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Essentials of Human Metabolism — the Relationship of Biochemistry to Human Physiology and Diseases
BIOCHEMICAL EDUCATION
Essentials of Human Metabolism Relationship of Biochemistry to Physiology and Diseases By W .
C. M c M u r r a y .
P p . 308.
October 1977 Vol. 5 No. 4
- - the Human
H a r p e r a n d Row, I n c .
H a g e r s t o w n , U . S . A . 1977. P a p e r b a c k , $14.95 or £11.20. Anyone planning to write a biochemistry textbook for medical students faces a number of fundamental problems. The medical student occupies an unenviable position between the student of general biology on the one hand, and the student of biochemistry on the other - - he needs rather more than a simple outline of any topic and rather less than the fine details and conditional clauses appropriate to a specialist study of the subject. He wants to know the relationship of biochemistry to h u m a n physiology and disease to him that's what it's all about! - - but this requires an appreciation of the whole scene rather than an absorption of the many details. A number of biochemistry textbooks written for medical students in the last few years have not, it seems to me, surmounted these problems. If any general criticism can be levelled at them it is that, while they contain excellent descriptions of molecular structure and function, full details of metabolic pathways and often a chapter or two on particular tissues, the student - - faced with so much detail cannot see the wood for the trees. In "Essentials of Human Metabolism", the latest biochemistry textbook for medical students, Professor W. C. McMurray confronts this problem and succeeds very largely in surmounting it initially, 1 believe, because he chooses to leave descriptions of trees to others and writes about the wood! For a student in his preclinical years this appreciation of the wood is probably more important than a detailed knowledge of the trees (which can be acquired later, if required). The omission of detail leads to refreshingly clear descriptions of metabolic pathways with both text and diagrams uncluttered by the names of all the enzymes involved. Enzymes are only named if the student needs to know them. This clarity of style makes for easy reading and clear understanding. Long biochemical names have been kept to a minimum and there is a glossary at the beginning of the book. In keeping with this clarity the general appearance and lay-out of the book are pleasing, with a well printed text, plenty of good clear linediagrams and points made in a direct authoritative manner without dogmatism. The choice of material for any biochemistry textbook is a subject that causes endless debate and I am sure that "Essentials of Human Metabolism" will be no exception. Some will undoubtedly argue that such a book is incomplete without a detailed consideration of the structure and function of haemoglobin or the mechanism of blood clotting. Yet there is a strong case for omitting these topics - not because they are either unimportant or irrelevant to medical studies, but because they have already been described very well in other biochemistry textbooks readily available in most medical libraries, as Professor McMurray seems well aware. His aim was to deal with the essentials of human metabolism, and certainly his seven chapter headings form a basic list of essentials - - "'Life as a Molecular Process", "Enzymes". "Energetics", "Carbohydrates", "Lipids", "Nitrogen Metabolism" and "Integration of Metabolism". What makes the book outstanding, however, is not the choice of material but the way in which that material is treated. In each of his chapters on carbohydrates, lipids and nitrogen metabolism, for example, he gives a simple description of the molecules concerned, outlines their metabolism and then fills in details by discussing the metabolism of each type of molecule in the context of particular tissues. Not only are descriptions of structure closely related to descriptions of function, but the biochemistry of tissues is described in relation to their physiological activities. Topics are sometimes dealt with in an order which at first sight is unexpected - - but which works. Protein synthesis, for example, can only be approached by a long and tortuous route through all the central metabolic pathways - - or so the placing of this topic -
-
-
-
-
-
87
towards the end of most biochemistry textbooks would have us believe! Professor McMurray describes it right at the beginning of Chapter 1 - - surely a logial introduction to Life as a Molecular Process ! The chapter on Energetics draws together transport across mitochondrial and plasma membranes, respiratory control. regulation of the citric acid cycle, and the adenine and nicotinamide nucleotide pairs - - topics which do not usually shelter under the same umbrella. This challenges the firmly-ingrained idea that details of metabolic pathways must be studied before control mechanisms - - and not before time! There are a number of points with which l take issue. For example, it would have been more helpful (to British medical students at least) if blood sugar levels had been expressed in mM values rather than as mg/100ml. And why was the pentose phosphate pathway (hexose monophosphate shunt) called the phosphogluconate pathway - - to propagate the Krebs. Citric Acid. Tricarboxylic Acid Cycle syndrome? In a book which deserves a great deal of praise for its simple direct approach it was disappointing that the tendency to use more complicated and academic-sounding language than necessar', was nevertheless still present from time to time. It has al'xays seemed strange to me that, while biochemists talk quite happily about cells "using" substrates or molecules "crossing" membranes, they write about cells "utilising" substrates or molecules "traversing" membranes! But perhaps the occasional appearance of this form of academic pomposity in "'Essentials of Human Metabolism" is no more than a lapse of the pen? A more serious criticism is the lack of colour. With the advantages of colour-coding for diagrams firmly established, it ,.,,as surprising to find that the illustrations ',,,'ere in black and white. Had this been in the interests of economy it would have been understandable, but the price of this paperback volume in my local bookshop is £11.20 - - surely an inflationary record! But if valuefor-money is considered from the point of view of choice of content and its treatment, then this book is not an alternative to other textbooks - - it fills a gap they leave. The author's intention ',,,'as to produce a biochemistry textbook for medical students which was less ponderous than other textbooks. He succeeds admirably - - material carefully chosen on the "need to know" basis, simple, direct language and clear, uncluttered diagrams. Despite the occasional interchange of nouns, adjectives and verbs, the lack of colour and the sometimes confusing terminology, this book should be in every medical library. Indeed, if it were not for the depressing question of cost, it should be in every medical student's library E . M . Evans Department of Medical Biochemistry. University of Manchester, U.K.
Education and Training for Clinical Chemistry E d i t e d by M a r t i n R u b i n a n d Per Lous. P u b l i s h e d for the I n t e r n a t i o n a l F e d e r a t i o n of Clinical C h e m i s t r y C o m m i t t e e on E d u c a t i o n a n d T r a i n i n g in Clinical C h e m i s t r y by M T P Press Ltd. Can be o b t a i n e d f r o m Prof. M. R u b i n , G e o r g e t o w n Medical School, 3800 Reservoir R o a d , W a s h i n g t o n D . C . 20007, U . S . A . ($ 5.00) or Dr. D. N. Raine, Biochemistry D e p a r t m e n t , The Children's Hospital, B i r m i n g h a m , B16 8 E T , E n g l a n d (£2.50 s u r f a c e mail, £3.50 air m a i l ) 1977. Pp. 1 % . P a p e r b a c k . Most of this reference book is taken up with the results of a survey made in 1972-6 about the status of clinical chemistry throughout the world Separate accounts are given for each of 42 countries, incorporating sections on history, legal status, training and education, the place of clinical chemistry in hospital and nonhospital service, etc. The introductory section reviews the development of clinical chemistry, lists societies and journals, assesses the role of the clinical chemisty in medical education, service, and research and makes recommendations about the manner in which clinical chemists should be trained and educated.
Essentials of Human Metabolism Relationship of Biochemistry to Physiology and Diseases By W .
C. M c M u r r a y .
P p . 308.
October 1977 Vol. 5 No. 4
- - the Human
H a r p e r a n d Row, I n c .
H a g e r s t o w n , U . S . A . 1977. P a p e r b a c k , $14.95 or £11.20. Anyone planning to write a biochemistry textbook for medical students faces a number of fundamental problems. The medical student occupies an unenviable position between the student of general biology on the one hand, and the student of biochemistry on the other - - he needs rather more than a simple outline of any topic and rather less than the fine details and conditional clauses appropriate to a specialist study of the subject. He wants to know the relationship of biochemistry to h u m a n physiology and disease to him that's what it's all about! - - but this requires an appreciation of the whole scene rather than an absorption of the many details. A number of biochemistry textbooks written for medical students in the last few years have not, it seems to me, surmounted these problems. If any general criticism can be levelled at them it is that, while they contain excellent descriptions of molecular structure and function, full details of metabolic pathways and often a chapter or two on particular tissues, the student - - faced with so much detail cannot see the wood for the trees. In "Essentials of Human Metabolism", the latest biochemistry textbook for medical students, Professor W. C. McMurray confronts this problem and succeeds very largely in surmounting it initially, 1 believe, because he chooses to leave descriptions of trees to others and writes about the wood! For a student in his preclinical years this appreciation of the wood is probably more important than a detailed knowledge of the trees (which can be acquired later, if required). The omission of detail leads to refreshingly clear descriptions of metabolic pathways with both text and diagrams uncluttered by the names of all the enzymes involved. Enzymes are only named if the student needs to know them. This clarity of style makes for easy reading and clear understanding. Long biochemical names have been kept to a minimum and there is a glossary at the beginning of the book. In keeping with this clarity the general appearance and lay-out of the book are pleasing, with a well printed text, plenty of good clear linediagrams and points made in a direct authoritative manner without dogmatism. The choice of material for any biochemistry textbook is a subject that causes endless debate and I am sure that "Essentials of Human Metabolism" will be no exception. Some will undoubtedly argue that such a book is incomplete without a detailed consideration of the structure and function of haemoglobin or the mechanism of blood clotting. Yet there is a strong case for omitting these topics - not because they are either unimportant or irrelevant to medical studies, but because they have already been described very well in other biochemistry textbooks readily available in most medical libraries, as Professor McMurray seems well aware. His aim was to deal with the essentials of human metabolism, and certainly his seven chapter headings form a basic list of essentials - - "'Life as a Molecular Process", "Enzymes". "Energetics", "Carbohydrates", "Lipids", "Nitrogen Metabolism" and "Integration of Metabolism". What makes the book outstanding, however, is not the choice of material but the way in which that material is treated. In each of his chapters on carbohydrates, lipids and nitrogen metabolism, for example, he gives a simple description of the molecules concerned, outlines their metabolism and then fills in details by discussing the metabolism of each type of molecule in the context of particular tissues. Not only are descriptions of structure closely related to descriptions of function, but the biochemistry of tissues is described in relation to their physiological activities. Topics are sometimes dealt with in an order which at first sight is unexpected - - but which works. Protein synthesis, for example, can only be approached by a long and tortuous route through all the central metabolic pathways - - or so the placing of this topic -
-
-
-
-
-
87
towards the end of most biochemistry textbooks would have us believe! Professor McMurray describes it right at the beginning of Chapter 1 - - surely a logial introduction to Life as a Molecular Process ! The chapter on Energetics draws together transport across mitochondrial and plasma membranes, respiratory control. regulation of the citric acid cycle, and the adenine and nicotinamide nucleotide pairs - - topics which do not usually shelter under the same umbrella. This challenges the firmly-ingrained idea that details of metabolic pathways must be studied before control mechanisms - - and not before time! There are a number of points with which l take issue. For example, it would have been more helpful (to British medical students at least) if blood sugar levels had been expressed in mM values rather than as mg/100ml. And why was the pentose phosphate pathway (hexose monophosphate shunt) called the phosphogluconate pathway - - to propagate the Krebs. Citric Acid. Tricarboxylic Acid Cycle syndrome? In a book which deserves a great deal of praise for its simple direct approach it was disappointing that the tendency to use more complicated and academic-sounding language than necessar', was nevertheless still present from time to time. It has al'xays seemed strange to me that, while biochemists talk quite happily about cells "using" substrates or molecules "crossing" membranes, they write about cells "utilising" substrates or molecules "traversing" membranes! But perhaps the occasional appearance of this form of academic pomposity in "'Essentials of Human Metabolism" is no more than a lapse of the pen? A more serious criticism is the lack of colour. With the advantages of colour-coding for diagrams firmly established, it ,.,,as surprising to find that the illustrations ',,,'ere in black and white. Had this been in the interests of economy it would have been understandable, but the price of this paperback volume in my local bookshop is £11.20 - - surely an inflationary record! But if valuefor-money is considered from the point of view of choice of content and its treatment, then this book is not an alternative to other textbooks - - it fills a gap they leave. The author's intention ',,,'as to produce a biochemistry textbook for medical students which was less ponderous than other textbooks. He succeeds admirably - - material carefully chosen on the "need to know" basis, simple, direct language and clear, uncluttered diagrams. Despite the occasional interchange of nouns, adjectives and verbs, the lack of colour and the sometimes confusing terminology, this book should be in every medical library. Indeed, if it were not for the depressing question of cost, it should be in every medical student's library E . M . Evans Department of Medical Biochemistry. University of Manchester, U.K.
Education and Training for Clinical Chemistry E d i t e d by M a r t i n R u b i n a n d Per Lous. P u b l i s h e d for the I n t e r n a t i o n a l F e d e r a t i o n of Clinical C h e m i s t r y C o m m i t t e e on E d u c a t i o n a n d T r a i n i n g in Clinical C h e m i s t r y by M T P Press Ltd. Can be o b t a i n e d f r o m Prof. M. R u b i n , G e o r g e t o w n Medical School, 3800 Reservoir R o a d , W a s h i n g t o n D . C . 20007, U . S . A . ($ 5.00) or Dr. D. N. Raine, Biochemistry D e p a r t m e n t , The Children's Hospital, B i r m i n g h a m , B16 8 E T , E n g l a n d (£2.50 s u r f a c e mail, £3.50 air m a i l ) 1977. Pp. 1 % . P a p e r b a c k . Most of this reference book is taken up with the results of a survey made in 1972-6 about the status of clinical chemistry throughout the world Separate accounts are given for each of 42 countries, incorporating sections on history, legal status, training and education, the place of clinical chemistry in hospital and nonhospital service, etc. The introductory section reviews the development of clinical chemistry, lists societies and journals, assesses the role of the clinical chemisty in medical education, service, and research and makes recommendations about the manner in which clinical chemists should be trained and educated.