Neural network imaging to characterize brain injury in cardiac procedures: the emerging utility of connectomics.

Cognitive dysfunction is a poorly understood but potentially devastating complication of cardiac surgery. Clinically meaningful assessment of cognitive changes after surgery is problematic because of the absence of a means to obtain reproducible, objective, and quantitative measures of the neural disturbances that cause altered brain function. By using both structural and functional connectivity magnetic resonance imaging data to construct a map of the inter-regional connections within the brain, connectomics has the potential to increase the specificity and sensitivity of perioperative neurological assessment, permitting rational individualized assessment and improvement of surgical techniques.

Combination chemotherapy with the M-2 protocol (BCNU, cyclophosphamide, vincristine, melphalan, and prednisone) for chronic lymphocytic leukemia (stages III and IV).

The M-2 protocol was administered every 5 weeks to 25 patients with stage III and IV chronic lymphocytic leukemia (CLL). Complete remission (CR; absence of all clinical and bone marrow evidence of leukemia including normal immune markers for monoclonal disease) and partial remission (PR; greater than 50% decrease in organ enlargement and reduction of WBC count to below 15,000 X 10(6)/l) were achieved in 20 and 48%, respectively. A median number of 24 cycles of therapy was required to produce a CR. The median duration of unmaintained remission was 12 months. All CR patients are still surviving. The median survival of the PR patients and the overall groups is 21 months. To improve the CR rate and survival in patients with advanced CLL, more effective methods of determining residual leukemic cells and different treatment strategies will be needed.

Podophyllum toxicity: a report of a fatal case and a review of the literature.

A 59-yr-old male ingested 10 g of podophyllum in a fatal suicide attempt. Previously unreported nuclear and cytoplasmic changes were observed in circulating leukocytes. Symptoms did not occur until 10 h after ingestion with loss of reflexes, coma, and a marked lactic acidosis. Despite hemoperfusion, the patient expired 39 h after ingestion. The literature on podophyllum toxicity is reviewed.

Myelofibrosis-myeloid metaplasia in childhood.

A child with idiopathic myeloid metaplasia is described and her course contrasted with another child having myeloid metaplasia secondary to reticulum cell sarcoma. Despite prior reports the idiopathic form of illness may pursue a relatively indolent course in children. A thorough search should be made for underlying disease when myeloid metaplasia is first diagnosed.