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Diagnostic Patient Studies in Surgery
Mayo Clin Proc, April 1987, Vol 62
BOOK REVIEWS
323
"histiocytosis X" (chapter 28) seems to have been endoscopy, or function analysis. It does not, howdiscarded by many authors because the cell of ever, provide algorithms or initiate the probleminterest has been shown to be the Langerhans cell. solving search. The authors are well-respected experts in their Overall, this book has and deserves wide readership. It provides pertinent information about various fields and in some instances are up-andskeletal tumors that should appeal to all persons coming young physicians who are on the foredealing with patients having or suspected of front of their field and are aware of the clinical having a bone tumor. Access to this book is problems. Recognizable names of surgeons are important because it offers a careful analysis of a Abcarian (an expert in colonoscopy), DeMeester vast group of cases, the likes of which would be (in esophageal function), and Yao (in noninvasive difficult to duplicate. This book will endure for peripheral vascular assessment). The chapters are written with a tone of authority, are pithy, and years. have a limited number of examples of the problems encountered and the results obtained. ReferHarlan J. Spjut, M.D. ences are frequently cited throughout the text and Department of Pathology in some instances are extensive. Baylor College of Medicine Houston, Texas It is difficult to judge the audience for whom the book is intended. It would not, for instance, be a book that a general surgeon would use because virtually all the tests described would be performed by specialists in each particular area. Nor would it be a book that a general surgeon would Diagnostic Patient Studies in Surgery, edited take to a remote part of the world because the by Bernard Sigel, 449 pp, with illus, $60, Phila- sophisticated equipment would not be available. delphia, Lea & Febiger, 1986 A surgeon who might want to know more about Bernard Sigel has edited a compendium of topics, "angiography" or "luminal contrast studies of the each with independent authors, that describe bile and pancreatic ducts" would probably consult diagnostic procedures used by surgeons in evalua- a larger reference source specifically devoted to tion of patients. "Patient studies" are defined as that technique and organ system rather than read diagnostic procedures that necessitate the pres- a brief description in this book. If a large reference ence of a patient, to distinguish such tests from library were not generally available, however, this laboratory studies that are performed on speci- book may serve its purpose on the surgeon's mens from the patient and analyzed later. Three bookshelf. It attempts to present a middle ground general types of patient studies are described: between the paucity of available information (1) imaging, (2) endoscopy, and (3) function analy- about diagnostic tests that a general surgeon may sis. Because numerous complex, invasive, and be interested in knowing and the amount of detail expensive studies are available in modern medi- that is usually sought if a surgeon is personally cine, the book is intended to help surgeons under- performing a procedure. stand frequently used diagnostic procedures. It Generally, when a surgeon requests a diagshould serve as a reference source for patient nostic study, he will depend on interpretation of the results by a specialist rather than attempting studies and a guide to their use. The general format for each diagnostic pro- to interpret the results independently. I do not cedure is as follows: a brief description of the deny that it is helpful to understand the technique technology, indications for use, examples of the and limitations of a test and that it is intellectudata derived, and associated pitfalls. The primary ally interesting to be able to interpret the results. aim is not to teach the surgeon how to perform or Nevertheless, in modern medicine that can afford interpret patient studies,but rather to teach an such tests, the general surgeon is unlikely to assume this responsibility. If the general surgeon understanding of how the tests are best used. Because of the diverse topics, the book does not is particularly adept at one of these procedures, have to be read sequentially but can be used as a such as endoscopy or noninvasive peripheral vasreference tool for specific organ systems or general cular studies, he will probably know more about types of examination, whether it be imaging, the topic than what is included in this book. Thus,
324
BOOK REVIEWS
Mayo Clin Proc, April 1987, Vol 62
I believe that the information in each chapter is well presented, accurate, and interesting, but I am uncertain about its applicability in daily surgical practice. The book may be of value for the resident in training or, as previously stated, for the general surgeon who does not have easy access to a large reference library. Sylvester Sterioff, M.D. Department of Surgery
Neurosurgery: The Scientific Basis of Clini cal Practice, edited by Alan Crockard, Richard Hayward, and Julian T. Hoff, 647 pp, with illus, $99.95, Boston, Blackwell Scientific Publications (distributed by Blackwell Mosby Book Distributors, St. Louis), 1985 This neurosurgical volume is another in a series on the scientific basis of clinical practice published in Great Britain. The text is multiauthored and consists predominantly of contributions from the British Isles. It is intended for postgraduate students as a review of the basic scientific underpinnings of current neurosurgical practice and offers little discussion of therapy for or prognosis associated with individual diseases. The first grouping of chapters is entitled "Basic Neurosciences." A brief overview of central nervous system embryogenesis is followed by an encyclopedic description of developmental anomalies. A cursory review of stereotactic techniques is presented, and one chapter addresses neurochemistry. The second group of chapters thoughtfully and systematically reviews various subsystems of the central nervous system and correlates anatomy, physiology, and neurochemistry with clinical syndromes. The discussions of the sensory system, including pain, the control of movement, speech and language, and the neural control of respiration, are particularly good. These presentations have the advantages of being succinct and of synthesizing basic scientific and clinical information; excellent bibliographies are provided for those readers who require more depth. The third section is the best part of the book. The discussions of cerebral metabolism and blood flow, cerebral arterial spasm, pathophysiologic
features of increased intracranial pressure, and cerebrospinal fluid dynamics are outstanding. The authors have made major research contributions in the field under discussion but avoid the pitfall of presenting only their own findings. The discussions are insightful and are balanced with excellent references. In the fourth group of chapters—the middle third of the volume—the response of the central nervous system to various disease processes is discussed. In a systematic fashion, vascular, neoplastic, inflammatory, degenerative, infectious, and systemic conditions are reviewed, and their influence on the central and peripheral nervous system is described. The chapters in this section are somewhat inconsistent but, in general, serve as a satisfactory overview of these various topics. The final set of chapters concludes with a discussion of the various techniques (imaging techniques, neurophysiologic methods, and psychologic testing) for investigation of the nervous system. At the end of each balanced discussion, the uninitiated reader is given a good overview of the technical aspects of the investigative procedure, an idea about what useful information might be obtained, and an assessment of the limitations of the technique. In summary, I recommend this volume as a useful resource for graduate students during the early part of their training in neurosurgery or neurology. It should be helpful for preparation for written board examinations in that it provides a review and discussion of pertinent basic science topics for that examination. If this text has a shortcoming, it is related to the extensive agenda it attempts to address. This scope would be difficult to manage in a multivolume resource, much less in a single volume. W. Richard Marsh, M.D. Department of Neurologic Surgery
Reproductive Failure, edited by Alan H. DeCherney, 308 pp, with illus, $45, New York, Churchill Livingstone (distributed by Longman, White Plains, New York), 1986 This text presents a timely review of a variety of current topics of interest in reproductive endocrinology and infertility. The editor is an experienced
BOOK REVIEWS
323
"histiocytosis X" (chapter 28) seems to have been endoscopy, or function analysis. It does not, howdiscarded by many authors because the cell of ever, provide algorithms or initiate the probleminterest has been shown to be the Langerhans cell. solving search. The authors are well-respected experts in their Overall, this book has and deserves wide readership. It provides pertinent information about various fields and in some instances are up-andskeletal tumors that should appeal to all persons coming young physicians who are on the foredealing with patients having or suspected of front of their field and are aware of the clinical having a bone tumor. Access to this book is problems. Recognizable names of surgeons are important because it offers a careful analysis of a Abcarian (an expert in colonoscopy), DeMeester vast group of cases, the likes of which would be (in esophageal function), and Yao (in noninvasive difficult to duplicate. This book will endure for peripheral vascular assessment). The chapters are written with a tone of authority, are pithy, and years. have a limited number of examples of the problems encountered and the results obtained. ReferHarlan J. Spjut, M.D. ences are frequently cited throughout the text and Department of Pathology in some instances are extensive. Baylor College of Medicine Houston, Texas It is difficult to judge the audience for whom the book is intended. It would not, for instance, be a book that a general surgeon would use because virtually all the tests described would be performed by specialists in each particular area. Nor would it be a book that a general surgeon would Diagnostic Patient Studies in Surgery, edited take to a remote part of the world because the by Bernard Sigel, 449 pp, with illus, $60, Phila- sophisticated equipment would not be available. delphia, Lea & Febiger, 1986 A surgeon who might want to know more about Bernard Sigel has edited a compendium of topics, "angiography" or "luminal contrast studies of the each with independent authors, that describe bile and pancreatic ducts" would probably consult diagnostic procedures used by surgeons in evalua- a larger reference source specifically devoted to tion of patients. "Patient studies" are defined as that technique and organ system rather than read diagnostic procedures that necessitate the pres- a brief description in this book. If a large reference ence of a patient, to distinguish such tests from library were not generally available, however, this laboratory studies that are performed on speci- book may serve its purpose on the surgeon's mens from the patient and analyzed later. Three bookshelf. It attempts to present a middle ground general types of patient studies are described: between the paucity of available information (1) imaging, (2) endoscopy, and (3) function analy- about diagnostic tests that a general surgeon may sis. Because numerous complex, invasive, and be interested in knowing and the amount of detail expensive studies are available in modern medi- that is usually sought if a surgeon is personally cine, the book is intended to help surgeons under- performing a procedure. stand frequently used diagnostic procedures. It Generally, when a surgeon requests a diagshould serve as a reference source for patient nostic study, he will depend on interpretation of the results by a specialist rather than attempting studies and a guide to their use. The general format for each diagnostic pro- to interpret the results independently. I do not cedure is as follows: a brief description of the deny that it is helpful to understand the technique technology, indications for use, examples of the and limitations of a test and that it is intellectudata derived, and associated pitfalls. The primary ally interesting to be able to interpret the results. aim is not to teach the surgeon how to perform or Nevertheless, in modern medicine that can afford interpret patient studies,but rather to teach an such tests, the general surgeon is unlikely to assume this responsibility. If the general surgeon understanding of how the tests are best used. Because of the diverse topics, the book does not is particularly adept at one of these procedures, have to be read sequentially but can be used as a such as endoscopy or noninvasive peripheral vasreference tool for specific organ systems or general cular studies, he will probably know more about types of examination, whether it be imaging, the topic than what is included in this book. Thus,
324
BOOK REVIEWS
Mayo Clin Proc, April 1987, Vol 62
I believe that the information in each chapter is well presented, accurate, and interesting, but I am uncertain about its applicability in daily surgical practice. The book may be of value for the resident in training or, as previously stated, for the general surgeon who does not have easy access to a large reference library. Sylvester Sterioff, M.D. Department of Surgery
Neurosurgery: The Scientific Basis of Clini cal Practice, edited by Alan Crockard, Richard Hayward, and Julian T. Hoff, 647 pp, with illus, $99.95, Boston, Blackwell Scientific Publications (distributed by Blackwell Mosby Book Distributors, St. Louis), 1985 This neurosurgical volume is another in a series on the scientific basis of clinical practice published in Great Britain. The text is multiauthored and consists predominantly of contributions from the British Isles. It is intended for postgraduate students as a review of the basic scientific underpinnings of current neurosurgical practice and offers little discussion of therapy for or prognosis associated with individual diseases. The first grouping of chapters is entitled "Basic Neurosciences." A brief overview of central nervous system embryogenesis is followed by an encyclopedic description of developmental anomalies. A cursory review of stereotactic techniques is presented, and one chapter addresses neurochemistry. The second group of chapters thoughtfully and systematically reviews various subsystems of the central nervous system and correlates anatomy, physiology, and neurochemistry with clinical syndromes. The discussions of the sensory system, including pain, the control of movement, speech and language, and the neural control of respiration, are particularly good. These presentations have the advantages of being succinct and of synthesizing basic scientific and clinical information; excellent bibliographies are provided for those readers who require more depth. The third section is the best part of the book. The discussions of cerebral metabolism and blood flow, cerebral arterial spasm, pathophysiologic
features of increased intracranial pressure, and cerebrospinal fluid dynamics are outstanding. The authors have made major research contributions in the field under discussion but avoid the pitfall of presenting only their own findings. The discussions are insightful and are balanced with excellent references. In the fourth group of chapters—the middle third of the volume—the response of the central nervous system to various disease processes is discussed. In a systematic fashion, vascular, neoplastic, inflammatory, degenerative, infectious, and systemic conditions are reviewed, and their influence on the central and peripheral nervous system is described. The chapters in this section are somewhat inconsistent but, in general, serve as a satisfactory overview of these various topics. The final set of chapters concludes with a discussion of the various techniques (imaging techniques, neurophysiologic methods, and psychologic testing) for investigation of the nervous system. At the end of each balanced discussion, the uninitiated reader is given a good overview of the technical aspects of the investigative procedure, an idea about what useful information might be obtained, and an assessment of the limitations of the technique. In summary, I recommend this volume as a useful resource for graduate students during the early part of their training in neurosurgery or neurology. It should be helpful for preparation for written board examinations in that it provides a review and discussion of pertinent basic science topics for that examination. If this text has a shortcoming, it is related to the extensive agenda it attempts to address. This scope would be difficult to manage in a multivolume resource, much less in a single volume. W. Richard Marsh, M.D. Department of Neurologic Surgery
Reproductive Failure, edited by Alan H. DeCherney, 308 pp, with illus, $45, New York, Churchill Livingstone (distributed by Longman, White Plains, New York), 1986 This text presents a timely review of a variety of current topics of interest in reproductive endocrinology and infertility. The editor is an experienced