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Biomedical subjects

T R Overton

Publications and source records attributed to T R Overton.

At least 55 records · Page 3Linked to original sources

A special purpose x-ray fan-beam CT scanner for trabecular bone density measurement in the appendicular skeleton.

A special purpose x-ray CT scanner with the capability of scanning objects 75-220 mm in diameter with constant relative geometrical resolution has been developed. The data collection scheme for the scanner uses multiple rotations of a linearly shifted, asymmetric fan beam permitting user-defined variable resolution. Details of hardware and the calibration procedures for the scanner are described and the methods used to measure trabecular bone density (TBD) in the peripheral skeleton are outlined. The standard error of estimate (SEE) of a calibration line of pixel value as a function of K2HPO4 concentration was determined to be 0.07%. The short-term, in vivo precision of the TBD determination, by repeated measurements of a volunteer with repositioning between each measurement, was +/- 0.67% (coefficient of variation (CV] with a 50s scan time and a radiation dose of less than 20 mR per slice.

Bone Density↗

Dental health status and treatment needs of elderly residents of Edmonton, Alberta.

The oral health of 140 independent elderly volunteers, selected from different sections of Edmonton, Alberta, was assessed in conjunction with their nutritional and medical status, in an attempt to evaluate the dental needs of this population. Dental caries was assessed using WHO standards and the CPITN was used in assessing periodontal and gingival health needs. The mean age of the participants was 70.9 +/- 2.6 years. The average time since they had last seen a dentist was 3.0 +/- 6.2 years. Twenty-six percent of the group were edentulous and wore full dentures. An evaluation of denture hygiene and retention showed that 53 per cent of all maxillary and 57 per cent of all mandibular appliances exhibited poor hygiene; 33 per cent and 54 per cent, respectively, had problems with retention and/or occlusion. Only 12 per cent of the group exhibited any sort of mucosal pathology, all of which was related to ill fitting dentures. The total population had a mean of 15.0 +/- 11.1 teeth, only 0.5 of these were decayed, while 8.9 were restored. CPITN scores taken from a total of 511 sextants with standing teeth showed that 16 per cent of the group exhibited bleeding upon probing, 29 per cent had calculus, 13 per cent exhibited pocketing, while 3.6 per cent had deep pockets. Sixty-seven per cent of the population required dental treatment, none of whom needed emergency intervention. Over 49 per cent of the dentate population could benefit from prophylaxis; 16 per cent required more definitive periodontal treatment. Forty-five per cent of the denture population required treatment.

Aged↗

Performance evaluation of density measurements of axial and peripheral bone with x-ray and gamma-ray computed tomography.

We examined sources of error in bone measurements made with computed tomography (CT) using a whole-body scanner (GE 8800) and a peripheral-bone CT scanner (developed at the University of Alberta). We investigated the influence of various factors on trabecular bone density: homogeneity and noise in the image plane, linearity of calibration, body size, effects of cortical bone, and the image analysis procedure. With the GE 8800 scanner, the precision (SD) of measurements of a single vertebra is expected to be +/- 1.65% (noise: +/- 0.22%, calibration: +/- 1.3%, analysis: +/- 1%); the accuracy, excluding consideration of marrow fat, varied between -2.7 and +7.3% (compact-bone thickness: 2-5%, body size: -2.5 - +1.5%, calibration: -0.47 - +0.77%). With the peripheral-bone CT scanner, the total precision error (+/- 0.53%) was dominated by noise, with only a minor contribution from the analysis procedure (+/- 0.04%); accuracy varied between -0.6 and +3.4% (effect of cortical bone: up to 3.0%; changes in size of object: -0.59 - +0.4%). The magnitude of these errors was determined under 'ideal' conditions, mostly through phantom measurements; therefore, the errors represent optimistic lower limits in clinical application. Furthermore, measurements of density of cortical bone were not reliable for bone thicknesses of less than about 4 mm with the GE 8800 scanner and less than about 1.5 mm with the peripheral scanner.

Absorptiometry, Photon↗

Skeletal challenge: an experimental study of pharmacologically induced changes in bone density in the distal radius, using gamma-ray computed tomography.

Bone density (BD) at the distal end of the radius was measured serially with gamma-ray computed tomography (gamma-CT) in five groups of healthy postmenopausal women. One group comprised untreated controls; women in the other groups were subjected to pharmacologic challenge with putative activators and/or depressors of bone remodeling. The challenge agents, taken orally, were ergocalciferol (vitamin D2) alone and followed by calcium; calcitriol (1,25(OH)2D3), and prednisone. All of the subjects showed changes in BD following challenge; these changes were significant (P less than 0.05) for the groups receiving vitamin D2 and vitamin D2 plus calcium. Responses to ergocalciferol, calcitriol, and prednisone were similar within groups, whereas the group receiving ergocalciferol then calcium comprised two distinct subgroups: bone density transiently increased in one and decreased in the other. For all five groups, the direction of change in bone density in response to the challenge, and its duration and magnitude, were consistent with reported histomorphometric data. We conclude that gamma-CT assessment of change in bone density after pharmacologic challenge provides a useful noninvasive approach to skeletal investigation.

Aged↗

The effect of methacholine inhalation challenge on regional residual volume in patients with subclinical asthma.

Regional residual volume to total lung capacity (RVr/TLCr) was measured with xenon 133 before and after methacholine challenge in 26 nonsmoking subjects (mean age 34 years). Eleven were normal control subjects and 15 were patients referred for methacholine challenge because of previous asthma-like symptoms. All had normal pulmonary function and normal RVr/TLCr distribution. Following methacholine challenge, RVr/TLCr increased in two control subjects and ten patients who also had decreases in FEV1 of greater than 20 percent. The RVr/TLCr changes were patchy, suggesting that the degree of bronchospasm varied between individual lung regions. The other 14 subjects did not have a 20 percent decrease in FEV1, but two controls and four patients had generalized increases in RVr/TLCr, while seven controls and one patient had no significant changes in RVr/TLCr. In all subjects, FEV1 and RVr/TLCr returned to the baseline level after salbutamol administration. The results indicate that methacholine can cause localized or diffuse effects on lung emptying and that bronchodilator completely reverses the bronchoconstriction induced by methacholine.

Adult↗

Skin blood flow during histamine flare using the clearance of epicutaneous applied Xenon-133 in diabetic and non-diabetic subjects.

The increase in skin blood flow produced by both reactive hyperemia and histamine was examined in 8 normal, 8 diabetic and 3 cancer patients using the epicutaneous Xenon-133 clearance method. The histamine flare response in both diabetic and cancer groups was reduced compared to that in the normal group. There was no significant difference in the reactive hyperemia responses. It is concluded that the reduction in the histamine flare response is due to a defect in the sensory nerves mediating the axon reflex and not due to a change in the vascular response.

Diabetes Mellitus↗

Quantitative measurement of bone density using gamma-ray computed tomography.

A special purpose gamma-ray computed tomography scanner has been developed for precise measurements of bone density in the human appendicular skeleton. Details of the scanner's hardware and of the software organization for system control and data analysis are given, together with an outline of the theoretical basis for conversion of measured linear attenuation coefficients to physical bone densities. Performance of the system was evaluated on bone-like phantoms. Clinically, a precision of +/- 0.5% is obtained for bone density determinations. This device is being used in experimental studies and clinical investigations.

Bone Resorption↗

Experimental subarachnoid hemorrhage in the cynomolgus monkey: evaluation of treatment with hypertension, volume expansion, and ventilation.

We evaluated the treatment regime of dopamine-induced hypertension in association with volume expansion and ventilatory support in an experimental subarachnoid hemorrhage (SAH) model using the cynomolgus monkey. Regional cerebral blood flow, vessel caliber, intracranial pressure, and other pertinent physiological parameters were monitored throughout each study. We report the results for nine animals receiving treatment after an induced SAH and compare them with results obtained in a group of five animals not treated after SAH. Improvements in cerebral blood flow, vessel caliber, and morbidity and mortality rates were seen with this treatment. Seven of nine animals were alive at 20 hours after SAH in the treatment group, whereas all five animals in the untreated group died before this time. The mechanisms of action of this treatment are discussed. (Neurosurgery, 6: 57--62, 1980)

Animals↗

Vasospasm and cerebral blood flow after subarachnoid hemorrhage.

In a cynomolgus monkey model, the effect of subarachnoid hemorrhage on vessel calibre and cerebral blood flow was studied. Arterial calibres were measured angiographically and cerebral blood flow was measured with 133Xenon intra-arterial clearance techniques. Only a poor correlation between large artery calibre and cerebral blood flow was found, indicating that cerebrovascular resistance changes at the microvascular level play a major role in the acute reduction of cerebral blood flow after subarachnoid hemorrhage, when vasospasm is of mild to moderate degree.

Animals↗

Treatment of subarachnoid hemorrhage with sodium nitroprusside and phenylephrine: an experimental study.

The effectiveness of simultaneous intravenous sodium nitroprusside and phenylephrine in improving the cerebrovascular disturbances and survival rate after induced subarachnoid hemorrhage (SAH) was studied in the cynomolgus monkey. We measured regional cerebral blood flow (rCBF) using the intra-arterial xenon-133 clearance technique. In our experimental animal model, SAH was associated with a persistent reduction in rCBF, elevation of cerebrovascular resistance (CVR), cerebral vasospasm for the duration of the study (150 minutes), and poor survival. For animals receiving the treatment regime (administered approximately 25 minutes after the induced SAH), rCBF remained low, CVR was high, and cerebral vasospasm was persistent. Survival in this group was the same as that observed for the untreated animals. Simultaneous administration of sodium nitroprusside and phenylephrine was ineffective in improving rCBF, CVR, cerebral vasospasm, or survival after SAH. In the control group (receiving only the treatment and not an intracranial insult), rCBF was below resting levels both during and after therapy, indicating impaired cerebral autoregulation. (Neurosurgery, 5: 688--595, 1979).

Animals↗

Cerebrovascular responses to subarachnoid blood and serotonin in the monkey.

Preliminary in vitro experiments were performed to determine the serum concentration of serotonin in the monkey, and the ability of cyproheptadine to block serotonin and serum-induced contractions in monkey cerebral arteries. Thirty-four cynomolgus monkeys were subsequently used to study changes in regional cerebral blood flow (CBF) obtained by the intracartoid 133Xe technique, and in the angiographic cerebral arterial caliber resulting from subarachnoid injection of artificial cerebrospinal fluid (CSF), blood, and serotonin. Five animals in each injection group were given 1.0 mg/kg intravenous cyproheptadine (a serotonin-blocking agent) during the post-injection period. Subarachnoid injection of artificial CSF produced no change in CBF or arterial caliber. Post-injection administration of cyproheptadine also had no effect on these parameters. A subarachnoid injection of fresh autogenous blood produced a significant but transient (less than 1 hour) decrease in CBF and moderate vasospasm, which lasted at least 3 hours. This vasospasm was essentially unaffected by intravenous cyproheptadine. The CBF and arterial caliber were unchanged following a subarachnoid injection of serotonin at concentrations (5 x 10(-6)M) present in normal monkey serum. In contrast, 5 x 10(-6) M serotonin invariably produced near maximal contractions in the in vitro cerebral artery preparations. Higher (x10) serotonin concentrations caused a transient CBF response similar to that obtained with blood. However, the cerebral vasospasm induced was of shorter duration than that obtained with blood. These results do not support a major role for serotonin in the production of post-subarachnoid hemorrhage vasospasm. Moreover, our data indicate that in vitro experiments do not reflect the ability of serotonin to constrict cerebral arteries in the intact animal.

Animals↗

Effects of age on regional residual volume.

Forty-one normal non-smokers between the ages of 20 and 80 were studied to determine if the increased residual volume, known to occur with aging, results from increased residual volume throughout, or only in specific regions of the lung. The subjects were dividied into groups consisting of 20-29, 30-39, 40-49, 50-69, and 70+ yr. Measurements of regional residual volume to regional total lung capacity ratio (RVr/TLCr) were made using zenon-133 and a multidetector analysis system in which five zones (from top to bottom) were analyzed in each lung. Closing volume was also measured. The subjects were in the sitting position for all studies. The results showed regardless of age, the RVr/TLCr was higher at the top than at the bottom of the lung. In addition, the ratio of upper to lower RVr/TLCr was not significantly different between any of the age groups. The results can be explained if airways throughout the lung close at higher volumes as age increases, or if altered emptying sequences within regions occur due to retarded emptying of highly compliant lung regions.

Adult↗

Cerebral arterial responses to induced hypertension following subarachnoid hemorrhage in the monkey.

Regional cerebral blood flow (rCBF), angiographic cerebral arterial caliber, and cerebrospinal fluid (CSF) pressure were measured in rhesus monkeys to determine the effect of experimentally induced subarachnoid hemorrhage (SAH) on cerebral arterial responses to graded increases in blood pressure. These measurements were also performed in a control group of monkeys subjected to a mock SAH by injection of artificial CSF into the cerebral space. Before subarachnoid injection of blood or artificial CSF, graded increases in mean arterial blood pressure (MABP) to a level 40% to 50% above baseline values had no effect on rCBF. The major cerebral arteries constricted and CSF pressure remained unchanged. Similar responses were observed after injections of artificial CSF. When MABP was increased in animals that had been subjected to subarachnoid injection of blood, rCBF increased and was associated with dilatation of the major cerebral arteries and moderate increases in CSF pressure. These results demonstrate that cerebral arterial responses to increases in blood pressure may be abnormal in the presence of subarachnoid blood. The manner in which abnormal cerebral arterial reactivity, changes in blood pressure, and vasospasm combine to determine the level of cerebral perfusion following SAH is postulated.

Animals↗

Frequency dependence of ventilation distribution in normal and obstructed lungs.

Differences in regional pulmonary time constant may cause ventilation distribution to vary with breathing frequency and frequency-dependent changes in regional ventilation per unit volume might be expected. We measured the regional distribution of inhaled xenon-133 (133Xe) at 10 and 60 breaths/min in normal subjects and in patients with a clinical diagnosis of chornic bronchitis or asthma. Breathing frequency had no siqnificant effect on ventilation distribution in normals but in patients with chronic bronchitis ventilation decreased in the lower lung regions at 60 breaths/min compared with 10 breaths/min. In six asthmatic patients the lung regions demonstrating the greatest frequency-dependent reductions in ventilation, which were assumed to have the greatest time constants, also showed decreased ventilation-perfusion ratios (V/Q) measured by standard 133Xe techniques. Bronchodilator increased ventilation more than perfusion in these regions and thus V/Q ratio increased toward the normal range. These results imply that measurement of the frequency dependence of regional ventilation provides information about the relative distribution of airway obstruction, and that airway function in the most obstructed lung regions in asthmatics is improved following bronchodilator therapy.

Asthma↗