Chest wall reconstruction for deep radiation necrosis: case report and overview of surgical options.

INTRODUCTION: To report a case of radiation necrosis after reirradiation for breast cancer and the difficulties encountered when treating these complex cases. PATIENTS AND METHODS: We present an 86-year-old woman with a history of right-sided intraductal breast cancer treated with a right mastectomy followed by local adjuvant radiotherapy (50 Gray). Twelve years later, she was diagnosed with a local recurrence in the mastectomy scar which was treated with local resection (including resection of rib four) and adjuvant radiotherapy up to 32 Gray. In July 2020 she presents at the Department of Plastic and Reconstructive Surgery with a chronic ulcer on the right-sided hemithorax. RESULTS: A multi-staged, multidisciplinary approach was necessary to secure lasting coverage of the extensive defect. CONCLUSION: Thoracic radiation necrosis should be subject to a multidisciplinary approach (plastic and thoracic surgeons) pre-, per-, and post-operatively. Each case may require a different surgical approach depending on the size and depth of the defect, patients' age, comorbidities, and previous medical treatment.

Metabolic studies with promagnon, methylclostebol and methasterone in the uPA+/+-SCID chimeric mice.

The chimeric uPA(+/+)-SCID mouse model, transplanted with human hepatocytes, was previously validated as an alternative tool to study in vivo the human steroid metabolism. This humanized mouse model was now applied, in the framework of anti-doping research, to test different nutritional supplements containing steroids. These steroids, intentionally or accidentally added to a nutritional supplement, usually are derivatives of testosterone. Information about the metabolism of these derivatives, which is important to assure their detection, is quite limited. However, due to ethical constraints, human volunteers cannot be used to perform experimental excretion studies. Therefore the chimeric mice were selected to perform three separated excretion studies with superdrol (methasterone), promagnon and also methylclostebol. The urine of the humanized mice was collected 24h after a single dose administration and analyzed by gas chromatography-mass spectrometry (GC-MS). The results indicated the presence of several metabolites including a 3-keto reduced metabolite and numerous hydroxylated metabolites. Also phase 2 metabolism was investigated to update the complete picture of their metabolism.

Development and validation of a quantitative gas chromatography-mass spectrometry method for the detection of endogenous androgens in mouse urine.

A quantitative method based on gas chromatography-mass spectrometry (GC-MS) has been developed for the detection of 16 endogenous androgens in the urine of mice. The substances are extracted from 100 microL urine with freshly distilled diethyl ether after alkalinisation. The substances are derivatised with a mixture of N-methyl-N-trimethylsilyltrifluoroacetamide/NH(4)I/ethanethiol (383/1/2, v/w/v) and detected by GC-MS in the selected ion monitoring mode. The results of the method validation indicate good linearity, accuracy and precision, making the method suitable for the quantification of endogenous androgens in mouse urine. The selectivity of the method showed that no interfering peaks were observed at the retention times of the analytes. The method allows for the direct quantification and identification of testosterone and 15 other endogenous androgens at low concentrations (ng/mL) in mouse urine. The applicability of the method is shown by the analysis of a mouse urine. Several endogenous steroids could be detected.

Results of stability studies with doping agents in urine.

For a correct interpretation of analytical results in doping control, knowledge on the stability of prohibited substances in the urinary matrix is a prerequisite. So far, limited data is available on the stability of prohibited substances in unaltered urine because most of the studies investigating the stability of drugs have used stabilized, sterilized, or filtered urine. In this work, the long-term stability of ephedrine, methylephedrine, cathine, 19-norandrosterone glucuronide, and a wide range of diuretics was determined over a period of 9 months at -20 degrees C, 4 degrees C, 22 degrees C, and 37 degrees C. Short-term stability, including the influence of 6 freeze-thaw cycles and 15 h storage at 60 degrees C, was also investigated. Often, a tolerance limit of 15%, similar to what is commonly used in the evaluation of precision data during method validation, is used to evaluate stability. This paper describes an alternative approach, using measurement uncertainty data to evaluate long-term stability with a probability of 95%, and proposes a simple alternative for investigating the stability for non-threshold substances. The results indicate that all the investigated substances are stable (alpha=0.05) when stored at -20 degrees C and 4 degrees C, but that at higher temperatures significant degradation effects can occur. The study also shows that degradation can be dependent on the urinary matrix and that the results from stability studies using stabilized, filtered, or sterilized urine can underestimate degradation effects.