PubMed Health⌕ Search

Biomedical subjects

W L Dunn

Publications and source records attributed to W L Dunn.

At least 19 recordsLinked to original sources
PubMed1997

Prevalence of low femoral bone density in older U.S. adults from NHANES III.

Most estimates of osteoporosis in older U.S. adults have been based on its occurrence in white women, even though it is known to affect men and minority women. In the present study, we used dual-energy X-ray absorptiometry measurements of femoral bone mineral density (BMD) from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) to estimate the overall scope of the disease in the older U.S. population. Specifically, we estimate prevalences of low femoral BMD in women 50 years and older and explore different approaches for defining low BMD in older men in that age range. Low BMD levels were defined in accordance with an approach proposed by an expert panel of the World Health Organization and used BMD data from 382 non-Hispanic white (NHW) men or 409 NHW women ages 20-29 years from the NHANES III dataset. For women, estimates indicate 13-18%, or 4-6 million, have osteoporosis (i.e., BMD > 2.5 standard deviations [SD] below the mean of young NHW women) and 37-50%, or 13-17 million, have osteopenia (BMD between 1 and 2.5 SD below the mean of young NHW women). For men, these numbers depend on the gender of the reference group used to define cutoff values. When based on male cutoffs, 3-6% (1-2-million) of men have osteoporosis and 28-47% (8-13 million) have osteopenia; when based on female cutoffs, 1-4% (280,000-1 million) have osteoporosis and 15-33% (4-9 million) have osteopenia. Most of the older U.S. adults with low femur BMD are women, but, regardless of which cutoffs are used, the number of men is substantial.

Absorptiometry, Photon↗
PubMed1996

Technical pitfalls in image acquisition, processing, and display.

Optimal image quality is an ideal in nuclear medicine that is not always realized, being subject to a variety of conditions that can act, either singly or in combination, to undermine its accomplishment. These conditions include potential defects and limitations in both the hardware and software used for the acquisition and reconstruction of nuclear medicine images. Factors relating to individual patients can contribute to these obstacles, including limitations in mobility and compliance. Importantly, suboptimal or erroneous technique is a common source of poor imaging results, with loss of diagnostic efficacy. Appropriate test selection and careful attention to patient preparation and procedural details are essential elements in avoiding image flaws and artifacts in nuclear medicine.

Artifacts↗
PubMed1996

Cold spots on bone scans in patients wearing weighted breast prostheses.

A bone scan is frequently obtained in patients with breast cancer for evaluation of possible metastatic bone disease or for evaluation of response of known metastases to treatment. These patients commonly wear breast prostheses after unilateral or bilateral mastectomies. On some bone scans, the authors have observed artifacts resulting from certain breast prostheses. In particular, in the patient described, a weighted breast prosthesis was not removed during Tc-99m HMDP bone scanning and was interpreted as being permanent pacemaker or defibrillation unit. The scintigraphic appearance of several commonly used, commercially available weighted breast prostheses is discussed.

Bone and Bones↗
PubMed1996

Bone scintigraphy evaluated in diagnosing and staging Langerhans' cell histiocytosis and related disorders.

UNLABELLED: An analysis of patients with proven Langerhans' cell histiocytosis (LCH) was undertaken with the aim of evaluating the role of bone scintigraphy in the diagnosis and staging of LCH. METHODS: Radiographic skeletal surveys and whole-body bone scintigraphy study results were reviewed for all patients treated at the Mayo Clinic in Rochester, Minnesota during 1965-1994 with histologic proven LCH. All available studies were then reported in a randomized and blinded fashion. RESULTS: Of the 73 patients with the histologic diagnosis, 56 (76%) had a definite lesion reported on radiographs and subsequent biopsy-proven bone involvement. For this population, the sensitivity and specificity of radiographic survey were 100% and 61%, respectively, compared to 91% and 55% for bone scintigraphy. Solitary bone lesions were reported on 21 radiographic surveys and 24 bone scintigrams. For solitary lesions, radiograph sensitivity and specificity were 95% and 73%, respectively, compared to 88% and 77% for bone scintigraphy. Bone scintigraphy receiver operating characteristic curves showed the region of greatest diagnostic accuracy to be skull, facial bones and mandible (88% sensitivity, 52% specificity). Radiation dosimetry to adult reproductive organs was less favorable for radiographic skeletal survey compared to bone scintigraphy. CONCLUSION: Our results support the use of radiographic skeletal survey in the initial diagnosis of LCH. Bone scintigraphy may have a role in monitoring a patient's progress in which the initial scintigram and radiographic survey show good correlation.

Adult↗
PubMed1995

Prevalence of low femoral bone density in older U.S. women from NHANES III.

Data on the number of U.S. women with low femoral bone mineral density (BMD) are currently available only from indirect estimates. We used dual-energy X-ray absorptiometry (DXA) measurements of femoral BMD from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III, 1988-1991) to estimate prevalences of low femoral BMD in women ages 50 years and older using an approach proposed recently by an expert panel of the World Health Organization (WHO). Cutpoints for low BMD were derived from BMD data of 194 non-Hispanic white (NHW) women aged 20-29 years from the NHANES III dataset. The prevalence of older U.S. women with femoral osteopenia (BMD between 1 standard deviation [SD] and 2.5 SD below the mean of young NHW women) ranged from 34-50% in four different femur regions, which corresponds to approximately 12-17 million women. The prevalence with osteoporosis (BMD > 2.5 SD below the mean of young NHW women) ranged from 17-20%, or approximately 6-7 million women. Prevalences were 1.3-2.4 times higher in NHW women than non-Hispanic black women (NHB), and 0.8-1.2 times higher in NHW versus Mexican American (MA) women. The estimated numbers of NHW, NHB, and MA women with osteopenia were 10-15 million, 800,000-1.2 million, and 300,000-400,000, respectively; corresponding figures for osteoporosis were 5-6 million, 200,000-300,000, and 100,000 respectively. Thus, the first data on BMD from a nationally representative sample of older women show a substantial number with low femoral BMD.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1995

Proximal femur bone mineral levels of US adults.

This paper describes bone mineral levels in the proximal femur of US adults based on a nationally representative sample of 7116 men and women aged 20 years and older. The data were collected in phase 1 of the third National Health and Nutrition Examination Survey (NHANES III, 1988-1991) using dual-energy X-ray absorptiometry, and included bone mineral density (BMD), bone mineral content (BMC) and area of bone scanned in five selected regions of interest (ROI) in the proximal femur: femur neck, trochanter, intertrochanter, Ward's triangle and total. These variables are provided separately by age and sex for non-HIspanic whites (NHW), non-Hispanic blacks (NHB) and Mexican Americans (MA). BMD and BMC in the five ROI tended to decline with age, whereas area did not. BMD and BMC were highest in NHB, intermediate in MA and lowest in NHW, but areas were highest in NHW, intermediate in NHB and lowest in MA. Men had greater BMD, BMC and area than women in all three race/ethnic groups. Differences by age, sex or race/ethnicity tended to be the largest in Ward's triangle, followed by the femur neck; patterns in the trochanter, intertrochanter and total ROI were reasonably similar to each other. This report provides extensive data on femur bone mineral levels of adults from one of the largest samples available to date and should be valuable as reference data for other studies which examine this skeletal site in adults.

Adult↗
PubMed1995

111In-oxine-labelled granulocyte dosimetry in normal subjects.

The aim of this study was to determine organ uptake and dosimetry in human subjects using 111In granulocytes obtained by ficoll-hypaque purification. Anterior-posterior whole-body imaging was performed at 1, 3, 5, 24 and 48 h after injection of approximately 18.5 MBq (0.5 mCi) 111In granulocytes in 10 normal volunteers. Utilizing relative geometric mean analysis, the fraction of injected activity (FIA) was determined at each imaging time for the kidney, liver, lungs, bone marrow, spleen and whole-body remainder. Residence time was determined by integration of the bi-exponential fit of the FIA data over time. Curve fitting was performed with SAAM software (University of Washington). Red marrow uptake was calculated from activity in the L3-L4 vertebrae and iliac crests. Total body marrow uptake was extrapolated from these data using ICRP 23. Dose was determined with MIRDOSE 2 for the various organs. The liver had the highest organ uptake (40.3% at 48 h). The spleen, liver, red marrow, kidney and lung doses were 4.1, 1.6, 0.8, 0.5 and 0.4 mGy MBq-1, respectively. Urinary and stool excretion was negligible and blood clearance half-time was 6.9 h. Using current methods providing improved quantification of organ uptake and dosimetry, our results confirm the liver, spleen, bone marrow,lungs and kidneys to be the principal target organs of 111In granulocytes.

Bone Marrow↗
PubMed1995

Filtered technetium-99m-sulfur colloid evaluated for lymphoscintigraphy.

UNLABELLED: Several 99mTc-labeled radiopharmaceuticals have been developed for lymphoscintigraphy of the extremities. In the United States, however, these agents are not widely used clinically. This study evaluates the use of smaller particle sizes ( < 0.1 micron) of 99mTc-sulfur colloid (99mTc-SC) for lymphoscintigraphy. METHODS: The 99mTc-SC was prepared by kit, and the final preparation was filtered through a sterile 0.1-micron filter. The radiochemical purity (RCP) of the filtered 99mTc-SC was determined before administration. Nineteen patients with suspected lymphedema were injected with 18.5 MBq (500 muCi) filtered 99mTc-SC intradermally in each foot, and whole-body images were obtained immediately and 1, 3, 6 and 24 hr later. Local views over the inguinal or axillary lymph nodes were also obtained every 5 min for the first hour. RESULTS: The average RCP value was 93.4% +/- 4.2% (n = 19), and the RCP difference pre- and postfiltration of the 99mTc-SC preparation was -1.7% +/- 1.4% (n = 40). Evaluation of the particle size with the polycarbonate filter showed that 89.9% +/- 4.5% (n = 28) of particles were less than 50 nm, and the particle size was further determined by electron microscopy to be 38.0 +/- 3.3 nm (n = 202). The mean particle sizes of two peaks measured by laser light scattering techniques were 7.5 and 53.9 nm (major peak). Clinical studies with filtered 99mTc-SC demonstrated similar lymphoscintigrams compared with those obtained with 99mTc antimony sulfide colloid (99mTc-ATC). Filtered 99mTc-SC showed a faster transport rate to the inguinal lymph nodes and lower radiation dosimetry for liver, spleen and whole body compared with 99mTc-ATC. CONCLUSION: Filtered 99mTc-SC can be easily prepared and is readily available for routine clinical use in lymphoscintigraphic studies.

Antimony↗
PubMed1994

Quality control of bone densitometry in a national health survey (NHANES III) using three mobile examination centers.

A quality control (QC) program for bone mineral measurements at the proximal femur by dual-energy x-ray absorptiometry (DXA) was designed for the osteoporosis component of the Third National Health and Nutrition Examination Survey (NHANES III). Major elements of the QC program are (1) a QC center for review of all scans, (2) setup procedures for and continuous monitoring of daily QC procedures, (3) reference standards for cross-calibration, (4) longitudinal studies for assessment of instrument stability, (5) monitoring of technologist performance, and (6) training. This report describes the results of the QC program of the first half of this 6 year study, which began in 1988. Measurements were performed on 7376 subjects in three mobile examination centers, which traveled to a new location about every 3 months, a total of 44 locations. A small percentage (3.5%) of all scans were rejected, mostly because of patient motion during scanning, but 33% of the remaining scans required reanalysis at the QC center to refine the location of the regions of interest. Precision in spine and hip phantoms was below 1% at all ROIs. In 535 subjects with duplicate scans, age 20-91 of both sexes, examined in a blinded review, precision for BMD at the femur neck ROI was 3.2% (CV) and 5.1% for Ward's triangle BMD. The central review improved scan quality, increased the number of usable scans, and reduced significantly the range of the mean percentage difference in the duplicate scans. Minor alterations in machine function were observed and corrected. QC results on phantoms were similar to those obtained with stationary instruments in dedicated laboratories. Retrospective analysis of the regression slopes from QC records did not show a need for correction of the data base, indicating that the instruments were stable during the course of the study.

Absorptiometry, Photon↗
PubMed1993

Assessment of body composition with use of dual-energy x-ray absorptiometry: evaluation and comparison with other methods.

Dual-energy x-ray absorptiometry (DEXA) is a relatively new method of assessing body composition in humans. In the current study, DEXA was analyzed for accuracy and precision by using both anthropomorphic phantoms and a combination of body composition techniques in humans. Satisfactory precision for measurement of total body fat, fat-free mass, and total body bone mineral could be demonstrated in vivo and in vitro. Predictions of lean body mass in humans on the basis of DEXA, total body water, and total body potassium were significantly different. The results of multiple regression analysis suggested that a component of total body water was related to body potassium, and another component was predicted by body fat. In addition, extracellular fluid volume, as measured by the bromide space technique, was significantly associated with both fat-free mass and fat mass as measured by DEXA. These findings have implications for the interpretation of body composition data in humans.

Absorptiometry, Photon↗
PubMed1988

Comparison of dual-energy x-ray absorptiometry and dual photon absorptiometry for bone mineral measurements of the lumbar spine.

A new x-ray-based (dual-energy x-ray absorptiometry [DEXA]) instrument for measurement of bone mineral in the spine and hips (QDR-1000, Hologic, Inc.) was compared with a commercial dual photon absorptiometry (DPA) instrument that uses a 153Gd source (DP3, Lunar Radiation Corporation). Measurements were made on phantoms and lumbar spines of patients to study accuracy, precision, limitations, and compatibility of results between instruments. Both instruments measure bone mineral of integral bone in terms of area bone density with an entrance exposure of less than 5 mR. For spinal bone mineral measurements, the DEXA instrument had a shorter scanning time and higher resolution images than the DPA system. The DEXA instrument also showed better precision in a spine phantom and reduced influence of thickness for patient measurement. For bone mineral content, accuracy was about equal for both instruments; for measurements of the area of the region of interest, accuracy was better with the DEXA instrument. With both instruments, fat had little effect on bone mineral density in bone phantom studies. Measurements on both instruments were influenced by the location of a bone phantom within the photon beam. Results in patients showed good correlation (r = 0.988) for bone mineral density. Measurements of bone mineral density in patients were consistently lower with the DEXA instrument because of better accuracy in area measurements. The new x-ray-based instrument is a major advance in bone mineral absorptiometry and provides improved, yet less expensive, measurements in research and clinical applications.

Adipose Tissue↗
PubMed1987

Histochemical procedures for the simultaneous visualization of neutral sugars and either sialic acid and its side chain O-acyl variants or O-sulphate ester. I. Methods based upon the selective periodate oxidation of sialic acids.

Five new methods, based upon the selective oxidation of sialic acid residues with 0.4 mM periodic acid in approximately 1 M hydrochloric acid at 4 degree C for 1 h (PA), have been devised for the simultaneous visualization of neutral sugars and either sialic acid and its side chain O-acyl variants or O-sulphate ester. In the first of these, the selective periodate oxidation-borohydride reduction-saponification-selective periodate oxidation-Thionin Schiff-saponification-borohydride reduction-periodic acid-Schiff (PA-Bh-KOH-PA-T-KOH-Bh-PAS) technique, sialic acids with O-acyl substituents at C7, C8 or C9 (or which have two of three side chain O-acyl substituents) stain blue while neutral sugars with periodate-sensitive vicinal diols (hexose, 6-deoxyhexose, and N-acetylhexosamine) stain magenta. The second method, the saponification-selective periodate oxidation-Thionin Schiff-saponification-borohydride reduction-periodic acid-Schiff (KOH-PA-T-KOH-Bh-PAS), stains all sialic acids blue and neutral sugars magenta. In the third procedure, the selective periodate oxidation-Thionin Schiff-borohydride reduction-periodic acid-Schiff-saponification (PA-T-Bh-PAS-KOH) method, sialic acids without side chain substituents (or which have an O-acyl substituent at C7) stain blue and neutral sugars stain magenta. In the fourth method, the saponification-selective periodate oxidation-borohydride reduction-Alcian Blue pH 1.0-periodic acid-Schiff (KOH-PA-Bh-AB1.0-PAS) technique, O-sulphate esters stain aquamarine blue and neutral sugars stain magenta. In all of these techniques mixtures of the components stain in various shades of purple.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Histochemical procedures for the simultaneous visualization of neutral sugars and either sialic acid and its O-acyl variants or O-sulphate ester. II. Methods based upon the periodic acid-phenylhydrazine-Schiff reaction.

Four methods based upon the periodic acid-phenylhydrazine-Schiff reaction have been developed for the simultaneous visualization of neutral sugars with periodate oxidizable vicinal diols (hexose, 6-deoxyhexose, N-acetylhexosamine) and either sialic acids or side chain O-acyl sialic acids. In the first of these procedures, the saponification-periodic acid oxidation-2,4-dinitrophenylhydrazine-Azure A-Schiff-saponification (KOH-PA-DNPH-Az-KOH) method, all sialic acids stain Azure blue, neutral sugars with oxidizable vicinal diols stain yellow and mixtures of such components stain in various shades of green. In the second technique, periodic acid oxidation-2,4-dinitrophenylhydrazine-Azure A Schiff-saponification (PA-DNPH-Az-KOH), Azure Blue staining is confined to sialic acids without side chain substituents or which have an O-acyl substituent at position C7, while in the third method, the selective periodate oxidation-borohydride reduction-saponification-periodic acid oxidation-2,4-dinitrophenyl hydrazine-Azure A-Schiff-saponification (PA-Bh-KOH-PA-DNPH-Az-KOH) technique, only sialic acids with O-acyl substituents at positions C7, C8 or C9 (or which have two or three O-acyl side chain substituents) stain Azure blue. Finally in the fourth procedure, periodic acid oxidation-2,4-dinitrophenylhydrazine-Azure A-Schiff-saponification-borohydride reduction-periodic acid oxidation-Schiff (PA-DNPH-Az-KOH-Bh-PAS), sialic acids without side chain substituents or which have O-acyl substituents at C7 stain Azure blue, sialic acids substituted at position C8 or C9 (or which are di- or tri-substituted) stain magenta and neutral sugars stain yellow. Where mixtures of these components are present, a wide range of colours is obtained.

Animals↗
PubMed1987

Errors in longitudinal measurements of bone mineral: effect of source strength in single and dual photon absorptiometry.

The effect of changing strength during the useful life of a radiation source was evaluated in studies performed on four dual photon (DPA) and two single photon (SPA) bone absorptiometry instruments. Two DPA units and one SPA unit did not show any systematic dependence of measured bone mineral content or bone mineral areal density (BMD) on source activity when evaluated over an entire source life. One DPA and one SPA instrument, however, showed significant time trends associated with source activity. The fourth DPA instrument had a significant linear decrease in BMD over a source life in the automatic mode but performed better in the manual mode.

Bone and Bones↗
PubMed1986

Comparison of three platelet markers for measurement of platelet survival time in healthy volunteers.

We studied mean platelet survival times in healthy volunteers with use of [51Cr]disodium chromate, 111In-oxine (in a solution of acid-citrate-dextrose [ACD] and saline), and 111In-tropolone (in ACD-plasma) as markers. Differences found between the 51Cr and 111In labels probably can be attributed to a variation in localization of the label on the cell and of renal handling of the free label after release. The mean platelet survival time with 51Cr was slightly longer than the survival time with both indium labels and showed a sex difference not seen with 111In-oxine. Protein-bound plasma 51Cr was lower than plasma 111In and remained constant throughout the study. Plasma 111In increased with time. For survival time calculations, no correction for free 51Cr is necessary, but correction should routinely be performed when 111In markers are used. Both 111In markers gave similar results with respect to platelet survival time. The somewhat more elaborate plasma labeling procedure with tropolone shows no measurable advantage over the original 111In-oxine method. 111In-tropolone labeling takes less time and maintains platelets in the physiologic environment of plasma during incubation. Biodistribution studies show no difference between the two 111In markers.

Blood Platelets↗
PubMed1985

Chemical and histochemical studies of normal and diseased human gastrointestinal tract. III. Changes in the histochemical and chemical properties of the epithelial glycoproteins in the mucosa close to colonic tumours.

Histochemical, chemical and histological studies were performed on 26 specimens of human colonic tumours and 62 specimens of mucosa taken at distances of 0.5-5.0 cm from the tumour. The tumour glycoproteins were divided almost equally between three anionic types, sulphomucin, sialomucin and mixed sialomucin and sulphomucin. All showed a reduction in staining for side chain O-acylated sialic acid. In 56% of the tumours, this was accompanied by loss of glycoprotein while, in 44%, abundant mucin was still present. Histochemical examination of the mucosal specimens indicated that in 24.2% the side chain O-acylated sialic acids did not differ from normal. In 41.9% there was a focal change and in 33.9% there was a generalized field reduction in the proportion of side chain O-acyl sialic acids. The latter were subdivided into moderate and severe. Chemical analyses correlated well with the histochemical classification of the mucosal specimens and showed that, on average, the classifications focal and severe field change were not due to sampling error. Forty-five per cent of the cases showed only focal change and 40% only field change. Mucosal specimens associated with 60% of the moderately differentiated tumours showed only focal change while those associated with 75% of well-differentiated tumours showed only field change. Abnormal patterns of staining for side chain O-acylated sialic acids (a) were largely independent of the distance from the tumour, (b) occurred in the presence of a normal pattern of staining for sialomucins and sulphomucins and (c) were associated with 61.4% of the specimens that showed no discernible evidence of histological abnormality. In contrast, only one specimen showed evidence of histological change without a corresponding change in O-acylated sialic acids. The data suggest that abnormal patterns of staining for O-acylated sialic acids may represent premalignant change but their precise significance and specificity requires further studies of non-neoplastic diseases of the colon.

Colonic Neoplasms↗