Clinical Studies with Vincristine

Forty patients with malignant neoplastic disease received vincristine in aneffort to define the toxicity, the tolerated dose, the effect of varying doseschedules, and the antitumor properties. The toxicity of vincristine is doserelated, and the tolerated dose for the weekly schedule is 0.05 mg. per Kg.for the majority of patients. The tolerated dose per unit time is independentof the schedule of administration. The toxic manifestations relate primarilyto the neuromuscular system and the gastrointestinal tract. At the tolerateddose or below, these manifestations are reversible and not accumulative.Hematologic toxicity is rare, and thrombocytosis occurs in some patients.Vincristine produces tumor regression in the majority of the patients withlymphoma where its activity compares favorably with that of the alkylatingagents and vinblastine. There is suggestive evidence that cross-resistance between vincristine and the alkylating agents and between vincristine and vinblastine does not occur.

Accepted on December 28, 1962     

MM:3The children with special health care needs podcast series

This work is posted on the Podcasting from the U website, maintained by the University of Utah Department of Marketing and Communication. Jason Smith, coordinator of the Podcasting from the U website, assists in editing.     

MM:4The children with special health care needs podcast series

This work is posted on the Podcasting from the U website, maintained by the University of Utah Department of Marketing and Communication. Jason Smith, coordinator of the Podcasting from the U website, assists in editing.     

A Case of Atrial Tachycardia Treated with Ivabradine as Bridge to Ablation

Ivabradine is indicated in cardiac failure and ischemia to reduce sinus rate by inhibition of the pacemaker I(f) current in sinoatrial node. We report a case of an 18‐year‐old woman with left atrial tachyarrhythmia resistant to several antiarrhythmic drugs and to electric cardioversion who responded only to ivabradine, which significantly reduced heart rate without abolishing the arrhythmia itself. An ectopic focus in the ostium of left pulmonary veins was found and the patient was successfully ablated. We suggest that ivabradine might be therefore useful in the treatment of supraventricular tachyarrhythmias due to an enhanced automaticity.     

COMPLICATION RATE OF MICROSURGICAL VARICOCELE LIGATION WITHOUT DELIVERY OF THE TESTIS

It is commonly assumed that the complication rate of microsurgical varicocele repair is lower than that of nonmicrosurgical techniques, particularly since magnification allows for preservation of lymphatic vessels and, thus, a theoretically lower incidence of hydrocele. However, review of the literature reveals relatively few papers on this subject. The authors reviewed their experience to determine the incidence of complications following microsurgical varicocele repair without delivery of the testicle in the adult population. From 1 July 1997 to 1 September 2001 139 men underwent microsurgical varicocele ligation without delivery of the testicle, with a mean follow-up of 22 months. Of the 139 men, 4 (2.9%) had complications. One (0.7%) had a recurrence, 1 (0.7%) had a wound infection, 1 (0.7%) had epididymitis, and 1 (0.7%) had an unintentional injury of the testicular artery. None of the men developed a hydrocele. The published complication rate for nonmicrosurgical varicocle ligation ranges from 5.4 to 7.2%, with the most common complication being hydrocele formation. In the authors' series, the overall complication rate was 2.9%, with no patient developing a hydrocele. Thus, microsurgical varicocele ligation without delivery of the testicle results in a lower complication rate and a lower incidence of hydrocele than nonmicrosurgical techniques.