Acid-Base Physiology in Medicine. (3rd edition). Edited

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					                                         BOOK REVIEWS                                              213
   The first half of the book is devoted to papers on brush border enzymes. There is an introductory
contribution by D. S. Parsons giving some historical notes and considering how the brush border
hydrolases may be associated with sugar transport in the intestine. Peptidases are dealt with in terms
of their relationship to the microvillar membrane; A. J. Kenny and I. S. Fulcher compare
endopeptidases from kidney and intestine and S. Maroux, H. Feracci, J. P. Gorvel and A. Benajiba
concentrate on the molecular characteristics of the intestinal aminopeptidases from pig and rabbit.
Changes in the structure of intestinal hydrolases are followed during their life cycle from biosynthesis
to degradation by M. Sj6str6m, 0. Noren, E. M. Danielsen and H. Skovbjerg. y-Glutamyltransferase
from the brush border of proximal tubule cells from rat kidney is the subject of a paper by T. Frielle
and N. P. Curthoys who reconstituted the enzyme into lecithin vesicles in order to label the
hydropholic domain of the enzyme with membrane-soluble reagents before cleaving it from the
remainder of the enzyme with papain. Two papers are devoted to sucrase-isomaltase, an enzyme which
differs strikingly from the generally accepted form of intrinsic membrane proteins. G. Semenza,
J. Brunner and H. Wacker provide detailed information about the structure of the enzyme and H.-P.
Hauri, who has examined its biosynthesis, gives some intriguing evidence suggesting that it is inserted
into the basolateral membrane of the enterocyte before ending up in the microvilli. A. Quaroni takes
the reader into new territory by showing how monoclonal antibodies can be used to study the brush
border enzymes. A useful general discussion, much of which concentrates on the biosynthesis and
assembly of brush border enzymes, completes this first half of the book. Although all of the papers
mentioned above deal with brush border enzymes, anyone interested in the biosynthesis and insertion
of membrane proteins will find both the papers and the printed discussions interesting and
   Probably the most novel feature of this book is provided by the group of five papers on the
microvillar cytoskeleton. These contributions and the associated discussions give a useful picture of
the problems that are encountered in any attempt to discover the function of these structural
components of the epithelial cell brush border. A. Bretscher opens this section by describing the
organization and function of the filament bundles that make up the core of the intestinal microvilli.
The fact that tissues other than intestine and kidney have brush borders is underlined by two papers
dealing with the human placenta: the structure of the microvillus core is described by A. G. Booth
and 0. A. Vanderpuye and placental co-transport systems are reviewed by C. A. R. Boyd. The part
played by calcium ions in the contractility of the enterocyte cytoskeleton is considered by
M. S. Mooseker, T. C. S. Keller and N. Hirokawa. The association between the intestinal microfila-
ments and the microvillar membrane is the subject of two papers: E. Coudier, H. Reggio and
D. Louvard have purified an integral membrane glycoprotein which may provide attachment sites
for cytoskeletal proteins and P. T. Matsudaira has studied the proteins involved in the bundling of
active filaments within the microvilli.
   Attention is switched to the other side of the microvillar membrane by two contributions dealing
with the receptors for maternal immunoglobulin G (IgG) on brush borders from neonatal rats:
N. Simister and A. R. Rees provide evidence suggesting that the IgG recognition involves the F, region
of the molecule, and R. Rodewald, D. M. Lewis and J.-P. Kraehenbuhl show that although there are
two classes of IgG binding sites only the high-affinity sites are involved in IgG transfer. In a paper
on the Na-K-ATPase, which is not a brush border enzyme, P. L. J0rgensen provides evidence that
conformational changes in the a-subunit are involved in cation transport. The book ends with a
general discussion on the role of the cytoskeleton in enterocyte function which indicates that the
intestinal epithelial cell has much to offer to those who have a more general interest in the role of
   This book can be highly recommended to all those working in the field of epithelial transport, but
it will also be valuable for anyone concerned with membrane proteins or the structure of epithelial
                                                                                          J. R. BRONK

Acid-Base Physiology in Medicine. (3rd edition). Edited by R. W. WINTERS and R. B. DELL.
    Pp. 281 (Little Brown & Co., Boston, 1983.) $21.00.
  Acid-base physiology remains a part of the subject which many students find difficult to understand.
Any attempt to lessen the problems must be welcomed by student and teacher alike. Several other
well known introductory texts on this subject are already available, and it was interesting to compare
these with this new addition to the range.

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214                                        BOOK REVIEWS

   The book is designated a self instruction programme. Essential information is presented in panel,
diagram or flow-chart form. This information is followed by an extensive series of questions related
to this information, and, in later chapters, often recalling much earlier information as well. The reader
responds by ticking or circling one or more of a number of alternative suggestions, or completing
a diagram, or writing one or two lines. The answers can be compared as one progresses by unmasking
a column at the side of each page (the mark is provided). The text develops conventionally from basic
chemistry through buffer systems, respiratory and renal compensatory mechanisms, to acidosis and
alkalosis in its various forms.
   There is little doubt that the student who manages to work through this manual should be able
to detail the basic changes occurring during acid-base disturbances. My doubt is whether the
'essential' information presented is sufficient for a full understanding. It is severely restricted, the
emphasis being on what happens in a given situation, rather than why it happens. As an example,
the functional importance of carbonic anhydrase in the erythrocyte gets appropriate coverage, but
there is no mention of its equally important role in the kidney tubule. Limited, or highly simplified
information may be a natural hazard of this type of text, but is not always helpful, particularly for
the uninitiated. For instance, the term Base Excess is introduced early on (Chapter 5), but with little
or no indication of its significance, and a full definition never appears. Alternatives to Base Excess,
i.e. Standard Bicarbonate, are never mentioned, nor are the limitations of these methods for estimating
the metabolic component. Likewise, the contribution of keto-acids in acid production is listed, but
their contribution to titratable acidity, particularly in diabetic ketosis, is not mentioned.
    Many of the problems stem, I suspect, from the need to reduce both 'questions and answers to
an irreducible number of words. As a result some responses, such as the expected definitions for types
of compensation (Chapter 7) are vague and rather meaningless. The wording of questions is generally
clear, but a more precise use of words would at times be helpful. One question calls for a list of four
'.constituents' of blood and plasma altered in metabolic acidosis and had as one of the answers, Base
    The programmed text limits what the book can achieve, but within those limits it has more than
a little merit. My impression is that the average student would find it very difficult to learn and
understand acid-base physiology from this source alone. In my opinion its use should follow a course
of lectures in the subject, when it would have an effective role for revision purposes. The authors
themselves compare its use to the tutorial situation, and the analogy is an apt one.
                                                                                            A. L. HAIGH

Principles of Renal Physiology. Edited by CHRISTOPHER J. LOTE. Pp. 179. (Croom Helm,
     London, 1982.) Cloth edition £12.95, paperback £6.95.
  This is a well written, compact physiology text on the functions of the kidney, based on the lecture
course offered on this subject at the University of Birmingham. The author has carefully selected the
relevant topics and provided the student with an up-to-date and well-balanced analysis of basic
functions of the nephron as well as with a concise survey of the major regulatory mechanisms of salt
and water homeostasis.
  After a brief introduction of the basic structure and properties of body fluids and of the main
features of the anatomy of the kidney, the main functional characterization of glomerular filtration
and of tubular transport operations are described in a simple yet comprehensive and up-to-date
manner. The analysis of tubular transport phenomena is based on recent work on single tubules and
provides an excellent description of the essential cellular event underlying tubular transport. The
second part of the book is devoted to the renal control mechanisms that safeguard body fluid
osmolality, extracellular volume, acid-base balance, potassium and divalent ion distribution. Sections
surveying important elements of abnormal sodium and water transport and the mechanism of action
of diuretics are also included.
  The book is lucidly written, well illustrated and should serve as a valuable introductory text for
physiology students.
                                                                                  GERHARD GIEBISCH

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