Malignant skin tumours

Book Reviews unnecessary. The quality of the black and white photographs is poor and, for example, the photographs of breast prostheses and tissue expanders would give a patient very little idea of what these actually look like. The quality of the prints is reflected partly by the quality of the paper and this, together with the sometimes quaint drawings, gives the impression of an older generation of book. This is therefore a book aimed at the general public who might be considering cosmetic plastic surgery and, as might be expected, it covers the various topics at a relatively simplistic level. Nevertheless, I think it gives a clear and concise description of the common cosmetic operations and gives a satisfactory overview of the procedures, together with expectations of results. I found it easy to read. Priced at $18.95 it is eminently affordable. It would be useful if available in libraries for reference or provide rewarding reading if placed in the plastic surgeon’s waiting room! B. G. H. LAMBERTY Malignant Skin Tumours. Edited by Anthony J. J. Emmett and Michael O’Rourke. 2nd edition 1991. Edinburgh, London, Melbourne and New York, Churchill Livingstone, 422 pp., illustrated. E65. ISBN O-443-04089-3. This edition is larger than its predecessor by a little over a third. Its general layout has not changed greatly, with two main blocks of text remaining, one in which the clinical and pathological aspects of the various tumours are covered, the other describing their surgical management. The extensive coverage which the latter provides would imply that the book is aimed at a surgical audience. The contributors, with the exception of 4 of the 28, are entirely from the Brisbane area, and in the clinico-pathological section particularly, the text, with a few exceptions, continues to exhibit a degree of parochialism. Between the two blocks of text, there is a section on therapeutic techniques other than the overtly surgical. Excepting the discussion of topical cytotoxic therapy and cytotoxic regional arterial perfusion for recurrent malignant melanoma, they are discussed uncritically, and in a form with little relevance to the practicalities of skin tumour management. With the presumed object of being allinclusive, a chapter on “Cell and Molecular Biology of Cancer Cells”, has also been included, with 3f pages of references. It makes difficult reading. The content of the clinico-pathological component is largely unchanged from the first edition, except to include recently recognised entities. These are discussed effectively and economically. The clinical descriptions continue to be separate from those of the pathologist, a separation which has occasionally resulted in mutually contradictory statements from the two disciplines. A general criticism of the pathological content is that, as in the first edition, its relevance too often is more to other pathologists than to the surgeon. The excellent colour photographs of the clinical appearances of the various tumour forms have been retained, but life would be easier for the reader if they were positioned closer to the relevant text. The black and white histological pictures are much more effective than the colour photographs, which are generally disappointing. The section on “Surgical Techniques” has been extensively enlarged, rather than revised, with the inclusion of more complex reconstructions. The plastic surgeon with less experience would be wise to stick to the simpler techniques illustrated, and this caveat applies even more to general surgeons. The complaint made in the review of the first edition concerning the separation of the illustrations from the relevant text in this chapter, remains still valid. I preferred the slimmer first edition, but restoration to its original size would require ruthless pruning of material which is not strictly relevant to the surgeons who are treating skin tumours, remembering that many of them are not plastic surgeons. I. A. MCGREGOR

An Atlas of Forearm and Hand Cross-Sectional Anatomy with Computed Tomography and Magnetic Resonance Imaging Correlation. By Roy A. Meals and Leanne L. Seeger. London, Martin Dunitz Ltd., 1991. ISBN l-85317-029-1. Pp. 200, colour illustrations. Price f65.

183 An arm from a 59 year old man has been cut when freshly frozen into 2 millimetre thick sections from finger tip to the mid humerus. Each section is photographed from the caudal surface (the convention for the CT and MRI imaging). One hundred and seventy nine sections are presented, each accompanied by a CT photograph and an MRI photograph of a similar level. Half the sections are accompanied by a carefully labelled line drawing so that the structures can be clearly followed. Each page also has a line drawing to tell you the level at which the section was taken, making the book very easy to use and follow. The preparation of the specimens and photographs is superb. For instance, you can see the fascicular groups within the median nerve. The print quality and paper are high, making the book excellent value at E65.00. There are two main achievements of the book. One is to present upper limb anatomy in cross section, thus showing the relations of anatomical structures as you see them at surgery. Either a single section can be studied to see anatomical relations, or a structure can be followed through a long series of sections to watch its changing spatial relationships. The other equally important achievement of the book is to teach me the interpretation of CT and MRI scans. The book shows how the two types of scanning techniques differ. For instance, the flexor tendons are black spaces on MRI and white on CT. Bone and bone marrow show opposite densities in the two techniques and so does fat. The muscle groups can be seen in both scans, perhaps a little more clearly in MRI. A structure as large as the median nerve, however, cannot be really discerned from muscle in either type of scan. To those studying anatomy for the first time the book brings home the “density” of anatomical structures in the upper limb. For instance, the density of the tendons in the carpal tunnel and fingers is well appreciated and also the volume and complexity of the muscles of the hand. Because the specimen was fresh, the sections give a good perspective of the articular cartilage of joints and the intercarpal ligaments. I would recommend the book for all, from medical students to practising hand surgeon. It provides a fourth type of anatomical book to go with the standard anatomical text, with the latex injection anatomical studies and with the various operative exposure texts. S. WATSON

Oral Implantology. Basics-U1 Hollow Cylinder System. (Thieme Flexibook). Edited by Andre Schroeder, Franz Sutter and Gisbert Krekeler. (Stuttgart, Georg Thieme Verlag; New York, Thieme Medical Publishers Inc., 1991). ISBN O-86577-367-X. Pp. xiv + 374, illustrated. Price DM 44. This small paperback book of 374 pages describes the development of oral implantology by IT1 (International Team for Implantology) in collaboration with the Strauman Institute Switzerland. It would seem that IT1 is rather a misnomer since all the authors bar one, who have contributed to the book, are Swiss. The book begins with a useful and well-illustrated chapter on anatomy and is followed by fundamental details of the metallurgy of titanium. Basic principles of implant design, and the necessity for plasma coating are discussed, according to the work of the IT1 group. There is an excellent chapter on bone and soft tissue reactions to titanium, with some first class illustrations. Thereafter the book becomes a manual for the IT1 and Bonefit systems and undoubtedly would be most valuable for those who use the system. Interesting points are made regarding the necessity for the presence of attached keratinised mucosa around the implant, and there is a good description of the methods by which difficulties may be overcome by using split mucosal grafts from the palate before and after fitting the implants. Apart from these points, little is said which has relevance to implantation in general. It can only be concluded therefore, that while the book could be of value to those using the IT1 system, it has limited value to those with no implant experience. R. P. JUNIPER