The sensitivity of cells exposed in vitro to the antibiotics bleomycin or adriamycin is only mildly increased at 41°over that seen at 37°. However, at 430 a marked synergism between the effects of hyperthermia and drug is observed. This synergism can also be demonstrated to occur in solid tumors in vivo. Cells after bleo mycin exposure at 370 repair potentially lethal damage, and 430 inhibits this repair. This inhibition may in part account also for the observed sensitization of the cells to bleomycin, but not to adriamycin, since for the latter no repair can be demonstrated. However, fluorescence measurements show that at 430 much more adriamycin is able to enter the cells than at 37°. The possible implications of the results for cancer treatment are discussed.

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walls of which, though distended, can be advanced caudally and united to the perineum.1 The use of a free skin graft to line a pocket newly created between the bladder and rectum may be a simple procedure but an annular construction often develops at the site of union between the graft and vaginal epithelium, which necessitates the frequent use of moulds in order to retain vaginal patency. Secondly, in the absence of a functioning uterus Williams's vulvovagino,Dlasty,2 a form of long perineorrhaphy, is particularly easy to perform. The operation is not only brilliantly simple in design but healing usually occurs quickly and without the troublesome formation of postoperative granulation tissue. As soon as the perineal skin is united the new vouch is immediately functional as a vagina. It does not depend for its patency upon coitus or the insertion of vaginal moulds. Any anatomical disadvantages which may attend vulvovaginoplasty are more theoretical than practical and are perhaps quite overshadowed by the singular advantage of the operation-namely, that it may safely be performed at a time which will assist the natural sociosexual development of the teenager. Free skin graft procedures, though reFulting in a normally situated vagina, are best deferred until regular coitus is expected; otherwise vaginal patency must be mnaintained by the regular use of dilators, instruments which sometimes Ferve chiefly to remind the young female of her fundamental abnormality as a woman. While accepting Mr. Cobbett's comment that the use of a free skin graft to line a newly created pocket is a simple operation, I submit that in amenorrhoeic women a vulvovaginoplasty is simpler and preferable and that in Datients with a functioning uterus advancement of the vagina is probably the treatment of choice.-I am, ec.

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