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The enzymatic technique using 3α-hydroxysteroid dehydrogenase for determining bile acids in blood has been modified by measuring the reduced nicotinamide adenine dinucleotide fluorimetrically. The increased sensitivity attained enables the concentration of total bile acids in serum to be estimated using 3 ml for normal subjects and 1 ml for jaundiced patients. The range of normal values in serum was found to be 0-4·7 μmol/litre for males and 1·0-8·2 μmol/litre for females.

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A procedure is described for the purification of the steroid-induced 3 -hydroxysteroid dehydrogenase of Pseudomonas testosteroni. The purified preparations catalyze the nicotinamide-adenine dinucleotide dependent oxidation of about 300 ,umoles of androsterone/min per mg of protein at pH 9.0 and 25°. The purification depends upon stabilization of the enzyme in glycerolwater mixtures; removal of nucleic acids with protamine

Six patients with severe hyponatraemia had neurological features of hyponatraemia and pronounced hypoalbuminaemia. AU had biochemical features typical of the syndrome of inappropriate secretion of antidiuretic hormone with low serum osmolality and an inappropriately high urinary osmolality. All were given infusions ofwhole plasma or albumin solution, or both, to restore their plasma albumin concentrations to normal, which led to a dramatic increase in plasma sodium concentrations and serum osmolality, with a concomitant fall in urinary osmolality in all patients. Neurological features were reversed in four patients.It is suggested that severe hypoalbuminaemia is an important cause of appreciable hyponatraemia; infusions of plasma and albumin in such patients may reverse the biochemical and clinical features and should form the basis of management.

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