An effect of phenobarbitone on griseofulvin metabolism in the rat

Prior administration of phenobarbitone to male and female rats dosed orally or intravenously with griseofulvin caused a fall in blood levels of the antibiotic. The effect of a single oral dose of phenobarbitone was significant after 12 hr and maximal between 12 and 48 hr, and it lasted for at least 96 hr; it was more pronounced when the barbiturate was administered repeatedly. Liver slices from animals dosed with phenobarbitone metabolized griseofulvin more rapidly than did those from undosed animals. The possible relevance of these findings to the clinical use of griseofulvin is discussed.     

A ganglion of the temporomandibular joint presenting as a parotid tumor

A case of temporomandibular joint (TMJ) ganglion is described, and 4 previously reported cases are noted. In all cases, initial diagnosis of parotid neoplasm proved incorrect at surgical exploration. Management of all cases consisted of identification of the facial nerve and excision of the ganglion with a cuff of TMJ capsule. The diagnosis of TMJ ganglion should be entertained when a presumed parotid neoplasm changes in size or position with jaw movement.     

Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates

OBJECTIVE: The use of bisphosphonates is well established for the treatment of patients with metastatic bone disease, osteoporosis, and Paget's disease. Osteonecrosis of the mandible or maxilla associated with the use of bisphosphonates is a newly described entity never before discussed in the otolaryngology literature. In this paper, we review a series of patients diagnosed with osteonecrosis, all treated with new generation bisphosphonates. Our objective is to inform and educate others, particularly otolaryngologists/head and neck surgeons, about this drug induced entity, a condition that should be recognized early to avoid potential devastating consequences. STUDY DESIGN: Retrospective chart review of a series of patients from a tertiary referral center. METHODS: Pathology reports of specimens submitted from either the mandible or maxilla were reviewed from the previous 12 months. Any patient diagnosed with osteonecrosis without evidence of metastatic disease at that site was included; those with a previous history of radiation therapy were excluded. Each patient's medical history and profile were reviewed. RESULTS: Twenty-three patients were identified with osteonecrosis of the mandible or maxilla. All of these were associated with the use of new generation bisphosphonates: zolendronate (Zometa, Novartis), pamidronate (Aredia, Novartis), and alendronate (Fosamax, Merck). Eighteen patients with known bone metastases had been treated with the intravenous form, whereas five patients with either osteoporosis or Paget's disease were using oral therapy. Patients typically presented with a nonhealing lesion, often times the result of previous dental intervention. Although the majority of these patients were treated with conservative surgical debridement, we present a case requiring a near total maxillectomy. CONCLUSIONS: Drug induced osteonecrosis of the mandible or maxilla has been recently recognized as a sequelae of treatment with the new generation of bisphosphonates. Most patients can be treated with conservative surgical debridement and cessation of bisphosphonate therapy, whereas a few may require radical surgical intervention. Other recommendations include regimented prophylactic care with an assessment of dental status before the administration of bisphosphonates, avoidance of dental procedures, and close monitoring of oral hygiene.     

Subcutaneous island pedicle flaps

The subcutaneous island pedicle flap is a useful and reliably successful means of closing small- to medium-sized cutaneous excisional defects. It is especially useful in areas where primary closure could result in distortion of critical features. The technique is conceptually straightforward and offers advantages over skin grafting and transposition flaps. We describe our experience with 60 consecutive, successful subcutaneous island pedicle flaps.     

Chondroma of the anterior nasal spine.

Chondromas in the head and neck, and particularly in the nasal region, are uncommon. A unique case of a chondroma within the anterior nasal spine has been reported. The asymptomatic lesion was discovered radiographically and mimicked a mesiodens. The tumor consisted of benign-appearing cartilaginous tissue; enucleation has resulted in a apparent cure. A hamartomatous origin has been postulated for this unusual lesion.     

Current topics in computer-aided drug design

The addition of computer-aided drug design (CADD) technologies to the research and drug discovery approaches could lead to a reduction of up to 50% in the cost of drug design. Designing a drug is the process of finding or creating a molecule which has a specific activity on a biological organism. Development and drug discovery is a time-consuming, expensive, and interdisciplinary process whereas scientific advancements during the past two decades have altered the way pharmaceutical research produces new bioactive molecules. Advances in computational techniques and hardware solutions have enabled in silico methods to speed up lead optimization and identification. We will review current topics in computer-aided molecular design underscoring some of the most recent approaches and interdisciplinary processes. We will discuss some of the most efficient pathways and design.