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Pathology (1982), 14, July

BOOK REVIEWS

types of biopsies are said to result in false negatives (i.e. missed cancers) in 10% of specimens, while false positives are quite rare. As might be expected in a multi-author book on a controversial topic, there is plenty of disagreement. Williams (p. 388) states: ‘There seems little doubt that the proper treatment for a malignant lymphoma . . . is thyroidectomy’. On p. 271 we find the statement: ‘Lymphoma is never surgically treated’. The arguments in favour of the various needle biopsies are presented in a somewhat partisan fashion and neither group appears unduly worried by the false negatives (due, presumably, to sampling errors). Chapter 6 by Korff and DeGroot of Chicago is entitled ‘The Management of Radiation Induced Tumours of the Thyroid’. This is a superb summary of various diagnostic and therapeutic options and contains a clear flow chart for the management of the unfortunate patient who was subjected to radiation in childhood. Gerard-Marchant and Caillou, in a provocative chapter, seek to reintroduce the concept of the ‘lateral aberrant thyroid’ or ‘benign metastasis’. While this may seem outlandish to physicians and pathologists brought up on the teachings of Rupert Willis, the arguments and the conclusion (‘a group of normal-appearing follicles in a lymph node is not always metastatic’) are very plausible. This book is recommended without reservation to physicians, surgeons, pathologists, specialists in nuclear medicine and all other practitioners interested in the investigation and management of thyroid cancers. Solomon Posen

INGAMARIE Progress in Fibrinolysis, Vol. V, Eds JOHNF. DAVIDSON, NILSON & BIRGERASTEDT. 1981. Churchill Livingstone, Edinburgh, London, Melbourne, New York. Australian distributor, Longman Cheshire Group, Melbourne. 460 pp., illustrated. ISBN 0 443 02328 X. $84.00. This book is a record of papers and posters presented at the Fifth International Conference on Synthetic Fibrinolytic Thrombolytic Agents-Progress in Fibrinolysis, held in Sweden in June 1980. The change in title, from ‘Progress in Chemical Fibrinolysis and Thrombolysis’, reflects the broad coverage of basic and clinical aspects of fibrinolysis in this volume. The introductory paper, the Prix Servier Lecture by Dr K. C. Robbins, provides an excellent overview of recent advances in fibrinolysis. Normal plasminogen, variant plasminogens, and plasminogen activators are discussed in biochemical and functional terms,-,leading in to a discussion of current new approaches to fibrinolytic therapy and foreshadowing ‘fine-tuning’ of thrombolytic therapy for individual patients in the near future. The bulk of this volume consists of 100 research papers covering fibrinolysis in its broadest aspects. The nature and source of activators and the biochemistry of plasminogen activation are the subject of approximately a third of the papers. Both naturally occurring and synthetic inhibitors of fibrinolysis are discussed. Available methods for clinical and research studies offibrinolysis are considered in a number of papers. There is a series of reports on the interrelationships between fibrinolysis and the growth and metastasis of tumours in animals and man. The results of various assays of fibrinolysis in a number of clinical situations (e.g. recurrent venous thrombosis, childhood obesity, arteriosclerosis) are reported, as are the effects of drugs (e.g. estrogens stanazolol, B-blockers) on fibrinolysis. The role of local mucosal fibrinolysis in a number of gastrointestinal disorders (e.g. peptic ulceration, ulcerative colitis) is considered. A number of recent approaches to fibrinolytic therapy are discussed. This book represents the proceedings of an international meeting on fibrinolysis, and contains many papers of interest to those who have a major involvement in clinical and research aspects of fibrinolysis and thrombolytic therapy. Although the standard ofpapers is high, the book is very expensive and can only be recommended to those with a

particular interest in this field.

J . McPherson

Notes on Medical Bacteriology, J. DOUGLAS SLEIGH& MORAG TIMBURY. 1981. Churchill Livingstone, New York, Edinburgh, London. Australian distributor, Longman Cheshire Pty. Ltd., Melbourne. 354 pp., illustrated. ISBN 0 443 02264 X. $16.70. This book is full of facts concerning what may be termed clinical bacteriology. There are 4 sections: ‘Bacterial biology’ is devoted to topics such as bacterial structure and physiology. ‘Medically important bacteria’ contains brief descriptions of old established bacteria like staphylococci and streptococci as well as new arrivals, notably Campylobacter jejuni and Legionella pneumophila. ‘Bacterial Disease’ contains chapters on a wide variety of infectious diseases arranged under headings which include respiratory tract infections, diarrheal diseases, sepsis, sexually transmitted diseases, tuberculosis and leprosy. These give an outline of the history, signs and symptoms of the diseases together with a description of the characters of the pathogenic organisms involved. The last section contains information on antimicrobial therapy and immunization. This book is remarkable in its scope and as an accurate up-todate account of what most medical bacteriologists consider information essential for the laboratory diagnosis and treatment and prevention of bacterial disease. Not only does it contain all the facts that one could expect of a medical student, it might be recommended as a handy reference book for any clinician in general medicine, surgery or general practice. Douglas D. Smith

Fundamentals of Oncology, 2nd ed., HENRYC. PITOT. 1981. Marcel Dekker, Inc., New York. 304 pp., illustrated. ISBN 0 8247 1419 9. $16.50. The second edition of this short introduction to oncology is most welcome. The text has been revised, new and improved figures and tables have k e n included, and a short chapter on principles of cancer chemotherapy has been added. This text remains the best overview of the fundamentals of oncology. It is strongly recommended for any student, scientist or clinician entering the field of cancer research or cancer treatment. Martin Tattersall

Microbiology of the Human Skin, W. C . NOBLE.(Vol. 2 in Major Problems in Dermatology.) 1981. Lloyd-Luke (Medical Books) Ltd., London. 443 pp., illustrated. ISBN 0 85324 150 3. f25.00. This is a very well presented book covering a broad and often controversial field. It is an academic text and although it is very clearly written the numerous references in the text make reading somewhat slow. The author has not shirked controversy but gives opposing points of view in various references and in some cases these are quite old as there has not been new work done in many areas. On the whole it is an excellent book whrch would benefit both practising and academic pathologists and dermatologists. It is written in such a way as to raise many questions and while being an excellent reference book also manages to stimulate one to think far beyond its

BOOK REVIEWS

scope. It is thoroughly recommended for anybody with an interest in this field. R . B. McCuflagh Gut Hormones, 2nd ed. Eds STEPHEN R. BLOOM& JULIAM. POLACK. I98 1, Churchill Livingstone, Edinburgh, London, New York. Australian distributor, Longman Group Ltd., Melbourne. 605 pp.. illustrated. ISBN 0 443 23239 8. $67.20.

The bewildering subject of gut hormone production and function is thoroughly presented in this second edition. Sadly it generates less, rather than more order, for it presents yet further evidence for a seemingly extremely complex, diffuse and inter-related system of peptide producing cells with not only endocrine, but also paracrine and neurocrine functions. Putatively they are involved in a wide range of biochemical and physiological processes. Despite the 165 contributors, repetition of material is not a significant feature. The editors are to be congratulated on this account. Indeed, the preface refers to a ‘high pressure editorial technique’ which also resulted in a printer’s deadline being met only 2 months after the initial request to authors for a contribution. It is, therefore, disappointing that the bibliography does not extend beyond 1980 and many papers which are referred to, are still listed as ‘in press’. We are now in 1982 and it is a great pity that such editorial effort has not been better rewarded. The book begins with an editor’s introduction followed by an historical background in which it is pleasing to see proper acknowledgement of Dr R. A. Gregory, the physiologist of Liverpool University in the United Kingdom and Dr V. Mutt the biochemist of the Karolinska Institute, Stockholm, Sweden, who were the pioneer scientists in this particular field of endeavour. There follow papers concerned with some basic chemistry, the methodologies used in the study of these hormones, their mode of action and release from the cells which produce them and a section concerning the developmental origin of these cells. Thereafter the book deals with different hormones in turn, e.g. gastrin, pancreatic polypeptide, secretin, cholecystokinin, tetrin, gastrointestinal inhibitory polypeptide, motilin, neurotensin, glucagon, somatostatin and the numerous neuropeptides. Each is covered in depth with a consideration of site of origin, its chemistry, its variants, its actions in experimental situations and its possible physiological role in humans. The final section concerns pathology and is the most disappointing. Perhaps this is a reflection of the current state of the art in the field of gut hormones. As an example of this, one could reflect that every final year medical student will know that a gastrin producing tumour is associated with high acid output peptic ulceration, but are we any nearer to understanding the role of gastrin in the etiology ofthe usual peptic ulcer? It is to the editors’ credit that with so many contributors the book retains a theme. There are, however, a few curious anomalies, namely, the inclusion of a section on prostaglandins and a paper on ‘Gut hormone response in the human neonate’ under the Pathoiogy section which would have been better placed following the paper on the ‘Development of regulatory peptides in the human fetal intestine’.

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In summary, this book is not for those wanting a simplified presentation of the anatomy, chemistry and pathophysiology of the gut hormone system, rather it is for those with an active interest in wishing to be abreast of the latest literature without reverting to more timeconsuming methods. There is every indication in this particular field of research, expanding at its present rate, that a more definitive work is a long way off. Current immunologically based methodology has probably produced some spurious results. Many of the increasing number of ‘new hormones’ now being reported may prove to be byproducts or chain products of metabolic pathways concerned in the manufacture or breakdown of fewer hormones with which they share common antigen binding sites. R . Whitehead Medical Examination Review: Pathology, 7th ed., M. ALI, E. V. BRAUN& A. 0. FAYEMI.1981. Medical Examination Publishing Co. Inc., New York. 370 pp.. soft cover, ihstrated. ISBN 0 87488 204 4. $11.75.

This book is specifically designed to give practice to candidates sitting various American examinations, including the Educational Commission on Foreign Medical Graduates (ECFMG) and the Visa Qualifying (VQE), in the subject ofpathology. As such it fulfils its aim. It is divided into 15 sections which include case studies; general pathology and immunology; infectious and parasitic diseases; metabolic, genetic and endocrine diseases; laboratory medicine; pediatric and obstetric pathology; and 9 anatomical systems. Each section has questions phased in a variety of ways such as ‘one best response’, matching, ‘multiple true-false’ etc. with answers and commentary at the end of the section. A few references, mainly to major pathology tomes, to enable further reading, are listed at the end of the book. Pathology in general and in detail is comprehensively covered by 1060 questions. It is suggested that prospective exam candidates identify by self assessment which subject areas need more preparation. The editors state that ‘each question has been scrutinized by specialists to verify that it is relevant and current’. However, a few questions are obviously wrong, possibly due to misprinting in some instances, and some remain ambiguous even after reading the answers and commentary. In the Case Studies section, several of the black and white photographs (of macroscopic and microscopic pathology) are indistinct and fail to show the lesion to a satisfactory degree, making it almost impossible to select the initial appropriate answer upon which the subsequent questionslanswers hinge. American ‘medspeak’ and use of eponyms repeatedly appear, but this could be helpful to candidates hopeful of working in the U.S.A. In short, a useful book for its designed purpose-sitting American examinations in pathology-but not without some faults and since its aim is to review knowledge, not a book of widespread interest. The library’s copy would be close enough to borrow if needed. C . S . Lauer