Perspectives in Biology and Medicine

BOOK REVIEWS Ultrastructural Pathology of the Cell and Matrix. By Feroze N. Ghadially. 2d ed. rev. London and Boston: Butterworths, 1982. Pp. xx+971. $240.00. The revised and enlarged second edition of Ghadially's book on ultrastructural pathology is a superb work both in text and illustrations. It is concerned primarily with organelle pathology, while the practical application of ultrastructural studies in clinical diagnosis is demonstrated in Ghadially's second textbook, Diagnostic Electron Microscopy of Tumors (Butterworths, 1980). The book is consistendy well organized. The text is on die left page, widi die corresponding illustrations on the facing page. The book's 17 chapters are divided into numerous well-defined sections. The second edition contains a new chapter on extracellular matrix and 56 new sections concerned with various types of secretory granules, specialized forms of endoplasmic reticulum, bodies of lysosomal storage diseases, intracytoplasmic inclusions, and viruses. Organelles of neoplastic cells are not overlooked. Only a few topics, such as classification of vacuoles and use of the thickness of the limiting membrane in the identification of organelles and in die differential diagnosis of lesions, could be added. Most sections foUow die same logical pattern: definition, nomenclature, correlation with light microscopy, history, description, enumeration of previous reports with references and interpretations of lesions. The nomenclature in ultrastructural padiology in the past was confusing. A single structure would often have several different names, and, alternatively, the same name would be applied to different structures. Ghadially attempts to standardize the nomenclature by simultaneously defining and illustrating pathological entities. In this regard, one picture is certainly worth a thousand words. He selects and occasionally creates names that he considers to be most appropriate. Yet in a few instances , the terminology may be expected to develop further, particularly where die nomenclature is influenced by previous biochemical (e.g. lysosome), functional (e.g. intracisternal sequestration), and developmental (e.g. autophagy) terms. The book contains nearly 3,500 references. The occurrence of each lesion is documented by numerous references to previous reports. References to reviews are used when a widely studied structure, such as a lysosome, is discussed. This, however, obscures historical priorities of bodi discovery and development of concepts. The 885 photographs are well chosen to illustrate the lesions described. They are of excellent technical quality and high aesthetic value. Permission to reprint a book review printed in diis section may be obtained only from die author. 506 J Book Reviews Ghadially's book is more than an atlas and a reference book. In spite ofits size, it is a concise and easily understandable textbook. It establishes a specific terminology which strengthens die reputation of ultrastructural pathology as an exact science. Until recently, biochemistry enjoyed excessive prestige, while morphological investigations had to constantlyjustify dieir existence. Many important concepts in cell biology (e.g. autophagy, muscle contraction) are based on correlation of structure and biochemistry. AU the thousands of forms illustrated in Ghadially's book are undoubtedly associated widi yet unknown chemical composition and processes. The research biochemist should be challenged by this variety of structure and routinely include ultrastructural studies widi each biochemical study he performs. Zdenek Hruban Department ofPathology University ofChicago Letters to a YoungDoctor. By Richard Selzer. New York: Simon & Schuster, 1982. Pp. 205. $13.95. Literature and medicine have always enjoyed a symbiotic relationship. Literature has often employed illness as a major theme and doctors as main characters. Suffering and healing are popular literary subjects. Likewise, many medical professionals have significantly contributed to world literature. The tradition of the physician-writer includes Rabelais, Anton Chekhov, Oliver Wendell Holmes, Arthur Conan Doyle, A. J. Cronin, William Carlos Williams, and Somerset Maugham. This plethora of dual professionalists may at first glance appear unusual, but upon closer inspection it becomes apparent diat many of the qualities necessary for the good physician are also necessary attributes of the good writer—such as refined powers of observation, dedication, intellectual curiosity, sensitivity, and compassion. A medical career is a window to human nature. As such, a medical practice offers an infinite opportunity to develop characters, plot, and theme. In recent years an entire corps of talented physician-writers have emerged, including Michael Crichton, Walker Percy, Robin Cook, and Richard...