脱氢氯甲睾酮人体内代谢研究

本文叙述了用GC-MS联用技术研究脱氢氯甲睾酮人体内代谢的方法。尿样中的甾体化合物经大孔树脂吸附提取后,酶解。浓缩并衍生化,进行GC-MS分析。在服药后8～30h的尿样中,检出了脱氢氯甲睾酮原型,并发现了七个代谢产物。分析色谱和质谱数据,得到了这些代谢物的结构及其浓度变化趋势,推测了脱氢氯甲睾酮可能的体内代谢模式,确定了筛检尿中脱氢氯甲睾酮的特定代谢物和特征检测离子,比较了不同的样品处理方法对分析结果的影响。     

Sternocostoclavicular hyperostosis: a review and report of 11 cases

Sternocostoclavicular hyperostosis is a benign ossifying diathesis of unknown etiology characterized by hyperostosis and soft-tissue ossification between the clavicles, anterior portion of the upper ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. Our cumulative experience with 11 cases is reported, with emphasis on radiographic features of the condition. Scintigraphic results in five patients and computed tomographic findings in one patient are presented. A review of the literature and our own material indicates that sternocostoclavicular hyperostosis may be more common than has been previously recognized.     

Venous drainage of free flaps following radical neck dissection.

Large tissue defects may occur following head and neck surgery. When combined with ipsilateral radical neck dissection the venous drainage of a free flap used to cover the defect may be compromised. Twelve patients having radical neck dissections underwent on-table venography to study the pattern of venous drainage of these flaps. The predominant drainage pattern is initially in a cephalic direction, then across the midline and finally in a caudal direction on the contralateral side of the neck. Venous drainage to the contralateral side of the neck may be a determinant of flap survival. In order to facilitate venous drainage following free flap procedures, patients should be positioned so that the contralateral internal jugular vein is not compressed. Drains should be placed caudal to the microvascular anastomoses in order to minimize interference with the cephalic direction of venous drainage. Any patient having a radical neck dissection requiring a central venous catheter should have it placed ipsilateral to the neck dissection. Thrombosis around a contralaterally placed cannula may significantly increase head and neck venous pressure.     

Pediatric patients with achondroplasia: CT evaluation of the craniocervical junction

Twenty-six patients (4 months to 6 years old) with achondroplasia complicated by sleep apnea and/or other neurologic manifestations underwent plain computed tomography (CT) of the craniocervical junction; six also underwent CT myelography. For objectification, multiplanar reconstruction was used to complement axial plane measurements by providing coronal and sagittal measurements; multiplanar reconstruction also improved perception of the longitudinal relationships between the brain stem and subarachnoid space. A narrow subarachnoid space was found in all 26 patients; marked cord compression was present in nine, six of whom underwent CT myelography. These six had marked focal obliteration of the subarachnoid space on both plain CT and CT myelography. Since the subarachnoid space immediately above and below the craniocervical junction is normally capacious, when marked constriction was present, no additional information could have been gained from CT myelography. Thus, plain CT was shown to be sufficient for surgical planning (suboccipital decompression) in nine patients with cord compression due to achondroplasia.