Effect of sodium phenytoin concentration on neural tube development in the early stages of chicken embryo development.

Animal and human research has shown that anticonvulsants are teratogens and pose a risk of causing fetal malformations. In various studies, the teratogenic effects of sodium phenytoin (PTH) in several systems have been investigated. Toe and finger, renal, and even facial malformations have been described in the literature. However, there is debate about whether the true risk of teratogenesis is lower or higher than previously reported for PTH. There is also little published information on the effect of this agent on neural tube closure in an embryological model. In this study, 0.1 mL of three different concentrations of PTH solution (mg/mL: 1, 3, 5) or vehicle was applied under the embryonic disc of specific pathogen-free Leghorn chicken embryos after 24 hours' incubation. Incubation was continued until 72 hours of maturation. At 72 hours, all embryos were evaluated macroscopically and microscopically. There were serious neural tube closure defects in the embryos administered large amounts (0.5 mg) of PTH, but doses of 0.1 mg (subtherapeutic concentration for humans) and 0.3mg (therapeutic concentration for humans) produced no statistically significant defects (p=0.05). The difference between the defects in the high concentration group and the other three groups was statistically significant. In our study PTH administered in a strict concentration regimen produced a lower level of neural tube closure-related defects than previously reported.

Frontal sinus osteoma complicated with intracranial inflammatory polyp: a case report and review of the literature.

BACKGROUND: Osteomas of the paranasal sinuses rarely cause intracranial manifestations. A neurological symptom may be the first sign of a previously unrecognized osteoma. CASE DESCRIPTION: A 28-year-old male was referred with one episode of witnessed tonic-clonic seizure and loss of consciousness. Radiologic examination revealed a calcific mass in the frontal sinus and a cystic structure was detected in the posterior component of the lesion. The patient underwent a combined nasal endoscopic approach and a bilateral frontal osteoplastic craniotomy. The ossifying tumoral tissue and the polypoid soft tissue mass were removed. The histo-pathologic diagnosis of the hard, bony tumor was consistent with an osteoma and the polypoid soft tissue was an inflammatory polyp. CONCLUSION: This case report illustrates a rare and life threatening complication of a frontal sinus osteoma with an intracranial extension of an inflammatory polyp.