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The broad field of gene therapy promises a number of innovative treatments that are likely to become important in preventing deaths from cancer. In this review, we discuss the history, highlights and future of three different gene therapy treatment approaches: immunotherapy, oncolytic virotherapy and gene transfer. Immunotherapy uses genetically modified cells and viral particles to stimulate the immune system to destroy cancer cells. Recent clinical trials of second and third generation vaccines have shown encouraging results with a wide range of cancers, including lung cancer, pancreatic cancer, prostate cancer and malignant melanoma. Oncolytic virotherapy, which uses viral particles that replicate within the cancer cell to cause cell death, is an emerging treatment modality that shows great promise, particularly with metastatic cancers. Initial phase I trials for several vectors have generated excitement over the potential power of this technique. Gene transfer is a new treatment modality that introduces new genes into a cancerous cell or the surrounding tissue to cause cell death or slow the growth of the cancer. This treatment technique is very flexible, and a wide range of genes and vectors are being used in clinical trials with successful outcomes. As these therapies mature, they may be used alone or in combination with current treatments to help make cancer a manageable disease.

The ability of pellets of 26 pure metals to induce clinical epilepsy was evaluated in chronic experiments in 40 monkeys after precentral motor cortical implantation. Nickel and antimony were most effective. A variable mild epileptogenic effect was noted with bismuth, cadmium, zirconium, tin, titanium, iron, molybdenum, mercury, vanadium, tungsten, and tantalum. Other metals, including lead, beryllium, silicon, copper, silver, chromium, cobalt, manganese, zinc, and magnesium were ineffective. Most metal implants were associated with local meningocerebral cicatrix formation, but with five metals (nickel, copper, mercury, antimony, and cadmium) a profound, severe, necrotizing foreign-body reaction occurred. Clinical evidence of toxicity attributable to the metal implants was noted in monkeys treated with nickel, antimony, cadmium, and thallium. Submitted on February 7, 1962

general practitioners rather than in hospital closely associated with the surgical services could certainly have some advantages as regards the convenience of the patients, but will probably .---THIS book is divided into four sections on: the central nervous system, the peripheral nerves and autonomic system, principles of neurodiagnosis and central nervous system disorders. The book first appeared about 40 years ago, has been translated into six languages and two more translations are on the way. In its student appeal, the book can be compared with Ranson and Clark, Fulton and Walshe. Whatever the opinions and criticisms of reviewers, the book obviously meets the needs of both undergraduates and postgraduates. Without doubt, this is the book for the examinee.There are many tables of associated information and most of the illustrations are line drawings. Brief mention is made of many of the findings at the growing edges of anatomy, physiology, biochemistry and pharmacology. The more recent speculations about pain and pain pathways do not appear, hut the explanation of the function and malfunction of the basal nuclei is now in terms of their chemical transmitters rather than in their fibre connections. Many modern diagnostic investigations (e.g. EM1 scans) are outlined and their application indicated.Throughout, the emphasis is on the clinical aspects of neurology. This leads occasionally to a rather cursory summary of many modern findings. The chapters on congenital defects, vascular diseases, trauma and tumours contain summaries which would be useful to the surgeon, but the chapter on the cerebrospinal fluid is short, and elsewhere only a brief mention is made to the blood-brain barrier.The use of eponyms to describe the innumerable variants of syndromes and signs is an occupational hazard of neurologists and not all names appear in the index. Even in this age of diminished classical education it is rather patronizing to have to read 'hypoglossal hemiplegia alternans (alternating hypoglossal hemiplegia)' ! Modern Stoma Care Edited Frank C . Walker. 235 X 160 mm. Pp. 193. Illustrated. 1976. Edinburgh: Churchill Liuingstone. f8. ONE of the more important innovations in colorectal surgery in the past l'ew years has been the elevation of the detailed care of colostomies and ileostomies into a speciality-so-called 'enterostomal therapy'. The recent publication of the elegant and well-illustrated hook by Frank Walker and his colleagues on this theme is thus most timely. However, it is not quite clear exactly for whom the book is intended. The publisher's blurb and editor's preface express the hope that it may he helpful to doctors, stomal therapists and patients, but with its discussion of all three forms of stoma (ileostomy, faecal and urinary and colostomy) and its account of some aspects of surgical treatment and complications, it would not really he appropriate material for the average ileostomy or colostomy patient. As regards its suitability for surgeons, though it does provide some background information about ...

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