Experimental Demonstration of the Thin-Film Liquid-Metal Jet as a Charge Stripper.

For high-power heavy ion accelerators, the development of a suitable charge stripper, which can handle intense beams, is essential. This Letter describes the first experimental demonstration of a heavy ion liquid lithium charge stripper. A 10-20 µm thick liquid lithium jet flowing at >50 m/s was formed and confirmed stable when bombarded by various heavy ion beams, while increasing the charge state of the incoming beams to the desired charge state range. This demonstration proved the existing power limitation with the conventional strippers can be overcome by the liquid-metal stripper, opening completely new possibilities in high-power accelerator development.

First Simultaneous Acceleration of Multiple Charge States of Heavy Ion Beams in a Large-Scale Superconducting Linear Accelerator.

Experimental studies of the simultaneous acceleration of three-charge-state ^{129}Xe^{49+,50+,51+} beam from 17 to 180 MeV/nucleon in a superconducting linear accelerator are presented. The beam parameters for each individual- and multiple-charge-state beam were measured and compared with the particle tracking simulations. Detailed measurements were performed to characterize the multiple-charge-state beam's recombination after a second-order achromat and isopath 180° bending system. As a result of the recombination of three charge states in the six-dimensional phase space, the xenon beam intensity was increased by 2.5-fold compared to the single-charge-state beam. The results presented in the Letter fully validate the possibility to produce and utilize high-quality multiple-charge-state heavy-ion beams in a large-scale superconducting linac to increase the available beam power on an isotope production target.

Three-body nonmesonic weak decay of the (Lambda)12C hypernucleus.

We have measured the branching ratio of the three-body process in the nonmesonic weak decay of Lambda12C to be 0.29+/-0.13. This result was obtained by reproducing the nucleon and the nucleon pair yields introducing a measured final state interaction. At the same time, we have determined the absolute decay widths, Gamma(n) and Gamma(p), along with Gamma2N, whose relative ratio has been a long-standing puzzle. Including the three-body process, we have successfully reproduced the nucleon energy distribution, the coincidence two-nucleon angular correlation, and the momentum sum distribution simultaneously.

Fine positioning of a poloidal probe array.

Multipoint detection is an essential requirement for investigating plasma turbulence which is a highly nonlinear phenomenon in space and time. We have fabricated an array of 64-channel poloidal probes surrounding the linear cylindrical plasma named LMD-U in order to study turbulence properties, particularly the nonlinear mode couplings, in the domain of poloidal wave number and frequency. However, misalignments of probe tips produce spurious modes, which do not exist in the real plasma, to distort the precise wave number measurements. The paper presents the description of the 64-channel poloidal probe array with means to adjust the probe positions, with discussion on the effects of the misalignments on the wave number measurements.

Are patients with chronic pain depressed?

Of 100 consecutive patients treated in a program for management of chronic pain, 25 were definitely depressed, 39 were probably depressed, and 36 were not depressed. Comparisons between the definitely depressed and nondepressed groups showed them to have strikingly similar characteristics as well as treatment outcome. Nearly 90% of the definitely depressed patients showed resolution of their depression without use of antidepressant medication.

Toward a biochemical classification of depressive disorders, VII: urinary free cortisol and urinary MHPG in depressions.

The authors measured urinary free cortisol and urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in 24 severely depressed patients and 22 normal control subjects. Urinary free cortisol levels were significantly higher in the depressed patients than in the control subjects, but mean urinary MHPG levels were not significantly different in these two groups. A very high positive correlation between urinary MHPG levels and urinary free cortisol levels was found in the depressed patients but not in the control subjects.

MHPG as a predictor of antidepressant response to imipramine and maprotiline.

To explore the hypothesis that depressed patients with low pretreatment levels of urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) respond more favorably to antidepressant drugs which act on noradrenergic neuronal systems than do patients with high MHPG levels, the authors administered 150--200 mg/day of imipramine or maprotiline to 13 depressed patients. All of the 5 patients with low pretreatment MHPG levels responded to treatment compared with 1 of the 14 patients with high MHPG levels; 4 patients dropped out of the study.

Toward a biochemical classification of depressive disorders, V: Heterogeneity of unipolar depressions.

The authors found that the mean urinary level of 3-methoxy-4-hydroxyphenylglycol (MHPG) was significantly lower in 20 patients with bipolar manic-depressive or schizoaffective depressions than in either 50 patients with unipolar depressions or 26 age- and sex-matched control subjects. In contrast, the mean MHPG levels in the total group of patients with unipolar depressions and in any subgroup defined by Research Diagnostic Criteria (RDC) were not significantly different from control values. However, examination of the distribution of urinary MHPG levels in patients with unipolar depressions in relation to other recent findings by the authors' collaborative research group suggested the existence of at least three biochemical subtypes of unipolar depressions that may, in part, be differentiated on the basis of urinary MHPG levels.

Problems with the use of oxycodone compound in patients with chronic pain.

In a pain management program (200 patients), a group of daily users of oxycodone compound (29 patients) and a subgroup who were taking a "high dose" of oxycodone compound (13 patients) were compared with a group of 171 non-users of oxycodone compound. A significantly lower treatment success rate was observed in the users (P = 0.04) and high-dose users (P = 0.03). A similar trend was seen in preliminary data available in a larger sample (514 patients). Continued study of these findings is necessary. Meanwhile, in patients with chronic pain, there should be cautious use of this compound.

Status of patients with chronic pain 13 years after treatment in a pain management center.

This study describes the current vital, health, and employment status of 249 patients with chronic pain who were treated in a pain management center at the Mayo Clinic, on average, 13 years ago. These patients do not have an increased risk of mortality; their death rate is similar to that of the US white population. However, 68% of the patients reported worse-than-average or an abnormal level of bodily pain, with increased morbidity in their physical health, physical functioning, and social functioning. Emotional and mental health were claimed to be adequate. About half of the patients reported being gainfully employed.

Normal serum thyroxine values in patients with acute psychiatric illness.

The medical records of 278 consecutive patients with acute psychiatric illness admitted to a closed psychiatric unit after admission from the emergency room were reviewed. Serum thyroxine levels had been determined within 72 hours of admission in 106 patients (38 percent); in 74 of these patients (70 percent), the determination had been made within 24 hours. Ten patients (9 percent) were hypothyroxinemic, but further thyroid testing revealed that they were functionally euthyroid. Only one patient had hyperthyroxinemia, which was considered secondary to her postpartum state. The prevalence of hypothyroxinemia in the population studied is consistent with that in previous reports. However, the striking absence of hyperthyroxinemia in these patients is contrary to findings in several recent reports. Further prospective studies should clarify this issue.

Clinical significance of serum pulmonary surfactant proteins a and d for the early detection of radiation pneumonitis.

PURPOSE: Radiation pneumonitis (RP) is one of the most serious complications for patients who receive thoracic irradiation. To avoid this, early diagnosis of radiation pneumonitis is extremely important. The purpose of the present study is to investigate whether serum pulmonary surfactant proteins A and D (SP-A and SP-D, respectively) could be useful markers for RP. METHODS AND MATERIALS: Eighty-six patients (lung cancer: 42 [primary: 39, metastatic: 3], breast cancer: 23, esophageal cancer: 21) who underwent radiation therapy were prospectively studied. Radiation doses ranged from 30-76 Gy (median, 58 Gy). Serum SP-A and SP-D levels were evaluated sequentially by a sandwich enzyme-linked immunosorbent assay (ELISA) method before, during, and throughout the follow-up period until the development of symptomatic RP or until one year after completion of radiotherapy. Specificity of the ELISA results was confirmed by Western blot analysis. Patients symptomatic for RP were graded according to the Common Toxicity Criteria. RESULTS: RP occurred in 19 patients. Serum SP-D levels of patients with RP were sequentially higher than those in patients without RP. In the monitoring, serum SP-D levels at 50-60 Gy showed greater sensitivity and positive predictive values for RP detection (74% and 68%, respectively) than SP-A (26% and 21%, respectively). Western blot analysis showed that the development of RP was due to overproduction, but not proteolysis of surfactant proteins. CONCLUSION: We confirm that serum SP-A and SP-D monitoring is a practical and useful diagnostic method for the early detection of RP.

Therapeutic use of propranolol for intermittent explosive disorder.

Intermittent explosive disorder is a syndrome characterized by episodic sudden outbursts of verbal abuse and physical violence in response to minor provocations. Propranolol has been proposed as a promising treatment for this cause of violent behavior. Of eight Mayo Clinic patients with intermittent explosive disorder who had been treated with propranolol between 1983 and 1985, five had substantial diminution or complete remission of symptoms. This response confirms the previously published reports of the effectiveness of propranolol in the treatment of intermittent explosive disorder.

Patients complaining of extreme pain.

Some patients chronic pain say that their pain is both constant and extreme. A graphic rating scale was used to identify 35 patients in a pain management program who complained of extreme pain. They were compared with 31 subjects who rated their pain as low. The patients with extreme pain were older, were more often female, had a longer history of pain, were disabled longer, had had more surgical procedures and hospitalizations, were more dependent on drugs, had higher ratings of bodily and facial pain behavior, and responded less well to treatment than the patients in the low-pain group. A rating of extreme pain remained a rather fixed presentation. It did not correlate with orthopedic or neurologic diagnoses. Possible explanations of the complaint are discussed, and illustrative case material is presented.

Psychiatric consultation in the chronic pain patient.

A process and technique for psychiatric evaluation of chronic pain patients are discussed. It is the task of a psychiatrist to rule in or rule out a psychiatric component rather than to assume the existence of "psychogenic" pain when there is a negative medical and surgical examination. Accurate communications about any psychiatric components to the referring physician, without premature judgment on "cause" of pain, lead to themost accurate decisions about future treatment.

Clinical use of the dexamethasone suppression test for psychiatric disorders. Need for sensitive method for measuring corticosteroids and cautious interpretation of results.

The corticosteroid levels in 256 plasma samples from 112 patients with the clinical diagnosis of depression were assayed in two ways: by the routine method (sensitivity of 5 to 40 micrograms/dl) and by a newer, more sensitive method (sensitivity of 1 to 10 micrograms/dl). Of the 152 "true-negative" samples measured by the more sensitive method, 81 (53%) were reported as positive ("false-positive") by the routine method. The routine method does not yield accurate results on borderline levels of corticosteroids (5 to 7 micrograms/dl) for the dexamethasone suppression test for psychiatric disorders.

Series on pharmacology in practice: 1. Drugs that alter mood. I. Tricyclic agents and monoamine oxidase inhibitors.

In the last 20 years, the treatment of mood disorders has advanced immeasurably. We now have relatively safe and effective agents for the treatment of depression and mania. This review discusses two types of agents that elevate mood--tricyclic antidepressants and monoamine oxidase inhibitors--including the indications for their use and their modes of action, pharmacokinetics, side effects, and drug interactions.

Series on pharmacology in practice. 1. Drugs that alter mood. II. Lithium.

In the last two decades, there has been rapid progress in the pharmacologic treatment of affective disorders. In Part I of this review, drugs mainly used for depression (tricyclic antidepressants and monoamine oxidase inhibitors) were discussed. Here, lithium carbonate, the most effective drug for manic-depressive illness (bipolar depression) is the focus. Its indications, mode of action, pharmacokinetics, dosage, and side effects are discussed. A section on drug interactions with lithium deals with the combination effect of lithium used with antidepressant and other psychotropic agents.

Drug abuse and dependency in patients with chronic pain.

Of 144 patients with chronic pain of nonmalignant cause, 35 (24%) were drug-dependent, 59 (41%) drug abusers, and 50 (35%) nonabusers. Codeine and oxycodone (Percodan) were most frequently abused. In regard to characteristics tested, differences between the groups were not great; but there was a significant difference in outcome between nonabuse and dependent groups. Early detection and treatment of drug abuse should minimize some of the difficulties involved in management of treatment-resistive patients with chronic pain.