Carboplatin and recurrent childhood brain tumors

Carboplatin, a cisplatin analogue, was administered as an intravenous (IV) one-hour infusion in a 4-consecutive weekly dose schedule to 44 patients with recurrent childhood brain tumors. Twenty-four patients were registered on our phase I, and 20 on our phase II studies. The maximum tolerable dose derived from our phase I study was 210 mg/m2/wk in patients with solid tumors, and the recommended dose for subsequent pediatric phase II studies was 175 mg/m2/wk. This dose was administered to 14 patients in the phase I and all 20 patients in the phase II study. Nine of 36 (25%) evaluable patients in the combined studies experienced objective responses for a median duration of 10+ months. Seven of nine responders had received prior cisplatin. Disease-specific response rates were as follows: medulloblastoma, six of 14 (43%) with three complete (CR) and three partial responses (PR); pineoblastoma, one of one (PR); germinoma, one of two (CR); and brainstem glioma, one of eight (13%) (PR). Carboplatin had mild emetic effects but no significant auditory or renal toxicity. Thrombocytopenia (less than 49,000) was encountered in nine of 28 (32%) evaluable trials at a dose of 175 mg/m2/wk. Because of its low potential for auditory, renal, and emetic toxicity, ease of administration, and high disease-specific activity, carboplatin deserves further study in multiagent phase II and III trials, especially in chemotherapy-sensitive diseases such as medulloblastoma.

Implementation of Ultrasound in Anatomy Education

The use of different ways to view the body has always been associated with anatomy. With advancing technology, the use of ultrasound has become more portable and accessible as a way for students to learn anatomy. Moreover, ultrasound's direct clinical context makes it an important skill that students need to acquire and be competent in, not only after graduation but on clinical placements as a student. There does appear to be a learned skill in being able to interpret ultrasound images and to be able to relate the anatomy seen to existing anatomical knowledge. In addition, there is a learned skill in being able to correctly hold the ultrasound probe and gain clear images. Because ultrasound use and interpretation is a skill it therefore needs to be taught as part of undergraduate medical and allied health care professional education. A key to successful training is regular teaching sessions distributed longitudinally throughout the curriculum with active, hands-on learning time being the focus of any teaching session.