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Pancreatitis: Concepts and classification
BOOK REVIEWS 1093
April 1986
Pancreatitis: Concepts and Classification. By K. E. Gyr, M. V. Singer, and H. Sarles. International Congress Series 642. 450 pp., $90.75.Excerpta Medica (distributed in the U.S. by Elsevier Science Publishing Co., Inc., New York, New York), 1984. Does it serve a useful purpose to publish proceedings of a medical meeting? In the case of the second International Symposium on the Classification of Pancreatitis held in Marseilles, France in March 1984, the answer is yes. As stated in the title, the major emphasis of this symposium is concepts and classification of pancreatitis, but this book delivers much more. It provides the clinician and investigator with a considerable amount of information and new insights. The book begins with a preface that outlines both the first Marseilles classification of pancreatitis of 1963 and the revised classification of 1984. The preface includes comments by the editors about the importance of the revised classification in planning clinical and research studies. The main portion of the book is in eight sections. The first three sections include studies on pathomorphology, biochemistry, and pathophysiology of pancreatitis. The remaining sections are devoted to imaging procedures, pancreatic function testing, epidemiology and etiology, and clinical course of pancreatitis. The book contains a total of 77 papers from around the world, most of which are 3-7 pages in length. Each paper contains a current bibliography, and each section ends with a summary that pulls together the major themes and provides a final, balanced interpretation. The editors have done a fine job in organizing this book and in insisting that the authors prepare their material in a succinct manner. The figures and tables are clearly presented, and histolbgic reproduction is of high quality. This book was not intended to replace clinical textbooks on pancreatitis. It is best read by those who already have an overview in the diagnosis, treatment, and natural history of pancreatitis, and who seek either supplemental or more specialized information that is not readily available. For example, the section on pancreatic function testing is uniformly excellent, and the summary paper is superb. In addition, the papers in the pathomorphology, biochemistry, and pathophysiology sections are nicely presented and contain valuable information. For example, papers that address the role of lysosomes in the development of acute pancreatitis, fine structural and biochemical abnormalities in human acute pancreatitis, chemical and biochemical properties of pancreatic stones, and action of ethanol are but a few of the many excellent reports of general interest. This book should be in medical libraries and should be read by those who have a serious interest in the pancreas. PETER A. BANKS, M.D.
Brookline, Massachusetts
Hepatitis Academic
B. Edited by R. J. Gerety. Press, Inc., Orlando, Florida,
470 pp., 1985.
$79.00.
Dr. Gerety has attempted to present a definitive book on hepatitis B. Most such attempts have been rendered obso-
lete by the continuing accumulation of new information. As a result, no definitive work is available; this collection, almost by definition, also falls short of this ephemeral goal. Nevertheless, Dr. Gerety is to be congratulated on this effort in which he has assembled an all-star cast of authors. The 18 chapters deal with the hepatitis B virus (HBV) markers, the molecular biology of HBV, epidemiology, immunopathogenesis, histopathologic studies in human beings and the chimpanzee, clinical manifestations of acute and persistent HBV infection, and immunoprophylaxis. A mosaic chapter, entitled “new technologies,” which is directed to structure-function relationships of HBsAg in terms of immune reactivity is also included. There is careful scholarship and writing in many chapters. Miyakawa and Mayumi provide a beautifully lucid and intelligent discussion of the complexities of HBeAg and its intimate relationship to HBcAg, and Robinson’s chapter on the molecular biology of HBV is a superb synthesis and critique of current concepts and unresolved issues. Seeff presents a brilliant review of the history and utility of passive immunization in the prevention of HBV infection. There is considerable overlapping of content throughout; for example, the schematic sequence of serologic events in hepatitis B is shown in three chapters, and a figure depicting the worldwide prevalence of the HBsAg carrier state and incidence of primary hepatocellular carcinoma is shown in two chapters. While some redundancy may be necessary and even valuable. the amount here is excessive and suggests that the 470 pages might have been reduced by vigorous editing. (Is there a book editor remaining who truly edits submitted manuscripts?) Despite these shortcomings, I am pleased to have read this book and to have learned from it. It will be a useful source of information, if even for a brief interlude, in the quest for knowledge about hepatitis B, and it is essential for my personal library. RAYMOND S. KOFF, M.D.
Boston, Massachusetts
Radiology of the Liver Circulation. By C. L’Hermin&. 174 pp., $60.00. Martinus Nijhoff Publishers (distributed in the U.S. by Kluwer Academic Publishers, Hingham, Massachusetts), 1985. Approximately one-third of the pages in this book are taken up by text, the rest by illustrations grouped at the end of each chapter. The illustrations (are of excellent quality and are very well reproduced. Anatomy and physiology of hepatic circulation and angiographic methods are described briefly. Emphasis is given to chapters 3 and 5, which deal with angiographic signs of portal hypertension and their hemodynamic significance and with diffuse postsinusoidal obstructions. A few pages toward the end of the book are devoted to interventional radiology in relation to portal hypertension. The author attempts to interpret arterioportographic findings in hemodynamic terms. “Spleen patterns” and hepatic arterial changes form the main basis for this. His observations are undoubtedly of interest, but conclusions are inevitably based on observer impression and not on
April 1986
Pancreatitis: Concepts and Classification. By K. E. Gyr, M. V. Singer, and H. Sarles. International Congress Series 642. 450 pp., $90.75.Excerpta Medica (distributed in the U.S. by Elsevier Science Publishing Co., Inc., New York, New York), 1984. Does it serve a useful purpose to publish proceedings of a medical meeting? In the case of the second International Symposium on the Classification of Pancreatitis held in Marseilles, France in March 1984, the answer is yes. As stated in the title, the major emphasis of this symposium is concepts and classification of pancreatitis, but this book delivers much more. It provides the clinician and investigator with a considerable amount of information and new insights. The book begins with a preface that outlines both the first Marseilles classification of pancreatitis of 1963 and the revised classification of 1984. The preface includes comments by the editors about the importance of the revised classification in planning clinical and research studies. The main portion of the book is in eight sections. The first three sections include studies on pathomorphology, biochemistry, and pathophysiology of pancreatitis. The remaining sections are devoted to imaging procedures, pancreatic function testing, epidemiology and etiology, and clinical course of pancreatitis. The book contains a total of 77 papers from around the world, most of which are 3-7 pages in length. Each paper contains a current bibliography, and each section ends with a summary that pulls together the major themes and provides a final, balanced interpretation. The editors have done a fine job in organizing this book and in insisting that the authors prepare their material in a succinct manner. The figures and tables are clearly presented, and histolbgic reproduction is of high quality. This book was not intended to replace clinical textbooks on pancreatitis. It is best read by those who already have an overview in the diagnosis, treatment, and natural history of pancreatitis, and who seek either supplemental or more specialized information that is not readily available. For example, the section on pancreatic function testing is uniformly excellent, and the summary paper is superb. In addition, the papers in the pathomorphology, biochemistry, and pathophysiology sections are nicely presented and contain valuable information. For example, papers that address the role of lysosomes in the development of acute pancreatitis, fine structural and biochemical abnormalities in human acute pancreatitis, chemical and biochemical properties of pancreatic stones, and action of ethanol are but a few of the many excellent reports of general interest. This book should be in medical libraries and should be read by those who have a serious interest in the pancreas. PETER A. BANKS, M.D.
Brookline, Massachusetts
Hepatitis Academic
B. Edited by R. J. Gerety. Press, Inc., Orlando, Florida,
470 pp., 1985.
$79.00.
Dr. Gerety has attempted to present a definitive book on hepatitis B. Most such attempts have been rendered obso-
lete by the continuing accumulation of new information. As a result, no definitive work is available; this collection, almost by definition, also falls short of this ephemeral goal. Nevertheless, Dr. Gerety is to be congratulated on this effort in which he has assembled an all-star cast of authors. The 18 chapters deal with the hepatitis B virus (HBV) markers, the molecular biology of HBV, epidemiology, immunopathogenesis, histopathologic studies in human beings and the chimpanzee, clinical manifestations of acute and persistent HBV infection, and immunoprophylaxis. A mosaic chapter, entitled “new technologies,” which is directed to structure-function relationships of HBsAg in terms of immune reactivity is also included. There is careful scholarship and writing in many chapters. Miyakawa and Mayumi provide a beautifully lucid and intelligent discussion of the complexities of HBeAg and its intimate relationship to HBcAg, and Robinson’s chapter on the molecular biology of HBV is a superb synthesis and critique of current concepts and unresolved issues. Seeff presents a brilliant review of the history and utility of passive immunization in the prevention of HBV infection. There is considerable overlapping of content throughout; for example, the schematic sequence of serologic events in hepatitis B is shown in three chapters, and a figure depicting the worldwide prevalence of the HBsAg carrier state and incidence of primary hepatocellular carcinoma is shown in two chapters. While some redundancy may be necessary and even valuable. the amount here is excessive and suggests that the 470 pages might have been reduced by vigorous editing. (Is there a book editor remaining who truly edits submitted manuscripts?) Despite these shortcomings, I am pleased to have read this book and to have learned from it. It will be a useful source of information, if even for a brief interlude, in the quest for knowledge about hepatitis B, and it is essential for my personal library. RAYMOND S. KOFF, M.D.
Boston, Massachusetts
Radiology of the Liver Circulation. By C. L’Hermin&. 174 pp., $60.00. Martinus Nijhoff Publishers (distributed in the U.S. by Kluwer Academic Publishers, Hingham, Massachusetts), 1985. Approximately one-third of the pages in this book are taken up by text, the rest by illustrations grouped at the end of each chapter. The illustrations (are of excellent quality and are very well reproduced. Anatomy and physiology of hepatic circulation and angiographic methods are described briefly. Emphasis is given to chapters 3 and 5, which deal with angiographic signs of portal hypertension and their hemodynamic significance and with diffuse postsinusoidal obstructions. A few pages toward the end of the book are devoted to interventional radiology in relation to portal hypertension. The author attempts to interpret arterioportographic findings in hemodynamic terms. “Spleen patterns” and hepatic arterial changes form the main basis for this. His observations are undoubtedly of interest, but conclusions are inevitably based on observer impression and not on