Advancesin Clinical Chemistry, 14.

respectively. These descriptions will be useful for the laboratory investigator ‘with some experience. In summary, this book can best be characterizedas a hybrid of Advances in Immunology on one hand, and Methods in Immunology and Immunochemistry, on the other. It can be recommended to the reader who has particular interests in one of the topics described, although it is generally not of a caliber to invite regular subscription.

R. ROSE

NOEL

The Center for Immunology

State Univ. of N.Y. at Buffalo Buffalo,

N.Y.

14214

Selecting a Computer System for

the

Clinical

Laboratory.

Marion

The author of this book has sensed (perhaps even experienced)the information gap that exists between hospital administrators,pathologists,laboratory directors,and the computer industry. In an effortto remedy this situation, the reader is introduced to the field with a briefglossaryof computer terms.

3 is made up largely of pathol-

ogist’s endorsements and their philosophies of laboratory computer systems. Chapters 4, 5, and 6 contain examples of some input-out formats,manufacturer’s photographs, and literature of selected available computer systems. Chapter 7 is devoted to “How to Select a Computer,” but is only slightly over two pages long. The suggested questions in this chapter to ask the technologist during a visitto an operating laboratory are most appropriate. Chapters 8, 9, and 10 are entitled “When to Employ a Consultant,” “Laboratory and Management,” and the “Conclusion.” These three chapters are all in a total of four pages. The appendix contains the questionnairesused,additionaldetailson the systems, and some suggestions for gathering information on computer systems. The information in the book is objectively presented and does contain warnings about selecting a computer system for the clinical laboratory. However, the assumption is made initially

and throughout

the book that

labora-

tories should have computers. Some disadvantages of computers are cited, but in general no attempt to justify their use ismade by the author. A seriousliability of the book isthat nearly allof the information collectedis second-hand. Information gathered from individuals with a financial stake (manufacturers and vendors) and (or) an ego involvement (directors) often does not put the assets and liabilities of the systems in their proper perspective.

In summary,

this book is written

beginner.

J.

Ball. Charles C Thomas, Springfield, III., 1971,xi + 115pp. $14.75.

Chapter

the absolute

for

Therefore,

more

details on hardware and software characteristics of the systems discussed in this book are needed. Information on other available computer systems (not covered in this book) should be examined before any decision can be made by potential users. More authoritative, more comprehensive, and more up-to-date information is already available in the laboratory computer field than included in this text. The price of the book, like many computer systems, is excessive.However, the book’s costis so infinitesimally small compared to the expenditure being considered, one cannot reject the book on the basis of financial logic. MERLE

A. EvNsoN

University of Wisconsin Madison, Wis. 53706

Topics in Medicinal Chemistry, Vol. 4, Absorption Phenomena. J. L. Rabinowitz and R. M. Myerson, Eds. John Wiley & Sons, 605 Third Ave.,

New York, N. V. 10016, 1971, xiii + 356 pp. $19.95. The principles involved in the transport of drugs and foodstuffsacross cell membranes as well as the physical and chemical factors influencing this process is discussed by 13 contributors. Nine articles elaborate various aspects of absorption phenomena through the skin,the oral cavity,and the intestine, stressing the related biochemistry and physiology and methods for obtaining these data. In the discussion of epithehal control of gastrointestinal absorption, numerous illustrations obtained by electron microscopy illustrate the text. Because maladsorption may lead to serious fluid inbalances, a detailed discussion on the use of parenteral solutions is presented, as is a section on therapeutic considerations in the management of malabsorption syndromes. Those concerned with absorption phenomena will find in this volume an indepth coverage that is timely and informative. IRVING

Case Western Cleveland,

Reserve

SUNSHINE

University

Ohio 44106’

Advances in Immunology, Vol. 14. F. J. Dixon and Henry G. Kunkel, Eds. Academic Press, New York, N.Y. 10003,1971,xviii + 377pp. $18.50. This volume maintains the high standards of those preceding it. The reviews are thorough and scholarly. Because they deal with subjects applicable to clinical medicine and stress fields such as protein structure and biosynthesis,

598 CLINICAL CHEMISTRY, Vol. 18, No. 6, 1972

complement genetic or they are chemists. Alan E. discuss the

components, and the somatic basis for immunity, of interest to all clinical

Beer and R. E. Willingham immunobiology of mammalian reproduction with interesting relations to non-rejection or tolerance, to treatment of Rh sensitization, to viviparity and maternal-fetal interactions. Sidney Schulman reviews thyroid antigens and auloimmunity with emphasis on thyroglobulin heterogeneity and the controversial topic of thyroiditis. George Klein does a fine job of keeping clear the interrelations and immunological implications of Burkitt’s lymphoma and oncogenic viruses. Chester A. Alper and Fred S. Rosen consider the genetic aspects of the complement systems as contributed to by deficiency states in man and other animals. Finally L. Hood and J. Prahi discuss the immune system as a model for differentiation in higher organisms. As the simpler explanation they prefer the genetic basis for specific immunity over the somatic. There is a very elegant consideration of the current status of amino acid sequences in light and heavy chains of the immunoglobulins, as these apply to information-storage, expression, and evolution. RUSSEL

0.

BOWMAN

3551 Flair Drive Dallas, Texas 75229

Advancesin Clinical Chemistry, 14. Oscar Bodansky and A. L. Latner,

Eds. Academic Press, New York, N. Y. 10003,1971,xi + 500pp. $22.50. For those of us living in the “excited state” caused by the hotbed of service clinical chemistry, some of the chapters in this volume may seem dull and irrelevant. But we could not long survive as professional chemists without the serene intellectual challenge provided by this series. It tells us clearly where we are going, and sheds light on future pathways. The chapter, “Immunoglobulins in Clinical Chemistry” by Hobbs, is the highest point of exposition in Vol. 14. The busy clinical chemist appreciates its lucid, comprehensive review of a subject undergoing prolific pursuit. The curt chapter, “Multiple Analyses and Their Use in the Investigation of Patients” by Whitehead, though useful in pointing out future problems to be solved in profile analysis, is apparently written without regard for precedent. Biochemists may take great pride in their contributions to our knowledge of “Hereditary Disorders of the Urea Cycle” (Levin). The chemical bases of these disorders are established, and

analytical tools to detect them are available. On the other hand, there is little reason for acclaim in “The Biochemistry of Skin Disease” (Haiprin and Taylor). Much effort has not yet elicited a basis for this disease. Saifer’s review of “Rapid Screening Methods for the Detection of Inherited and Acquired Aminoacidopathies” is one that deserves the profound thanks of everyone faced with testing for amino acid abnormalities.

The

review

is thorough-covering

SAMUEL MEITES Children’s Hospital 561 S. 17th St.

Columbus, Ohio 43205

Blood-1971. Charles

Bishop, Ed. Service, 508 Getz. yule Rd., Buffalo, N. V. 14226, 1971, 277 pp. Paperback. $5.50. Blood Information

This little volume at firstglance looks

or a computerized

set of lecturenotes in hematology. But ifthe reader takes the time to become familiar with its slightly unusual format, its hand-drawn figures, and its lack of contrast in printing, he realizes that Blood is a poor man’s hematology text in pocket form as well as a reference book on many aspects of that fluid. The contents cover the categories of blood-plasma, erythrocytes, granulocytes, lymphocytes, monocytes, and platelets-and under each of these headings deal with practical features such as specimen collection, testing procedures, and also more general matters such as composition, properties, functions, metabolism, interactions, pathology, and comparative aspects. The information is accurate, up to date, and usefully indexed. One learns simple ways to testred cellfragility, that turtle red cells have a 700-day life span, that sickling is “normal” in some species of deer, and that catalase deficiency may

PETERS,

THEODORE

all

facets of analysis, and the extensive literature at hand. More importantly, itdoes us the extreme kindness of making critical choices among methods, based in large part on Saifer’spersonal experience. The chapter, “Pituitary Gonadotropins-Chemistry, Extraction, and Immunoassay” (Stevenson and Loraine) is a pithy objective commentary on the “state of the art” of analysis of FSH and LH. The chapter, “Biochemical Aspects of Muscle Disease” (Pennington) is useful in letting us know what biochemical changes have been observed in muscular dystrophy. My superficial review notwithstanding, no clinical chemist should be without access to this volume. The replacement of C. P. Stewart by A. L. Latner as an editor, has assured that the continuity and the high quality of previous volumes are maintained.

like a large pamphlet

be associated with oral gangrene. Probably the most difficult feature to become accustomed to isthe bibliography,which is arranged by year and then title. Blood should be a useful handbook for the hematology or chemical laboratory and an adjunct to update more expensive hematology texts for the medical student,graduate student,researcher,or practitioner.

The Mary Imogene Bassett Cooperstown, N. V. 13326

JR.

Hospital

Biochemical Profiling in Diagnostic Medicine. J. A. Preston and D. B. Troxel. Technicon Instruments Corp.,Tarrytown,N. Y. 10591,1971,51

pp. Gratis. Oh, the brave old King of France He had ten thousand men; He marched them up the hill, And marched them down again. And when they were up, they were up, And when they were down, they were down, And when they were only half-way up, They were neither up nor down. -Old

Nursery Rhyme

If the secret of caring for the patient is caring for the patient, how then may clinicians best employ their many diagnostic and therapeutic tools that technology has harvested from the fields of science in the past 20 years? Automated chemical analyzers, cardiac monitors, and ultrasonic scanners-among other devices-have already greatly extended our capacities, at the same time expanding the spectrum of our inadequacies by forcing us to consider how much of all this is to the ultimate benefit of a dying patient. How carefully must we attend to fluid balance of a sick person with mechanically assisted respiration, acute renal failure, and disseminated intravascular clotting when our best efforts can lead families to medical mdigency or when funds so used might be better applied to delivery of medical care to those who used to be called the underprivileged? Our economy seems incapable of paying for both butter and guns, let alone of supporting such established life-sustaining services as chronic hemodialysis, so there is little wonder that we have yet to fit automated multiphasic health testing into our medical-care systems despite their well-recognized value in identifying conditions not recognizable by history taking and physical examination alone and in providing more information at less cost about hospitalized patients. Perhaps we are still asking ourselves what we really expect of these

machines. It is apparent that sequential multiple analysis (5MA) does not represent a shortcut to diagnostic and therapeutic excellence, but instead demands greater knowledge and perspicacity from the physician who receives the results. It has been suggested that we can apply a method called pattern recognition to the biochemical profile provided by the SMA and a graphic display of biochemical data as a biochemical biopsy, and this monograph initiating the reader into the mysteries of this approach has been offered as a desk reference and for medical teaching. Before commenting on the validity of this concept, it might be well to establish the adequacy of the physician-authors’ exposition of clinical chemistry by examining some of their data. The approach offered is a simple one: they list the chemical procedure and note the conditions leading to abnormal results, without noting at any point that some of these results can be affected depending on whether the patient has been fed or fasted before blood is drawn. Unfortunately, the lists are unselective, are unsupported by clarifying comments, and contain many errors of commission and of omission, the most glaring being the assertion that abnormal elevations of serum phosphorus are caused by hyperparathyroidism, presumably primary, because renal failure, the most common cause of secondary hyperparathyroidism, is also listed, correctly, as a cause. The authors further assert that hypophosphatemia results from a negative nitrogen balance, without further comment, and do not include hyperparathyroidism as a cause of low serum phosphorus. Increased recognition of hyperparathyroidism being one of the greatest benefits of multiphasic screening, this is indeed a serious omission. But medical students of all ages recognize that unwarranted assertions and random lists cannot withstand rigorous examination, so there is no need to continue carping. It is rather the notion that such oversimphication can be part of a brave new medical world that must be discounted. Clinical judgment rests on the evaluation of chemical data, radiologic studies, and other tests, a careful physical examination, and above all a carefully taken medical history, because it is during the interviews that the patient and the physician establish rapport. This rapport may determine how comfortably and easily the patient accepts the delivery of all the medical care that may prove necessary. Such monographs offer false security to believers, and therein lies danger for the believer and his patient. The analysis of curves and straight lines can hardly be an end in itself; phrenology arose on

CLINICAL CHEMISTRY, Vol. 18, No. 6, 1972 599