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Cardiac Arrhythmias: The Role of Triggered Activity and Other Mechanisms
890
BOOK REVIEWS
Mayo Clin Proc, July 1989, Vol 64
though central to the management of patients with cancer, have previously been left to individual investigation in an ad hoc fashion. The inclusion of these topics appropriately demonstrates the place of importance they deserve in the field. In the preface, the editors state t h a t this text "has been written primarily for fellows undertaking postgraduate training in gynecologic oncology but should be of interest to gynecology residents, consultant gynecologists, and physicians in allied health fields whose expertise involves a significant component of gynecologic oncology." They have achieved their goal admirably and have done it with style! Maurice J. Webb, M.D. Section of Gynecologic Surgery
D i a g n o s i s a n d M a n a g e m e n t of Orbital Tumors, by Jerry A. Shields, 401 pp, withillus, $125, Philadelphia, W. B. Saunders Company, 1989 This text, a companion to the author's 1983 monograph on intraocular tumors, reflects Dr. Shields' approximately 20-year interest in ocular, adnexal, and orbital oncology, particularly the neoplasias. The book is divided into three sections: section 1 consists of seven chapters on orbital anatomy, patient examination, principles of diagnosis and therapy, surgical approaches, and inflammatory conditions t h a t simulate orbital neoplasms; section 2 contains 10 chapters devoted to primary tumors in the orbit; and section 3 includes four chapters t h a t describe metastatic and secondary tumors. The first section covers the subject matter in a rather standard fashion. Some of the anatomic and surgical illustrations, drawn by Dr. Carol Lally Shields, lack the third-dimension finesse of similar drawings by professional medical illustrators. The numerous cross-references to later portions of the book throughout this section are disruptive. Sections 2 and 3 are the "meat" of the text. In these sections, the author provides a factual summary of current knowledge about the various tumors and lists the 645 biopsy-proven orbital spaceoccupying lesions seen at the Wills Eye Hospital during a 20-year period. The discussion of some tumors is more brief t h a n I had anticipated, and I was disappointed t h a t color illustrations were not included in the chapters on orbital lesions in which a particular hue or tint of color might be of value in the
diagnostic evaluation. In the chapter on lymphoid tumors, the reader is referred to the ophthalmic literature for the current classification of these lesions. On the basis of his extensive experience in the field of orbital tumors, I wish that the author had more often expressed his own views in controversial areas concerning the pathogenesis, classification, or management of individual tumors or tumor groups. The text is printed in a two-column page format. The frequent use of large, boldface subheadings tends to clutter the page and distract the reader in some chapters. The quality of some of the clinical photographs and low-power photomicrographs was compromised by cropping them to fit the narrow (23Ainch) columns. Something went amiss in either the reproduction or the printing of several of the photographs of clinical features and gross specimens; the resulting overly black, featureless pictures were certainly not what the author had intended. The extensive and up-to-date references at the end of each chapter make this book a valuable addition to medical-center libraries that serve those who study particular tumors or tumor groups in depth. For clinicians and oncologists who want a book of this type in their own libraries, another recent text (Rootman J: Diseases of the Orbit. 628 pp, $115, Philadelphia, J. B. Lippincott Company, 1988) may be a better buy. The latter book is larger, covers orbital diseases as well as orbital tumors in detail, and costs less. John W. Henderson, M.D. Department of Ophthalmology (Emeritus)
Cardiac Arrhythmias: The Role of Triggered Activity a n d Other M e c h a n i s m s , by Paul F. Cranefield and Ronald S. Aronson, 706 pp, with illus, $125, Mount Kisco, New York, Futura Publishing Company, 1988 For years, physicians have treated disorders of cardiac rhythm without having a clear understanding of the genesis of these abnormalities. The recent development of clinical electrophysiologic studies has contributed significantly to the understanding of the mechanisms of these arrhythmias and has created a greater clinical interest in the underlying cellular events t h a t generate the electrical activity and facilitate the conduction of electrical impulses throughout
Mayo Clin Proc, July 1989, Vol 64
the myocardium. Although most textbooks of cardiology include excellent descriptions of the clinical electrophysiologic mechanisms of arrhythmias, the information provided about basic cellular events is often sketchy and poorly related to the understanding of clinical arrhythmias. This book by Cranefield and Aronson is singular in that it provides a detailed review of what is currently known about the generation and conduction of the cardiac impulse and its relationship to the clinical disturbances of cardiac rhythm. Readers will have difficulty in putting the book down once they have begun to follow the masterfully presented explanation of the excitatory events that occur within the heart. Many clinicians express frustration at the explanations of sometimes complicated electrical investigations. Cranefield and Aronson have crafted an explanatory style t h a t offers the reader a clear understanding of cardiac electrical events based on a careful presentation of investigational methods and a thoughtful and scholarly interpretation of the conclusions of various investigators. The evolution of knowledge of these events is presented in a fashion that reminds one of the great detective stories t h a t constantly tug at the reader to continue through chapters with overbearing titles. Although the book is uniformly excellent, particular parts of the text will be especially intriguing and helpful to clinicians who care for patients with cardiac rhythm disturbances, medical students, physiologists, pharmacologists, and students of the basic sciences. The first three chapters present an excellent discussion of cellular electrophysiology that will be useful to anyone interested in cardiac electrical activity, especially medical students and students of the basic sciences as they formulate their knowledge of electrical activity. For basic scientists or students, subsequent chapters provide a detailed account of both past and present investigational techniques used in the study of cardiac electrical activity. Clinicians will find the chapters at the end of the book t h a t are devoted specifically to arrhythmias induced by ischemia and to the effects of antiarrhythmic agents and other drugs extremely interesting and helpful. The only shortcoming of the book is its title, which I found somewhat misleading. Although the authors do discuss the role of triggered activity in the genesis of cardiac arrhythmias, the book encompasses much more and thus is a valuable resource for a wide audience. Although active investigation in this field has produced frequent changes, this textbook is unlikely to be outdated and will undoubtedly become a
BOOK REVIEWS
891
basic reference source for those who are undertaking investigations in cardiac electrical activity, as well as those who are interested in a careful examination of current knowledge and future investigation of cardiac electrical events. The price of the text seems somewhat daunting at first glance, but even a cursory reading of this exemplary book will convince the reader of its value. Although Drs. Cranefield and Aronson are apologetic in the preface of their work, I believe they deserve congratulations and praise for producing a book of a quality t h a t is unlikely to be replicated in the near future. Douglas L. Wood, M.D. Division of Cardiovascular Diseases and Internal Medicine
Surgery of t h e U p p e r Respiratory System, Vol 2, 2nd ed, by William Montgomery. 760 pp, with illus, $87.50, Philadelphia, Lea & Febiger, 1989 For years, Surgery of the Upper Respiratory System by Montgomery has been a classic textbook, providing basic essential information for residents and practitioners in this field. This eagerly awaited new edition is an improved text that will continue to be used by students for years to come. The chapters on surgical procedures for the neck, salivary glands, and trachea are well illustrated and provide good basic reviews of these subjects. The strength of the book, however, is Professor Montgomery's extensive unique personal experience with the management of the many varied problems discussed in sections devoted to trachéal and laryngeal stenosis. Acute and chronic problems in this area continue to perplex head and neck surgeons. Any physician who treats stenosis of the upper airway will thoroughly enjoy these chapters. During the past 16 years, however, numerous advances have been made in the field of surgery of the upper airway. Unfortunately, the second edition of this text has failed to incorporate many of these innovations in diagnosis and treatment. The current book differs little from the first edition, published in 1973, with the exception of the addition of information on computed tomographic scans, an introduction to myocutaneous flaps, and expansion of the material on laryngeal paralysis. The omissions are glaring, and the additions are often incomplete. For example,
BOOK REVIEWS
Mayo Clin Proc, July 1989, Vol 64
though central to the management of patients with cancer, have previously been left to individual investigation in an ad hoc fashion. The inclusion of these topics appropriately demonstrates the place of importance they deserve in the field. In the preface, the editors state t h a t this text "has been written primarily for fellows undertaking postgraduate training in gynecologic oncology but should be of interest to gynecology residents, consultant gynecologists, and physicians in allied health fields whose expertise involves a significant component of gynecologic oncology." They have achieved their goal admirably and have done it with style! Maurice J. Webb, M.D. Section of Gynecologic Surgery
D i a g n o s i s a n d M a n a g e m e n t of Orbital Tumors, by Jerry A. Shields, 401 pp, withillus, $125, Philadelphia, W. B. Saunders Company, 1989 This text, a companion to the author's 1983 monograph on intraocular tumors, reflects Dr. Shields' approximately 20-year interest in ocular, adnexal, and orbital oncology, particularly the neoplasias. The book is divided into three sections: section 1 consists of seven chapters on orbital anatomy, patient examination, principles of diagnosis and therapy, surgical approaches, and inflammatory conditions t h a t simulate orbital neoplasms; section 2 contains 10 chapters devoted to primary tumors in the orbit; and section 3 includes four chapters t h a t describe metastatic and secondary tumors. The first section covers the subject matter in a rather standard fashion. Some of the anatomic and surgical illustrations, drawn by Dr. Carol Lally Shields, lack the third-dimension finesse of similar drawings by professional medical illustrators. The numerous cross-references to later portions of the book throughout this section are disruptive. Sections 2 and 3 are the "meat" of the text. In these sections, the author provides a factual summary of current knowledge about the various tumors and lists the 645 biopsy-proven orbital spaceoccupying lesions seen at the Wills Eye Hospital during a 20-year period. The discussion of some tumors is more brief t h a n I had anticipated, and I was disappointed t h a t color illustrations were not included in the chapters on orbital lesions in which a particular hue or tint of color might be of value in the
diagnostic evaluation. In the chapter on lymphoid tumors, the reader is referred to the ophthalmic literature for the current classification of these lesions. On the basis of his extensive experience in the field of orbital tumors, I wish that the author had more often expressed his own views in controversial areas concerning the pathogenesis, classification, or management of individual tumors or tumor groups. The text is printed in a two-column page format. The frequent use of large, boldface subheadings tends to clutter the page and distract the reader in some chapters. The quality of some of the clinical photographs and low-power photomicrographs was compromised by cropping them to fit the narrow (23Ainch) columns. Something went amiss in either the reproduction or the printing of several of the photographs of clinical features and gross specimens; the resulting overly black, featureless pictures were certainly not what the author had intended. The extensive and up-to-date references at the end of each chapter make this book a valuable addition to medical-center libraries that serve those who study particular tumors or tumor groups in depth. For clinicians and oncologists who want a book of this type in their own libraries, another recent text (Rootman J: Diseases of the Orbit. 628 pp, $115, Philadelphia, J. B. Lippincott Company, 1988) may be a better buy. The latter book is larger, covers orbital diseases as well as orbital tumors in detail, and costs less. John W. Henderson, M.D. Department of Ophthalmology (Emeritus)
Cardiac Arrhythmias: The Role of Triggered Activity a n d Other M e c h a n i s m s , by Paul F. Cranefield and Ronald S. Aronson, 706 pp, with illus, $125, Mount Kisco, New York, Futura Publishing Company, 1988 For years, physicians have treated disorders of cardiac rhythm without having a clear understanding of the genesis of these abnormalities. The recent development of clinical electrophysiologic studies has contributed significantly to the understanding of the mechanisms of these arrhythmias and has created a greater clinical interest in the underlying cellular events t h a t generate the electrical activity and facilitate the conduction of electrical impulses throughout
Mayo Clin Proc, July 1989, Vol 64
the myocardium. Although most textbooks of cardiology include excellent descriptions of the clinical electrophysiologic mechanisms of arrhythmias, the information provided about basic cellular events is often sketchy and poorly related to the understanding of clinical arrhythmias. This book by Cranefield and Aronson is singular in that it provides a detailed review of what is currently known about the generation and conduction of the cardiac impulse and its relationship to the clinical disturbances of cardiac rhythm. Readers will have difficulty in putting the book down once they have begun to follow the masterfully presented explanation of the excitatory events that occur within the heart. Many clinicians express frustration at the explanations of sometimes complicated electrical investigations. Cranefield and Aronson have crafted an explanatory style t h a t offers the reader a clear understanding of cardiac electrical events based on a careful presentation of investigational methods and a thoughtful and scholarly interpretation of the conclusions of various investigators. The evolution of knowledge of these events is presented in a fashion that reminds one of the great detective stories t h a t constantly tug at the reader to continue through chapters with overbearing titles. Although the book is uniformly excellent, particular parts of the text will be especially intriguing and helpful to clinicians who care for patients with cardiac rhythm disturbances, medical students, physiologists, pharmacologists, and students of the basic sciences. The first three chapters present an excellent discussion of cellular electrophysiology that will be useful to anyone interested in cardiac electrical activity, especially medical students and students of the basic sciences as they formulate their knowledge of electrical activity. For basic scientists or students, subsequent chapters provide a detailed account of both past and present investigational techniques used in the study of cardiac electrical activity. Clinicians will find the chapters at the end of the book t h a t are devoted specifically to arrhythmias induced by ischemia and to the effects of antiarrhythmic agents and other drugs extremely interesting and helpful. The only shortcoming of the book is its title, which I found somewhat misleading. Although the authors do discuss the role of triggered activity in the genesis of cardiac arrhythmias, the book encompasses much more and thus is a valuable resource for a wide audience. Although active investigation in this field has produced frequent changes, this textbook is unlikely to be outdated and will undoubtedly become a
BOOK REVIEWS
891
basic reference source for those who are undertaking investigations in cardiac electrical activity, as well as those who are interested in a careful examination of current knowledge and future investigation of cardiac electrical events. The price of the text seems somewhat daunting at first glance, but even a cursory reading of this exemplary book will convince the reader of its value. Although Drs. Cranefield and Aronson are apologetic in the preface of their work, I believe they deserve congratulations and praise for producing a book of a quality t h a t is unlikely to be replicated in the near future. Douglas L. Wood, M.D. Division of Cardiovascular Diseases and Internal Medicine
Surgery of t h e U p p e r Respiratory System, Vol 2, 2nd ed, by William Montgomery. 760 pp, with illus, $87.50, Philadelphia, Lea & Febiger, 1989 For years, Surgery of the Upper Respiratory System by Montgomery has been a classic textbook, providing basic essential information for residents and practitioners in this field. This eagerly awaited new edition is an improved text that will continue to be used by students for years to come. The chapters on surgical procedures for the neck, salivary glands, and trachea are well illustrated and provide good basic reviews of these subjects. The strength of the book, however, is Professor Montgomery's extensive unique personal experience with the management of the many varied problems discussed in sections devoted to trachéal and laryngeal stenosis. Acute and chronic problems in this area continue to perplex head and neck surgeons. Any physician who treats stenosis of the upper airway will thoroughly enjoy these chapters. During the past 16 years, however, numerous advances have been made in the field of surgery of the upper airway. Unfortunately, the second edition of this text has failed to incorporate many of these innovations in diagnosis and treatment. The current book differs little from the first edition, published in 1973, with the exception of the addition of information on computed tomographic scans, an introduction to myocutaneous flaps, and expansion of the material on laryngeal paralysis. The omissions are glaring, and the additions are often incomplete. For example,