Effect of Zonisamide (CI-912) on a Synaptic System Model

The effect of the experimental antiepileptic drug zonisamide (1,2-benzisoxazole-3-methanesulfonamide, ZNS) on the trigeminal complex of cats was compared with the effect of established antiepileptic drugs. Intravenous administration of 10-40 mg/kg ZNS significantly depresses descending excitatory mechanisms, as well as segmental and descending inhibitory mechanisms, but has only a minor effect on segmental excitatory mechanisms. This spectrum of activity is similar to that of valproate, and suggests that ZNS should also be a broad-spectrum antiepileptic drug. In agreement with our experimental observations, it has been found that ZNS is effective against complex partial, generalized tonic clonic, and myoclonic seizures. The antiepileptic profile of ZNS in conventional screening tests resembles that of carbamazepine (CBZ) and phenytoin. However, CBZ exacerbates rather than prevents myoclonic seizures. Our experimental model thus provides a more accurate prediction of ZNS's clinical spectrum of activity. The relationship of these findings to the mechanism of action of antiepileptic drugs is discussed.     

Use of a 2.0-mm locking plate/screw system for mandibular fracture surgery.

PURPOSE: In this study, we examined the use of a 2.0-mm locking bone plate/screw system in mandibular surgery. PATIENTS AND METHODS: All patients who were treated with a 2.0-mm locking bone plate/screw system during an 8-month period for fractures of the mandible or other defects of the mandible were prospectively studied. Ease of use of locking plate/screw system, characteristics of the fractures and defects, and complications were tabulated. RESULTS: A total of 80 fractures in 59 patients were treated with the 2.0-mm locking plate/screw system. One hundred two 2.0-mm locking plates were applied to the 80 fractures; 58 fractures received 1 plate and 22 fractures received 2 plates. There were no intraoperative difficulties associated with their application. Fracture reductions were considered to be excellent in all cases. At the latest follow-up, all fractures had healed, but 2 patients had slight malocclusions. Six patients developed postsurgical infections. Only 1 patient required hospitalization for treatment of the infection; all others were managed in the outpatient clinic. Four patients required removal of their plates for varying reasons. CONCLUSIONS: The use of a 2.0-mm locking plate/screw system was found to be simple and to provide sound fixation in all cases.     

Predicting the experience of dentinal caries or restorative dental treatment in adolescents using D1 and D3 visual caries assessments

Standardised epidemiological caries assessments used in oral health surveys have been shown to be poor at predicting whether a tooth surface will be treated restoratively when a patient visits a dentist. However, it has been argued that oral health surveys may be more relevant in determining needs at the level of an individual or groups of individuals. The objective of this study was to determine the discriminatory power of visual caries assessments at two thresholds (D₁ & D₃) in adolescents of average age 12.1 years to predict experience of dentinal caries 3 years later or the experience of restorative treatment (not re‐treatment) during the 3‐year period. The data was derived from a prospective 3‐year longitudinal study in which the dental care provided by 41 dentists for 403 adolescents was monitored. Dental caries experience was monitored by annual standardised assessments of caries undertaken by a single trained examiner. ROC analysis showed that caries assessed visually at the D₁ threshold in 12‐year‐olds was a better predictor (P < 0.001) of experiencing some dentinal caries after 3 years (Az = 0.781) than was caries assessed visually at D₃ threshold in 12‐year‐olds (Az = 0.670). Assessing caries visually at either the D₁ or the D₃ threshold had no discriminatory power for predicting whether an individual would experience some restorative treatment during the ensuing 3‐year period (Az for D₁ = 0.507; Az for D₃ = 0.518).