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Published by Danielle

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Published by: Danielle on Feb 20, 2011
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252 Book reviewsvaluable and beautifully illustrated work, very adequatelycovering their subject. The head and neck structures areencompassed in depth, but the central nervous system iscovered in much less detail and from the perspective of ahead and neck radiologist rather than a neuroradiologist.Thus the basal cisterns, cranial nerves and basal arteries areillustrated and described but not the intrinsic structure ofthe central nervous system.The book is highly recommended to radiologists intraining, radiologists and all other specialists with an interestin the head and neck as well as to students of anatomy.BRIAN KENDALLConcepts of Human Anatomy and Physiology, 4thedn. By KENT M. VAN DE GRAAF and STUART IRAFox. (Pp. xix+ 1002; fully illustrated in colourand black & white; includes CD Rom; 21.95
hardback; ISBN 0 697 16076 9); Dubuque andGuildford: William C. Brown. 1995.As a retired surgeon teaching preclinical anatomy in BritainI am depressed that it has changed little since I taught it 40years ago. For as long as I can remember there has been talkof 'integrated teaching'. The trouble is that there are veryfew integrated teachers-and teaching is undervalued. Itdoes not bring in research grants. As a result our studentslearn lots of useless facts but have little understanding.This American book shows how we should do it. Withbrightly coloured illustrations it carries us from atoms, ionsand molecules through to systematic anatomy, biochemistryand physiology. New words are explained, and even theirpronunciation is given. There is a glossary, a list of prefixesand a list of suffixes. Each chapter begins with a detailed listof contents and outline of objectives. At the end is asummaryandanopportunity to testknowledgewithMCQsand short answer questions. It is possible to dip into thebook without starting at the beginning. There are associatedvideotapes and a CD Rom.No, it does not have lists of relations of structures anddetailed root values for every muscle. However, I believethat ifourpreclinical students spentayearbeingexcited by,and gaining an understanding of, the structure and functionofthehumanbody in themanner setoutby thisbook, theywould not look like dull zombies until they embark on theirclinical studies. Are there any people out there in British
anatomy and physiology departments interested in producinginspired doctors?R. M. KIRKSex Determination, Differentiation and IntersexualityinPlacentalMammals.ByR. H. F.HUNTER. (Pp.xxi+310;illustrated;50/$79.95hardback;ISBN
0 521 46218 5.) Cambridge: Cambridge UniversityPress. 1995.This elegant and informative book is devoted to sexdifferences and the process of differentiation in the gonads,the reproductive tract and the genitalia. It tells its storythrough 10 chapters, the first of which is devoted tohistorical landmarks. Historical reviews seem de rigueur inany book on sex and reproduction I doubt they occur soregularly in major texts on the skin, kidneys or salivaryglands-but this one is relatively succinct. It does, however,contain one of the few genuine oddities of the book, a two-page table devoted to famous reproductive biologistsassociated with Edinburgh University. The word'associated' is apt, for the list certainly includes some whoseprominence was achieved elsewhere and some who (I amtold) were not always favourably disposed to their almamater; a future edition woulIG benefit from a little less 'AuldReekie'.Chapter 2, on Mechanisms of Sex Determination, isconcerned exclusively with genes and their actions. TheinactiveX(Lyonhypothesis), sex-determininggenesandH-Y antigen receive full consideration, with an interestingaside on the links between ideas on sex reversal and thetestis-determining geneon theYchromosome. Acceleratedgrowth in male embryos as a genetic (pregonadal) phenomenonis also explored; one wonders what the situation is formammals in which the female is bigger the golden hamsteris a ready example.Chapter 3 deals with differentiation of the gonads andreviews the origin, migration and multiplication of primordialgerm cells before dealing with the formation anddifferentiation of the testis and ovary. These are all themeswhere the gaps in our knowledge are wide and Hunterhandles these well, though there is little on gonadalhistogenesis and its stages. Descent of the gonad alsoreceives a rather short consideration which, given therelativefrequencyofmaldescentofthe testisand thelackofconsensus over mechanisms (androgens and 'descendin' arecommented on, GAGs and CGRP are not), is perhaps apity.
Chapter4 isdevoted to differentiationofthereproductivetract and genitalia. After an initial description of the eventsin both sexes, most of the chapter deals with controlprocesses. There is unequal weight here, with the greatestemphasis on antimullerian hormone (AMH) and thedegeneration of the paramesonephric duct in males. This isunderstandable; the discovery ofAMHis a classic scientificset-piece, and due homage is paid to Nathalie Josso andothers. Nevertheless, there are omissions regarding the roleof the testis in maintaining the wolffian duct; the existenceofaseparatefetal/neonatalpopulationofLeydig cells isnotdiscussed, nor is there any consideration of whether theseare controlled by a functional fetal hypothalamopituitarysystem.Chapters 5-7 can be considered together since they dealwith spontaneous anomalous development in farm animals,laboratory rodents and humans respectively. There is aninitial temptation to wonder why three chapters werenecessary, since the mechanisms are much the same for alleutherian mammals, but the author is very much on hometerritory and each chapter permits different kinds ofexamples to be used. Freemartins and intersexes arenaturally to the fore in the chapter on domestic animals,while that on laboratory rodents deals almost wholly withmutants (sex reversals, hypogonadal and testicularfeminising syndromes, etc.) but with a brief nod totransgenics. The chapter on human anomalies againconcentrates on genetic disorders and there is thus noreference to female offspring virilised by synthetic steroidsaimed at preventing miscarriage ('progestin-induced hermaphroditism')so classically reported on by Money,Ehrhardt and others. 5a-reductase deficiency is mentionedas a rare recessive syndrome but with no indication of theappearance ofsuch individuals nor that, in some parts oftheworld, they were held to change sex miraculously fromfemale to male at puberty.Chapter 8 differs from the last three in that it discusses sexdifferentiation in chimaeras, and thus mixes the spontaneouswith the experimentally derived. Chapter 9 deals with the

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