BOOK REV~WS

in DNA methylation studies are MspI and HpaII (not H’I as in Figs 28.44 and 28.45). With regard to imprinting (the differential phenotypic effects of parental alleles), the data do not prove that the imprint is DNA methylation @. 839), other scenarios invoking indirect effects are possible. In Figs 38.4 and 38.10, it is dorsal that is the morphogen, not Toll.

Molecular Medicine: An Introductory Text for Students by R.J. Trent

Churchill Livingstone, 1993. A14.95 pbk (239 pages) ISBN 0 443 04635 2

Molecular Medicine aims to provide an overview of the impact that recombinant DNA is having, and will continue to have, on the practice of medicine. In this, the book succeeds well, managing to transcend theoretical speculations about the effects of the ‘molecular revolution’. The bridge between basic science and molecular biology leads logically to medical genetics, greatly improved diagnosis of hereditary disorders and the possibility of radical new forms of treatment, including gene therapy. This is not, however, a textbook of medical genetics and mentions only briefly the special contribution made by medical geneticists, in both the clinic and laboratory, in diagnosing and managing ran genetic disorders, supporting families aflicted with hereditary disease and advocating the rights of the individual in reproduction and in consenting to screening, Implicit in the text, however, is the great contribution made by studies of rare hereditary disazkrs to the wider applications of recombinant DNA technology in medicine.

This introductory and highly accessible text combines the minimum of technical detail essential for understanding with a wealth of practical clinical examples and will convince most people that medical practice will be changed radically by recombinant DNA technology. Molecular biology is also the key to a new synthetic approach ro medical education, especially when allied to new undergraduate learning strategies involving a multidisciplinary core curriculum freed of the shackles of entrenched departmental teaching.

The text is admirably clear: the largely jargon-free descriptions of molecular techniques and genetic phenomena should be accessible to both students

As a student, your source of information should be both parsimonious and correct.

Genes Vis a laudable attempt to present molecular biology in an integrated form and will be recommended by many course directors. No doubt they will charge their students with the task of reading and learning it. I’m sure there

and professionals, and are complemented by the excellent glossary and list of abbreviations. Throughout the book, clinical examples drive home an understanding of practical applications, ranging from those familiar to medical geneticists, such as molecular prenatal diagnosis, to rapidly evolving diagnostic techniques in medical microbiology, oncology and forensic medicine.

The chapter on medical oncology exemplties the clear organization of the book, and illustrates the way in which DNA techniques are influencing clinical practice. The reader is guided logically from oncogenes and tumour suppressor genes; to a consideration of genetic factors in retinoblastoma, leukaemia and lymphoma, cancer of the colon ant: breast; to environmental factors, including viruses; and to the possible role of genetic imprinting in human cancer. The discussion relating anatomical pathology, haematology and the search for minimal residual disease to new diagnostic applications of molecular genetics is particularly interesting. Immlnent applications Include those that come from a new understanding of how cancer develops (pathogenesls). Early diagnosis and presymptomatic screening are already being improved although these benefits are still mainly confined to rare hereditary cancers, However, DNA-based methods for prognosis. xc proving idplul in some common cancers and in leukaemia, allowing selective treatments, while clarification of the complex chain of events leading from ‘first hit’ to invasive cancer is rapidly opening new opportunities for novel treatments.

The universal relevance of molecular medicine is brought home in the refreshingly direct chapter on ethical and social issues. These concerns sometimes dominate public discussion of molecular genetics, and students need a solid understanding of the procedures built c n a framework of the fundamental principles of good medical care and social reality, Medical genetics is arguably the most appropriate forum for teaching ethics to medical students: all the dilemmas and perceived dangers of advancing technology can be illustrated, and often moved from seemingly

will be a chorus yes, I will yes’.

of replies, ‘I will,

RichardMehan

Institute of Cell and Molecular Biology, Uniwsity of E.linburgb,

King’s Buildings, Edinburgh, lKEH93JR.

unanswerable questions to pragmatic resolutions. One example might be the conflict between an individual’s right to confidentiality and the potential harm that ignorance of withheld information might inflict on others.

One ethical issue which is perhaps insufficiently stressed is the need for continuing appraisal of the distribution of resources to conventional medical procedures that become superseded by molecular genetic advances. Genetic research is thriving, and increasing resources are needed for the development and evaluation of new clinical applications.

The subtitle of Trent’s book, An Intmducto y Text for Students, is too modest: this volume will be of great istctrest to doctors who want to catch up on molecular medicine as quickly and as painlessly as possible, and for molecular scientists who want clear descriptions of clinical applications. It will, however, be a valuable source for a multidisciplinary core curriculum in medical schools; its value could be funher enhanced by the addition of some problem-solving exercises and by frequent publication of up-dated revised editions. Such a text could spearhead the integration of laboratory, clinical, public health and social studies into a convincing blueprint for the education of the medical practitioner of the 21~1 century.

Rodney Harris

Depurfnlent ofMedia? Ghetics, 9 Mary’s Hospital, Mancbes!er, UKM1.3 OJH.

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ofeverypaperpublishedonthetopic. Authors writing for TIC are given a

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