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The Liver: Biology and Pathobiology
GASTROENTEROLOGY 1 9 9 5 ; 1 0 8 : 1 6 0 3 - 1 6 0 4
BOOK REVIEWS Jonathan E. Clain, M.D. Book Review Editor
Mayo Foundation 200 First Street S.W. Rochester, Minnesota 55905
The Liver: Biology and Pathobiology. 3rd ed. Edited by Irwin M. Arias, James L. Boyer, Nelson Fausto, William B. Jakoby, David Schachter, and David A. Shafritz. 1662 pp. $265.00. Raven Press, New York, New York, 1994. ISBN 0-78170133-3.
During the past 1 0 - 1 5 years, the discipline of hepatology has truly "come of age." In the clinical arena, this has been brought about largely by the acceptance of orthotopic liver transplantation as a successful means for treating end-stage liver disease and, more recently, by the availability of new antiviral agents used in the treatment of chronic viral hepatitis. The proliferation of excellent multi-authored textbooks of clinical hepatology (many of which are now in their third or later editions) has provided witness to the maturity of hepatology as a discipline. Now in its third edition, The Liver: Biology and Pathobiology provides an outstanding adjunct to the many superb clinical hepatology textbooks. The stated aims of this book have been, and continue to be, to bridge the gaps between the rapid advances in basic molecular biology, biochemistry, and cell biology and their application to the diagnosis and treatment of patients with liver disease. In essence, the editors have initiated the process of taking information learned at the bench and applying it to the bedside. The book is divided into seven major sections with 84 chapters, the vast majority of which are written by the leading experts in the field. Numerous figures show molecular and cellular processes that have become newly understood. Each chapter is well referenced. Of particular interest is the seventh section, entitled "Horizons," which provides insight into the promise that (it is hoped) new technology will have on clinical applications. This section has chapters on liver stem cells, hepatocyte transplantation, gene therapy, apoptosis, immunosuppression, use of transgenic mice, and cell cycle regulation, and it describes areas in which significant advances are likely to be made over the next several years. Who should buy this book? It is doubtful that the information in this book will be of use to the busy practicing gastroenterologist. In fact, there is very little material that is disease oriented or clinically useful, and this book should not be considered to replace one of the many excellent textbooks of clinical hepatology. However, it should be in the libraries of all medical schools and training programs in gastroenterology and hepatology. Additionally, physician scientists will find many chapters on topics outside their very narrow field of expertise to be valuable, and basic scientists working on liver-related topics will find the information in this book useful in helping
them relate what they do to understanding the pathophysiology of various liver diseases. Fellows in gastroenterology who are actively involved in laboratory-based hepatic research will find many of the chapters useful as up-to-date reviews of their respective subjects. The book is beautifully presented, clearly achieves its stated aims, and fits into a well-defined niche in the hepatology library. I look forward to seeing how many of the topics discussed in the "Horizons" section result in clinical advances over the next several years. BRUCE R. BACON, M.D. St. Louis University School of Medicine St. Louis, Missouri
Pediatric Enteral Nutrition. Edited by Susan B. Baker, Robert D. Baker, Jr., and Anne Davis. 545 pp. $59.95. Chapman & Hall Series in Clinical Nutrition, New York, New York, 1994. ISBN 0412984512.
Pediatric Enteral Nutrition, edited by Susan B. Baker, Robert D. Baker Jr., and Anne Davis, is an excellent resource for managing patients with nutritional abnormalities. Specialized enteral nutrition support is being used more frequently in children with acute and chronic illnesses. This book attempts to summarize current information on nutritional needs and delivery systems appropriate to children with various diseases. The book takes a practical approach, emphasizing specific nutritional disorders associated with disease in different organ systems and making concrete recommendations for enteral feeding programs. The chapters are brief and emphasize a clinical approach, but the references for each chapter are extensive, providing direction for those interested in reviewing specific diseases or pathophysiology. The appendices are especially useful for tailoring a nutritional program to a specific patient. Despite the large number of contributing editors, each chapter is of consistently high quality. There are good lists for trouble shooting problems with enteral feeds (e.g., diarrhea, nausea). Some information that is rarely addressed is found here, specifically, discussions of the ethics and psychological implications of tube feedings. There are a few problems with the text. Some information is repeated in multiple places, for example, the technique and application of skin-fold thickness measurements. Some information of value is not included. The most glaring absence is a chapter on the complications of gastrostomy tubes, with a discussion of specific types of gastrostomy tubes, etiology of
BOOK REVIEWS Jonathan E. Clain, M.D. Book Review Editor
Mayo Foundation 200 First Street S.W. Rochester, Minnesota 55905
The Liver: Biology and Pathobiology. 3rd ed. Edited by Irwin M. Arias, James L. Boyer, Nelson Fausto, William B. Jakoby, David Schachter, and David A. Shafritz. 1662 pp. $265.00. Raven Press, New York, New York, 1994. ISBN 0-78170133-3.
During the past 1 0 - 1 5 years, the discipline of hepatology has truly "come of age." In the clinical arena, this has been brought about largely by the acceptance of orthotopic liver transplantation as a successful means for treating end-stage liver disease and, more recently, by the availability of new antiviral agents used in the treatment of chronic viral hepatitis. The proliferation of excellent multi-authored textbooks of clinical hepatology (many of which are now in their third or later editions) has provided witness to the maturity of hepatology as a discipline. Now in its third edition, The Liver: Biology and Pathobiology provides an outstanding adjunct to the many superb clinical hepatology textbooks. The stated aims of this book have been, and continue to be, to bridge the gaps between the rapid advances in basic molecular biology, biochemistry, and cell biology and their application to the diagnosis and treatment of patients with liver disease. In essence, the editors have initiated the process of taking information learned at the bench and applying it to the bedside. The book is divided into seven major sections with 84 chapters, the vast majority of which are written by the leading experts in the field. Numerous figures show molecular and cellular processes that have become newly understood. Each chapter is well referenced. Of particular interest is the seventh section, entitled "Horizons," which provides insight into the promise that (it is hoped) new technology will have on clinical applications. This section has chapters on liver stem cells, hepatocyte transplantation, gene therapy, apoptosis, immunosuppression, use of transgenic mice, and cell cycle regulation, and it describes areas in which significant advances are likely to be made over the next several years. Who should buy this book? It is doubtful that the information in this book will be of use to the busy practicing gastroenterologist. In fact, there is very little material that is disease oriented or clinically useful, and this book should not be considered to replace one of the many excellent textbooks of clinical hepatology. However, it should be in the libraries of all medical schools and training programs in gastroenterology and hepatology. Additionally, physician scientists will find many chapters on topics outside their very narrow field of expertise to be valuable, and basic scientists working on liver-related topics will find the information in this book useful in helping
them relate what they do to understanding the pathophysiology of various liver diseases. Fellows in gastroenterology who are actively involved in laboratory-based hepatic research will find many of the chapters useful as up-to-date reviews of their respective subjects. The book is beautifully presented, clearly achieves its stated aims, and fits into a well-defined niche in the hepatology library. I look forward to seeing how many of the topics discussed in the "Horizons" section result in clinical advances over the next several years. BRUCE R. BACON, M.D. St. Louis University School of Medicine St. Louis, Missouri
Pediatric Enteral Nutrition. Edited by Susan B. Baker, Robert D. Baker, Jr., and Anne Davis. 545 pp. $59.95. Chapman & Hall Series in Clinical Nutrition, New York, New York, 1994. ISBN 0412984512.
Pediatric Enteral Nutrition, edited by Susan B. Baker, Robert D. Baker Jr., and Anne Davis, is an excellent resource for managing patients with nutritional abnormalities. Specialized enteral nutrition support is being used more frequently in children with acute and chronic illnesses. This book attempts to summarize current information on nutritional needs and delivery systems appropriate to children with various diseases. The book takes a practical approach, emphasizing specific nutritional disorders associated with disease in different organ systems and making concrete recommendations for enteral feeding programs. The chapters are brief and emphasize a clinical approach, but the references for each chapter are extensive, providing direction for those interested in reviewing specific diseases or pathophysiology. The appendices are especially useful for tailoring a nutritional program to a specific patient. Despite the large number of contributing editors, each chapter is of consistently high quality. There are good lists for trouble shooting problems with enteral feeds (e.g., diarrhea, nausea). Some information that is rarely addressed is found here, specifically, discussions of the ethics and psychological implications of tube feedings. There are a few problems with the text. Some information is repeated in multiple places, for example, the technique and application of skin-fold thickness measurements. Some information of value is not included. The most glaring absence is a chapter on the complications of gastrostomy tubes, with a discussion of specific types of gastrostomy tubes, etiology of