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one author, the text is catholic in its presentation of material and does not have the sometimes opinionated overtone of a monograph. The reader would expect the text to include chapters on embryology, congenital abnormalities, anatomy, biomechanics, clinical and radiographic evaluation, surgi cal approaches, arthritis, fractures, dislocations, and tumors—and it does. In my opinion, the large chapter on regional, variational, and surgical anatomy is the best presentation on this aspect of the shoulder published anywhere. The author's work on biologic aging—based on dissection of 352 shoulders—is thoroughly reported and will stand as a classic. Chapters on analysis of pain in this region and sports mechanics and injuries have been included. Each chapter is up to date, well illustrated, and extensively referenced. Because the text is so well ar ranged, the appended index is almost unnecessary. Before publication of this edition, choosing among the five available texts on the shoulder was difficult. This is no longer the case. This text is an excellent example for other potential authors who are specialists in a region of the musculoskeletal system. Robert H. Cofield, M.D. Department of Orthopedics
Basics of Respiratory Therapy: A Laboratory Manual, by Frank Sinsheimer, 275 pp, with illus, $15.95, Boston, Little, Brown & Company, 1983 This combined laboratory manual and workbook is aimed at the student respiratory therapist or technician. It is obviously the product of one instructor's approach and is considerably less than encyclopedic in its coverage. Those subjects that are treated are reviewed with a logic and thoroughness appropriate to a laboratory workbook. Although the illustrations consist of somewhat primitive line drawings and a few graphs and tables, they are adequate for a laboratory manual. The discussions about the hardware of respiratory therapy are somewhat uneven, certain items being ex haustively analyzed and others being totally neglected. Some of the important voids are arterial blood gas equipment, gas analyzers, safety principles in the hand ling of oxygen and some compressed gases, and the principles of sterilization. All of the pages are perforated near the binding, and it appears to be the intent of the author or publisher to have the entire volume, including the title page and the index, consumed by the student. When the reader is halfway
through the book, the binding, cover, and remaining pages may have a somewhat unstable relationship be cause of these perforations, but this aspect was not tested. This laboratory manual might satisfy the needs of an instructor who has neither the time nor the facilities to produce his own book, but it would be of only modest use to the established program instructor who would likely prefer not to stay within the constraints imposed by this volume. Edward P. Didier, M.D. Department of Anesthesiology
Surgery of the Pancreas, by John R. Brooks, 492 pp, with illus, $55, Philadelphia, W. B. Saunders Company, 1983 This book, aimed at both the "senior surgeon and young resident," intends to provide a "contemporary review of basic science and clinical practice." The list of contribu ting authors, in addition to faculty members at Harvard Medical School, includes many notable authorities from across the United States. The editor, who is also the author of many chapters, is an international figure in pancreatic surgery. As such, the reader would expect a valuable synthesis of his extensive experience with cur rent knowledge and techniques. Unfortunately, the book falls short of this expectation. All aspects of the pancreas are represented in the 492 pages, which are divided into 38 chapters. These include anatomy, physiology, pathology, several radiologic sec tions, acute and chronic pancreatitis and complications thereof, surgical techniques, benign and malignant pan creatic and periampullary neoplasms, irradiation and chemotherapy, endocrine disease, trauma, medical and nutritional treatment, and transplantation. Each chapter is extensively referenced, and a useful index is ap pended. A picture and brief curriculum vitae of each contributor add a thoughtful touch. A surgically oriented volume that successfully inte grates the expertise of many nonsurgical specialists is uncommon. Brooks' book also suffers in this respect. The chapters on anatomy, biochemistry and physiology, and ultrasound imaging are dry and technical, and they lack the appropriate surgical perspective that a skillful editor should be able to produce. Many chapters are brief, concisely addressing specific and limited topics and thereby facilitating access to these subjects. With this approach, however, the chapters on endoscopic retrograde pancreatography and computed
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tomography, both of which are significant advances in the field of pancreatic surgery, are inadequate and super ficial. Even with the space constraints imposed by a single volume, these studies should have received more attention in both the text and the illustrations. Repetition throughout the book seems excessive, even in light of the multiple authors. The illustrations and figures are generally good with the exception of those in the chapters on pancreatic resection, which are rather unrealistic and misleading. These criticisms aside, without exception the data presented are current and comprehensively reviewed. Basic concepts are generally well presented, and contro versial issues are acknowledged and discussed from the viewpoints of both pro and con. An example is the excellent chapter on acute pancreatitis in which differ ences of opinion are recognized with regard to treatment, but the author's approach is logically outlined and well substantiated. Considerable time and effort were obviously expended in the preparation of this book. It offers surgical residents a reasonably priced, we 11-referenced, single source of current data on surgical procedures of the pancreas. Nevertheless, it is disappointing that Dr. Brooks did not exercise his editorial prerogative to impart "special in sights" that would distinguish this book as truly valuable for the "senior surgeon." Clive S. Grant, M.D. Department of Surgery
Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, 3rd ed, by Marvin H. Sleisenger and John S. Fordtran, 1,850 pp, with illus, $89.50 (single vol), Philadelphia, W. B. Saunders Company, 1983 The third edition of Gastrointestinal Disease, by Sleiseng er and Fordtran, is a superb, up-to-date, and comprehen sive treatment of the subject by recognized experts in the field of gastroenterology. As in previous editions, how ever, liver disease is excluded, an intentional limitation of scope. The previous editions have become the standard text book of gastroenterology, and in preparing the new edition, the editors have expanded the sections that review the pathophysiology of disease and have updated their presentation of radiologic and endoscopic tech niques as applied to lesions of the gastrointestinal tract. In addition, new emphasis has been given to the sub ject of nutritional management of patients, with chapters
ranging from behavioral eating problems to considera tions of various methods of intensive nutritional support. Bibliographies at the end of each chapter are complete and timely. This edition will serve as an up-to-date, reliable reference volume for all students, residents, and practitioners who are interested in the subject of gastro intestinal disease. Richard E. Sedlack, M.D. Division of Gastroenterology and Internal Medicine
FUO: Fever of Undetermined Origin, edited by Henry W. Murray, 351 pp, with illus, $39.50, Mount Kisco, New York, Futura Publishing Company, 1983 Patients with fever are frequently diagnostic and thera peutic challenges. This book attempts to provide a single, detailed source of updated information for house officers and experienced clinicians to use when confronted by a patient with fever of undetermined origin. Because of the outstanding organization and editing, it succeeds in achieving that objective. The book is divided into seven sections for easy access. The first section contains an excellent review of the basic biologic mechanisms of regulation of temperature and production of fever. The second section covers causes of the syndrome of fever of undetermined origin, which have been classified into infectious, neoplastic, rheu matic, drug, factitious, and miscellaneous. Section three is a guide to eliciting the history, performing the physical examination, and planning the diagnostic evaluation; it contains an abundance of practical advice on the ap proach to the febrile patient. Section four reviews diag nostic procedures and laboratory methods. This area has probably changed more rapidly in recent years than any other, because of new techniques for scanning and biop sy procedures. Although this section is brief, the studies and indications are well described. Section five consists of chapters that address specific patients with fever of undetermined origin, such as those in community hospi tals, elderly patients, travelers, children, those who have undergone an operation, those who are immunocompromised, and rural-area patients. Although there is a con siderable amount of overlap with material in section two, this section allows the reader to review possibilities raised by specific patients. The chapter on the patient from a rural area is basically a monograph on North American zoonoses and is the best collection of this information that I have seen. Section six deals with the