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Mayo Cliu Proc, June 1992, Vol 67
BOOK REVIEWS
tions well suited to the modality. This comprehensive book will be useful to many persons: fellows who are learning the basics of cardiac imaging, clinicians who want a deeper understanding of the various imaging modalities currently in use, and researchers who want a broad-based introduction to specific techniques. For example, the sections on digital coronary angiography and quantitative coronary angiography constitute a state-of-the-art summary, useful for even technically knowledgeable persons. The only trade off for this comprehensiveness is the sheer volume of the text-more than 1,300 pages. Because of the magnitude of the subject matter, the book has shortcomings. The sections on experimental, clinically unproven imaging methods such as cardiac magnetic resonance imaging, ultrafast computed tomography, and positron emission tomography are more detailed than is the section on conventional radionuclide imaging, despite the more extensive use and current application of radionuclide imaging. Direct and extensive discussions of the clinical aspects and utility of radionuclide imaging could be included in future editions. In addition, little attention is directed to threedimensional cardiac imaging techniques or current and future applications. Overall, the strengths of this book substantially outweigh its deficiencies. That a first edition could comprehensively cover a subject associated with rapidly changing technologies is remarkable. This reference source is a "must read" for all cardiologists. Robert S. Schwartz, M.D. Division of Cardiovascular Diseases and Internal Medicine
Textbook of Bunion Surgery, 2nd ed, edited by Joshua Gerbert, 569 pp, with illus, $80, Mount Kisco, New York, Futura Publishing Company, 1991 This text is devoted to the operative procedures of the first metatarsophalangeal joint. The three sections deal with the preoperative assessment, surgical procedures, and complications of bunion operations. Although the first edition had a separate chapter on the anatomic features of the foot, it is not included in the second edition; thus, the pertinent anatomic characteristics are presented in various chapters. The radiographs, line drawings, and illustrations are commendable and are more numerous in comparison with those in the first edition. The section on surgical procedures, which consists of 11 chapters, reflects the procedures most commonly performed by the surgical staff at the California College of Podiatric Medicine. Many of these chapters are devoted to a single
bunionectomy, including the Silver, McBride, Akin, Austin, and Keller operations and implant arthroplasty. The section on complications has chapters on iatrogenic hallux varus, intraoperative complications of bunion surgical procedures, and postoperative complications. This expanded section now includes hallux limitus and rigidus and a chapter on complications of implants. In summary, this multiauthored volume is an excellent text for surgeons analyzing the nuances of hallux valgus operations on the first metatarsophalangeal joint. James L. Graham, D.P.M. Section of Podiatry
Surgical Management of the Diabetic Patient, edited by Michael Bergman and Gregorio A. Sicard, 407 pp, with illus, $90, New York, Raven Press, 1991 In the preface, the editors of this typical multiauthored text make the following statement: "This book affords practical information for the detailed assessment of the diabetic patient from the early stages when surgery is considered through the surgical and postsurgical periods as well." In an attempt to provide this material, the editors have included contributions on carbohydrate metabolism, medical management, nutritional support, major diabetic complications, and special surgical considerations and procedures in patients with diabetes. Each working day at the Mayo Clinic, approximately five patients with diabetes undergo surgical procedures. Diabetes often presents special surgical risks and challenges of medical management. A well-organized, succinct textbook that outlines the care of patients with diabetes intraoperatively and perioperatively would be welcomed by surgeons, internists, and residents. Individually, many reviews in this volume are excellent. Unfortunately, in my opinion, the editors have failed in their task, inasmuch as no overall organization or cohesion exists. The authors seem to have written their reviews entirely independently, with minimal relationship to the efforts of other authors. The most serious example of this failure is the presentation of management of insulin intraoperatively. Almost every author has written recommendations for use of insulin. All recommendations vary in minor ways; the third chapter on this topic does not evaluate the advantages of each recommendation, nor does it unify the variations. The organizational structure of the book is confusing. Logically, I expected a sequence of discussions on preoperative evaluation, operative complications and management, and then postoperative management. Instead, the material is presented haphazardly. Medical management intraoperatively is addressed in the third chapter, and chapters on