TY - JOUR
AU - Doumas, Basil, T
AB - This book is a compilation of 39 papers that appeared in the scientific literature from 1919 to 1992. Each paper is preceded by a commentary in which the editor provides brief descriptions of the tests, the impetus for their development, and sometimes, anecdotes about the scientists. The book is divided into 7 sections: Immunoassay Technology, Therapeutic Drug Monitoring, Enzymology, Specific Analytes, Instrumentation and Techniques, Chemometrics, and Molecular Diagnostics. Many of the papers selected are, indeed, landmarks in clinical chemistry. They represent a historical journey through the evolution of the chemistry laboratory. In less than 90 years, the chemistry laboratory moved from the Duboscq colorimeter (circa 1919) to the most advanced of automated analytical instruments, virtually eliminating all manual procedures while simultaneously expanding the number of diagnostic tests. To those of us who were “present at the creation” of clinical chemistry (the arrival of this reviewer in the US in 1957 coincided with the introduction of the Technicon AutoAnalyzer, the first instrument for automated analysis in clinical chemistry, which may be seen at the Smithsonian Institution in Washington, DC), the book will invoke memories of how things used to be when all analyses were manual and required some dexterity in pipetting and mixing, when relatively strong biceps were needed to lift quite a few pounds of mercury to perform CO2 combining power with a Van Slyke apparatus, especially when you had to do as many as 40 per day (yes, there was plenty of Hg floating on the large tray and floor, but no one was poisoned!), when in the hot and humid summer days you were spending hours with an unstable and fairly inaccurate flame photometer to measure sodium and potassium in a few specimens, and when the only STAT analyses available were blood sugar, NPN (nonprotein nitrogen), amylase, bilirubin (babies only), CO2, and chloride. On the other hand, there were no laboratory inspectors and regulators, no paper-mountains of documentation or multiple volumes of procedures and policies. If you developed a test, you could use it right away without anyone’s permission. Many of the commentaries are of particular interest because they provide insight into the genesis of important technologies. For example, Yalow and Berson developed the RIA technique for insulin after they administered 131I-insulin to nondiabetic controls, patients with diabetes who had never had insulin, and patients with diabetes who were receiving insulin therapy. Yalow and Berson observed that insulin clearance times were the same in the controls and diabetic patients who had never received insulin but were markedly increased in insulin-treated diabetic patients. By further experimentation, Yalow and Berson demonstrated that an insulin–antibody complex in the blood of insulin-treated diabetic patients led to the increased clearance times. These results were published only after the authors agreed to replace the term “insulin antibody” with “insulin-binding protein”. Eventually, this discovery disproved the theory that small proteins (Mr <6000) could not elicit an immune response. Yalow and Berson were able to raise an insulin antibody, leading to the development of the RIA for insulin and opening the door to other immunoassays (FPIA, ELISA, Emit) that did not require radioactive tracers. Sulfanilamide was released in the US in 1936, when safety and efficacy studies were not required; the sole FDA requirement was that the product label list all active ingredients. The New York Times headline of December 17, 1936, “Young Roosevelt Saved by New Drug” (the US President’s son was cured of a life-threatening streptococcal infection with sulfanilamide) helped launch the era of antibiotics. There was no method to measure the new drug in blood until E. K. Marshall of Johns Hopkins developed and published for the first time (Science 1937) a method for measuring sulfanilamide in biological fluids. Leonard Skeggs, the inventor of the artificial kidney, was head of the clinical laboratory at the Cleveland Veterans Administration Hospital. In 1950, when all tests were performed manually, he began building an automated instrument in his basement. For almost 4 years Skeggs tried unsuccessfully to find a company to develop his prototype. In 1954, Edwin Whitehead of the Technicon Company and his engineers recognized the value of Skeggs’ invention, and 3 years later introduced the AutoAnalyzer, which was a smashing success, selling more than 18 000 units by 1969. This book would be a valuable addition to medical school libraries and to the libraries of those who are interested in the history of our profession. © 2006 The American Association for Clinical Chemistry This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - Landmark Papers in Clinical Chemistry. Richard M. Rocco, ed. Amsterdam: Elsevier B.V., 2006, 522 pp., $86.95, hardcover. ISBN 0-444-51950-5.
JF - Clinical Chemistry
DO - 10.1373/clinchem.2006.068833
DA - 2006-10-01
UR - https://www.deepdyve.com/lp/oxford-university-press/landmark-papers-in-clinical-chemistry-richard-m-rocco-ed-amsterdam-2bNZp6Gpsi
SP - 1977
VL - 52
IS - 10
DP - DeepDyve
ER -