BOOK R E V I E W S
confusing to the average medical student. This is not a book which could easily meet all the requirements of an undergraduate in the average current style curriculum and could not be recommended as a set text. Nevertheless because it represents a first class collection of excellent colour photographs of gross pathology, some examples of which are quite I-are, it should be an acquisition of every medical library.
EM study alone and there are a number of other statements that could confuse or mislead the trainee. All in all, the book fulfils its small print I found it stimulating and title-“a self evaluation manual”-and rewarding as a quick revision of “spot diagnoses ”. But it provides neither a reliable guide nor an introduction to “diagnostic ultrastructural pathology” and cannot be recommended to the novice.
K . Whiteheud
Microlm and /nfeciions of the Gut. S. C . GOODWIN Blackwcll Scientific Book Distributors, Highett, Victoria. $42.50. ISBN 0-86793-104-3. 377 p p . , illustrated. Infectious disease is one of the most rapidly expanding fields of medicine and infections involving (he gut are no exception to this rule. This book covers a wider subject than microbial gastroenteritis. There are useful chapters on the gut flora and the immunology of the gut. The greater part of the book is devoted to microbial diarrheas and as well as old favourites (salmonellosis, entcropathogenic E. coli) it considers newer pathogens (Aeromonus, thc halophilic vibrios, Clostridium dij]icile). The remainder is devoted to organisms which produce clinical states not necessarily associated with diarrhea such as infant botulism, Yersinia infection of the gut parenchyma, bacterial overgrowth syndromes, and post-operative wound infections after abdominal surgery. The next edition will need a chapter on the gut and AIDS, and on Cumpylohucter pyloris and its possible role in peptic ulcer. Goodwin has assembled a capable team of authors for this project and the result contributes not only to the diagnosis of various forms of diarrhea, but to the understanding of the complex interactions between the gut, its normal flora and its invader?. V. Ackerman
Diugnosric Ultrustructurul Puthology: A self evaluation manual. F. N. GtmDtALi Y Butterworths, London, 1984. 110 pp.. 50 photographs fY.95. ISBN 407003568. Professor Ghadially is a major international figure in electron microscopy ( E M ) and has visited Australia several times. He has written a major reference work (“The ultrastructural pathology of the cell”) and a useful introductory guide (“Diagnostic electron microscopy of tumours”), each published by Butterworths. Now he has entered into a tertiary phase and collected a series of micrographs for those wishing “to acquire a fair amount of .....knowledge” about ultrastructural pathology “without much expenditure of time or money”. The selection of micrographs has been restricted largely to conditions showing “specific diagnostic patterns” where “the diagnosis can be made at a glance with little background information”. Would that these conditions occurred more commonly in normal practice! There are no light micrographs and the 50 cases are presented with a brief history and several specific questions about the diagnosis and morphological features. About half the micrographs are concerned with turnours and 15 illustrate cytoplasmic dense - core granules of one sort or another (3 micrographs are devoted to melanosomes). Non-neoplastic conditions illustrated include storage diseases (4 micrographs), glomerular lesions (4) and blood disorders (6). The illustrations are excellent-as we have come to expect from Professor Ghadially-and the short commentaries, though variable in quality, usually are informative; references generally arc to the author’s earlier books. I f this book-and others in the genre-is to be useful to the trainee or established diagnostic pathologist, it should demonstrate the value of EM in day to day practice. So it does. Most commentaries stress the information that can be gained only from the electron micrographsometimes to an impractical degree-and there is much to be learned. But the book has no theme, the approach to learning is fragmentary and the all important question-which problems are likely to be resolved by EM?-is not addressed. Worse, some commentaries suggest that differentiation between benign and malignant tumours is possible by
Bone Marrow Biopsies RevisitedA New Dimension f o r Hemutologicul Malignancies. R. BARTL.B. FRISCHA N D R. BURKHARDT. 2nd revised edition. S. Karger, Basel, Miinchen, Paris, London, New York, Tokyo, Sydney. 1985. SFr58.-; DM69.-; US$34.75. ISBN 3-8055-3937-1. 138 pp., illustrated. This is an eminently readable book of 130 pages containing 78 figures and 18 tables, all of which are clear and concise. The quality of production of the sixteen colour plates is excellent and shows a brilliant morphology obtainable only by plastic embedding. Bone marrow is the last area in the body to be intensively explored by histological techniques, hence new and practical facts are emerging rapidly, indicating the need for this second edition. The hematologist has depended on the results of bone marrow aspirates alone up till the 1960’s. It then became clear, as aspiration and trephine biopsy were combined, that the cells we most needed to examine were so often those which were most densely confined by reticulin fibres. The guide lines for their interpretation and for the widely differing marrow patterns found in what have hitherto appeared to be closely allied conditions, direct us through this edition to a more definite and clinically helpful diagnosis, frequently with prognostic significance. The book emphasises the importance of good processing in the preparation of marrow cores and the significant part which can be played by immunological techniques. The normal and orderly production of the various cell lines in their respective sites in bone marrow has been succinctly presented. Without this recent and essential knowledge we have been floundering in our approach to bone marrow histology. From these observations the authors have proceeded to clarify the findings in such conditions as the myelodysplastic syndromes. From this text we now have additional parameters to observe in the assessment of prognosis in multiple myeloma and similarly in the NonHodgkin’s and Hodgkin’s lymphomas. In the former they have also presented data which can alert the hematologist-histopathologist to the special characteristics of some infiltrates which might otherwise have been considered to be follicular and reactive groups of cells. The book deals with all the important hematological conditions which may be found in bone marrow. It is a rich source of reference material and as such is a comprehensive treatise on our current knowledge of bone marrow pathology as it relates to hematological disease. It is strongly recommended as an essential addition to the library of those involved in the interpretation of bone marrow cores. R. Horsley
Leucocyte Typing-Human Leucocyte Differentiation Antigens Detected by Monoclonal Antibodies. Eds. A. BERNARD, L. BOUMSELL, J. DAUSSET, C. MILSTEIN A N D S . F. SCHLOSSMAN. 1984. Springer-Verlag, Berlin, Heidelberg, New York, Tokyo. ISBN 3-540-12056-4, 814 pp, illustrated US$48.60. This book contains the proceedings of the First International Workshop on Human Leukocyte Differentiation Antigens, held in Paris in November, 1982. The aim of the meeting, convened by the leading international figures in this field, was to attempt to classify and produce a standard nomenclature for the rapidly increasing profusion of murine monoclonal antibodies reactive with human leukocytes. In a major
Pathology (1985). 17, October
collaborative effort involving 55 laboratories from 14 countries, an extensive coded series of monoclonal antibodies, grouped into T-cell, B-cell, and myeloid protocols, was tested in a “blind” fashion by participant groups. The initial section of this volume deals with the detailed statistical analysis, prepared by the editors and statistician, of these typing data. The chapter is rather heavy going in places, but its importance is the final proposals for classification of antibodies into I5 Cluster Designations, based on cell reactivity patterns. The major proportion of the book is then devoted to a series of short papers by individual participants in the workshop, which deal with further aspects of cellular reactivity and cytotoxicity, antigen immunochemistry, cellular sub-set functional studies, and so forth. These articles are divided into sections dealing with T-cell antigens, B-cell antigens and CALLA, Monocyte-Granulocyte antigens, tissue section studies, leukocyte common antigens, and finally, leukocyte pathology. The style and content of these articles is. understandably, rather uneven. Some summarize previously published data, or material which has since appeared in more complete form elsewhere. Nevertheless, there is a great deal of original and interesting material, and many useful comments and proposals on problem areas. The book concludes with a series of excellent brief reviews on selected topics, and finally with the submitted abstracts of the meeting. A wall chart containing the details of the Antigen Cluster Designations is an invaluable bonus, and is the most complete summary of the workshop findings. Despite the time elapsed since the meeting, and the subsequent occurrence of the Second Workshop in 1984, this book will serve as a unique reference work, and, at the above price, represents excellent value for money. It is not recommended for the trainee, clinician, or interested onlooker as a general review of this field; in fact, such a book has yet to be written. Rather, it is an essential acquisition for those with a close involvement in hybridoma and leukocyte membrane research. K . F. Bradstock
Anderson’s Pafhology, 8th ed. Vols. I & 2. JOHNM. KISSANE.Ed. 1985. The C. V. Mosby Company, S t . Louis, Toronto, Princetown. (Aust. Distr. C.I.G. Medishield, Sydney) $159 (for both volumes) ISBN 0-8016-0191-6, 1-984 & 995-1938 pp., illustrated. The 8th Edition of “Anderson’s Pathology” promises to be as successful as its predecessors. This edition is dispensed as two attractively bound hard cover volumes with Volume 1 encompassing all material on mechanisms of disease plus several chapters on organ and systemic pathology, and Volume 2 which includes the rest of systemic and organ pathology. I recall reading the 4th edition of “Anderson’s Pathology” from cover to cover. The 8th edition has undergone tremendous changes comprising over twice the number of pages and having a complete and comprehensive revision of contents and illustrations. The text is well written and clear and the 2,949 illustrations are relevant and generally good. The references are up to date and comprehensive. This edition will remain the classic it has been and will continue to be a standard text and reference for the trainee and practising pathologist. The cost is most reasonable by today’s standards.
Anthony Leong Changing Patterns of Infecfious Disease. Lois M. BERC~QUIST. 1984. Lea & Febiger, Philadelphia. Aust. Distr. Australia & New Zealand Book Co, Sydney. $52.95. ISBN 0-8121-0940-6. 285 pp., illustrated. This 285-page paperback contains 21 chapters on selected topics in Infectious Disease. Criteria for the selection of particular subjects include: changing aspects of classical infections (eg. botulism, staphylococcal infections, herpes genitalis), lesser known opportunistic infections (eg. cryptosporidiosis, Pneumocystis carinii infection, pseudallescheriosis), new entities due to antimicrobial therapy (eg.
pseudomembranous colitis) and diseases which may be sequelae of infections (eg. Kawasaki syndrome, Reye syndrome). Five chapters are devoted to causes of gastroenteritis and four, to viral infections. The author has presented a short practical discussion of the etiology, epidemiology, predisposing factors, laboratory diagnosis and prognosis of selected infections. Reference to clinical features is brief and management is referred to only in the 2-4 case reports which accompany each chapter. The subjects are dealt with alphabetically. There are few errors (one, notably, stated that “toxic shock syndrome has not been reported in other countries” outside the U.S.A.). Although enjoyable to read, it is difficult to define an ideal audience for this booklet, particularly as the cost is $52.95. I t will be of most value to physician trainees in general medicine or infectious disease/clinical microbiology. T. Sore11
Proceedings of f h e Sixth Infernational Congress f o r Stereology, Gainesville, Florida, U .S.A. Acta Stereologica, Vol. 2, Suppl.l, Ed. M. KALlsNlh 1983. Published for International Society for Stereology. US$5O.CN Hard cover ISSN 0351-58OX. 322 pp. The Proceedings of the Sixth International Congress for Stereology is presented in this supplement to Acta Stereologica. I t is divided into sessions under the following themes: Foundations of Stereology, Statistics, Design and Models, Fractures and Other Non-Planar Surfaces, Image Analysis, Materials Science and Life Science; each session is preceded by a relevant keynote address given by an authorative speaker. These keynote addresses deal with special areas, some focusing on a particular long standing problem, others summing up the advances made in the last 20 or so years. Many interesting and varied problems are presented as individual papers demonstrating the broad basis and wide applications of stereology and its associated disciplines in current use today. Papers published in this supplement were edited by noted referees. This book does not tell you how to go about stereological analysis. I t is not an instruction manual. But it does tell you what methods are currently in use, how problems are being addressed and what sort of answers researchers are finding, thus seeding ideas for future stereological analysis. As such, it is recommended for group purchase rather than for the personal library. D. Alcorn
Alcoholic Liver Disease-Pafhobiology. Epidemiology & Clinical Aspects. Edited by P A U IIN F HALL,E D W I N A K ND,OLondon, I 1985. f28.00. ISBN 0-7131-4454-8. 327 pp., illustrated. A wealth of information is packed into this 317 page book of 14 chapters. There are three separate sections covering the pathobiology, epidemiology and clinical aspects of alcoholic liver disease. This is not a book just for pathologists, although there are two very good relevant chapters, firstly on pathology and pathogenesis by Pauline Hall of Flinders University Department of Pathology and, secondly on the immune mechanisms in this disease by Roderick MacSween and Robert Anthony. Rather, the book is quite encyclopedic in its embrace of the whole subject and thus is suited to anyone, and indeed, everyone who has a serious interest in the effects of alcohol on the liver and the associated implications. What at once is so clear, i.e. that the cause of the disease is knownalcohol-and that its prevention is simple-abstention-becomes, under the scrutiny of these chapters, a minefield of difficulty in biological, clinical, social, economic and political terms. In all its aspects, alcoholic liver disease is an enormous problem and although understanding it pathologically and clinically may well be the province of the medical practitioner, fundamental solutions are in the hands of others. With rising costs of medical and hospital care, societies are going to be forced