A History of Medical Informatics in the United States: 1950 to 1990

by Morris F. CoElen, MD. Bethesda, Maryland: American Infomatics Association; 1995. 489 pages. $40.

T his book is an exhaustive review of the history of med- ical informatics from its inception with the develop- ment of computers in the 1940s and 1950s to the pre-

sent utilization of computers for the management of medical information. The book begins with the history of develop- ment of computers and their evolution from very simple ma- chines to the present day devices that are utilized through- out the country. After setting the tone of the book with this historical perspective, the history of the creation of the dis- cipline of informatics is then outlined. With this groundwork in place, the author describes medical, hospital, and office information systems. He describes in great detail the purposes and goals of each system, the specific problems encountered in each system, and the solutions that have been devised to make the systems work. At the conclusion of each chapter, he summarizes with a personal commentary, which provides the reader with a great deal of insight into not only the de- velopment of these systems, but also their value, strengths, and weaknesses, in addition to direction for the future.

This is a very meticulously referenced, highly technical work that is fascinating reading for those who are closely in- volved in current medical informatics. For these individuals it should prove to be an invaluable reference guide and re- source. For the average physician, this book does not pro- vide practical “how-to” directions for managing their own office charts or patient information. Although it certainly remains interesting reading for those interested in this par- ticular topic, it will probably be found more often on the medical library shelves than in the physician’s office.

Matthew Concannon, MD Department of Surgery University of Louisville

Louisville, Kentucky

Minimally Invasive Surgery of the Foregut Edited by Drs. Jeffrey H. Peters ad Tom R. DeMeester. St.

Louis: Quality Medical Publishing, Inc. ; 1995. 344 pages. $I 15; CD-ROM: $199.95.

T his is the first edition of Minimally Invasiwe Surgery of the Foregut edited by Drs. Jeffrey Peters and Tom DeMeester. The authors include a globally diverse

collection of esophageal and gastric surgeons, many of whom have pioneered these new approaches; including many lead- ing American innovators, such as Drs. Filipi, Hinder, and Hunter, who are not merely laparoscopic enthusiasts. This is an attractive, hardbound book printed on high quality pa- per with outstanding illustrations and many helpful tables. The cost of approximately $115 is necessary for the beauti- ful reproduction of the many color illustrations. This un- dertaking is comprehensive and encompasses not only de- tailed descriptions of new surgical techniques, but incorporates broader physiologic principles of diagnostic

evaluation and surgical management. The text is divided into six major sections. Part I includes

a very interesting overview of the history of endoscopic ex- amination of the foregut and thoroughly outlines the diag- nostic evaluation of the foregut. Thoracoscopic and laparo- scopic approaches to esophageal motor disorders are covered in detail in Part II. The highlight of this edition is the sec- tion dedicated to laparoscopic management of gastro- esophageal reflux disease. This part of the book contains ex- cellent chapters fully describing techniques of laparoscopic nissen fundoplication and partial fundoplication, one chap- ter dedicated to the physiology of antireflux surgery and an insightful overview of lessons learned from failed antireflux repairs. Part IV reviews the pathophysiology of peptic ulcer disease and its managetnent with minimally invasive tech- niques. Part V details the management of common frequent neoplasms, including leiomyoma, mtramucosal esophageal cancer, and pancreatic cancer. A very practical section de, scribing techniques of laparoscoplc gastrostomy and je- junostomy catheter placetnent completes this tour-de-force of laparoscopic surgery of the foregut.

Minimally Invasive Surgery oj the Foregur is a comprehen- sive, well-organized, and beautifully illustrated initial un- dertaking and deserves a place in the library of any surgeon managing patients with gastroesophageal reflux, peptic ul- cer disease, or esophageal motor disorders.

E Dean McKenzie, MD Unielersity of Louisville

Louisville, Kentucky

Gastrointestinal Cancers: Biology, Diagnosis and Therapy

Edited by Dr. Anil K. Rust@. New York: Lippincott-Raven Publishers; 1995. 683 pages. $169.

his book is aimed at the diverse and extensive group T of physicians and researchers involved in the care of the patient with gastrointestinal cancer. Cancer re-

mains the second most common cause of mortality in the United States after heart disease, accounting for 22% of all deaths. Cancers of the gastrointestinal tract comprise over a quarter of the overall incidence and mortality. The book ac- complishes a comprehensive survey of gastrointestinal malig- nancy in a manner which is both readable and scientifically relevant. The list of authors encompasses a broad group of contributors representing the various disciplines involved in gastrointestinal cancer investigation and treatment. Fitting to this em of molecular medicine, a good portion of the discus- sions are devoted to the molecular genetic basis of cancer.

The introductory section reviews the basic principles of de- velopment of the gastrointestinal tract on a gross and mole- cular level, including an exceptional review of oncogenes and tumor suppressor genes. Subsequent sections deal individu- ally with esophogeal, stomach, pancreatic, colorectal, and he- patobiliary cancers, as well as several less common tumors of the gastrointestinal tract. Each section is concisely organized into discussions of clinical aspects, biologic basis, and med-

302 THE AMERICAN JOURNAL OF SURGERY” VOLUME 171 FEBRUARY 1996

ical and surgical therapeutic considerations. The clinical por- tions serve as an excellent overview of each topic. The dis- cussion of the biologic basis of each cancer comprise com- prehensive reviews with extensive bibliographies which are impressively up to date. Particularly well done are the chap- ters on the molecular genetics of colorectal cancer and dys- plasia in ulcerative colitis. Although brief, the final section provides an important summary regarding future perspective in gastrointestinal cancers. Principles of gene therapy and im- munotherapy are briefly reviewed, and many of the current techniques employed in molecular diagnosis are described in a succinct and intelligible manner. My only criticism of this book is that it is not particularly well illustrated.

Overall, however, the text is well written, well organized, and should serve as an outstanding resource for all interested in the principles of gastrointestinal cancer treatment and research.

Richard Pokorny , MD Department of Surgery University of Louisville

Lot&&, Kentucky

Vascular Surgery-Theory and Practice Edited by Drs. Allan Callow and Calvin B. Ernst. Stamford,

Connecticut: Appleton B Lange; 1995. 995 pages. $I 95.00.

A lthough several books on vascular disease have been published, this new text represents a significant, unique contribution to the surgical literature be-

cause of its “user-friendly” approach to the blending of the basic science of vascular disease and biology with the clini- cal practice of vascular surgery. Allen Callow and Calvin B. Ernst have clearly and concisely correlated the ever-ex- panding basic science information with the clinical prob- lems commonly faced by both the vascular surgeon and the trainee, without overwhelming the reader with minutiae. The book has several major strengths; the best include un- precedented sections and chapters-many of which were written by the primary authors-interrelating the cellular and molecular vascular biology with the pathogenesis of ath- erosclerosis and intimal hyperplasia.

Other exceptional chapters cover hematologic and throm- botic disorders with the latest information on low molecu- lar weight heparin; diagnostic imaging modalities with data regarding magnetic resonance angiography for carotid and lower-extremity disease; the peri- and postoperative man- agement of patients undergoing vascular reconstruction; and the surface characteristics and healing of vascular grafts, a subject in the forefront of emerging endovascular technolo- gies. The text also has an invaluable chapter by Robert Rutherford succinctly outlining the recommended standards for reporting on lower-extremity, cerebrovascular, aneurys- mal, and venous diseases, as well as complication in vascu- lar surgery, as created by the joint council of the Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery. In addi- tion, this text is clearly written, easy to read, and beautifully illustrated. Because of the chosen focus of the authors, the only deficit of this textbook is a lack of depth regarding cur- rent operative techniques.

1 BOOK REVIEWS ,

Overall this textbook is enthusiastically recommended for the physician caring for patients with vascular diseases.

Thomas M. Bergamini, MD University of Louisville

Louisville, Kentucky

Management of Diabetic Foot Problems (2nd ed.) George P. Kozak, MD, David R. Campbell, MD, Robert G.

Frykberg, DPM, MPH, Geoffrey M. Habershaw, DPM. Philadelphia: W.B. Saunders; 1995. 308 pages. $70.

M anugement of Diabetic Foot Problems (2nd edition) is a concise and interesting volume which contains some specific and valuable information for the

clinician interested in diseases of the lower extremity in the diabetic patient.

Chapter 2, which includes “Guidelines for the Examin- ation,” chapter 5, “Pathology,” and chapter 7, “Biomechan- ical Considerations,” are particularly valuable.

There is an emphasis on management of vascular disease which is very much up-to-date and practical. The overall treatment of the neurological lesions of the foot is somewhat dated and perhaps eschewed to the interest of this very se- lect group of authors.

The chapters are nicely written and easily readable. It would, however, be beneficial to have more extensive bib- liographies with a wider variety of viewpoints regarding the management of various diseases.

Overall, this book has a great deal of valuable information which can be used by vascular, general, and reconstructive surgeons who are interested in this serious problem related to the diabetic patient. The price of $70 is somewhat high, how- ever, for a text that is more concise than comprehensive.

T. Jefferr Wiemun, MD Department of Surgery University of Louisville

Louisville, Kentucky

Thoracoscopy for Surgeons: Diagnostic and Therapeutic

Edited by Raymond A. Dieter, Jr., LMD. New York: Igaku- S/win Medical Publishers, Inc.; 1995. 271 pages. $98.50.

T horacoscopy is an old technique recently reenergized by the minimally invasive surgery movement and enhanced by the attachment of the video camera to

the thoracoscope. Raymond A. Dieter, Jr., MD, the editor, and eighteen contributors have described and illustrated its current spectrum of indications, techniques, and complica- tions in nineteen chapters. Before the advent of video-en- doscopic technology, direct thoracoscopy imposed a single operator limitation that restricted intrathoracic tissue ma- nipulation. Indirect video-assisted techniques emerged ap- proximately five years ago and enabled the deployment of multiple operators. This advance permitted the performance of procedures previously requiring open thoracotomy and led to the creation of the new surgical domain of video-assisted thoracic surgery or VATS. This book describes both direct and indirect thoracoscopic techniques.

Certain sections of the book deserve special mention. The

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