American Journal of Diseases of Children

KAPLAN, S. A.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020005001pmid: 14453784

Abstract For many years, sodium bicarbonate has proved reasonably effective for treatment of acidosis. It is also the preferred treatment of salicylate poisoning in children under the age of 2 years.1-3 Its use, however, has some disadvantages. In the first place, it is ineffective in the treatment of respiratory acidosis. Second, it must be administered with caution in certain situations, such as acute renal failure, since the amount of sodium which must be administered concomitantly may be prohibitively large.4 As Gamble has pointed out, bicarbonate is a relatively inefficient buffer at the pH of extracellular fluid, its buffering capacity being only one-fourth as great as at its isoelectric point of 6.1.5 Organic buffers have been used for in vitro buffering since 1949.6 Some have proved remarkably stable and of low toxicity, and in 1959 Nahas first reported on the use of tris(hydroxymethyl)aminomethane (THAM) in vivo.7 THAM References 1. Kaplan, S. A., and Del Carmen, F. T.: Experimental Salicylate Intoxication: Observations on the Effects of Carbonic Anhydrase Inhibitor and Bicarbonate , Pediatrics 21:762, 1958. 2. Oliver, T. K., Jr., and Dyer, M. E.: The Prompt Treatment of Salicylism with Sodium Bicarbonate , Amer. J. Dis. Child. 99:553, 1960. 3. Whitten, C. F.; Kesaree, N. M., and Goodwin, J. F.: Managing Salicylate Poisoning in Children , Amer. J. Dis. Child. 101:178, 1961.Crossref 4. Kaplan, S. A.; Strauss, J., and Yuceoglu, A. M.: Conservative Management of Acute Renal Failure , Pediatrics 25:409, 1960. 5. Gamble, J. L.: Chemical Anatomy, Physiology, and Pathology of Extracellular Fluid , Ed. 5, Cambridge, Mass., Harvard University Press, 1949, Chart 5a . 6. Pardee, A. B.: Measurement of Oxygen Uptake Under Controlled Pressures of Carbon Dioxide , J. Biol. Chem. 179:1085, 1949. 7. Nahas, G. G.: Use of an Organic Carbon Dioxide Buffer in Vivo , Science 129:782, 1959.Crossref 8. Bates, R. G.: Amine Buffers for pH Control , Ann. N.Y. Acad. Sci. 92:341, 1961.Crossref 9. Wallace, W. M., and Hastings, A. B.: The Distribution of Bicarbonate Ion in Mammalian Muscle , J. Biol. Chem. 144:637, 1942. 10. Robin, E. D.; Wilson, R. J., and Bromberg, P. A.: Intracellular Acid-Base Relations and Intracellular Buffers , Ann. N.Y. Acad. Sci. 92:539, 1961.Crossref 11. Holmdahl, M. H., and Nahas, G. G.: Volume of Distribution of C" Tagged 2-Amino-2-Hydroxymethyl-1, 3-Propanediol , Ann. N.Y. Acad. Sci. 92:724, 1961.Crossref 12. Berman, L. B.; O'Connor, T. F., and Luchsinger, P. C.: Carbon Dioxide Buffering in Man , J. Appl. Physiol. 15:393, 1960. 13. Brinkman, G. L.: Use of THAM to Prevent Hyperventilation and Acidosis While Breathing Carbon Dioxide , Amer. J. Med. Sci. 239:728, 1960.Crossref 14. Brinkman, G. L.; Remp, D. G.; Coates, E. O., Jr., and Priest, E. M.: Treatment of Respiratory Acidosis with THAM , Amer. J. Med. Sci. 239:341, 1960.Crossref 15. Clark, L. C., Jr.: The Use of Amine Buffers in Cardiovascular Surgery , Ann. N.Y. Acad. Sci. 92:687, 1961.Crossref 16. Mahler, H. R.: The Use of Amine Buffers in Studies with Enzymes , Ann. N.Y. Acad. Sci. 92:426, 1961.Crossref 17. Strauss, J.; Nahas, G. G.; and Clark, H.: Effects of Tris (Hydroxymethyl) Aminomethane (THAM) in the Treatment of Acute Salicylate Poisoning, Abstract 97, Proceedings of the American Pediatric Society , Amer. J. Dis. Child. 102:771, 1961. 18. Strauss, J., and Nahas, G. G.: Use of Amine Buffer (THAM) in Treatment of Acute Salicylate Intoxication , Proc. Soc. Exp. Biol. Med. 105:348, 1960.Crossref 19. Bennett, T. E., and Tarail, R.: The Hypoglycemic Activity of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol , Ann. N.Y. Acad. Sci. 92:651, 1961.Crossref 20. Roberts, M., and Linn, S.: Acute and Subchronic Toxicity of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol (THAM) , Abstracts, Fed. Proc. 20:75, 1961 (Abstract). 21. Nahas, G. G.: Personal communication to the author.

KAPLAN, SAMUEL;FOX, R. PHYLLIS;CLARK, LELAND C.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020008002pmid: 14453781

Abstract During the progression of a state of uncompensated acidosis, the marked increase in hydrogen ion concentration reflects severe metabolic alterations which eventually result in irreversible cellular damage. To date, the control of some acidotic states has been difficult because of the limitations of sodium buffers. Although amine buffers have been used for many years by biochemists, physiologic applications of these compounds have only recently been stimulated by the work of Nahas.1 The purpose of this presentation is to report the use of an amine buffer, tris(hydroxymethyl)aminomethane,* in the clinical management of acidosis due to a variety of causes. Materials and Methods Six infants and children with acidosis due to a variety of disease processes (Table) were treated with Tris (THAM) buffer. All of these patients except the baby with probable hyaline membrane disease were considered to be in a moribund state, and their clinical condition was deteriorating in spite References 1. Nahas, G. G.: Use of an Organic Carbon Dioxide Buffer in Vivo , Science 129:782, 1959.Crossref 2. Rosenthal, T. B.: Effect of Temperature on pH of Blood and Plasma in Vitro , J. Biol. Chem. 173:25, 1948. 3. Clark, L. C., Jr.; Kaplan, S.; Matthews, E. C.; Edwards, F. K., and Helmsworth, J. A: Monitor and Control of Blood Oxygen Tension and pH During Total Body Perfusion , J. Thor. Cardiov. Surg. 36:488, 1958. 4. Benesch, R. E., and Benesch, R.: The Stability of the Silver Complex of Tris(Hydroxymethyl)-aminomethane , J. Amer. Chem. Soc. 77:2749, 1955.Crossref 5. Robin, E. D.; Wilson, R. J., and Bromberg, P. A.: Intracellular Acid-Base Relations and Intracellular Buffers , Ann. N.Y. Acad. Sci. 92:539, 1961.Crossref 6. Samiy, A. H.; Oken, D. E.; Rees, S. B.; Robin, E. D., and Merrill, J. P.: Effect of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol on Electrolyte Excretion , Ann N.Y. Acad. Sci. 92:570, 1961.Crossref 7. Waddell, W. J., and Butler, T. C.: Calculation of Intracellular pH from the Distribution of 5,5-Dimethyl-2, 4-Oxazolidinedione (DMO): Application to Skeletal Muscle of the Dog , J. Clin. Invest. 38:720, 1959.Crossref 8. Wallace, W. M., and Hastings, A. B.: The Distribution of the Bicarbonate Ion in Mammalian Muscle , J. Biol. Chem. 144:637, 1942. 9. Nahas, G. G.; Jordan, E. C., and Ligou, J. C.: Effects of a 'Carbon Dioxide Buffer' on Hypercapnia of Apneic Oxygenation , Amer. J. Physiol. 197:1308, 1959. 10. Berman, L. B.: The Renal Effects of THAM in Man , Physiologist 2:10, 1959. 11. Clark, L. C., Jr.: The Use of Amine Buffers in Cardiovascular Surgery , Ann. N.Y. Acad. Sci. 92:687, 1961.Crossref 12. Ngai, S. H.; Katz, R. L.; Nahas, G. G., and Wang, S. S.: Effects of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol on the Central Respiratory Mechanisms in the Cat , Ann. N.Y. Acad. Sci. 92:632, 1961.Crossref 13. Nahas, G. G., and Lumpkin, W. L.: The Effects of THAM on the Ventilation of the Resting Dog , Physiologist 2:87, 1959. 14. Luchsinger, P. C.: The Use of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol in the Management of Respiratory Acidosis , Ann. N.Y. Acad. Sci. 92:743, 1961.Crossref 15. Tarail, R., and Bennett, T. E.: Hypoglycemic Activity of Tris Buffer in Man and Dog , Proc. Soc. Exp. Biol. Med. 102:208, 1959.Crossref 16. Rees, S. B.; Younger, M. D., and Freedlender, A. E.: Some in Vivo and in Vitro Observations on Effects of Tris (Hydroxymethyl)-aminomethane in Diabetic Acidosis , Ann. N.Y. Acad , Sci. 92:755, 1961.Crossref 17. Medovy, H., in discussion of Kaplan S., and Fox, R. P.: Amine Buffers in the Management of Acidosis, Transactions of the American Pediatrics Society , Amer. J. Dis. Child. 102:695, 1961. 18. Clark, L. C., Jr.: in discussion of Nahas, G. G.; Manger, W. M., and Mittelman, A.: Transfusion Acidosis and Its Correction with THAM , Trans. Amer. Soc. Artificial Intern. Organs 6:247, 1960. 19. Strauss, J.; Nahas, G. G.; James, S., and Schwartz, I.: Effects of 2-Amino-2-Hydroxymethyl-1, 3-Propanediol on Renal Function in Reference to Salicylate and Glucose , Ann. N.Y. Acad. Sci. 92:579, 1961.Crossref

STEELE, MARK W.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020014003pmid: 13916491

Abstract The primary objective of this study was to demonstrate shifts of plasma between vascular and extravascular spaces during the first 2½ hours of life. Such shifts in plasma volume have been postulated by Marks et al. in order to account for the significant rise in packed cell volume that they demonstrated within the first 2½ hours of life.1 Plasma volume was measured by human serum-albumin-bound iodine131 (Risa, Abbott Laboratories). Since, to date, this agent has not been used for this purpose in newborn infants, a demonstration of its effectiveness was the second major objective. A third objective of this study was to relate the early changes occurring in the blood compartments to the pathogenesis of hyaline membrane disease. For this purpose, infants born by Cesarean section were compared with infants born by normal vaginal delivery. Materials and Method Nine normal newborns and 9 elective Cesarean section infants were References 1. Gairdner, D.; Marks, J.; Roscoe, J. D., and Brettell, R. O.: The Fluid Shift from the Vascular Compartment Immediately After Birth , Arch. Dis. Child. 33:489, 1958.Crossref 2. Diagnostic Procedures with Radioisotopes , North Chicago, Ill., Abbott Laboratories, Jan., 1956, pp. 15-21. 3. Mollison, P. L.; Veall, N., and Cutbuch, M.: Red Cell and Plasma Volume in Newborn Infants , Arch. Dis. Child. 25:242, 1950.Crossref 4. Furth, F. W.: Effect of Spherocytosis on Volume of Trapped Plasma in Red Cell Column of Capillary and Wintrobe Hematocrits , J. Lab. & Clin. Med. 48:421, 1956. 5. Guilford, J. P.: Fundamental Statistics in Psychology and Education , Ed. 3, New York, McGraw Hill Book Company, Inc., 1956. 6. Reeve, E. B.: The Contribution of I131 Labeled Proteins to Measurements of Blood Volume , Ann. N.Y. Acad. Sci. 70:137, 1957. 7. Franks, J. J., and Zigga, F.: Simultaneous Measurement of Plasma Volume in Man with T-1824 and an Improved I131 Albumin Method , J. Appl. Physiol. 13:299, 1958. 8. Gitlin, D.: Distribution Dynamics of Circulating and Extravascular I131 Plasma Proteins , Ann. N.Y. Acad. Sci. 70:122, 1957. 9. Risa-Simple: Accurate Determination of Blood Volumes , North Chicago, Ill., Abbott Laboratories, 1959 (pamphlet). 10. Freeman, W.: Radioisotope Determinations of Blood Volume: The Results of More than 300 Tests , Amer. J. Clin. Path. 27:393, 1957. 11. Taylor, D.: The Measurement of Radio-Isotopes , London, Methuen & Co., Ltd., 1950. 12. Sisson, T. R., and Whalen, L. E.: The Blood Volume of Infants , J. Pediat. 56:43, 1960. 13. Whipple, G. A.; Sisson, T. C., and Lund, C. J.: Delayed Ligation of the Umbilical Cord and Its Influence on the Blood Volume of the Newborn , Obstet, Gynec. 10:603, 1957. 14. Brandt, I. K.: Respiratory Distress Syndrome of the Newborn , Conn. Med. 22:88, 1958. 15. Gitlin, D., and Craig, J. M.: The Nature of the Hyaline Membrane in Asphyxia of the Newborn , Pediatrics 17:64, 1956. 16. Stevenson, S. S., and Lauff, L. E.: Experimental Production of the Pulmonary Hyaline Membrane , A.M.A. J. Dis. Child. 88:521, 1954.

SASLAW, MILTON S.;JABLON, JAMES M.;JENKS, SALLIE ANNE;BRANCH, CLAUDETTE C.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020023004pmid: 14497361

Abstract Recent reports1,2 that β-hemolytic streptococci have been recovered from cultures of throats of subjects who are receiving antibiotic therapy as prophylaxis against recurrent rheumatic fever, led us to consider the possibility that such organisms may remain in some location where the antibiotics are unable to exert their bactericidal effects. Observations among patients of the National Children's Cardiac Hospital indicated that these unaffected streptococci might be recoverable from the tonsillar tissues. Because of the histological structure of tonsils, organisms might remain within deep crypts, secure from contact with, and hence action of, antibiotics. The present study was designed to test this hypothesis. Materials and Methods Materials.—Between 1957 and 1959, children who were scheduled for tonsillectomy constituted the source of material for study. These children, up to 16 years of age, were recruited through the efforts of several otolaryngologists and general practitioners, who notified us of their surgical schedules for References 1. Wood, H. F.; Stollerman, G. H.; Feinstein, A. R.; Hirschfield, L.; Rusoff, J. H.; Taranta, A.; Haas, R. C., and Epstein, J. A.: A Controlled Study of Three Methods of Prophylaxis Against Streptococcal Infection in a Population of Rheumatic Fever in the First Two Years of the Study , New Engl. J. Med. 257:394-398, 1957.Crossref 2. Woods, H. F.: Prevention of Rheumatic Fever , Amer. J. Cardiol. 1:456-463, 1958.Crossref 3. Saslaw, M. S., and Streitfeld, M. M.: Group A β-Hemolytic Streptococci and Rheumatic Fever in Miami, Fla.: A Preliminary Report , Public Health Rep. 69:877-882, 1954.Crossref 4. Streitfeld, M. M.; Saslaw, M. S., and Doff, S. D.: Group A β-Hemolytic Streptococcus and Rheumatic Fever in Miami, Fla.: 8 Month Bacteriological and Serologic Study , Public Health Rep. 71:745-755, 1956.Crossref 5. Saslaw, M. S., and Streitfeld, M. M.: Group A β-Hemolytic Streptococci in Relation to Rheumatic Fever , A.M.A. J. Dis. Child. 92:550-557, 1956.Crossref 6. Lancefield, R. C.: The Antigenic Complex of Streptococcus Hemolyticus: III. Chemical and Immunological Properties of the Species-Specific Substance , J. Exper. Med. 47:481-491, 1928.Crossref 7. Lancefield, R. C.: A Serological Differentiation of Human and Other Groups of Hemolytic Streptococci , J. Exp. Med. 57:571-595, 1933.Crossref 8. Rantz, L. A., and Randall, E.: A Modification of the Technique for the Determination of the Antistreptolysin Titer , Proc. Soc. Exper. Biol. Med. 59:22, 1945.Crossref 9. Saslaw, M. S.; Saul, M.; Jenks, S. A., and Jablon, J. M.: β-Hemolytic Streptococci from Several Sources Reactive in Both Groups A and F Antisera , J. Bact. 77:519, 1959. 10. Rice, J. W.: Personal communication to the authors. 11. Rammelkamp, C. H., Jr.; Breese, B. B.; Griffeath, H. I.; Houser, H. B.; Kaplan, M. H.; Kuttner, A. G.; McCarty, M.; Stollerman, G. H., and Wannamaker, L. W.: Prevention of Rheumatic Fever and Bacterial Endocarditis Through Control of Streptococcal Infections , Mod. Conc. Cardiov. Dis. 25:365-369, 1956.

BRADY, HARRY R.;PAUL, H. RICHARD;ROGERS, KENNETH D.;THOMPSON, DONOVAN J.;GEZON, HORACE M.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020031005pmid: 13872352

Abstract In recent years, epidemic staphylococcal infection has been recognized as a problem in hospitals throughout the world.1-3 Its occurrence in newborn nurseries has stimulated conjecture and speculation as well as scientific study concerning the source and mode of transmission of staphylococci and methods for their control.4-9 "Traditional" methods of communicable disease control in newborn nurseries have included use of gowns, masks, frequent lengthy hand washes, special cleansing and disinfecting agents, and wide spatial separation of babies. For the most part the effectiveness of these measures has not been evaluated specifically in relation to control of staphylococcal infection and disease. The relationship between newborn nursery floor space allotment per infant and staphylococcal infection* and disease † was selected for study with specific interest directed toward the recommended space requirements per infant as outlined by the American Academy of Pediatrics.10 Two hypotheses were proposed for testing: (1) the rate References 1. Fakety, F. R.; Buchbinder, L.; Shaffer, E. L.; Goldberg, S.; Price, H. P., and Pyle, L. A.: Control of an Outbreak of Staphylococcal Infections Among Mothers and Infants in a Suburban Hospital , Amer. J. Public Health 48:298 ( (March) ) 1958.Crossref 2. Ravenholt, R. T., and LaVeck, G. D.: Staphylococcal Disease: An Obstetric, Pediatric, and Community Problem , Amer. J. Public Health 46:1287 ( (Oct.) ) 1956.Crossref 3. Ravenholt, R. T., and Ravenholt, O. H.: Staphylococcal Infections in the Hospital and Community: Hospital Environment and Staphylococcal Disease , Amer. J. Public Health 48:277 ( (March) ) 1958.Crossref 4. Gezon, H. M.; Rogers, K. D.; Thompson, D. J., and Hatch, T. F.: Environmental Aspects of Staphylococcal Infections Acquired in Hospitals: II. Some Controversial Aspects in the Epidemiology of Hospital Nursery Staphylococcal Infections , Amer. J. Public Health 50:473 ( (April) ) 1960.Crossref 5. Ravenholt, R. T.; Wright, P., and Mulhern, M.: Epidemiology and Prevention of Nursery-Derived Staphylococcal Disease , New Engl. J. Med. 257:789 ( (Oct. 24) ) 1957.Crossref 6. Rountree, P. M., and Barbour, R. G. H.: Staphylococcus Pyogenes in New-Born Babies in a Maternity Hospital , Med. J. Aust. 1:525 ( (April 22) ) 1950. 7. Shaffer, T. E.; Sylvester, R. F., Jr.; Baldwin, J. N., and Rheins, M. S.: Staphylococcal Infections in Newborn Infants: II. Report of 19 Epidemics Caused by an Identical Strain of Staphylococcus Pyogenes , Amer. J. Public Health 47: 990 ( (Aug.) ) 1957.Crossref 8. Starkey, H.: Control of Staphylococcal Infections in Hospitals , Canad. Med. Ass. J. 75:371 ( (Sept. 1) ) 1956. 9. Wallace, A. T., and Duguid, J. P.: Staph. Aureus Air Infection in a Maternity Hospital , Edinburgh Med. J. 59:200 ( (April) ) 1952. 10. American Academy of Pediatrics Committee on Fetus and Newborn: Standards and Recommendations for Hospital Care of Newborn Infants Full Term and Premature , Ed. 2, Evanston, Ill., American Academy of Pediatrics, 1957, p. 14. 11. Blair, J. E., and Carr, M.: Bacteriophage Typing of Staphylococci , J. Infect. Dis. 93:1 ( (July) -Aug.) 1953.Crossref 12. Eichenwald, H. F.; Kotsevalov, O., and Fasso, L. A.: The "Cloud Baby": An Example of Bacterial-Viral Interaction , Amer. J. Dis. Child. 100:161 ( (Aug.) ) 1960.

OECONOMOPOULOS, CHRIS T.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020039006pmid: 14481125

Abstract The incidence of electrical burns among children has risen in the last few years, with increasing use of electricity in the household. Electrical cords carelessly left on the floor, or outlets in the wall, may become objects of curiosity to be tested by the child. Items of curiosity are often grasped and invariably go into the mouth of the young child. Consequently, electrical injuries in this age group more commonly affect the hand and the mouth. The total number of accidents from electricity in children is difficult to estimate. Such accidents are not very common, but occur frequently enough to merit serious consideration by pediatricians and surgeons. Although medical literature has dealt extensively with thermal burns in the pediatric age group, electrical burns have received little attention. The majority of children with these injuries present a different problem from that seen in adults. In the latter, most of the electrical References 1. Baldridge, R. R.: Electrical Burns: Report of a Case , New Engl. J. Med. 250: 46-49, 1954.Crossref 2. Sevitt, S.: Burns: Pathology and Therapeutic Applications , London, Butterworth & Co., Ltd., 1957. 3. Jellinek, S.: Der elektrische Unfall , Ed. 3, Leipzig, Franz Deuticke, 1931. 4. Dale, H. R.: Electric Accidents , Brit. J. Plast. Surg. 7:44-66, 1954.Crossref 5. Davies, R. M.: Burns Caused by Electricity , Brit. J. Plast. Surg. 11:288-299, 1959.Crossref 6. Hyslop, B. V.: Treatment of Electric Burns of the Lips , J. Plast. & Reconst. Surg. 20:315-317, 1957. 7. Adam, A. L., and Klein, M.: Electrical Cataract: Notes on Case and Review of Literature , Brit. J. Ophthal. 29:169-175, 1945. 8. Kazanzian, V. H., and Roopenian, A.: The Treatment of Lip Deformities Resulting from Electric Burns , Amer. J. Surg. 88:884-890. 1954. 9. Lewis, K. G.: Injuries Caused by Electricity , Clin. Med. 5:791-796, 1958. 10. Fleury, A. F.: Electrical Burns of the Lips: A Modified Plan of Treatment , Amer. Surg. 25:328-331, 1959. 11. Moncrief, J. A.: Complications of Burns , Ann. Surg. 147:443-475, 1958. 12. Wells, D. B.: Treatment of Electrical Burns by Immediate Resection and Skin Graft , Ann. Surg. 90:1069-1078, 1929. 13. Schultz, W. L., and Vazirani, J. S.: Electrical Burns of the Mouth , Amer. J. Surg. 98:921-922, 1959. 14. Muir, I. F. K.: The Treatment of Electrical Burns , Brit. J. Plast. Surg. 10:292-299, 1958. 15. Brown, J. B., and Fryer, P. M.: Reconstruction of Electrical Injuries, Including Cranial Losses, with Preliminary Report of Cathode-Ray Burns , Ann. Surg. 146:342-356, 1957.

MILLER, HERBERT C.;BEHRLE, FRANKLIN C.;NIEMAN, JOHN L.;DRIVER, RACHEL;DUDDING, BURTON A.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020043007pmid: 14474015

Abstract The marked fall in body temperature of premature infants immediately after birth and their notable tendency to be poikilothermic have led to the widespread practice of elevating and stabilizing the body temperatures of these infants by artificial regulation of ambient temperature and humidity. The selection of the ideal atmospheric conditions and of the most suitable body temperature has been made without knowledge of heat production by these infants during the critical first few days after birth. Most recommendations concerning the proper ambient temperature and humidity in the immediate postnatal period have rested on empirical grounds and on studies made on newborn animals and older premature infants, all of whom were presumed to be healthy.1-3 A good many premature infants suffer from References 1. McCance, R. A.: The Maintenance of Stability in the Newly Born: II. Thermal Balance , Arch. Dis. Child. 34:459, 1959.Crossref 2. Blackfan, K. D., and Yaglou, C. P.: The Premature Infant , Amer. J. Dis. Child. 56:1175, 1933. 3. Day, R. L.; Curtis, J., and Kelly, M.: Respiratory Metabolism in Infancy and Childhood: XXVII. Regulation of Body Temperature of Premature Infants , Amer. J. Dis. Child. 65:376, 1943.Crossref 4. Karlberg, P.: The Proceedings of the Eleventh Northern Pediatric Congress , Acta Paediat. (Upps.) 44:84, 1955. 5. Miller, J. A.: Physiology of Prematurity , in Transactions of the Fourth Conference , Josiah Macy, Jr. Foundation, Madison, N.J., Madison Printing Company, Inc., 1960, p. 53. 6. Silverman, W. A., and Blanc, W. A.: The Effect of Humidity on Survival of Newly Born Premature Infants , Pediatrics 20:477, 1957. 7. Silverman, W. A.; Fertig, J. W., and Berger, A. P.: The Influence of the Thermal Environment Upon the Survival of Newly Born Premature Infants , Pediatrics 22:876, 1958. 8. Miller, H. C.; Behrle, F. C.; Hagar, D. L., and Denison, T. R.: The Effect of High Humidity on Body Temperature and Oxygen Consumption of Newborn Premature Infants, Pediatrics, to be published. 9. Miller, H. C., and Conklin, E. V.: Clinical Evaluation of Respiratory Insufficiency in Newborn Infants , Pediatrics 16:427, 1955. 10. Brück, K.; Brück, M., and Lemtis, H.: Thermoregulatorische Veränderungen des Energiestoffwechsels bei reifen Neugeborenen , Pflügers Arch. Ges. Physiol. 267:382, 1958.Crossref 11. Cross, K. W.; Tizard, J. P. M., and Trythall, D. A. H.: The Gaseous Metabolism of the Newborn Infants Breathing 15% O2 , Acta Paediat. (Upps.) 47:217, 1958.Crossref 12. Hill, J.: The Oxygen Consumption of Newborn and Adult Mammals: Its Dependence on the O2 Tension in the Inspired Air and on the Environmental Temperature , J. Physiol. 149:346, 1959. 13. Adamsons, K.: Breathing and Thermal Environment in Young Rabbits , J. Physiol. 149:144, 1959. 14. Dawes, G. S.; Jacobson, H. N.; Mott, J. C., and Shelley, H.: Some Observations on Foetal and Newborn Rhesus Monkeys , J. Physiol. 152:271, 1960. 15. Taylor, P. M.: Oxygen Consumption in Newborn Rats , J. Physiol. 154:153, 1960.

RUTENBURG, ALEXANDER M.;PINEDA, ESTEBAN P.;GOLDBARG, JULIUS A.;LEVITAN, RUVEN;GELLIS, SYDNEY S.;SILVERBERG, MERVIN

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020051008

Abstract Histochemical studies of adult liver for leucine aminopeptidase (LAP) utilizing the synthetic substrate L-leucyl-β-naphthylamide show intense activity in the bile duct epithelium and a weaker reaction in the parenchymal cells.1,2 We have also observed high activity in the proliferating bile ducts of liver biopsies from 4 infants with biliary atresia. This intense activity in the bile ducts and the observation that LAP is excreted by the liver into the bile appear to explain the high serum LAP activity resulting from extrahepatic or intrahepatic biliary obstruction.1,3 Diagnostically significant elevations of serum LAP have been shown to relate almost exclusively to diseases of the liver, bile ducts, or pancreas.1,3-6 The normal range of enzymatic activity in infants has not been described and the clinical usefulness of serum LAP elevations in infants with hepatobiliary disease has not been assessed. By adult standards, LAP levels have been reported to be normal References 1. Rutenburg, A.M., Goldbarg, J. A. and Pineda, E. P.: Leucine Aminopeptidase Activity: Observations in Patients with Cancer of the Pancreas and other Diseases , New Engl. J. Med. 259:469, 1958.Crossref 2. Rosenholtz, M.: Use of the Histochemical Demonstration of Aminopeptidase to Distinguish Small Bile Ducts and Hepatic Parenchymal Cells , Gastroenterology 38:794, 1960. 3. Pineda, E. P., Goldbarg, J. A., Banks, B. M. and Rutenburg, A. M.: Serum Leucine Aminopeptidase in Pancreatic and Hepatobiliary Diseases , Gastroenterology 38:698, 1960. 4. Pineda, E. P.; Banks, B. M.; Goldbarg, J. A.; Kaplan, H., and Rutenburg, A. M.: The Use of Serum Leucine Aminopeptidase and β-Glucuronidase in the Detection and Management of Hepatitis and Cirrhosis, presented at the Pan American Congress of Gastroenterology , (October 25) , 1960, Santiago, Chile. 5. Banks, B.M.; Pineda, E.P.; Goldbarg, J. A., and Rutenburg, A. M.: The Clinical Value of Serum Leucine Aminopeptidase Determinations , New Engl. J. Med. 263:1277, 1960.Crossref 6. Pineda, E. P.; Goldbarg, J. A., and Rutenburg, A. M.: Serum Leucine Aminopeptidase and β-Glucuronidase in the Differential Diagnosis of Jaundice, to be published. 7. Shay, H.; Sun, D.C.H., and Siplet, H.: Leucine Aminopeptidase: Significance of Serum Elevations in Diseases of the Hepato-Biliary-Pancreatic System , Am. J. of Dig. Dis. 5:217, 1960.Crossref 8. Miller, A. L., and Worsley, L.: Serum Leucine Aminopeptidase in Carcinoma of the Pancreas and Other Diseases . Brit. Med. J. 2,5210: 1419, 1960.Crossref 9. Goldbarg, J. A., and Rutenburg, A. M.: The Colorimetric Determination of Leucine Aminopeptidase in Urine and Serum of Normal Subjects and Patients with Cancer and Other Diseases , Cancer 11:283, 1958.Crossref 10. Goldbarg. J. A.; Pineda, E. P., and Rutenburg, A. M.: The Measurement of Activity of Leucine Aminopeptidase in Serum, Urine, Bile, and Tissues , Am. J. of Clin. Path. 32:571, 1959. 11. Bressler, R., and Forsyth, B. R.: Serum Leucine Aminopeptidase Activity in Normal Pregnancy and in Patients with Hydatidiform Mole , New Engl. J. Med. 261:746, 1959.Crossref 12. Arst, H. E.; Manning, R. T., and Delp, M.: Serum Leucine Aminopeptidase Activity: Findings in Carcinoma of the Pancreas, Pregnancy and Other Disorders , Am. J. of the Med. Sci. 238.598, 1959.Crossref 13. Green, M. N.; Tsou, K-C.; Bressler, R., and Seligman, A. M.: The Colorimetric Determination of Leucine Aminopeptidase Activity with L-leucyl-β-naphthylamide Hydrochloride , Arch. Biochem. 57:458, 1955.Crossref 14. Siegel, I. A.: Leucine Aminopeptidase in Pregnancy , Obstet. and Gynec. (N.Y.) 14:488, 1959 15. Schung, G. E.: Importance of Early Operation in Congenital Atresia of the Extrahepatic Bile Ducts , Ann. Surg. 148:931, 1958.Crossref 16. Norris, W. J., and Hays, D. M.: Problems in Diagnosis Associated with Obstructive Neonatal Hepatitis , Amer. J. Surg. 94:321, 1957.Crossref 17. Clatworthy, H. W., Jr., and McDonald, V. G., Jr.: The Diagnostic Laparotomy in Obstructive Jaundice in Infants . Surg. Clin. North Amer. , 1956, p. 1545. 18. Myers, R. L.; Baggenstoss, A. H.; Logan, G. B., and Hallenbeck, G. A.: Congenital Atresia of the Extrahepatic Biliary Tract , Pediatrics 18:767, 1941. 19. Harris, R. C.: Liver Function Tests in Infancy , Bull. N.Y. Acad. Med. 28:721, 1952. 20. Krovetz, L. J.: Congenital Biliary Atresia. I. Analysis of 30 Cases with Particular Reference to Diagnosis , Surgery 47:453, 1960. 21. Krovetz, L. J.: Congenital Biliary Atresia, II. Analysis of the Therapeutic Problem , Surgery 47:468, 1960. 22. Kumate, J.; Beltran, F.; Benavides, L., and Flores, M. A.: Liver Function Tests in Infants with Biliary Atresia , Pediatrics 26:630, 1960. 23. Kove, S.; Perry, R., and Wroblewski, F.: Diagnosis of Neonatal Jaundice by Patterns of Serum Transaminase , Amer. J. Dis., Child 100:47, 1960. 24. Silverberg, M.; Craig, J., and Gellis, S. S.: Problems in the Diagnosis of Biliary Atresia , Amer. J. Dis. Child. 99:574, 1960.Crossref 25. Flood, C. A.; Gutman, E. B., and Gutman, A. B.: Phosphatase Activity, Inorganic Phosphorus and Calcium of Serum in Disease of Liver and Biliary Tract , Arch. Intern. Med. 59:981, 1937.Crossref

WHITTEN, CHARLES A.;MOYAR, JOHN B.;WISE, BURTON L.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020059009

Abstract In 1914, Dandy and Blackfan6 described an entity consisting of hydrocephalus associated with cystic dilatation of the fourth ventricle and absence of the posterior cerebellar vermis. In a subsequent report, Dandy5 noted that the foramina of Luschka and Magendie were absent, with resultant lack of communication between the ventricular system and the subarachnoid space. Taggart and Walker13 contributed an excellent review of the pathology, pathogenesis, and surgical therapy of the syndrome. They considered the cystic dilatation of the fourth ventricle to be due to failure of the foramina of Luschka and Magendie to open in the period of gestation before the third or fourth month. Dilatation of the fourth ventricle, occurring before the end of the fourth month, would prevent a fusion of the lateral cerebellar commissures to form the posterior vermis. (Gibson,7 however, feels that all parts of the inferior vermis are present, although they References 1. Alexander, E.; Davis, C. H., Jr., and Kitahata, L. M.: Hydranencephaly: Observations on Transillumination of the Head of Infants , A.M.A. Arch. Neurol. Psychiat. 76:578-584, 1956.Crossref 2. Benda, C. E.: The Dandy-Walker Syndrome or the So-Called Atresia of the Foramen of Magendie , J. Neuropath. Exp Neurol. 13:14-20, 1954. 3. Cohen, I.: Agenesis of the Cerebellum , J. Mount Sinai Hosp., N.Y. 8:441-446, 1942. 4. Coleman, C. C., and Troland, C. E.: Congenital Atresia of the Foramina of Luschka and Magendie , J. Neurosurg. 5:84-88, 1948.Crossref 5. Dandy, W. E.: The Diagnosis and Treatment of Hydrocephalus Due to Occlusions of the Foramina of Magendie and Luschka , Surg. Gynec. Obstet. 32:112-124, 1931. 6. Dandy, W. E., and Blackfan, K. D.: Internal Hydrocephalus: An Experimental Clinical and Pathological Study , Amer. J. Dis. Child. 8:406-482, 1914.Crossref 7. Gibson, J. B.: Congenital Hydrocephalus Due to Atresia of the Foramen of Magendie , J. Neuropath. Exp. Neurol. 14:244-262, 1955.Crossref 8. Kaplan, A.: Pia-Arachnoidal Cysts of the Posterior Fossa , Amer. J. Surg. 76:102-106, 1948.Crossref 9. Maloney, A. F. J.: Two Cases of Congenital Atresia of the Foramina of Magendie and Luschka , J. Neurol. Neurosurg. Psychiat. 17:134-138, 1954.Crossref 10. Matson, D. D.: Prenatal Obstruction of the Fourth Ventricle , Amer. J. Roentgenol. 76:499-506, 1956. 11. Sahs, A. L.: Congenital Anomaly of the Cerebellar Vermis , Arch. Path. 32:52-63, 1941. 12. Scarff, J. E.: Spastic Hemiplegia, Produced by a Congenital Cyst Replacing the Cerebellar Vermis , J. Nerv. Ment. Dis. 78:400, 1933.Crossref 13. Taggart, J. K., and Walker, A. E.: Congenital Atresia of the Foramens of Luschka and Magendie , Arch. Neurol. Psychiat. 48:583-612, 1942.Crossref 14. Thompson, R. K.: Cystic Cerebellar Arachnoiditis , J. Neurosurg. 3:461-467, 1946.Crossref 15. Trowbridge, V., and French, J. D.: Benign Arachnoid Cysts of the Posterior Fossa , J. Neurosurg. 9:398-404, 1952.Crossref 16. Walker, A. E.: A Case of Congenital Atresia of the Foramina of Luschka and Magendie , J. Neuropath. Exp. Neurol. 3:368-373, 1944.Crossref

LOFTIS, JOHN W.;SUSEN, ANTHONY F.;MARCY, JOSEPH H.;SHERMAN, FRANK E.

1962 American Journal of Diseases of Children

doi: 10.1001/archpedi.1962.02080020065010pmid: 14466280

Abstract Pneumopericardium is an unusual complication of mediastinal emphysema in infants. It is rarely recognized clinically, yet the symptoms and signs are characteristic, and the prompt relief of the gas tamponade by pericordotomy is lifesaving. Six infants with this condition have been observed in the past 2 years, and all were receiving positive pressure mechanical respiration. Two were recognized clinically, and prompt surgical measures were instituted with success. It is the purpose of this paper to call attention to this condition, discuss the etiology, the signs and symptoms, surgical relief, and prevention. Report of Cases Case 1.—A white boy, 3½ months old was admitted because of progressive enlargement of the head, and studies revealed noncommunicating hydrocephalus. A ventriculoatrial operation was planned, and as the ankle phlebotomy was being performed prior to surgery, under endotracheal anesthesia, the heart sounds became progressively distant. The pulse was quenched, and cardiac arrest occurred. No References 1. Macklin, C. C.: Transport of Air Along Sheaths of Pulmonic Blood Vessels from Alveoli to Mediastinum: Clinical Implications , Arch. Intern. Med. 64:913-926 ( (Nov.) ) 1939.Crossref 2. Graebner, H.: Pneumopericardium and Pneumomediastinum in Cases of Acute Obstructive Laryngitis , Arch. Otolaryng. 29:446-456 ( (March) ) 1939.Crossref 3. Adcock, J. D.; Lyons, R. H., and Barnwell, J. B.: Circulatory Effects Produced in a Patient with Pneumopericardium by Artificially Varying the Intrapericardial Pressure , Amer. Heart J. 19:283-291 ( (March) ) 1940.Crossref 4. Mauer, E. R.; Mendez, F. L., Jr.; Finklestein, M., and Lewis, R.: Cardiovascular Dynamics in Pneumopericardium and Hydropericardium , Angiology 9:176-179 ( (June) ) 1958.Crossref 5. Berglund, E.; Sarnoff, S. J., and Issacs, J. P.: Ventricular Function: Role of Pericardium in Regulation of Cardiovascular Hemodynamics , Circulation Res. 3:133-139 ( (March) ) 1955.Crossref 6. Ayre, P.: Anaesthesia for Intracranial Operation: A New Technique , Lancet 1:561-563 ( (March 6) ) 1937.Crossref 7. Ayre, P.: The T-Piece Technique , Brit. J. Anaesth. 28:520-523 ( (Nov.) ) 1956.Crossref