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Textbook of Bilio-Pancreatic Diseases
776 PRINT AND MEDIA REVIEWS
clinical significance, advantages, and limitations of all liver chemistry tests and viral serological testing are nicely outlined, and numerous radiographs add clarity to the chapters on diagnostic and interventional radiology. Uniformity of style is lacking in the subsequent sections dealing with specific liver conditions. The chapters on disorders of porphyria and bilirubin metabolism are encyclopedic as is the excellent section on pediatric liver disease; although exceptionally well written, however, they seem out of place in this text with an intended readership of primary care physicians. Some notable omissions in the book were discussions of hepatorenal syndrome, cholestasis of sepsis, and total parenteral nutrition–induced liver disease, all subjects the general physician or hospitalist should be adept at identifying. Although liver transplantation is mentioned throughout the latter chapters, a separate chapter outlining indications and contraindications of transplantation and related issues is lacking. More patients are returning to their general physicians for long-term medical management following liver transplantation, and primary caregivers need a greater knowledge base in dealing with these patients’ unique problems. Although there are other texts available that are written for primary care physicians and that address the medical care of liver transplant patients, this textbook would have been better if it had a separate section on liver transplantation. Bottom Line: This text is not meant to be an encyclopedic review of clinical hepatology, but it adequately provides primary caregivers a thorough background in the evaluation and management of patients with liver disease. Despite some weaknesses, this manual will be a useful addition to a general practitioner’s library. THOMAS SCHIANO, M.D. Division of Liver Disease Mt. Sinai Medical Center New York, New York
Inflammatory Bowel Disease: A Guide for Patients and Their Families. 2nd edition. Edited by Stanley H. Stein and Richard P. Rood. 235 pp. $22.00. Lippincott-Raven Publishers, Philadelphia, Pennsylvania, 1999. ISBN 0-397-51771-8. It can be difficult to prepare a medical reference text for patients and their families because there is tremendous variation in each reader’s medical background. Editors Stanley H. Stein and Richard P. Rood and their contributing authors have done an excellent job in compiling a text that is easily readable and suitable for patients with varying levels of understanding of inflammatory bowel disease (IBD). The book opens with a basic overview of gastrointestinal (GI) anatomy and physiology to orient the reader with normal GI function. Each chapter thereafter presents a specific topic in IBD. Although each of the 14 chapters has a different author, there is uniformity of style throughout. The chapters are well organized into subsections and flow naturally and logically. Tables, charts, and other graphic aids are used appropriately. The graphics are generally easy to understand and present
GASTROENTEROLOGY Vol. 116, No. 3
additional insights that might not be evident from the text itself. Each chapter addresses a specific issue in IBD and can stand alone. Hence, if a patient desires, he or she can read only those chapters of interest and not miss any relevant information. The book is quite comprehensive and addresses the major topics of interest to patients. The information is up-to-date and accurate. Topics include the potential etiology of IBD, complications, pregnancy, diet and nutrition, medical therapy, surgical therapy, alternative therapy, and psychosocial issues. Susan Peck and David Piccoli have written an excellent and comprehensive chapter on inflammatory bowel disease in children. I found the chapter by Samuel Benjamin dealing with alternative therapy to be of particular interest. It seems that more and more patients are beginning to inquire about alternative medicine and are anxious to get their hands on information about the various therapies available. Dr. Benjamin encourages patients not to abandon standard medical therapy for alternative treatment but to use an ‘‘integrative’’ approach to medicine, by combining both allopathic and alternative therapies. Contained at the end of the book are two separate glossaries to assist patients with any cumbersome medical jargon. The editors created a ‘‘Glossary of Medical Terms’’ and a ‘‘Glossary of Surgical Terms.’’ The rationale behind this subdivision is not entirely clear because many of the terms in the surgical glossary could logically be included in the medical glossary. The glossaries are a bit sparse, but words that are omitted seem to be well defined within the text. Additionally, there is an extensive subject index at the end of the text to direct the reader quickly and easily to specific topics. Bottom Line: This book should be recommended by physicians to all their patients with IBD. IBD is a complex and chronic disease; with the aid of this book, the well-educated patient can confront the challenges of this disorder more effectively. KEVIN M. KNOBLOCK Center for the Study of Inflammatory Bowel Disease Massachusetts General Hospital Boston, Massachusetts
Textbook of Bilio-Pancreatic Diseases. Volumes I–IV. By W. Hess and G. Berci. $439.75. Piccin Nuova Libraria Spa, Italy, 1997. ISBN 8829911984. This book is a classic—a must-buy for a complete library of hepatic, biliary, and pancreatic books! It represents a tremendous amount of work by some of the classic teachers in this discipline: 4 volumes, 140 chapters, 38 contributors, 2700 pages, 550 tables, 1100 illustrations, and more than 25,000 references. The book provides a great historical overview through a European slant on hepatopancreatobiliary (HPB) surgery. It gives a dramatically perceptive and comprehensive treatise on the state-of-the-art from 1988 to 1990 and should not be used as a current reference. Nevertheless, the book is a classic.
March 1999
Priced at $439.75, this textbook represents the definitive work of two masters in biliary and pancreatic surgery, Walter Hess and George Berci. These two principal authors have contributed so much of the therapy that we practice today. Their work is magnificently chronicled in this comprehensive textbook, which spans many years. Most of the other contributing authors are also master surgeons. The tireless reader will feel as though he or she is stealing important historical insights from these respected physicians. One must also admire the enormous task of translating this textbook from German, Italian, or French in which it was originally published. The appearance of the book is also striking. It is bright red, white, and blue. Next to other medical textbooks in a fairly large HPB library, this red book stands out, so much so that one of my new students went straight to this book to peruse, rather than any of the other classics on the shelves. The textbook weighs 21.2 pounds. When it first arrived, my secretary insisted that I carry it back into my office. She had just had surgery and did not want to injure herself! The 4 volumes are divided into the following 4 topics: volume I, the basic science behind many of the important HPB diseases; volume II, methods of diagnosis; volume III, treatment; and volume IV, strategies concerning diagnosis or treatment. Tucked at the end of volume IV is a wonderful history of surgery of the pancreas and biliary tract by Professor Praderi from Montevideo. The first 3 volumes represent the core of the book. The
PRINT AND MEDIA REVIEWS 777
figures and tables are excellent, particularly from a historical perspective. For example, surgical anatomy of the liver is beautifully presented by Dr. Hess, emphasizing the evolution of the anatomy appreciated during the 20th century by the French and Americans. The photographs in Dr. Starrzl’s chapter on liver transplantation are particularly attractive. The intended audience for this book must be those specialists particularly interested in this subspecialty. This textbook should not be used as the principal reference for medical students or residents. There are several other currently published textbooks that give a more current and readable focus on the subject. These comments are not meant to detract from the value of this book, which is wonderful. The presence of this book on the shelf will show to even the casual observer that its owner is dedicated to this field. Bottom Line: My recommendation is to buy this book if you have a profound interest in biliary and pancreatic disease. Use the book as an important, classic reference, not as a guide to current therapy.
WILLIAM C. MEYERS, M.D. Department of Surgery University of Massachusetts Medical School Worcester, Massachusetts
Image of the Month Answer Answer to Image of the Month Question (page 514): The CT scan shows small bowel wall edema with narrowing of the lumen (arrows). In view of the patient’s history, the most likely diagnosis is hereditary angioedema (HAE), which was confirmed by low C1-esterase inhibitor serum levels with impaired function and low serum C4 levels. HAE was subsequently diagnosed in the patient’s mother and two sons. Approximately 85% of cases of HAE are caused by an inherited autosomal dominant defect in the production of C1-esterase inhibitor, as in our patient. The remaining 15% have normal serum levels of a dysfunctional C1-esterase inhibitor protein, and therefore only C1-esterase function is impaired. HAE is best treated with C1-esterase inhibitor concentrate in patients with acute symptoms. The patient received 1000 U of C1-esterase inhibitor concentrate, resulting in clinical, radiological, and biochemical improvement within 2 days. She required a further 500 U of concentrate 2 months later. Although currently symptom-free, she will almost certainly require further infusions of concentrate. Fresh frozen plasma contains lower levels of C1-esterase inhibitor but can be used if the concentrate is unavailable. Acetylated artificial androgens (e.g., danazol) can be used prophylactically to increase hepatic production of C1-esterase inhibitor, but they are atherogenic and ineffective in ameliorating acute attacks. In our patient, danazol treatment was stopped after development of premature coronary atherosclerosis. For submission instructions, please fax the Editorial Office at (301) 951-0757, or write to: Editorial Office, 7910 Woodmont Avenue, 7th Floor, Bethesda, Maryland 02814-3015.
clinical significance, advantages, and limitations of all liver chemistry tests and viral serological testing are nicely outlined, and numerous radiographs add clarity to the chapters on diagnostic and interventional radiology. Uniformity of style is lacking in the subsequent sections dealing with specific liver conditions. The chapters on disorders of porphyria and bilirubin metabolism are encyclopedic as is the excellent section on pediatric liver disease; although exceptionally well written, however, they seem out of place in this text with an intended readership of primary care physicians. Some notable omissions in the book were discussions of hepatorenal syndrome, cholestasis of sepsis, and total parenteral nutrition–induced liver disease, all subjects the general physician or hospitalist should be adept at identifying. Although liver transplantation is mentioned throughout the latter chapters, a separate chapter outlining indications and contraindications of transplantation and related issues is lacking. More patients are returning to their general physicians for long-term medical management following liver transplantation, and primary caregivers need a greater knowledge base in dealing with these patients’ unique problems. Although there are other texts available that are written for primary care physicians and that address the medical care of liver transplant patients, this textbook would have been better if it had a separate section on liver transplantation. Bottom Line: This text is not meant to be an encyclopedic review of clinical hepatology, but it adequately provides primary caregivers a thorough background in the evaluation and management of patients with liver disease. Despite some weaknesses, this manual will be a useful addition to a general practitioner’s library. THOMAS SCHIANO, M.D. Division of Liver Disease Mt. Sinai Medical Center New York, New York
Inflammatory Bowel Disease: A Guide for Patients and Their Families. 2nd edition. Edited by Stanley H. Stein and Richard P. Rood. 235 pp. $22.00. Lippincott-Raven Publishers, Philadelphia, Pennsylvania, 1999. ISBN 0-397-51771-8. It can be difficult to prepare a medical reference text for patients and their families because there is tremendous variation in each reader’s medical background. Editors Stanley H. Stein and Richard P. Rood and their contributing authors have done an excellent job in compiling a text that is easily readable and suitable for patients with varying levels of understanding of inflammatory bowel disease (IBD). The book opens with a basic overview of gastrointestinal (GI) anatomy and physiology to orient the reader with normal GI function. Each chapter thereafter presents a specific topic in IBD. Although each of the 14 chapters has a different author, there is uniformity of style throughout. The chapters are well organized into subsections and flow naturally and logically. Tables, charts, and other graphic aids are used appropriately. The graphics are generally easy to understand and present
GASTROENTEROLOGY Vol. 116, No. 3
additional insights that might not be evident from the text itself. Each chapter addresses a specific issue in IBD and can stand alone. Hence, if a patient desires, he or she can read only those chapters of interest and not miss any relevant information. The book is quite comprehensive and addresses the major topics of interest to patients. The information is up-to-date and accurate. Topics include the potential etiology of IBD, complications, pregnancy, diet and nutrition, medical therapy, surgical therapy, alternative therapy, and psychosocial issues. Susan Peck and David Piccoli have written an excellent and comprehensive chapter on inflammatory bowel disease in children. I found the chapter by Samuel Benjamin dealing with alternative therapy to be of particular interest. It seems that more and more patients are beginning to inquire about alternative medicine and are anxious to get their hands on information about the various therapies available. Dr. Benjamin encourages patients not to abandon standard medical therapy for alternative treatment but to use an ‘‘integrative’’ approach to medicine, by combining both allopathic and alternative therapies. Contained at the end of the book are two separate glossaries to assist patients with any cumbersome medical jargon. The editors created a ‘‘Glossary of Medical Terms’’ and a ‘‘Glossary of Surgical Terms.’’ The rationale behind this subdivision is not entirely clear because many of the terms in the surgical glossary could logically be included in the medical glossary. The glossaries are a bit sparse, but words that are omitted seem to be well defined within the text. Additionally, there is an extensive subject index at the end of the text to direct the reader quickly and easily to specific topics. Bottom Line: This book should be recommended by physicians to all their patients with IBD. IBD is a complex and chronic disease; with the aid of this book, the well-educated patient can confront the challenges of this disorder more effectively. KEVIN M. KNOBLOCK Center for the Study of Inflammatory Bowel Disease Massachusetts General Hospital Boston, Massachusetts
Textbook of Bilio-Pancreatic Diseases. Volumes I–IV. By W. Hess and G. Berci. $439.75. Piccin Nuova Libraria Spa, Italy, 1997. ISBN 8829911984. This book is a classic—a must-buy for a complete library of hepatic, biliary, and pancreatic books! It represents a tremendous amount of work by some of the classic teachers in this discipline: 4 volumes, 140 chapters, 38 contributors, 2700 pages, 550 tables, 1100 illustrations, and more than 25,000 references. The book provides a great historical overview through a European slant on hepatopancreatobiliary (HPB) surgery. It gives a dramatically perceptive and comprehensive treatise on the state-of-the-art from 1988 to 1990 and should not be used as a current reference. Nevertheless, the book is a classic.
March 1999
Priced at $439.75, this textbook represents the definitive work of two masters in biliary and pancreatic surgery, Walter Hess and George Berci. These two principal authors have contributed so much of the therapy that we practice today. Their work is magnificently chronicled in this comprehensive textbook, which spans many years. Most of the other contributing authors are also master surgeons. The tireless reader will feel as though he or she is stealing important historical insights from these respected physicians. One must also admire the enormous task of translating this textbook from German, Italian, or French in which it was originally published. The appearance of the book is also striking. It is bright red, white, and blue. Next to other medical textbooks in a fairly large HPB library, this red book stands out, so much so that one of my new students went straight to this book to peruse, rather than any of the other classics on the shelves. The textbook weighs 21.2 pounds. When it first arrived, my secretary insisted that I carry it back into my office. She had just had surgery and did not want to injure herself! The 4 volumes are divided into the following 4 topics: volume I, the basic science behind many of the important HPB diseases; volume II, methods of diagnosis; volume III, treatment; and volume IV, strategies concerning diagnosis or treatment. Tucked at the end of volume IV is a wonderful history of surgery of the pancreas and biliary tract by Professor Praderi from Montevideo. The first 3 volumes represent the core of the book. The
PRINT AND MEDIA REVIEWS 777
figures and tables are excellent, particularly from a historical perspective. For example, surgical anatomy of the liver is beautifully presented by Dr. Hess, emphasizing the evolution of the anatomy appreciated during the 20th century by the French and Americans. The photographs in Dr. Starrzl’s chapter on liver transplantation are particularly attractive. The intended audience for this book must be those specialists particularly interested in this subspecialty. This textbook should not be used as the principal reference for medical students or residents. There are several other currently published textbooks that give a more current and readable focus on the subject. These comments are not meant to detract from the value of this book, which is wonderful. The presence of this book on the shelf will show to even the casual observer that its owner is dedicated to this field. Bottom Line: My recommendation is to buy this book if you have a profound interest in biliary and pancreatic disease. Use the book as an important, classic reference, not as a guide to current therapy.
WILLIAM C. MEYERS, M.D. Department of Surgery University of Massachusetts Medical School Worcester, Massachusetts
Image of the Month Answer Answer to Image of the Month Question (page 514): The CT scan shows small bowel wall edema with narrowing of the lumen (arrows). In view of the patient’s history, the most likely diagnosis is hereditary angioedema (HAE), which was confirmed by low C1-esterase inhibitor serum levels with impaired function and low serum C4 levels. HAE was subsequently diagnosed in the patient’s mother and two sons. Approximately 85% of cases of HAE are caused by an inherited autosomal dominant defect in the production of C1-esterase inhibitor, as in our patient. The remaining 15% have normal serum levels of a dysfunctional C1-esterase inhibitor protein, and therefore only C1-esterase function is impaired. HAE is best treated with C1-esterase inhibitor concentrate in patients with acute symptoms. The patient received 1000 U of C1-esterase inhibitor concentrate, resulting in clinical, radiological, and biochemical improvement within 2 days. She required a further 500 U of concentrate 2 months later. Although currently symptom-free, she will almost certainly require further infusions of concentrate. Fresh frozen plasma contains lower levels of C1-esterase inhibitor but can be used if the concentrate is unavailable. Acetylated artificial androgens (e.g., danazol) can be used prophylactically to increase hepatic production of C1-esterase inhibitor, but they are atherogenic and ineffective in ameliorating acute attacks. In our patient, danazol treatment was stopped after development of premature coronary atherosclerosis. For submission instructions, please fax the Editorial Office at (301) 951-0757, or write to: Editorial Office, 7910 Woodmont Avenue, 7th Floor, Bethesda, Maryland 02814-3015.