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Principles of bone remodeling. By Donald H. Enlow Ph.D. Springfield Illinois Charles C Thomas Company 1963. 131 pp. 6.75

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PATIENT.B y E. V. Cowdry, Ph.D., Sc.D. (Han.),F.R.M.S.
(Hon.). Saint Louis, The C. V. Mosby Company, 1963. 566 pp. $11.85.
This second edition of a collection of papers on various aspects of the care of the
elderly patient will be very useful as a reference manual, and yet is short enough to be
read as a one-volume discussion of the various aspects of gerontology. Many of the chapters are extremely well written. I wish that the editor himself had used as much effort in
organization of his material as did most of the essayists. It appears to this reviewer that
the chapters are thrown together in a hodge-podge without any conformity to the natural
development of the subject from one chapter to another. Also, one wonders if a general
framework were ever visualized in view of the fact that there are very serious omissions.
Degenerative and/or osteoarthritis, which is generally admitted as a serious problem of
aging, is given exactly one-half page and a few casual lines here and there. We feel
that the key to this disorganization of what would otherwise be good material can be
seen by looking at Chapter I, written by the editor himself. The editor’s naivete is
charming ( h e is not a physician, and claims to be a most interested patient), but his
use of second hand source material as scientific fact is disturbing, to say the least. One
of the many signal examples can be seen from the following quotation: “According to the
Saturday Review (August 2, 1962) Negovskii is a distinguished member of the Academy of
Medical Sciences.. As presented in the Review, his methods sound logical and his results
appear to be fully documented. There is no apparent reason to question them.”
This brings us to an ancillary and most interesting subject which pertains to one’s
concept of the role and responsibility of editors of books such as this, a type of book
which is being published more frequently than ever these days. Is the editor’s job
merely to collect a list of authorities, and having obtained a paper from each to jumble
them into one volume, without balance, sequence, or logical order? To what extent is the
publisher responsible for such editorial laissez-faire?
Fortunately, however, the book is well indexed and those who seek may find-at least
what is contained therein-and most of this is good.-EdwaTd F . Hartung, M.D.
B y H. M. Frost, M.D. Springfield, Illinois, Charles C
Thomas Company, 1963. 175 pp., 184 references, 12 appendices, 40 figures. $8.50.
This monograph summarizes the author’s concepts concerning the nature of bone
remodeling based upon his extensive anatomic studies of human bone samples collected
and correlated with the patient’s clinical course and treatment. Among the subjects discussed are elementals of bone physiology with special reference to the development of
bone cells and matrix, as well as the nature of osteoporosis, osteomalacia, aseptic necrosis
and a discussion of remodeling of bone as measured by his special methodologies. Through
particular attention to altered dimensions and calculated volumes of histologic regions
undergoing mineral accretion or resorption, he develops an elementary scheme for calculating rates of internal remodeling within bone sampled.
There is insufficient discussion of historical developments to separate what is new in
this author’s work from that of previous investigators. Also, it would have been worthwhile
for the author to accompany his extensive interpretations and conclusions with more
fundamental supporting data.
Despite these reservations, there is a need for exploring new approaches to the study
of bone and the subject is approached here both with creativity and enthusiasm.
B y Dofiald H. Edow, Ph.W. Springfield, Illinois, Charles
C Thomas Company, 1963. 131 pp. $6.75.
This book is of special interest to research workers, students and teachers concerned
with bone and skeletal growth. The author relates a succession of anatomical structural
changes which occur during the evolvement of the skeleton and correlates the microscopic
findings with gross metamorphosis.
Much of the descriptive material in this treatise is based upon careful observations of
bone specimens from the Rhesus monkey. There is a short but informative historical introduction followed by a detailed consideration of remodeling exemplified in the humerus
and mandible. The figures clearly illustrate major points considered in the text.
Unfortunately, there is little attempt to carry observations beyond descriptive morphology into other disciplines such a s biomechanics, rheology, or biochemistry. Nevertheless,
this is a scholarly and well written treatise.-Anonymous
Hall. New York, Academic Press, 1963, 401 pp., $14.00.
This new series of annual reviews should fill a pressing need for systematic surveys ofthe active research on connective tissues. This first volume contains the following contributions: The Fibroblast by A. Whitley Branwood; The Hormonal Control of Connective Tissue, by G. Asboe-Hansen; Chemical Aspects of Collagen Fibrillogenesis, by D. A. Lowther;
Molecular Structure of Collagen, by G. N. Ramachandran; The Enzymes of Elastase Complex by W. A. Loeven; Connective Tissue Changes in Atherosclerosis, by J. Balb; Diabetes
and Vascular Degeneration, by J. W. Czerkawski; Calcification of Skeletal Tissues, by S.
M. Weidmann. The announced contents for Volume I1 shows a similar pattern.
The quality of the contribntions to Volume I varies considerably. In ou’r opinion, the
reviews by G. N. Ramachandran, J. Ba16 and S. M. Weidmann were excellent. Those by
Branwood and by Lowther should be quite valuable. Loeven covers the chemistry of elastin
as well as the elastases, but one gets the impression that this field is in a state of considerable confusion.
The chapter on hormonal control is poorly documented and dogmatic statements are
made such as on page 30: “The presence of chondroitin sulfate is essential to any collagen
formation. . . . This author also apparently ascribes hyaluronate formation to the mast cell
(page 31) in contradiction to the more general belief (page 5 ) that the fibroblast is the
source. Different points of view are not mentioned. Czerkawski presents a hodgepodge ot
conflicting ideas and personal feeling, in which fact is not separated from supposition.
Important work is not mentioned,
Much repetition of material occurs between the various chapters. This is especially true
of hormonal effects and the chemistry ot collagen. The editor, David A. Hall, Department
of Medicine, University of Leeds, England would do well to select narrower fields for review so that the coverage could he deeper with less repetition. Until real advances have
been made, he would be wise to avoid the temptation to cover clinical and pathologic aspects better suited for text books.
This new series of reviews will be highly welcomed and should be available to all persons interested in developments in connective tissue research. It is hoped that future volumes will be more critical in the choice of contributions and truly international.-Ward
P i g m n , Ph.D. and Bernard Wagner, M . D .
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131, donalds, springfield, thomas, remodeling, charles, 1963, illinois, enlow, company, bones, principles
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