A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering

In order to predict the exhaled breath concentration of chloroform in individuals exposed to chloroform while showering, an existing physiologically based pharmacokinetic (PB‐PK) model was modified to include a multicompartment, PB‐PK model for the skin and a completely mixed shower exposure model....

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Risk analysis 1993-02, Vol.13 (1), p.51-62
Hauptverfasser: Chinery, Robert L., Gleason, A. Kevin
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 62
container_issue 1
container_start_page 51
container_title Risk analysis
container_volume 13
creator Chinery, Robert L.
Gleason, A. Kevin
description In order to predict the exhaled breath concentration of chloroform in individuals exposed to chloroform while showering, an existing physiologically based pharmacokinetic (PB‐PK) model was modified to include a multicompartment, PB‐PK model for the skin and a completely mixed shower exposure model. The PB‐PK model of the skin included the stratum corneum as the principal resistance to absorption and a viable epidermis which is in dynamic equilibrium with the skin microcirculation. This model was calibrated with measured exhaled breath concentrations of chloroform in individuals exposed while showering with and without dermal absorption. The calibration effort indicated that the expected value of skin‐blood partitioning coefficient would be 1.2 when the degree of transfer of chloroform from shower water into shower air was 61%. The stratum corneum permeability coefficient for chloroform was estimated to be within the range of 0.16‐0.36 cm/hr and the expected value was 0.2 cm/hr. The estimated ratio of the dermally and inhaled absorbed doses ranged between 0.6 and 2.2 and the expected value was 0.75. These results indicate that for the purposes of risk assessment for dermal exposure to chloroform, a simple steady‐state model can be used to predict the degree of dermal absorption and that a reasonable value of skin permeability coefficient for chloroform used in this model would be 0.2 cm/hr. Further research should be conducted to compare the elimination of chloroform via exhaled breath when different exposure routes are being compared. The model results from this study suggest that multiple measurements of exhaled breath concentrations after exposure may be necessary when making comparisons of breath concentrations that involve different exposure routes.
doi_str_mv 10.1111/j.1539-6924.1993.tb00728.x
format Article
fullrecord <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_6692651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>16413157</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4651-fc3df78c0ca7ec237277922e8ea332d3b5269558edf74a1248253433dadd898a3</originalsourceid><addsrcrecordid>eNqVkU1v1DAQhiMEKkvhJyBZPXBL8EccJxyQ0lCWSuVDbFG5WY4zIVmSeLG96vbEX8dpVnvHl5H8PvOOZt4ouiA4IeG93SaEsyLOCpompChY4muMBc2Tw5NodZKeRitMBY1Txujz6IVzW4wJxlycRWd5ykma4VX0t0SVGXfK-hEmrwb02TQwoNZY5DtA3yw0vfa9mZBp0aUF5bvQMOkAW_X4r6YGlbUztoYGfTAOZrLqBmNNcBlR2Xqw6OqwM25vAd11_QBo05l7sP3062X0rFWDg1fHeh79-Hh1W32Kb76ur6vyJtZpxkncata0ItdYKwGaMkGFKCiFHFTYrmE1p1nBeQ6BShWhaU45C4s3qmnyIlfsPLpYfI3zvXS696A7baYJtJdZOFeYEqA3C7Sz5s8enJdj7zQMg5rA7J0kWUoY4SKA7xZQW-OchVbubD8q-yAJlnNEcivnHOScg5wjkseI5CE0vz5O2dcjNKfWYyZBf7_o9-FSD__hLL9fb8rHNeLFoHceDicDZX_LTDDB5d2XtUxvf6Ybsankmv0DNNOw3w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>16413157</pqid></control><display><type>article</type><title>A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Chinery, Robert L. ; Gleason, A. Kevin</creator><creatorcontrib>Chinery, Robert L. ; Gleason, A. Kevin</creatorcontrib><description>In order to predict the exhaled breath concentration of chloroform in individuals exposed to chloroform while showering, an existing physiologically based pharmacokinetic (PB‐PK) model was modified to include a multicompartment, PB‐PK model for the skin and a completely mixed shower exposure model. The PB‐PK model of the skin included the stratum corneum as the principal resistance to absorption and a viable epidermis which is in dynamic equilibrium with the skin microcirculation. This model was calibrated with measured exhaled breath concentrations of chloroform in individuals exposed while showering with and without dermal absorption. The calibration effort indicated that the expected value of skin‐blood partitioning coefficient would be 1.2 when the degree of transfer of chloroform from shower water into shower air was 61%. The stratum corneum permeability coefficient for chloroform was estimated to be within the range of 0.16‐0.36 cm/hr and the expected value was 0.2 cm/hr. The estimated ratio of the dermally and inhaled absorbed doses ranged between 0.6 and 2.2 and the expected value was 0.75. These results indicate that for the purposes of risk assessment for dermal exposure to chloroform, a simple steady‐state model can be used to predict the degree of dermal absorption and that a reasonable value of skin permeability coefficient for chloroform used in this model would be 0.2 cm/hr. Further research should be conducted to compare the elimination of chloroform via exhaled breath when different exposure routes are being compared. The model results from this study suggest that multiple measurements of exhaled breath concentrations after exposure may be necessary when making comparisons of breath concentrations that involve different exposure routes.</description><identifier>ISSN: 0272-4332</identifier><identifier>EISSN: 1539-6924</identifier><identifier>DOI: 10.1111/j.1539-6924.1993.tb00728.x</identifier><identifier>PMID: 8451460</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>540320 -- Environment, Aquatic-- Chemicals Monitoring &amp; Transport-- (1990-) ; ABSORPTION ; ANIMAL TISSUES ; Baths ; BODY ; BREATH ; CHLORINATED ALIPHATIC HYDROCARBONS ; CHLOROFORM ; Chloroform - administration &amp; dosage ; Chloroform - pharmacokinetics ; DATA ; dermal ; DOSE RATES ; DRINKING WATER ; ENVIRONMENTAL SCIENCES ; EPIDERMIS ; EPITHELIUM ; EXPERIMENTAL DATA ; exposure ; HALOGENATED ALIPHATIC HYDROCARBONS ; HUMAN POPULATIONS ; Humans ; HYDROGEN COMPOUNDS ; INFORMATION ; inhalation ; MATHEMATICAL MODELS ; Models, Biological ; NUMERICAL DATA ; ORGANIC CHLORINE COMPOUNDS ; ORGANIC COMPOUNDS ; ORGANIC HALOGEN COMPOUNDS ; ORGANS ; OXYGEN COMPOUNDS ; PB-PK model ; PERMEABILITY ; POPULATIONS ; RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT ; Respiratory System - metabolism ; RISK ASSESSMENT ; Risk Factors ; shower model ; SKIN ; Skin - metabolism ; SKIN ABSORPTION ; SORPTION ; Tissue Distribution ; TISSUES ; UPTAKE ; WATER 560300 -- Chemicals Metabolism &amp; Toxicology ; Water Pollutants, Chemical - administration &amp; dosage ; Water Pollutants, Chemical - pharmacokinetics</subject><ispartof>Risk analysis, 1993-02, Vol.13 (1), p.51-62</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4651-fc3df78c0ca7ec237277922e8ea332d3b5269558edf74a1248253433dadd898a3</citedby><cites>FETCH-LOGICAL-c4651-fc3df78c0ca7ec237277922e8ea332d3b5269558edf74a1248253433dadd898a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1539-6924.1993.tb00728.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1539-6924.1993.tb00728.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8451460$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/6692651$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Chinery, Robert L.</creatorcontrib><creatorcontrib>Gleason, A. Kevin</creatorcontrib><title>A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering</title><title>Risk analysis</title><addtitle>Risk Anal</addtitle><description>In order to predict the exhaled breath concentration of chloroform in individuals exposed to chloroform while showering, an existing physiologically based pharmacokinetic (PB‐PK) model was modified to include a multicompartment, PB‐PK model for the skin and a completely mixed shower exposure model. The PB‐PK model of the skin included the stratum corneum as the principal resistance to absorption and a viable epidermis which is in dynamic equilibrium with the skin microcirculation. This model was calibrated with measured exhaled breath concentrations of chloroform in individuals exposed while showering with and without dermal absorption. The calibration effort indicated that the expected value of skin‐blood partitioning coefficient would be 1.2 when the degree of transfer of chloroform from shower water into shower air was 61%. The stratum corneum permeability coefficient for chloroform was estimated to be within the range of 0.16‐0.36 cm/hr and the expected value was 0.2 cm/hr. The estimated ratio of the dermally and inhaled absorbed doses ranged between 0.6 and 2.2 and the expected value was 0.75. These results indicate that for the purposes of risk assessment for dermal exposure to chloroform, a simple steady‐state model can be used to predict the degree of dermal absorption and that a reasonable value of skin permeability coefficient for chloroform used in this model would be 0.2 cm/hr. Further research should be conducted to compare the elimination of chloroform via exhaled breath when different exposure routes are being compared. The model results from this study suggest that multiple measurements of exhaled breath concentrations after exposure may be necessary when making comparisons of breath concentrations that involve different exposure routes.</description><subject>540320 -- Environment, Aquatic-- Chemicals Monitoring &amp; Transport-- (1990-)</subject><subject>ABSORPTION</subject><subject>ANIMAL TISSUES</subject><subject>Baths</subject><subject>BODY</subject><subject>BREATH</subject><subject>CHLORINATED ALIPHATIC HYDROCARBONS</subject><subject>CHLOROFORM</subject><subject>Chloroform - administration &amp; dosage</subject><subject>Chloroform - pharmacokinetics</subject><subject>DATA</subject><subject>dermal</subject><subject>DOSE RATES</subject><subject>DRINKING WATER</subject><subject>ENVIRONMENTAL SCIENCES</subject><subject>EPIDERMIS</subject><subject>EPITHELIUM</subject><subject>EXPERIMENTAL DATA</subject><subject>exposure</subject><subject>HALOGENATED ALIPHATIC HYDROCARBONS</subject><subject>HUMAN POPULATIONS</subject><subject>Humans</subject><subject>HYDROGEN COMPOUNDS</subject><subject>INFORMATION</subject><subject>inhalation</subject><subject>MATHEMATICAL MODELS</subject><subject>Models, Biological</subject><subject>NUMERICAL DATA</subject><subject>ORGANIC CHLORINE COMPOUNDS</subject><subject>ORGANIC COMPOUNDS</subject><subject>ORGANIC HALOGEN COMPOUNDS</subject><subject>ORGANS</subject><subject>OXYGEN COMPOUNDS</subject><subject>PB-PK model</subject><subject>PERMEABILITY</subject><subject>POPULATIONS</subject><subject>RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT</subject><subject>Respiratory System - metabolism</subject><subject>RISK ASSESSMENT</subject><subject>Risk Factors</subject><subject>shower model</subject><subject>SKIN</subject><subject>Skin - metabolism</subject><subject>SKIN ABSORPTION</subject><subject>SORPTION</subject><subject>Tissue Distribution</subject><subject>TISSUES</subject><subject>UPTAKE</subject><subject>WATER 560300 -- Chemicals Metabolism &amp; Toxicology</subject><subject>Water Pollutants, Chemical - administration &amp; dosage</subject><subject>Water Pollutants, Chemical - pharmacokinetics</subject><issn>0272-4332</issn><issn>1539-6924</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkU1v1DAQhiMEKkvhJyBZPXBL8EccJxyQ0lCWSuVDbFG5WY4zIVmSeLG96vbEX8dpVnvHl5H8PvOOZt4ouiA4IeG93SaEsyLOCpompChY4muMBc2Tw5NodZKeRitMBY1Txujz6IVzW4wJxlycRWd5ykma4VX0t0SVGXfK-hEmrwb02TQwoNZY5DtA3yw0vfa9mZBp0aUF5bvQMOkAW_X4r6YGlbUztoYGfTAOZrLqBmNNcBlR2Xqw6OqwM25vAd11_QBo05l7sP3062X0rFWDg1fHeh79-Hh1W32Kb76ur6vyJtZpxkncata0ItdYKwGaMkGFKCiFHFTYrmE1p1nBeQ6BShWhaU45C4s3qmnyIlfsPLpYfI3zvXS696A7baYJtJdZOFeYEqA3C7Sz5s8enJdj7zQMg5rA7J0kWUoY4SKA7xZQW-OchVbubD8q-yAJlnNEcivnHOScg5wjkseI5CE0vz5O2dcjNKfWYyZBf7_o9-FSD__hLL9fb8rHNeLFoHceDicDZX_LTDDB5d2XtUxvf6Ybsankmv0DNNOw3w</recordid><startdate>199302</startdate><enddate>199302</enddate><creator>Chinery, Robert L.</creator><creator>Gleason, A. Kevin</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>199302</creationdate><title>A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering</title><author>Chinery, Robert L. ; Gleason, A. Kevin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4651-fc3df78c0ca7ec237277922e8ea332d3b5269558edf74a1248253433dadd898a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>540320 -- Environment, Aquatic-- Chemicals Monitoring &amp; Transport-- (1990-)</topic><topic>ABSORPTION</topic><topic>ANIMAL TISSUES</topic><topic>Baths</topic><topic>BODY</topic><topic>BREATH</topic><topic>CHLORINATED ALIPHATIC HYDROCARBONS</topic><topic>CHLOROFORM</topic><topic>Chloroform - administration &amp; dosage</topic><topic>Chloroform - pharmacokinetics</topic><topic>DATA</topic><topic>dermal</topic><topic>DOSE RATES</topic><topic>DRINKING WATER</topic><topic>ENVIRONMENTAL SCIENCES</topic><topic>EPIDERMIS</topic><topic>EPITHELIUM</topic><topic>EXPERIMENTAL DATA</topic><topic>exposure</topic><topic>HALOGENATED ALIPHATIC HYDROCARBONS</topic><topic>HUMAN POPULATIONS</topic><topic>Humans</topic><topic>HYDROGEN COMPOUNDS</topic><topic>INFORMATION</topic><topic>inhalation</topic><topic>MATHEMATICAL MODELS</topic><topic>Models, Biological</topic><topic>NUMERICAL DATA</topic><topic>ORGANIC CHLORINE COMPOUNDS</topic><topic>ORGANIC COMPOUNDS</topic><topic>ORGANIC HALOGEN COMPOUNDS</topic><topic>ORGANS</topic><topic>OXYGEN COMPOUNDS</topic><topic>PB-PK model</topic><topic>PERMEABILITY</topic><topic>POPULATIONS</topic><topic>RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT</topic><topic>Respiratory System - metabolism</topic><topic>RISK ASSESSMENT</topic><topic>Risk Factors</topic><topic>shower model</topic><topic>SKIN</topic><topic>Skin - metabolism</topic><topic>SKIN ABSORPTION</topic><topic>SORPTION</topic><topic>Tissue Distribution</topic><topic>TISSUES</topic><topic>UPTAKE</topic><topic>WATER 560300 -- Chemicals Metabolism &amp; Toxicology</topic><topic>Water Pollutants, Chemical - administration &amp; dosage</topic><topic>Water Pollutants, Chemical - pharmacokinetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chinery, Robert L.</creatorcontrib><creatorcontrib>Gleason, A. Kevin</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>Risk analysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chinery, Robert L.</au><au>Gleason, A. Kevin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering</atitle><jtitle>Risk analysis</jtitle><addtitle>Risk Anal</addtitle><date>1993-02</date><risdate>1993</risdate><volume>13</volume><issue>1</issue><spage>51</spage><epage>62</epage><pages>51-62</pages><issn>0272-4332</issn><eissn>1539-6924</eissn><abstract>In order to predict the exhaled breath concentration of chloroform in individuals exposed to chloroform while showering, an existing physiologically based pharmacokinetic (PB‐PK) model was modified to include a multicompartment, PB‐PK model for the skin and a completely mixed shower exposure model. The PB‐PK model of the skin included the stratum corneum as the principal resistance to absorption and a viable epidermis which is in dynamic equilibrium with the skin microcirculation. This model was calibrated with measured exhaled breath concentrations of chloroform in individuals exposed while showering with and without dermal absorption. The calibration effort indicated that the expected value of skin‐blood partitioning coefficient would be 1.2 when the degree of transfer of chloroform from shower water into shower air was 61%. The stratum corneum permeability coefficient for chloroform was estimated to be within the range of 0.16‐0.36 cm/hr and the expected value was 0.2 cm/hr. The estimated ratio of the dermally and inhaled absorbed doses ranged between 0.6 and 2.2 and the expected value was 0.75. These results indicate that for the purposes of risk assessment for dermal exposure to chloroform, a simple steady‐state model can be used to predict the degree of dermal absorption and that a reasonable value of skin permeability coefficient for chloroform used in this model would be 0.2 cm/hr. Further research should be conducted to compare the elimination of chloroform via exhaled breath when different exposure routes are being compared. The model results from this study suggest that multiple measurements of exhaled breath concentrations after exposure may be necessary when making comparisons of breath concentrations that involve different exposure routes.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>8451460</pmid><doi>10.1111/j.1539-6924.1993.tb00728.x</doi><tpages>12</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0272-4332
ispartof Risk analysis, 1993-02, Vol.13 (1), p.51-62
issn 0272-4332
1539-6924
language eng
recordid cdi_osti_scitechconnect_6692651
source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects 540320 -- Environment, Aquatic-- Chemicals Monitoring & Transport-- (1990-)
ABSORPTION
ANIMAL TISSUES
Baths
BODY
BREATH
CHLORINATED ALIPHATIC HYDROCARBONS
CHLOROFORM
Chloroform - administration & dosage
Chloroform - pharmacokinetics
DATA
dermal
DOSE RATES
DRINKING WATER
ENVIRONMENTAL SCIENCES
EPIDERMIS
EPITHELIUM
EXPERIMENTAL DATA
exposure
HALOGENATED ALIPHATIC HYDROCARBONS
HUMAN POPULATIONS
Humans
HYDROGEN COMPOUNDS
INFORMATION
inhalation
MATHEMATICAL MODELS
Models, Biological
NUMERICAL DATA
ORGANIC CHLORINE COMPOUNDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANS
OXYGEN COMPOUNDS
PB-PK model
PERMEABILITY
POPULATIONS
RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT
Respiratory System - metabolism
RISK ASSESSMENT
Risk Factors
shower model
SKIN
Skin - metabolism
SKIN ABSORPTION
SORPTION
Tissue Distribution
TISSUES
UPTAKE
WATER 560300 -- Chemicals Metabolism & Toxicology
Water Pollutants, Chemical - administration & dosage
Water Pollutants, Chemical - pharmacokinetics
title A Compartmental Model for the Prediction of Breath Concentration and Absorbed Dose of Chloroform After Exposure While Showering
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T12%3A27%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_osti_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Compartmental%20Model%20for%20the%20Prediction%20of%20Breath%20Concentration%20and%20Absorbed%20Dose%20of%20Chloroform%20After%20Exposure%20While%20Showering&rft.jtitle=Risk%20analysis&rft.au=Chinery,%20Robert%20L.&rft.date=1993-02&rft.volume=13&rft.issue=1&rft.spage=51&rft.epage=62&rft.pages=51-62&rft.issn=0272-4332&rft.eissn=1539-6924&rft_id=info:doi/10.1111/j.1539-6924.1993.tb00728.x&rft_dat=%3Cproquest_osti_%3E16413157%3C/proquest_osti_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=16413157&rft_id=info:pmid/8451460&rfr_iscdi=true