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The Exocrine Pancreas: Biology, Pathobiology, and Diseases
DvJ^JPIV IVCV IfZ,W9 Mucosal Ulcerative Colitis, edited by David G. Jagelman, 301 pp, with illus, $42.50, Mount Kisco, New York, Futura Publishing Company, 1986 The Cleveland Clinic has a long and distin guished record of contributions to the knowledge and treatment of inflammatory bowel disease. The 19 authors of Mucosal Ulcerative Colitis (a term that was coined at the Cleveland Clinic) are staff members of that institution. The editor, a colorectal surgeon, enlisted the assistance of members of the departments of surgery, gastroenterology, pediatrics, microbiology, pathology, ra diology, and enterostomal therapy to produce a comprehensive review of ulcerative colitis. A com mon annoyance of a multiauthored text—redun dancy—has been avoided, and the chapters have been logically woven into a cohesive presentation. Two chapters are particularly well done. Dr. Fiocchi presents an outstanding discussion of immunologic factors in his review of the causes of ulcerative colitis, and Dr. Sivak, a leader in gas trointestinal endoscopy, contributes an authorita tive chapter on the important role of colonoscopy in diagnosis and in screening for dysplasia in long-standing disease. Four chapters deal with the surgical alterna tives for management of ulcerative colitis: these are detailed, well-illustrated, technical discus sions of proctocolectomy with end-ileostomy, ileorectal anastomosis, ileoanal pouch anastomosis, and the continent ileostomy. In addition, the "how-to's" of enterostomal therapy (a specialty that was developed at the Cleveland Clinic) are presented in detail and amply illustrated. Surgeons, physicians, nurses, and other profes sionals who deal with patients with inflammatory bowel disease will find valuable information in this volume. Up-to-date references at the end of each chapter direct interested readers to addi tional sources. This attractive little book is well done and is reasonably priced. I hope that the authors are contemplating writing a sequel on Crohn's disease. William J. Tremaine, M.D. Division of Gastroenterology and Internal Medicine Mayo Clin Proc 61:759, 1986
759
The Exocrine Pancreas: Biology, Pathobiology, and D i s e a s e s , edited by Vay Liang W. Go, Frank P. Brooks, Eugene P. DiMagno, Jerry D. Gardner, Emanuel Lebenthal, and George A. Scheele, 900 pp, with illus, $135, New York, Raven Press, 1986 This book is the successful product of an ambi tious effort to present in one volume the current knowledge about the exocrine pancreas in health and disease. The book consists of three major and three minor sections written by 86 distinguished scientists and clinicians. The major sections are "Biology" (387 pages, 27 chapters), "Pancreatitis" (152 pages, 12 chapters), and "Pancreatic Neo plasms" (142 pages, 10 chapters); the minor sec tions are "Experimental Models" (35 pages, 3 chapters), "Congenital and Hereditary Diseases" (56 pages, 4 chapters), and "Imaging of the Pan creas" (32 pages, 1 chapter). The section on the biologic aspects of the pan creas presents a unique, comprehensive, and al most encyclopedic (in the best sense of the word) coverage of a topic often given short shrift in textbooks on the pancreas. This section covers the development of the pancreas, cellular and gross structure, replication, regeneration, gene expres sion, cellular processing of protein, membrane function, receptors, secretion, secretory products, duct function, neural and hormonal regulation, insulin acinar and enteroinsular access, luminal digestion, and effect of nutrition on the exocrine pancreas. The 27 chapters in this section are well written and well illustrated. In particular, the photomicrographs are of exceptionally fine qual ity and are accompanied by useful legends. Noth ing else available in print is comparable to the depth and breadth of these sections. In comparison with the "Biology" section, the other two major sections ("Pancreatitis" and "Pancreatic Neoplasms") are. more conventional and similar to material in other textbooks on the exocrine pancreas. Both of these sections, how ever, contain well-written chapters by recognized authorities in the field. The photomicrographs of the neoplasms are superb. The chapters I found particularly appealing were "Acute Pancreatitis" by John Ranson, "Chronic Pancreatitis" by E. P. DiMagno and J. E. Clain, "Surgical Treatment of
760
BOOK REVIEWS
Chronic Pancreatitis" by M. A. Adson and D. C. Mcllrath, and "Surgical Treatments of Exocrine Pancreatic Cancer" by A. R. Moossa. The book has a few minor deficiencies. In the chapter entitled "Pancreatic Abscess," little dis tinction is made among infected necrosis, necro sis, and loculated infected collections, all of which are associated with different prognoses and meth ods of management. Among the shorter sections, "Congenital and Hereditary Diseases" and "Im aging of the Pancreas" are very well done, but I was disappointed in the experimental section on acute pancreatitis because little or no attention is given to models that simulate the systemic effects of necrotizing or severe pancreatitis or to models pertinent to the study of the complications of acute necrotizing pancreatitis, including pulmonary and renal failure and sepsis. Furthermore, the role and interaction of the coagulation, complement, and prostaglandin systems, the kinins, pancreatic enzymes, and oxygen-free radicals are not ad dressed. The isolated perfused pancreas model used by Cameron and his co-workers is not men tioned or referenced. In addition, the rationale for omitting the exciting work on whole-organ preser vation and transplantation of the pancreas in this otherwise comprehensive text is unclear to me. When viewed in the context of such an enormous undertaking, these deficiencies and omissions do not detract from the overall quality and compre hensiveness of this superb compendium on the pancreas. This text should be valuable for a wide spectrum of scientists and clinicians who have an interest in the pancreas and an important refer ence work for the house officer and medical stu dent. The editors and authors of this book should be congratulated on a masterful job. Charles F. Frey, M.D. Department of Surgery University of California, Davis Sacramento, California
Drug Therapy in Infants and Children With Cardiovascular D i s e a s e s , by Adam Schneeweiss, 398 pp, $45, Philadelphia, Lea & Febiger, 1986 The armamentarium of drugs available to treat cardiovascular disorders has expanded rapidly in
Mayo Clin Proc, September 1986, Vol 61
recent years; thus, up-to-date information on the potential pharmacologic methods of treatment and their possible side effects is difficult to find. The problem is compounded in dealing with in fants and children, as new medications are almost always used first in adults and initial clinical trials published in the current cardiovascular literature seldom discuss the efficacy or safety in children. Indeed, approval by the Food and Drug Administration for use of new drugs in children often lags well behind the clearance for adults. Therefore, pediatric cardiologists are often frus trated in their attempts to determine whether a new therapeutic agent that has proved effective for adult patients can even be used in children and, if so, whether special precautions must be kept in mind. This book provides a superb up-to-date synopsis of medications that are currently approved for use in children, including several that have only recently become available. It is appropriately divided into chapters that review the various classes of drugs such as inotropic agents, calcium blockers, vasodilators, and antiarrhythmic agents. Although diuretics, an important adjunct of cardiovascular therapy, are not addressed, this omission is not a major shortcoming because several excellent texts that deal exclusively with this large class of drugs are now available. Each chapter has material on hemodynamic effects, antiarrhythmic effects (if any), clinical pharmacologic features, side effects, and dosage and route of administration. The presentations are thorough but concise, and the text is well referenced. The extensive bibliography is impor tant, particularly in regard to data on doses and potential side effects, as these may differ consider ably in children and adults and studies of these aspects often are published in journals that are not routinely read by the practicing pediatric cardiologist. The chapters on calcium blockers and antiar rhythmic agents are particularly valuable. In recent years, important advances with these classes of drugs have provided optimism for relief of symptoms and even prolongation of life in patients who may have had little reason for hope previously. Drugs such as verapamil, mexiletine, propafenone, and amiodarone can now be used in the treatment of difficult to manage cardiovascu lar problems in children with the expectation that considerable alleviation of symptoms may be
759
The Exocrine Pancreas: Biology, Pathobiology, and D i s e a s e s , edited by Vay Liang W. Go, Frank P. Brooks, Eugene P. DiMagno, Jerry D. Gardner, Emanuel Lebenthal, and George A. Scheele, 900 pp, with illus, $135, New York, Raven Press, 1986 This book is the successful product of an ambi tious effort to present in one volume the current knowledge about the exocrine pancreas in health and disease. The book consists of three major and three minor sections written by 86 distinguished scientists and clinicians. The major sections are "Biology" (387 pages, 27 chapters), "Pancreatitis" (152 pages, 12 chapters), and "Pancreatic Neo plasms" (142 pages, 10 chapters); the minor sec tions are "Experimental Models" (35 pages, 3 chapters), "Congenital and Hereditary Diseases" (56 pages, 4 chapters), and "Imaging of the Pan creas" (32 pages, 1 chapter). The section on the biologic aspects of the pan creas presents a unique, comprehensive, and al most encyclopedic (in the best sense of the word) coverage of a topic often given short shrift in textbooks on the pancreas. This section covers the development of the pancreas, cellular and gross structure, replication, regeneration, gene expres sion, cellular processing of protein, membrane function, receptors, secretion, secretory products, duct function, neural and hormonal regulation, insulin acinar and enteroinsular access, luminal digestion, and effect of nutrition on the exocrine pancreas. The 27 chapters in this section are well written and well illustrated. In particular, the photomicrographs are of exceptionally fine qual ity and are accompanied by useful legends. Noth ing else available in print is comparable to the depth and breadth of these sections. In comparison with the "Biology" section, the other two major sections ("Pancreatitis" and "Pancreatic Neoplasms") are. more conventional and similar to material in other textbooks on the exocrine pancreas. Both of these sections, how ever, contain well-written chapters by recognized authorities in the field. The photomicrographs of the neoplasms are superb. The chapters I found particularly appealing were "Acute Pancreatitis" by John Ranson, "Chronic Pancreatitis" by E. P. DiMagno and J. E. Clain, "Surgical Treatment of
760
BOOK REVIEWS
Chronic Pancreatitis" by M. A. Adson and D. C. Mcllrath, and "Surgical Treatments of Exocrine Pancreatic Cancer" by A. R. Moossa. The book has a few minor deficiencies. In the chapter entitled "Pancreatic Abscess," little dis tinction is made among infected necrosis, necro sis, and loculated infected collections, all of which are associated with different prognoses and meth ods of management. Among the shorter sections, "Congenital and Hereditary Diseases" and "Im aging of the Pancreas" are very well done, but I was disappointed in the experimental section on acute pancreatitis because little or no attention is given to models that simulate the systemic effects of necrotizing or severe pancreatitis or to models pertinent to the study of the complications of acute necrotizing pancreatitis, including pulmonary and renal failure and sepsis. Furthermore, the role and interaction of the coagulation, complement, and prostaglandin systems, the kinins, pancreatic enzymes, and oxygen-free radicals are not ad dressed. The isolated perfused pancreas model used by Cameron and his co-workers is not men tioned or referenced. In addition, the rationale for omitting the exciting work on whole-organ preser vation and transplantation of the pancreas in this otherwise comprehensive text is unclear to me. When viewed in the context of such an enormous undertaking, these deficiencies and omissions do not detract from the overall quality and compre hensiveness of this superb compendium on the pancreas. This text should be valuable for a wide spectrum of scientists and clinicians who have an interest in the pancreas and an important refer ence work for the house officer and medical stu dent. The editors and authors of this book should be congratulated on a masterful job. Charles F. Frey, M.D. Department of Surgery University of California, Davis Sacramento, California
Drug Therapy in Infants and Children With Cardiovascular D i s e a s e s , by Adam Schneeweiss, 398 pp, $45, Philadelphia, Lea & Febiger, 1986 The armamentarium of drugs available to treat cardiovascular disorders has expanded rapidly in
Mayo Clin Proc, September 1986, Vol 61
recent years; thus, up-to-date information on the potential pharmacologic methods of treatment and their possible side effects is difficult to find. The problem is compounded in dealing with in fants and children, as new medications are almost always used first in adults and initial clinical trials published in the current cardiovascular literature seldom discuss the efficacy or safety in children. Indeed, approval by the Food and Drug Administration for use of new drugs in children often lags well behind the clearance for adults. Therefore, pediatric cardiologists are often frus trated in their attempts to determine whether a new therapeutic agent that has proved effective for adult patients can even be used in children and, if so, whether special precautions must be kept in mind. This book provides a superb up-to-date synopsis of medications that are currently approved for use in children, including several that have only recently become available. It is appropriately divided into chapters that review the various classes of drugs such as inotropic agents, calcium blockers, vasodilators, and antiarrhythmic agents. Although diuretics, an important adjunct of cardiovascular therapy, are not addressed, this omission is not a major shortcoming because several excellent texts that deal exclusively with this large class of drugs are now available. Each chapter has material on hemodynamic effects, antiarrhythmic effects (if any), clinical pharmacologic features, side effects, and dosage and route of administration. The presentations are thorough but concise, and the text is well referenced. The extensive bibliography is impor tant, particularly in regard to data on doses and potential side effects, as these may differ consider ably in children and adults and studies of these aspects often are published in journals that are not routinely read by the practicing pediatric cardiologist. The chapters on calcium blockers and antiar rhythmic agents are particularly valuable. In recent years, important advances with these classes of drugs have provided optimism for relief of symptoms and even prolongation of life in patients who may have had little reason for hope previously. Drugs such as verapamil, mexiletine, propafenone, and amiodarone can now be used in the treatment of difficult to manage cardiovascu lar problems in children with the expectation that considerable alleviation of symptoms may be