Book Reviews

This latest edition to surgical literature is aimed at those undertaking higher surgical training. The Editors indicate that this is based on providing specialist trainees in general surgery with the knowledge required for training in general surgery and essential subspecialty training but falling short for providing advanced sub-specialty training. As one can expect in trying to cover all of this for the whole of general surgery, it is not a small book. That said, I found it relatively easy to read and there were very clear diagrams and photographs amongst the text, which were very easy to follow. I think this is essential when aimed at such a broad topic and, on the whole, the text achieves what the Editors set out to achieve.

The criticisms I have are probably common to all multi-author texts. There is variation in the standard of some of the chapters. It does seem that some of the authors go into more detail than others; some are perhaps providing the more involved sub-specialty advanced training, which the Editors say is not specifically covered. I also found there was a slight difference in style between the eight sections, which are set out to cover the different topics that make up the SAC syllabus for general surgery. I found, for example, that some sections, particularly the lower GI section, covered specific topics such as obstruction and bleeding, whereas others dwelt on particular pathologies. Likewise, some authors went into more detail with the operative technique and it is always difficult with such a text to know whether it is intended to provide a text of operative surgery or one of surgery in general. Unfortunately, many chapters fall between the two approaches. 

There were a few omissions and, again, slight imbalances. In Section 1, for instance, the section on oesophageal motility was longer than that on oesophageal cancer and there was little mention of gastro-oesophageal reflux or bariatric surgery, both of which constitute a large amount of the work practice of upper GI surgeons. I found the lone section on therapeutic endoscopy slightly out of place. The same could be said of the section on endoscopic surgery. I think to consider laparoscopic surgery as a specialty on its own is rather outdated and the place of these techniques would be better incorporated into the individual sections.

In Section 8, paediatric surgery, I would have welcomed an introductory chapter, perhaps talking about the specific problems faced by paediatric surgery, rather than simply launching into various procedures. Similarly, in the epilogue, although governance is discussed, in today’s climate it is perhaps worth considering other topics of general interest to the surgeon, which are required to be considered in the final FRCS examination. In this regard, I wonder whether topics such as surgical research should also be considered.

Most of these criticisms, however, are matters of style rather than content. And, as mentioned above, the book is easy to read and to follow. As such, it provides a valuable basis for higher surgical trainees.

K. Park
Aberdeen Royal Infirmary
Aberdeen, U.K.

Safety at Scene - a Manual for Paramedics and Immediate Care Doctors
V. Calland
Mosby
ISBN 072343199X
£21.95

Safety at scene fills a gap in the immediate care library and is a welcome addition. The enthusiastic author has researched the subject in detail and, at 225 pages, has provided a concise text that is remarkably wideranging. As the author admits, it is not a definitive text of scene safety, but more a detailed overview. Nevertheless, there is an abundance of useful information to be gleaned. For those so inclined, there are several sensible self-test MCQs at the back of each chapter and short, discussed answers at the back of the book.

It is difficult to explain the scope of the book without resorting to a pointlessly long list. In general, the first six chapters deal with road traffic accidents and personal safety. They provide a useful summary of scene safety and extrication techniques used by the Fire Service and would be a good starting point and aide memoire for the excellent RTA/Safety at Scene courses that are becoming increasingly popular. This is not a manual for rescue techniques; when mentioned, they are only in the context of the safety of the rescuer. What it does do is enable the paramedic and immediate care doctor to operate safely at the scene and have some knowledge of what is happening whilst the Fire Service get on with the business of rescue.

The book goes on to cover chemical, biological and radiation hazards including a good explanation of the various hazard identification labels in existence. A smattering of background scientific knowledge enables the unenlightened reader to gain some insight into the subjects covered. This is very much the style throughout. A good balance between text and illustration makes the book accessible and easy to read without losing detail. The remaining chapters cover less familiar material with the same intensity of factual content. Rail and aircraft crash scene safety (including the essential workings of the ejector seat!) are given appropriate coverage. The book moves on to casualty rescue from collapsed structures and confined space, followed by a generalised ‘difficult terrain’ chapter. Rope work, water, ice, snow and mud rescue; exciting reading for the adventurous doctor or paramedic but the emphasis is always on personal safety.

The remainder of the book fizzles out a little. There is an all too brief mention of sporting events, which is surprising as outside the RTA-based immediate care schemes this is the most common place to find doctors and paramedics practising pre-hospital care. The following chapter on ‘when people affect safety’ provides some guidance on how to deal with violent patients and potentially volatile situations including hostage-taking and civil disturbance. Manual handling techniques appear at the back of the book like an afterthought. Little emphasis is given to this most common activity that paramedics (and sometimes doctors!) will perform.

Those who have some experience or knowledge of scene safety and extrication would find the book a useful quick-reference. For newcomers to the speciality it provides an excellent and authoritative introduction to safe practice in the pre-hospital environment. It is also a source of entertaining minutiae and will undoubtedly find its way to the bookshelves and glove compartments of the majority of immediate care practitioners and this is not a bad thing. 

I. Greeves
Middlesborough General Hospital, U.K.

Surgery at a Glance
Second Edition
P.A. Grace and N.R. Borley (Eds.)
Blackwell Publishing
ISBN 0632059885 £13.95

This is an attractive book that seems to be aimed at medical students. There are good aide memoirs, particularly the diagrams, which will be useful before starting a house officer’s job or any revision. However, the book is not detailed enough for MRCS candidates as there is very little information of embryology, anatomy and physiology. If the book is to be used for the MRCS revision, it is really only useful for the MCQII (systems) or part II (viva and oral). However, the content of the book is easily accessible and well-organised, with material on a two-page spread format. A couple of details one could mention, for dynophagia, i.e. painful swallowing as opposed to dysphagia (difficulty swallowing) in chapter 2.

Similarly, in chapter 2 Achalasia, i.e. the failure to relax the oesophagus is not given any definition. In chapter 4, the colour, i.e. green or blue could be mentioned in brackets next to the normal cyst fluid on the chart on page 16. Similarly, the 30% rule for fibroadenomas could be mentioned as an aide on page 17, chapter 4, i.e. 30% resolved, 30% stay the same and 30% progress. In chapter 5, regarding breast pain, mention could be made of distinction between breast pain and pleuritic chest pain, especially the differentiation from pulmonary embolism. Similarly, in chapter 5, the classic appearance of a sebaceous cyst, i.e. with a punctum on the surface is not mentioned.

The book, therefore, is very much a summary book as not many definitions are provided. I would recommend it as a summary book for final year medical students and also for MRCS revision for MCQII (systems) and part II of the MRCS (viva and oral).

N.R. Binnie
Aberdeen Royal Infirmary, U.K.

Internal Fixation in Osteoporotic Bone
Y.H. An (Ed.)
Thieme
ISBN 3131284714 £116.00

This is a 350-page book that worthily addresses fixation of osteoporotic bone. There are some excellent chapters, particularly in the first section. The biomechanics chapters are in the majority of aspects excellent. However, it is unfortunate the mechanics of the implants that have been developed, specifically for fixing osteoporotic bone, are not evaluated. Similarly, some of the biological general principles which are extremely well covered in the early chapters, do not go into those specific to osteoporotic bone.

There are several chapters that do not seem to be particularly relevant to osteoporotic bone, but rather to other forms of pathological bone; mainly the chapter on Pagets and on bone tumours. Furthermore, the title of the book refers to internal fixation, yet there is a chapter on external fixation of bone. Unfortunately, this chapter does not cover the particular problems of external fixation of osteoporotic bone and, in particular, does not mention the literature supporting the use of external fixation in the distal radius, which is one of the commonest sites where it is worth using external fixation (see extensive literature by McQueen et al.).

A number of the remaining chapters have considerable overlap. For example, there are chapters in the spine section on internal fixation, which largely overlap. Also, although very relevant, there are multiple chapters on vertebroplasty that could have been combined. Similarly, there are several chapters on fillers/cements to aid bone fixation, and it would have been helpful if these were also combined.

Overall, I am not sure of the market for this book. It is not suitable for the trainee, nor condensed appropriately for the practising consultant. There are, however, a number of good chapters and a number of useful facts on osteoporotic bone.

A.H.R.W. Simpson
Princess Margaret Rose Hospital
Edinburgh, U.K.

Forensic Medicine.
Clinical and Pathological Aspects.
Edited by J. Payne-James, A. Busuttil and W. Smock.
Greenwich Medical Media Ltd. 2003.
ISBN 181100269
£135.00

This is a large text book by any standard. It comprises 804 pages of near A4 size text divided into 51 Chapters contained within 4 Sections entitled ; General Issues , Causes and Investigation of Death and Injury , Practical Investigation and Management and, finally, Related Specialties. 

With the exception of Chapter 28, (Adult sexual assaults: practical management) which is 44 pages long; each Chapter is between 10 and 20 pages including an abbreviated bibliography. The result is a very broad overview of forensic medicine providing a companion to a general introductory course to forensic studies appropriate to a graduate from any discipline. The very little knowledge of human anatomy, physiology and pathology required to follow this text could be provided in Lectures and Demonstrations.

In addition to being an introductory course text book it provides the subspecialist with information in areas with which he/she may be quite unfamiliar. For example I found the Chapters dealing with Shari’ah Law and the Judicial System , Custody and Restraint Deaths , Diving Injuries and Barotrauma ( not including drowning) and Agrochemical Poisoning fascinating . The last Chapter on Report Writing for the Courts and Lawyers is welcomed and deserves greater prominence since this important topic is frequently overlooked resulting in data useful to the Court sometimes being poorly presented and consequently undervalued.

In the current climate of evidencebased medicine the chapter devoted to statistical techniques and their role in evidence interpretation is a salutary reminder of the need for expert statistical advice before writing a Report which purports to inform the Court on uncertain matters, since, as the author suggests “uncertainty is best measured by probability”. After reading this chapter I decided that the potential for a mathematical disputation in Court is considerable and should be handled by experts who have analysed the raw, first source, data. However, I remain unconvinced that all uncertainties can be presented mathematically. A human bite mark inflicted during sexual arousal may be appreciated by one person as a painful experience and by another as pleasurable so the mathematical “probability” of a bite having caused suffering cannot be assessed. A subjective opinion on the basis of “roughly right rather than exactly wrong” might be more appropriate.

The topics covered in this compendium are so diverse that no one person can adequately ( or justly) make a review and so the reviewers opinions tend to be coloured by his/her reading of the Chapters about which topics he/she has some intimate knowledge. Chapter 17 dealing with mass disaster organisation is very informative and is clearly written out of much experience. My own practice of forensic dentistry for some 24 years allows me to suggest that the Chapter on forensic odontology is a very fair overview of the subject given the editorial restraints and the level at which this text is pitched. It was personally interesting to read of the case mix in Melbourne which suggests that 92% were related to identification and only 8% to bite mark cases. Dental identification was required in 504 cases over a 10 year period in a catchment area of about 3 million; roughly 17 cases per million per annum. My own experience in Edinburgh and South East Scotland is somewhat lower at around 12 per million per annum but I am asked to inspect a similar number (12 -15) of possible bite marks per year. The value of bite marks in the UK has been established by well known experts such as Macdonald and Whittaker while our colleagues in Australia have experienced difficulties from which they are now recovering and this may explain, in part at least, the quantitative differences in the case mix.

In contrast to Clements’ chapter the comments on page 477 dealing with bites on children constitute sweeping generalisations which I feel certain the author would have qualified if space had permitted. The bite illustrated in Fig 30.11 may indeed be an adult bite but there is insufficient evidence in the photograph to make this assertion. On pages 553/4 a bite mark through clothing is illustrated but there is insufficient opportunity for the author to deal with the effects of clothing in such a situation. The author makes reference to the use of digital cameras in recording such wounds but some Courts are still very suspicious of the images produced and the method described on page 419 using a 35mm camera is preferred. While photography is briefly mentioned in several chapters I feel the omission of a chapter dealing solely with photography is unfortunate. Interpretation of photographs of wounds is more complex than may be imagined. There are problems with attempting to accurately image in two dimensions wounds on curved surfaces and the avoidance of photographic distortion due to inappropriate positioning of the camera. Postural distortion may be captured on film if the victim is photographed in a different position from that which they were in when the wound was inflicted. Ultra violet light photography to illustrate “old” wounds is highly controversial but deserves discussion. Such a chapter might be considered more relevant in a book of this nature than chapter 26 which is solely devoted to the physiology of male and female sexual arousal, interesting though that may be.

In summary, this book could function as the sole text book required to accompany an introductory series of lectures and tutorials at Certificate rather than Diploma level and secondarily as a text providing a useful introduction to some of the lesser appreciated aspects of forensic medicine. It is, however, very expensive.

H. Moody
Edinburgh Dental Institute
Edinburgh, U.K.

Vascular access simplified
A.H. Davies and C.P. Gibbons (Eds.)
TFM Publishing
ISBN 1903378133
£25.00

Access surgery for renal dialysis has always been a Cinderella speciality that most vascular surgeons in the past did not want to get involved with and similarly vascular surgical trainees also rejected as part of their field, despite that fact that the speciality is now more than 35 years old.

As a result, it has been a service that often has been badly performed. However, as the demand for the service has increased due to the rapidly and steadily increasing number of patients on dialysis treatment, at the same time as the population requiring this treatment is getting steadily older with increasing generalised vascular disease, it was inevitable that vascular surgeons would have to set aside more time to deal with this problem. Because of the Cinderella status of this speciality no major textbook exists to guide the consultant surgeon or, for that matter, the trainee surgeon who has to deal with these problems, and this book, therefore, is very opportune.

It is a multi-author book consisting of 14 chapters written by practising surgeons, radiologists, nephrologists and anaesthetists and deals with all aspects of renal access surgery including peritoneal dialysis. A more appropriate title for the book might, therefore, have been ‘Renal dialysis access surgery’ rather than ‘Vascular access simplified’. As the book is fairly comprehensive I do not think that authors need to be modest by adding simplified in the title.

I found this book easy to read, comprehensive and informative. Although the history of renal access surgery is briefly dealt with in the appropriate chapters I feel that in honour of those who initiated this form of surgery a chapter on the history would be of interest. A little more detail on the operative technique of the anastomosis dealing with the pros and cons of interrupted versus continuous anastomosis and the length of arteriotomies would be of help to the individual embarking on this form of surgery. Overall, this is a nice little book that should be mandatory reading for everybody who gets involved in renal dialysis access surgery.

J. Engeset
Aberdeen Royal Infirmary
Aberdeen, U.K.

Surgical Management of Hepatobiliary and Pancreatic Disorders
G.J. Poston and L.H. Blumgart (Eds.)
Martin Dunitz
ISBN 1899066977 
£120.00

“The surgical management of hepatobiliary and pancreatic disorders” is an impressive 500-page volume written in a refreshing problembased style avoiding the tedious lists encountered in larger tomes, allowing it to tackle some of the complex areas within the specialty in detail. Difficult problems are dealt with by international experts who, using what supporting evidence there is, guide the reader through the current ‘best practice’ in many areas. There are also excellent chapters on state-of-the-art techniques (e.g. laparoscopic pancreatic surgery, ex-vivo liver resection). Pictures and diagrams are used extensively and are on the whole of high quality - although there are a number with inaccurate labelling and upside-down or back-tofront images. The book covers liver and biliary tumours and chronic pancreatitis in great detail with clear diagrams and a ‘question and answer’ approach.

In the preface the editors state their purpose to cover the spectrum of common HPB diseases that will confront the general surgeon in his or her regular practice and to be sufficiently comprehensive to cover the broad spectrum of HPB surgery for candidates coming to examinations at the completion of surgical training. My major criticism is there are a number of large sections of HPB practice barely touched on or not covered at all. For example, whilst pancreatoduodenectomy with portal vein resection receives a whole chapter there are no other chapters on the management of pancreatic cancer; likewise, there is no discussion of cystic pancreatic tumours. The chapter on cholecystectomy has several pages  devoted to mini-cholecystectomy and its supposed advantages but no description of the basic technique of laparoscopic cholecystectomy, despite the fact that 90% of gallbladders are removed this way. There is no discussion of pre/peri-operative identification and management of bile duct stones nor of the increasingly complex algorithms for managing gallstone disease (ERCP v MRCP v EUS/ open v laparoscopic v endoscopic CBD stone removal and techniques, etc.). In this respect, the book cannot be considered either comprehensive or to ‘cover the spectrum of common HPB diseases that will confront the general surgeon’, since the commonest diseases (gallstones and pancreatic cancer) are barely mentioned.

Let this not detract from what is an excellent book that would be better marketed as dealing with controversies and difficulties in HPB diseases rather than purporting to appeal to the generalist. Although not comprehensive, it will be essential reading for final fellowship/surgical boards candidates and as a reference volume for HPB surgeons.

I.J. Beckingham
Queen’s Medical Centre
University Hospital NHS Trust
Nottingham, U.K.

Anorectal and  colon diseases, textbook and colour atlas of proctology
E Stein
Springer
ISBN 3540430393
£127.20

Ernst Stein produced a German textbook of proctology, which was profusely illustrated. The first four editions were in the German language. This is the first English translation, essentially of his 4th Edition.

Surgeons will be delighted with the quality of photographs in this book. It does provide a very comprehensive library of colorectal conditions, which can be easily photographed. Because so much more can be photographed around the anal region than elsewhere in the colon and rectum, there is a bias towards anal disease and perianal conditions complemented admirably by excellent photographs of colonoscopies and some resection specimens.

Hence, although this book is titled as a colorectal text, the bias within the book is strongly towards anal disease and perianal problems. Overall, the quality of the photographs is excellent but a few of the endoscopy photographs are disappointing.

The book is slightly over 500 pages long. Over 100 of these pages are related to infectious diseases and intestinal parasites. Thus, for the tropical coloproctologist the text provides not only useful information but also excellent photographs of relatively rare infectious conditions. By contrast, the section on inflammatory bowel disease occupies less than 30 pages. Injuries to the colon, rectum and anal sphincter amount to only seven pages. The ‘bread and butter’ of colorectal surgery, namely colorectal cancer, is confined to only 10 pages. There are some excellent photographs of polyps and of anal cancers and rare tumours. Over 100 pages are devoted to perianal skin diseases.

There are some excellent photographs and the colorectal surgeon will find this book particularly useful in identifying unusual skin disorders that affect the anorectal and perianal region. It would be wrong to promote this book as a comprehensive colorectal text. It is not. It is an excellent collection of photographs with a heavy bias on perianal disease and anal disorders. The text is well written but is not comprehensive and the time and space devoted to the most common colorectal disorders is disproportionate to their frequency. This is more a book for the proctologist rather than the colorectal surgeon, but even the colorectal surgeon will wish to use it as a reference tome, particularly when confronted with unusual skin disorders around the anal region.

M.R.B. Keighley
Queen Elizabeth Hospital
Birmingham, U.K.

Surgical Anatomy of the Hand & Upper Extremity
J.R. Doyle and M.J. Botte
Lippencott Williams & Wilkins
ISBN 039751725
£167.00

This is an extremely impressive volume, and quite likely to become one of the definitive works on this topic. It is clear from the foreword written by David Green that the authors were sympathetic to his view that “The best surgeons are those well versed in anatomy.” It is all the more unfortunate, therefore, that in Britain, at least over the last few years, this subject has been given a far smaller role in the medical curriculum than was formerly the case. Clearly, this will soon have disastrous consequences for surgery.

The authors meticulously and most helpfully provide the derivation of each of the anatomical terms encountered in the text, although whether there is any value in providing the appropriate Latin plural forms is another matter, as these are never really likely to be used. While emphasising that this is an excellent volume, it is appropriate to draw attention to certain features that could, in this reviewer’s opinion, be improved in future editions. I personally do not like the presentation of the majority of the figures prepared and invariably signed by Elizabeth Roselius, principally because they look as though the subject matter has been viewed through an opaque screen. Compared to the images that anatomists and surgeons are familiar with, they are simply too “arty.” I personally prefer illustrations to be either diagrammatic or realistic, not somewhere between the two. A considerable number of the illustrations, such as figures 7.11, 7.14, 7.16, 7.18, 7.28, 7.34, 8.23, 8.25 and 8.43 are poor, while 7.32 can only be described as dreadful, and would be best replaced by an appropriate photograph. Elsewhere, photographs are provided throughout the text, so why not in this case? The bizarre cap worn by the subject in many of the drawings appears to be poor imitation of that shown by Charles Bellon some if the wounded from Corunna that illustrate his Dissertation on Gunshot Wounds of 1814.

Much of the terminology used will not be familiar to a British readership, and may be equally unfamiliar to American readers. For example, the term “lacertus fibrosus” is used throughout the text, and would be best replaced by the more familiar “bicipital aponeurosis.” It might not be inappropriate to describe the terminology used here as pretentious. Equally, a considerable number of figures have large numbers of abbreviations without an associated “key”. While reviewing this volume I thought that it would be helpful to discuss my thoughts with a hand surgeon, particularly as I encountered so many terms with which I was unfamiliar. This was a helpful exercise, as I learned, for example, that the term “middle” finger is not used in the United States, as medical secretaries are often unable to distinguish between “middle” and “little” fingers. To avoid confusion they prefer hand surgeons to refer to this finger as the “long” finger. To my knowledge this is not a problem encountered in Britain. This clearly is not a workshop manual for hand or upper extremity surgeons. At best, it might be suitable to offer as a retirement gift, so that the recipient could spend many happy hours looking up all the large number of anatomical terms and clinical conditions he failed to recognise or diagnose during his career as a hand surgeon. For example, the reader will no doubt be interested to hear of the origin of the term “nightstick” fracture, amongst the huge number of other infamiliar terms, although the term “nightstick” does not appear in the reviewer’s copy of the Shorter Oxford English Dictionary. Altogether an excellent read for those that have the time to do so.

M.H. Kaufman
Division of Biomedical and Clinical Laboratory Sciences
University of Edinburgh
Edinburgh, U.K.

The Ophthalmology Examinations 
Review by Tien Yin Wong
World Scientific Publishing 2001
ISBN 9810243995
£56.00

There are now so many standard general ophthalmology textbooks on the market that it is refreshing to review something completely different directed at our trainees.

This four hundred and twenty page book, composed by Dr Tien Yin Wong FRCSEd assisted by Dr Li Wern Voon FRCSEd both advanced/higher Singaporean Ophthalmology Trainees, is as the title suggests intended as a revision guide for examination candidates. It is based on their own and their local colleagues’ experience in the training and examination system in Singapore. However, it is also ideally suited for any candidate taking basic qualifying tests in ophthalmology anywhere in the English speaking world.

It is quite a remarkable and comprehensive fund of information and must surely contain every question ever put by any examiner in an oral/viva examination and also covers all the published syllabuses both for basic sciences and clinical components of our examinations. It is not, however, suitable as a basic comprehensive text because of the format used which consists of presenting questions such as in a viva - what? why? when? how? tell me? followed by concise formulated answers . All 10 main sections have one or two opening general questions with “exam tips” followed by subsidiary questions just as in a well conducted viva; there is a total of over 1000 questions. The reviewer who was an ophthalmology examiner for 30 years finds every question he or any co-examiner has ever asked in this book.

The subject matter is divided into sections comprising: (1) Cataract and Cataract Surgery, (2) Glaucoma and Glaucoma Surgery, (3) Corneal and External Eye Disease, (4) Surgical Retina, (5) Medical Retina, (6) Neuroophthalmology, (7) Oculoplastic and Orbital Diseases, (8) Uveitis, Systemic Diseases and Tumours, (9) Squints and Paedriatic, Eye Diseases, and finally (10) Miscellaneous Examination Problems. There is a minimum of five and maximum of eighteen topics in each section but there are no illustrations or even line diagrams to break the repetitive question and answer format so a trainee might have great difficulty in absorbing such a concentrated mass of information. The cost, however, has thus been kept low at £56.00.

There is a useful eight page index, and as unfortunately required nowadays a comprehensive list of no fewer than 116 abbreviations used throughout the text.

Trainees, therefore, might consider the use of this book as a reasonable guarantee for success in the examinations mentioned provided preliminary reading has been completed. It could also be of assistance to harassed examiners in drawing up suitable lists of topics for viva examinations and, in addition, assist them in the difficult task of setting and checking MCQ papers.

J.F.B. Cullen
jbarrycullen@yahoo.com

Review Vascular Highlights 2002-2003
Edited by Alun Davies
Health Press Limited 2003
ISBN 1903734363
£15.00

I think these little books are excellent. The Editor, Alun Davies, always manages to choose topics that are topical and of broad interest to vascular specialists. The authors are of “who’s who” of the vascular world and the information is, therefore, up to date and authoritative. The volumes are well illustrated and the articles are exactly the right length. The production values are high. I think this is exactly the sort of format that suits the busy modern specialist whether it is vascular disease or any other branch of surgery or medicine. Some would argue that priced at £15.00 it is a little bit expensive. However, on close examination the volume shows that it does contain a lot of useful information presented in an extremely attractive and accessible manner. I would thoroughly recommend these volumes to all vascular specialists wishing to keep abreast of current developments.

A.W. Bradbury
Birmingham, U.K.