- Email: [email protected]
Cardiovascular Pathology
Pathology (1984). 16. pp. 110-113
BOOK REVIEWS
Pathologic Mechanisms and Human Disease, R. S. CAWSON.A. W . MCCRACKEN & P. B. M4ncus. 1982. The C. V. Mosby Company, St. Louis, Toronto, London. 594 pp.. illustrated. ISBN 0-8016-0439-9 $35.00 This book is aimed at medical students and consists of the usual chapters o n general organ system pathology. The book is easy to read and the approach in each chapter is very traditional. The liberal use of tables summarizing salient aspects of important entities is very useful for medical students during revision time. The authors’ attempt at correlating pathological findings with clinical data is an asset but is not always successful. There are some serious errors that may confuse students. for example, on page 436, the legend is inconsistent with the accompanying illustration. The quality of most illustrations is below average and in some the reviewer had trouble finding changes stated in the legend. The references are selective, not excessive and up-to-date. Students who plan to use this book as a standard textbook of pathology will have to complement it with the references provided in each chapter t o acquire a sound basis in pathology. This book is not superior and will not serve as a substitute to the standard textbooks of pathology currently available to medical students. Alan B. P. N g Guidelinesfor rhe Control of Leptospirosis, Ed. S . FAINE1982. WHO Offset Publication No. 67, Geneva. Australian Government Publishing Service, Canberra. French edition in preparation. 176 pp. ISBN 92 4 170067. Sw.fr. IS.-.
This is a unique and valuable publication on leptospirosis. Twenty-four international authorities have contributed current information about leptospirosis which has been expertly assembled and edited by Professor S. Faine. Leptospirosis was first recognized as an acute illness by Weil in I886 and still continues to cause widespread disease in man and animals. Like the great majority of infectious diseases control depends upon clinical recognition and action, proper laboratory diagnosis, surveillance programme and implementation of preventive measures. These areas have been well covered with emphasis on practical information. The scoring scheme for the likelihood of finding the source of infection is interesting and the concise explanation of the leprospirosis serovars and interpretation of serological tests highly commendable. It is noted with a measure of pride that one of the eight W H O collaborating centre reference laboratories in the world is in Brisbane, Australia. Through the adoption of the photo-offset reproduction the WHO has facilitated the availability of this immensely valuable publicat ion. A . Roo
Immunoassays f o r Clinical Chemistry, 2nd ed., Eds. W. M. HUNTER & J . E. T. C O R R I E1983. Chuichill Livingktoiir, L U I I ~ I I IChrshirr ~II Pty. Ltd., Melbourne. 701 pp.. illustrated. ISBN 0-443-02704-8 $84.00
This book presents the proceedings of a Workshop held in Edinburgh in 1982 which brought together many of the key scientists involved in immunoassay development in the United Kingdom. It provides an excellent review of the status of immunoassay today covering many of the idiosyncracies of a technique which still remains under development after 20 years. The topics for workshop sessions included reagents, e.g. standards and antibodies; techniques, e.g., labelling of protein antigens, separation systems and data processing; and specific areas, e.g., steroids and free hormones. Both presentations and group discussions were published. Although the majority of the workshop dealt with radioimmunoassay, the design permitted contributions to be made on immunoradiometric assay, enzyme-, nuoro- and magnetic particle immunoassay. New horizons were covered in sections on monoclonal antibodies and cherniluminescence immunoassays. There is little attention t o theory except for the contributions from Ekins, one of the fathers of immunoassay. However, the range of topics covered and the frequent reference to anecdotal data make the book particularly valuable. There are two shortcomings: firstly the use of the term second edition is misleading-the first edition was published as the proceedings of the 1970 workshop; secondly the book lacks an index. However the book will prove highly valuable as a reference book for those willing to spend some time searching. The medical scientist wishing to establish new assays, the laboratory director seeking ideas on progress in the field to help him with management decisions and the laboratory worker needing answers to problems with his assay, will each find useful information. Margaret C. Stuart
Cardiovascular Pathology, Vols. 1 and 2, Ed. MALCOLM D. S I L V E R . 1983. Churchill Livingstone, Longman Cheshire Pty. Ltd., Melbourne. 1407 pp.. illustrated. ISBN 0-443-08049-6. $278.00 This is a two volume publication of 1407 pages, with 28 contributions edited by Malcolm D. Silver of London, Ontario. It is based on a Core Curriculum Course given in Acquired Heart Disease for the American College of Cardiology. In the preface the editor indicates that it is intended to be a comprehensive pathology text dealing with acquired cardiovascular disease in adults and that a discussion of congenital heart disease is omitted. However, the final chapter (the 37th) is on postoperative congenital cardiac disease. This is unnecessary and out of place in the general text. The publication is designed for pathologists, cardiologists, cardiovascular surgeons and clinicians. There is a good correlation of clinical medicine and clinical pathology. Each chapter is followed by a list of relevant references most of which are up to date. As often occurs in such an edited publication, material is uneven although generally good. Volume one begins with an excellent, precise modern description of the gross anatomy and structure of the heart. This is followed by equally worthwhile chapters on the ultrastructure of the heart and age related cardiovascular changes. Diseases of the pericardium, the coronary arteries, the heart valves, the heart muscle and the conducting system are covered. Unfortunately, the chapter on myocardial infarction is disappointing and does not correlate well with the chapter o n diseases of the coronary arteries. Further, there is a lack of recent references
BOOK REVlEWS in this very important area. While the chapter on mitral incompetence is modern and includes recent work on mitral valve prolapse, the section on mitral stenosis is poor and does not include much of the interesting cardiac surgical pathology. Volume two covers a wider range of material and includes excellent chapters on endocrine disorders and the cardiovascular system, the effects of drugs on the cardiovascular system, the pathology of endomyocardial biopsy, cardiovascular prostheses, cardiac pacing, cardiac transplantation, cardiovascular disease in the tropics, parasitic diseases of the heart, the cardiovascular system in sudden death and diseases of arteries and veins. There is inadequate cross referencing in the text so that material which is not adequately covered in one section is not readily referenced in another section. For example, the chapter on cardiomyopathies does not contain sufficient references t o the excellent material which is available in the sections on collagen vascular diseases and the cardiovascular system and the effects of drugs on the cardiovascular system. Despite these criticisms this is a worthwhile text which does contain much of the new pathological material which has become available following cardiac surgery. I t will be a useful reference text for both clinicians and pathologists especially for those working in institutions with active cardiac and cardiac surgical departments. John B. Hickie
Man, Marsupials and Muscle. BYRONKAKULAS. 1982. University of Western Australia Press, Perth. 422 pp., illustrated. ISBN 0-85564-172X. No price quoted. This interesting monograph represents publication of a thesis written by Professor Kakulas concerning an acquired muscle disease affecting the quokka, a small marsupial found almost exclusively on Rottnest Island, off the Western Australian mainland. These animals develop an acute and rapidly fatal myopathy as a result of vitamin E deficiency resulting from inadequate diet. The monograph contains every detail of his careful investigation of this unusual condition. It must be remembered that this work was written about 20 years ago; there are no references later than 1963, and histopathological examination of muscle tissue is almost entirely limited to hematoxylin and eosin stained paraffin embedded sections. Using these methods there were no specific features about either the degeneration or the regeneration which differentiates this disease from any of the toxic or metabolic myopathies or from polymyositis. There are certainly no changes t o justify any suggestion that there is similarity between this condition and human muscular dystrophy, and the term ‘muscular dystrophy’ is occasionally used by some authors when referring t o metabolic diseases in animals. The only relationship drawn between ‘man’ as referred t o in the title, and this condition, is a review of the small amount of literature published at that time on human muscle disease. However, as a record of the unusual disease affecting this remarkable little animal, the work is a particularly valuable one and must represent the only detailed analysis of muscle disease affecting this animal. John Wulsh
Clinics in Immunology & Allergy, Vol. 2, No. 2. Ed. BYRONH. WAKSMAN. 1982. W. B. Saunders & Co. Ltd., London, Philadelphia, Toronto. 485 pp., illustrated. ISBN 0260-4639. €11.75. This is a most important and timely edition of Clinics in Immunology and Allergy. The immunopathology of neurological disease is a relatively
11 1
new area of expertise which has already made important contributions t o neurology. To understand how important, one need look no further than the recent unfolding of pathogenetic mechanisms in myasthenia gravis. Byron Waksman has assembled a truly impressive group of contributors for this issue and each chapter provides a pertinent and current analysis of relevant issues. This volume provides a clear illustration of the use of some recent immunological technologies, i.e. monoclonal antibodies and measurements of T cell subsets. Sadly, much current literature is filled with accounts of variations in T cell subsets in all manner of diseases and often (as in sections of this book) weighty theories of pathogenesis are developed on changes in a migratory population of cells within the peripheral blood. It will be difficult t o make any meaning from these observations until we know what changes occur in these parameters within the relevant target organs. This will be difficult to achieve within the CNS of man but the importance of this aim is stressed by Drs Arnason, Weiner and Hauser and current studies with cerebrospinal fluid and CSF mononuclear cells may lead us closer to the crucial changes within brain tissue. Most of this volume provides useful background studies o n the enigmatic CNS disease, multiple sclerosis. These studies are wide ranging and include sections on immunoregulatory cells, virology, morphology, immunosuppressive therapy, studies on the Interferon-natural killer cell systems, and in the controversial area of myelinotoxic and neuroelectric blocking factors in vitro. An important biochemical viewpoint is added in a chapter on myelin and myelin components in CSF in CNS disease. Myelin biochemistry has recently seen a considerable resurgence of interest with the discovery of a PNS demyelinating disease with a circulating autoantibody to a known antigen-myelin associated glycoprotein (MAG). Very interesting parallels may be drawn between recently published electron micrographs of changes in myelin periodicity in these neuropathies associated with paraproteins, and early changes in EAE illustrated in a delightful chapter in this volume by P. W. Lampert. Immunopathology within the PNS and neuromuscular junction is discussed in two excellent chapters which cover fully but succinctly recent developments within these areas. This is a book that will be of value not only to immunologists and pathologists to illustrate how their insights may help probe the frontiers of neurology but it is a book no neurologist seriously interested in pathogenesis, should be without. John Pollard
Soft Tissue Tumors. FRANZM. ENZINGER & SHARON W. WEISS.1983. C . V. Mosby Co., London, St. Louis, Toronto. (Aust. Distr. Medishield Ramsay, Sydney) 840 pp.. illustrated. ISBN 0-8016-1499-6. $152.25. For close on 20 years, Dr Franz Enzinger of the Armed Forces Institute of Pathology, Washington, D.C. has been one of the world’s leading authorities on soft tissue tumours. His latest book, co-authored by his assistant, Sharon Weiss, reflects his total mastery of his speciality. The 31 chapters, which generally follow the W.H.O. classification of soft tissue tunours, cover tumours and proliferations differentiating as fibrous tissue, fat, smooth and voluntary muscle, vascular, synovial, mesothelial, neural, cartilaginous, osseous and other tissues. Each disease is approached in a systematic manner with sections on clinical and gross findings, light and electron microscopic appearances, differential diagnosis, treatment and discussion. The photomicrographs are all of first class quality. The text is comprehensive but succinct; the references are numerous, well selected and alphabetically ordered in logical groups, and the index is excellent.
BOOK REVIEWS
Pathologic Mechanisms and Human Disease, R. S. CAWSON.A. W . MCCRACKEN & P. B. M4ncus. 1982. The C. V. Mosby Company, St. Louis, Toronto, London. 594 pp.. illustrated. ISBN 0-8016-0439-9 $35.00 This book is aimed at medical students and consists of the usual chapters o n general organ system pathology. The book is easy to read and the approach in each chapter is very traditional. The liberal use of tables summarizing salient aspects of important entities is very useful for medical students during revision time. The authors’ attempt at correlating pathological findings with clinical data is an asset but is not always successful. There are some serious errors that may confuse students. for example, on page 436, the legend is inconsistent with the accompanying illustration. The quality of most illustrations is below average and in some the reviewer had trouble finding changes stated in the legend. The references are selective, not excessive and up-to-date. Students who plan to use this book as a standard textbook of pathology will have to complement it with the references provided in each chapter t o acquire a sound basis in pathology. This book is not superior and will not serve as a substitute to the standard textbooks of pathology currently available to medical students. Alan B. P. N g Guidelinesfor rhe Control of Leptospirosis, Ed. S . FAINE1982. WHO Offset Publication No. 67, Geneva. Australian Government Publishing Service, Canberra. French edition in preparation. 176 pp. ISBN 92 4 170067. Sw.fr. IS.-.
This is a unique and valuable publication on leptospirosis. Twenty-four international authorities have contributed current information about leptospirosis which has been expertly assembled and edited by Professor S. Faine. Leptospirosis was first recognized as an acute illness by Weil in I886 and still continues to cause widespread disease in man and animals. Like the great majority of infectious diseases control depends upon clinical recognition and action, proper laboratory diagnosis, surveillance programme and implementation of preventive measures. These areas have been well covered with emphasis on practical information. The scoring scheme for the likelihood of finding the source of infection is interesting and the concise explanation of the leprospirosis serovars and interpretation of serological tests highly commendable. It is noted with a measure of pride that one of the eight W H O collaborating centre reference laboratories in the world is in Brisbane, Australia. Through the adoption of the photo-offset reproduction the WHO has facilitated the availability of this immensely valuable publicat ion. A . Roo
Immunoassays f o r Clinical Chemistry, 2nd ed., Eds. W. M. HUNTER & J . E. T. C O R R I E1983. Chuichill Livingktoiir, L U I I ~ I I IChrshirr ~II Pty. Ltd., Melbourne. 701 pp.. illustrated. ISBN 0-443-02704-8 $84.00
This book presents the proceedings of a Workshop held in Edinburgh in 1982 which brought together many of the key scientists involved in immunoassay development in the United Kingdom. It provides an excellent review of the status of immunoassay today covering many of the idiosyncracies of a technique which still remains under development after 20 years. The topics for workshop sessions included reagents, e.g. standards and antibodies; techniques, e.g., labelling of protein antigens, separation systems and data processing; and specific areas, e.g., steroids and free hormones. Both presentations and group discussions were published. Although the majority of the workshop dealt with radioimmunoassay, the design permitted contributions to be made on immunoradiometric assay, enzyme-, nuoro- and magnetic particle immunoassay. New horizons were covered in sections on monoclonal antibodies and cherniluminescence immunoassays. There is little attention t o theory except for the contributions from Ekins, one of the fathers of immunoassay. However, the range of topics covered and the frequent reference to anecdotal data make the book particularly valuable. There are two shortcomings: firstly the use of the term second edition is misleading-the first edition was published as the proceedings of the 1970 workshop; secondly the book lacks an index. However the book will prove highly valuable as a reference book for those willing to spend some time searching. The medical scientist wishing to establish new assays, the laboratory director seeking ideas on progress in the field to help him with management decisions and the laboratory worker needing answers to problems with his assay, will each find useful information. Margaret C. Stuart
Cardiovascular Pathology, Vols. 1 and 2, Ed. MALCOLM D. S I L V E R . 1983. Churchill Livingstone, Longman Cheshire Pty. Ltd., Melbourne. 1407 pp.. illustrated. ISBN 0-443-08049-6. $278.00 This is a two volume publication of 1407 pages, with 28 contributions edited by Malcolm D. Silver of London, Ontario. It is based on a Core Curriculum Course given in Acquired Heart Disease for the American College of Cardiology. In the preface the editor indicates that it is intended to be a comprehensive pathology text dealing with acquired cardiovascular disease in adults and that a discussion of congenital heart disease is omitted. However, the final chapter (the 37th) is on postoperative congenital cardiac disease. This is unnecessary and out of place in the general text. The publication is designed for pathologists, cardiologists, cardiovascular surgeons and clinicians. There is a good correlation of clinical medicine and clinical pathology. Each chapter is followed by a list of relevant references most of which are up to date. As often occurs in such an edited publication, material is uneven although generally good. Volume one begins with an excellent, precise modern description of the gross anatomy and structure of the heart. This is followed by equally worthwhile chapters on the ultrastructure of the heart and age related cardiovascular changes. Diseases of the pericardium, the coronary arteries, the heart valves, the heart muscle and the conducting system are covered. Unfortunately, the chapter on myocardial infarction is disappointing and does not correlate well with the chapter o n diseases of the coronary arteries. Further, there is a lack of recent references
BOOK REVlEWS in this very important area. While the chapter on mitral incompetence is modern and includes recent work on mitral valve prolapse, the section on mitral stenosis is poor and does not include much of the interesting cardiac surgical pathology. Volume two covers a wider range of material and includes excellent chapters on endocrine disorders and the cardiovascular system, the effects of drugs on the cardiovascular system, the pathology of endomyocardial biopsy, cardiovascular prostheses, cardiac pacing, cardiac transplantation, cardiovascular disease in the tropics, parasitic diseases of the heart, the cardiovascular system in sudden death and diseases of arteries and veins. There is inadequate cross referencing in the text so that material which is not adequately covered in one section is not readily referenced in another section. For example, the chapter on cardiomyopathies does not contain sufficient references t o the excellent material which is available in the sections on collagen vascular diseases and the cardiovascular system and the effects of drugs on the cardiovascular system. Despite these criticisms this is a worthwhile text which does contain much of the new pathological material which has become available following cardiac surgery. I t will be a useful reference text for both clinicians and pathologists especially for those working in institutions with active cardiac and cardiac surgical departments. John B. Hickie
Man, Marsupials and Muscle. BYRONKAKULAS. 1982. University of Western Australia Press, Perth. 422 pp., illustrated. ISBN 0-85564-172X. No price quoted. This interesting monograph represents publication of a thesis written by Professor Kakulas concerning an acquired muscle disease affecting the quokka, a small marsupial found almost exclusively on Rottnest Island, off the Western Australian mainland. These animals develop an acute and rapidly fatal myopathy as a result of vitamin E deficiency resulting from inadequate diet. The monograph contains every detail of his careful investigation of this unusual condition. It must be remembered that this work was written about 20 years ago; there are no references later than 1963, and histopathological examination of muscle tissue is almost entirely limited to hematoxylin and eosin stained paraffin embedded sections. Using these methods there were no specific features about either the degeneration or the regeneration which differentiates this disease from any of the toxic or metabolic myopathies or from polymyositis. There are certainly no changes t o justify any suggestion that there is similarity between this condition and human muscular dystrophy, and the term ‘muscular dystrophy’ is occasionally used by some authors when referring t o metabolic diseases in animals. The only relationship drawn between ‘man’ as referred t o in the title, and this condition, is a review of the small amount of literature published at that time on human muscle disease. However, as a record of the unusual disease affecting this remarkable little animal, the work is a particularly valuable one and must represent the only detailed analysis of muscle disease affecting this animal. John Wulsh
Clinics in Immunology & Allergy, Vol. 2, No. 2. Ed. BYRONH. WAKSMAN. 1982. W. B. Saunders & Co. Ltd., London, Philadelphia, Toronto. 485 pp., illustrated. ISBN 0260-4639. €11.75. This is a most important and timely edition of Clinics in Immunology and Allergy. The immunopathology of neurological disease is a relatively
11 1
new area of expertise which has already made important contributions t o neurology. To understand how important, one need look no further than the recent unfolding of pathogenetic mechanisms in myasthenia gravis. Byron Waksman has assembled a truly impressive group of contributors for this issue and each chapter provides a pertinent and current analysis of relevant issues. This volume provides a clear illustration of the use of some recent immunological technologies, i.e. monoclonal antibodies and measurements of T cell subsets. Sadly, much current literature is filled with accounts of variations in T cell subsets in all manner of diseases and often (as in sections of this book) weighty theories of pathogenesis are developed on changes in a migratory population of cells within the peripheral blood. It will be difficult t o make any meaning from these observations until we know what changes occur in these parameters within the relevant target organs. This will be difficult to achieve within the CNS of man but the importance of this aim is stressed by Drs Arnason, Weiner and Hauser and current studies with cerebrospinal fluid and CSF mononuclear cells may lead us closer to the crucial changes within brain tissue. Most of this volume provides useful background studies o n the enigmatic CNS disease, multiple sclerosis. These studies are wide ranging and include sections on immunoregulatory cells, virology, morphology, immunosuppressive therapy, studies on the Interferon-natural killer cell systems, and in the controversial area of myelinotoxic and neuroelectric blocking factors in vitro. An important biochemical viewpoint is added in a chapter on myelin and myelin components in CSF in CNS disease. Myelin biochemistry has recently seen a considerable resurgence of interest with the discovery of a PNS demyelinating disease with a circulating autoantibody to a known antigen-myelin associated glycoprotein (MAG). Very interesting parallels may be drawn between recently published electron micrographs of changes in myelin periodicity in these neuropathies associated with paraproteins, and early changes in EAE illustrated in a delightful chapter in this volume by P. W. Lampert. Immunopathology within the PNS and neuromuscular junction is discussed in two excellent chapters which cover fully but succinctly recent developments within these areas. This is a book that will be of value not only to immunologists and pathologists to illustrate how their insights may help probe the frontiers of neurology but it is a book no neurologist seriously interested in pathogenesis, should be without. John Pollard
Soft Tissue Tumors. FRANZM. ENZINGER & SHARON W. WEISS.1983. C . V. Mosby Co., London, St. Louis, Toronto. (Aust. Distr. Medishield Ramsay, Sydney) 840 pp.. illustrated. ISBN 0-8016-1499-6. $152.25. For close on 20 years, Dr Franz Enzinger of the Armed Forces Institute of Pathology, Washington, D.C. has been one of the world’s leading authorities on soft tissue tumours. His latest book, co-authored by his assistant, Sharon Weiss, reflects his total mastery of his speciality. The 31 chapters, which generally follow the W.H.O. classification of soft tissue tunours, cover tumours and proliferations differentiating as fibrous tissue, fat, smooth and voluntary muscle, vascular, synovial, mesothelial, neural, cartilaginous, osseous and other tissues. Each disease is approached in a systematic manner with sections on clinical and gross findings, light and electron microscopic appearances, differential diagnosis, treatment and discussion. The photomicrographs are all of first class quality. The text is comprehensive but succinct; the references are numerous, well selected and alphabetically ordered in logical groups, and the index is excellent.