TECHNIQUES IN GENERAL THORACIC SURGERY

TECHNIQUES IN GENERAL THORACIC SURGERt By R. MAURICE HOOD. New York: W.B. Saunden Company, 1985, 245 pp. t35.00 TedarUqua ita ~ ThortJck Surgery, by R. Maurice Hood, is a concise, weD-illustrated and practical guide to the perioperative and operative care of the noncardiac, thoracic surgical patient It is intended fOr residents and "Dows involved in the management of these patients, and in this regard it serws its stated purpose weD. It contains 11 chapten and a selected reading list and is weD-indexed. The cbapten on pre- and postoperative care are well done, although the author tends to be more aggressive with the use of early reoperation tOr certain complications, w, bronchopleural &stula, than the reviewer. The section on operative procedures fOr trauma is comprehensive, even including VWlunds of the ~ls of the base ofthe neck. The chapter on thoracic incisions is likewise comprehensive, although I prefer excision of the second costal cartilage when doing an anterior mediastinotomy b exploration of the mediastinum. The pulmonary anatomy is standard, except the artery to the anterior segment of the left upper lobe is described as arising from the interlobar portion of the left pulmonary artery. This is an uncommon origin fOr this vessel. In most patients, this vessel is fOund more superiorly in the region of the take-oft" of the apical posterior branch and runs anteriorly beneath the branches of the superior pulmonary vein. The sections on pulmonary and esophageal procedures are quite satisfactory and reBect the attitudes and habits of the autho~ The author obviously fawn the use of stapling instruments in most situations although, while they are certainly acceptable, the time honored methods of suture techniques should not be left unlearned by the young thoracic surgeon. The technique of transhiatal (non-thoracotomy) esophagectomy is not described. nor is the importance of proper placement of diaphragmatic incisions to avoid injury to the phrenic nerve noted. With these rare omissions, the book readily accomplishes its purpose and should be available tOr all general thoracic residents and feDows.

'I7aomtu ~ ShieltU, M.D.

ClUctJgo

CANDIDIASIS. Edited by GERALD ~ BoDEY and VICTOR FAINSTEIN. New York: Raven Press, 1985, 281 pp. t45.50

This is a comprehensive review of infections due to CandidtJ species. Dn. Bodey and Fainstein have collected, in 15 chapten, most of the literature published on CandidtJ. The text has been divided between clinical and noncIinical topics. Among the clinical areas, the chapten on C endoplatlaGlmUU and gastrointestinal candida infections are superb, as is the review of systemic candidiasis. Candida infections of the skin, genito-urinary tract and heart are covered with less emphasis and some redundancy. The chapter on mucocutaneous candidiasis should have been combined with cutaneous candidiasis. The lead in cbapten address the mycology and histopathology of C"ndidtJ infections. These are not so detailed with ini>rmation that they might confuse the novitiate, and are well referenced for easy access to methodologic infOrmation. Chapten dealing with radiologic diagnoses and laboratory, ie, serologic, diagnostic methods are both exceDent reviews. HowewJ; the latter is moomplete as it f8ils to reference any VWlrk PerfOrmed by Jeft'rey Jones and his co-authon, all ofwhich was published in Infection and Immunity within the last &ve years. Juxtaposed between these tOur cbapten on diagnostic methodology are two cbapten which serve as excellent introductory chapten to the clinical material. The &rst of these, by Donald B. Louria, reviews CaradUla infections in experimental animals. The second, by Charles B. Smith, is a brief but outstanding review of pathogenesis, host resistance and predisposing faeton. (M,rall, this text is a comprehensive, easily readable and enjoyable review of most major facets of Candida ~s. Serious students of CandidtJ will &nd it useful as a springboard into deeper undentanding of this ubiquitous pathogen. Joaeph R. Lentino, M.D., Ph.D. Hines,Illinoil ASTHMA: PHYSIOLOGl: IMMUNOPHARMACOLOCl: AND TREATMENT: 3rd International Symposium. Edited by A. BARRY KAY, K. FRANK AUSTEN and LAWRENCE M. LICHTENSTEIN. London: Academic Press, 1984, 442 pp. t79.00 The state of the science of asthma pathobiology is presented in this hardcover publication of the Proceedings of the Third International Conference on Asthma which was held at Nuneham Park. Nuneham Courtenany, OxfOrd, U.K. on May 16th to 18th, 1983. The VWlrld experts who presented at this

18

conference bring their reviews and updated VWlrk to a larger public through this book, along with well-edited discussions and an excellent summary. In truth, the text coven the immunophannacology of asthma with little on physiology or treatment The impressive review of the cellular and chemical mediaton of asthma is most valuable. One is informed not only of the role of the mast cell and its heterogenity, but also of the basophil, the alveolar macrophage, the eosinophil and other leukocytes. Of coune, a great deal of attention is paid to arachidonic acid metabolism with the resulting products of the Iipoxygenase path (leulcotrienes) and the cylooxygenase path (prostaglandins and thromboxanes). Many other chemical mediaton are also carefully discussed. These cells and chemicals are then reviewed with regard to the human and animal models of asthma. Early and late asthmatic response, exercise-induced asthma model and allergen exposure asthma are analyzed, with additional discussion on the role of inftammation in asthma. The latter part ofthe conference brings basic knowledge of immunopathogenesis to bear on the pharmacology of asthma as we know it today, and leaves us with the impression that we have a lot to learn. This text is not tOr every practitioner of chest medicine. The major role of this book is a reference tOr those who wish to uPdate their knowledge on the immunopharmacology ofasthma. It is however, a must fOr the library ofanyone who is seriously involved in the study of asthma.

Stanley W Epltein, M.D., F.e.C.l Toronto, Ontario INVASIVE CARDIOLOGY: CARDIOVASCULAR CLINIC. Edited by JOHN SPEER SCHROEDER. Philadelphia: EA. Davis Co, 1985,361 PI»- $50.00 Even after the recent decrease in morbidity and mortality, cardiovascular disease still remains the number one cause ofdeath today. This book provides an excellent summary of the current status of invasive techniques in both diagnosis and treatment of various cardiac disorden. Significant advances have been made since the early studies. Cardiac catheterization in combination with coronary angiogram have become "gold standard testing" fOr evaluation, especially fOr patients with coronary artery disease. Morbidity and mortality from these tests have diminished to an extent where they are used quite &equently at most of the major community hospitals. In the last decade, there have been tremendous advances in the treatment of acute myocardial infarction. The urgent cardiac catheterization has been found quite safe and has provided a good physiologic basis tOr thrombolactic therapy and coronary angioplasty. At this time, the limitation is usually the paucity of trained physicians and support personnel. nus is an excellent review of bedside hemodynamic monitoring, as well as percutaneous intra-aortic balloon counterpulsation and temporary physiologic pacing. The article on percutaneous transluminal coronary angioplasty shows significant advances in the technology of this procedure and the broadened spectrum of its indications that have been developed in a short time. Physiologic studies fOr arrhythmias are still limited to major centeno As the knowledge advances and as more speci&c drugs become available, this technique may enjoy wider use. One thought that comes to mind is that present day cost containment probably will make us more selective in utilizing this technique. In summary, overall this is an excellent review book and I find it quite useful fOr invasive cardiologists as well as Fellows in Cardiology training.

Moldt Sheth, M.D.

Henderson, kntucky RESPIRATORY MEDICINE. Edited by G. M. STERUNC. Chicago: Year Book Medical Publishen, 1984, 151 pp. $19.95

This volume is from the integrated clinical science series of books edited by George ~ McNicol, and aims to provide the basic and applied scientific knowledge and the art of clinical practice to medical students in a unified manner. It is also expected to assist teachen in adapting an integrated approach to teaching clinical medicine. The book contains eight chapten, each of which combines a discussion of the clinical and scientific aspects ofrespiratory disease. Chapter one coven the structure and development of the lung and chest wall and includes descriptions of developmental abnormalities ofthe lung and age-related changes. The second chapter spans the entire field of diagnostic methods fOr clinical investigation of lung disease, from clinical history to lung biopsy, in a mere 15 pages. The third and tOurth chapters provide fairly sophisticated discussions of lung mechanics and airway physiology, and the alterations caused by restrictive and obstructive lung disease. A tene but bOOrmative description of pulmonary edema, fibrosing alveolitis, upper respiratory tract obstruction, Continued on page 21