F. William Sunderman

LIPIDS AND THE STEROID HORMONES IN CLINICAL MEDICINE

Lipids and the Steroid Hormones in Clinical Medicine. Proceedings of an Applied Seminar of the Association of Clinical Scientists, held in Washington, D . C. Edi ted by F . WILLIAM SUNDERMAN, M.D. , P H . D . , S C . D . , Director, Division of Metabolic Research and Clinical Professor of Medicine, Jefferson Medical College, Philadelphia, AND F . WILLIAM SUNDERMAN, J R . , M.D. , Head, Chemistry Branch and Instructor in Clinical Pathology, United States Naval Medical School, Bethesda, Maryland. Director of Seminar: F . William Sunderman, M.D. , Ph .D . 18 Lecturers; 11 Assisting Physicians, ix and 207 pp. , 54 figs., 38 tables.

STUDIES IN SERUM ELECTROLYTES: I. Concentration of Electrolytes and Non-electrolytes in the Serum during Lobar Pneumonia

10.75. Philadelphia: J . B . Lippincott Company, 1960. This volume consists of the edited proceedings of an applied seminar on Lipids and Steroid Hormones in Clinical Medicine, held under the auspices of the Association of Clinical Scientists a t Jefferson Medical College. The book has been prepared principally in order to assist scientists, in clinical and research laboratories, in selecting reliable methods of analysis and in interpret ing the analytic results.

STUDIES OF SERUM ELECTROLYTES: IV. The Chloride and Nitrogen Balances, and Weight Changes in Pneumonia.

It has long been known that during the course of lobar pneumonia alterations in the chloride distribution in the blood and urine occur. During the stage of active infection there is a retention of chloride in the body as manifested by a decreased chloride elimination, whereas the blood in this period shows a hypochloremia. The present study was designed to follow the changes in the concentration in the serum of the electrolytes in general and of the non-electrolytes in patients with lobar pneumonia. Hutchison (1898) studied the chloride metabolism in pneumonia and reviewed the literature up to 1898. He showed that diminution in the urinary chlorides might occur in other febrile conditions but was not as constant as in pneumonia and did not occur in other pulmonary diseases. For this reason he believed that an examination of the chlorides was of value in differentiating pneumonia from empyema, pleurisy, et cetera. Peabody (1913) studied the inorganic metabolism in pneumonia and reviewed the literature. In eight cases of pneumonia in which he studied the relation of chloride changes in the blood to changes in the urinary excretion he found that the decrease in the chloride excretion was associated with a lowered chloride concentration in the blood; and that at the time when excretion was increased, the blood chloride concentration was raised. His results also indicated a lowering of calcium and magnesium concentration of the blood during the stage of active infection.

STUDIES IN SERUM ELECTROLYTES II. THE ELECTROLYTE COMPOSITION AND THE pH OF SERUM OF A POIKILOTHERMOUS ANIMAL AT DIFFERENT TEMPERATURES

In an earlier study (1) data were presented on the changes in the blood serum during the course of lobar penumonia. It was found that the concentration of total base, chloride, and protein in the serum was usually decreased during the active infection. Following the crisis these concentrations returned to their normal values, the chloride less rapidly than the total base. The low excretion of chloride in the urine during the precritical period has long been known and the inference has been drawn that there is a correlation between the urinary excretion and the serum concentration. No satisfactory explanation of the mechanism of the change in composition of the serum or of the decreased urinary excretion of chloride has been established, but from studies in the literature it has often been inferred that during the precritical period the body tissues retain chloride which is subsequently released during the epicritical period. In an attempt to obtain data on factors concerned in these changes, studies of the intake and output were undertaken in patients suffering with lobar pneumonia.