Needle biopsy of the liver is now an accepted procedure in most  large hospitals, and surgeons and laparoscopists are more likely to  biopsy the liver under direct vision than in the past. Consequently,  increasing demands are being made on pathologists for rapid diagnosis.  This full colour atlas provides a practical guide to the  histopathological diagnosis of liver disorders, with particular  emphasis on clinicopathological correlation and the need for the  pathologist to be in full possession of all the available clinical  information. Although containing over 350 colour illustrations, the  book is more than just an atlas and each section includes a brief  description of the main clinical and pathological features of the  subject under discussion.  For this second edition, many chapters have been rewritten - e.g. on  viral hepatitis - and many new illustrations added. The book is  intended for the practising and trainee pathologist and the clinician  who performs liver biopsies, but will also be of value to  postgraduates, residents and students in other branches of medicine.

Atlas of Liver Pathology (Current Histopathology)

D. G. Wight

Health, Fitness & Dieting

Springer London

In the past few years there has been a great upsurge of interest in the problem of essential hypertension. This has been stimulated by several comparatively recent advances, the most important being the demon stration that many if not most of the cOInplications of hypertension can be prevented with adequate and effective medical treatment. Because of the extremely high prevalence of hypertension (roughly one in six or seven adults) effective preventive treatment will have a tremendous im pact on national health and longevity. This new approach to the problem of hypertension differs markedly from the old, which concentrated on a meticulous and expensive search for curable forms ofhypertension representing at most 5% ofthe hyper tensive population. Today, however, we are facing up to a much greater challenge. Now many patients with hypertension, not just a selected frac tion, are possible candidates for treatment. Therapeutic decisions need to be made which will affect the health and well-being of millions of people. This change has been truly revolutionary as, for the first time, it has become possible to influence a leading cardiovascular disorder therapeu tically and prevent its complications. This volume presents the current thought ofleading experts in the new movement in hypertension. Their purpose is to supply the most recent in formation in the field in such a way that it can be applied by the physi cian in practice. In fact, this book is intended as a guide to the new management ofhypertension.

The Treatment of Hypertension

E. D. Freis

Medicine is news. There is constant public interest in health and disease; in medical miracles and in breakthroughs; in medical disasters, failures and malpraxis ; in deficiencies and defects ofhealth services; and in the rising costs ofhealth care. Medicine is 'big business'. Physicians co me out near the top money earners in most medical care systems. In the Uni ted Kingdom the National Health Service (NHS) now costs over [6000 million a year ($ ro 800 million), a free service that costs every British man, woman and child [120 a year ($216) in direct and indirect taxes. But this is less than the [500 ($900) a year that medical care costs each person in USA and West Germany. In developed countries health care costs are approaching ro% ofthe gross national product (GNP). It is big business also in that in Britain the NHS is one of the largest employers; about I million Britons work as employees of the NHS, caring for the other 54 millions and in the USA the numbers are 5 million caring for 2. 5 millions. The provision of health services is full of problems and dilemmas. These problems and dilemmas cross all' national boundaries. All countries share the same problems and dilemmas. Problems of objectives, of standards, of effectiveness and efficiency, and problems of relations between the medical profession, the public and govern ment. Medical care still is full of mystique.

A New Approach to Medicine: Principles and Priorities in Health Care

John, Fry

The story of the benzodiazepines is a fascinating one: the synthesis of a long series of inert compounds and the abandonment of the project: months later, the renewal of the project and the discovery that this compound R05-0690 (Librium ®) was a sedative and muscle relaxant in laboratory animals: the recognition that its postulated structure was wrong and that it was in fact a member of an entirely new chemical class: the excitement caused by the discovery of the powerful taming effect of the drug in wild animals: the even greater excitement in medical circles when its dramatic anxiety relieving effects were cstablished in humans: the subsequent enormous world wide usc of drugs of the benzodiazepine group. I have reason to know the story well for during that period I worked in various capacities in research, marketing and manage ment in the British subsidiary of F. Hoffmann-Ia Roche. It was during this period that I became interested in whether dependence on benzodiazepines could occur and if so to what extent, but felt that this could be examined best from outside the concern. Having now retired from Roche back to academic medicine I have taken the opportunity to examine and analyse the evidence.

The Benzodiazepines: Use, overuse, misuse, abuse

Science & Math

J. Marks

Mathematics

Handbook of Lithium Therapy

As a medical student in the 1930s, I remember well that a very clear line of distinction was drawn between physical illness and mental illness. Physical illness resulted from pathology which could be identified and studied in detail and the cause could often be deduced. Treatment thus was often specific and based upon a proper appreciation of underlying basic science. Mental illness, on the other hand, could not, it was believed, be based upon identifiable changes in basic science. It was literally 'all in the mind' and, occurring in the absence of causes that could be identified, analysed and remedied, had no treatment that could in any way be called specific. N ow it is all too easy, in Medicine, for a doctor to become so immersed in a specialty that he fails to notice how his colleagues in other specialties are faring and, through laziness, to miss advances even of fundamental importance in fields other than those in which he himself works. As a consultant surgeon, after W orId War II, although I realized the importance of keeping in touch with those medical specialties which appeared to have a common interface with my own surgical interests, such as general medi cine, gastro-enterology, hepatology and endocrinology, it did not occur to me that there was any pressing need to ask what was new in Psychological Medicine.

F. N. Johnson

The past few years have seen the publication of a large number of articles and not a few books on the subject of relief of intractable pain. New ideas have been put forward on pain mechanisms, new methods of treatment have been reported and improved results c1aimed, and a growing catalogue of complications oftreatment has been recorded. The vast and expanding literature on the subject poses for the reader the dual problems of surveil lance and of assessment. The object of the present book is to provide a critical and constructive review of current writings and ideas on a wide range of aspects of the nature of intractable pain, particularly of present day practice and new ideas on treatment. Each chapter is written by an acknowledged authority and the approach throughout is practical rather than academic. In editing the individual chapters an effort was made to achieve a contemporary approach and to eliminate material which was unduly historicalor retrospective in content. At the same time the individ ual style of the authors was retained as far as possible. For decades chronic pain has been a therapeutic 'no man's land'. For the surgeon pain was an unfortunate complication wh ich not infrequently followed surgery; for the physician it was a distressing symptom in a number of disease syndromes; to the psychiatrist it was one of a number of features in many cases of mental illness.

The Therapy of Pain

Mark Swerdlow

The newcomer to the field of clinical chemistry is faced with the daunting prospect of understanding the ever increasing aspects of the subject: new techniques, tests, terminology, methods of diagnosing diseases and other advances which relate to clinical chemistry. The aim of this book is to provide basic information regarding all branches of the subject which the trainee will need to understand. The book should also provide a basis for answering many of the examination questions of clinical chemistry. It is therefore hoped that this book will prove useful to any person starting a career in clinical chemistry, be that person a laboratory scientific officer, graduate or trainee pathologist. Wherever possible, suggestions for further reading are given. Many subjects are so broad however that the reader is referred to the general list of analytical and clinical textbooks supplied at the end of the book. My grateful thanks are extended to the three ladies who typed this manuscript: Christine Cliffe, Margaret Donnelly and Judith Hardy. I would like to thank Dr Brian Wisdom of Queens University, Belfast for his suggestions on the entry "Enzyme-immunoassay". Finally my thanks go to Mr Martin Lister of MTP Press for his help and encouragement in this venture. W. H. ASHTON-UNDER-L YNE APRIL 1980 vii A ABETALIPOPROTEINAEMIA A rare hereditary disorder in which there is a complete absence of j3-lipoprotein, pre:f3-1ipoprotein and chylomicrons. It presents clinically as ataxia and malabsorption with steatorrhoea. Thorny shaped erythrocytes (acanthocytes) are a feature of the disease.

A–Z of Clinical Chemistry: A Guide for the Trainee

W. Hood

Medical Books

In this volume I have attempted to cover the more important aspects of immunosuppressive therapy. In doing this, I have been very fortunate in securing the help of the distinguished authors who have contributed the chapters that follow and I am grateful to them for providing such thorough and up-to-date accounts of their subjects. Immunosuppression can be mediated by many hundreds of agents and it has been difficult to strike a balance between the 'small print' of drug action in animals and the useful ness or otherwise of drugs and other agents for inducing immunosuppression in patients. The first six chapters deal mainly with the experimental aspects of lmmunosuppression and include a full discussion of total lymphoid lrradiation and cyclosporin-A. Both these agents have shown great promise recently as forms of immunosuppression in animals and undoubtedly will come to be used more and more in patients recelvmg transplants of one form or another. The last four chapters are devoted to the use of the more traditional immunosuppressive agents for specific clinical conditions. In her chapter on renal transplantation, Dr McGeown describes in great detail not only the immunosuppressive regime she employs but the general manage ment of transplant patients. The clinical results have been so good in her unit that I felt her account should include these other aspects of treatment since they would seem to be just as important as the immunosuppressive regime she uses.

Immunosuppressive Therapy (Current Status of Modern Therapy)

Throughout the history of mankind from primitive man to the present time, vitamin ddiciencies have been a major cause of death and disease. Pellagra, scurvy and beri-beri have decimated armies, ships' crews and even nations (Figure I). As late as 1925 the disease 'pernicious' anaemia caused by the ab­ sence of vitamin Bl2 within a person's body really lived up to its name. Although there were isolated instances of recognition of dietary deficien­ cies even a thousand years ago, the importance of dietary factors in the gene­ sis of these diseases was more widely recognized from the eighteenth century onwards and it was not until this century that the chemical structure of these factors was determined and the substances themselves synthesized. As the science of biochemistry has developed it has been found that the clinical manifestations of vitamin deficiency follow derangement of multiple metabolic functions. The majority of the vitamins in fact form specific co-en­ zymes in various chemical processes but at least one is converted within the body into a hormone. The commercial extraction and synthesis of the vitamins, which began mainly in the 1930S and 1940s, produced adequate quantities for a relief of vitamin detlciency diseases. The use of vitamins then became fashionable and dramatic cures were claimed for an ever increasing number of diseases.

A Guide to the Vitamins: Their Role in Health and Disease

John Marks

This is the fourth volume of Standard Operating Procedures (SOPs) compiled from documents prepared in these laboratories in part fulfilment of the requirements of various Good Laboratory Practice (GLP) regulations and guidelines. SOPs have now become an everyday feature of work in most industrial and contract toxicology laboratories. They provide a written definition of the mechanics of unit operations which together comprise the framework for experiments in safety evaluation. Metabolic studies and analytical chemistry are closely linked to toxicology since they embody essential aspects of the overall assessment of product safety. Some authorities consider certain parts of these subjects to be outwith the scope of the GLP requirements but for the reasons stated this is contrary to our own view. We have tried where possible to define in SOP format for use in our own laboratories the unit operations involved in these disciplines and they form the basis of this volume. Some relevant material from previous volumes has been brought together in updated form and is also presented here for completeness. Dr I P Sword Managing Director Inveresk Research International Musselburgh EH21 7UB Scotland ix Introduction GENERAL 1. The Food and Drug Administration of the US Government published its Good Laboratory Practice Regulations for Non-Clinical Laboratory Studies in the Federal Register (22 December 1978). The Regulations are the culmin ation of a number of years of investigation into the standards to which safety evaluation studies were performed in laboratories in the USA.

Standard Operating Procedures Analytical Chemistry and Metabolism

A. W. Waddell I. P. Sword

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