Phenobarbital in hair and drug monitoring.

Phenobarbital analysis was performed in vertex hair of patients by gas chromatography mass spectrometry (GC/MS). After washing with dichloromethane, about 250 mg were ground to dust in a ball mill. A 50-mg sample was stirred mechanically for 10 min with 3 ml of NH4Cl/HCl buffer (pH 2.0) containing phenobarbital D5. A solid phase extraction was performed (extrelut Merck) and elution was achieved with chloroform/isopropanol/n-heptane (50:17:33; v/v). A full scan (40-240 uma) acquisition was realized by GC/MS with an ion trap (ITD 700 Finnigan) using a DB5-MS chromatographic column. Quantification was achieved by integrating dominants ions (phenobarbital, 204; phenobarbital D5, 209). Compared to serum, hair concentrates phenobarbital during anti-epileptic therapy (average value 36.4 ng/mg, n = 40 vs. 18.7 mg/l, n = 23). A group correlation exists between phenobarbital in hair and phenobarbital in serum, and between phenobarbital in hair and clinic observation in some typical cases. Phenobarbital in hair yields good information over a long period, especially when blood collection has not been made, when clinical disorders are observed on long-term therapeutic observance.

[Upper cervical intradural lipoma. Apropos of a case]. / Lipome intradural cervical haut. A propos d'une observation.

Intradural lipoma is a rare and slow growing tumor which represents 1% of all intra-spinal tumors. This tumor is often associated with dysraphism. It can be isolated without any associated vertebral or cutaneous malformations. Its clinical evolution is extremely slow and progressive. The fatty composition of this type of tumor allows easy detection by CT as well as by MRI. MRI permits: Reliable and direct assessment (in 3 different plans) of the extension of the lesion. An excellent post operative control.