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ARTERIAL BLOOD GASES—A SELF STUDY MANUAL
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CARDIAC SURGERY: A LOOSELEAF WOIUCBOOK AND UPDATE SERVICE. By DoNALD D. DorY. ChicagO: Yearbook Medical Publishers Inc, 1985, unpaginated, $150.00 Surgical technique is too often a confused amalgam of avant-garde literature reports plus hand-me-downs from the -chief: How should ones operative technique ewhe? This book reveals bow a noted surgeon has reBned his methods. The key scienti6c reports that have ligitimized his techniques are included as condensed articles, complete with comments from otherfamous surgeons like Kirklin, Spence!; and DeBalcey. A workbook format in a looseleaf' binder is used. Thiswill allow the reader to continue recording new or altered techniques. It may also inspire him to organize his own Blesi A periodic update is promised to insure a continuously current text on operative technique. Besides the 250 abstracts previously published in the r.,-book ojSurgery and Cardiology from 1937to 1983, Doty has added 140abstractswith his own editorial comments. These callattention to important nuances. Most of the book coven congenital heart diseases, although all the important adult cardiac operations are also illustrated. Particularists may be ofended by a few pictures, eg, those that show surgical forceps pinching the saphenous vein too hard (and thus possibly injuring the intima). And tninees are not always warned of possible technical complications; for instance, in illustrating a subannular sewing technique for inserting a tilting disk valve, no comment is made of the risk for the disk to jam shut if it impinges on the subannular pledget. These quibbles aside, the overall impact of this atlas is that it is an excellent companion for a thinldng hip. The author nicely incarnates the power of human intellect to comprehend the operative experience. Instead of the familiar atlas format, he brings both unfamiliar detail and a fresh voice.
Alan I: Ma,."" M.D., FoC.C.P. EVG~,lndI4nt1
ARTERIAL BLOOD GASES-A SELF STUDY MANUAL. By JOHN G. WATUNS, JR. Philadelphia: J. B. Uppinoott Company, 1985,477 pp, $19.75 An undentanding of acid base disorden is of critical importance in the management of patients. Correct and rapid interpretation of arterial blood gas levels in emergency situations is of vital significance. The contents of this book conJines itself to interpretation of arterial blood gases and treatment in an organized and programmed manner. A brief text of the subject is given, followed by self-assessment questions pertaining to the text. In addition, exercises are given at the end of the chapter where deemed necessary. In my vi8\lv, the text is very brief and hardly gives the lcnowledge and undentanding to answer the exercises which foll~ but given sufBcient baclcground in physiology, the self-assessment questions and exercises give one enough working lcnowledge to deal with day-to-day arterial blood gasdisorden. The causes, salient features, laboratory values, and treatment of important disorden lilce respiratory acidosis and alIcalosis, metabolic acidosis and alkalosis, and their dift"erent torms, are dealt with adequately. This book would be useful mr medical students, respiratory therapists, nurses, and other health penonnel whowould like to exercise their slcillsin the interpretation of arterial blood gas levels. In summary, this book is good b review and reumrcement of bowledge Pertaining to arterial blood gas l~ls with regard to their interpretation and treatment. TtJhir I. Mufti, M.D.
Sf. Lou"
NUTRITION AND HEART DISEASE. Edited by ELAINE B. FELDMAN. New York: Churchill Uvingstone, 1983, 219 pp, t35.00 Although fewwould argue with Shakespeare's advice, "Leave gormandising: bow the grave doth gape for thee thrice wider than mr other men," the exact relationship between diet and cardiovascular disease is complex and clouded by centuries of presupposition and dogma. The limitations in the methodology used, current nutritional theories of atherogenesis, and practical infOrmation for counselling patients are all critically reviewed here. Some interesting data about the cholesterol lowering ability of specific 6ben (q, those in oatbran, beans, barley, and psillium hydrophilic mucilloids) are only brie8y covered, and inconsistency creeps in at times (fOr instance, regarding whether vitamin E helps raise HDL or not.) Other frontien such as
22
the anti-atherogenic dietary 8sh oils, the bimodal mortality effects of alcohol ingestion, and the hypocholesterolemic effects of eating certain plant and marine animal sterols (li1ce B-sitosterol) are presented in a balanced way. For the most part, the literature cited ranges from 1970-1982. Now that more recent prospective studies Iuwe proven the value oflowering serum cholesterol levels, this book is not yet out of date. It draws helpful attention to a wider variety of nutritional facton implicated in the etiology and pathogenesis of coronary heart disease, hypertension, cardiomyopathy, and speci6c deflcteney diseases aHecting the heart. AltJn I: Ma,."" M.D., FoC.C.P. EVtJ~,
Indiantl
OXYGEN TRANSPORT TO TISSUE-VI. Edited by D. BRULEY, H. I. BleHER and D. RENEAU. New York: Plenum Press, 1984, 958 pp, $125.00 The survival of mammalian tissues is vitally dependent on the availability of an adequate and continued supply of oxygen. This condition has been exquisitely tuned by evolution, which has set capillary architecture and 80w in such a fashion that the chemical characteristics of hemoglobin and red cells, acting in concert with the physical laws of convection and diffusion, match the tissue metabolic demand. While the physiologic and analytic tenets of oxygen supply to the tissue were set forth at the beginning of this century by Krogh, a precise understanding of this phenomenon is only recently beginning to emerge. The problem is that the microcirculation is an organ with a spatially and temporally inhomogeneous structure, where active and passive mechanisms cause the unifOrm and appropriate delivery of oxygen to every cell in the body through its lifetime. The complexity of this process is shown by the array of theoretic and experimental methods used in its study, and presented at the meeting, in 1983, when the International Society on Oxygen lhmsport to TIssue was formally constituted. This volume is the result of that meeting. The material covered ranges &om theoretic studies at the microscopic level to their macroscopic integration. The latter approach is particularly relevant, since diagnostic techniques rely on data of systemic origin and therefore, attempts to establish micro-macrocorrelates will lead to a better understanding of the underlying microscopic phenomena. New information is provided on micro-electrode oxygen sensors, oxygen8uorescence transducen (optodes), andthe analysis ofO. metabolism utilizing NADH 8uorescence. Experimental studies of direct clinical relevance deal primarily with the heart and brain. Thmor oxygenation is discussed in relation to radiation therapy. By contrast, the more generalized problem of tissue ischemia is only sporadically addressed, probably because, at present, this syndrome is primarily studied in a clinical context. This book gives a comprehensive summary of the present approaches in dealing with oxygen transport, and extends this to key clinical problems. The editon were successful in insuring a uniJOrm fOrmat fOr the articles, which enhances its value as a basic reference on current work, and as a means for identifying primary literature in this interdisciplinary Beld. This text will be of value to specialists as well as clinical investigaton interested in basic physiologic phenomena. M. 1nt4glI8tt4, M.D., FoC.C.P.
La Jolla, California
BIOLOGICAL EFFECTS OF MAN-MADE MINERAL FIBRES, VOLUMES 1 AND 2. Proceedings of a WHOIIARC Conference, COPenhagen, 20-22 Apra 1982. Edited by THORSTEIN GUTHE. Copenhagen: World Health Organization Regional Office for Europe, 1984, vol 1-443 pp, vol 2-406 pp, 55 francs (Swiss) After an introductory session, the bulk of this important conference consisted of six sets of sclenti6c papen (44 in all) on: environmental (not experimental, as printed) surveys; technology of environmental sampling; mortality and incidence of current production workers, respiratory morbidity of current production worken; Bber inhalation, deposition and elimination in experimental animals; Bbrogenicity and carcinogenicity in experimental animals; and vitro studies of MMME The reports of the discussion fOllowing each set of papen are too highly condensed to be of much use, but there were Bve peer reviews, by W. H. Walton, J. C. McDonald, R Sadoul, M. Lippmann and M. Kuschner, which form convenient -state of the art" summaries of dust measurement in the manufacture and use of MMMF, mortality of worken exposed to MMMF, morbidity from chronic respiratory diseaseassociated with the production and Continued on page 27
'n
CARDIAC SURGERY: A LOOSELEAF WOIUCBOOK AND UPDATE SERVICE. By DoNALD D. DorY. ChicagO: Yearbook Medical Publishers Inc, 1985, unpaginated, $150.00 Surgical technique is too often a confused amalgam of avant-garde literature reports plus hand-me-downs from the -chief: How should ones operative technique ewhe? This book reveals bow a noted surgeon has reBned his methods. The key scienti6c reports that have ligitimized his techniques are included as condensed articles, complete with comments from otherfamous surgeons like Kirklin, Spence!; and DeBalcey. A workbook format in a looseleaf' binder is used. Thiswill allow the reader to continue recording new or altered techniques. It may also inspire him to organize his own Blesi A periodic update is promised to insure a continuously current text on operative technique. Besides the 250 abstracts previously published in the r.,-book ojSurgery and Cardiology from 1937to 1983, Doty has added 140abstractswith his own editorial comments. These callattention to important nuances. Most of the book coven congenital heart diseases, although all the important adult cardiac operations are also illustrated. Particularists may be ofended by a few pictures, eg, those that show surgical forceps pinching the saphenous vein too hard (and thus possibly injuring the intima). And tninees are not always warned of possible technical complications; for instance, in illustrating a subannular sewing technique for inserting a tilting disk valve, no comment is made of the risk for the disk to jam shut if it impinges on the subannular pledget. These quibbles aside, the overall impact of this atlas is that it is an excellent companion for a thinldng hip. The author nicely incarnates the power of human intellect to comprehend the operative experience. Instead of the familiar atlas format, he brings both unfamiliar detail and a fresh voice.
Alan I: Ma,."" M.D., FoC.C.P. EVG~,lndI4nt1
ARTERIAL BLOOD GASES-A SELF STUDY MANUAL. By JOHN G. WATUNS, JR. Philadelphia: J. B. Uppinoott Company, 1985,477 pp, $19.75 An undentanding of acid base disorden is of critical importance in the management of patients. Correct and rapid interpretation of arterial blood gas levels in emergency situations is of vital significance. The contents of this book conJines itself to interpretation of arterial blood gases and treatment in an organized and programmed manner. A brief text of the subject is given, followed by self-assessment questions pertaining to the text. In addition, exercises are given at the end of the chapter where deemed necessary. In my vi8\lv, the text is very brief and hardly gives the lcnowledge and undentanding to answer the exercises which foll~ but given sufBcient baclcground in physiology, the self-assessment questions and exercises give one enough working lcnowledge to deal with day-to-day arterial blood gasdisorden. The causes, salient features, laboratory values, and treatment of important disorden lilce respiratory acidosis and alIcalosis, metabolic acidosis and alkalosis, and their dift"erent torms, are dealt with adequately. This book would be useful mr medical students, respiratory therapists, nurses, and other health penonnel whowould like to exercise their slcillsin the interpretation of arterial blood gas levels. In summary, this book is good b review and reumrcement of bowledge Pertaining to arterial blood gas l~ls with regard to their interpretation and treatment. TtJhir I. Mufti, M.D.
Sf. Lou"
NUTRITION AND HEART DISEASE. Edited by ELAINE B. FELDMAN. New York: Churchill Uvingstone, 1983, 219 pp, t35.00 Although fewwould argue with Shakespeare's advice, "Leave gormandising: bow the grave doth gape for thee thrice wider than mr other men," the exact relationship between diet and cardiovascular disease is complex and clouded by centuries of presupposition and dogma. The limitations in the methodology used, current nutritional theories of atherogenesis, and practical infOrmation for counselling patients are all critically reviewed here. Some interesting data about the cholesterol lowering ability of specific 6ben (q, those in oatbran, beans, barley, and psillium hydrophilic mucilloids) are only brie8y covered, and inconsistency creeps in at times (fOr instance, regarding whether vitamin E helps raise HDL or not.) Other frontien such as
22
the anti-atherogenic dietary 8sh oils, the bimodal mortality effects of alcohol ingestion, and the hypocholesterolemic effects of eating certain plant and marine animal sterols (li1ce B-sitosterol) are presented in a balanced way. For the most part, the literature cited ranges from 1970-1982. Now that more recent prospective studies Iuwe proven the value oflowering serum cholesterol levels, this book is not yet out of date. It draws helpful attention to a wider variety of nutritional facton implicated in the etiology and pathogenesis of coronary heart disease, hypertension, cardiomyopathy, and speci6c deflcteney diseases aHecting the heart. AltJn I: Ma,."" M.D., FoC.C.P. EVtJ~,
Indiantl
OXYGEN TRANSPORT TO TISSUE-VI. Edited by D. BRULEY, H. I. BleHER and D. RENEAU. New York: Plenum Press, 1984, 958 pp, $125.00 The survival of mammalian tissues is vitally dependent on the availability of an adequate and continued supply of oxygen. This condition has been exquisitely tuned by evolution, which has set capillary architecture and 80w in such a fashion that the chemical characteristics of hemoglobin and red cells, acting in concert with the physical laws of convection and diffusion, match the tissue metabolic demand. While the physiologic and analytic tenets of oxygen supply to the tissue were set forth at the beginning of this century by Krogh, a precise understanding of this phenomenon is only recently beginning to emerge. The problem is that the microcirculation is an organ with a spatially and temporally inhomogeneous structure, where active and passive mechanisms cause the unifOrm and appropriate delivery of oxygen to every cell in the body through its lifetime. The complexity of this process is shown by the array of theoretic and experimental methods used in its study, and presented at the meeting, in 1983, when the International Society on Oxygen lhmsport to TIssue was formally constituted. This volume is the result of that meeting. The material covered ranges &om theoretic studies at the microscopic level to their macroscopic integration. The latter approach is particularly relevant, since diagnostic techniques rely on data of systemic origin and therefore, attempts to establish micro-macrocorrelates will lead to a better understanding of the underlying microscopic phenomena. New information is provided on micro-electrode oxygen sensors, oxygen8uorescence transducen (optodes), andthe analysis ofO. metabolism utilizing NADH 8uorescence. Experimental studies of direct clinical relevance deal primarily with the heart and brain. Thmor oxygenation is discussed in relation to radiation therapy. By contrast, the more generalized problem of tissue ischemia is only sporadically addressed, probably because, at present, this syndrome is primarily studied in a clinical context. This book gives a comprehensive summary of the present approaches in dealing with oxygen transport, and extends this to key clinical problems. The editon were successful in insuring a uniJOrm fOrmat fOr the articles, which enhances its value as a basic reference on current work, and as a means for identifying primary literature in this interdisciplinary Beld. This text will be of value to specialists as well as clinical investigaton interested in basic physiologic phenomena. M. 1nt4glI8tt4, M.D., FoC.C.P.
La Jolla, California
BIOLOGICAL EFFECTS OF MAN-MADE MINERAL FIBRES, VOLUMES 1 AND 2. Proceedings of a WHOIIARC Conference, COPenhagen, 20-22 Apra 1982. Edited by THORSTEIN GUTHE. Copenhagen: World Health Organization Regional Office for Europe, 1984, vol 1-443 pp, vol 2-406 pp, 55 francs (Swiss) After an introductory session, the bulk of this important conference consisted of six sets of sclenti6c papen (44 in all) on: environmental (not experimental, as printed) surveys; technology of environmental sampling; mortality and incidence of current production workers, respiratory morbidity of current production worken; Bber inhalation, deposition and elimination in experimental animals; Bbrogenicity and carcinogenicity in experimental animals; and vitro studies of MMME The reports of the discussion fOllowing each set of papen are too highly condensed to be of much use, but there were Bve peer reviews, by W. H. Walton, J. C. McDonald, R Sadoul, M. Lippmann and M. Kuschner, which form convenient -state of the art" summaries of dust measurement in the manufacture and use of MMMF, mortality of worken exposed to MMMF, morbidity from chronic respiratory diseaseassociated with the production and Continued on page 27
'n