Surgery for stroke

Abstract

Hemodynamic forces and vascular cell biology Bauer E. Sumpio, Austin, 1993, R.G. Landes Company, 119 pages, $89.95. With increasing recognition of the interaction between hemodynamic forces and vascular cell response, this timely, short, multiple-authored book brings together many of the salient issues involved in current investigations. Its organization is well thought out, proceeding from a discussion of basic mechanical forces present in an artery, through current models for simulating these forces in an isolated fashion, the relationship between mechanics and atherosclerosis, and finally to an in-depth discussion of the biologic responses induced. There is some redundancy among the chapters that generally serves to reinforce important aspects of the issues rather than to detract from the book. By necessity, research to date on the response of vascular wall cells to mechanical forces has used in vitro models, which have isolated these forces. This point is covered well in chapter 5 (by Drs. Mills, Cohen, and Sumpio), which for readers interested in beginning an investigative effort or better understanding of the existing data, is a very important chapter. There is an excellent up-to-date summary of the currently available models and contrasts the advantages and disadvantages of each. Ironically, this raises questions about the whole premise involved with such research. Although clearly studies of vascular cells under static condition are not representative of the in vivo conditions, one can't help but wonder whether forces applied in an isolated fashion are indeed representative either. Furthermore, the problem with all cell culture experiments is that culturing itself constitutes a perturbation of normal cell biologic condition. What is truly needed is information comparing cell behavior under static conditions versus that after hemodynamic forces applied singly and then in combination. The last three chapters are more useful to the investigative vascular surgeon than the first three. In these chapters phenomenologic observations are listed, followed by an excellent review of possible mechanisms of cell response. There are many observations as to the effect of cyclic flow and shear stress on endothelial and smooth muscle cell function in human and other species. The data presented provide a summary of existing knowledge but also again underscore the proposition that isolated hemodynamic forces may not provide an accurate picture. Nonetheless, each review of varied mechanical forces and cell response is thorough, well referenced, and provides the basis for ongoing experimental questions. The chapters on the mechanisms of cellular response are particularly helpful. By necessity, they concentrate on mechanisms that are currently invoked as signal transducers for the hemodynamic forces in question, but a very clear description of various second messenger pathways, strain receptors, and G-proteins are included. The graphics are complex but well thought out. The theories, which reflect the primary author's experimental work, are well supported and well presented. Although some of the reproduced data did not provide specific information on the various inhibitors that were used to dissect out the mechanisms in question the information is properly referenced and readily available. This book fills a need in the vascular surgical literature at a time when recognition of the impact of mechanical forces on endothelial and smooth muscle cell biology is increasingly at the forefront of vascular biologic research. It is an excellent review of the many relevant subjects, is well written, well illustrated, and provides a thorough and up-to-date bibliography. The logical progression from basic mechanics to biologic response will prove a valuable reference for investigators in vascular cell biology. The receipt of the books listed below is acknowledged. This listing is regarded as appropriate return for the courtesy of the sender. The books that are of particular interest will be reviewed and the review published as a space permits. Hemodynamic forces and vascular cell biology Bauer E. Sumpio, Austin, 1993, RG Landes Company, 119 pages, $89.95. Neurosurgical intensive care Brian T. Andrews, New York, 1993, McGraw-Hill Health Professions, 450 pages, $69. The cath lab: An introduction David L. Lubell, Malvern, 1993, Lea & Febiger, 125 pages, $29.95. Cell interactions in atherosclerosis Horst Robenek, Nicholas J. Severs, Boca Raton, 1992, CRC Press, Inc., 318 pages, $169.95. Pharmacologic suppression of intimal hyperplasia William J. Quiñones-Baldrich, Austin, 1993, RG Landes Company, 126 pages, $89.95. Cardioplegia: Current concepts and controversies Ray C.-J. Chiu, Austin, 1993, RG Landes Company, 113 pages, $89.95. Conduits for myocardial revascularization Michael Carrier, L. Conrad Pelletier, Austin, 1993, RG Landes Company, 106 pages, $89.95. Graft arteriosclerosis in heart transplantation Donald V. Cramer, Austin, 1993, RG Landes Company, 95 pages, $89.95. Vascular graft monitoring Sushil K. Gupta, Austin, 1993, RG Landes Company, 102 pages, $89.95. Surgery for stroke R. M. Greenhalgh, L. H. Hollier, London, 1993, Harcourt Brace Jovanovich Ltd., 420 pages, $70.