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Lung Development: Biological and Clinical Perspectives
Book Reviews hypoxia and polycythaemia and the role of polycythaemia as a compensatory mechanism is considered in several papers, including one concerned with chronic mountain sickness. Interesting accounts are given of expeditions to conduct scientific research at high altitude by those who took part. The second part of the book is written for climbers and it presents, in relatively nontechnical language, some of the important issues relating to acclimatization and medical problems of high altitude. Of particular interest are the accounts by climbers themselves of illness that they have suffered including pulmonary oedema and pulmonary embolus or pneumonia. Some detailed advice is given on who should or should not be advised against going high in the mountains. The first part of book has apparently been published previously in another form. There is, as might be expected, some unevenness in style. While some chapters describe in detail the results of original research, others are more in the nature of a review or an expression of personal opinions. At the end of many chapters there is an account of a discussion, but rather irritatingly, in some instances the comments are not attributed. The book contains much of interest to readers from the groups already mentioned. It highlights many remaining questions, the answers to some of which one hopes will be forthcoming at the next meeting in Banff which is doubtless already being planned. J. M. Bishop
Lung
Deuelopment:
Vol. Vol.
One Two
Ed.
Philip
Biological
and Clinical
Perspectives
Biochemistry and Physiology Aleonatal Respiratory Distress Farrell
New York: Academic Press. 1982. 1st edition. Pp. Vol. One 407; Vol. Two 307. Price E31.40 Vol. One $47.40; E24.80Vol. Two $37.50 This two volume publication under the general editorship of Dr Philip Farrell gives a marvellously complete review ofall that one could want to know about surfactant. Volume one, which describes the theoretical and biochemical background to the clinical studies described in volume two, starts with good chapters on lung growth, lung cytology and methods of measuring surfactant. The next five
413
chapters describe the techniques for studying lung surfactant biochemistry and physiology with major emphasis, as elsewhere in both volumes, on the technical details and methodology of tissue slices, profused lung, subcellular fractions and isolated type II cells. Although these chapters might be of interest, though perhaps too superficial to experts in the field, they would be too detailed for most clinical readers. There are then four excellent chapters outlining with great clarity the biochemistry and the chemical structure of the various surfactant lipids. This can only be ofgreat value to paediatricians interested in neonatal respiratory medicine. The second half of volume one consists of eight chapters, each one describing in detail one of the enzymes involved in pulmonary surfactant synthesis. There is perhaps too much detailed biochemistry for clinicians. However, each chapter contains sections on the location in the lung, the age at which the enzyme appears, and the effect of hormones -including steroids -and drugs on the development of the enzyme which are of considerable practical interest. Volume two deals with surfactant deficient respiratory distress syndrome (RDS). The first seven chapters describe the role of surfactant in RDS, the clinical features and diagnoses of the disease, and a particularly good chapter on the radiology of all neonatal lung disease. There are good chapters on the pathophysiology and long term sequelae of RDS, but the chapter on treatment was rather disappointing, and unlike other chapters in this book could not be used either as a comprehensive reference source nor as a practical guide for someone with a sick baby to look after. The second section of this volume deals with the problem ofDS prevention, primarily addressing the subject of steroids as surfactant inducers. There are excellent reviews of the various tests now available for assessing surfactant in amniotic fluid, followed by a detailed and technical review of the endocrine factors involved in lung development. Howie and Liggins again review their own seminal study of betamethasone to prevent RDS, and Zachman concludes by reviewing the recent NIH study of prophylactic steroids which produced less impressive results, did not >alter the perinatal mortality, but did show some reduction in morbidity in female infants of 30-34 weeks’ gestation. These two volumes provide the most comprehensive source available of all that is currently
414
Book Reviews
known about surfactant, its synthesis and the results of its absence in preterm infants. While volume one is perhaps somewhat too technical and laboratory orientated for the simple clinician, volume two could be regarded as essential reading for everyone who regards the prevention or management of RDS as part of his stock in trade. Volume one costs E3 1.40 and volume two g24.80. If you cannot afford both, make your library buy volume one and buy volume two yourself. N. R. C. Roberton
knowledge in the field of paediatric pneumonology’. Some papers are sadly only in abstract form, as they will be published elsewhere. In fact this is so of probably two of the best papers presented at the’Meeting by Helms et al. and Gaultier et al. I would imagine that any high quality studies will be published in reputable journals, and only those studies which are incomplete or unacceptable for publication in a journal wili find their way into publications of proceedings. I can therefore not recommend this book to paediatricians or respiratory physicians. J. 0. Warner
A Revzew on Modern
Problems
in Paediatrics
Vol. 21 Paediatric Respiratory Physiology Clinical Aspects of Paediatric PneumorwloQ Ed.
and AllerD
R. Kraemer
Basel: S. Karger AG. SFr. 165.-/DM198.-/US$99.00
Keith 1982.
Pp. xii + 247. (paper)
Price
The tremendous proliferation in medical books is due not a little to publications of proceedings of international meetings. Few, if any, are of lasting value to anyone but those individuals lucky enough to attend the meeting. Thus those paediatricians with an interest in respiratory disease who had the opportunity to visit Berne in 198 1 to attend what proved to be a rather chaotic joint meeting of various European paediatric societies will find this book useful as a reminder of the papers with a respiratory flavour. Excessive price will probably deter most delegates from acquiring one. As with all publications of proceedings, the book contains chapters ranging from excellent reviews (such as those by Geubelle on small airway physiology; Junod on lung metabolism; and Godfrey on trigger factors in childhood asthma) to good research studies (notably Carswell et al. on house dust mites; Zapletal on lung elasticity measurements in childhood; and Zach on immunoglobulins in recurrent croup) to the incomplete and superfluous (I am still not sure why the paper by Ghar et al. on fetal erythropoiesis was included). The book contains 34 lectures, reviews and reports, grouped into sections on lung physiciliary function, lung metabolism, oQ?-Y, asthma, epidemiology respiratory disease, neonatology, pulmonary function assessment and statistics. It does not, as claimed by the publishers, ‘offer a stimulating overview of present
Therapeutics Eaton,
Anne
London: Bailliere 126. Price E5.50
Adams Tindall.
and Janet 1982.
Duterley
1st edition.
Pp.
This small book some 125 pages long has been written by three authors. Keith Eaton is a Hospital Practitioner in Allergy in the Reading Hospital Group, Anne Adams is a Practical Work Teacher in District Nursing Studies and Janet Duberley is a Lecturer in Nursing Studies at the University of Surrey. The aim of the book was to produce a short, simple and basic text for doctors, nurses and technicians working in general practice and assisting in allergy clinics, and I think that this aim has been admirably fulfilled. The book consists of some 12 chapters, the last two being on the allergy team and the role of the nurse in this team. It is somewhat rare for medical books to include such topics though they are clearly of increasing importance in many aspects ofhealth care. Alleru Therapeutics contains an interesting initial chapter on the history ofthe subject, commenting on the remarkable contribution made by Blackley towards the end of the nineteenth century when he discovered the cause of hay fever. This is followed by clear definitions of allergy and allergens. There is a well written and easily understood chapter on the immunology basis of allergy, though the authors’ insistence on including Type III allergic mechanisms in the pathogenesis of asthma is now out of date. There is an informative chapter on particular allergens with interesting and detailed reference to those from grasses, cereals, trees, moulds and fungi. The house dust mite and other sources of
Lung
Deuelopment:
Vol. Vol.
One Two
Ed.
Philip
Biological
and Clinical
Perspectives
Biochemistry and Physiology Aleonatal Respiratory Distress Farrell
New York: Academic Press. 1982. 1st edition. Pp. Vol. One 407; Vol. Two 307. Price E31.40 Vol. One $47.40; E24.80Vol. Two $37.50 This two volume publication under the general editorship of Dr Philip Farrell gives a marvellously complete review ofall that one could want to know about surfactant. Volume one, which describes the theoretical and biochemical background to the clinical studies described in volume two, starts with good chapters on lung growth, lung cytology and methods of measuring surfactant. The next five
413
chapters describe the techniques for studying lung surfactant biochemistry and physiology with major emphasis, as elsewhere in both volumes, on the technical details and methodology of tissue slices, profused lung, subcellular fractions and isolated type II cells. Although these chapters might be of interest, though perhaps too superficial to experts in the field, they would be too detailed for most clinical readers. There are then four excellent chapters outlining with great clarity the biochemistry and the chemical structure of the various surfactant lipids. This can only be ofgreat value to paediatricians interested in neonatal respiratory medicine. The second half of volume one consists of eight chapters, each one describing in detail one of the enzymes involved in pulmonary surfactant synthesis. There is perhaps too much detailed biochemistry for clinicians. However, each chapter contains sections on the location in the lung, the age at which the enzyme appears, and the effect of hormones -including steroids -and drugs on the development of the enzyme which are of considerable practical interest. Volume two deals with surfactant deficient respiratory distress syndrome (RDS). The first seven chapters describe the role of surfactant in RDS, the clinical features and diagnoses of the disease, and a particularly good chapter on the radiology of all neonatal lung disease. There are good chapters on the pathophysiology and long term sequelae of RDS, but the chapter on treatment was rather disappointing, and unlike other chapters in this book could not be used either as a comprehensive reference source nor as a practical guide for someone with a sick baby to look after. The second section of this volume deals with the problem ofDS prevention, primarily addressing the subject of steroids as surfactant inducers. There are excellent reviews of the various tests now available for assessing surfactant in amniotic fluid, followed by a detailed and technical review of the endocrine factors involved in lung development. Howie and Liggins again review their own seminal study of betamethasone to prevent RDS, and Zachman concludes by reviewing the recent NIH study of prophylactic steroids which produced less impressive results, did not >alter the perinatal mortality, but did show some reduction in morbidity in female infants of 30-34 weeks’ gestation. These two volumes provide the most comprehensive source available of all that is currently
414
Book Reviews
known about surfactant, its synthesis and the results of its absence in preterm infants. While volume one is perhaps somewhat too technical and laboratory orientated for the simple clinician, volume two could be regarded as essential reading for everyone who regards the prevention or management of RDS as part of his stock in trade. Volume one costs E3 1.40 and volume two g24.80. If you cannot afford both, make your library buy volume one and buy volume two yourself. N. R. C. Roberton
knowledge in the field of paediatric pneumonology’. Some papers are sadly only in abstract form, as they will be published elsewhere. In fact this is so of probably two of the best papers presented at the’Meeting by Helms et al. and Gaultier et al. I would imagine that any high quality studies will be published in reputable journals, and only those studies which are incomplete or unacceptable for publication in a journal wili find their way into publications of proceedings. I can therefore not recommend this book to paediatricians or respiratory physicians. J. 0. Warner
A Revzew on Modern
Problems
in Paediatrics
Vol. 21 Paediatric Respiratory Physiology Clinical Aspects of Paediatric PneumorwloQ Ed.
and AllerD
R. Kraemer
Basel: S. Karger AG. SFr. 165.-/DM198.-/US$99.00
Keith 1982.
Pp. xii + 247. (paper)
Price
The tremendous proliferation in medical books is due not a little to publications of proceedings of international meetings. Few, if any, are of lasting value to anyone but those individuals lucky enough to attend the meeting. Thus those paediatricians with an interest in respiratory disease who had the opportunity to visit Berne in 198 1 to attend what proved to be a rather chaotic joint meeting of various European paediatric societies will find this book useful as a reminder of the papers with a respiratory flavour. Excessive price will probably deter most delegates from acquiring one. As with all publications of proceedings, the book contains chapters ranging from excellent reviews (such as those by Geubelle on small airway physiology; Junod on lung metabolism; and Godfrey on trigger factors in childhood asthma) to good research studies (notably Carswell et al. on house dust mites; Zapletal on lung elasticity measurements in childhood; and Zach on immunoglobulins in recurrent croup) to the incomplete and superfluous (I am still not sure why the paper by Ghar et al. on fetal erythropoiesis was included). The book contains 34 lectures, reviews and reports, grouped into sections on lung physiciliary function, lung metabolism, oQ?-Y, asthma, epidemiology respiratory disease, neonatology, pulmonary function assessment and statistics. It does not, as claimed by the publishers, ‘offer a stimulating overview of present
Therapeutics Eaton,
Anne
London: Bailliere 126. Price E5.50
Adams Tindall.
and Janet 1982.
Duterley
1st edition.
Pp.
This small book some 125 pages long has been written by three authors. Keith Eaton is a Hospital Practitioner in Allergy in the Reading Hospital Group, Anne Adams is a Practical Work Teacher in District Nursing Studies and Janet Duberley is a Lecturer in Nursing Studies at the University of Surrey. The aim of the book was to produce a short, simple and basic text for doctors, nurses and technicians working in general practice and assisting in allergy clinics, and I think that this aim has been admirably fulfilled. The book consists of some 12 chapters, the last two being on the allergy team and the role of the nurse in this team. It is somewhat rare for medical books to include such topics though they are clearly of increasing importance in many aspects ofhealth care. Alleru Therapeutics contains an interesting initial chapter on the history ofthe subject, commenting on the remarkable contribution made by Blackley towards the end of the nineteenth century when he discovered the cause of hay fever. This is followed by clear definitions of allergy and allergens. There is a well written and easily understood chapter on the immunology basis of allergy, though the authors’ insistence on including Type III allergic mechanisms in the pathogenesis of asthma is now out of date. There is an informative chapter on particular allergens with interesting and detailed reference to those from grasses, cereals, trees, moulds and fungi. The house dust mite and other sources of