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1.
China Journal of Chinese Materia Medica ; (24): 430-442, 2023.
Article in Chinese | WPRIM | ID: wpr-970480

ABSTRACT

The chemical constituents in stem leaf, root, and flower of Ixeris sonchifolia were identified by the ultra performance li-quid chromatography coupled with linear ion trap quadrupole-orbitrap mass spectrometry(UPLC-LTQ-Orbitrap-MS~n). The separation was performed on an Acquity UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) with a mobile phase of water(containing 0.1% formic acid, A)-acetonitrile(B) with gradient elution. With electrospray ionization source, the data of 70% methanol extract from stem leaf, root and flower of I. sonchifolia were collected by high-resolution full-scan Fourier transform spectroscopy, data dependent acquisition, precursor ion scan, and selected ion monitoring in the negative and positive ion modes. The compounds were identified based on accurate molecular weight, retention time, fragment ions, comparison with reference standard, Clog P and references. A total of 131 compounds were identified from the 70% methanol extract of I. sonchifolia, including nucleosides, flavonoids, organic acids, terpenoids, and phenylpropanoids, and 119, 110, and 126 compounds were identified from the stem leaf, root and flower of I. sonchifolia, respectively. In addition, isorhamnetin, isorhamnetin-7-O-sambubioside and caffeylshikimic acid were discovered from I. sonchifolia for the first time. This study comprehensively analyzed and compared the chemical constituents in different parts of I. sonchifolia, which facilitated the discovery of effective substances and the development and application of medicinal material resources of I. sonchifolia.


Subject(s)
Drugs, Chinese Herbal/chemistry , Methanol , Chromatography, High Pressure Liquid/methods , Mass Spectrometry , Asteraceae
2.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 122-130, 2023.
Article in Chinese | WPRIM | ID: wpr-997665

ABSTRACT

ObjectiveBased on serum pharmacochemistry and ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS) the transitional components in the serum of rats after intragastric administration of water extract of Alismatis Rhizoma(AR)and salt-processed Alismatis Rhizoma(SAR) were compared. MethodSD rats were randomly divided into blank group, AR group(10 g·kg-1) and SAR group(10 g·kg-1), 3 rats in each group, the administration groups were given AR and SAR aqueous extracts by gavage, respectively, and the blank group was given an equal volume of drinking water by gavage once in the morning and once in the evening, for 3 consecutive days. Sixty minutes after the last administration, blood was collected from the eye orbits, and the serum samples were prepared. The serum samples were prepared on an ACQUITY UPLC BEH C18 column(2.1 mm×50 mm, 1.7 μm) with the mobile phase of acetonitrile(A)-0.1% formic acid aqueous solution(B) in a gradient elution(0-10 min, 10%-50% A; 10-27 min, 50%-95%A; 27-27.1 min, 95%-10% A; 27.1-30 min, 10%A), the data were collected at a flow rate of 0.3 mL·min-1 in positive ion mode with a scanning range of m/z 100-1 200. Based on the self-constructed chemical composition library of AR, the total ion flow diagrams and secondary MS fragmentation information of the aqueous extracts of AR and SAR, as well as the administered serum and the blank serum, were compared with each other by UNIFI 1.9.2, so as to deduce the possible blood-migrating constituents and their cleavage patterns in the aqueous extracts, and the response intensity ratios of each chemical component were calculated before and after processing. ResultA total of 20 components, including 5 prototypical components and 15 metabolites, were analyzed and deduced from the serum of rats given aqueous extract of AR. And 14 components, including 5 prototypical components and 9 metabolites, were analyzed and deduced from the serum of rats given aqueous extract of SAR. Of these, 13 components were common to both of them, including 5 prototypical components and 8 metabolites. The 5 prototypical components were 16-oxoalisol A, alisol A 24-acetate, alisol A, alisol B and alisol C. The metabolites were mainly involved in phase Ⅰ metabolism(oxidation) and phase Ⅱ metabolism(glucuronidation). There was a big change in the intensity of response of the common components before and after salt-processing, and the response intensities of the prototypical components, 16-oxoalisol A, alisol B and alisol C, were elevated, while the type and response intensity of metabolites were generally decreased, and it was hypothesized that the metabolic rate of terpenoids might be slowed down after salt-processing of AR, so that the blood-migrating constituents could participate in the metabolism of the body more in the form of prototypes. ConclusionSalt-processing of AR may promote the absorption of prototypical components into the blood by slowing down the metabolic rate of terpenoids, which can provide support for the research on material basis of AR and SAR.

3.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 1-12, 2023.
Article in Chinese | WPRIM | ID: wpr-969593

ABSTRACT

ObjectiveTo characterize the chemical constituents of Dayuanyin based on ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap MS). MethodThe detection was performed on a Thermo Acclaim™ RSLC 120 C18 column(2.1 mm×100 mm, 2.2 μm), the mobile phase was acetonitrile(A)-0.1% formic acid aqueous solution(B) for gradient elution (0-7.5 min, 10%-19%A; 7.5-12 min, 19%-22.5%A; 12-23 min, 22.5%-27%A; 23-27 min, 27%-56%A; 27-35 min, 56%-84%A; 35-36 min, 84%-90%A), the flow rate was 0.3 mL·min-1, and the column temperature was 30 ℃. The data were collected in the positive and negative ion modes by heated electrospray ionization(HESI), and the detection range was m/z 80-1 200. Combining the retention time of the reference substance, fragment ions, databases such as PubChem and related literature, Xcalibur 3.0 was used to identify the chemical constituents of Dayuanyin. ResultA total of 161 compounds were identified, including 14 alkaloids, 60 flavonoids, 16 terpenoids, 26 saponins, 18 phenylpropanoids, 16 organic acids and 11 others. ConclusionThe established method can effectively and quickly identify the chemical components in Dayuanyin, and clarify its chemical composition, which can provide a basis for the development of compound preparations of this famous classical formula.

4.
China Journal of Chinese Materia Medica ; (24): 1179-1190, 2021.
Article in Chinese | WPRIM | ID: wpr-879020

ABSTRACT

To demonstrate the fragmentation patterns of simple coumarins furanocourmarin(C_7-C_8), furanocourmarin(C_6-C_7) and dihydrofuran coumarin by mass spectrometry, with fraxin, scopoletin, isopsoralen, pimpinellin, isoimperatorin, notopterol and noda-kenin as study subjects, so as to provide a basis for rapid identification of compounds in different subtypes of coumarins. Ultrahigh performance liquid chromatography combined with quardrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was implemented in both positive and negative ion modes. Masslynx software was employed to provide the elemental constituents of each detected ion based on its accurate molecular weight. Chemdraw 2014 was used to cultivate mass number of each inferred structure. The fragment pattern of each compound was determined based on the structures inferred from all the relevant ions. And the patterns were drawn by Chemdraw 2014. The deviation between the calculated molecular weight of the inferred structure and the detected value of the ions was used to assess the correctness of the inferred structures in the fragmentation patterns. The results showed that with UPLC-Q-TOF, neutral loss of CO_2 and CO was reflected in lactone and furan skeletons from the courmarin structure. An even mass was attributed to the loss of an odd number of methyl radicals from compounds with a methoxy substituent. Furanocourmarin(C_7-C_8) produced a protonated molecular ion([M+H]~+), while the other courmarin subtypes produced either a sodium adduct of the molecular ion([M+Na]~+) or a sodium adduct of the molecular ion([M+Na]~+) with a protonated molecular ion([M+H]~+). The m/z 203.03 was a diagnostic ion for furanocourmarin(C_6-C_7), and the m/z 147.04 was supplementary evidence for furanocourmarin(C_6-C_7) identification. The characteristic ion of furanocourmarin(C_7-C_8) was m/z 131.05, while m/z 187.04 was the characteristic ion of dihydrofuran coumarin. The m/z 203.03 ion for furanocourmarin(C_7-C_8) was pretty weak. In negative ion mode, furanocourmarin(C_7-C_8) did not have any signals that were different from the other subtypes of courmarins. The fragmentation patterns in negative ion mode for the other subtypes of courmarins were similar to those in positive ion mode. Four types of fragmentation patterns were identified as forcourmarins from Notopterygium inchum. This study provides the basis for the rapid identification of courmarin subtypes by mass spectrometry.


Subject(s)
Humans , Chromatography, High Pressure Liquid , Chromatography, Liquid , Coumarins , Ions , Mass Spectrometry , Plant Extracts , Spectrometry, Mass, Electrospray Ionization
5.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 116-123, 2021.
Article in Chinese | WPRIM | ID: wpr-906152

ABSTRACT

Objective:To systematically analyze the chemical constituents of Qizhi Jiangtang capsules by ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high resolution mass spectrometry (UPLC-QE-Orbitrap-MS). Method:Analysis was conducted on a ACQUITY UPLC HSS T3 column (2.1 mm×100 mm, 1.8 μm) with acetonitrile (A)-water (B) as the mobile phase for gradient elution (0-13 min, 1%-25%A; 13-21 min, 25%-35%A; 21-28 min, 35%-85%A; 28-30 min, 85%-100%A; 30-32 min, 100%-1%A). The flow rate was 0.2 mL·min<sup>-1</sup>, the column temperature was 30 ℃, and the volume of sample injection was 3 μL. Electrospray ionization (ESI) was used to collect data in the negative and positive ion modes with the scanning range of <italic>m</italic>/<italic>z</italic> 100-1 500. Meanwhile, a variety of MS analytic methods were used, including comparing with the information of control substances, self-built compounds database and literature references, diagnostic ion filtering, Compound Discoverer 3.0 software, for identification of the chemical components. Result:Based on the above strategy, a total of 52 compounds were identified in Qizhi Jiangtang capsules, and the sources of these compounds were identified. Amino acids were mainly derived from Hirudo, phenylpropanoids were derived from Astragali Radix and Rehmanniae Radix, iridoid glycosides were derived from Rehmanniae Radix, coumarins and triterpenes were derived from Astragali Radix, flavonoids were from Astragali Radix and Polygonati Rhizoma. Conclusion:The established UPLC-QE-Orbitrap-MS analytical method can comprehensively and rapidly analyze and identify of the chemical constituents in Qizhi Jiangtang capsules. Many of the ingredients have been proved by modern pharmacological studies to have the effect of improving related symptoms of diabetes and its complications, reflecting the characteristics of synergistic action of multiple components in Qizhi Jiangtang capsules. This study can provide reference for the further research on the pharmacodynamic material basis and the quality control of Qizhi Jiangtang capsules.

6.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 149-156, 2021.
Article in Chinese | WPRIM | ID: wpr-906062

ABSTRACT

Objective:To compare the chemical constituents of Puerariae Flos from three different varieties of <italic>Pueraria montana</italic> var. <italic>lobata</italic>, <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>. Method:Ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) was used with the mobile phase of 0.1% formic acid aqueous solution (A)-acetonitrile (B) for gradient elution (0-20 min, 10%-30%B; 20-30 min, 30%-55%B; 30-35 min, 55%-95%B; 35-37 min, 95%B; 37-40 min, 95%-10%B), the flow rate was 0.25 mL·min<sup>-1</sup>. Electrospray ionization (ESI) was used to scan and collect MS data in positive and negative ion modes with scanning range of <italic>m</italic>/<italic>z</italic> 50-1 500. The chemical components from different sources of Puerariae Flos were identified in combination with the chemical composition database and literature information. After the obtained data were normalized by MarkerView<sup>TM</sup> 1.2.1, they were imported into SICMA-P 14.1 software for principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) to select the main differentiated components among the three different varieties. Result:A total of 35 compounds were identified from three different varieties of Puerariae Flos, including 22 isoflavones, 6 flavonoids and 7 saponins. The flowers of <italic>P</italic>. <italic>lobata</italic>, <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> contained 32, 35, 33 compounds, respectively. And 18 differential compounds were screened under the positive and negative ion modes, including kakkalide, tectoridin, 6″-<italic>O</italic>-xylosyl-tectoridin, 4'-methyltectorigenin-7-glucoside, glycitin, 6″-<italic>O</italic>-xylosyl-glycitin, irisolidone, kaikasaponin Ⅲ, 6″-<italic>O</italic>-malonylglycitin, kakkalidone, tectorigenin, rutin, soyasaponin BB, vitexin, biochanin A, genistin, kakkatin, azukisaponin Ⅱ. Conclusion:This research is the first to systematically study the chemical constituents of the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>, although the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> is used as adulterants, it has high contents of tectoridin and 6″-<italic>O</italic>-xylosyl-tectoridin, which has great potential for development. The efficacy components such as kakkalide and tectoridin in Puerariae Flos from the three sources of varieties are obviously different, and it is necessary to carefully consider the application of these three varieties as Puerariae Flos.

7.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 152-159, 2021.
Article in Chinese | WPRIM | ID: wpr-906001

ABSTRACT

Objective:To rapidly identify the chemical constituents of Chaishi Tuire granules by ultra-performance liquid chromatography-electrospray/quadrupole time-of-flight tandem mass spectrometry (UPLC-ESI-Q-TOF-MS/MS). Method:Chromatographic separation was conducted on a Phenomenex<sup>®</sup> Luna omega C<sub>18</sub> column (2.1 mm×100 mm, 1.6 μm) with 0.1% formic acid aqueous solution (A)-acetonitrile (B) as the mobile phases for gradient elution (0-20 min, 5%-40%B; 20-40 min, 40%-95%B; 40-43 min, 95%B), the flow rate was set at 0.3 mL·min<sup>-1</sup>. MS data were collected in positive and negative ion modes, the scanning range was <italic>m</italic>/<italic>z</italic> 150-1 500 and electrospray ionization (ESI) was employed. The chemical constituents of Chaishi Tuire granules were identified by comparing with the retention time and the mass data of the reference substances, as well as the accurate mass, MS/MS fragment ions, mass spectrometry databases (PubChem, MassBank, ChemicalBook and others) and related literature. Result:A total of 85 chemical constituents were identified, including 28 flavonoids, 24 phenylpropanoids, 11 terpenoids, 10 alkaloids, 4 quinones, and 8 others. Among them, 19 constituents derived from Lonicerae Japonicae Flos, 14 constituents derived from Scutellariae Radix, 10 constituents derived from Isatidis Radix, 9 constituents derived from Taraxaci Herba, 9 constituents derived from Forsythiae Fructus, 4 constituents derived from Bupleuri Radix, 4 constituents derived from Anemarrhenae Rhizoma, and 4 constituents derived from Rhei Radix et Rhizoma. Conclusion:Chaishi Tuire granules is rich in phytochemicals, which are derived from many of traditional Chinese medicines. This study can lay a foundation for the quality control, material basis and <italic>in vivo</italic> metabolic analysis of this preparation.

8.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 157-162, 2019.
Article in Chinese | WPRIM | ID: wpr-802283

ABSTRACT

Objective:To systematically and comprehensively analyze coumarin components in Angelicae Sihensis Radix by an efficient and stable HPLC-Q-TOF-MS/MS method,in order to offer the theoretical basis to develop coumarin,establish the quality control standard and apply in clinic. Method:The separation effect of coumarin components was extracted by adjusting the column,temperature,mobile phase,flow rate,sample concentration and other conditions,and various coumarin components in Angelicae Sihensis Radix were identified by corresponding standards,precise molecular mass,polarity,pyrolysis pattern. Result:In this study,a high-efficiency and stable coumarin separation method was established that can be used to separate complex components,and 14 coumarin components were identified in this study,including phellopterin and osthenol that were rarely reported as effective components in Angelicae Sihensis Radix. Major fragment ions of coumarin components were analyzed. The cleavage in methoxy bond or anisole bond on the parent nucleus was the primary pattern for coumarin components, which was summarized for detecting unknowing coumarins. Conclusion:Abundant coumarins were contained in Angelicae Sihensis Radix. Further qualitative and quantitative analysis of coumarins are conducive to improving the quality standards of Angelicae Sihensis Radix,and providing reference for the development of coumarins and clinical application of Angelicae Sinensis Radix.

9.
Chinese Journal of Biotechnology ; (12): 2284-2294, 2019.
Article in Chinese | WPRIM | ID: wpr-781638

ABSTRACT

With the development of liquid biopsy technology, plasma cell-free DNA (cfDNA) becomes one of the research hotspots. Whole-genome bisulfite sequencing of plasma cell-free DNA has shown great potential medical applications such as cancer detection. However, the practical stability evaluation is still lacking. In this study, plasma cell-free DNA samples from two volunteers at different time were collected and prepared for sequencing in multiple laboratories. The library preparation strategies include pre-bisulfite, post-bisulfite and regular whole-genome sequencing. We established a set of quality control references for plasma cell-free DNA sequencing data and evaluated practical stability of blood collection, DNA extraction, and library preparation and sequencing depth. This work provided a technical practice guide for the application of plasma cfDNA methylation sequencing for clinical applications.


Subject(s)
Humans , Cell-Free Nucleic Acids , DNA Methylation , High-Throughput Nucleotide Sequencing , Sequence Analysis, DNA , Sulfites , Whole Genome Sequencing
10.
Chinese Pharmaceutical Journal ; (24): 1423-1428, 2016.
Article in Chinese | WPRIM | ID: wpr-859011

ABSTRACT

OBJECTIVE: To investigate the impurity profile of raloxifene thus to lay a foundation for the establishment of drug quality standard. METHODS: HPLC-IT-TOF-MS was adopted to analyze destroyed raloxifene and reference substances of impurities. According to the mass spectrometry fragmentation patterns of known impurities, the structures of unknown impurities were speculated. RESULTS: Destroyed raloxifene totally produced three impurities, one of which was unknown. Based on the regular mass spectrometry fragmentation patterns of raloxifene and known impurities, the unknown impurity was speculated to be a sulfone that was generated through further oxidation of raloxifene. CONCLUSION: The methods and results of this study could lay a foundation for the impurity control during production and in vivo analysis of raloxifene.

11.
China Journal of Chinese Materia Medica ; (24): 3244-3251, 2016.
Article in Chinese | WPRIM | ID: wpr-307170

ABSTRACT

This study was aimed to qualitatively analyze the chemical components in Congrong Zonggan capsule by using ultra-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry method (UPLC-Q-TOF-MS/MS). An Agilent SB-C₁₈ Rapid Resolution HD (3.0 mm×100 mm,1.8 μm) was used with acetonitrile (A) - 0.1% formic acid solution (B) as the mobile phase for gradient elution. The flow rate was 0.2 mL•min⁻¹; the detection wavelength was set at 330 nm and the column temperature was maintained at 30 ℃. Electrospray ion (ESI) source was applied for the qualitative analysis under the negative ion mode. Finally, based on comparison with standard samples, database matching analysis and reviewing relevant literature, 41 compounds were identified from Congrong Zonggan capsule. This method could be used to rapidly detect the chemical components in Congrong Zonggan capsule, providing reference for the quality control of Congrong Zonggan capsule and laying a foundation for the further study on active components mechanism.

12.
Journal of Pharmaceutical Analysis ; (6): 285-295, 2015.
Article in Chinese | WPRIM | ID: wpr-482025

ABSTRACT

Forced degradation study on doxorubicin (DOX) was carried out under hydrolytic condition in acidic, alkaline and neutral media at varied temperatures, as well as under peroxide, thermal and photolytic conditions in accordance with International Conference on Harmonization (ICH) guidelines Q1(R2). It was found extremely unstable to alkaline hydrolysis even at room temperature, unstable to acid hy-drolysis at 80 °C, and to oxidation at room temperature. It degraded to four products (O-I-O-IV) in oxidative condition, and to single product (A-I) in acid hydrolytic condition. These products were re-solved on a C8 (150 mm × 4.6 mm, 5μm) column with isocratic elution using mobile phase consisting of HCOONH4 (10 mM, pH 2.5), acetonitrile and methanol (65:15:20, / / ). Liquid chromatography-pho-todiode array (LC-PDA) technique was used to ascertain the purity of the products noted in LC-UV chromatogram. For their characterization, a six stage mass fragmentation (MS6) pattern of DOX was outlined through mass spectral studies in positive mode of electrospray ionization (+ESI) as well as through accurate mass spectral data of DOX and the products generated through liquid chromato-graphy-time of flight mass spectrometry (LC-MS-TOF) on degraded drug solutions. Based on it, O-I-O-IV were characterized as 3-hydroxy-9-desacetyldoxorubicin-9-hydroperoxide, 1-hydroxy-9-desacetyldox-orubicin-9-hydroperoxide, 9-desacetyldoxorubicin-9-hydroperoxide and 9-desacetyldoxorubicin, re-spectively, whereas A-I was characterized as deglucosaminyl doxorubicin. While A-I was found to be a pharmacopoeial impurity, all oxidative products were found to be new degradation impurities. The mechanisms and pathways of degradation of doxorubicin were outlined and discussed.

13.
World Science and Technology-Modernization of Traditional Chinese Medicine ; (12): 1735-1746, 2014.
Article in Chinese | WPRIM | ID: wpr-453952

ABSTRACT

This article was aimed to rapidly analyze chemical composition in A loe Barbadensis Mill, and to compare the chemical composition of commercial aloe vera medicinal materials with that of fresh aloe yellow exudate. An opti-mized liquid chromatography-mass spectrometry-ion trap-time-of-flight (LCMS-IT-TOF) method was applied for the analysis of commercial aloe vera medicinal materials and fresh aloe yellow exudates. The Agilent TC-C18 column (4.6 í 250 mm, 5 m) was used. The gradient elution was a solvent system of water(A)-methanol(B). ESI source was operated in both positive and negative ion modes. The results showed that chromones, pyrones, naphthalene deriva-tive, anthrones and anthraquinones were separated successfully, 30 compounds were characterized by the comparison of characteristic MS/MS fragment ions data with the literature. The diagnostic fragmentation patterns of different chemical compositions were also discussed on the basis of EST-IT-TOF MS data. It was concluded that the chemical composition of commercial aloe vera medicinal materials were significantly different from that of fresh aloe yellow ex-udate in terms of types and contents: the former one mainly contains isoaloeresin D and aloin, and few aloesin; but the latter is mainly composed of aloesin and aloin, and the content of aloesin is the highest. The LCMS-IT-TOF analysis can be used to rapidly obtain rich structural information of different chemical compositions, which improves the efficiency of qualitative analysis of chemical composition, and is of great significance to the quality control, eval-uation and the utilization of A loe Barbadensis Mill.

14.
Clinics in Orthopedic Surgery ; : 223-229, 2014.
Article in English | WPRIM | ID: wpr-100963

ABSTRACT

BACKGROUND: Within the lateral pillar classification of the Legg-Calve-Perthes (LCP) disease, hips seem quite variable in the pattern of fragmentation as seen in radiographs. The purpose of this study was to determine: if it is possible to reliably subdivide the lateral pillar groups into femoral head fragmentation patterns, and if such a subdivision of the lateral pillar groupings is clinically useful in managing LCP disease. METHODS: Two hundred and ninety-three anteroposterior radiographs taken at the maximal fragmentation stage (189 lateral pillar B, 57 B/C border, and 47 C hips; mean bone/chronologic age at the time of first visit, 6.2/7.9 years) and at skeletal maturity (mean age, 16.6 years) were analyzed. We distinguished 3 fragmentation patterns in each pillar group based on the region of major involvement. We tested the inter- and intraobserver reliability of our classification system and analyzed the relationships between the fragmentation patterns and the Stulberg outcomes as well as other factors such as surgical treatment and age. RESULTS: Inter- and intraobserver consistency in fragmentation pattern assignments was found to be substantial to excellent. A statistically significant trend (p = 0.001) in the proportion of Stulberg III or IV outcomes in comparison with Stulberg I and II was only found for the different fragmentation patterns in our lateral pillar B patients: fragmentation patterns having mainly lateral-central necrosis led to poor outcomes. No significant association was found between fragmentation patterns and Stulberg outcomes in pillar groups B/C border and C. CONCLUSIONS: Our results are consistent with the lateral pillar classification itself. Therefore, fragmentation patterns in each lateral pillar classification did not provide clinical usefulness in the management of LCP disease.


Subject(s)
Adolescent , Child , Humans , Young Adult , Femur Head/diagnostic imaging , Femur Head Necrosis/classification , Legg-Calve-Perthes Disease/classification , Observer Variation , Prognosis , Retrospective Studies
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