The pancreas: Biology, pathology and disease, second edition

age need to be developed.” A chapter by Paul Lacy looks at the future of islet transplantation and serves to summarize the impact of islet transplantation research and this book. “The remarkable accomplishments in islet transplantation reviewed in this book provide a firm foundation for the prediction of a brilliant future for islet transplantation in several different scientific domains. The islet transplant model should provide new and important basic information in

transplantation immunology, insight into autoimmune diabetes, and a new therapeutic approach for the treatment of diabetes early in the course of the disease.” On this optimistic note I recommend this book to all of you working in the field of diabetes research. TEM Ronald L. Fournier

Department of Chemical Engineering University of Toledo Toledo, OH 43606, USA

To Treat or Not To Treat Treatment of the Postmenopausal Woman: Basic and Clinical Aspects Edited by Rogerio A. Lobe. New York, Raven, 1994, $138.00 (v + 443 pages), ISBN O-781 7-0113-9. Probably the most frequently asked question about menopause is whether or not estrogen therapy is effective and worth the putative risks. This book, Treatment of the Postmenopausal Woman, provides the data for an informed answer to the question. The book is an extensive review of the basic scientific understanding of the clinical health care problems in postmenopausal women. Although the technical reading level is best suited for the obstetrician/gynecologist or endocrinologist, the chapters are written clearly and the book is well edited so that other health care professionals and lay persons can understand most of the material. The book is organized into nine major sections with 43 chapters. The first section is devoted to the physiology of ovarian failure. The endocrinologic changes of the ovary, adrenal, and other endocrine glands, occurring with menopause, are presented in detail with extensive graphs and tables. Included in this section are topical chapters on premature ovarian failure with the new reproductive technologies that can extend the age of reproductive ability. In section 2, the pharmacology and functional relationships of replacement steroids are covered extensively. A chapter on estrogens contains helpful tables of treatment with different commercial preparations, with their resultant in vivo 312

serum laboratory values. Newer estrogenie and progestin compounds are included. The middle sections of Treatment of the Postmenopausal Woman are more clinically focused. Symptoms related to vasomotor changes, collagen and connective tissue changes, and psychological changes are detailed in several chapters. The broad topic areas of osteoporosis and cardiovascular disease describe landmark epidemiology studies; well laid-out tables present the meta-analyses that summarize our current understanding of the literature. Detection and prevention of these important health care problems are discussed. A few chapters are dedicated to lifestyle habits that may positively or negatively impact on menopause; these include exercise, nutrition, smoking, and sexual function. In addition, there is a complete section on the epidemiology, pathophysiology, and detection of breast and endometrial cancer. Near the end of the book, the sections weigh the advantages and disadvantages of hormone replacement therapy for the

practicing clinician. This is done with risk-benefit assessments, along with a cost analysis of hormone replacement regimens and their contraindications. Tables of hypothetical patient populations present the best guess of the benefits of hormone replacement therapy and calculate the morbidity/mortality improvements. These data show that the estimated increased risks of breast and uterine cancer that might occur from hormone replacement therapy are outweighed several-fold by the protective effects against osteoporosis and cardiovascular disease. The editor, Rogerio Iobo, writes a helpful page prior to each section outlining important areas of focus and controversy. He also wrote the last chapter of Treatment of the Postmenopausal Woman to review the important clinical points, describing how both quality of life and longevity are increased with hormone replacement therapy in postmenopausal women. Although many different viewpoints are presented, the recurring theme of the many well-known contributors to the book is that hormone replacement therapy will help to manage the changes that occur with menopause in a positive way. This book is a valuable addition to any reference library. The endocrinology of hormonal changes in menopause is the principal subject, but many other clinical areas relating to menopause are covered, with focus on the benefits of hormone replacement therapy. If you have questions about a specific area relating to menopause, this book probably contains the answer. TEM Joseph V. Kamitis

Medical College of Ohio Toledo, OH 43614, USA

The Pancreas as a Whole The Pancreas: Biology, Pathology and Disease, second edition Edited by V.L.W. Go, E.P. Dimagno, J.D. Gardner, E. I-ebenthal, H.A. Reber, and G.A. Scheele. New York, Raven, 1993, $228.00 (xvii + 1176 pages), ISBN O-88167986-0. 01994,

Elsevier Science Inc., 1043-2760/94/$7.00

This is a revised second edition of a compendium that was first published in 1986 under the title The Exocrine Pancreas: Biology, Pathobiology and Diseases. It is clearly not just a rewrite, but an extensive modification of the original, including a section on exocrine-endocrine pancreatic interrelationships, hence the new title. According to the preface, TEM Vol. 5,No.7,1994

only three chapters survive relatively intact from the original. It is obvious that a number of new authors, recognized experts such as Dan Longnecker, have been added. Sadly, some others, such as Pat Fitzgerald, are no longer with us. Although the title suggests three major topics: biology, pathobiology, and diseases, the table of contents is organized into seven areas: biology, experimental models, pancreatitis, endocrine and exocrine pancreatic relationships, pancreatic neoplasms, congenital and hereditary diseases, and imaging of the pancreas. Under these headings, there are 57 chapters by more than 80 authors and co-authors. The production of the book is excellent, with numerous illustrations ranging from line drawings to photomicrographs and electron micrographs of generally very high quality. Whereas multi-authored texts often suffer from unevenness of style and/or differences in presentation, this book appears to have been well edited and

to maintain a generally high standard throughout. Chapter 2, by H.F. Kern, on the ‘Fine Structure of the Human Exocrine Pancreas,” is particularly wellillustrated by excellent electron micrographs, which are often difficult to obtain with human material. Dan Iongnecker’s chapter on experimental models of exocrine pancreatic tumors is first rate. He points out that most animal models are more relevant to acinar cell tumors than ductal carcinoma. Because the latter is the most frequent in humans, he spends the major part of his chapter on the animal models that more closely resemble their human counterparts. The new section on endocrine-exocrine relationships, although not attempting to be encyclopedic on a topic that has an immense literature, is well drafted and presents important features of the endocrine pancreas. The chapter by Forney and Sutherland entitled “Pancreas and Islet Transplantation” is interesting and informative. It concentrates, how-

ever, on autologous transplants after surgical excision of the pancreas for relief of the symptoms of pancreatitis. I would have liked more discussion of the use of transplant in chronic diabetes and some discussion of the use of nonhuman islets, such as bio-artificial pancreas devices, which are being developed by a number of investigators. In summary, this is an excellent reference book. It is a costly book-not something that everyone with a passing interest in the pancreas should obtain. For the person with a deep interest in either clinical or basic aspects of pancreatic biology and disease, it can be highly recommended for the general and specific information in many areas of advances in knowledge of this versatile organ. TEM Peter J. Goldblatt Department of Pathology Medical College of Ohio Toledo, OH 43699-0008, USA

An Introduction to Neuroendocrinology Messengers in the Brain, New and Old

enable the reader to understand the advances in the field? There are sections in which many of the interactions among By Richard E. Brown. Cambridge, UK, peptides, steroid hormones, cytokines, Cambridge University press, 1994, $79.95 and cell products of various kinds are hardcover, $34.95 paperback (xxii + 408 listed in great detail, both in tables and pages), ISBNO-5214-1645O,ISBNO-5214text. As a result, portions of the book 2665-O. could serve as a source book. Offsetting such “high detail” sections, however, are Neuroendocrinology is one of the rapidly review questions and essay questions at advancing specialties of neuroscience. the end of each chapter that help to focus This textbook is suitable for undergraduthe reader’s attention on the most imporate and graduate students with interest tant topics and information. The author in the neurobehavioral sciences. It is a suggests that adequate answers to the first step on the arduous, and perhaps essay questions depend on the reader’s endless, journey toward understanding use of references given in a “further the full extent of chemical communicareading” section, also found at the end of tions in body and brain. The material is each chapter. complex, even at its beginning level, but In an introductory note, the author is well presented by Professor Brown. indicates that the preparation of the text However, student readers must have took about eight years of long hours at reasonable backgrounds in chemistry the office. When I examined the referand biology to read the book easily; a ences, it became apparent that most of strong behavioral background is not the experimental studies cited come from necessary because this area is not emthe period between 1983 and 1989; the phasized. Modern students in neural and next largest number came from the behavioral sciences should know neuro1976-1982 era. All of the 1991-1992 endocrinology at least to the level found references are textbooks, reviews, or reviewlike chapters in edited books. The in this book. How well does this book TEM Vol. 5, No. 7, 1994

01994,

Elsevier Science Inc., 1043-2760/94/$7.00

newest information, therefore, comes from secondary sources and is consequently subject to the interpretation of the writer of the textbook or the review. References to primary sources, naturally, would be preferred. Furthermore, some of the most recent information in neuroendocrinology is not found in the book. Nevertheless, the book provides a great deal of basic information for those electing to study in the fields of neuroscience or psychobiology. These days it will not take long for students in these fields to recognize the great importance of neuroendocrinology and its relationship to the immune systems. The arrival of this book at my office coincided with the current issue of Physiology and Behavior. A full 25% of the articles in that issue dealt with neuroendocrinology and/or immunology. Physiology and Behavior is not known as a primary publication vehicle for articles in these fields. Some of the assumptions made by the author concerning behavior and mental function were oversimplified, especially for a text that attempts to relate neuroendocrinology with behavior. For example, 313