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Microcirculatory approaches to current therapeutic problems
Book reviews
STUDIES ON THE PHYSIOLOGICAL EMBRYONIC HEART. By Paul
ANATOMY
OF THE
N. Johnstone, A.B., M.D., F.A.C.S., F.I.C.S., Springfield, Ill., 1971, Charles C Thomas, Publisher, 139 pp. Price $11.50. Johnstone and his assistants have devised a photographic technique for recording the externally observable movements of the embryonic heart while simultaneously recording the electrocardiogram on the same photographic frames. This method was used by others many years ago and Johnstone, like the earlier investigators, has found that mechanical (motion) phenomena transpiring deep into the epicardium are not observable, whereas the electric phenomena originating from deep myocardial fibers as well as from superficial fibers are recorded. In spite of this shortcoming, such limited correlations are interesting and can have important physiologic applications. Johnstone’s description of his studies in this short monograph should interest experimentalists most, although the book contains information of value for all physicians. DIE BEDEUTUNG DEN
DER ADRENERGEN BLOCKADE FUR HAEMORREIAGISCAEN SCHOCR. Anaesthesiology
and Resuscitation. By G. Zierott, Berlin, Heidelberg, and New York, 1971, Springer-Verlag, 115 pp. Price $11.60. This paperback monograph of about 100 pages is a good review of the relationship of the sympathetic nervous system to hemorrhagic shock. Although there is nothing new to be found by those actively engaged in the field, the publication contains a fairly extensive review of the literature and includes a good bibliography. Perhaps the book’s chief function is its thought-provoking nature; it presents a discussion of the pathophysiology of experimental hemorrhagic shock, the role of sympathetic nervous system activity in the shock syndrome, hormonal activity and the effects of drugs, a description of a standard research model in rabbits and dogs, and aspects of the clinical treatment of hemorrhagic shock. Altogether this is a useful monograph on an extremely important albeit poorly understood subject. MICROCIRCULATORY APEUTIC PROBLEMS.
APPROACHES
TO CURRENT
TEIER-
Lung in Shock, Organ Transplantation, Diabetic Microangiopathy. Edited by Torn Ditzel and David H. Lewis, Base1 and New York, 1971, S. Karger AG, 156 pp. Price $12.50. These proceedings of a symposium on the microcirculatory approaches to current therapeutic problems was held in Aalborg, Denmark, in 1970. The sessions were concerned with three important problems, i.e., lung in shock, organ transplanta-
298
tion, and diabetic microangiopathy. Each sect&o includes brief papers of presentations delivered at the symposium; most of the contributors were from the Scandinavian countries. The reader will find the papers interesting but will discover that they vary considerably in detail, length, and value. HYPERTROPHIC
OBSTRUCTIVE
CARDIOMYOPATHY.
Ciba Foundation Study Group No. 37. Edited by G. E. W. Wolstenholme and Maeve O’Connor, London, 1971, J. & A. Churchill, Ltd., 220 pp, Price $8.00. . This is another interesting publication of the Ciba Symposia. In this series small study groups devote a day to a discussion of a subject; the discussion held on Fridav._. September 4. 1970. was concerned with hypertrophjc obstructive cardiomyopathy (HOCM). Even though HOCM is a relatively uncommon cardiac disease, it is important and presents interesting manifestations which challenge the clinician in diagnosis and treatment. Those in attendance at the symposium have been interested in this disease for many years. The physiologic, clinical, diagnostic, pathologic, and therapeutic aspects are very clearly presented. As usual, the question and answer discussions are most profitable to the reader. Most of the contributors to this discussion participated in the previous Ciba symposium on cardiomyopathy which eventually dealt almost entirely with HOCM. These same participants have reversed themselves a great deal during the past seven years. The definition of HOCM is now considered unclear: cardiac hypertrophy could not now be defined: some even spoke of HOCM as familial and non-familial, or as sporadic. This reviewer finds this new terminology highly arbitrary and unreliable. The classification of HOCM into hypertrophic and congestive types is even more difficult to accept, because the former is an anatomic term and the latter a physiologic one. Other opinions brought out that surgery is now considered to be of little value, that left ventricular catheterization is relied upon with undue confidence, and that, in fact, HOCM need not even be obstructive. This publication, read in association with the previous one of 1964, is extremely interesting and reveals a distressing state of confusion even in the minds of those who have studied the largest series of patients with HOCM. CONTRACTILE PROTEINS AND MUSCLE. Edited by Koloman Laki, New York, 1971, Marcel Dekker, Inc., 606 pp. Price $42.50.
This monograph on contractile proteins and muscle is excellent and should interest all cardiologists, as well as physiologists, biochemists, and physical
STUDIES ON THE PHYSIOLOGICAL EMBRYONIC HEART. By Paul
ANATOMY
OF THE
N. Johnstone, A.B., M.D., F.A.C.S., F.I.C.S., Springfield, Ill., 1971, Charles C Thomas, Publisher, 139 pp. Price $11.50. Johnstone and his assistants have devised a photographic technique for recording the externally observable movements of the embryonic heart while simultaneously recording the electrocardiogram on the same photographic frames. This method was used by others many years ago and Johnstone, like the earlier investigators, has found that mechanical (motion) phenomena transpiring deep into the epicardium are not observable, whereas the electric phenomena originating from deep myocardial fibers as well as from superficial fibers are recorded. In spite of this shortcoming, such limited correlations are interesting and can have important physiologic applications. Johnstone’s description of his studies in this short monograph should interest experimentalists most, although the book contains information of value for all physicians. DIE BEDEUTUNG DEN
DER ADRENERGEN BLOCKADE FUR HAEMORREIAGISCAEN SCHOCR. Anaesthesiology
and Resuscitation. By G. Zierott, Berlin, Heidelberg, and New York, 1971, Springer-Verlag, 115 pp. Price $11.60. This paperback monograph of about 100 pages is a good review of the relationship of the sympathetic nervous system to hemorrhagic shock. Although there is nothing new to be found by those actively engaged in the field, the publication contains a fairly extensive review of the literature and includes a good bibliography. Perhaps the book’s chief function is its thought-provoking nature; it presents a discussion of the pathophysiology of experimental hemorrhagic shock, the role of sympathetic nervous system activity in the shock syndrome, hormonal activity and the effects of drugs, a description of a standard research model in rabbits and dogs, and aspects of the clinical treatment of hemorrhagic shock. Altogether this is a useful monograph on an extremely important albeit poorly understood subject. MICROCIRCULATORY APEUTIC PROBLEMS.
APPROACHES
TO CURRENT
TEIER-
Lung in Shock, Organ Transplantation, Diabetic Microangiopathy. Edited by Torn Ditzel and David H. Lewis, Base1 and New York, 1971, S. Karger AG, 156 pp. Price $12.50. These proceedings of a symposium on the microcirculatory approaches to current therapeutic problems was held in Aalborg, Denmark, in 1970. The sessions were concerned with three important problems, i.e., lung in shock, organ transplanta-
298
tion, and diabetic microangiopathy. Each sect&o includes brief papers of presentations delivered at the symposium; most of the contributors were from the Scandinavian countries. The reader will find the papers interesting but will discover that they vary considerably in detail, length, and value. HYPERTROPHIC
OBSTRUCTIVE
CARDIOMYOPATHY.
Ciba Foundation Study Group No. 37. Edited by G. E. W. Wolstenholme and Maeve O’Connor, London, 1971, J. & A. Churchill, Ltd., 220 pp, Price $8.00. . This is another interesting publication of the Ciba Symposia. In this series small study groups devote a day to a discussion of a subject; the discussion held on Fridav._. September 4. 1970. was concerned with hypertrophjc obstructive cardiomyopathy (HOCM). Even though HOCM is a relatively uncommon cardiac disease, it is important and presents interesting manifestations which challenge the clinician in diagnosis and treatment. Those in attendance at the symposium have been interested in this disease for many years. The physiologic, clinical, diagnostic, pathologic, and therapeutic aspects are very clearly presented. As usual, the question and answer discussions are most profitable to the reader. Most of the contributors to this discussion participated in the previous Ciba symposium on cardiomyopathy which eventually dealt almost entirely with HOCM. These same participants have reversed themselves a great deal during the past seven years. The definition of HOCM is now considered unclear: cardiac hypertrophy could not now be defined: some even spoke of HOCM as familial and non-familial, or as sporadic. This reviewer finds this new terminology highly arbitrary and unreliable. The classification of HOCM into hypertrophic and congestive types is even more difficult to accept, because the former is an anatomic term and the latter a physiologic one. Other opinions brought out that surgery is now considered to be of little value, that left ventricular catheterization is relied upon with undue confidence, and that, in fact, HOCM need not even be obstructive. This publication, read in association with the previous one of 1964, is extremely interesting and reveals a distressing state of confusion even in the minds of those who have studied the largest series of patients with HOCM. CONTRACTILE PROTEINS AND MUSCLE. Edited by Koloman Laki, New York, 1971, Marcel Dekker, Inc., 606 pp. Price $42.50.
This monograph on contractile proteins and muscle is excellent and should interest all cardiologists, as well as physiologists, biochemists, and physical