American Journal of Diseases of Children

Day, Richard L.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170043001pmid: 6019434

Abstract THIS REPORT reviews the literature on the survival of the fetus and child in relation to the pregnancy spacing and age of parents. The intention was to be selective rather than comprehensive. Not all of the studies listed in the bibliography are referred to in the text. Parity, Birth Intervals, and Age of Mother Yerushalmy and co-workers1 studied the entire female population of Kauai, one of the Hawaiian Islands. At the time of the study, in 1953, Kauai had a rural economy and a population of 30,000. It was selected for study because a preliminary survey indicated good rapport between the people and the Health Department as well as a relaxed and natural attitude about pregnancy, making it possible to obtain a reliable obstetrical history from the women. The investigation was retrospective, and depended upon the recollection of the women interviewed.Inspection of the data by pregnancy order, age References 1. Yerushalmy, J., et al: Longitudinal Studies of Pregnancy on the Island of Kauai, Territory of Hawaii: I. Analysis of Previous Reproductive History , Amer J. Obstet Gynec 71:80-96 ( (Jan) ) 1956. 2. Yerushalmy, J.: On the Interval Between Successive Births and Its Effect on Survival of Infant: I. An Indirect Method of Study , Hum Biol 17:65-106 ( (May) ) 1945. 3. Heady, J.A., and Morris. J.N.: Variation of Mortality With Mother's Age and Parity , J Obstet Gynaec Brit Comm 66:577-592 ( (Aug) ) 1959.Crossref 4. Newcombe, H.B., and Tavendale, O.G.: Maternal Age and Birth Order Correlations , Mutat Res 1:446-467 ( (Dec) ) 1964.Crossref 5. Newcombe, H.B.: Environmental Versus Genetic Interpretations of Birth-Order Effects , Eugen Quart 12:90-101 ( (June) ) 1965. 6. Carr, D.H.: Chromosome Studies in Spontaneous Abortions , Obstet Gynec 26:308-326 1965. 7. Delhanty, J.D.A.; Ellis, J.R.; and Rowley, P.T.: Triploid Cells in a Human Embryo , Lancet 1:286, 1961. 8. Thiede, H.A., and Salm, S.B.: Chromosome Studies in Spontaneous Abortions , Amer J Obstet Gynec 90:205, 1964. 9. Newcombe, H.B., and Tavendale, O.G.: Effects of Father's Age on the Risk of Child Handicap or Death , Amer J Hum Genet 17:163-178 ( (Mar) ) 1965. 10. Penrose, L.S.: Parental Age and Mutation , Lancet 2:312-313 ( (Aug 13) ) 1955.Crossref 11. Sonneborn, T.M.: Parental Age and Stillbirth Rate in Man , Rec Genet Soc Amer 25:661, 1956. 12. Woolf, C.M.: Stillbirths and Parental Age , Obstet Gynec 26:1-8 ( (July) ) 1965. 13. Montagu, M.F.A.: Prenatal Influences , Springfield, Ill: Charles C Thomas Publishers, 1962. 14. Parental Age and the Characteristics of the Offspring, (Symposium) , Ann NY Acad Sci 57:451 ( (Jan 15) ) 1954. 15. Donnelly, J.F., et al: Fetal, Parental and Environmental Factors Associated With Perinatal Mortality in Mothers Under 20 Years of Age , Amer J Obstet Gynec 80:663-671 ( (Oct) ) 1960. 16. Baird, D.: The Epidemiology of Prematurity , J Pediat 65:909-924 ( (Dec) ) 1964.Crossref 17. Bishop, E.H.: Prematurity: Etiology and Management , Postgrad Med 35:185-188 ( (Feb) ) 1964. 18. Douglas, J.W.B.: Some Factors Associated With Prematurity: The Results of a National Survey , J Obstet Gynaec Brit Comm 57:143, 1950.Crossref 19. Robertson, I., and Kemp, M.: Child Health and Family Size , S Afr Med J 34:888-893 ( (Aug 31) ) 1963. 20. Grant, M.W.: Rate of Growth in Relation to Birth Rank and Family Size , Brit J Prev Soc Med 18:35-42 ( (Jan) ) 1964. 21. Israel, S.L., and Blazar, A.S.: Obstetric Behavior of the Grand Multipara , Amer J Obstet Gynec 91:326-332 ( (Feb 1) ) 1965. 22. Semmens, J.P.: Implications of Tean-Age Pregnancy , J Obstet Gynec 26:77-85, 1965. 23. Bochner, K.: Pregnancies in Juveniles , Amer J Obstet Gynec 83:269, 1962. 24. Shapiro, S.: Influence of Birth Weight, Sex, and Plurality on Neonatal Loss in the United States , Amer J Public Health 44:1142-1153 ( (Sept) ) 1964.Crossref 25. Israel, S.L., and Woitersz, T.B.: Teen-Age Obstetrics: Cooperative Study , Amer J Obstet Gynec 85:659 ( (Mar 1) ) 1963. 26. Eastman, N.J.: The Abuse of Rest in Obstetrics , JAMA 125:1077-1079 ( (Aug 19) ) 1944.Crossref 27. Shapiro, S., and Ross, L.J.: Relationship of Selected Prenatal Factors to Pregnancy Outcome and Congenital Anomalies , Amer J Public Health 55:268-282 ( (Feb) ) 1965.Crossref 28. Butler, N.R., and Bonham, D.G.: Perinatal Mortality , Edinburgh & London: E. & S. Livingstone, Ltd., 1963.

Davis, Starkey D.;Ching, Yi-Chuan;Schaller, Jane;Shurtleff, David B.;Hecht, Frederick;Wedgwood, Ralph J.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170050002pmid: 5335488

Abstract THE FIRST type of agammaglobulinemia reported was an X-linked recessive disease characterized by recurrent bacterial infections, very low serum immunoglobulins,* and absence of antibody responses.1 Many other types have since been recognized2-5 and a short classification of the agammaglobulinemias is listed in Table 1. Each type appears to be distinct, and each is probably the result of a different defect in the maturation and function of immunologic mechanisms. The purpose of this report is to present studies of seven patients with agammaglobulinemia. These studies indicate that cases currently called congential sporadic agammaglobulinemia may be a heterogeneous group with different defects of immunity. Agammaglobulinemia is used here in the generic sense to mean a group of related diseases which are characterized by low serum immunoglobulins, impaired antibody response, and abnormal lymphoid morphology. The use of agammaglobulinemia in this sense is comparable to the use of anemia to indicate diseases References 1. Bruton, O.C.: Agammaglobulinemia , Pediatrics 9:722-727, 1952. 2. Gitlin, D., et al: "Agammaglobulinemia," in Lawrence, H.S.: Cellular and Humoral Aspects of the Hypersensitive States , New York: Paul B. Hoeber, Inc. Medical Bk. Dept of Harper & Row, 1959, pp 375-437. 3. Hitzig, W.H., and Willi, H.: Hereditare Lympho-plasmocytäre Dysgenesie ("Alymphocytose mit Agammaglobulinämie") , Schweiz Med Wschr 91:1625-1633, 1961. 4. Good, R.A., et al: Immunological Deficiency Diseases , Progr Allerg 6:187-319, 1962. 5. Soothill, J.F., and Squire, J.R.: "The Antibody Deficiency Syndrome," in Gell, P.G.H., and Coombs, R.R.A.: Clinical Aspects of Immunology , Philadelphia: F. A. Davis Company, 1962, pp 288-314. 6. Nelson, W.E.: Textbook of Pediatrics , ed 8, Philadelphia: W. B. Saunders Company, 1964. 7. Hitzig, W.H.: Kay, H.E.M.; and Cottier, H.: Familial Lymphopenia With Agammaglobulinemia: An Attempt at Treatment by Implantation of Fetal Thymus , Lancet 2:151-154, 1965.Crossref 8. Gleich, G.J.; Condemi, J.J.; and Vaughan, J.H.: Dysgammaglobulinemia in the Presence of Plasma Cells , New Eng J Med 272:331-340, 1965.Crossref 9. Wolf, J.K.: Primary Acquired Agammaglobulinemia, With a Family History of Collagen Disease and Hematologic Disorders , New Eng J Med 266:473-480, 1962.Crossref 10. Maynard-Smith, S., and Penrose, L.S.: Monozygotic and Dizygotic Twin Diagnosis , Ann Hum Genet 19:273-289, 1955.Crossref 11. Fahey, J.L., and McKelvey, E.M.: Quantitative Determination of Serum Immunoglobulins in Antibody-Agar Plates , J Immun 94:84-90, 1965. 12. Burtin, P.; Buffe, D.; and Grabar, P.: Les Hypogammaglobulinemies Atypiques , Ann Inst Pasteur (Paris) 106:519-542, 1964. 13. Squire, J.R.: Hypogammaglobulinaemia in Great Britain , Acta Haemat (Basel) 24:99-104, 1960.Crossref 14. West, C.D.; Hong, R.; and Holland, N.H.: Immunoglobulin Levels From the Newborn Period to Adulthood and in Immunoglobulin Deficiency States , J Clin Invest 41:2054-2064, 1962.Crossref 15. Fudenberg, H.H.; Heremans, J.F.; and Franklin, E.C.: Hypothesis for Genetic Control of Synthesis of γ-globulins , Ann Inst Pasteur (Paris) 104:155-168, 1963. 16. Rocky, J.H., et al: β2A Aglobulinemia in Two Healthy Men , J Lab Clin Med 63:205-212, 1964. 17. Hong, R., et al: Antibody Deficiency Syndrome Associated With β2 Macroglobulinemia , J Pediat 61:831-842, 1962.Crossref 18. Rosen, F.S., et al: Recurrent Bacterial Infections and Dysgammaglobulinemia: Deficiency of the 7Sγ-Globulins in the Presence of Elevated 19Sγ-Globulins , Pediatrics 28:182-195, 1961. 19. Uhr, J.W., et al: The Antibody Response to Bacteriophage øX 174 in Newborn Premature Infants , J Clin Invest 41:1509-1513, 1962.Crossref 20. Adams, M.H.: Bateriophages , New York: Interscience Publishers, Inc., 1959. 21. Ching, Y.; Davis, S.D.; and Wedgwood, R.J.: Antibody Production in Hypogammaglobulinemia , J Clin Invest 45:1593-1600, 1966.Crossref 22. MacCallam, F.O.: Bacterial and Viral Antibodies in Patients With Hypogammaglobulinemia , Proc Roy Soc Med 55:397-398, 1962. 23. Baron, S., et al: Antibody Production by Hypogammaglobulinemic Patients , J Immun 88:443-449, 1962. 24. Rebuck, J.W., and Crowley, J.H.: A Method of Studying Leukocytic Functions In Vivo , Ann NY Acad Sci 59:757-805, 1955.Crossref 25. Ecker, E.E., and Lopez-Castro, G.: Complement and Opsonic Activities of Fresh Human Sera , J Immun 55:169-181, 1947. 26. Craig, J.M.; Gitlin, D.; and Jewett, T.C.: The Response of Lymph Nodes of Normal and Congentally Agammaglobulinemic Children to Antigenic Stimulation , Amer J Dis Child 88:626, 1954. 27. Good, R.A.: Studies on Agammaglobulinemia: II. Failure of Plasma Cell Formation in the Bone Marrow and Lymph Nodes of Patients With Agammaglobulinemia , J Lab Clin Med 46:167-181, 1955. 28. Schaller, J.; Davis, S.D.; and Wedgwood, R.J.: Failure of Development of the Thymus, Lymphopenia, and Hypogammaglobulinemia , Amer J Med , 41:462-472, 1966.Crossref 29. Good, R.A., et al: Transplantation Studies in Patients With Agammaglobulinemia , Ann NY Acad Sci 64:882-924, 1957.Crossref 30. Giedion, A., and Scheidegger, J.L.: Kongenitale Immunparese bei Fehlen Spezifischer B2-Globuline and Quantitativ Normalen γ-Globulinen , Helv Paediat Acta 12:241-259, 1957. 31. Schubert, W.K., et al: Homograft Rejection in Children With Congenital Immunological Defects: Agammaglobulinemia and Aldrich Syndrome , Transplantation Bull 26:125-128, 1960.Crossref 32. Rosen, F.S.; Gitlin, D.; and Janeway, C.A.: Alymphocytosis, Agammaglobulinemia, Homografts, and Delayed Hypersensitivity: Study of a Case , Lancet 2:380-381, 1962.Crossref 33. Marshall, D.C., et al: The Rejection of Skin Homografts in the Normal Human Subject: Part I. Clinical Observations , J Clin Invest 41:411-419, 1962.Crossref 34. Stetson, C.A.: Role of Humoral Antibody in the Homograft Reaction , Advances Immun 3:97-130, 1963. 35. Lawrence, H. S.: Homograft Sensitivity , Physiol Rev 39:811-859, 1959. 36. Russell, P.S., and Monaco, A.P.: The Biology of Tissue Transplantation , New Eng J Med 271:502-510, 1964.Crossref 37. Miller, J.F.A.P.: The Thymus and Transplantation Immunity , Brit Med Bull 21:111-117, 1965. 38. Gowans, J.L.: The Role of Lymphocytes in the Destruction of Homografts , Brit Med Bull 21:106-110, 1965. 39. Elphinstone, R.H.; Wickes, I.G.; and Anderson, A.B.: Familial Agammaglobulinemia , Brit Med J 2:336-338, 1956.Crossref 40. Kushner, D.S., et al: Familial Hypogammaglobulinemia, Splenomegaly and Leukopenia , Amer J Med 29:33-42, 1960.Crossref 41. Diamant, M.; Kallós, P.; and Rubensohn, G.: Familial Agammaglobulinemia , Int Arch Allerg 19:193-201, 1961.Crossref 42. Jamieson, W.M., and Kerr, M.R.: A Family With Several Cases of Hypogammaglobulinaemia , Arch Dis Child 37:330-336, 1962.Crossref 43. Citron, K.M.: Agammaglobulinemia With Splenomegaly , Brit Med J 1:1148-1151, 1957.Crossref 44. Pearce, K.M., and Perinpanayagam, M.S.: Congenital Idiopathic Hypogammaglobulinaemia , Arch Dis Child 32:422-430, 1957.Crossref 45. Traggis, D.G., et al: Hypogammaglobulinemia in a Young Girl , Amer J Dis Child 102:38-46, 1961. 46. Sell, S.: Immunoglobulins of the Germfree Guinea Pig , J Immun 93:122-131, 1964.

Michener, William M.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170059003pmid: 6019435

Abstract HYPERURICEMIA associated with mental retardation, bilateral dystonic-like movements, and self-mutilation, namely lip-biting and finger-biting, is a newly recognized syndrome.1-6 The relationship between the elevated values of blood uric acid, and the pathophysiology of the syndrome is not known. The investigations of Lesch and Nyhan1 in two brothers with the syndrome revealed increased urinary uric acid excretion, an increased uric acid pool, and an increased incorporation of labeled glycine into uric acid when given intravenously. This report describes the syndrome in further detail, and correlates the experiences observed after treating six patients with the uricosuric drug probenecid. Report of Cases Case 1.—This 6½-year-old boy was first examined at the Cleveland Clinic at the age of 2½ years, on Oct. 30, 1959, because, according to the parents "the child has cerebral palsy." The father and mother were healthy and are not related to each other. No gout was present in References 1. Lesch, M., and Nyhan, W.L.: A Familial Disorder of Uric Acid Metabolism and Central Nervous System Function , Amer J Med 36:561-570, 1964.Crossref 2. Catel, W.. and Schmidt, J.: Über familiäre gichtische Diathese in Verbindung mit zerebalen and renalen Symptomen bei einem Kleinkind , Deutsche Med Wschr 84:2145-2147, 1959.Crossref 3. Riley, I.D.: Gout and Cerebral Palsy in Three-Year-Old Boy , Arch Dis Child 35:293-295, 1960.Crossref 4. Hoefnagel, D.: The Syndrome of Athetoid Cerebral Palsy, Mental Deficiency, Self-Mutilation and Hyperuricemia , J Ment Defic Res 9:69-74, 1965. 5. Hoefnagel, D., et al: Hereditary Choreoathetosis, Self-Mutilation, and Hyperuricemia in Young Males , New Eng J Med 273:130-135, 1965.Crossref 6. Sass, J.K.; Itabashi, H.H.; and Dexter, R.A.: Juvenile Gout With Brain Involvement , Arch Neurol 13:639-655, 1965.Crossref

Giroux, Joan;Miller, James R.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170071004pmid: 6019436

Abstract THE BROAD THUMB and great toe syndrome was first reported by Rubinstein and Tabyi in 1963.1 In a series of seven children they observed broad thumbs and great toes, psychomotor retardation, unusual facial features, high arched palates, and histories of respiratory infections. Six more children who had similar anomalies were described in 1964 by Coffin.2 Recently, in describing two additional cases, Robinson et al3 drew attention to a new finding, a pattern of the dermal ridges in the thenar/first interdigital (thenar/Int I) area of at least one hand. Because patterns in this area are normally rare, it was decided to examine the dermatoglyphics of a larger series. Material The material for the present study comprises prints from 19 individuals: the two patients reported by Robinson et al, nine patients of Dr. Rubinstein in Cincinnati, five patients from Dr. Coffin in Sonoma, Calif, two patients from the Rainier References 1. Rubinstein, J.H., and Tabyi, H.: Broad Thumbs, Toes, and Facial Abnormalities , Amer J Dis Child 105:588, 1963.Crossref 2. Coffin, G.: Brachydactyly: Peculiar Facies and Mental Retardation , Amer J Dis Child 108:351, 1964. 3. Robinson, G.C., et al: The Syndrome of Broad Thumbs and Toes and Mental Retardation , Amer J Dis Child 111:287, 1966.Crossref 4. Penrose, L.S.: The Distal Triradius t on the Hands of Parents and Sibs of Mongol Imbeciles , Ann Hum Genet 19:10, 1954.Crossref 5. Walker, N.F.: The Use of Dermal Configurations in the Diagnosis of Mongolism , J Pediat 50: 19-26, 27-29, 1957.Crossref 6. Uchida, I.A.; Patau, K.; and Smith, D.W.: Dermal Patterns of 18 and D1 Trisomies , Amer J Hum Genet 14:345, 1962. 7. Holt, S.B., and Lindsten, J.: Dermatoglyphic Anomalies in Turner's Syndrome , Ann Hum Genet 28:87, 1964.Crossref 8. Uchida, I.A.; Miller, J.R.; and Soltan, H.C.: Dermatoglyphics Associated With the XXYY Chromosome Complement , Amer J Hum Genet 16:284, 1964. 9. Pfeiffer, R.A., and Schulte zu Berge, U., cited by Holt, S.B.: Dermatoglyphics of Congenital Malformations , Develop Med Child Neurol 7:568, 1964. 10. Achs, R.; Harper, R.G.; and Seigal, M.: Unusual Dermatoglyphic Findings Associated With Rubella Embryopathy , New Eng J Med 274:148, 1966.Crossref

Sheptak, Peter E.;Susen, Anthony F.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170074005pmid: 5335489

Abstract IN DIASTEMATOMYELIA, a segment of the spinal cord and meninges is divided longitudinally into two discrete portions. The splitting is congenital and is caused by a bony or fibrocartilaginous spicule that arises from the vertebral body and transfixes the cord. There is usually neurologic deficit, and associated cutaneous and skeletal defects are common. A personal experience (A.F.S.) with 11 surgically verified cases prompted this report. Etiology and Pathophysiology The term diastematomyelia (Greek: diastemato—split, myelia—nerve) was coined by Hertwig in 1892 to describe defects in amphibian embryos.1 A sagittal splitting of the embryo's dorsum allows the underlying yolk material to bulge through. The head and tail regions are spared and only that neural ectoderm which gives rise to the spinal cord is affected. The cleft also involves the notochord, the nonneural ectoderm, and the mesenchymal supporting elements (Fig 1).The cause of the defect is not known. Gardner References 1. Cameron, A.H.: Malformations of the Neurospinal Axis, Urogenital Tract and Foregut in Spina Bifida, Attributable to Disturbances of the Blastospore , J Path Bact 73:213-221, 1957.Crossref 2. Gardner. W.J.: Diastematomyelia and the Klippel-Feil Syndrome , Cleveland Clin Quart 31:19,44, 1964.Crossref 3. Bently, J.F., and Smith, J.R.: Developmental Posterior Enteric Remnants and Spinal Malformations: The Split Notocord Syndrome , Arch Dis Child 35:76-86, 1960.Crossref 4. Bremer, J.L.: Congenital Anomalies of the Viscera , Cambridge, Mass: Harvard University Press, 1957, pp 62-66. 5. Bremer, J.L.: Dorsal Intestinal Fistula , Arch Path 54:132-138, 1952. 6. Campbell, J.B.: Congenital Anomalies of the Neural Axis , Amer J Surg 75:231-256, 1948.Crossref 7. Seamen, W.B., and Schwartz, H.G.: Diastematomyelia in Adults , Radiology 70:692-696, 1958.Crossref 8. Ingraham, F.D., and Matson, D.D.: Neurosurgery of Infancy and Childhood , Springfield, Ill: Charles C Thomas, Publisher, 1954, pp 57-67. 9. Perret, G.: Diagnosis and Treatment of Diastematomyelia , Surg Gynec Obstet 105:69-83, 1957. 10. Perret, G.: Symptoms and Diagnosis of Diastematomyelia , Neurology 10:51-60, 1960.Crossref 11. Matson, D.D., et al: Diastematomyelia: Diagnosis and Surgical Treatment , Pediatrics 6:98-112, 1950. 12. James, C.C., and Lassman, L.P.: Diastematomyelia , Arch Dis Child 33:536-539, 1958.Crossref 13. James, C.C., and Lassman, L.P.: Diastematomyelia , Arch Dis Child 39:125-130, 1964.Crossref 14. Neuhauser, E.B.; Wittenborg, M.H.; and Dehlinger, K.: Diastematomyelia , Radiology 54:659-664, 1950.Crossref

Dudding, Burton A.;Gorlin, Robert J.;Langer, Leonard O.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170078006pmid: 6019437

Abstract TAYBI, in 1962, reported a case of "generalized skeletal dysplasia with multiple anomalies," suggesting that this possibly represented a new clinical entity.1 Three male siblings with a similar constellation of anomalies were seen at the University of Minnesota. Because of the well-defined nature of the anomalies, it is suggested that this condition be called the "oto-palato-digital syndrome" and that some of the more interesting aspects be discussed. Report of a Case An 8-year-old boy was admitted to University of Minnesota Hospitals for the first time in April 1965, for evaluation of poor school progress.The patient was the product of an uneventful, full-term gestation and an uncomplicated delivery. His birth weight was 2,836 gm (6 lb 4 oz), and his length was 48.3 cm (19 inches). A cleft of the soft palate was noted at birth. He sat without support at 9 months, crawled at 12 months, walked at References 1. Taybi, H.: Generalized Skeletal Dysplasia With Multiple Anomalies , Amer J Roentgen 88:450, 1962. 2. DiGeorge, A.M.; Olmsted, R.W.; and Harley, R.D.: Waardenburg's Syndrome , Trans Amer Acad Ophthal Otolaryng 64:816, 1960. 3. Mori, P.A., and Holt, J.F.: Cranial Manifestations of Familial Metaphyseal Dysplasia , Radiology 66:335, 1956.Crossref 4. Shuler, S.E.: Pycnodysostosis , Arch Dis Child 38:620, 1963.Crossref 5. Hajdu, N., and Kauntze, R.: Cranioskeletal Dysplasia , Brit J Radiol 21:42, 1948.Crossref 6. Chawla, S.: Cranioskeletal Dysplasia With Acroosteolysis , Brit J Radiol 37:702, 1964.Crossref 7. Papavasiliou, C.; Gargano, F.F.; and Walls, W.W.; Idiopathic Nonfamilial Acro-osteolysis Associated With Other Bone Abnormalities , Amer J Roentgen 83:687, 1960. 8. Greenberg, B.D., and Street, D., Idiopathic Nonfamilial Acro-osteolysis , Radiology 69:259, 1957.Crossref 9. Rubinstein, J.H., and Taybi, H.: Broad Thumbs and Toes and Facial Abnormalities , Amer J Dis Child 105:588, 1963.Crossref

Stone, H. Harlan;Henderson, W. Douglas;Guidio, Felix A.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170086007pmid: 6019438

Abstract THE CERVICAL region is generally considered to be an uncommon location for the development of teratomas.1 In addition, most of such tumors have occurred in newborn or stillborn infants. Recent experience with the management of cervical teratomas in older children prompted a review of the problem as seen by the surgical service of the hospitals affiliated with Emory University. During the 18-year period from Jan 1, 1948, through Dec 31, 1965, five patients underwent surgical excision of a teratoma situated in the anterior compartment of the neck. The following is a report of these patients together with a summary of all cases previously recorded in the medical literature. Report of Cases Case 1.—On Aug 9, 1956, this 20-year-old Negro woman was admitted to the hospital for evaluation of a mass located in the vicinity of the thyroid gland. The lesion had been present for one year, but it had References 1. Willis, R.A.: Pathology of Tumours , ed 3, London: Butterworth & Co., 1960, pp 944-985. 2. Silberman, R., and Mendelson, I.R.: Teratoma of the Neck: Report of Two Cases and Review of the Literature , Arch Dis Child 35:159, 1960.Crossref 3. Bale, G.F.: Teratoma of the Neck in the Region of the Thyroid Gland: A Review of the Literature and Report of Four Cases , Amer J Path 26:565, 1950. 4. Saphir, O.: Teratoma of the Neck , Amer J Path 5:313, 1929.

Whitehouse, H.S.;Bannan, E.A.;Ryan, N.W.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170089008pmid: 6019792

Abstract A NUMBER of investigators have reported that fabrics can contain numerous residual bacteria after home laundering.4 One might expect this contamination to be appreciable in the case of diapers since the level of bacteria in human feces is 25% to 30% by dry weight.5 It is generally believed that the elimination of this contamination is beneficial in the management of diaper dermatitis. Since Koch first reported the germicidal activity of hypochlorites in 1881, chlorinereleasing compounds have been used extensively as disinfectants. At the present time, hypochlorite solutions are widely used in home laundering for bleaching fabrics such as diapers. Some physicians, however, have the impression that bleaching of diapers is contraindicated, feeling that bleached diapers are irritating to the skin of infants.6 To our knowledge, a controlled study to determine the effect of bleaching on the bacterial contamination of home-laundered diapers or on the infant's skin has References 1. Ridenour, G.M.: "A Bacteriological Study of Automatic Clothes Washing ," in National Sanitation Foundation Publication , Ann Arbor: University of Michigan Press, 1951. 2. Sherill, J.C., and Kinard, C.L.: Sterility of Laundered Fabrics , JAMA 159:15 (1479) 1955. 3. Oesterling, J.F., et al: Sterilization in the Power Laundry , Penn State Coll Bull 37:32 (1943). 4. McNeil, E., and Choper, E.A.: The Effectiveness of Disinfectants in Home Laundering , Proc Chem Spec Mfgs Assoc May , 1962, p 22. 5. White, A., et al: Principles of Biochemistry , New York: McGraw-Hill Book Co., Inc., 1954. 6. Lawrence, C.A. and Maffia, A.J.: The Use of Antiseptics Impregnation of Fabrics in the Treatment and Prevention of Disease , Bull Amer Soc Hosp Pharm 14:164 ( (March) -April) 1957. 7. McNeil, E.: Studies of Bacteria Isolated From Home Laundering , Develop Industr Microbiol 4:314, 1963. 8. Cooke, J.V.: The Etiology and Treatment of Ammonia Dermatitis of the Gluteal Region of Infants , Amer J Dis Child 22:481, 1921. 9. Cooke, J.V.: Dermatitis of the Diaper Region in Infants , Arch Derm Syph 14:539, 1926.Crossref 10. Benson, R.A., et al: A New Treatment for Diaper Rash , J Pediat 31:369, 1947.Crossref 11. Stephens, L.J., et al: O-Benzl-p-chlorophenol in the Prevention and Treatment of Ammonia Dermatitis , J Pediat 40:750 ( (June) ) 1952.Crossref 12. Lowenburg, H., Jr.: The Management of Diaper Rash , Urol Cutan Rev 47:640, 1943.

Armendares, Salvador;Urrusti-Sanz, Juan;Diaz-del-Castillo, Ernesto

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170093009pmid: 4225312

Abstract DIAGNOSIS of Down's syndrome (mongolism) is mainly based on physical signs. To these, chromosome studies have been recently added. The latter have made possible the differentiation of three types: the classical trisomic, the translocated, and the mosaic.1 The three cannot be differentiated by physical examination. Since the procedures for chromosome studies are not yet sufficiently simple to be used for routine diagnostic purposes, the search for other diagnostic procedures has continued and some new ones have been suggested, such as the abnormalities of the pelvic bones, described by Caffey and Ross in 1956.2 Caffey and Ross, in 1958,3 reporting a more extensive investigation comprising 48 infants, age 2 days to 12 months, with Down's syndrome, found reduced acetabular and iliac angles and concluded that the findings are diagnostic in about 80% of the cases, suggestive in about 20%, and uncertain or normal in less than 5%. With References 1. Polani, P.E.: Cytogenetics of Down's Syndrome , Pediat Clin North Amer 10:423, 1963. 2. Caffey, J., and Ross, S.: Mongolism: Mongoloid Deficiency During Early Infancy: Some Newly Recognized Diagnostic Changes in the Pelvic Bones , Pediatrics , 17:642, 1956. 3. Caffey, J., and Ross, S.: Pelvic Bones in Infantile Mongoloidism: Radiographic Features , Amer J Roentgen 80:458, 1958. 4. Armendares, S., et al: XVII Reglamentary Meeting, Asociación Investigación Pediátrica , México, 192, 1963. 5. Gustavson, K.H.: Down's Syndrome: A Clinical and Cytogenetical Investigation , the Institute for Medical Genetics of the University of Uppsala, Sweden, Uppsala, Sweden: Almqvist and Wiksells, 1964. 6. Hall, B.: Mongolism in Newborns: A Clinical and Cytogenic Study , Acta Pediát , (suppl 154) , p 42, 1964.

Zangeneh, Fereydoun;Steiner, Matthew M.

1967 American Journal of Diseases of Children

doi: 10.1001/archpedi.1967.02090170098010pmid: 6019439

Abstract DURING the past 25 years various investigators have used testosterone and its analogues to accelerate growth in short-statured children. Although in all cases a definite growth spurt was achieved,1-12 the clinical reports concerning the effect of testosterone in acceleration of osseous maturation have been rather controversial.2-5,9,11,12 The results of some studies2,3,12 indicated that there was undue acceleration of osseous maturation and sexual development as compared to linear growth and chronologic age (CA). Further investigations4,5,9,11 suggested that these untoward effects might be avoided when small to moderate doses of testosterone were used. Despite these reports, however, opinion concerning testosterone and its analogues as growth-promoting agents has continued to be guarded.12 In the past few years, several anabolic steroids have been synthesized in an attempt to minimize virilizing properties while retaining the anabolic effect. Clinical studies on these synthetic anabolic steroids have been carried out. Although growth References 1. Deamer, W.C.: Stimulation of Growth in Boys by Sublingual Testosterone Therapy , Amer J Dis Child 75:850-859 ( (June) ) 1948. 2. Sobel, E.H., et al: Use of Methyltestosterone to Stimulate Growth: Relative Influence on Skeletal Maturation and Linear Growth , J Clin Endocr 16:241-248 ( (Feb) ) 1956.Crossref 3. Prader, A.: The Influence of Anabolic Steroids on Growth , Acta Endocr (Kobenhavn) 39 (suppl 63): 78-88 ( (May) ) 1956. 4. Bayley, N.; Gordan, G.S.; and Lisser, H.: Long-Term Experience With Methyltestosterone as a Growth Stimulant in Short Immature Boys , Pediat Clin N Amer ( (Nov) ) 1957, pp 819-825. 5. Hortling, H., and Wahlfors, K.: Long-Term Treatment of Dwarfism With Androgens and Thyroid Hormone , Acta Endocr (Kobenhavn) 32:563-574 ( (Dec) ) 1959. 6. Hubble, D., and Macmillan, D.R.: A Study of Growth Promotion in Children , Arch Dis Child 37:518-524 ( (Oct) ) 1962.Crossref 7. Fisher, D.A., and Panos, T.C.: Methandrostenolone in Children With Growth Retardation , JAMA 185:410-411 ( (Aug) ) 1963.Crossref 8. Kirschvink, J.F., et al: Comparison of the Effects of Norethandrolone and Methyltestosterone on Height and Skeletal Maturation in Mongoloid Children , Amer J Dis Child 40:66-70 ( (Oct) ) 1963. 9. Foss, G.L.: The Influence of Androgen Treatment on Ultimate Height in Males , Arch Dis Child 40:60-70 ( (Feb) ) 1965.Crossref 10. Whitelaw, M.J., and Graham, W.H.: Anabolic Steroids: Their Effects on Epiphyseal Closure, (June) abstracted from Proceedings of the Endocrinological Society, 47th Meeting, 1965, p 136. 11. Kaplan, S.A.: Growth Disorders in Children and Adolescents , Springfield: Charles C Thomas, Publishers, 1964, pp 161-166. 12. Wilkins, L.: The Diagnosis and Treatment of Endocrine Disorders in Childhood and Adolescence , ed 3, Springfield: Charles C Thomas, Publishers, 1965. 13. Reilly, W.A., and Gordan, G.S.: Dissociation of Growth-Stimulating and Skeleton-Maturing Actions of the Synthetic Angrogen, Fluoxymesterone , J Pediat 59:188-193 ( (Aug) ) 1961.Crossref 14. Falliers, C.J., et al: Anabolic Effects of Stanozolol , Amer J Dis Child 106:388-401 ( (Oct) ) 1963.Crossref 15. Geller, J.: The Effect of 17 Alpha-Ethyl-19-Nortestosterone and 17 Alpha-Ethyl-19-Nortestosterone 3-Enol-Propionate on Growth and Endocrine Function in Normal Young Males of Short Stature , Acta Endocr (Kobenhavn) 45:13-25 ( (Jan) ) 1964. 16. Dennis, J.L., and Panos, T.C.: Growth and Bone Age Retardation in Cystic Fibrosis, Response to an Anabolic Steroid , JAMA 194:855-858 ( (Nov) ) 1965.Crossref 17. Bierich, J.R., and Becker, B.: Treatment of Growth Disturbances With Anabolic Steroids , Acta Endocr (Kobenhavn) 49 ( (suppl 101) ):45, 1965. 18. Bayer, L.M., and Bayley, N.: Growth Pattern Shifts in Healthy Children: Spontaneous and Induced , J Pediat 62:631-645 ( (May) ) 1963.Crossref 19. Greater Growth in Mongoloids , editorial. JAMA 187:54 ( (Jan 4) ) 1964. 20. Danowski, T.S., et al: Oxandrolone Therapy of Growth Retardation , Amer J Dis Child 109:526-532 ( (June) ) 1965. 21. Ray, C.G., et al: Studies of Anabolic Steroids , Amer J Dis Child 110:618-623 ( (Dec) ) 1965.Crossref 22. Pappo, R., and Jung, C.J.: 2-Oxasteroids: A New Class of Biologically Active Compounds , Tetrahedron Lett 9:365, 1962.Crossref 23. Lennon and Saunders, cited in Fox, M.; Minot, A.S.; and Liddle, G.W. (eds.): Oxandrolone: A Potent Anabolic Steroid of Novel Chemical Configuration , J Clin Endocr 22:921-924 ( (Sept) ) 1962.Crossref 24. DeLorimier, A.A., et al: Methyltestosterone, Related Steroids and Liver Function , Arch Intern Med 116:289-294 ( (Aug) ) 1965.Crossref 25. Stuart, H.C.: Standards of Physical Development for Reference in Clinical Appraisement: Suggestions for Their Presentation and Use , J Pediat 5:194-209 ( (Aug) ) 1934.Crossref 26. Stuart, H.C., and Meredith, H.V.: Use of Body Measurements in the School Health Program: Two Methods to be Followed in Taking and Interpreting Measurements, and Norm to be Used , Amer J Public Health 36:1373-1386 ( (Dec) ) 1946.Crossref 27. Greulich, W.W., and Pyle, S.I.: Radiographic Atlas of Sleletal Development of the Hand and Wrist , ed 2, Stanford, Calif: Stanford University Press, 1959.