Leslie Gail Dodd | Scholars@Duke

Leslie Gail Dodd
Adjunct Associate Professor in the Department of Pathology

Surgical Pathology and cytopathology of neoplasms.
Orthopedic pathology

Current research interests include: 1. Characterization of solid organ neoplasms by fine needle aspiration (FNA) cytology and 2. Quantification of tumor characteristics using digital cell image analysis. In cytology, current interests center around the characterization of neoplastic diseases: refining the criteria for FNA diagnosis of tumors, expanding the use of FNA in primary diagnosis, and findings of unusual lesions. A related interest is the correlation between cytopathology and histopathologic findings of neoplasms. Ongoing studies in the cell imaging lab concern the concept of tumor heterogeneity. Intratumoral heterogeneity, defined as the existence of more than one stemline of malignant cells per primary tumor has been documented in numerous neoplasms including: renal, ovarian, prostate, lung, gastroesophageal, colorectal, thyroid, oral and laryngeal carcinomas. In breast carcinoma, heterogeneity has been documented with respect to hormone receptors and DNA indices in a limited series of tumors. Tumors in this study are mapped and analyzed visually via image analysis systems. The rationale behind this method (as opposed to flow cytometry for DNA and conventional dextran-charcoal for ER/PR) is to sample multiple, discrete regions of tumor including the tumor/host tissue interface. This discrete region method most closely simulates the type and amount of tissues currently sent for analyses by conventional methods. Also, visual mapping allows for correlation with histopathological grade of specific regions. In the cell imaging laboratory, we are currently measuring simultaneous parameters and studying intraparametric relationships as well as looking for correlates to histopathologic features and clinical outcomes.

Current Appointments & Affiliations

Adjunct Associate Professor in the Department of Pathology, Pathology, Clinical Science Departments 2012

Contact Information

353M Davison Bldg, Durham, NC 27710
Duke Box 3712, Durham, NC 27710
dodd0003@mc.duke.edu (919) 684-4093

Background
Education, Training, & Certifications
- Faculty Associate, Cytopathology/Surgical Pathology, Pathology, University of Texas Medical School, Houston 1992 - 1993
- Fellow, Surgical Pathology & Cytopathology, Pathology, University of Texas Medical School, Houston 1991 - 1992
- Intern and Resident, Pathology, University of California - Los Angeles 1987 - 1991
- M.D., University of Nevada, Reno 1987
Previous Appointments & Affiliations
- Associate Professor of Pathology, Pathology, Clinical Science Departments 1998 - 2012
- Assistant Professor of Pathology, Pathology, Clinical Science Departments 1993 - 1998
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Trembath, Dimitri G., Rajesh Dash, Nancy M. Major, and Leslie G. Dodd. “Cytopathology of mesenchymal chondrosarcomas: a report and comparison of four patients.” Cancer 99, no. 4 (August 25, 2003): 211–16. https://doi.org/10.1002/cncr.11300.
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  - Dodd, Leslie G., Sean P. Scully, R Lee Cothran, and John M. Harrelson. “Utility of fine-needle aspiration in the diagnosis of primary osteosarcoma.” Diagn Cytopathol 27, no. 6 (December 2002): 350–53. https://doi.org/10.1002/dc.10196.
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  - Dodd, Leslie G., and Nancy M. Major. “Fine-needle aspiration cytology of articular and periarticular lesions.” Cancer 96, no. 3 (June 25, 2002): 157–65. https://doi.org/10.1002/cncr.10615.
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  - New, K. C., K. R. Bulsara, L. G. Dodd, and T. J. Cummings. “Fine-needle aspiration diagnosis of medulloblastoma metastatic to the pelvis.” Diagn Cytopathol 24, no. 5 (May 2001): 361–63. https://doi.org/10.1002/dc.1078.
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  - Dodd, L. G., and S. Martinez. “Fine-needle aspiration cytology of pseudosarcomatous lesions of soft tissue.” Diagn Cytopathol 24, no. 1 (January 2001): 28–35. https://doi.org/10.1002/1097-0339(200101)24:1<28::aid-dc1004>3.0.co;2-g.
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  - Butnor, K. J., T. A. Sporn, and L. G. Dodd. “Fine needle aspiration cytology of mucinous cystadenocarcinoma of the lung: report of a case with radiographic and histologic correlation.” Acta Cytol 45, no. 5 (2001): 779–83. https://doi.org/10.1159/000328305.
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  - Liu, K., R. C. Stern, R. T. Rogers, L. G. Dodd, and K. P. Mann. “Diagnosis of hematopoietic processes by fine-needle aspiration in conjunction with flow cytometry: A review of 127 cases.” Diagn Cytopathol 24, no. 1 (January 2001): 1–10. https://doi.org/10.1002/1097-0339(200101)24:1<1::aid-dc1000>3.0.co;2-j.
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  - Cummings, T. J., K. Liu, L. K. Jordan, and L. G. Dodd. “Fine-needle aspiration diagnosis of psammomatous melanotic schwannoma.” Diagn Cytopathol 23, no. 1 (July 2000): 55–58. https://doi.org/10.1002/1097-0339(200007)23:1<55::aid-dc13>3.0.co;2-b.
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  - Liu, K., L. G. Dodd, J. A. Powers, and S. H. Bigner. “Detection of trisomy 12 by fluorescence in situ hybridization on archival cytopathologic material in chronic lymphocytic leukemia/small lymphocytic lymphoma.” Acta Cytol 44, no. 3 (2000): 368–74. https://doi.org/10.1159/000328480.
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  - Stern, R. C., K. Liu, and L. G. Dodd. “Cytomorphologic features of sebaceous carcinoma on fine needle aspiration.” Acta Cytol 44, no. 5 (2000): 760–64. https://doi.org/10.1159/000328558.
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  - Keenlyside, R. A., C. L. Collins, J. S. Hancock, M. C. Gagnon, R. D. Cohn, A. L. Menoff, L. G. Dodd, D. F. Kurtycz, T. L. Hearn, and E. L. Baker. “Do proficiency test results correlate with the work performance of screeners who screen Papanicolaou smears?” Am J Clin Pathol 112, no. 6 (December 1999): 769–76. https://doi.org/10.1093/ajcp/112.6.769.
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  - Liu, K., L. G. Dodd, B. M. Osborne, S. Martinez, B. A. Olatdioye, and J. F. Madden. “Diagnosis of anaplastic large-cell lymphoma, including multifocal osseous KI-1 lymphoma, by fine-needle aspiration biopsy.” Diagn Cytopathol 21, no. 3 (September 1999): 174–79. https://doi.org/10.1002/(sici)1097-0339(199909)21:3<174::aid-dc6>3.0.co;2-q.
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  - Dameron, R. D., D. M. deLong, A. J. Fisher, D. M. DeLong, L. G. Dodd, and R. C. Nelson. “Indeterminate findings on imaging-guided biopsy: should additional intervention be pursued?” Ajr Am J Roentgenol 173, no. 2 (August 1999): 461–64. https://doi.org/10.2214/ajr.173.2.10430154.
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  - Liu, K., K. P. Mann, K. M. Vitellas, E. K. Paulson, R. C. Nelson, J. P. Gockerman, and L. G. Dodd. “Fine-needle aspiration with flow cytometric immunophenotyping for primary diagnosis of intra-abdominal lymphomas.” Diagn Cytopathol 21, no. 2 (August 1999): 98–104. https://doi.org/10.1002/(sici)1097-0339(199908)21:2<98::aid-dc4>3.0.co;2-v.
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  - Dash, R. C., K. Liu, D. H. Sheafor, and L. G. Dodd. “Fine-needle aspiration findings in idiopathic retroperitoneal fibrosis.” Diagn Cytopathol 21, no. 1 (July 1999): 22–26. https://doi.org/10.1002/(sici)1097-0339(199907)21:1<22::aid-dc7>3.0.co;2-g.
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  - Govert, J. A., L. G. Dodd, P. S. Kussin, and W. M. Samuelson. “A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma.” Cancer 87, no. 3 (June 25, 1999): 129–34. https://doi.org/10.1002/(sici)1097-0142(19990625)87:3<129::aid-cncr5>3.0.co;2-g.
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  - Dodd, L. G., E. M. Marom, R. C. Dash, M. R. Matthews, and R. E. McLendon. “Fine-needle aspiration cytology of "ancient" schwannoma.” Diagn Cytopathol 20, no. 5 (May 1999): 307–11. https://doi.org/10.1002/(sici)1097-0339(199905)20:5<307::aid-dc12>3.0.co;2-f.
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  - Keogan, M. T., K. S. Freed, E. K. Paulson, R. C. Nelson, and L. G. Dodd. “Imaging-guided percutaneous biopsy of focal splenic lesions: update on safety and effectiveness.” Ajr Am J Roentgenol 172, no. 4 (April 1999): 933–37. https://doi.org/10.2214/ajr.172.4.10587123.
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  - Liu, K., K. P. Mann, J. L. Garst, L. G. Dodd, and B. A. Olatidoye. “Diagnosis of posttransplant granulocytic sarcoma by fine-needle aspiration cytology and flow cytometry.” Diagn Cytopathol 20, no. 2 (February 1999): 85–89. https://doi.org/10.1002/(sici)1097-0339(199902)20:2<85::aid-dc9>3.0.co;2-v.
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  - Dodd, L. G., W. F. Moore, and C. R. Eedes. “Signet ring adenocarcinoma metastatic to the bronchus and mimicking goblet cell hyperplasia. A case report.” Acta Cytol 43, no. 6 (1999): 1108–12. https://doi.org/10.1159/000331362.
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  - Liu, K., G. K. Klintworth, and L. G. Dodd. “Cytologic findings in vitreous fluids. Analysis of 74 specimens.” Acta Cytol 43, no. 2 (1999): 201–6. https://doi.org/10.1159/000330977.
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  - Liu, K., J. F. Madden, B. A. Olatidoye, and L. G. Dodd. “Features of benign granular cell tumor on fine needle aspiration.” Acta Cytol 43, no. 4 (1999): 552–57. https://doi.org/10.1159/000331146.
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  - Liu, K., R. K. Dodge, L. G. Dodd, and L. J. Layfield. “Logistic regression analysis of low grade spindle cell lesions. A cytologic study.” Acta Cytol 43, no. 2 (1999): 143–52. https://doi.org/10.1159/000330968.
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  - Mooney, E. E., L. G. Dodd, T. D. Oury, J. L. Burchette, L. J. Layfield, and R. L. Scher. “Middle ear carcinoid: an indolent tumor with metastatic potential.” Head Neck 21, no. 1 (January 1999): 72–77. https://doi.org/10.1002/(sici)1097-0347(199901)21:1<72::aid-hed10>3.0.co;2-g.
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  - Mooney, E. E., L. J. Layfield, and L. G. Dodd. “Fine-needle aspiration of neural lesions.” Diagn Cytopathol 20, no. 1 (January 1999): 1–5. https://doi.org/10.1002/(sici)1097-0339(199901)20:1<1::aid-dc1>3.0.co;2-j.
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  - Ackley, C. D., L. Heineman, and L. G. Dodd. “Utility of fine-needle aspiration in the diagnosis of recurrent pulmonary lymphangioleiomyomatosis: a case report.” Diagn Cytopathol 19, no. 6 (December 1998): 458–61. https://doi.org/10.1002/(sici)1097-0339(199812)19:6<458::aid-dc11>3.0.co;2-g.
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  - Layfield, L. J., K. Liu, L. G. Dodd, and B. A. Olatidoye. “"Dedifferentiated" chordoma: a case report of the cytomorphologic findings on fine-needle aspiration.” Diagn Cytopathol 19, no. 5 (November 1998): 378–81. https://doi.org/10.1002/(sici)1097-0339(199811)19:5<378::aid-dc14>3.0.co;2-c.
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  - Layfield, L. J., E. E. Mooney, and L. G. Dodd. “Not by blood alone: diagnosis of hemangiomas by fine-needle aspiration.” Diagn Cytopathol 19, no. 4 (October 1998): 250–54. https://doi.org/10.1002/(sici)1097-0339(199810)19:4<250::aid-dc4>3.0.co;2-e.
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  - Liu, K., L. G. Dodd, and L. J. Layfield. “Fine-needle aspiration of choroidal melanoma metastatic to the liver.” Diagn Cytopathol 19, no. 2 (August 1998): 155–56. https://doi.org/10.1002/(sici)1097-0339(199808)19:2<155::aid-dc21>3.0.co;2-d.
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  - Dodd, L. G., R. C. Nelson, E. E. Mooney, and M. Gottfried. “Fine-needle aspiration of gastrointestinal stromal tumors.” Am J Clin Pathol 109, no. 4 (April 1998): 439–43. https://doi.org/10.1093/ajcp/109.4.439.
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  - Dodd, L. G., C. Chai, H. P. McAdams, and L. J. Layfield. “Fine needle aspiration of osteogenic sarcoma metastatic to the lung. A report of four cases.” Acta Cytol 42, no. 3 (1998): 754–58. https://doi.org/10.1159/000331840.
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  - Dodd, L. G., and J. Tello. “Cytologic examination of urine from patients with interstitial cystitis.” Acta Cytol 42, no. 4 (1998): 923–27. https://doi.org/10.1159/000331969.
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  - Chai, C., L. G. Dodd, B. J. Glasgow, and L. J. Layfield. “Salivary gland lesions with a prominent lymphoid component: cytologic findings and differential diagnosis by fine-needle aspiration biopsy.” Diagn Cytopathol 17, no. 3 (September 1997): 183–90. https://doi.org/10.1002/(sici)1097-0339(199709)17:3<183::aid-dc3>3.0.co;2-g.
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  - Dodd, L. G., S. Scully, and L. J. Layfield. “Fine-needle aspiration of epithelioid malignant peripheral nerve sheath tumor (epithelioid malignant schwannoma).” Diagn Cytopathol 17, no. 3 (September 1997): 200–204. https://doi.org/10.1002/(sici)1097-0339(199709)17:3<200::aid-dc6>3.0.co;2-i.
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  - Layfield, L. J., B. J. Glasgow, S. Hirschcowitz, and L. G. Dodd. “Intramammary lymph nodes: cytologic findings and implications for fine-needle aspiration cytology diagnosis of breast nodules.” Diagn Cytopathol 17, no. 3 (September 1997): 223–29. https://doi.org/10.1002/(sici)1097-0339(199709)17:3<223::aid-dc11>3.0.co;2-h.
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  - Layfield, L. J., and L. G. Dodd. “Fine-needle aspiration cytology findings in a case of aggressive angiomyxoma: a case report and review of the literature.” Diagn Cytopathol 16, no. 5 (May 1997): 425–29. https://doi.org/10.1002/(sici)1097-0339(199705)16:5<425::aid-dc8>3.0.co;2-a.
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  - Layfield, L. J., E. J. Moffatt, L. G. Dodd, S. P. Scully, and J. M. Harrelson. “Cytologic findings in tenosynovial giant cell tumors investigated by fine-needle aspiration cytology.” Diagn Cytopathol 16, no. 4 (April 1997): 317–25. https://doi.org/10.1002/(sici)1097-0339(199704)16:4<317::aid-dc3>3.0.co;2-a.
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  - Dodd, L. G., B. J. Kerns, R. K. Dodge, and L. J. Layfield. “Intratumoral heterogeneity in primary breast carcinoma: study of concurrent parameters.” J Surg Oncol 64, no. 4 (April 1997): 280–87. https://doi.org/10.1002/(sici)1096-9098(199704)64:4<280::aid-jso6>3.0.co;2-5.
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  - Dodd, L. G., E. E. Mooney, L. J. Layfield, and R. C. Nelson. “Fine-needle aspiration of the liver and pancreas: a cytology primer for radiologists.” Radiology 203, no. 1 (April 1997): 1–9. https://doi.org/10.1148/radiology.203.1.9122373.
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  - Mooney, E. E., L. G. Dodd, R. T. Vollmer, and E. H. Bossen. “Fine-needle aspiration biopsy diagnosis of primary bronchial basaloid-squamous carcinoma.” Diagn Cytopathol 16, no. 2 (February 1997): 187–88. https://doi.org/10.1002/(sici)1097-0339(199702)16:2<187::aid-dc21>3.0.co;2-h.
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  - Dodd, L. G., W. W. Johnston, C. N. Robertson, and L. J. Layfield. “Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis.” Acta Cytol 41, no. 2 (1997): 377–84. https://doi.org/10.1159/000332528.
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  - Layfield, L. J., and L. G. Dodd. “Cytologic findings in a case of postirradiation angiosarcoma of the breast.” Acta Cytol 41, no. 2 (1997): 612–14.
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  - Dodd, L. G., and L. J. Layfield. “Fine-needle aspiration of inflammatory carcinoma of the breast.” Diagn Cytopathol 15, no. 5 (December 1996): 363–66. https://doi.org/10.1002/(SICI)1097-0339(199612)15:5<363::AID-DC1>3.0.CO;2-D.
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  - Dodd, L. G., and L. J. Layfield. “Fine-needle aspiration cytology of ganglion cysts.” Diagn Cytopathol 15, no. 5 (December 1996): 377–81. https://doi.org/10.1002/(SICI)1097-0339(199612)15:5<377::AID-DC4>3.0.CO;2-9.
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  - Mooney, E. E., L. G. Dodd, and L. J. Layfield. “Squamous cells in fine-needle aspiration biopsies of salivary gland lesions: potential pitfalls in cytologic diagnosis.” Diagn Cytopathol 15, no. 5 (December 1996): 447–52. https://doi.org/10.1002/(SICI)1097-0339(199612)15:5<447::AID-DC19>3.0.CO;2-N.
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  - Ibrahim, S. N., H. R. Krigman, A. C. Coogan, T. D. Wax, L. G. Dodd, R. C. Bentley, S. J. Robboy, and W. W. Johnston. “Prospective correlation of cervicovaginal cytologic and histologic specimens.” Am J Clin Pathol 106, no. 3 (September 1996): 319–24. https://doi.org/10.1093/ajcp/106.3.319.
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  - Layfield, L. J., and L. G. Dodd. “Cytologically low grade malignancies: an important interpretative pitfall responsible for false negative diagnoses in fine-needle aspiration of the breast.” Diagn Cytopathol 15, no. 3 (September 1996): 250–59. https://doi.org/10.1002/(SICI)1097-0339(199609)15:3<250::AID-DC15>3.0.CO;2-F.
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  - Dodd, L. G., E. J. Moffatt, E. R. Hudson, and L. J. Layfield. “Fine-needle aspiration of primary gallbladder carcinoma.” Diagn Cytopathol 15, no. 2 (August 1996): 151–56. https://doi.org/10.1002/(SICI)1097-0339(199608)15:2<151::AID-DC14>3.0.CO;2-G.
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  - Layfield, L. J., and L. G. Dodd. “Fine-needle aspiration of a primary right atrial myxoma.” Diagn Cytopathol 14, no. 2 (March 1996): 162–64. https://doi.org/10.1002/(SICI)1097-0339(199603)14:2<162::AID-DC11>3.0.CO;2-K.
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  - Pinkard, N. B., R. W. Wilson, N. Lawless, L. G. Dodd, H. P. McAdams, M. N. Koss, and W. D. Travis. “Calcifying fibrous pseudotumor of pleura. A report of three cases of a newly described entity involving the pleura.” Am J Clin Pathol 105, no. 2 (February 1996): 189–94. https://doi.org/10.1093/ajcp/105.2.189.
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  - Dodd, L. G., and L. J. Layfield. “Renal epithelial dysplasia.” Am J Surg Pathol 19, no. 11 (November 1995): 1335–37.
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  - Gabriel, E. M., J. H. Sampson, L. G. Dodd, and D. A. Turner. “Glomus jugulare tumor metastatic to the sacrum after high-dose radiation therapy: case report.” Neurosurgery 37, no. 5 (November 1995): 1001–5. https://doi.org/10.1227/00006123-199511000-00022.
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  - Dodd, L. G. “Fine-needle aspiration cytology of adenoid (acantholytic) squamous-cell carcinoma.” Diagn Cytopathol 12, no. 2 (March 1995): 168–72. https://doi.org/10.1002/dc.2840120218.
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  - Dodd, L. G., T. A. Farrell, and L. J. Layfield. “Mucinous cystic tumor of the pancreas: an analysis of FNA characteristics with an emphasis on the spectrum of malignancy associated features.” Diagn Cytopathol 12, no. 2 (March 1995): 113–19. https://doi.org/10.1002/dc.2840120205.
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  - Patz, E. F., N. L. Müller, S. J. Swensen, and L. G. Dodd. “Congenital cystic adenomatoid malformation in adults: CT findings.” J Comput Assist Tomogr 19, no. 3 (1995): 361–64. https://doi.org/10.1097/00004728-199505000-00004.
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  - Morris, L. F., P. R. Cohen, and L. G. Dodd. “Nongenital granuloma inguinale in an oncology patient.” Am J Clin Oncol 17, no. 5 (October 1994): 456–60. https://doi.org/10.1097/00000421-199410000-00021.
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  - Ajani, J. A., L. G. Dodd, K. Daugherty, D. Warkentin, and D. H. Ilson. “Taxol-induced soft-tissue injury secondary to extravasation: characterization by histopathology and clinical course.” J Natl Cancer Inst 86, no. 1 (January 5, 1994): 51–53. https://doi.org/10.1093/jnci/86.1.51.
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  - Dodd, L. G., D. B. Evans, F. Symmans, and R. L. Katz. “Fine-needle aspiration of pancreatic extramedullary plasmacytoma: possible confusion with islet cell tumor.” Diagn Cytopathol 10, no. 4 (1994): 371–74. https://doi.org/10.1002/dc.2840100417.
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  - Dodd, L. G., N. P. Caraway, M. A. Luna, and R. M. Byers. “Myoepithelioma of the parotid. Report of a case initially examined by fine needle aspiration biopsy.” Acta Cytol 38, no. 3 (1994): 417–21.
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  - Dodd, L. G., N. Sneige, G. P. Reece, and B. Fornage. “Fine-needle aspiration cytology of silicone granulomas in the augmented breast.” Diagn Cytopathol 9, no. 5 (October 1993): 498–502. https://doi.org/10.1002/dc.2840090505.
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  - Davidson, B. S., J. E. Lee, L. G. Dodd, M. A. Dimopoulos, and D. B. Evans. “Extramedullary plasmacytoma of the pancreas.” Am J Clin Oncol 16, no. 4 (August 1993): 363–68. https://doi.org/10.1097/00000421-199308000-00019.
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  - Dodd, L. G., N. Sneige, Y. Villarreal, C. V. Fanning, G. A. Staerkel, N. P. Caraway, E. G. Silva, and R. L. Katz. “Quality-assurance study of simultaneously sampled, non-correlating cervical cytology and biopsies.” Diagn Cytopathol 9, no. 2 (1993): 138–44. https://doi.org/10.1002/dc.2840090206.
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  - Dodd, L. G., D. L. Rosenthal, and P. Cancilla. “A 35-year experience with the post-sophomore fellowship in pathology: analysis of its effectiveness as a recruitment resource.” Hum Pathol 23, no. 4 (April 1992): 407–10. https://doi.org/10.1016/0046-8177(92)90087-j.
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  - Dodd, L. G., J. H. McBride, G. L. Gitnick, P. J. Howanitz, and D. O. Rodgerson. “Prevalence of non-A,non-B hepatitis/hepatitis C virus antibody in human immunoglobulins.” Am J Clin Pathol 97, no. 1 (January 1992): 108–13. https://doi.org/10.1093/ajcp/97.1.108.
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  - Sercarz, J. A., B. Strasnick, A. Newman, and L. G. Dodd. “Midline nasal destruction in cocaine abusers.” Otolaryngol Head Neck Surg 105, no. 5 (November 1991): 694–701. https://doi.org/10.1177/019459989110500510.
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  - Mark, R. J., J. A. Sercarz, L. Tran, L. G. Dodd, M. Selch, and T. C. Calcaterra. “Osteogenic sarcoma of the head and neck. The UCLA experience.” Arch Otolaryngol Head Neck Surg 117, no. 7 (July 1991): 761–66. https://doi.org/10.1001/archotol.1991.01870190073015.
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  - Dodd, L. G. “Balantidium coli infestation as a cause of acute appendicitis.” J Infect Dis 163, no. 6 (June 1991): 1392. https://doi.org/10.1093/infdis/163.6.1392.
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  - Dodd, L. G., J. H. McBride, G. L. Gitnick, P. J. Howanitz, and D. O. Rodgerson. “Prevalence of non-A, non-B hepatitis/hepatitis C virus antibody in laboratory quality-assurance sera.” Clin Chem 37, no. 6 (June 1991): 797–803.
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  - Dodd, L. G., and S. D. Nelson. “Disseminated coccidioidomycosis detected by percutaneous liver biopsy in a liver transplant recipient.” Am J Clin Pathol 93, no. 1 (January 1990): 141–44. https://doi.org/10.1093/ajcp/93.1.141.
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