Iron stores in man

American Federation for Clinical Research organic sulfur were modified during the administration of testosterone and of plasma albumin. METHYLANDROSTENEDIOL: ITS PRESENTCLINICAL STATUS. Gilbert S. Gordon, M.D. (From the University of California School of Medicine, San Francisco, Calif.) The clinical use of protein-anabolic steroids for stimulation of tissue formation has been limited by the fact that these compounds are also potent androgens. It has been hoped that by use of an appropriate assay procedure suitable steroids might be recognized which possess anabolic properties similar to those of testosterone but have little or no androgenic activity. During the screening of a number of compounds it was found that methylandrostenediol is a potent protein-anabolic steroid with little genital activity. Balance studies in female human subjects have confirmed the anabolic efficacy of this compound. The compound has proved effective for weight gain, increase in height and stimulation of bone matrix formation. Of greatest interest is the dearth of other effects which might be anticipated from administration of steroids (masculinization, inhibition of menses, untoward emotional responses). Present early evaluation indicates that methylandrostenediol is a promising experimental agent with metabolic actions similar to those of methyltestosterone but, in ordinary doses (20 to 40 mg. per day sublingually), little or no genital activity. SIMULTANEOUSMEAXJREMENTOF SEVERAL COMPONENTS OF PLASMA AND OF INTERSTITIAL FLUID. W. W. Hurst, M.D., F. R. Schemm, M.D. and 3. A. Layne, M.D. (From the Great Falls Clinic, Great Falls, Mont.) Tissue fluids were obtained free of blood in the manner described by Burch in thirteen patients with cardiac edema. Sodium (twelve studies): The sodium levels in the tissue fluid were lower than in the blood plasma in ten instances; average difference 3.0 mEq./L. (1 to 7 mEq./L.). In two instances the tissue fluid sodium excess was 2 and 5 mEq. (In two instances potassium levels were determined and were identical in tissue and plasma.) Chloride (eleven studies): Tissue fluid values were higher than in the plasma in all instances; difference’ 9.3 mEq./L. (4 to 14 average mEq./L.). Carbon dioxide combining power (nine studies): Tissue fluid values were higher than NOVEMBER,

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plasma values in all instances. The average difference was 13.7 vol. per cent (1.9 to 23.2 vol. per cent). Protein (twelve studies): The average values for plasma were total protein 6.2 gm. per cent, albumin 3.7 gm. per cent and globulin 2.5 gm. per cent (A/G ratio 1.5). Average values for tissue fluid were total protein 0.63 gm. per cent, albumin 0.48 gm. per cent and globulin 0.15 gm. per cent (A/G ratio 3.2). Specific gravity (twelve studies) : Average values were plasma 1.0265 and tissue fluid 1.0092. Urea (seven studies): In six the tissue fluid levels were higher than in the plasma (one identical). Average difference was 6.6 mg. per cent (0 to 14 mg. per cent). Non-protein nitrogen (eight studies): In six tissue fluid levels were lower than plasma levels (two identical). Average difference was 8.2 mg. per cent (0 to 16 mg. per cent). Cholesterol (seven studies) : Tissue fluid values were all less than 25 mg. per cent. Average plasma values were 177 mg. per cent (136 to 230 mg. per cent). Calculation indicates that the greater values for chloride and bicarbonate in the tissue fluid compensate nicely for the lower number of cation charges of the tissue fluid protein. Further studies are in progress. IRON STORESIN MAN. Alexander R. Stevens, Jr., M.D. and Clement A. Finch, M.D. (From the University of Washington School of Medicine, Seattle, Wash.) Dietary iron absorption is limited to a few milligrams per day even in the severely irondeficient individual. This is sufficient to replace a loss of 500 ml. of blood over a period of about three months. The chief defense against anemia of blood loss is a store of available iron within the body. This available iron store has been measured in adult male subjects by removal of 500 ml. of blood weekly for seven weeks. Amount from stores was represented by the total iron removed by bleeding minus red cell deficit. Approximately 1,200 to 1,500 ml. of available iron were found in normal subjects. In subjects who had no anemia but had previously donated blood repeatedly there was marked reduction in available iron stores. In patients with hemochromatosis there were unlimited stores. Intravenous iron (saccharated iron) provided a store of iron quantitatively available for hematopoiesis.