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Contrast-enhanced ultrasound, microvascular imaging, elastography, and fat quantification have varying degrees of utility, with some applications in the pediatric setting mirroring that in adults and having unique uses when applied to children in others. This review will present novel ultrasound technologies and the clinical context in which they are applied to the pediatric abdomen. New ultrasound technologies have a broad range of applications in clinical practice and represent a powerful diagnostic tool with the potential to replace other imaging modalities, such as magnetic resonance imaging and computed tomography, in specific cases., (© 2024. The Author(s).)

Purpose: Direct interactions between patients and diagnostic radiologists are uncommon, but recent medicolegal developments in the United States may increase patient interest in communicating directly with radiologists. Patient participation rates in prior attempts at direct radiology consultation vary widely in the literature. Our objective was to design and build a virtual radiology consult service for a subset of patients undergoing lung cancer screening CTs to enable communication between patients and radiologists regarding imaging results and radiology recommendations., Methods: Patients scheduled for lung cancer screening CTs were identified using a custom scheduling system and offered via text message a free 15-minute consultation with a radiologist to discuss the results., Results: Of 38 patients texted, 10 (26.3%) responded. Nine (90%) scheduled a consultation, but 5 (55.5%) subsequently cancelled. Of the remaining four, 3 (75%) attended their appointments, with an overall 3/38 (7.9%) text-to-consult conversation rate. The 3 consults averaged 18 (±8.2) minutes., Conclusion: The recruitment rate for our virtual service was between the low rate of a prior phone consult line study and the high rate in consults integrated into another physician visit. Further research is needed to identify patients most interested in a radiology consultation and optimize consultation modality by patient population., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Cancers frequently metastasize to the spine, where they can cause severe morbidity, including pain, vertebral collapse, and paralysis. Accurate assessment and timely communication of actionable imaging findings are critical. We developed a scoring mechanism to capture the key imaging features of examinations performed to detect and characterize spinal metastases in patients with cancer. An automated system was developed to relay those findings to the institution's spine oncology team to expedite treatment. This report describes the scoring scheme, the automated results communication platform, and initial clinical experience with the system. The scoring system and communication platform enable prompt, imaging-directed care of patients with spinal metastases.

Purpose: Microvascular imaging ultrasound (MVI) can detect slow blood flow in small-caliber cerebral vessels. This technology may help assess flow in other intracranial structures, such as the ventricular system. In this study, we describe the use of MVI for characterizing intraventricular cerebrospinal fluid (CSF) flow dynamics in infants., Materials and Methods: We included infants with brain ultrasound that had MVI B-Flow cine clips in the sagittal plane. Two blinded reviewers examined the images, dictated a diagnostic impression, and identified the third ventricle, cerebral aqueduct, fourth ventricle, and CSF flow direction. A third reviewer evaluated the discrepancies. We evaluated the association of visualization of CSF flow as detectable with MVI, with the diagnostic impressions. We also assessed the inter-rater reliability (IRR) for detecting CSF flow., Results: We evaluated 101 infants, mean age 40 ± 53 days. Based on brain MVI B-Flow, a total of 49 patients had normal brain US scans, 40 had hydrocephalus, 26 had intraventricular hemorrhage (IVH), and 14 had hydrocephalus+IVH. Using spatially moving MVI signal in the third ventricle, cerebral aqueduct, and fourth ventricle as the criteria for CSF flow, CSF flow was identified in 10.9% (n = 11), 15.8% (n = 16), and 16.8% (n = 17) of cases, respectively. Flow direction was detected in 19.8% (n = 20) of cases; 70% (n = 14) was caudocranial, 15% (n = 3) was craniocaudal, and 15% (n = 3) bidirectional, with IRR = 0.662, p < 0.001. Visualization of CSF flow was significantly associated with the presence of IVH alone (OR 9.7 [3.3-29.0], p < 0.001) and IVH+hydrocephalus (OR 12.4 [3.5-440], p < 0.001), but not with hydrocephalus alone ( p = 0.116)., Conclusion: This study demonstrates that MVI can detect CSF flow dynamics in infants with a history of post-hemorrhagic hydrocephalus with a high IRR.

Modern MRI scanners have trended toward higher field strengths to maximize signal and resolution while minimizing scan time. However, high-field devices remain expensive to install and operate, making them scarce outside of high-income countries and major population centers. Low-field strength scanners have drawn renewed academic, industry, and philanthropic interest due to advantages that could dramatically increase imaging access, including lower cost and portability. Nevertheless, low-field MRI still faces inherent limitations in image quality that come with decreased signal. In this article, we review advantages and disadvantages of low-field MRI scanners, describe hardware and software innovations that accentuate advantages and mitigate disadvantages, and consider clinical applications for a new generation of low-field devices. In our review, we explore how these devices are being or could be used for high acuity brain imaging, outpatient neuroimaging, MRI-guided procedures, pediatric imaging, and musculoskeletal imaging. Challenges for their successful clinical translation include selecting and validating appropriate use cases, integrating with standards of care in high resource settings, expanding options with actionable information in low resource settings, and facilitating health care providers and clinical practice in new ways. By embracing both the promise and challenges of low-field MRI, clinicians and researchers have an opportunity to transform medical care for patients around the world. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 6., (© 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Abstract: To evaluate the feasibility and potential utility of contrast-enhanced ultrasound for real-time imaging of whole-brain perfusion during cardiopulmonary resuscitation (CPR), cardiac arrest was induced in 8- to 7-week-old 10-kg piglets ( Sus scrofa domesticus ). Contrast-enhanced ultrasound was performed through a parietal cranial window in the coronal plane visualizing the thalami during hemodynamic-directed CPR. Whole-brain mean and maximum pixel intensities in each slice during resuscitation were calculated. Piglets were monitored for 24 hours postarrest. Seven piglets achieved return of spontaneous circulation and 6 survived to 24 hours. Of the 6 surviving piglets, 2 piglets demonstrated greater intra-CPR brain enhancement at maximum 73.2% and 42.1% and mean 36.7% and 31.9% enhancement above background, respectively, compared with maximum 5.8%, 22.9%, 6.0%, and 26.6% and mean 5.1%, 8.9%, 2.9%, and 6.6% above background, respectively, in the other 4. Intra-CPR average mean arterial pressures were similar between all 6 surviving piglets. One piglet achieved return of spontaneous circulation but expired 10 minutes later with enhancement maximum 45.2% and mean 18.9% enhancement above background. The final piglet did not achieve return of spontaneous circulation and exhibited minimal enhancement at maximum 2.8% and mean 0.9% enhancement above background. Contrast-enhanced ultrasound can detect brain perfusion during CPR, identifying a spectrum of cerebral blood flow responses in the brain despite similar systemic hemodynamics. This novel application can form the basis for future large animal model studies and eventually human clinical studies to further explore the neurologic implications of cerebral blood flow responses during resuscitation and stimulate novel strategies for optimizing brain perfusion restoration., Competing Interests: C.W.F. has received a GPU grant from NVIDIA to study the use of machine learning to track ultrasound contrast microbubbles. M.H. has received an investigator-initiated pilot grant from Bracco for the study of contrast-enhanced ultrasound in neonatal brain injury. The remaining authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Abdominal emergencies in neonates require surgical management in almost all cases and complications may include bowel perforation, sepsis, shock, and even death. Radiological imaging has become a very important aid in the clinical setting as it shortens time to diagnosis., Objective: The objective of this review is to discuss the more prevalent neonatal gastrointestinal emergencies, review appropriate imaging options, and illustrate common radiological presentations of these entities., Conclusion: Despite advancements in imaging techniques, it is important to keep in mind that neonates have a higher susceptibility to the adverse effects of ionizing radiation, and therefore radiography and ultrasonography remain the main diagnostic modalities for ruling out the diseases with the worst prognosis. Other modalities (fluoroscopy, computed tomography, and magnetic resonance imaging) may have limited use in very specific conditions. All providers in an emergency department should be familiar with the basic radiological findings that may indicate a gastrointestinal emergency, especially in health institutions that do not have 24-h radiologist coverage., Competing Interests: Conflict of interest statement None declared., (Copyright © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)

Because of its portability, safety profile, and accessibility, ultrasound has been integral in pediatric neuroimaging. While conventional B-mode and Doppler ultrasound provide anatomic and limited flow information, new and developing advanced ultrasound techniques are facilitating real-time visualization of brain perfusion, microvascular flow, and changes in tissue stiffness in the brain. These techniques, which include contrast-enhanced ultrasound, microvascular imaging, and elastography, are providing new insights into and new methods of evaluating pathologies affecting children requiring critical care, including hypoxic-ischemic encephalopathy, stroke, and hydrocephalus. This review introduces advanced neurosonography techniques and their clinical applications in pediatric neurocritical care.

Aim: To investigate the sex-related differences in arterial spin-labelled (ASL) perfusion of metabolically active brain structures in neonatal hypoxic-ischaemic encephalopathy (HIE)., Materials and Methods: Seventy-three term neonates were identified for a retrospective case-control study following an institutional review board (IRB) approved protocol. The cerebral pulsed arterial spin labelling values were compared by permutation test to identify metabolically active brain structures with significant perfusion changes between 10 male controls and eight female controls, and between 31 HIE males and 24 HIE females., Results: In the perfusion comparison between HIE male and female neonates, significantly lower perfusion was found in the thalamus in males (p=0.02). The other brain clusters, including basal ganglia, hippocampus cluster, cingulate gyrus cluster, brainstem cluster, sensorimotor cortex cluster, and cerebellum and peduncle cluster, demonstrated no significant differences between HIE males and females. In the perfusion comparison between male and female controls, there were no significant perfusion changes in those brain clusters., Conclusion: Brain perfusion in neonatal HIE differs between males and females in the thalamus, a metabolically active region within neonates, with males demonstrating lower perfusion. This difference in perfusion may reflect sex-related disparities in response to and recovery from hypoxic-ischaemic events., (Copyright © 2021. Published by Elsevier Ltd.)

Among 2820 inpatients with coronavirus disease (COVID-19), 59 (2.1%) underwent brain MRI. Of them, six (10.2%) had MRI findings suspicious for COVID-19-related disseminated leukoencephalopathy (CRDL), which is characterized by extensive confluent or multifocal white matter lesions (with characteristics and locations atypical for other causes), microhemorrhages, diffusion restriction, and enhancement. CRDL is an uncommon but important differential consideration in patients with neurologic manifestations of COVID-19.

Purpose: To provide radiologic-pathologic correlation of brain injury in the Papez circuit in hypoxic-ischemic encephalopathy (HIE) neonates and correlate radiologic findings with long-term neurodevelopmental outcomes., Methods: Twenty full-term HIE neonates were evaluated. Cerebral blood flow (CBF) values, obtained through pulsed arterial spin labeling (ASL) perfusion-weighted MRI, were compared by permutation test to identify brain regions with statistically significant perfusion changes between 14 HIE neonates without evidence of developmental delay by Bayley-III (mean age 8.2 ± 7.2 days) and 6 HIE neonates with evidence of developmental delay (mean age 13.1 ± 8.0 days). Four histopathologic studies on specimens were taken from post-mortem brains of another group of infants (mean age 10 ± 6.8 days) with HIE. The infants were not the same ones who had MRIs., Results: Significantly decreased perfusion in Papez circuit was found in HIE neonates with developmental delay compared with HIE neonates without delay. Decreased ASL perfusion values were seen in Papez circuit structures of the fornix (p = 0.002), entorhinal cortex (p = 0.048), amygdala (p = 0.036), hippocampus (p = 0.033), and thalamus (p = 0.036). In autopsy specimens of neonates with HIE, anoxic (eosinophilic) neurons, reactive astrocytes, and white matter rarefaction were observed in these regions, providing pathology correlation to the imaging findings of HIE., Conclusion: The Papez circuit is susceptible to hypoxic-ischemic injury in neonates as demonstrated by perfusion-weighted imaging and histopathology. This sheds new light onto a possible non-familial mechanism of neuropsychiatric disease evolution initiated in the infant period and raises the potential for early identification of at-risk children.

In this clinical case series, we report our experience to date with neurologic complications of extracorporeal membrane oxygenation therapy for COVID-19 Acute Respiratory Distress Syndrome. We have found an unexpectedly increased rate of complications as demonstrated by neuroimaging compared with meta-analysis data in extracorporeal membrane oxygenation therapy for all Acute Respiratory Distress Syndrome etiologies over the past few decades and compared with the most recent baseline data describing the incidence of neurologic complication in all patients with COVID-19. For our 12-patient cohort, there was a rate of intracranial hemorrhage of 41.7%. Representative cases and images of devastating intracranial hemorrhage are presented. We hypothesize that the interplay between hematologic changes inherent to extracorporeal membrane oxygenation and inflammatory and coagulopathic changes that have begun to be elucidated as part of the COVID-19 disease process are responsible. Continued analysis of extracorporeal membrane oxygenation therapy in this disease paradigm is warranted., (© 2020 by American Journal of Neuroradiology.)

Aim: To assess the prevalence of various imaging manifestations in neurosarcoidosis (NS) patients at presentation and to explore if specific imaging findings may cluster in different sub-groups., Materials and Methods: A retrospective, dual-institution, systematic imaging review was undertaken of the magnetic resonance imaging (MRI) findings in 100 consecutive NS patients who presented over a 15-year period. Clustering analysis (k-mode) was performed to evaluate co-occurrence of imaging findings., Results: Non-enhancing white matter (NEWM) lesions were the most common imaging abnormality (56%), followed by leptomeningeal (47%) and pachymeningeal (32%) involvement. Other common manifestations included cranial nerve involvement (30%), parenchymal granulomas (27%), hypothalamic-pituitary-adrenal axis involvement (26%), and hydrocephalus (14%). Additionally, a higher prevalence of perivascular enhancement (23%), cerebrovascular events (including ischaemic and haemorrhagic events; 17%), and ependymal involvement (20%) were noted than recognised previously. Additional k-mode analysis was performed to explore underlying disease sub-clusters. This was evaluated for clusters varying between two though five (k=2-5). For k=4, the analysis revealed that the imaging findings may possibly be divided into disease sub-sets of four groups, each with varying distribution of imaging manifestations and clinical manifestations., Conclusion: Overall, NEWM lesions and meningeal involvement are the most common imaging manifestations of NS. The prevalence of perivascular enhancement, cerebrovascular events, and ependymal involvement is likely higher than reported previously. Additionally, different imaging findings in NS may cluster together and imaging subtypes in NS possibly exist., (Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Rationale and Objectives: To compare cerebral pulsed arterial spin labeling (PASL) perfusion among controls, hypoxic ischemic encephalopathy (HIE) neonates with normal conventional MRI(HIE/MRI⊕), and HIE neonates with abnormal conventional MRI(HIE/MRI⊖). To create a predictive machine learning model of neurodevelopmental outcomes using cerebral PASL perfusion. Materials and Methods: A total of 73 full-term neonates were evaluated. The cerebral perfusion values were compared by permutation test to identify brain regions with significant perfusion changes among 18 controls, 40 HIE/MRI⊖ patients, and 15 HIE/MRI⊕ patients. A machine learning model was developed to predict neurodevelopmental outcomes using the averaged perfusion in those identified brain regions. Results: Significantly decreased PASL perfusion in HIE/MRI⊖ group, when compared with controls, were found in the anterior corona radiata, caudate, superior frontal gyrus, precentral gyrus. Both significantly increased and decreased cerebral perfusion changes were detected in HIE/MRI⊕ group, when compared with HIE/MRI⊖ group. There were no significant perfusion differences in the cerebellum, brainstem and deep structures of thalamus, putamen, and globus pallidus among the three groups. The machine learning model demonstrated significant correlation ( p < 0.05) in predicting language( r = 0.48) and motor( r = 0.57) outcomes in HIE/MRI⊖ patients, and predicting language( r = 0.76), and motor( r = 0.53) outcomes in an additional group combining HIE/MRI⊖ and HIE/MRI⊕. Conclusion: Perfusion MRI can play an essential role in detecting HIE regardless of findings on conventional MRI and predicting language and motor outcomes in HIE survivors. The perfusion changes may also reveal important insights into the reperfusion response and intrinsic autoregulatory mechanisms. Our results suggest that perfusion imaging may be a useful adjunct to conventional MRI in the evaluation of HIE in clinical practice., (Copyright © 2020 Zheng, Martin-Saavedra, Saade-Lemus, Vossough, Zuccoli, Gonçalves, Freeman, Ouyang, Singh, Padula, Demauro, Flibotte, Eichenwald, Detre, Sze, Huang and Hwang.)

Objective: The aim of this study was to evaluate whether a call triage assistant, who answered telephone calls to the main reading room during the busiest hours of weekend call, would impact resident workflow efficiency, diagnostic errors, and stress level., Methods: The call triage assistant answered all telephone calls to the main reading room from 12 pm to 7 pm on 6 weekend days over a 3-month period. We compared report turnaround times and resident discrepancy rates on these days with control days, when the same residents were on call without the assistant. We also surveyed residents to determine whether the assistants relieved anxiety associated with the call shift., Results: We recorded 168 telephone calls over the study period. We found the majority of telephone calls could be handled by the assistant without disturbing the on-call resident, resulting in a 71% reduction in interruptions. The mean turnaround time for studies read on the days the assistant was on duty was 44.3 min, compared with 75.2 min on the control days (P < .01). Resident major discrepancy rates (0.4% on the intervention days compared to 0.2% on the control days) were similar (P = .58), as were minor discrepancy rates (7.5% on the intervention days compared with 6.7% on the control days; P = .61). Residents reported fewer distractions, improved workflow efficiency, and decreased call-related stress when the assistant was on duty., Conclusions: A call triage assistant effectively improved workflow efficiency and reduced resident stress on call. Resident error rates were unaffected by the presence of the assistant., (Copyright © 2019 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Variations in the venous drainage of the central nervous system can have imaging and clinical findings that mimic pathology, presenting a challenge for neuroimagers and clinicians. Patients with these variants may undergo unnecessary testing, and patients with pathology may receive delayed diagnoses because of overlap with benign findings. Consequently, the accurate identification of venous variations on cross-sectional imaging and angiography and their potential causes are critical for differentiating benign imaging variants from potential pathologic processes requiring further evaluation. For example, in the epidural space, benign dilation of the epidural venous plexus may be mistaken for evidence of a fistula, abscess, or metastasis. Hypoplasia of a dural venous sinus or an arachnoid granulation may mimic venous sinus thrombosis. The superior ophthalmic vein may demonstrate benign dilation in intubated patients, mimicking thrombosis, increased intracranial pressure, orbital varix, inflammatory pseudotumor, or other conditions. Furthermore, certain venous variations, such as the occipital sinus or emissary veins, may complicate surgery or herald pathology and should be reported. In addition, some supposedly benign variations, such as the developmental venous anomaly, can be complicated by pathology. The objective of this review article is to provide a descriptive and pictorial review of common anatomic and physiologic variations in the venous drainage system of the brain, spine, and orbits that can mimic pathology. Neuroimaging findings of related pathologies and differences in clinical presentations will also be discussed to assist in the approach to differential diagnosis., (© 2019 by the American Society of Neuroimaging.)

Objective: The purpose of this study was to determine whether unenhanced MRI without sedation is a feasible substitute for dimercaptosuccinic acid (DMSA) scintigraphy in the detection of renal scars in pediatric patients., Subjects and Methods: Patients scheduled for 99m Tc-labeled DMSA scintigraphy for assessment of possible renal scars were recruited to undergo unenhanced MRI (free-breathing fat-suppressed T2-weighted single-shot turbo spin-echo and T1-weighted gradient-echo imaging, 13 minutes' total imaging time). Scintigraphic and MRI studies were evaluated by two independent blinded specialty-based radiologists. For each imaging examination, readers identified scars in upper, middle, and lower kidney zones and rated their diagnostic confidence and the quality of each study. The scintigraphic readers' consensus score opinion for the presence of scars was considered the reference standard., Results: DMSA scintigraphy showed scarring in 19 of the 78 (24.4%) evaluated zones and MRI in 18 of the 78 (23.1%). The two MRI readers found mean sensitivities of 94.7% and 89.5%, identical specificities of 100%, and diagnostic accuracies of 98.7% and 97.4%. Interobserver agreement was 98.7% for MRI and 92.3% for DMSA scintigraphy. The MRI readers were significantly more confident in determining the absence rather than the presence of scars (p = 0.02). MRI readers were more likely to rate study quality as excellent (84.6%) than were the scintigraphic readers (57.7%) (p = 0.024)., Conclusion: Unenhanced MRI has excellent sensitivity, specificity, diagnostic accuracy, and interobserver agreement for detecting renal scars in older children who do not need sedation. It may serve as a substitute modality, especially when DMSA is not available.

Introduction: Selectivity index (SI) and lateralization index (LI) thresholds determine the adequacy of adrenal vein sampling (AVS) and the degree of lateralization. The purpose of this study was investigate the clinical outcome of patients whose adrenal vein sampling was interpreted using "strict criteria" (SC) (SIpre-stimuli≥3, SIpost-stimuli≥5 and LIpre-stimuli≥4, LIpost-stimuli≥4)., Materials and Methods: A retrospective review of 73 consecutive AVS procedures was performed and 67 were technically successful. Forty-three patients showed lateralization and underwent surgery, while 24 did not lateralize and were managed conservatively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), kalemia (K(+)), and the change in number of blood pressure (BP) medications were recorded for each patient before and after AVS and potential surgery were performed., Results: In the surgery group, BP and K(+) changed respectively from 160±5.3/100±2.0 mmHg to 127±3.3/80±1.9 (p <0.001) and from 3.00±0.10 to 4.4±0.09 (p <0.001). In the medically managed group, BP and K(+) changed respectively from 148±7.3/93±4.3 to 135±3.3/86±1.9 (p <0.001) and from 2.68±0.10 to 4.3±0.09. After surgery or AVS, the patients who took ≥3 blood pressure medications were six (14.0%) in the lateralized group and 22 (91.7%) in the non-lateralized group (p <0.001)., Conclusions: AVS interpretation with SC leads to significant clinical improvement in both patients who underwent surgery and those managed conservatively.

We were a group of Christian friends searching for affirmations that lay at the heart of our faith and reached to the limits of our existence and moral authority. As we have reflected on our role in deciding whether and to what extent we could assist in allowing our terminally ill friend, seventy-nine-year-old, Norman to die, we were deeply troubled by the moral ambiguity of our involvement. Through a careful process of authority through communal discernment, our responsibility for Norman became clear: we were to assist him in living the life he embraced in baptism -- a life which included a destiny that was conformed to the crucified and risen one. That was not the destiny we chose for Norman; it was the destiny he owned. We recognized with Norman that our lives are not our own to be guided by autonomy and liberty, but rather to be lived for the glory of Jesus the Christ.

The Minnesota Multiphasic Personality Inventory was administered to 47 male patients on the Renal Dialysis Unit at the Seattle VA Hospital. The patients were divided into three survival groups for comparison. Group A died within 1 year of initiating dialysis. Group B had been alive on dialysis between 3 and 7 years, while group C had been alive between 7 and 10 years at the time of data analysis. Group A differed significantly from group B on the Hs, D, and Hy scales, and from group C on the F, Hs, D, and Pt scales. Interpretation of the mean MMPI profiles implies that persons in group A are characterized by feelings of helplessness, high levels of depression, anxiety, and preoccupation with somatic difficulties, whereas those in groups B and C tended to be dependent, have mild levels of depression, and have a sense of hopefulness about the future. The authors suggest that psychiatric intervention might increase the longevity of those patients judged to be moderately to severely depressed with somatic preoccupations.

A reproducible method is presented for selecting patients with low-back pain and sciatica for lumbar discectomy based on specific objective criteria in four categories: neurologic signs, sciatic tension signs, personality factors (MMPI scores), and lumbar myelography. Operative findings for 50 consecutive cases selected using this method revealed complete nucleus pulposus herniation in 43 cases. This contrasts with complete herniation in only 5 of 26 patients undergoing lumbar discectomy before the method was employed. This objective preoperative evaluation method reduced negative disc explorations and improved early surgical results. We recommend its use for patients being considered for elective lumbar discectomy.

There is a need to examine the usefulness of an abbreviated form of the MMPI with alcoholic patients. The Faschingbauer Abbreviated MMPI (FAM) was administered to 225 male alcoholics. The correlations between the T-scores for the FAM and their full MMPI counterparts ranged from .761 to .919. Examination of the high-point code for each FAM-MMPI pair yielded 52.89% with identical high-point codes. A comparison between the MMPI and the FAM pairs showed that 78% of the profiles had the same number of scales with T-score above 70 plus or minus one scale. The authors suggest that when a full MMPI administration is not feasible, the FAM is a valid substitute for alcoholic populations.

Alcoholic Ss were categorized into four subtypes based upon differential levels of perceived locus of control and experienced control. The relationship between generalized psychopathology, as measured by the MMPI, and subtype classification was investigated. Alcoholics with an internal locus of control and high levels of experienced control exhibited the least psychopathology. The greatest degree of psychopathology was found among Ss with an external locus of control and minimal levels of experienced control. The implications of these results with respect to psychosocial functioning and drinking behavior among alcoholic subgroups were discussed.

The survival of 71 patients on chronic dialysis correlated positively with vocational rehabilitation. Employed patients (n = 47) survived longer (p less than 0.001) than unemployed (n = 24). Within the employed group, parttime workers (n = 23) lived longer (p less than 0.01) than fulltime workers (n = 24). Although patients on chronic dialysis appear to live longer if employed, fulltime employment may be excessively stressful in a patient population whose treatment makes large demands on the patient's time.

Conventional cell culture methods were compared with a direct immunofluorescence test (MicroTrak, Syva UK, Maidenhead, Berkshire) to detect Chlamydia trachomatis in 137 patients (126 women, 11 men) attending a sexually transmitted diseases (STD) clinic. Results obtained by the two tests agreed in 87.6% of cases. Of 34 positive specimens, 17 were detected by culture and fluorescence, 15 by fluorescence only, and two by culture only. The excess of specimens that were negative on culture but positive on fluorescence might be accounted for by delays in culture (up to 18 hours). The MicroTrak test appears to be of value in peripheral hospitals that have to rely on transporting specimens to larger centres for culture.

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional,""organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are well represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional" pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this study would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.

The usefulness of the Somatization factor of the MMPI-168 with low back pain patients was examined in two separate studies. In study 1, 58 male veteran low back pain patients who had been divided into organic and mixed groups served as Ss. MMPI protocols were rescored for the five factors of Overall, Hunter, and Butcher (1973). The organic and mixed groups differed only on the Somatization factor. A cutting score of raw greater than or equal to 8 (T = 75) was determined to classify the sample correctly 74.5% of the time. In study 2, a second sample of 48 male veteran low back pain patients was divided into mixed, organic, and functional groups. The mixed group was subdivided further into a mixed-pain group who still were having pain and were seeking treatment and a mixed-relief group who were experiencing a reduction of pain and were returning to vocational activities. The functional and mixed-pain groups differed from the organic and mixed-relief groups on the Somatization and Depression factors. The cutting score determined in the study 1 correctly classified patients 83% of the time.

The present study was designed to identify personality and drinking behavior correlates associated with membership in Alcoholics Anonymous (A.A.). Affiliation profiles were developed on the basis of frequency of A.A. attendance; subtypes were defined as non, low, and high affiliates, respectively. An initial canonical correlation analysis assessed the amount of common variance between personality and drinking characteristics. Subsequent discriminant function analyses on the second-order scales of the drinking and personality variables sets identified those variables differentiating the A.A. affiliated groups. High levels of affiliation were associated with a greater degree of anxiety, a tendency to be more affected by feelings rather than intellect, and more deterioration in the physical, exhibited significant differences in perceived benefits, style, and consequences of alcohol usage. The potential therapeutic utility of A.A. affiliation profiles was discussed.

Assessed the utility of the Faschingbauer Abbreviated MMPI (FAM) and MMPI-168 for use with the elderly. FAM and MMPI-168 items were extracted from the MMPIs of 24 older male veteran medical or alcoholic patients. The results indicate that both abbreviated forms are highly correlated with and yield similar diagnostic inferences to the standard MMPI. For this sample population, the FAM was significantly (p less than .001) more in accordance with the standard MMPI than the MMPI-168.

The feasibility of using psychological tests to predict patient drop-outs from an alcohol treatment program was studied. Eighty-four alcoholic male veterans being treated in an inpatient program were administrered the Rotter Locus of Control scale (I-E) and the MMPI-168 at the beginning of the treatment. Those patients who completed an 8 week inpatient program and a one year outpatient program were compared to those patients who completed the inpatient phase, but dropped out during the outpatient phase on the five MMPI-168 factors and the total I-E score. The two groups differed significantly only on the I-E. The data was also subjected to a discriminant analysis to generate a prediction equation. The prediction equation correctly classified 82% of the drop-outs.

1. [3alpha-(3)H]Cholesta-7,9-dien-3beta-ol is converted in high yield into cholesterol by a 10000g(av.) supernatant fraction of rat liver homogenate. 2. Incubation of cholesta-7,9-dien-3beta-ol with [4-(3)H]NADPH and rat liver microsomal fractions under anaerobic conditions resulted in (3)H being incorporated into the 14alpha-position of cholest-7-en-3beta-ol. 3. Under anaerobic conditions in the absence of NADPH cholesta-7,9-dien-3beta-ol was isomerized into cholesta-8,14-dien-3beta-ol by rat liver microsomal fractions.