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Perinatal research, in British medical bulletin
BOOK REVIEWS "the effect of these drugs is thus similar to that resulting from depletion of norepinephrine levels by reserpine and guanethidine", while p. 191 states "one of the characteristic effects of this group of drugs is their ability to antagonise and to reverse the ... effects of monoamine releasing drugs such as reserpine". Concerning the monoamine oxidase inhibitors, on p. 190 the reader is referred to p. 34 for a review of their mechanism of action, but page 34 contains no mention of them. Nor is there such a review elsewhere in the book: the reader is forced to make do with the three sentences intended as a "brief summary" of their mecha n isms of action given on p. 190. Thus those interested in drugs and behaviour are likely to be disappointed. On the other hand, as a Primer in Neuropsychopharmacology, which is its subtitle, the book has more to offer. Its discussion of basic neuropharmacological principles is sound and concise, including its description of the structure of cells in general and ofneurones in particular, of synapses and neurotransmitters and of the functional
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organisation of the central nervous system. Three chapters are devoted to biological factors affecting drug activity, mechanisms of drug action and sources of variability in drug activity: these contain some good general pharmacology, which can, however, be found in other textbooks. The last chapter, entitled "Pharmacology of the CNS" has some interesting sections on cholinergic and adrenergic symipses and on serotonergic mechanisms which may stimulate the reader to follow up the references in the well-selected bibliography. The claim on the jacket that this book "explores the basic behavior principles of psychoactive drugs so that practitioners as well as students in the fields of neurophysiology, neuropharmacology, neurochemistry and behavioral psychology can gain major insights into the interactions between drugs and human behavior" is hardly justified. Nevertheless the book could be of use as an introduction for research workers, unfamiliar with basic pharmacology, who wish to investigate psychotropic drugs. HEATHER ASHTON
Perinatal Research, in British Medical Bulletin, Vol. 31, No. 1, January 1975, British Council, London, £3.50. Few practising neurologists would spare a glance at this issue of the Bulletin if they noticed it on a library shelf. But they should, especially if they admit to wishing occasionally for a more active role in preventing as well as in identifying neurological disease. There is material here to set them thinking about how to prevent perinatal brain disease. As a bonus there are interesting sidelights on the development of human cerebral function. Fifteen articles cover areas of perinatal research from respiratory physiology to the role of the reninangiotensin system (J. C. Mott). K. Boddy and G. S. Dawes describe the monitoring of fetal breathing by an ultrasonic technique. Human fetal breathing may be detected as early as I1 weeks' gestation. Abnormal breathing may give early warning of impending fetal distress so we may find yet another technique of fetal monitoring added to the increasing technology of obstetrics or fetal paediatrics. Certainly we must now begin to look at "delay in the onset" of respiration after birth in the light of what changes in breathing have gone before. Two paoers on fetal lung maturation (by M. E. Avery and E. O. R. Reynolds) emphasize the revolution which has occurred in our understanding of the respiratory distress syndrome and in its management since the discovery of the importance of surfactant and the development of better techniques of ventilation.
The implications for prevention of perinatal cerebral anoxic damage are obvious. R. S. Comline and M. Silver discuss placental transfer of blood gases. D. Hull reviews the role of fatty acids as a source of cellular energy in fetal tissues, while H. J. Shelley and her colleagues discuss the control of carbohydrate metabolism. The important topic of the role of the fetal endocrine system in the initiation of parturition is reviewed by J. R. G. Challis and G. D. Thorburn. In the introduction K. W. Cross speculates that this will have repercussions in obstetric practice in a few years. If it helps to avoid mistakes in the timing of induced labour it will be welcome. Articles by G. Alexander and by E. Hey on temperature regulaton emphasise the great importance of maintaining a state of thermal neutrality in preterm infants as part of the overall attempt to imitate the homoeostasis of the fetus. G. R. van Petten writes about fetal pharmacology, concentrating on the B-adrenoceptor responses and using as his model the unanaesthetised fetal lamb. C. M. Mistretta and R. M. Bradley have a fascinaing article on fetal taste and swallowing in which they speculate on taste as a mechanism by which the fetus might monitor and control the composition of the amniotic fluid. Finally P. A. Davies and A. L. Stewart have written a valuable summary of present knowledge of the relationship of low birth weight to subsequent cerebral function. The great
649
organisation of the central nervous system. Three chapters are devoted to biological factors affecting drug activity, mechanisms of drug action and sources of variability in drug activity: these contain some good general pharmacology, which can, however, be found in other textbooks. The last chapter, entitled "Pharmacology of the CNS" has some interesting sections on cholinergic and adrenergic symipses and on serotonergic mechanisms which may stimulate the reader to follow up the references in the well-selected bibliography. The claim on the jacket that this book "explores the basic behavior principles of psychoactive drugs so that practitioners as well as students in the fields of neurophysiology, neuropharmacology, neurochemistry and behavioral psychology can gain major insights into the interactions between drugs and human behavior" is hardly justified. Nevertheless the book could be of use as an introduction for research workers, unfamiliar with basic pharmacology, who wish to investigate psychotropic drugs. HEATHER ASHTON
Perinatal Research, in British Medical Bulletin, Vol. 31, No. 1, January 1975, British Council, London, £3.50. Few practising neurologists would spare a glance at this issue of the Bulletin if they noticed it on a library shelf. But they should, especially if they admit to wishing occasionally for a more active role in preventing as well as in identifying neurological disease. There is material here to set them thinking about how to prevent perinatal brain disease. As a bonus there are interesting sidelights on the development of human cerebral function. Fifteen articles cover areas of perinatal research from respiratory physiology to the role of the reninangiotensin system (J. C. Mott). K. Boddy and G. S. Dawes describe the monitoring of fetal breathing by an ultrasonic technique. Human fetal breathing may be detected as early as I1 weeks' gestation. Abnormal breathing may give early warning of impending fetal distress so we may find yet another technique of fetal monitoring added to the increasing technology of obstetrics or fetal paediatrics. Certainly we must now begin to look at "delay in the onset" of respiration after birth in the light of what changes in breathing have gone before. Two paoers on fetal lung maturation (by M. E. Avery and E. O. R. Reynolds) emphasize the revolution which has occurred in our understanding of the respiratory distress syndrome and in its management since the discovery of the importance of surfactant and the development of better techniques of ventilation.
The implications for prevention of perinatal cerebral anoxic damage are obvious. R. S. Comline and M. Silver discuss placental transfer of blood gases. D. Hull reviews the role of fatty acids as a source of cellular energy in fetal tissues, while H. J. Shelley and her colleagues discuss the control of carbohydrate metabolism. The important topic of the role of the fetal endocrine system in the initiation of parturition is reviewed by J. R. G. Challis and G. D. Thorburn. In the introduction K. W. Cross speculates that this will have repercussions in obstetric practice in a few years. If it helps to avoid mistakes in the timing of induced labour it will be welcome. Articles by G. Alexander and by E. Hey on temperature regulaton emphasise the great importance of maintaining a state of thermal neutrality in preterm infants as part of the overall attempt to imitate the homoeostasis of the fetus. G. R. van Petten writes about fetal pharmacology, concentrating on the B-adrenoceptor responses and using as his model the unanaesthetised fetal lamb. C. M. Mistretta and R. M. Bradley have a fascinaing article on fetal taste and swallowing in which they speculate on taste as a mechanism by which the fetus might monitor and control the composition of the amniotic fluid. Finally P. A. Davies and A. L. Stewart have written a valuable summary of present knowledge of the relationship of low birth weight to subsequent cerebral function. The great