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Bone implanting grafting
are clear. Assisted suicide touches such a wide array of societal interests that it will be a long-term issue. Part II presents two essays that deal with the issue of human experimentation particularly related to fetuses, such as the practice of‘selective termination’ in which several fetuses in a multiple pregnancy are selectively aborted. In the final essay, the risks and benefits offetal surgery are reviewed. The essays in this text cast a power of their own. They are descriptive and argumentative. Each one forces the reader to reflect and ponder about the moral dilemma posed. The issue ofpower- ofautonomy in the case of the patient, of moral independence in the case of the physician-is at the heart of the notion, ‘quality ofcare’. As such, it warrants the central focus it obtains in this text. This text serves as an excellent stimulant to the arguments raised in the ongoing ethical debates. For those engaged it is a ‘must read’. Joseph D. Bonzino
Fetal Heart Rate Monitoring: A Practical Guide I. Ingemarsson, E. Ingemarsson and J.A.D. Spencer Oxford Medical Publications, Oxford; 1993 This publication deals, in 18 sections, with the most important clinical aspects related to the use of continuous heart rate monitoring in the human fetus. The technique has been employed for more than 30 years in recording fetal heart rate (FHR) activity in both the antenatal period and at term by using a variety of sensors or transducers (ultrasonic, mco, phono, ECGelectrode, and auscultory means). Despite the fact that more than 75% ofthe deliveries in USA and Western Europe are monitored during labour, no unanimous position has been reached among obstetricians and gynaecologists about the usefulness ofcontinuously recording FHR, probably due to the poor correlation between abnormal FHR changes and the condition of the baby at birth. The book, conceived as a practical guide well correlated with numerous recordings ofvarious cases (particularly cardiotocographic signals), does not enter this specific quarrel and illustrates, in a balanced way, the pros and cons ofsuch a procedure, especially from the clinical standpoint. The authors’ position is to describe clearly their experience in the clinical interpretation of the data, by emphasizing the importance ofthe information (which is sometimes difficult to interpret) obtainable through monitoring and by remarking the fact that excessive (and notjustified) technological intervention may be not in accordance with a sensible and sensitive attitude towards pregnant women care. The most relevant topical pathophysiological cases of interest in FHR analysis are analysed: acid-base balance, hypoxia, the effects ofdrugs, acceleration and deceleration, relation to uterine contractions, preterm cases, antenatal and terminal recordings, fetal stimulation, as well as the investigation of the role ofautonomic nervous system. The book does not enter the technical issues of instrumentation and signal processing; it is therefore recommended as a primer text of FHR monitoring to obstetricians (i.e. in training), to non-medical staff, and to biomedical engineers who wish to approach the nonstationary and complex behavior ofFHR control mechanisms in a variety ofclinical cases. S. Cerutti
Bone Implanting Grafting John Older Springer-Verlag,
Berlin, 1992,226~~.
DM 170.00 ISBN
3-540- 19720-6 This book, based on a symposium held in May 199 1, provides contributions from a group of recognized international experts in the field ofgrafting, and as such, represents an authoritative exposition ofthe state ofthe art. The increasing demand for orthopaedic surgery associated with revision knee and hip arthroplasty is placing higher expectations on the design and technology of the implant systems. At the same time, as revision cases have been on the increase, the results have ben frequently disappointing due to the poor structural integrity ofthe remaining bone and the difliculty ofobtaining rigid fixation. The application of bone grafting has been seen as a potential solution. Regarding the implants themselves the introduction ofnew materials, rigorous pre-clinical evaluation, and improved design and manufacturing technology, has provided the potential for increased longevity. It is against this background that this book is compiled. The book is divided into live chapters dealing with the basic principles ofbone grafting, followed by comprehensive chapters on grafting the acetabulum, femur and the knee. The final chapter deals with the crucial aspect ofbone banking. While the book is comprehensive from a surgical point of view, it provides little coverage ofthe scientific framework. For example, the structural properties ofbone-implant constructs are not described, nor is there sufficient coverage ofthe biological aspects ofgraft incorporation, ofboth block and morselized allograft. There is also little mention of alternate materials to bone graft, which would be useful to provide some perspective. For the purposes of a biomedical engineer, this book has utility in providing a comprehensive view of the problem, thus giving the basic data for the design of better implants and instrumentation. At the same time, even though the book is primarily written for the practising orthopaedic surgeon, in today’s world oforthopaedics it should be recognized that advances are made most efficiently by including contributions from other specialities as well. Peter S. Walker
Biomechanica and Exercise Physiology Arthur T. Johnson John Wiley, Chichester; O-47 l-85398-4
1991,456~~. E66.70 ISBN
This is not a book for the faint-hearted, being full ofcomplex mathematical relationships and models describing human physiological responses under the stressful conditions of exercise. It purports to give a new perspective on physiology, and this it clearly does. It is divided into five chapters: Exercise Limitations, Exercise Biomechanics; Cardiovascular Responses; Respiratory Responses; and Thermal Responses: ofwhich the last three make up the bulk of the book (85%)) with the chapter on Respiratory Responses being by far the largest (43% ofthe book). Where appropriate, each chapter begins with a review ofthe relevant physiology, although this is often somewhat limited, before immersing the reader in equations concerning the mechanical and control aspects of the system under consideration, as well as predictively describing the physiology of an exercise response. In the chapters on Respiratory Responses and Thermal Responses several control modehare presented and compared. The author has cleverly integrated phsyiology with engineering by making extensive use ofligures and tables. In so doing, he has brought together a unique collection of information. Each chapter is fully referenced, in addition to which a comprehensive explanation ofthe symbols used in Med. Eng. Phys. 1994, Vol. 16, September
437
Fetal Heart Rate Monitoring: A Practical Guide I. Ingemarsson, E. Ingemarsson and J.A.D. Spencer Oxford Medical Publications, Oxford; 1993 This publication deals, in 18 sections, with the most important clinical aspects related to the use of continuous heart rate monitoring in the human fetus. The technique has been employed for more than 30 years in recording fetal heart rate (FHR) activity in both the antenatal period and at term by using a variety of sensors or transducers (ultrasonic, mco, phono, ECGelectrode, and auscultory means). Despite the fact that more than 75% ofthe deliveries in USA and Western Europe are monitored during labour, no unanimous position has been reached among obstetricians and gynaecologists about the usefulness ofcontinuously recording FHR, probably due to the poor correlation between abnormal FHR changes and the condition of the baby at birth. The book, conceived as a practical guide well correlated with numerous recordings ofvarious cases (particularly cardiotocographic signals), does not enter this specific quarrel and illustrates, in a balanced way, the pros and cons ofsuch a procedure, especially from the clinical standpoint. The authors’ position is to describe clearly their experience in the clinical interpretation of the data, by emphasizing the importance ofthe information (which is sometimes difficult to interpret) obtainable through monitoring and by remarking the fact that excessive (and notjustified) technological intervention may be not in accordance with a sensible and sensitive attitude towards pregnant women care. The most relevant topical pathophysiological cases of interest in FHR analysis are analysed: acid-base balance, hypoxia, the effects ofdrugs, acceleration and deceleration, relation to uterine contractions, preterm cases, antenatal and terminal recordings, fetal stimulation, as well as the investigation of the role ofautonomic nervous system. The book does not enter the technical issues of instrumentation and signal processing; it is therefore recommended as a primer text of FHR monitoring to obstetricians (i.e. in training), to non-medical staff, and to biomedical engineers who wish to approach the nonstationary and complex behavior ofFHR control mechanisms in a variety ofclinical cases. S. Cerutti
Bone Implanting Grafting John Older Springer-Verlag,
Berlin, 1992,226~~.
DM 170.00 ISBN
3-540- 19720-6 This book, based on a symposium held in May 199 1, provides contributions from a group of recognized international experts in the field ofgrafting, and as such, represents an authoritative exposition ofthe state ofthe art. The increasing demand for orthopaedic surgery associated with revision knee and hip arthroplasty is placing higher expectations on the design and technology of the implant systems. At the same time, as revision cases have been on the increase, the results have ben frequently disappointing due to the poor structural integrity ofthe remaining bone and the difliculty ofobtaining rigid fixation. The application of bone grafting has been seen as a potential solution. Regarding the implants themselves the introduction ofnew materials, rigorous pre-clinical evaluation, and improved design and manufacturing technology, has provided the potential for increased longevity. It is against this background that this book is compiled. The book is divided into live chapters dealing with the basic principles ofbone grafting, followed by comprehensive chapters on grafting the acetabulum, femur and the knee. The final chapter deals with the crucial aspect ofbone banking. While the book is comprehensive from a surgical point of view, it provides little coverage ofthe scientific framework. For example, the structural properties ofbone-implant constructs are not described, nor is there sufficient coverage ofthe biological aspects ofgraft incorporation, ofboth block and morselized allograft. There is also little mention of alternate materials to bone graft, which would be useful to provide some perspective. For the purposes of a biomedical engineer, this book has utility in providing a comprehensive view of the problem, thus giving the basic data for the design of better implants and instrumentation. At the same time, even though the book is primarily written for the practising orthopaedic surgeon, in today’s world oforthopaedics it should be recognized that advances are made most efficiently by including contributions from other specialities as well. Peter S. Walker
Biomechanica and Exercise Physiology Arthur T. Johnson John Wiley, Chichester; O-47 l-85398-4
1991,456~~. E66.70 ISBN
This is not a book for the faint-hearted, being full ofcomplex mathematical relationships and models describing human physiological responses under the stressful conditions of exercise. It purports to give a new perspective on physiology, and this it clearly does. It is divided into five chapters: Exercise Limitations, Exercise Biomechanics; Cardiovascular Responses; Respiratory Responses; and Thermal Responses: ofwhich the last three make up the bulk of the book (85%)) with the chapter on Respiratory Responses being by far the largest (43% ofthe book). Where appropriate, each chapter begins with a review ofthe relevant physiology, although this is often somewhat limited, before immersing the reader in equations concerning the mechanical and control aspects of the system under consideration, as well as predictively describing the physiology of an exercise response. In the chapters on Respiratory Responses and Thermal Responses several control modehare presented and compared. The author has cleverly integrated phsyiology with engineering by making extensive use ofligures and tables. In so doing, he has brought together a unique collection of information. Each chapter is fully referenced, in addition to which a comprehensive explanation ofthe symbols used in Med. Eng. Phys. 1994, Vol. 16, September
437