. Bernheimer, A. W.: Streptolysins and Their Inhibitors , in Streptococcal Infections , edited by M. McCarty, New York, Columbia University Press, 1954, pp. 20-21. 16. Coburn, A. F., and Pauli, R. H.: The Interaction of Host and Bacterium in the Development of Communicability by Streptococcus Hemolyticus , J. Exper. Med. 73: 531, 1941.Crossref 17. Trewartha, G. T.: An Introduction to Climate , New York, McGraw-Hill Book Company, Inc., 1954, Plate I.

KENDIG, EDWIN L.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030552003pmid: 13372048

Abstract There is some tendency toward reliance on clinical findings for early diagnosis of primary tuberculosis. Practitioners of both pediatrics and general medicine are guilty of this unjustified approach. Many symptoms and symptom complexes have been mentioned. In the Scandanavian countries it has been noted that 95% of the cases of erythema nodosum are associated with tuberculosis.1 In the United States, however, erythema nodosum occurs much oftener in association with rheumatic fever and occurs infrequently under any conditions. At a recent round-table discussion on tuberculosis conducted by the American Academy of Pediatrics, a group of approximately 35 participants was polled as to the frequency of erythema nodosum. Only one member reported the incidence of as many as two cases each year, and his residence was in northern Michigan, a climate comparable to that of the Scandanavian countries. In the past, presence of phlyctenular conjunctivitis has been considered almost pathognomic of References 1. Miller, J. A., and Wallgren, A.: Pulmonary Tuberculosis in Adults and Children , New York, Thomas Nelson and Sons, 1939, p. 126. 2. Kendig, E. L., Jr., and Angell, F. L.: Streptomycin and Promizole in the Treatment of Widespread Pulmonary Tuberculosis in a 19-Day-Old Infant: Case Report . Am. Rev. Tuberc. 61:747 ( (May) ) 1950. 3. Kendig, E. L., Jr.: Tuberculosis in the Very Young: Report of Three Cases Less Than One Month of Age , Am. Rev. Tbc. 70:161 ( (July) ) 1954. 4. Kendig, E. L., Jr.: The Routine Tuberculin Test—A Neglected Pediatric Procedure , J. Pediat. 40:813 ( (June) ) 1952.Crossref

SKINNER, ALFRED L.;MOLL, FREDERIC C.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030556004pmid: 13372049

Abstract Elevation of the serum sodium concentration has been recognized as a frequent phenomenon in the fluid and electrolyte imbalances accompanying infant diarrhea.* Its importance is indicated by the fact that the mortality rate in such cases is five times that of patients with normal or low sodium concentration.2 Recognition of the disturbance is more difficult than the diarrheal imbalances in which salt depletion is prominent. Marked disturbances of the central nervous system occur. Fluid and electrolyte management during repair is difficult. Our experience with patients with diarrhea and hypernatremia has led us to conclude that two mechanisms, singly or together, are the causes of the disturbance. These are (a) profound water depletion with hyperosmolarity of which the hypernatremia is a part and (b) sodium administration in excess of the excretory capacity of the kidney. This report will present the clinical problem as manifested in a number of patients, and References 1. Rapoport, S.: Hyperosmolarity and Hyperelectrolytemia in Pathologic Conditions of Childhood , Am. J. Dis. Child. 74:682, 1947. 2. Finberg, L., and Harrison, H. E.: Hypernatremia in Infants: An Evaluation of the Clinical and Biochemical Findings Accompanying this State , Pediatrics 16:1, 1955. 3. Tarail, R,; Bass, L. W., and Runco, A. S.: The Frequency and Nature of Hypertonicity of the Body Fluids in Infantile Diarrhea , Am. J. Dis. Child. 86:658, 1953. 4. Weil, W. B., and Wallace, W. M.: Hypertonic Dehydration in Infancy , Pediatrics 17:171, 1956. 5. Syllabus for the Post-Graduate Course in Fluid and Electrolyte Balance , edited by B. G. Scribner, Seattle, University of Washington Press, 1955. 6. Nelson, W. E.: Mitchell-Nelson's Textbook of Pediatrics , Ed. 5, Philadelphia, W. B. Saunders Company, 1950, p. 1605. 7. White, J. U.: Precision of a Simple Flame Photometer , Anal. Chem. 24:394, 1952.Crossref 8. Schales, O., and Schales, S.: A Simple and Accurate Method for the Determination of Chloride in Biological Fluids , J. Biol. Chem. 140:879, 1941. 9. Peters, J. P., and Van Slyke, D. D.: Quantitative Clinical Chemistry , Vol. 2, Baltimore, Williams & Wilkins Company, 1932, p. 244. 10. Scribner, B. H., and Weigert, H. T.: Bedside Determination of Total Base in Serum , J. A. M. A. 155:639, 1954.Crossref 11. Scribner, B. H.: Bedside Determination of Chloride: A Method for Plasma, Urine and Other Fluids and Its Application to Fluid Balance Problems , Proc. Staff Meet. Mayo Clinic 25:209, 1950. 12. Scribner, B. H., and Caillouette, J. C.: An Improved Method for the Bedside Determination of Bicarbonate in Serum , J. A. M. A. 155:644, 1954.Crossref 13. Gentzkow, C. J.: An Accurate Method for the Determination of Blood Urea, Nitrogen by Direct Nesslerization , J. Biol. Chem. 143:531, 1942. 14. Clark, E. P., and Collip, J. B.: A Study of the Tisdall Method for the Determination of Blood Serum Calcium with a Suggested Modification , J. Biol. Chem. 63:461, 1925. 15. Fiske, C. H., and Subbarow. Y.: The Colorimetric Determination of Phosphorus , J. Biol. Chem. 66:375, 1925. 16. Marriott, H. L.: Water and Salt Depletion , Springfield, Ill., Charles C Thomas, Publisher, 1950. 17. Darrow, D. C., and Yannett, H.: Changes in Distribution of Body Water Accompanying Increase and Decrease in Extracellular Electrolyte , J. Clin. Invest. 14:266, 1935.Crossref 18. Holt, L. E.; Courtney, A. M., and Fales, H. L.: The Chemical Composition of Diarrheal as Compared with Normal Stools in Infants , Am. J. Dis. Child. 9:213, 1915. 19. Chung, A. W.: The Effect of Oral Feeding at Different Levels on the Absorption of Foodstuffs in Infantile Diarrhea , J. Pediat. 33:1, 1948.Crossref 20. Darrow, D. C.: The Retention of Electrolyte During Recovery from Severe Dehydration Due to Diarrhea , J. Pediat. 28:515, 1946.Crossref 21. Levine, S. Z.; Wilson, J. R., and Kelly, M.: The Insensible Perspiration in Infancy and Childhood: Its Constancy in Infants Under Standard Conditions and Effect of Various Physiologic Factors , Am. J. Dis. Child. 37:791, 1929.Crossref 22. Darrow, D. C.; Cooke, R. E., and Segar, W. E.: Water and Electrolyte Metabolism in Infants Fed Cow's Milk Mixtures During Heat Stress , Pediatrics , 14:602, 1954. 23. Heeley, A. M., and Talbot, N. B.: Insensible Water Losses per Day by Hospitalized Infants and Children , Am. J. Dis. Child. 90:251, 1955. 24. Gamble, J. L., and Butler, A. M.: Measurement of the Renal Water Requirement , Tr. A. Am. Physicians 58:157, 1944. 25. Butler, A. M.; Talbot, N. B.; MacLachlan, E. A.; Appleton, J. E., and Linton, M. A.: Effect of Testosterone Proprionate on Losses Incident to Inadequate Dietary Intake , J. Clin. Endocrinol. 5:327, 1945.Crossref 26. Pratt, E. L., and Snyderman, S. E.: Renal Water Requirement of Infants Fed Evaporated Milk With and Without Added Carbohydrate , Pediatrics 11:65, 1953. 27. Barnett, H. L., and Vesterdal, J.: The Physiologic and Clinical Significance of Immaturity of Kidney Function in Young Infants , J. Pediat. 42:99, 1953.Crossref 28. Heller, H.: The Water Metabolism of Newborn Infants and Animals , Arch. Dis. Childhood 26:195, 1951.Crossref 29. Pratt, E. L.; Bienvenu, B., and Whyte, M. M.: Concentration of Urine Solutes by Young Infants , Pediatrics 1:181, 1948. 30. Barnett, H. L.; Vesterdal, J.; McNamara, H., and Lauson, H. D.: Regulation of Renal Water Excretion in Premature Infants , Tr. Am. Pediat. Soc., in Am. J. Dis. Child. 84:481, 1952. 31. Calcagno, P. L., and Rubin, M. I.: Effect of Dehydration Produced by Water Deprivation, Diarrhea and Vomiting on Renal Function in Infants , Pediatrics 7:328, 1951. 32. Calcagno, P. L.; Rubin, M. I., and Singh, W. S. A.: The Influence of Surgery on Renal Function in Infancy: The Effect of Surgery in the Postoperative Renal Excretion of Water—The Influence of Dehydration , Pediatrics 16:619, 1955. 33. Smith, H. W.: The Kidney: Structure and Function in Health and Disease , New York, Oxford University Press, 1951, pp. 498, 524-525. 34. Elman, R.; Lemmer, R. A.; Weichselbaum, T. E.; Owen, J. G., and Yore, R. W.: Minimum Postoperative Maintenance Requirements for Parenteral Water, Sodium, Potassium, Chloride and Glucose , Ann. Surg. 130:703, 1949.Crossref 35. Talbot, N. B.; Crawford, J. D., and Butler, A. M.: Medical Progress: Hemostatic Limits to Safe Parenteral Fluid Therapy , New England J. Med. 248:1100, 1953.Crossref 36. Dean, R. F. A., and McCance, R. A.: The Renal Response of Infants and Adults to the Administration of Hypertonic Solutions of Sodium Chloride and Urea , J. Physiol. 109:81, 1949. 37. Leaf, A., and Couter, W. T.: Evidence that Renal Sodium Excretion by Normal Subjects is Regulated by Adrenal Cortical Activity , J. Clin. Invest. 28:1067, 1949.Crossref 38. Gamble, J. L.; Wallace, W. M.; Eliel, L., and Holliday, M. H.: Effects of Large Loads of Electrolytes , Pediatrics 7:305, 1951.

WEINBERG, SIDNEY R.;O'CONNOR, WALTER J.;SENGER, FEDOR L.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030570005pmid: 13372050

Abstract Unilateral multicystic disease is rare, but its recognition is important because surgical treatment is so satisfactory even in infants. It must be differentiated from the other forms of renal cystic disease, that is, bilateral polycystic disease or solitary cysts of the kidney.* Review of the Literature Bugbee and Wollstein6 studied the urinary tract of 4903 infants at necropsy and found a total of only four cases of unilateral cystic renal disease, an incidence of 0.1%. In the same study 11 bilateral cystic kidneys were found, 0.2%.The present knowledge of the pathogenesis of these disorders is scant and theoretical. It is known, however, that the ureteral bud (which is derived from the Wolfian duct) as it ascends from the pelvis to form the collecting system of the permanent kidney must unite with the nephrons of the metanephrons. The most widely accepted theory concerning the origin of the polycystic and References 1. Lynch, K. D., and Thompson, R. F.: Unilateral Multicystic Kidney in an Infant , J. Urol. 38:58-60, 1937. 2. Carver, J. H.: Cystic Disease of the Right Kidney in an Infant , Brit. J. Urol. 21:229-231, 1949.Crossref 3. Bunge, R. G., and Harness, W. W.: Unilateral Polycystic Kidney in an Infant , J. Urol. 65:972-975, 1951. 4. Wakeley, C.: Case of Unilateral Polycystic Kidney in a Child, Age One Year and Eight Months , Brit. J. Surg. 18:161-165, 1930. 5. Christeson, W. W.: Simple Renal Cysts in the Newborn: Report of 2 cases , J. Urol. 72:1137-1139, 1954. 6. Bugbee, H. G., and Wollstein, M.: Surgical Pathology of Urinary Tract in Children , J. A. M. A. 83:1887-1894, 1924.Crossref 7. Lambert, P. P.: Polycystic Disease of the Kidney: Review , Arch. Path. 44:34-58, 1947. 8. Spence, H. M.: Congenital Unilateral Multicystic Kidney: An Entity to Be Distinguished from Polycystic Kidney Disease and Other Cystic Disorders , J. Urol. 74:693-706, 1955. 9. Ravitch, M. M., and Sanford, M. C.: Unilateral Multicystic Kidney in Infants , Pediatrics 4:769-781, 1949. 10. Schwartz, J.: An Unusual Unilateral Multicystic Kidney in an Infant , J. Urol. 35: 259-263, 1936. 11. Campbell, M.: Clinical Pediatric Urology , Philadelphia, W. B. Saunders Company, 1951, pp. 9-180. 12. Willson-Pepper, J. K., and Slade, D. A.: Calcification in a Polycystic Kidney , Brit. J. Urol. 27:172-176, 1955.Crossref 13. Mixter, C. G.: Tumors of Kidney in Infancy and Childhood , Ann. Surg. 76:52-63, 1922. 14. Howze, C. P., and Hill J. H.: Unilateral Multiple Cysts of the Kidney , J. Urol. 61:187-193, 1949.

FETTERMAN, GEORGE H.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030575006pmid: 13372051

Abstract In 1950 Duffy and Fitzgerald1 reported a series of 28 children with thyroid carcinoma, of whom 9 had received irradiation to the thymic area in infancy. Hesitant to draw conclusions from these figures, Duffy and Fitzgerald did suggest that the possible relationship of thymic irradiation and thyroid carcinoma "might be profitably explored." Although neither the report of Horn and Ravdin2 in 1951 nor that of Warren and co-workers3 in 1953 presented comparable statistics regarding the association of irradiation in infancy and later development of thyroid carcinoma, other studies have appeared which indicate that it is well worth while to pursue this line of inquiry. Simpson and her colleagues4 reported that of 1400 children who had received thymic irradiation in infancy 6 subsequently developed thyroid carcinoma and 9 thyroid adenoma. In a control series of 1795 untreated siblings of the irradiated children, there were no cases of References 1. Duffy, B. J., Jr., and Fitzgerald, P. J.: Cancer of the Thyroid in Children: A Report of 28 Cases , J. Clin. Endocrinol. 10:1296 ( (Oct.) ) 1950.Crossref 2. Horn, R. C., Jr., and Ravdin, I. S.: Carcinoma of the Thyroid Gland in Youth , J. Clin. Endocrinol. 11:1166 ( (Oct.) ) 1951.Crossref 3. Warren, S.; Alvizouri, M., and Colcock, B. P.: Carcinoma of the Thyroid in Childhood and Adolescence , Cancer 6:1139 ( (Nov.) ) 1953.Crossref 4. Simpson, C. L.; Hempelmann, L. H., and Fuller, L. M.: Neoplasia in Children Treated with X-Rays in Infancy for Thymic Enlargement , Radiology 64:840 ( (June) ) 1955. 5. Winship, T., and Chase, W. W.: Thyroid Carcinoma in Children , Surg. Gynec. & Obst. 101:217 ( (Aug.) ) 1955. 6. Winship, T.: Childhood Thyroid Carcinoma, Pediatrics, to be published. 7. Clark, D. E.: Association of Irradiation with Cancer of the Thyroid in Children and Adolescents , J. A. M. A. 159:1007 ( (Nov. 5) ) 1955. 8. Winship, T.: Symposium on Thyroid Tumors: Carcinoma of the Thyroid in Children , Tr. Am. Goiter A. (1951) p. 364, 1952. 9. Hayles, A. B.; Kennedy, R. L. J.; Beahrs, O. H., and Woolner, L. B.: Carcinoma of the Thyroid Gland in Children , A. M. A. Am. J. Dis. Child. 90:705 ( (Dec.) ) 1955. 10. Crile, G., Jr., and Fisher, E. R.: Simultaneous Occurrence of Thyroiditis and Papillary Carcinoma: Report of 2 Cases , Cancer 6:57 ( (Jan.) ) 1953. 11. Meissner, W. A.: Seminar on Tumors of the Neck, Proc. Twenty-First (1955) Seminar, American Society of Clinical Pathologists, p. 40, 1956. 12. Crile, G., Jr.: Treatment of Cancer of the Thyroid with Desiccated Thyroid , Cleveland Clin. Quart. 22:161 ( (Oct.) ) 1955. 13. Lattman, I.; Winship, T.; Klopp, C. T.; Caulk, R. M.; Williams, S. F.; Andrews, J. R.; Berman, H. L., and Copeland, E. P.: The Irradiation Effects of Therapy of the Thymus Gland in Relation to the Production of Thyroid Carcinoma , Clin. Proc. Child. Hosp. , Washington 11:215 ( (Oct.) ) 1955. 14. Dennis, J. M.: Association of Irradiation with Neoplasia in Children and Adolescents: Editorial , Ann. Int. Med. 44:579 ( (March) ) 1956.

JONXIS, J. H. P.;VISSER, H. K. A.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030582007pmid: 13372052

Abstract Until recently, fetal hemoglobin was a protein which could be detected in human blood only during the first year of life. Therefore the interest in this hemoglobin was mainly limited to those who were interested in infant physiology. Since Vecchio's discovery that fetal hemoglobin is found in large amounts in the blood of patients with Cooley's anemia, the interest of hemotologists has increased. It is now known that also in patients with sickle-cell-syndrome anemia (and perhaps in other hereditary hemolytic anemias) fetal hemoglobin may occur. An accurate method for the determination of small percentages of fetal hemoglobin is References 1. Singer, K.; Chernoff, A. I., and Singer, L.: Studies on Abnormal Hemoglobins: I. Their Demonstration in Sickle Cell Anemia and Other Hematologic Disorders by Means of Alkali Denaturation , Blood 6:413, 1951. 2. Künzer, W.: Untersuchungen über das Vorkommen fetalen Hämoglobins bei Blutkrankheiten , Ztschr. Kinderh. 76:58, 1955.Crossref 3. Brinkman, R., and Jonxis, J. H. P.: Occurrence of Several Kinds of Haemoglobin in Human Blood , J. Physiol. 85:117, 1935. 4. Huisman, T. H. J., and Jonxis, J. H. P., Blood, to be published. 5. Betke, K.: Der menschliche rote Blutfarbstoff bei Fetus und reifem Organismus , Berlin, Springer-Verlag, 1954. 6. van der Schaaf, P. C., and Huisman, T. H. J.: The Amino-Acid Composition of Human Adult and Foetal Carbonmonoxyhaemoglobin Estimated by Ion Exchange Chromatography , Biochim. et biophys. acta 17:81, 1955.Crossref 7. Huisman, T. H. J.; Jonxis, J. H. P., and Dozy, A.: Is Foetal Haemoglboin Present in the Blood of Normal Human Adults? Biochim. et biophys. acta 18:576, 1955.Crossref 8. Jonxis, J. H. P.: Foetal Haemoglobin and Erythroblastosis , Nature , London 161:850, 1948.Crossref 9. Jonxis, J. H. P.: Foetal Haemoglobin and Rh Antogonisms , in Haemoglobin, Barcroft Symposium , New York, Interscience Publishers, Inc., 1949. 10. Beaven, G. H.; Hock, H., and Holiday, E. R.: Haemoglobins of Human Foetus and Infant: Electrophoretic and Spectroscopic Differentiation of Adult and Foetal Types , Biochem. J. 49:374, 1951. 11. Chernoff, A. I.: Immunologic Studies of Hemoglobins: Productions of Antihemoglobin Sera and Their Immunologic Characteristics , Blood 8:399, 1953.

RICCA, JOSEPH J.;MORRIONE, THOMAS G.;ADEL, HAROLD

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030586008

Abstract Struma lymphomatosa is characterized as a progressive disease of the thyroid gland of unknown etiology, occurring almost entirely in females. It appears predominantly in middle age. Although there is a divergence of opinion as to whether it is inflamatory in nature, it is generally classified as a form of thyroiditis. The thyroid gland is grossly enlarged, firm, rubbery, and may be lobulated with a scalloped border. The capsule of the gland is intact with no adhesions to underlying or adjacent structures. Both lobes of the gland are involved in almost all cases. Microscopically, there is marked lymphoid infiltration, atrophic follicles with scanty colloid present, and mild fibrosis. Frequently, there are large hyperplastic lymph nodules with germinal centers present. The patient commonly complains of fullness of the neck and dysphagia. The results of thyroid function tests are variable, and there seems to be no specific diagnostic pattern. Gribetz and co-workers12 References 1. Hashimoto, A.: Zur Kenntnis der lymphomatösen Veränderung der Schilddrüse (Struma lymphomatosa) , Arch. klin. Chir. 97:219-248, 1912. 2. Graham, A.: Riedel's Struma in Contrast to Struma Lymphomatosa (Hashimoto) , West. J. Surg. 39:681-689, 1931. 3. McClintock, J. C., and Wright, A. W.: Riedel's Struma and Struma Lymphomatosa (Hashimoto): Comparative Study , Ann. Surg. 106:11-32, 1937.Crossref 4. Joll, C. A.: Pathology, Diagnosis, and Treatment of Hashimoto's Disease (Struma Lymphomatosa) , Brit. J. Surg. 27:351-389, 1939.Crossref 5. Statland, H.; Wasserman, M. M., and Vickery, A. L.: Struma Lymphomatosa (Hashimoto's Struma): Review of 51 Cases with Discussion of Endocrinologic Aspects , A. M. A. Arch. Int. Med. 88:659-678, 1951.Crossref 6. Lindsay, S.; Daily, M. E.; Friedlander, J.; Yee, G., and Soley, M. H.: Chronic Thyroiditis: Clinical and Pathological Study of 354 Patients , J. Clin. Endocrinol. 12:1578-1600, 1952.Crossref 7. Furr, W. E., and Crile, G., Jr.: Struma Lymphomatosa: Clinical Manifestations and Response to Therapy , Tr. Am. Goiter A. (1953) pp. 66-73, 1954. 8. Marshall, S. F., and Meissner, W. A.: Struma Lymphomatosa (Hashimoto's Disease) , Ann. Surg. 141:737-746, 1955.Crossref 9. Hazard, J. B.: Thyroiditis: A Review: Part II , Am. J. Clin. Path. 25:399-426, 1955. 10. Blake, K. W., and Sturgeon, C. T.: Struma Lymphomatosa , Surg, Gynec. & Obst. 97:312-317, 1953. 11. Means, J. H.: The Thyroid and Its Diseases , Philadelphia, J. B. Lippincott Company, 1948. 12. Gribetz, D.; Talbot, N. B., and Crawford, J. D.: Goiter Due to Lymphocytic Thyroiditis (Hashimoto's Struma): Its Occurrence in Preadolescent and Adolescent Girls , New England J. Med. 250:555-557, 1954. 13. Davis, H. C., and Hanske, E. A.: Hashimoto's Disease in Childhood , A. M. A. Am. J. Dis. Child. 90:173-175, 1955.

SOBEL, GERTRUDE;ARONSON, BETTY;ARONSON, STANLEY;WALKER, DOUGLASS

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030590009

Abstract This article is a report on an outbreak of pharyngoconjunctival fever due to APC Type III virus which occurred in a children's camp during the summer of 1955. The adenopharyngeal conjunctival or APC group of viruses was isolated in 1952 by Huebner, Rowe, Bell, and others.* They studied surgically removed tonsils and adnoids by tissue culture technique. Through repeated subculturing of these tissues, they were able to unmask a new group of viruses. Because of the characteristic tissue culture degenerating effects produced by these micro-organisms, they were originally named "adenoid-degenerating agents". This was later renamed "adenoidal-pharyngeal-conjunctival viruses" or "APC viruses." As a result of the work first done in the U. S., investigation has been undertaken along similar lines in other countries. Zaiman and co-workers,5 in England, have also been able to isolate this new group of viruses from surgically removed tonsils and adenoids and have noted the presence References 1. Huebner, R. J.; Rowe, W. P.; Ward, T. G.; Parrott, R. H., and Bell, J. A.: Adenoidal-Pharyngeal-Conjunctival Agents: A Newly Recognized Group of Common Viruses of the Respiratory System , New England J. Med. 251: 1077 ( (Dec. 30) ) 1954.Crossref 2. Rowe, W. P.; Huebner, R. J.; Gilmore, L. K.; Parrott, R. H., and Ward, T. G.: Isolation of Cytopathogenic Agent from Human Adenoids Undergoing Spontaneous Degeneration in Tissue Culture , Proc. Soc. Exper. Biol. & Med. 84:570 ( (Dec.) ) 1953. 3. Rowe, W. P.; Huebner, R. J.; Hartley, J. W.; Ward, T. G., and Parrott, R. H.: Studies of the Adenoidal-Pharyngeal-Conjunctival (APC) Group of Viruses , Am. J. Hyg. 61:197 ( (March) ) 1955. 4. Parrott, R.: Adenoidal-Pharyngeal-Conjunctival Viruses in Common Respiratory Disease (Pharyngo-Conjunctival Fever) , Clin. Proc. Children's Hosp. 11:152 ( (July) ) 1955. 5. Zaiman, E.; Balducci, D., and Tyrreel, D. A. J.: A. P. C. Viruses and Respiratory Disease in Northern England , Lancet 2:595 ( (Sept. 17) ) 1955. 6. Neva, F. A., and Enders, J. F.: Isolation of Cytopathogenic Agent from Infant with Disease in Certain Respects Resembling Roseola Infantum . J. Immunol. 72:315 ( (April) ) 1954. 7. Huebner, R. J.; Bell, J. A.; Rowe, W. P.; Ward, T. G.; Suskind, R.; Hartley, J., and Pappenbarger, R.: Studies of Adenoidal-Pharyngeal-Conjunctival Vaccines in Volunteers , J. A. M. A. 159:986 ( (Nov. 5) ) 1955. 8. Hellerman, M., and Werner, J.: Recovery of New Agent from Patients with Acute Respiratory Illness , Proc. of Soc. Exper. Bio. & Med. 85:183 ( (Jan.) ) 1954. 9. Hilleman, M. R.; Werner, J. H.; Adair, C. V., and Dreisbach, A. R.: Outbreak of Acute Respiratory Illness Caused by RI-67 and Influenza A Viruses, Fort Leonard Wood, 1952-1953 , Am. J. Hyg. 61:163 ( (March) ) 1955. 10. Berge, T. O.; England, B.; Mauric, C.; Shuey, H. E., and Lennett, E. H.: Etiology of Acute Respiratory Disease Among Service Personnel at Fort Ord, California , Am. J. Hyg. 62: 283 ( (Nov.) ) 1955. 11. Ormsby, H. L.; Fowler, A. M. C., and Cockeram, A.: Relationship of Epidemic Keratoconjunctivitis to the Adenoidal-Pharyngeal-Conjunctival (APC) Virus Syndrome , Canad. M. A. J. 73:710 ( (Nov. 1) ) 1955. 12. Derrick, E.: Swimming Bath Conjunctivitis, with a Report of 3 Probable Cases and a Note on its Epidemiology , M. J. Australia 30:334, 1943. 13. Cockburn, T. A.: An Epidemic of Conjunctivitis in Colorado Associated with Pharyngitis, Muscle Pain, and Pyrexia , Am. J. Ophth. 36:1534 ( (Nov.) ) 1953. 14. Parrott, R. H.; Rowe, W. P.; Huebner, R. J.; Bernton, H. W., and McCullough, N. B.: Outbreak of Febrile Pharyngitis and Conjunctivitis Associated with Type 3 Adenoidal-Pharyngeal-Conjunctival Virus Infection , New England J. Med. 251:1087 ( (Dec. 30) ) 1954. 15. Bell, J. A.; Rowe, W. P.; Engler, J. I.; Parrott, R. H., and Huebner, R. J.: Pharyngoconjunctival Fever , J. A. M. A. 157:1083 ( (March 26) ) 1955. 16. Wallis, A. L.: Unusual Epidemic , Lancet 2: 290 ( (Aug. 6) ) 1955. 17. Dingle, J.: Evidence for the Specific Etiology of Acute Respiratory Diseases (ARD) , Tr. A. Am. Physicians 67:149, 1954. 18. Dingle, J., and others: Exudative Tonsilitis and Pharyngitis of Unknown Cause , J. A. M. A. 133:588 ( (March 1) ) 1947. 19. Jordan, W. S.; Badger, G. F.; Dingle, J. H.; Ginsburg, H. S., and Katz, S.: The Serologic Epidemiology of Respiratory Agents Isolated in the Hela Cell Culture , J. Lab. & Clin. Med. 44: 816 ( (Nov.) ) 1954. 20. Loosli, C. G.: Acute Respiratory Infections: The Problem of Control , New York J. Med. 55: 3079 ( (Nov. 1) ) 1955. 21. Chancey, R. L., and Zatz, L. M.: Sporadic Acute Anicteric Hepatitis Associated with Upper Respiratory Infection , J. A. M. A. 158:1013 ( (July 23) ) 1955.Crossref 22. Epidemic in London Hospital, Foreign Letters , J. A. M. A. 159:700 ( (Oct. 15) ) 1955. 23. Taboado, V.: Foreign Letters . J. A. M. A. 159:1083 ( (March 26) ) 1955.

1956 A.M.A. Journal of Diseases of Children

doi: 10.1001/archpedi.1956.02060030607010

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