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A SIMPLIFIED APPROACH TO ELECTROCARDIOGRAPHY
Conflnuedjrom page 20 maker, which is now the most commonly implanted dual chamber pacemaker, but do not provide the reader with an adequate step-by-step explanation with diagrams of how it functions. Triggered pacemakers are also mentioned in the fint few pages but there is no explanation of the principles upon which they operate, Coverage of programmability and telemetry, which are major aspects of pacemaker therapy, is limited to two paragraphs. In other parts of the book, terms such as polarization resistance, pulse system analyzer, and cross talk are utilized without adequate explanation. In writing this text the authors presuppose a relatively sophisticated lmowIedge of the principles of pacemaker therapy on the part of their reader audience. Thus, for those who are already at this level this book offers a concise and informative review, but fOrthosewho want to start on the ground Roor this book cannot be recommended.
JfJfI1a E. Davia, M.D.
OverllInd Ibrk, Kama
A SIMPLIFIED APPROACH TO ELECTROCARDIOGRAPHY. By RICHARD JOHNSON and MARl: H. SWARn. Philadelphia: WB Saunders, 1986, 331 pp, $19.95
A Sim"l~d Approach to Electrocardiograph" is a "how-to" book on electrocardiography interpretation prepared for a medical-student audience by two authors, one of whom was a medical student at the time that the book was written. The authors begin with several chapters that brieRy describe relevant functional anatomy and physiology. They then cover the normal electrocardiogram and provide fairly detailed infOrmation about a variety of electrocardiographic abnormalities. They end with a large section of illustrative tracings in which the reader is led by the hand through some of the complexities of electrocardiographic interpretation. The book is clearly written and quite comprehensive considering the huge subject matter. The tone is pramcal and clearly addressed to its target audience. One of the few weak points relates to the understandable need to sacrifice accuracy for brevity and ease of understanding. Particularly in the discussion of therapy, which is necessarily extremely brief: statements are made which may mislead the reader. For example, I am not certain that everyone would agree that"a patient with pre-existing heart disease with frequent or mult:OOcal ventricular premature contractions will require therapy." In future editions, it would be preferable to omit discussion of therapy in a book whose major aim is electrocardiographic interpretation. I also feel that the book might benefit from some additional tables (for example, classification of AVblock) as a means of reinfOrcing the text. These criticisms notwithstanding, I believe that this book will prove a valuable aid to medical students learning the fundamentals of electrocardiographic interpretation.
In spite of contributions from multiple authors, we found no repetltion of contents or typographic errors, evidencing editorial excellence. The suggested reading list and references were well-considered and adequate. A glossary of terms likely to be unfamiliar to medical students and other specialists may be helpful. The original edition wasnoteworthy for its inclusion of attractive female models. The recent edition has attempted to meet the current trend of liberation with a smattering of male counterparts in nondominant roles. This book is worth reading for anyone seeking basic information about anesthesiology and its practice. It cannot, nor was it intended to be, considered a basic text of anesthesiology for the serious practitioner of the specialty. Bhagwandtu Gupta, M.D., and
John B. D0tDn8, M.D., RC.C.l
Columbtu,Ohlo
INTRODUCTION TO VASCULAR UlXRASONOGRAPHY, 2nd ed. Edited by WILLIAM J. ZWIEBEL. Orlando: Grune ~ Stratton Inc, 1986, 550 pp, price not stated
As vascular imaging proceeds toward visualization of arteries and veins without introduction ofcontrast media, it is welcome indeed to see this second edition of the attractive book on vascular ultrasonography put together by Zwiebel and his associates. At 6rst glance, perhaps one would not expect this book to be reviewed in a medical-surgical journal; but in fact, the text is directed toward vascularsurgeons. Thus, experts in the 6eld of ultrasonography direct their remarks toward the practicing vascular surgeon. Names familiarto vascular surgeons are listed as chapter coauthors. These include Ted Dietrich, James Yao, Bill Pearce, Gene Strandness, Bob Barnes, and David Sumner. Their remarks on upper and lower extremity vascular diagnosis using Doppler ultrasound and B-mode evaluation of Peripheral arteries and veins, as well as B-mode and duplex examination of the aorta, iliacarteries, and portal
vein, are mostwelcome. A notable lackin this book has been ultrasound evaluation of mesenteric,
celiac, and renal arteries, but perhaps observations in this ever-growing field are too recent to reach publication in book form. A notable inclusion is a marvelous section on intraoperative B-mode ultrasound techniques for arterial evaluation prepared by experts in this field, including Bernard Siegel, Preston Flanigan, and James Schuler. The volume is profusely illustrated, printed on excellent paper which reproduces the figures quite well. It can be recommended to those who do not have the first edition, as it will strengthen and provide excellent reference for any vascular library.
John J. Bergan, M.D.
Chicago
Robert w Peters, M.D.
Baltimore
ANESTHESIA FOR THE UNINTERESTED. By J. D. TOLMIE and A. A. BIRCH. Rockville, MD: Aspen Publishers Inc, 1986, 263 pp, $19.95 Although somewhat tongue-in-cheek, this book is appropriately titledand will be helpful to medical students and physicians of any discipline seeking basic infOrmation about the appropriate and safe practice of anesthesiology. The book is reasonably priced and its contents well-arranged in six sections, comprising 29 chapters written by 17 authors. A brief history is succinctly summarized, i>llowed by a discussion of the physiology of relevant organ systems. Practical topics such as the need fOrini>rmed consent are covered in a separate section. The discussion of anesthesia machines and laryngoscopes is too sketchy and therefore inadequate. These devices are probably the most confusing and their function the least understood by the nonanesthetist. Therefore, we believe this section deserves greater attention. Technical considerations and rationale ilr intravenous and arterial cannulation were well-described and likely will be helpful to physicians of all disciplines. The brief discussion of anesthetic uptake and distribution is a superb synopsis of a complicated subject. The chapter on blood transfusion and blood component therapy is concisely informative and applicable to all medical specialties. Techniques and special considerations for pediatric anesthesia were superflcially discussed and simpli8ed. H~~ it is unlikely that the medical student, tntern, or other individual Pemrming a short rotation in anesthesiology would be given responsibility for infants or children. Neurosurgical anesthesia entails a myriad of special monitoring and anesthetic techniques which receive little attention. Cardiac anesthesia is very popular and techniques change rapidly and signi&cantly, which may explain absence of discussion of recent advances in high-dose narcotic anesthesia. The role of anesthesia in maintenance of cardiopulmonary bypass, management of hypothermia and support of post-pump circulation are not discussed in deference to a basic discussion of cardiac physiology and pharmacology. Although respiratory care was discussed in thefinal section of the book,critical care medicine was not otherwise covered. This is a significant omission in view of the prominent role anesthesiologists have played in the development of this subspecialty and its emphasis in all anesthesia training programs.
22
THE NORMAL LUNG: THE BASIS FOR DIAGNOSIS AND TREATMENT OF PULMONARY DISEASE, 2nd ed. By JOHN R MuRRAY. Philadelphia: WB Saunders, 1986, 377 pp, $27.95 This book is in many ways a remarkable effort. Perhaps its most striking
attribute is the breadth of coverage, withchapters on growth and develop-
ment, anatomy, physiologic and metabolic function at rest and during exercise, defense mechanisms against environmental insults, and aging. Each of the 14 chapters is dealt with in a clear and balanced manner, and very little of importance is omitted. The chapters are well-referenced, and current to the date of "abandonment" (mid-I985). Given the standing of the author in the world of pulmonary medicine and physiology, the book could have been strengthened if he had taken a stronger position in the many areas in which discrepancies or controversies still exist in understanding the normal lung. Also, more emphasis on the relative importance of various issues and concepts described would have been welcome. The remarkable breadth of this book has, by necessity, limited its depth. Each of the chapters has been the subject of major treatises by others, and to cover all of normal lung structure and function in a single book would be impossible. However, it does raise the question of to whom this book is addressed. There is more here than all but the most dedicated medical student can use, and signposting of the critical factors fOr a medical student does not seem to have been attempted. On the other hand, it appears extremely well-suited to the graduate student in respiratory physiology, or the academic pulmonary fellO\Y, as the next step after texts such as Huplratory Phydology . . . The E"entitJIs by West. In this era of superspecialization, where the subject matter of each chapter is almost a discipline unto itselt: this book is also very useful for the more senior pulmonary physician or physiologist for keeping abreast of those areas in
which he is not active.
In summary, this book is remarkable for its breadth, with up-to-date referencing useful particularly for the graduate in pulmonary medicine or physiology. While this necessarily leads to some restriction on depth, Dr. Murray has achieved, in a unique way, a clearly written and easily read account of what we know about the normal lung.
Peter D. Wagner, M.D.
La loUD, California
JfJfI1a E. Davia, M.D.
OverllInd Ibrk, Kama
A SIMPLIFIED APPROACH TO ELECTROCARDIOGRAPHY. By RICHARD JOHNSON and MARl: H. SWARn. Philadelphia: WB Saunders, 1986, 331 pp, $19.95
A Sim"l~d Approach to Electrocardiograph" is a "how-to" book on electrocardiography interpretation prepared for a medical-student audience by two authors, one of whom was a medical student at the time that the book was written. The authors begin with several chapters that brieRy describe relevant functional anatomy and physiology. They then cover the normal electrocardiogram and provide fairly detailed infOrmation about a variety of electrocardiographic abnormalities. They end with a large section of illustrative tracings in which the reader is led by the hand through some of the complexities of electrocardiographic interpretation. The book is clearly written and quite comprehensive considering the huge subject matter. The tone is pramcal and clearly addressed to its target audience. One of the few weak points relates to the understandable need to sacrifice accuracy for brevity and ease of understanding. Particularly in the discussion of therapy, which is necessarily extremely brief: statements are made which may mislead the reader. For example, I am not certain that everyone would agree that"a patient with pre-existing heart disease with frequent or mult:OOcal ventricular premature contractions will require therapy." In future editions, it would be preferable to omit discussion of therapy in a book whose major aim is electrocardiographic interpretation. I also feel that the book might benefit from some additional tables (for example, classification of AVblock) as a means of reinfOrcing the text. These criticisms notwithstanding, I believe that this book will prove a valuable aid to medical students learning the fundamentals of electrocardiographic interpretation.
In spite of contributions from multiple authors, we found no repetltion of contents or typographic errors, evidencing editorial excellence. The suggested reading list and references were well-considered and adequate. A glossary of terms likely to be unfamiliar to medical students and other specialists may be helpful. The original edition wasnoteworthy for its inclusion of attractive female models. The recent edition has attempted to meet the current trend of liberation with a smattering of male counterparts in nondominant roles. This book is worth reading for anyone seeking basic information about anesthesiology and its practice. It cannot, nor was it intended to be, considered a basic text of anesthesiology for the serious practitioner of the specialty. Bhagwandtu Gupta, M.D., and
John B. D0tDn8, M.D., RC.C.l
Columbtu,Ohlo
INTRODUCTION TO VASCULAR UlXRASONOGRAPHY, 2nd ed. Edited by WILLIAM J. ZWIEBEL. Orlando: Grune ~ Stratton Inc, 1986, 550 pp, price not stated
As vascular imaging proceeds toward visualization of arteries and veins without introduction ofcontrast media, it is welcome indeed to see this second edition of the attractive book on vascular ultrasonography put together by Zwiebel and his associates. At 6rst glance, perhaps one would not expect this book to be reviewed in a medical-surgical journal; but in fact, the text is directed toward vascularsurgeons. Thus, experts in the 6eld of ultrasonography direct their remarks toward the practicing vascular surgeon. Names familiarto vascular surgeons are listed as chapter coauthors. These include Ted Dietrich, James Yao, Bill Pearce, Gene Strandness, Bob Barnes, and David Sumner. Their remarks on upper and lower extremity vascular diagnosis using Doppler ultrasound and B-mode evaluation of Peripheral arteries and veins, as well as B-mode and duplex examination of the aorta, iliacarteries, and portal
vein, are mostwelcome. A notable lackin this book has been ultrasound evaluation of mesenteric,
celiac, and renal arteries, but perhaps observations in this ever-growing field are too recent to reach publication in book form. A notable inclusion is a marvelous section on intraoperative B-mode ultrasound techniques for arterial evaluation prepared by experts in this field, including Bernard Siegel, Preston Flanigan, and James Schuler. The volume is profusely illustrated, printed on excellent paper which reproduces the figures quite well. It can be recommended to those who do not have the first edition, as it will strengthen and provide excellent reference for any vascular library.
John J. Bergan, M.D.
Chicago
Robert w Peters, M.D.
Baltimore
ANESTHESIA FOR THE UNINTERESTED. By J. D. TOLMIE and A. A. BIRCH. Rockville, MD: Aspen Publishers Inc, 1986, 263 pp, $19.95 Although somewhat tongue-in-cheek, this book is appropriately titledand will be helpful to medical students and physicians of any discipline seeking basic infOrmation about the appropriate and safe practice of anesthesiology. The book is reasonably priced and its contents well-arranged in six sections, comprising 29 chapters written by 17 authors. A brief history is succinctly summarized, i>llowed by a discussion of the physiology of relevant organ systems. Practical topics such as the need fOrini>rmed consent are covered in a separate section. The discussion of anesthesia machines and laryngoscopes is too sketchy and therefore inadequate. These devices are probably the most confusing and their function the least understood by the nonanesthetist. Therefore, we believe this section deserves greater attention. Technical considerations and rationale ilr intravenous and arterial cannulation were well-described and likely will be helpful to physicians of all disciplines. The brief discussion of anesthetic uptake and distribution is a superb synopsis of a complicated subject. The chapter on blood transfusion and blood component therapy is concisely informative and applicable to all medical specialties. Techniques and special considerations for pediatric anesthesia were superflcially discussed and simpli8ed. H~~ it is unlikely that the medical student, tntern, or other individual Pemrming a short rotation in anesthesiology would be given responsibility for infants or children. Neurosurgical anesthesia entails a myriad of special monitoring and anesthetic techniques which receive little attention. Cardiac anesthesia is very popular and techniques change rapidly and signi&cantly, which may explain absence of discussion of recent advances in high-dose narcotic anesthesia. The role of anesthesia in maintenance of cardiopulmonary bypass, management of hypothermia and support of post-pump circulation are not discussed in deference to a basic discussion of cardiac physiology and pharmacology. Although respiratory care was discussed in thefinal section of the book,critical care medicine was not otherwise covered. This is a significant omission in view of the prominent role anesthesiologists have played in the development of this subspecialty and its emphasis in all anesthesia training programs.
22
THE NORMAL LUNG: THE BASIS FOR DIAGNOSIS AND TREATMENT OF PULMONARY DISEASE, 2nd ed. By JOHN R MuRRAY. Philadelphia: WB Saunders, 1986, 377 pp, $27.95 This book is in many ways a remarkable effort. Perhaps its most striking
attribute is the breadth of coverage, withchapters on growth and develop-
ment, anatomy, physiologic and metabolic function at rest and during exercise, defense mechanisms against environmental insults, and aging. Each of the 14 chapters is dealt with in a clear and balanced manner, and very little of importance is omitted. The chapters are well-referenced, and current to the date of "abandonment" (mid-I985). Given the standing of the author in the world of pulmonary medicine and physiology, the book could have been strengthened if he had taken a stronger position in the many areas in which discrepancies or controversies still exist in understanding the normal lung. Also, more emphasis on the relative importance of various issues and concepts described would have been welcome. The remarkable breadth of this book has, by necessity, limited its depth. Each of the chapters has been the subject of major treatises by others, and to cover all of normal lung structure and function in a single book would be impossible. However, it does raise the question of to whom this book is addressed. There is more here than all but the most dedicated medical student can use, and signposting of the critical factors fOr a medical student does not seem to have been attempted. On the other hand, it appears extremely well-suited to the graduate student in respiratory physiology, or the academic pulmonary fellO\Y, as the next step after texts such as Huplratory Phydology . . . The E"entitJIs by West. In this era of superspecialization, where the subject matter of each chapter is almost a discipline unto itselt: this book is also very useful for the more senior pulmonary physician or physiologist for keeping abreast of those areas in
which he is not active.
In summary, this book is remarkable for its breadth, with up-to-date referencing useful particularly for the graduate in pulmonary medicine or physiology. While this necessarily leads to some restriction on depth, Dr. Murray has achieved, in a unique way, a clearly written and easily read account of what we know about the normal lung.
Peter D. Wagner, M.D.
La loUD, California