THE BOOKSHELF ARTIFICIAL HEART: Total Replacement and Partial Support. By TETSuzo Alrorsu. Amsterdam, Elsevier Excerpta Medica, and Tokyo, Igaku Shoin Ltd ( copublishers), 1975, 364 pp, $39.95. This book is a thorough review of the history and current obstacles of the many phases in the development of the total artificial heart and circulatory assistance devices by one of the earliest pioneers in the field. The extensive review of the literature in each chapter makes the volume an indispensable reference for physicians and bioengineers interested in this field. The introductory chapter comments on the current status of the artificial heart and reviews various partial-support systems. Chapters 2 and 3 extensively review the design, energy sources, and the major problem of finding a suitable material for constructing the blood-handling parts of the artificial heart. Studies of Baier, Sawyer, and Leininger are presented; but details of the chemistry of plastics and the blood-plastic interface are not within the scope of this book. Chapters 4 and 5 discuss the series and parallel types of circulatory assistance devices. Work by various laboratories is reviewed before the author gives extensive experimental data from his own laboratory. The major problems encountered were infection, thrombosis, hemolysis, and mechanical failures. Chapter 6 tackles the historic development of the total artificial heart and reviews pertinent data of approximately 40 different designs. Dr. Akutsu has had extensive experience in the construction and implantation of total artificial hearts. His results of numerous studies range from systolic/ diastolic ratios to hemodynamic effects of cardiovascular drugs. The last chapter discusses clinical applications, transplantation, ·and expenses. This comprehensive book has been completed prior to the successful implantation of a total artificial heart. That goal, certainly within reach by the author, will need further governmental support to achieve success. W. ]. Kolff, M.D., Ph.D. Salt Lake City PULMONARY EMBOLI. Edited by Airrmm A. SASAHARA, EDMUND H. SoNNENBUCK, and MICHAEL LESCH. New York, Grune and Stratton, Inc., 1975, 175 pp, $16.50.
Pulmonary Emboli is a multi-authored report of the current status of the field of thromboembolism
Pre.c:rlblng Information De.c:rlptlon: Each white, scored tablet contains 125 mg. theophylline U.S.P.. anhydrous. THEOLAIA (theophylline U.S.P.. anhydrous) Tablets provide therapeutic levels of theophylline as rapidly as do hydroalcoholic solutions of theophylline. The reliable and predictable blood levels are due to the rapid dissolution and absorption characteristics of theophylline crystals of microfine size. This is achieved without the use of highly alkaline salts such as ethylenediamine or choline or the use of hydroalcoholic media. Actions: THEOLAIR (theophylline U.S.P.. anhydrous) Tablets relieve bronchospasm and increase Vital Capacity (V.C.) and Forced Expiratory Volume (FEV1). THEOLAIA is a potent xanthine bronchodilator that is effective orally, less irritating to the gastrointestinal tract than highly alkaline salts of theophylline. and is as rapidly absorbed as theophylline in hydroalcoholic solution. Indications: Symptomatic relief of bronchospasm associated with acute asthma. chronic bronchitis and emphysema. THEOLAIA is especially suitable for long-term treatment programs. since tolerance to the xanthines occurs rarely compared with long-term use of the sympathomimetic bronchodilators. Precautions: THEOLAIR (theophylline U.S.P.. anhydrous) should be used with caution in patients with cardiovascular disease. especially if cardiac arrhythmias are present. Severe hypertension may be increased. Concurrent use with other xanthine-containing compounds may increase the incidence and severity of adverse reactions. notably gastric upset. palpitations and central nervous system excitation. Contraindication•: Sensitivity to theophylline. Warning: Safety ol use during pregnancy has not been established. Use during pregnancy requires that the potential benefits of the drug outweigh the possible hazards to mother and fetus. Adverse Aaectlona: Rarely, nausea or gastric distress may be experienced . THEOLAIA reduces the potential for irritation of the gastric mucosa by theophylline; rapid dissolution and absorption reduce the exposure time in the stomach. Palpitatiou and insomnia have been reported on occasion. Dosage and Administration: Adults: 3 tablets initially and then 1 to 2 tablets every 6 hours taken on an empty stomach. In severe attacks: 3 tablets as a single dose. Children (6 to 12 years of age) : Vz to 1 tablet every 6 hours. It is important that the protective foil wrapping around each tablet be opened only when a dose is taken. Extended exposure to air may affect efficacy of the tablets. How Supplied: Boxes of 100 tablets. each tablet contained in '~ sealed aluminum foil pouch (NDC 0089-034~·16). This pouch has two functions: (1) It is resistant to opening by children. and (2) it preserves the efficacy of the medication by protecting the tablet against exposure to air. Caution: Federal law prohibits dispensing without prescription. THE(). I
You may obtain additional information about THEOLAIR Tablets from your Riker Representative or Medical Department. Riker Laboratories. Inc.. 19901 Nordhoff Street. Northridge. California 91324 .
~!~~ ~~~~~~~~~~~·.~.~~; 3Dl Member Company Certified Medical Representatives Institute. Inc
so skillfully edited by Sasahara and colleagues that overlapping material is minimal, yet each of the 17 chapters can be read separately. The chapters have all appeared originally in the 1975 issues of Progress in Cardiovascular Disease, a journal published by Grone and Stratton, Inc., and edited by Sonnenblick and Lesch. Sasahara was the guest editor for these chapters discussing a disease which affects half a million people yearly in the United States. Much of the material stems from the urokinasepulmonary embolism trial of the National Heart and Lung Institute, a massive source of fascinating data. It has become obvious that the occurrence of pulmonary embolism is much more frequent than suspected, and the majority of patients present a nonspecific clinical picture, so that a high degree of suspicion is needed to implement the final proofs of the diagnosis. Those of us who study this disease of pulmonary embolism have always realized its seriousness in cardiac patients. It was a pleasure to read the results of cardiodynamic studies obtained in the urokinase trial, particularly those relating the decline in cardiac index and stroke work index to preexisting congestive heart failure. The newer techniques for diagnosing deep venous thrombosis are well described and include occlusive impedance phlebography, radiographic fibrinogin, ultrasonic techniques, blood coagulation assays, and cineradiography. The final diagnostic studies include the nonspecific electrocardiogram, the sensitive lung scans, and the specific angiographic studies. All modes of therapy are clearly and separately discussed by known authorities on anticoagulation, thrombOlysis, venous interruption, the umbrella filter, and pulmonary embolectomy. There is an excellent resume of prevention by various means: physical measures, anticoagulation, alteration of platelet function, and patient selection. The volume is neatly bound and clearly printed on quality paper and contains numerous tables, photographs, x-ray films, and illustrations to document and clarify the text. The book will prove to be the current source of information on a serious life-threatening disease and should be read by all physicians who are called upon for its treatment. John]. Byrne, M.D. Boston
CARDIOVASCULAR CUNICS: INNOVATIONS IN THE DIAGNOSIS AND MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION (vol7, No.2). Edited by ALBERT N. BREST, LEsLIE
WIENER, EDWARD K. CHUNG, and HRATCH KAsPhiladelphia, F. A. Davis Co., 1975, 336 pp, 124 illus, $28.00. PARIAN.
Dr. Brest has done it again! In this comprehensive treatment of a "hot" subject, the series editor (this time with distinguished co-editors) has succeeded in maintruning the high standards of previous numbers of the series, Cardiovascular Clinics. Directly contributing to this result are Dr. Brest's own incisive discussions of infarction without coronary disease and heart failure in acute infarction. It is difficult to choose for special mention among 28 chapters whose contents transcend the book's title; while diagnostic and therapeutic innovations are indeed described, evaluated, and placed in context, established approaches are brought up-to-date. Corya's succinct, nicely illustrated echocardiographic chapter is a superb demonstration of the application of this noninvasive method to determiniiig ventricular dimensions, wall motion, and stroke volume. Hood's selfcontained monograph, "Modification of Infarct Size," a well-written discussion of the theory and state of the art, should be digested before turning to the valuable contributions of Lefer on glucocorticoids for stabilizing lysosomes, Austin and colleagues on intra-aortic balloon "assist," and Walinsky's outstanding presentations of the "nuts and bolts" of hemodynamic monitoring and of vasodilator therapy. Other "must" reading includes the pros and cons in evaluating and dealing with bradyarrhythmias, beautifully summarized by Meltzer, and Roberts' customary virtuoso performance, a think-piece on the puzzling correlations (and noncorrelations ) between coronary arterial disease and coronary heart disease. The contributors and editors of this book can be congratulated for a magnificent group effort which offers a great deal for everyone concerned with myocardial infarction and its consequences. David H. Spodick, M.D., D.Sc., F.C.C.P. Baston
BOOKS RECEIVED IMPORTANT TOPICS IN CONGENITAL, VALVULAR, AND CORONARY ARTERY DISEASE. Edited by DRYDEN P. MoRSE and HARRY GoLDBERG. Mt Kisco, NY, Futura Publishing Co., 1975, 191 pp, $18.95. PAEDIATRIC ANAESTHESIA (2nd ed) . By HAROLD T. DAVENPORT. Chicago, Year Book Medical Publishers, Inc., 1973, 258 pp, $16.95.