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Pancreatic Disease.
  1. M SARNER

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Pancreatic Disease. Edited by PJ Lankisch, EP DiMagno (Pp 272; illustrated; £49.50). Germany: Springer-Verlag, l999. ISBN 3-540-65357-0.

This is a meetings book (“songs from the show”) containing 24 contributions in just over 260 pages on the state of the art in pancreatic disease, as of September 1998. It is a virtual textbook with eight chapters on acute pancreatitis, eight on chronic pancreatitis, three on cystic fibrosis, four on cancer, and one on epidemiology (“lessons from”). The chapter titles are intriguing, focusing on biological mechanisms and current management attitudes. Genetics features strongly, as well as an emphasis on clinical care and directions for research. The flavour is strongly European: for pancreatic inflammatory disease, both acute and chronic, 11 of the 16 contributions are from Germany (the meeting was, after all, in Munich) giving a welcome access to a literature which is not often cited in English language journals. Most of the chapters are approximately 10 pages long, fully referenced, and up to date. As is inevitable, there is a fair amount of overlap and repetition and the quality is certainly uneven, ranging from detailed molecular pathology suitable for research workers (for example, the chapters on cystic fibrosis, mechanisms of fibrosis in chronic pancreatitis, and growth factors in carcinoma) to what would be more suitable for a lecture to undergraduates (exocrine pancreatic secretion).

However, for those interested in pancreatic disease, this little book (it is a pocket size paperback) offers a useful work of reference. The introductory chapters on the genetics of cellular injury, intracellular events, and immune mechanisms in acute pancreatitis are particularly well done, although the subsequent contributions on varieties of clinical management contain nothing new. The section on chronic pancreatitis contains some overlap between chapters but the contribution on mechanisms of fibrosis and potential therapy using inhibitors is fascinating, if still a distant dream. The chapters on cystic fibrosis are detailed and very interesting with good reviews on the status of gene therapy today and problems with enzyme therapy. The chapter on what we now call idiopathic chronic pancreatitis is certainly worth a careful read. The section on pancreatic cancer is, like the disease, disappointing, representing the essentially bleak situation of specialists searching around for mechanisms and treatment modalities with little success.

In all, as meetings books go, this one should be worth a place in the departmental library if you can afford it. There are lots of good references, figures, and diagrams, and it covers the ground of pancreatic disease very thoroughly.

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