15. Jochum M, Gippner-Steppert C, Machleidt W, Fritz H. The role of

phagocyte proteinases and proteinase inhibitors in multiple organ failure. Am

J Respir Crit Care Med 1994;150:S123-S130.

16. Fritz H, JochumM, Geiger R, Duswald KH, Dittmer H, Kortmann H,

et al. Granulocyte proteinases as mediators of unspecific proteolysis in

inflammation: a review. Folia Histochem Cytobiol 1986;24:99-115.

17. BalduyckM, Albani D, JourdainM,Mizon C, Tournoys A, Drobecq H,

et al. Inflammation-induced systemic proteolysis of inter-alpha-inhibitor in

plasma from patients with sepsis. J Lab Clin Med 2000;135:188-98.

18. Lim YP, Opal SM, Bendelja K, Salvemini P, Yang S, Gruber G, et al.

Inter-a trypsin inhibitor: decreased plasma levels in septic patients and its

beneficial effects in an experimental sepsis model. Shock 2000;13:367.

19. Daveau M, Rouet P, Scotte M, Faye L, Hiron M, Lebreton JP, et al.

Human inter-alpha-inhibitor family in inflammation: simultaneous synthesis

of positive and negative acute-phase proteins. Biochem J 1993;292:485-92.

20. Yang S, Lim YP, Zhou M, Salvemini P, Schwinn H, Josic D, et al.

Administration of human inter-alpha-inhibitors maintains hemodynamic

stability and improves survival during sepsis. Crit Care Med 2002;30:

617-22.

21. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-

Rodriguez A, et al. Efficacy and safety of recombinant human activated

protein C for severe sepsis. N Engl J Med 2001;344:699-709.

22. Matthay MA. Severe sepsis—a new treatment with both anticoagulant

and antiinflammatory properties. N Engl J Med 2001;344:759-62.

50 Years Ago in The Journal of PediatricsMEDICAL PROGRESS: RECENT PROGRESS IN POLIOMYELITIS RESEARCH

R Ward. J Pediatr 1953;43:98-107

Fifty years ago, Dr Ward summarized research underway on poliomyelitis. Polio was a very important public health

problem at the time: in 1952, there were 57,879 cases in the United States alone, with 21,269 cases of paralysis and 3000

deaths.1 The virus had been first isolated in 1909, but the propogation of the virus in tissue culture by Enders, Weller, and

Robbins in the late 1940s was the critical breakthrough for further progress. DrWard reported that the development of the

inactivated vaccine of Salk, and of the live, attenuated vaccine of Sabin were underway. Of course, these efforts were

ultimately successful, and universal vaccination was implemented by the mid-1950s, leading to the eradication of wild-type

polio in the United States by 1979.

Today, a new feared pathogen has emerged and the comparisons are intriguing. Severe acute respiratory syndrome

(SARS) has emerged from the Far East, so far occurring in 3000 patients and causing 150 deaths.2 The reaction worldwide

has been immediate and profound. Fear has already had huge social and economic impact throughout eastern Asia, the

final extent of which is not yet known. Meanwhile, the medical research community has turned on a dime toward new

goals. Within months of the report of the first cases of this apparently new disease, the causative agent has been identified,

its entire genome sequenced, and work is well underway to develop diagnostic tests. Both therapeutic trials of existing

agents and the steps to develop a vaccine are under discussion.

The comparisons of the public health impact of the two diseases, the response of the public, and the expectations of the

medical research community are striking. What accounts for the differences? Surely, the pace of research has accelerated

with the technologic capabilities of today’s biologists. It remains to be seen whether the capabilities of the research teams

will keep pace with the public’s expectations.

Thomas P. Green, MD

Department of Pediatrics

Children’s Memorial Hospital and Northwestern University

Chicago, IL 60614

YMPD28910.1016/S0022-3476(03)00252-X

REFERENCES1. A Morag, PL Ogra. Polioviruses. In: Behrman RE, Kleigman RM, Jenson HB, eds. Nelson textbook of pediatrics. Philadelphia (PA): WB

Saunders; 2000. p. 569-9.

2. Crampton T. One-day death rate from new virus hits 9 in Hong Kong. The New York Times; April 15, 2003.

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