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Nonsurgical Biliary Drainage
Mayo Clin Proc, September 1985, Vol 60
Even though it is written mainly by authors who do not speak English, the book is easy to read. A bonus is the thorough review of the German and Japanese literature, most of which is unfamiliar to psychiatrists in the United States. If the reader is searching for specific treatment regimens for periodic psychoses, this book will be disappointing. For those interested in the history and the natural course of "periodic psychoses," however, this will be an appealing book. Toshihiko Maruta, M.D. Department of Psychiatry and Psychology
Hemostasis and Thrombosis (Butterworths International Medical Reviews: Hematology, Vol 2), edited by E. J. Walter Bowie and A. A. Sharp, 341 pp, with illus, $79.95, Stoneham, Massachusetts, Butterworth Publishers, 1985 This book is a collection of 10 concise monographs written by recognized experts, who review the current knowledge in various areas of hemostasis and thrombosis. Most of these contributions have clinical applications, but several of them are directed toward the knowledgeable practitioner or laboratory investigator, in that they discuss molecular structure and interaction. The first chapter is a thorough review of agents that affect all aspects of platelet function: aggregation, release, adhesion, calcium mobilization, and prostaglandin metabolism. It presents one of the most complete published lists of drugs that affect platelets. Also included is a short resume of clinical trials on the antithrombotic effects of various drugs. For ready reference, the chapter would have been enhanced by inclusion of a tabular summary of the agents and their sites of action in or on the platelet. The second chapter delves further into platelet function, particularly the problems that result from congenital defects and also from platelet-vessel wall interaction. It covers in detail prostaglandin metabolism in the platelet and the endothelium in relationship to both hemostasis and thrombosis. Chapter 3 deals with the factors that contribute to the "contact" phase of blood coagulation and their influence on processes in the body other than those involved with hemostasis, such as inflammation, arthritis, cholecystitis, shock immune reactions, and renal disease.
BOOK REVIEWS
643
In the fourth chapter, an excellent analysis of the various functions associated with the factor VIII molecule and how they relate to its structure is presented, as well as the therapeutic fractions that have been devised and their use in the treatment of congenital deficiencies. Chapter 5 is a scholarly discussion of the structure of the prothrombin molecule and the various factors associated with its conversion to thrombin. In chapter 6, fibronectin (which is not a coagulation factor) is described in its possible role in hemostasis and connective tissue structure. The seventh chapter catalogues congenital defects of the remaining coagulation factors and their influence on hemostasis. In the eighth chapter, the fibrinolytic system is reviewed, generally from the standpoint of experimental observations. The available therapeutic modalities for congenital coagulation factor defects (primarily hemophilia) are presented in chapter 9. Chapter 10 consists of a discussion of the causes, diagnosis, and treatment of both venous and arterial thromboses. Finally, in chapter 11, Charles A. Owen, Jr., one of the "old-time clotting experts," philosophizes about the past, present, and future of hemostasis. He wisely points out that although, through sophisticated research, the structure and amino acid sequence of most of the coagulation factors have been described, as yet no laboratory test is sensitive enough to screen for mild deficiencies, and only crude blood products are available for the treatment of bleeding problems. Despite the fact that this book is not a complete compendium of all aspects of hemostasis and thrombosis, it covers most of the subjects in which important problems have arisen recently. This book provides up-to-date material in this usually confusing area of medicine and an ample list of references for further pursuit of any particular related subject. J. N. Shanberge, M.D. William Beaumont Hospital Royal Oak, Michigan
Nonsurgical Biliary Drainage, edited by Meinhard Classen, JoeGeenen, and Keiichi Kawai, 126 pp, with illus, $25, New York, Springer-Verlag, 1984 This concise book reports the development of therapeutic techniques for draining the bile duct. Furthermore, it represents the first effort at compiling the results of a panel of experts who are perfecting these alternative procedures for palliation of biliary obstruction. The initial presentations emphasize that surgical intervention is the
644
BOOK REVIEWS
Mayo Clin Proc, September 1985, Vol 60
only curative approach and that histologic proof of distant metastases is the only means of establishing nonresectability and the suitability of the individual patient for palliative treatment. The frequent finding of nonresectability at the time of operation and the discouraging survival rate postoperatively increase the attraction of these alternative treatment modalities. Section 2 presents a thorough discussion of the percutaneous transhepatic approach for biliary drainage; it contains an excellent summary by Dr. J. S. Dooley. Areas of agreement and disagreement among the participants are developed. Extensive experience is thought to decrease the frequency of complications, as are certain differences in technique. Although most medical centers continue to use x-ray screening alone, Nakayama reported a lower complication rate when real-time ultrasound assistance was used. Section 3 deals with the transpapillary approach for draining the bile duct. Because the first nasobi liary catheter was designed only relatively recently (by Nagi in 1976) and Soehendra inserted the first biliary prosthesis in 1979, only limited experience is presented. Although many questions about nonsurgical biliary drainage remain unanswered—such as what are the optimal features for a prosthesis, which approach should be used, and which patients will benefit most from this procedure—I recommend this book to those interested in management and care of the patient with biliary obstruction. It should be particularly helpful to the interventional radiologist and endoscopist. Rollin W. Hughes, Jr., M.D. Division of Gastroenterology and Internal Medicine
Management of Diabetic Foot Problems, by George P. Kozak, Carl S. Hoar, Jr., John L. Rowbotham, FrankC. Wheelock, Jr., Gary W. Gibbons, and David Campbell, 250 pp, with illus, $39.50, Philadelphia, W . B. Saunders Company, 1984 Two dozen specialists from many areas of medicine contributed to this excellent text. The purpose of this volume was to present appropriate treatment modalities, from a practical point of view, for the multidisciplinary problem of foot disorders in patients with diabetes. This 20-chapter text reviews topics that range from foot care instructions for the diabetic patient without a pedal pathologic condition to the operative techniques for
arterial reconstruction and for amputation of the lower extremity. The first two chapters present an overall view of foot problems associated with diabetes and establish the needs and guidelines for proper examination of the lower extremities and particularly the feet in all patients who have diabetes. Chapters 3 and 4 deal with the pathogenesis of atherosclerosis and various vascular and neuropathic foot disorders. In chapter 3, an excellent discussion is presented on accelerated atherosclerosis in diabetes, and tables and figures augment the text material. In contrast, chapter 4 is brief and would have benefited from greater detail and the inclusion of illustrative material. The organization of the chapters seems appropriate except for chapters 7 through 12. The chapter "Diabetic Charcot Foot" should have preceded the chapter entitled "Other Arthritic Disorders in the Diabetic Foot." In addition, "Noninvasive Diagnostic Studies" would have been more suitably placed before "Arteriography" than between the chapters "Radiology of the Diabetic Foot" and "Infection in the Diabetic Foot." Although the placement of these chapters is not optimal, the content is excellent. Although the subject of neuropathies is addressed briefly in several chapters, not until the last chapter ("Physical Rehabilitation") are the types of neuropathies discussed. A separate chapter could have been devoted to this important complication of diabetes. Nevertheless, several paragraphs in chapter 2 describe the management of diabetic neuropathies, and considerable attention is directed to the associated complications and their treatment—such as neuropathic ulcers in chapter 6, the diabetic Charcot joint in chapter 11, and the biomechanical considerations of neuropathic entities in chapter 5. The chapter "Local Treatment of the Diabetic Foot" provides an excellent discussion of bedside and outpatient dressing techniques, a commonly overlooked yet important subject. This " h o w - t o " chapter demonstrates treatment techniques for the infected diabetic foot and also presents drawings that depict the application of dressings. Duplication of material among chapters by different authors is present but not detrimental to the book. The graphics are superb throughout the text but especially in the chapters on arterial reconstruction and amputation. Moreover, eight pages of excellent-quality color plates depict 64 macroscopic and microscopic pathologic specimens. The four appendixes supply patient information from the Joslin Clinic and the New England Deaconess Hospi-
Even though it is written mainly by authors who do not speak English, the book is easy to read. A bonus is the thorough review of the German and Japanese literature, most of which is unfamiliar to psychiatrists in the United States. If the reader is searching for specific treatment regimens for periodic psychoses, this book will be disappointing. For those interested in the history and the natural course of "periodic psychoses," however, this will be an appealing book. Toshihiko Maruta, M.D. Department of Psychiatry and Psychology
Hemostasis and Thrombosis (Butterworths International Medical Reviews: Hematology, Vol 2), edited by E. J. Walter Bowie and A. A. Sharp, 341 pp, with illus, $79.95, Stoneham, Massachusetts, Butterworth Publishers, 1985 This book is a collection of 10 concise monographs written by recognized experts, who review the current knowledge in various areas of hemostasis and thrombosis. Most of these contributions have clinical applications, but several of them are directed toward the knowledgeable practitioner or laboratory investigator, in that they discuss molecular structure and interaction. The first chapter is a thorough review of agents that affect all aspects of platelet function: aggregation, release, adhesion, calcium mobilization, and prostaglandin metabolism. It presents one of the most complete published lists of drugs that affect platelets. Also included is a short resume of clinical trials on the antithrombotic effects of various drugs. For ready reference, the chapter would have been enhanced by inclusion of a tabular summary of the agents and their sites of action in or on the platelet. The second chapter delves further into platelet function, particularly the problems that result from congenital defects and also from platelet-vessel wall interaction. It covers in detail prostaglandin metabolism in the platelet and the endothelium in relationship to both hemostasis and thrombosis. Chapter 3 deals with the factors that contribute to the "contact" phase of blood coagulation and their influence on processes in the body other than those involved with hemostasis, such as inflammation, arthritis, cholecystitis, shock immune reactions, and renal disease.
BOOK REVIEWS
643
In the fourth chapter, an excellent analysis of the various functions associated with the factor VIII molecule and how they relate to its structure is presented, as well as the therapeutic fractions that have been devised and their use in the treatment of congenital deficiencies. Chapter 5 is a scholarly discussion of the structure of the prothrombin molecule and the various factors associated with its conversion to thrombin. In chapter 6, fibronectin (which is not a coagulation factor) is described in its possible role in hemostasis and connective tissue structure. The seventh chapter catalogues congenital defects of the remaining coagulation factors and their influence on hemostasis. In the eighth chapter, the fibrinolytic system is reviewed, generally from the standpoint of experimental observations. The available therapeutic modalities for congenital coagulation factor defects (primarily hemophilia) are presented in chapter 9. Chapter 10 consists of a discussion of the causes, diagnosis, and treatment of both venous and arterial thromboses. Finally, in chapter 11, Charles A. Owen, Jr., one of the "old-time clotting experts," philosophizes about the past, present, and future of hemostasis. He wisely points out that although, through sophisticated research, the structure and amino acid sequence of most of the coagulation factors have been described, as yet no laboratory test is sensitive enough to screen for mild deficiencies, and only crude blood products are available for the treatment of bleeding problems. Despite the fact that this book is not a complete compendium of all aspects of hemostasis and thrombosis, it covers most of the subjects in which important problems have arisen recently. This book provides up-to-date material in this usually confusing area of medicine and an ample list of references for further pursuit of any particular related subject. J. N. Shanberge, M.D. William Beaumont Hospital Royal Oak, Michigan
Nonsurgical Biliary Drainage, edited by Meinhard Classen, JoeGeenen, and Keiichi Kawai, 126 pp, with illus, $25, New York, Springer-Verlag, 1984 This concise book reports the development of therapeutic techniques for draining the bile duct. Furthermore, it represents the first effort at compiling the results of a panel of experts who are perfecting these alternative procedures for palliation of biliary obstruction. The initial presentations emphasize that surgical intervention is the
644
BOOK REVIEWS
Mayo Clin Proc, September 1985, Vol 60
only curative approach and that histologic proof of distant metastases is the only means of establishing nonresectability and the suitability of the individual patient for palliative treatment. The frequent finding of nonresectability at the time of operation and the discouraging survival rate postoperatively increase the attraction of these alternative treatment modalities. Section 2 presents a thorough discussion of the percutaneous transhepatic approach for biliary drainage; it contains an excellent summary by Dr. J. S. Dooley. Areas of agreement and disagreement among the participants are developed. Extensive experience is thought to decrease the frequency of complications, as are certain differences in technique. Although most medical centers continue to use x-ray screening alone, Nakayama reported a lower complication rate when real-time ultrasound assistance was used. Section 3 deals with the transpapillary approach for draining the bile duct. Because the first nasobi liary catheter was designed only relatively recently (by Nagi in 1976) and Soehendra inserted the first biliary prosthesis in 1979, only limited experience is presented. Although many questions about nonsurgical biliary drainage remain unanswered—such as what are the optimal features for a prosthesis, which approach should be used, and which patients will benefit most from this procedure—I recommend this book to those interested in management and care of the patient with biliary obstruction. It should be particularly helpful to the interventional radiologist and endoscopist. Rollin W. Hughes, Jr., M.D. Division of Gastroenterology and Internal Medicine
Management of Diabetic Foot Problems, by George P. Kozak, Carl S. Hoar, Jr., John L. Rowbotham, FrankC. Wheelock, Jr., Gary W. Gibbons, and David Campbell, 250 pp, with illus, $39.50, Philadelphia, W . B. Saunders Company, 1984 Two dozen specialists from many areas of medicine contributed to this excellent text. The purpose of this volume was to present appropriate treatment modalities, from a practical point of view, for the multidisciplinary problem of foot disorders in patients with diabetes. This 20-chapter text reviews topics that range from foot care instructions for the diabetic patient without a pedal pathologic condition to the operative techniques for
arterial reconstruction and for amputation of the lower extremity. The first two chapters present an overall view of foot problems associated with diabetes and establish the needs and guidelines for proper examination of the lower extremities and particularly the feet in all patients who have diabetes. Chapters 3 and 4 deal with the pathogenesis of atherosclerosis and various vascular and neuropathic foot disorders. In chapter 3, an excellent discussion is presented on accelerated atherosclerosis in diabetes, and tables and figures augment the text material. In contrast, chapter 4 is brief and would have benefited from greater detail and the inclusion of illustrative material. The organization of the chapters seems appropriate except for chapters 7 through 12. The chapter "Diabetic Charcot Foot" should have preceded the chapter entitled "Other Arthritic Disorders in the Diabetic Foot." In addition, "Noninvasive Diagnostic Studies" would have been more suitably placed before "Arteriography" than between the chapters "Radiology of the Diabetic Foot" and "Infection in the Diabetic Foot." Although the placement of these chapters is not optimal, the content is excellent. Although the subject of neuropathies is addressed briefly in several chapters, not until the last chapter ("Physical Rehabilitation") are the types of neuropathies discussed. A separate chapter could have been devoted to this important complication of diabetes. Nevertheless, several paragraphs in chapter 2 describe the management of diabetic neuropathies, and considerable attention is directed to the associated complications and their treatment—such as neuropathic ulcers in chapter 6, the diabetic Charcot joint in chapter 11, and the biomechanical considerations of neuropathic entities in chapter 5. The chapter "Local Treatment of the Diabetic Foot" provides an excellent discussion of bedside and outpatient dressing techniques, a commonly overlooked yet important subject. This " h o w - t o " chapter demonstrates treatment techniques for the infected diabetic foot and also presents drawings that depict the application of dressings. Duplication of material among chapters by different authors is present but not detrimental to the book. The graphics are superb throughout the text but especially in the chapters on arterial reconstruction and amputation. Moreover, eight pages of excellent-quality color plates depict 64 macroscopic and microscopic pathologic specimens. The four appendixes supply patient information from the Joslin Clinic and the New England Deaconess Hospi-