Triple approach to rhinophyma

Rhinophyma is a common condition in the west of Scotland. Various surgical approaches have been described, most of which rely heavily on electrocautery, heated scalpel, or laser coagulation for hemostasis, resulting in thermal injury and substantial risk of scarring. The authors describe their experience with the "triple approach" for the surgical treatment of rhinophyma, consisting of tangential excision for debulking, the use of scissors for sculpting, and the use of mild dermabrasion for final contouring. The use of an alginate hemostatic dressing is also described. The triple approach has been used in 6 patients with pleasing results.     

A new coumarin from Murraya paniculata

A new natural product, 2'-O-ethylmurrangatin (1) was isolated along with two previously known compounds murranganone (2) and paniculatin (3) from the leaves of Murraya paniculata. The structure of compound 1 was elucidated with the help of spectroscopic studies and by chemical reactions. Compounds 2 and 3 have been found to be cholinesterase inhibitors.     

Diaphragmatic fenestration for resistant pleural effusions after univentricular repair

A 12-year-old child with chronic pleural effusions for a month and a half after a fenestrated Fontan operation underwent bilateral diaphragmatic fenestrations with complete relief. We suggest this approach as an alternative treatment for chronic pleural effusions that may ensue after total cavopulmonary connection.     

New norditerpenoid alkaloids from Aconitum falconeri

The roots of Aconitum falconeri have yielded two new norditerpenoid alkaloids, faleoconitine (1) and 3'-methoxyacoforestinine (2) along with the known compounds, karakoline, 3-hydroxy-2-methyl-4H-pyran-4-one, and 3,4-dimethoxymethylbenzoate, which have been isolated for the first time from this plant. The previously reported pseudaconitine (3) was also isolated. Compounds 1 and 3 were found to be moderate inhibitors of the enzyme acetylcholinesterase.     

Taraxacin, a new guaianolide from Taraxacum wallichii

A new guaianolide, taraxacin (1), and a known sesquiterpene ketolactone (2) have been isolated from an ethyl acetate-soluble part of a methanolic extract of Taraxacum wallichii. The structure of 1 was established using NMR, MS, and X-ray crystallographic methods. The (13)C NMR data of 2 is also being reported for the first time.