The Detection of Hemoglobinopathies

tion for anaerobes, but surely the criteria by which one judges the significance of a bacterium isolated are the same whether it be an aerobe or an anaerobe. It is useful to have all this information in one volume and medical libraries should possess a copy. For all but the anaerobe enthusiasts the price will be prohibitive. The weight, about 3 lb, is not conducive to armchair or bedside reading. E. JOAN STOKES


1974.
The 'non-fermenting bacteria' referred to in the title are Gram-negative bacteria, some of which are well recognized pathogens but many of which have in recent years come to be looked on as 'opportunist invaders'.
Distribution is mentioned only briefly in the text and is dealt with mainly in table I which is essentially a list of references dealing principally but not entirely with isolations from pathological processes in man and animals.
The remainder of the booklet is a report of a study of these bacteria by the methods of numerical taxonomy. A wide range of tests was used and the results were analysed by computer. It was possible to recognize 16 groups. Some of these groups corresponded to recognized species, ie, group 6 = Bordetella parapertussis, but, on the other hand, some groups were heterogeneous, ie, group 7 = Moraxella, Neisseria, Acinetobacter wolffi. The heterogeneous groups were divided into subgroups 'as a division of convenience rather than as a strictly unbiased interpretation ofthe relationships between strains'. All this gives rise to a certain unevenness in presentation. The results of the numerical taxonomy study were used to construct a practical key for identification of groups and subgroups, using a limited number of simple tests. Mathematical methods were used in selecting tests most useful for construction of the key. In a small field trial conducted by the author this key proved 92% successful in identification of freshly isolated strains. If this success rate is upheld the key should be useful to bacteriologists confronted with bacteria of this kind. This book consists of papers presented by 22 experts in the field of abnormal haemoglobins and thalassaemia presented at the 1973 International Conference on Standardization of Laboratory Methods and Reagents. The papers are short, ranging from one to six pages, with a longer section on peptide mapping, and provide comments on current methods for specimen handling, electrophoresis, chromatography, peptide chain separation and mapping, sickling tests, staining for inclusion bodies, detection of unstable haemoglobins, determination of foetal haemoglobin and HbA., and diagnosis of thalassaemia.
There is a need for an authoritative textbook on methodology, standardization, and quality control in this field. Several of these conference papers reach this standard and will be of considerable value to laboratories which provide a haemoglobinopathy diagnostic service. Other papers, however, are extremely brief or state only personal preferences and recommendations without providing either a substantial review or significant new data. This considerably reduces the impact of the book.
Despite this imbalance, haematologists with a laboratory interest should consider this book as a working manual to supplement existing textbooks on haemoglobinopathies. The text is not sufficiently detailed for the trainee or for laboratory staff without experience in the field, but many of the practical hints given will be of value to the more experienced haematologist or biochemist. The aim of the authors is to integrate the preclinical and clinical aspects of enzymology for the benefit of medical students, and to persuade them that the preclinical study is not just 'an obstacle to be surmounted ... which, once it is overcome, can be dismissed from the mind'. The reviewer's experience of medical students suggests that only the most dedicated of these would sustain their interest through the first 80 % of the book, dealing with pure biochemistry of the kind they feel has 'to be surmounted', to reach the last 20% or less of clinical application. The impression is that the clinical and the biochemistry sections were written in isolation. Much more could have been done to integrate theory and practice within the same chapter, and to show the clinical application of preclinical learning. From the point of view of the proposed audience, the biochemistry section is probably too ambitious, including as it does quite long sections on, for instance, methodology and protein synthesis. This, together with the rather unattractive layout, printing, and large blocks of unbroken text, will be unlikely to attract the unconverted reader.
This being said, the book is one which the reviewer read with pleasure, and which many graduates in clinical chemistry will find useful. It is a book for the already converted rather than for the audience at which it is aimed. JOHN STUART This is a truly monumental effort by a single author who has spent many years of By D. W. Moss research in the field of atherosclerosis. (Pp. 175;69 It begins with a survey of the evolution ndon: Pitman of knowledge on the subject of the natural disorder in man, of its experimental counterpart in aninmals, and of the E biochemistry macromolecular construction blocks of application of which the arterial wall is composed. The oight chapters chapter which follows describes the of enzyme bio-involvement of the two most important pies of meth-structural components of the vessel localization. (smooth muscle and endothelium) and e some of the suggests mechanisms by which intimal Both sections thickening may occur. The third chapter tive.