Differentiating violent and nonviolent prison inmates by use of selected MMPI scales

Used multivariate procedures to determine whether prisoners who committed violent acts while in prison could be differentiated from those who did not. Ss were 141 adult male inmates in maximum security prisons. Multiple variable profile analysis that employed 22 MMPI scales and four demographic items significantly differentiated between violet and nonviolent inmates. Discriminant analysis that used all 26 variables yielded a significant root that accounted for 34.9% of the variance between violent and nonviolent inmates. The MMPI scales that contributed most to prediction of group membership were F, PA, PT, and SC, all of which had discriminant load values above .40. Finally, a discriminant function prediction equation was derived to predict the criterion variable (violent or nonviolent behavior). Applying this equation without knowledge of the S's actual group membership correctly classified 72.9% of the violent and 80.6% of the nonviolent inmates.

Measurement of CBF and CMRO2 using the continuous inhalation of C15O2 and 15O. Experimental validation using CO2 reactivity in the anaesthetised dog

Experimental support for the steady state 15O inhalation technique, as used to measure cerebral blood flow (CBF) and oxygen utilisation (CMRO2), was obtained by describing the response of the cerebral vasculature to variations in arterial PCO2 in 6 anaesthetised dogs. Measurements were made using a positron emission tomography (ECAT II) and arterial blood sampling, during the sequential constant inhalation of C15O2 and 15O2. Values of CBF and CMRO2 were calculated for a mixture of white and grey matter, using the steady state tracer equations derived by Jones et al. (1976). The mean CMRO2 was 3.58 +/- 0.81 ml O2 . 100 ml-1 . min-1, whilst the mean CBF and OER (oxygen extraction ratio) values (for an arterial PCO2 of 40 mm Hg) were 39.9 ml . 100 ml-1 and 0.50 +/- 0.06, respectively. Arterial PCO2 was varied between 20 and 150 mm Hg. CBF was found to correlate closely with arterial PCO2, resulting in a mean slope (specific reactivity) of 1.52 +/- 0.38 ml . 10 ml-1. mm Hg-1. Pooling the flow data resulted in a linear relationship between CBF (% change) and arterial PCO2 in the range 20-70 mm Hg, with a slope (% reactivity) of 3.2% mm Hg-1 (2 P less than 0.001). The oxygen extraction ratio (OER) fell with increasing values of arterial PCO2 resulting in a stable CMRO2 throughout each study. There was no correlation between CMRO2 and artificially increased CBF. These results support and give confidence in the use of the 15O inhalation technique for measuring CBF, OER and CMRO2.

CMRO2 and CBF by the oxygen-15 inhalation technique. Results in normal volunteers and cerebrovascular patients

The oxygen-15 inhalation technique has been applied to the quantitation of regional CBF, CMRO2 and OER with positron emission tomography. The introduction of corrections for gamma-ray attenuation, and for recirculation, has allowed us to obtain values for CBF, CMRO2 and OER in close agreement with values obtained using other techniques. In 27 normal volunteers mean CMRO2 shows values ranging from 4.98 to 3.79 ml/100/min, depending on the region evaluated. Mean CBF values range from 55.3 to 38.8 ml/100ml/min. Mean OER is more constant, ranging from 0.56 to 0.49, with a mean of 0.53 +/- 0.04, thus reflecting the close matching between metabolism and blood supply. We have further identified corrections for cerebral blood volume, which is measurable, and for water partition coefficient, which remains uncertain. In preliminary studies these corrections decrease the OER over the physiological range of flow by 10%, with a 15% lower CMRO2. The reproducibility of the results and the effects of aging have been studied. A series of 27 studies on acute ischaemic CVD are reported. The course of the clinical condition has been correlated with the quantitation of oxygen utilization and blood flow performed at different intervals from the onset of symptoms.

Bacteremia in a small non-urban community hospital

Forty-six episodes of bacteremia were observed during a three-year period at a small, non-urban community hospital. The incidence of bacteremia was 4.3 episodes per 1,000 admissions; this rate is similar to the incidence of bacteremia in large, urban community hospitals but lower than the incidence of bacteremia in municipal or academic hospitals. Eleven percent of bacteremias were hospital acquired, an incidence of 0.5 hospital acquired bacteremias per 1,000 admissions. The low incidence of hospital acquired bacteremia was a reflection of the low incidence of nosocomial, aerobic, gram-negative bacteremia (0.1 per 1,000 admissions). Thirteen percent of bacteremic patients died. The mortality in patients with community acquired bacteremia (10%) was lower than that reported from larger, urban hospitals; the mortality in patients with hospital acquired bacteremia (40%) was similar to that reported from larger, urban hospitals. The lower rates of bacteremia and associated mortality that were observed appear to be due to the lesser severity of underlying diseases in these patients.

Regional cerebral oxygen utilization and blood flow in normal man using oxygen-15 and positron emission tomography

Quantitative determination of regional cerebral blood flow (rCBF), regional cerebral oxygen utilization (rCMRO2) and regional oxygen extraction ratio (rOER) was performed in 11 normal volunteers by an oxygen 15 inhalation method and positron emission tomography. Regional values comparable with figures from the literature have been obtained. This non-invasive approach offers the possibility of a simultaneous quantitative evaluation of these physiological parameters in health and disease.

Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure, and normal values

A method is described for quantifying regional cerebral blood flow (rCBF), oxygen extraction (rOER), and oxygen utilization (rCMRO2) in man non-invasively, using inhaled 15O-labeled CO2 and O2 and positron emission tomography. The theoretical considerations and practical aspects are described. The results of rCBF, rCMRO2, and rOER for gray and white matter in normal volunteers are presented. The significance and limitations of the results are discussed. The method appears suitable for the study of human cerebral aerobic metabolism and blood flow under differing physiological conditions and in a wide variety of neurological disorders.

Blood versus bone marrow ethanol concentrations in rabbits and humans

Post-mortem ethanol levels in bone marrow and heart blood were determined in rabbits and humans. The average ratio of blood/femur marrow ethanol in 39 rabbits was 2.10 +/- 0.23 with a range of 1.27 - 3.50. In 18 human autopsy cases the average ratio of blood/rib marrow ethanol levels was 2.16 +/- 0.32 with a range of 1.65 - 2.94. The average blood/marrow ratios in humans and rabbits were comparable. However, a wider range of ratios was noticed in the rabbit study.

Stented xenograft valve insertion

A simple holder and the associated technique for temporarily converting the stented xenograft type of valve into a Starr-Edwards configuration are described. With this technique, the struts are not caught by the sutures during insertion.

A study of coordination of services: referrals

This article reports a study of referrals among social service and mental health agencies. Staff from human service agencies were interviewed about the process of referring and asked to make simulated referrals using mock clients constructed for this study. Interview data show lack of communication and inappropriate referrals as the biggest problems with the referral system. Interjudge agreement about the simulated referral choices was found to be not significantly different from chance. The data also suggest that agency staff refer on the basis of "habits" as much or more than on the basis of client problems. The frequency of inappropriate simulated referrals was relatively high (15%) considering that agencies included in the sample are large public agencies with broad definitions of what clients are appropriate for their services. Implications of these findings are discussed in terms of existing incentives for agencies to cooperate or compete and need for methodology to evaluate service delivery systems or networks.

The neuropsychiatric disorder in systemic lupus erythematosus: evidence for both vascular and immune mechanisms

As part of a prospective survey of systemic lupus erythematosus (SLE) a detailed collaborative study of the clinical, psychiatric, and laboratory features in 15 patients with nonfocal neuropsychiatric disease has been undertaken. In addition to conventional clinical and psychometric evaluation, electroencephalograph, and cerebrospinal fluid analysis, the study included the assessment of cerebral blood flow with oxygen-15 brain scans and serological testing for the presence of antineuronal and lymphocytotoxic antibodies. Of the 15 patients 12 had psychiatric manifestations, while 13 had various neurological abnormalities. All except 2 episodes of cerebral disease were transient. Striking abnormalities in cerebral blood flow and metabolism were seen in 12 patients, even in the presence of subtle clinical features. Sequential scans showed that improvement in clinical features was accompanied by a reversal of scan abnormalities. All sera contained brain-reactive antibody, either antineuronal IgG antibody (13) or lymphocytotoxic IgM antibody (12) or both (10), though there was an inconsistent association between clinical features and antibody titre. It is suggested that transient disturbances of cerebral vascular function in SLE might allow brain-reactive antibodies from the circulation access to cerebral tissue. In this way the nature of the neuropsychiatric abnormalities would depend on both vascular and immunopathogenic mechanisms.

The use of radioactive oxygen to study muscle function in peripheral vascular disease

We have use 15O to study the relationship between blood flow and oxygen utilization in the limbs of patients with peripheral vascular diseases. This technique is noninvasive and provides a useful method of studying the function of ischemic limbs.

Regional impairment of cerebral oxidative metabolism in Parkinson's disease

Twenty-two patients affected by idiopathic Parkinsonism were studied using the oxygen-15 inhalation technique. The production of labelled metabolic water was found to be decreased in the parietal cerebral cortex, indicating an impairment in oxidative metabolism. This metabolic defect was localised mainly to the parietal cortex of the affected hemispheres; in non-affected hemispheres of patients presenting with unilateral Parkinsonism, the uptake was normal. In contrast, regional blood flow was not significantly altered. It is possible that this metabolic impairment is caused by chronic deafferentation.

The Discriminative Validity of the Whitaker Index of Schizophrenic Thinking

An attempt was made to assess the discriminative validity of the WIST with a sample of psychiatric inpatients. Through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis with nonpathognomic symptom combinations, a reliable and valid system was used to establish the criterion diagnosis. Approximately 63% of patients reliably diagnosed as schizophrenic were detected via the WIST while only 14% of nonschizophrenic patients scored in the schizophrenic range on the WIST. The assets and liabilities of using the WIST to diagnose schizophrenia are discussed.

Mechanism and kinetics of iron release from ferritin by dihydroflavins and dihydroflavin analogues

Dihydroflavins reductively release iron rapidly and quantitatively from purified horse spleen or horse heart ferritin. The NAD(P)H:flavin oxidoreductase from Beneckea harveyi is used to generate a constant concentration of dihydroflavin permitting a continuous assay for complete iron release. Sepharose-linked dihydroflavins are not competent to release ferritin iron, demonstrating that the dihydroflavin must pass through the channels of the protein shell prior to iron reduction. Several experiments fail to show any specific flavin binding site, though dihydroflavins do display saturation kinetics with very high apparent Km's. The rates of iron release by a number of dihydroflavin analogues show that the electron transfer is significantly rate determining in iron release by dihydroriboflavin, while diffusion of the dihydroflavin through the protein channel is slow in the release of iron by dihydroFMN. The rate of iron release is also dependent on the initial content of iron, having a maximum at 1200 iron atoms per ferritin.

MMPI criteria for diagnosing schizophrenia

An attempt was made to find a combination of MMPI scale relationships which were highly discriminating of schizophrenia. Through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis with nonpathognomonic symptom combinations, a reliable and valid system was used to establish the criterion diagnosis. Approximately 72% of patients reliably diagnosed as schizophrenics were detected on the MMPI via a set of standard criteria (T score on Sc greater than or equal to 80 less than or equal to 100; total raw score on Sc consisted of no more than 35% K items; T score on F greater than or equal to 75 less than or equal to 95; T score on Pt less than or equal to Sc). Only 5.5% of nonschizophrenics obtained all these standard criteria on the MMPI. The assets and liabilities of these MMPI criteria to diagnose schizophrenia are discussed.

Radioactive oxygen 15O studies in cerebral neoplasms

Methods of diagnosis and anatomical localization of cerebral neoplasms have reached a high level of efficiency. A new method of studying cerebral circulation and metabolism by a simple noninvasive technique of steady-state imaging during the inhalation of radioactive oxygen and radioactive oxygen-labelled CO2 is described. The results of preliminary studies of a group of cerebral neoplasms of various histological types are presented and the implications discussed.

Oxygen-15 brain scanning for detection of cerebral involvement in systemic lupus erythematosus

In 47 patients with systemic lupus erythematosus seen during fifty-one clinical episodes, oxygen-15, a short-lived gamma-emitting isotope, has been employed in a scannng technique to study cerebral oxygen utilisation and blood-flow. Abnormalities in regional distribution of oxygen utilisation and blood-flow were seen in twenty-three out of twenty-four instances of definite central-nervous-system disease, in fourteen out of fifteen instances of suspected C.N.S. lupus, and in ten out of twelve instances in which C.N.S. disease was not clinically apparent. The technique reflected remissions and relapses. It may prove valuable in diagnosis of subclinical cerebral disease, in monitoring of responses to therapy, and in study of the pathophysiology of cerebral lupus.