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Intestinal microbiology (aspects of microbiology, volume 10)
January
BOOK REVIEWS
1986
thoroughly than the recent exciting observation that a campylobacterlike organism may be an important causative factor. This book places particular emphasis on interpretation of endoscopic biopsy specimens, and it could certainly be useful to gastroenterologists who have an interest in and knack for pathology. It is written, however, primarily for surgical pathologists and, along with the book by Norris, is an important addition to the growing library of monographs on gastrointestinal pathology. This conclusion is supported by my personal observation that both the Appelman and Norris books have become popular with pathology house officers and fellows, as well as with more senior pathologists who have a special interest in gastrointestinal disease. JOHN H. YARDLEY,
M.D.
Baltimore, Maryland
251
edly different viewpoints concerning the treatment of gastroesophageal reflux with Nissen fundoplication. One group reported excellent results and another encountered major short- and long-term problems. Which group is correct? What accounts for the difference in results? Are one investigator’s results better because of his technique, or were the other investigator’s results poor because they were the experience of several surgeons at the same hospital? The reader is left with questions and no answers. Similarly, I was consistently bothered by the constant discussion of hiatus hernia in infants and children. In the United States, the percentage of infants and children with reflux who have concurrent hiatus hernia does not exceed 20%; therefore, it is not a major factor. This volume of Progress in Pediatric Surgery is not for the average clinician. Its value lies more in pointing out the current controversies than in giving a clear picture of the pathophysiology and treatment of GER. MARVIN E. AMENT, M.D.
Gastro-esophageal Reflux in Childhood: Problems of Splenit Surgery in Childhood (Progress in Pediatric Surgery, Volume 18). P. Wurnig, Volume Editor, with the cooperation of I. Klos. 193 pp., 75 figures, $46.00. Springer-Verlag, New York, New York, 1985. The first 131 pages of this volume are devoted to GER in childhood, and the remainder to splenic surgery in childhood. There are 16 chapters on GER-one on the physiology and pathophysiology of the esophagus in childhood; six on diagnostic tests; two on the relationship between GER, esophageal dysfunction, and either disturbances of respiratory regulation or bronchial asthma; one on the relationship between GER and severe mental retardation; and six on medical or surgical treatment. Of those chapters dealing with surgery, several are of great interest: “Late results after operations for hiatus hernia”; “To Nissen or not to Nissen”; “Retroesophageal hiatalplasty and gastropexy in the treatment of gastroesophageal reflux with or without hiatus hernia in childhood”; “Small bowel esophagoplasty with vascular microanastomosis in the neck for treatment of esophageal burns in childhood”; and “Followup examinations of conservatively and surgically treated children with hiatus hernia.” The chapters predominantly represent the viewpoints of an Austrian, German, and Swiss experience. Some of the contributors are not familiar to those of us on this side of the Atlantic who do investigation in GER. The chapters vary greatly in their “up-to-datedness.” References in most chapters do not extend beyond 1982, and in some do not go beyond the late 1979s. In a few, the limited experience of the author is stated, and his or her experience is compared with other published experience. Some of the chapters on diagnostic testing are particularly weak. The chapter on 24-hour pH monitoring is particularly lacking because no normal values are established. The reader must be careful in reviewing these chapters because they are not critiqued as in a peer-reviewed journal. I wonder why the editors did not provide a critique, rather than a summary, at the end of each chapter. It would certainly help a reader who is not thoroughly familiar with reflux and its treatment. There were decid-
Los Angeles, California
Comparative Biochemistry and Physiology of Enzymatic Digestion. By H. J. Vonk and J. R. H. Western. 501 pp., $80.00. Academic Press, Inc., Orlando, Florida, 1984. Readers of GASTROENTEROLOGY are familiar with the splendid efflorescence of the sciences underlying their specialty, but they are probably not so well acquainted with work that does not seem to have some remote possibility of clinical application. If they want to know what has happened in a broader field they might consult Vonk and Western’s compilation of results of comparative biochemical and physiological studies of enzymatic digestion in the entire range of metazoans. In three long chapters on proteinases in mammals, submammalian vertebrates, and invertebrates, they will find, for example, a table giving the properties of proteinases in 13 species of bivalves. Data on carbohydrases and lipases are almost equally comprehensive. Presentation of the physiology of enzymatic digestion is less complete, and comparison of Vonk and Western’s description of fat digestion in vertebrates with the corresponding chapter in any current textbook of the physiology of digestion in humans shows how much more thorough and illuminating the work of clinicians and medically oriented biochemists and physiologists has been. The figures are clear and the tables are well-organized. The long bibliographies make the book useful for consultation in the library. H. W. DAVENPORT,
Ph.D
Ann Arbor, Michigan
Intestinal Microbiology (Aspects of Microbiology, Volume 10). By B. S. Drasar and P. A. Barrow. 80 pp., $5.95. Van Norstrand Reinhold (U.K.) Company, Ltd., Wokingham, Berkshire, England. The microbiology of the gastrointestinal tract is indeed a complex subject. This short review is an attempt to pro-
252
GASTROENTEROLOGY Vol. 90, No.
BOOK REVIEWS
vide an overview for microbiologists and gastroenterologists. The scope of this book is broad in that both human and animal hosts are considered in each of the discussions. The first chapter deals with the conceptual and technical problems involved with the study of intestinal microflora. The authors correctly point out the difficulties involved in the study of the microflora of the gastrointestinal tract when viewed as an ecosystem. The second chapter is an overview of the bacterial flora of the normal intestinal tract and the important factors that affect both the numbers and types of bacteria at various sites. The third chapter is concerned with the role of intestinal microflora in malabsorption and diarrhea. This may be the weakest part of the book because the description of bacterial enteropathogens is somewhat out of date, and viral enteropathogens are almost completely ignored. The final chapter is an interesting discussion of both the benefits and harm that the intestinal microflora can cause. This short volume is well written and the illustrations, though simple, are well done. I would recommend it as an introduction to intestinal microbiology for students in gastroenterology or microbiology, and for anyone else who would like a short review. JOHN J. MATHEWSON,
Ph.D.
Houston, Texas
Giardia and Giardiasis: Biology, Pathogenesis, and Epidemiology. Edited by S. L. Erlandsen and E. A. Meyer. 407 pp., $65.00. Plenum Publishing Company, New York, New York, 1984. Written to celebrate the tricentennial discovery of Giardia by Leeuwenhoek, this book reviews advances in our knowledge of the organization and function of this parasitic protozoan and its interaction with its host. It is divided into three sections. The dominant theme of the first section is the biology of the organism and the correlation of structure-function relationships. The second section deals with the diagnosis and treatment of giardiasis and the immunologic reactions within the host. The third section relates recent studies on the epidemiology of giardiasis. In general, the book is well written, well organized, well illustrated, and well referenced. The first two chapters, on the structure of the trophozoite and cyst and on motility and the mechanism of attachment of trophozoites, are particularly well illustrated, with magnificent electron micrographs. The high-voltage electron micrographs present the parasite in intimate detail, and the scanning electron micrographs and microcinematographic photographs make it almost come alive. The chapters on metabolism of the trophozoite and Giardia isozymes contain much new and useful information. It was news to me, for example, that examination of various isozymes of Giardia has aided in distinguishing its various species which are so similar morphologically. Chapters dealing with methods of isolating trophozoites and cysts and on cultivating Giardia trophozoites should be very useful to scientists working with this organism.
1
The chapter on symptomatology, diagnosis, and treatment of giardiasis by Martin Wolfe is a good review. The chapter by Gillon and Ferguson on the small intestinal mucosa in giardiasis is disappointing in that it does not contain any photomicrographs, especially of the dramatic abnormalities that may be present in infected hypogammaglobulinemic patients. Two chapters deal with immune responses in giardiasis. The second, by Philip Smith, which deals with human immune responses, is especially good. Unfortunately, there is considerable redundancy of content in these two chapters, as well as in a following chapter on serologic diagnosis. The chapters on epidemiology contain useful and up-to-date information. Some of the subjects covered are waterborne outbreaks of giardiasis, detection of Giardia cysts in drinking water, resistance of cysts to disinfection agents, and fecal-oral transmission of giardiasis. Giardia and Giardiasis is recommended to anyone looking for a comprehensive, easy-to-read update on this important organism and disease. WILLIAM R. BROWN, M.D.
Denver. Colorado
Chemotherapy of Gastrointestinal Helminths. By H. Vanden Bossche, D. Thienpont, and P. G. Janssens. 719 pp., 62 figures, $198.00. Springer-Verlag, New York, New York, 1985. The title is deceptive, for this book contains extensive information over and above the in-depth discussion of chemotherapy of helminths. Pathogenic mechanisms, modes of transmission, life cycles, and epidemiologies are covered by international experts in human and animal parasitology. Chapters include the helminths of man, domestic animals, ruminants, equines, pigs, and carnivorous mammals and birds, which ensures that the book will have widespread veterinary and medical use. Preparation of the work has been careful with fewer than the usual typographic errors. Certain sections are redundant as contributors discuss the same subject from different viewpoints: however, the reader benefits from this diversity. The following chapters are of particular value to gastroenterologists: “Pharmacology of anthelmintics,” “Chemotherapy of gastrointestinal nematodiasis in man,” “Chemotherapy of intestinal trematodiasis in man,” and “Chemotherapy of tapeworm infections in man.” Importantly, there are discussions of such unusual infections as anisakiasis, oesophagostomiasis, and intestinal angiostrongyliasis, among others-infections which can be encountered by the endoscopist, who may appreciate such a reference. The book is too detailed and costly for the average practicing physician but he should know that it is available in a convenient library. LEE S. MONROE, M.D. San Diego, California
Lecture Notes on Gastroenterology. By E. Elias and C. Hawkins. 383 pp., $12.50. Blackwell Scientific Publications, Boston, Massachusetts, 1985.
BOOK REVIEWS
1986
thoroughly than the recent exciting observation that a campylobacterlike organism may be an important causative factor. This book places particular emphasis on interpretation of endoscopic biopsy specimens, and it could certainly be useful to gastroenterologists who have an interest in and knack for pathology. It is written, however, primarily for surgical pathologists and, along with the book by Norris, is an important addition to the growing library of monographs on gastrointestinal pathology. This conclusion is supported by my personal observation that both the Appelman and Norris books have become popular with pathology house officers and fellows, as well as with more senior pathologists who have a special interest in gastrointestinal disease. JOHN H. YARDLEY,
M.D.
Baltimore, Maryland
251
edly different viewpoints concerning the treatment of gastroesophageal reflux with Nissen fundoplication. One group reported excellent results and another encountered major short- and long-term problems. Which group is correct? What accounts for the difference in results? Are one investigator’s results better because of his technique, or were the other investigator’s results poor because they were the experience of several surgeons at the same hospital? The reader is left with questions and no answers. Similarly, I was consistently bothered by the constant discussion of hiatus hernia in infants and children. In the United States, the percentage of infants and children with reflux who have concurrent hiatus hernia does not exceed 20%; therefore, it is not a major factor. This volume of Progress in Pediatric Surgery is not for the average clinician. Its value lies more in pointing out the current controversies than in giving a clear picture of the pathophysiology and treatment of GER. MARVIN E. AMENT, M.D.
Gastro-esophageal Reflux in Childhood: Problems of Splenit Surgery in Childhood (Progress in Pediatric Surgery, Volume 18). P. Wurnig, Volume Editor, with the cooperation of I. Klos. 193 pp., 75 figures, $46.00. Springer-Verlag, New York, New York, 1985. The first 131 pages of this volume are devoted to GER in childhood, and the remainder to splenic surgery in childhood. There are 16 chapters on GER-one on the physiology and pathophysiology of the esophagus in childhood; six on diagnostic tests; two on the relationship between GER, esophageal dysfunction, and either disturbances of respiratory regulation or bronchial asthma; one on the relationship between GER and severe mental retardation; and six on medical or surgical treatment. Of those chapters dealing with surgery, several are of great interest: “Late results after operations for hiatus hernia”; “To Nissen or not to Nissen”; “Retroesophageal hiatalplasty and gastropexy in the treatment of gastroesophageal reflux with or without hiatus hernia in childhood”; “Small bowel esophagoplasty with vascular microanastomosis in the neck for treatment of esophageal burns in childhood”; and “Followup examinations of conservatively and surgically treated children with hiatus hernia.” The chapters predominantly represent the viewpoints of an Austrian, German, and Swiss experience. Some of the contributors are not familiar to those of us on this side of the Atlantic who do investigation in GER. The chapters vary greatly in their “up-to-datedness.” References in most chapters do not extend beyond 1982, and in some do not go beyond the late 1979s. In a few, the limited experience of the author is stated, and his or her experience is compared with other published experience. Some of the chapters on diagnostic testing are particularly weak. The chapter on 24-hour pH monitoring is particularly lacking because no normal values are established. The reader must be careful in reviewing these chapters because they are not critiqued as in a peer-reviewed journal. I wonder why the editors did not provide a critique, rather than a summary, at the end of each chapter. It would certainly help a reader who is not thoroughly familiar with reflux and its treatment. There were decid-
Los Angeles, California
Comparative Biochemistry and Physiology of Enzymatic Digestion. By H. J. Vonk and J. R. H. Western. 501 pp., $80.00. Academic Press, Inc., Orlando, Florida, 1984. Readers of GASTROENTEROLOGY are familiar with the splendid efflorescence of the sciences underlying their specialty, but they are probably not so well acquainted with work that does not seem to have some remote possibility of clinical application. If they want to know what has happened in a broader field they might consult Vonk and Western’s compilation of results of comparative biochemical and physiological studies of enzymatic digestion in the entire range of metazoans. In three long chapters on proteinases in mammals, submammalian vertebrates, and invertebrates, they will find, for example, a table giving the properties of proteinases in 13 species of bivalves. Data on carbohydrases and lipases are almost equally comprehensive. Presentation of the physiology of enzymatic digestion is less complete, and comparison of Vonk and Western’s description of fat digestion in vertebrates with the corresponding chapter in any current textbook of the physiology of digestion in humans shows how much more thorough and illuminating the work of clinicians and medically oriented biochemists and physiologists has been. The figures are clear and the tables are well-organized. The long bibliographies make the book useful for consultation in the library. H. W. DAVENPORT,
Ph.D
Ann Arbor, Michigan
Intestinal Microbiology (Aspects of Microbiology, Volume 10). By B. S. Drasar and P. A. Barrow. 80 pp., $5.95. Van Norstrand Reinhold (U.K.) Company, Ltd., Wokingham, Berkshire, England. The microbiology of the gastrointestinal tract is indeed a complex subject. This short review is an attempt to pro-
252
GASTROENTEROLOGY Vol. 90, No.
BOOK REVIEWS
vide an overview for microbiologists and gastroenterologists. The scope of this book is broad in that both human and animal hosts are considered in each of the discussions. The first chapter deals with the conceptual and technical problems involved with the study of intestinal microflora. The authors correctly point out the difficulties involved in the study of the microflora of the gastrointestinal tract when viewed as an ecosystem. The second chapter is an overview of the bacterial flora of the normal intestinal tract and the important factors that affect both the numbers and types of bacteria at various sites. The third chapter is concerned with the role of intestinal microflora in malabsorption and diarrhea. This may be the weakest part of the book because the description of bacterial enteropathogens is somewhat out of date, and viral enteropathogens are almost completely ignored. The final chapter is an interesting discussion of both the benefits and harm that the intestinal microflora can cause. This short volume is well written and the illustrations, though simple, are well done. I would recommend it as an introduction to intestinal microbiology for students in gastroenterology or microbiology, and for anyone else who would like a short review. JOHN J. MATHEWSON,
Ph.D.
Houston, Texas
Giardia and Giardiasis: Biology, Pathogenesis, and Epidemiology. Edited by S. L. Erlandsen and E. A. Meyer. 407 pp., $65.00. Plenum Publishing Company, New York, New York, 1984. Written to celebrate the tricentennial discovery of Giardia by Leeuwenhoek, this book reviews advances in our knowledge of the organization and function of this parasitic protozoan and its interaction with its host. It is divided into three sections. The dominant theme of the first section is the biology of the organism and the correlation of structure-function relationships. The second section deals with the diagnosis and treatment of giardiasis and the immunologic reactions within the host. The third section relates recent studies on the epidemiology of giardiasis. In general, the book is well written, well organized, well illustrated, and well referenced. The first two chapters, on the structure of the trophozoite and cyst and on motility and the mechanism of attachment of trophozoites, are particularly well illustrated, with magnificent electron micrographs. The high-voltage electron micrographs present the parasite in intimate detail, and the scanning electron micrographs and microcinematographic photographs make it almost come alive. The chapters on metabolism of the trophozoite and Giardia isozymes contain much new and useful information. It was news to me, for example, that examination of various isozymes of Giardia has aided in distinguishing its various species which are so similar morphologically. Chapters dealing with methods of isolating trophozoites and cysts and on cultivating Giardia trophozoites should be very useful to scientists working with this organism.
1
The chapter on symptomatology, diagnosis, and treatment of giardiasis by Martin Wolfe is a good review. The chapter by Gillon and Ferguson on the small intestinal mucosa in giardiasis is disappointing in that it does not contain any photomicrographs, especially of the dramatic abnormalities that may be present in infected hypogammaglobulinemic patients. Two chapters deal with immune responses in giardiasis. The second, by Philip Smith, which deals with human immune responses, is especially good. Unfortunately, there is considerable redundancy of content in these two chapters, as well as in a following chapter on serologic diagnosis. The chapters on epidemiology contain useful and up-to-date information. Some of the subjects covered are waterborne outbreaks of giardiasis, detection of Giardia cysts in drinking water, resistance of cysts to disinfection agents, and fecal-oral transmission of giardiasis. Giardia and Giardiasis is recommended to anyone looking for a comprehensive, easy-to-read update on this important organism and disease. WILLIAM R. BROWN, M.D.
Denver. Colorado
Chemotherapy of Gastrointestinal Helminths. By H. Vanden Bossche, D. Thienpont, and P. G. Janssens. 719 pp., 62 figures, $198.00. Springer-Verlag, New York, New York, 1985. The title is deceptive, for this book contains extensive information over and above the in-depth discussion of chemotherapy of helminths. Pathogenic mechanisms, modes of transmission, life cycles, and epidemiologies are covered by international experts in human and animal parasitology. Chapters include the helminths of man, domestic animals, ruminants, equines, pigs, and carnivorous mammals and birds, which ensures that the book will have widespread veterinary and medical use. Preparation of the work has been careful with fewer than the usual typographic errors. Certain sections are redundant as contributors discuss the same subject from different viewpoints: however, the reader benefits from this diversity. The following chapters are of particular value to gastroenterologists: “Pharmacology of anthelmintics,” “Chemotherapy of gastrointestinal nematodiasis in man,” “Chemotherapy of intestinal trematodiasis in man,” and “Chemotherapy of tapeworm infections in man.” Importantly, there are discussions of such unusual infections as anisakiasis, oesophagostomiasis, and intestinal angiostrongyliasis, among others-infections which can be encountered by the endoscopist, who may appreciate such a reference. The book is too detailed and costly for the average practicing physician but he should know that it is available in a convenient library. LEE S. MONROE, M.D. San Diego, California
Lecture Notes on Gastroenterology. By E. Elias and C. Hawkins. 383 pp., $12.50. Blackwell Scientific Publications, Boston, Massachusetts, 1985.