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Summary In a white American family with no evidence of Negro or Mediterranean ancestry, two children, aged one and three and one-half years, suffered from sickle-cell anemia since early infancy. Their father had sicklemia without anemia. In all the sickling was of the slow type, which requires from twelve to twenty-four hours to appear. Both children were stunted in growth, the girl being more dwarfed than her baby brother. The removal of an enlarged spleen in the younger child failed to affect the anemia or the sickling, while the spleen in the other patient was small. The noteworthy features in these cases, in addition to their ethnologic interest, concerns the early age at which symptoms of anemia appeared in both children and the slow type of sickling. It is suggested that even in anemia of white American children, the possibility of sickle-cell anemia should be remembered and a moist blood film examined after kept twenty-four hours.

Myringotomy can be a simple surgical procedure, but the younger child presents special problems. The type of instrument used, how it is introduced, the modality of anesthesia, and the emotional makeup of the child (and the parent) all need special attention if the operation is to go smoothly for both patient and physician.

Summary The case histories of 445 children with primary tuberculosis or pleural effusions are examined and analyzed. The serious nature of the disease is emphasized and the frequency and gravity of complications are discussed. In the child under 6, primary pulmonary tuberculosis takes a longer period to become arrested than in older children. Also the younger child is more liable to develop pulmonary complications, with the two exceptions of uncomplicated pleural effusion and parenchymatous spread. He will need a period of bed rest under observation, which can best be carried out in an institution. A proportion of older children will also require the same form of treatment.

Evaluation of 115 children who had irradiation to the liver reveals an increase in abnormality of the parameters studied when large volumes of liver are irradiated or when the liver is irradiated following resection. To some extent, this is dependent on dose but abnormalities have been observed at doses below 2,499 rads and as low as 1,200 rads. Possibly, this may be related to the increased sensitivity of the younger child who generally received these lower dosages.Although evaluation in the chronic phase shows no significant difference of abnormality of age as related to dose, there does appear to be a slight trend in the acute phase of irradiation to implicate sensitivity of children under 1 year.

Iron‐deficiency anemia persists in the face of a simple solution. The plight of the infant and younger child is emphasized; the needs of the menstruating and pregnant woman are also considered.

The condition appeared in sisters after the first half year of life. In the elder operation was not performed until the age of sixteen months and three years, respectively, with the loss of one eye and vision of 5/200 in the other. The younger child was brought to operation at nine months of age with conservation of useful vision. From the Department of Ophthalmology and Otolaryngology, University of Minnesota. Read before the Minnesota Academy of Ophthalmology and Otolaryngology, February 10, 1933.

• The 1974 and early-1975 model automobiles are equipped with belt interlock systems that require front outboard seat occupants who weigh more than 21.5 kg (47.3 lb) to wear three-point lap and diagonal upper-torso belts (or wear the lap belt and position upper-torso belt behind them), assuming that the interlock has not been circumvented. Recent legislation has eliminated the interlock requirement, but new models are still likely to be fitted with three-point restraints for the front outboard seating positions. These restraint systems were designed and tested for adult use. Thus, based on the different structure of a younger child and the fact that there is a wide variation of belt orientation, child size, and seating environments, there is legitimate concern that the upper diagonal belt might contribute to injury of the child under certain impact conditions. ( Am J Dis Child 129:946-949, 1975)

Subjects with GD have elevated LH & FSH and achieve greater rise in both after LRF (Silver, Yen 1973). Estrogens exert inhibitory action on FSH & LH release (Yen et al 1972). To ascertain an effect of estrogen on LH and/or FSH to LRF in GD, 8 females 7-20 yrs, were studied; 4 XO, 1 XO/XY, constitutional delay, hypopituitarism, normal female. LRF, 50-100 ugm IV, was followed by 0.1 mgm EE daily 3-7 days, with 1-7 days off EE prior to second LRF test. In 3 young XO GD, 7 days EE decreased basal FSH (mean 17.6 mIU/ml before EE, 6.1 after EE) and the FSH peak to LRF (mean FSH peak 64.1 before EE, 16.1 after); LH was not significantly affected. With 3 days EE, a 7 yr. XO/XY had no change in LH, FSH responses. An older XO had an LH rise to LRF after 3 days EE, with a decreased FSH responsiveness. LH levels with LRF (after EE) were decreased in a normal female and constitutional delay. The younger child with GD lacks ovarian feedback mechanism and may have chronic endogenous secretion of LRF which induces pubertal LH response, as shown in these studies. LH & FSH responses to EE varied with age.

Rectoscopy is the direct instrumental visualization of the rectum; rectosigmoidoscopy is such visualization of both the rectum and the sigmoid flexure of the colon. It is striking, in view of the frequency of intestinal disturbances in infants and children, that a standardized technic of rectosigmoidoscopy, the only procedure available for the direct observation of the rectum and sigmoid flexure, for use with young children and its advantages have not been described in the literature. A survey reveals a few vague references to sporadic efforts to use the procedure, but the data are too general or too brief to be of practical value. When practiced, it was used primarily in older children, probably because of the easier management and simpler instrumentation, and seems to have been restricted to the rectum. The problem with the older child is not unlike that with the adult. However, with the younger child and the infant

To the Editor: —On April 11, a child, aged 7, was playing with another boy, aged 13. and in some manner a toy blank cartridge pistol, which had been loaded with a 22-caliber cartridge, with the bullet whittled down to allow it to enter the bore of the pistol, was discharged, the bullet entering the younger child's back, between the lower ribs and the crest of the ilium. In spite of everything that could be done, even to opening the abdomen in the hope of tracing the bullet, which had been followed from the rear as far as the spine, the child died about thirty-six hours after the accident. It was found that the toy pistol causing the child's death had been purchased for the celebration of last Fourth of July. Attorneys, physicians, and business men, together with the press, at once took up the matter of a prohibitive ordinance