Regional cerebral blood flow during alcohol withdrawal.

Serial bilateral measurements of regional cerebral blood flow (rCBF) by the xenon Xe 133 inhalation method were made during 13 withdrawal periods in 12 male alcoholics with pronounced physical dependence. A significant global reduction of rCBF was found during the first two days of withdrawal. The largest decreases were seen in cases with clouded sensorium and with an extended preceding drinking period. An rCBF distribution with relatively high temporal and low parietal flows during the first two days was coupled to aggravated symptoms. In two men who reported auditory and visual hallucinations during the measurements, elevated rCBF values were found in the temporal, Sylvian, and occipital regions.

Effective pharmacotherapy of alcoholic amnestic disorder with fluvoxamine. Preliminary findings.

Ten patients with alcoholic chronic organic brain disease were categorized as having alcohol amnestic disorder, or Korsakoff's psychosis (n = 6), dementia associated with alcoholism (n = 3), or compensated alcoholic liver disease (n = 1). All patients had severe deficits in memory for recently acquired information (episodic memory). Patients with alcohol dementia also showed global intellectual decline, including decreased performance on measures of semantic (knowledge) memory and reduction in levels of cerebrospinal fluid somatostatin. In a 4-week double-blind crossover design, the serotonin-uptake blocker fluvoxamine maleate (100 to 200 mg/d) was found to improve episodic memory in only the patients with alcohol amnestic disorder. These improvements in memory were significantly correlated with reductions in levels of cerebrospinal fluid 5-hydroxyindoleacetic acid, suggesting that facilitation of serotonergic neurotransmission may ameliorate the episodic memory failure in patients with alcohol amnestic disorder.

The significance of the serum levels of vitamin B-1 and magnesium in delirium tremens and alcoholism.

The relation between serum levels of vitamin B-1 and magnesium at admission, and the clinical state was studied in hospitalized patients with either alcoholism or delirium tremens. Vitamin B-1 was deficient in the delirium group, magnesium in both groups. There was no correlation between vitamin B-1 and magnesium levels. Patients with an unfavorable outcome at discharge had lower vitamine B-1 levels and a higher age than patients with a favorable outcome in either group. The magnesium deficiency is discussed for longstanding malnutrition in both groups, the vitamin B-1 deficiency for an unusual high intake of alcohol before delirium tremens started.

[The pattern of phospholipids during the course of delirium tremens (author's transl)]. / Das Verhalten der Phospholipide während des Delirium tremens

Plasma phospholipids were examined in patients with delirium tremens in the acute phase of the disease and after recovery. The levels of lysolecithin, phosphatidylinositol, phosphatidylethanolamine, sphingomyelin and the total of phospholipids were decreased in comparison to normals. Phosphatidylethanolamine, phosphatidylinositol and the total phospholipids were diminished in comparison to patients with liver cirrhoses. Only in the plasma of patients with liver cirrhoses with bad prognosis (hepatic coma) similar low levels of total phospholipids were found. It is concluded from these results, that the synthesis of phospholipids is reduced during delirium tremens.

Decrease in alcohol tolerance: clinical significance in alcohol dependence.

In 237 male inpatients with alcohol dependence, clinical, demographic and biochemical data were analyzed in relation to alcohol tolerance. All subjects had a history of marked tolerance. At the time of assessment, 46% of subjects continued to meet the criteria for marked tolerance and 54% of the subjects reported a loss or decreased tolerance. Subjects with decreased tolerance were older than those with high tolerance and had a longer duration of illness. The age of onset was similar in both groups. Patients with decreased tolerance had more mental confusion and psychotic symptoms, and were less likely to be currently married.

Spiperone binding capacity in lymphocytes of patients with alcohol- and drug-induced psychosis: preliminary results.

An increased spiperone binding capacity in lymphocytes has been proposed as a possible biological marker for schizophrenia while in previous studies patients with alcohol dependence were shown to have a normal binding capacity. In a pilot study the spiperone binding capacity was studied in 8 patients with alcohol hallucinosis, 11 patients with acute drug-induced psychosis and 12 patients with other organic psychosis. An increased binding capacity, defined as > 4 fmol/l E6 cells, was found in only 1 patient with alcohol hallucinosis, 3 patients with drug-induced psychosis and 2 patients with other organic psychosis. Possible implications of these findings for future research are discussed.

[Radioimmunoassay for human plasma 8-arginine-vasopressin (author's transl)]. / Dosages plasmatiques radioimmunologiques de la 8-arginine vasopressine. Réponse à la stimulation par la nicotine

The authors have developed a radioimmunoassay for human plasma vasopressin (AVP) which permits the estimation of antidiuretic hormon (ADH) levels as low as 0,8 pg/ml. The average plasma level of AVP after overnight water restriction was found to be 14,3 pg/ml (sd = 4,4 pg/ml) in normal subjects. They provoked a hypersecretion of ADH by the intravenous injection of 1-2 mg of nicotine. In 11 volunteer normal subjects this stimulation by nicotine provoked ADH hypersecretion which reached a maximum between 2nd and 15th minutes after injection. In 3 cases of diabetes insipidus, nicotine injection did not induce ADH hypersecretion; in 1 case of potomania this response was weak; in 2 cases of syndrome of inappropriate ADH secretion, AVP plasma levels were elevated and the response after nicotine stimulation was exaggerated.

[Changes in the aggregative properties of the erythrocytes in chronic alcoholism]. / Dinamika izmenenii agregatsionnykh svoistv éritrotsitov krovi pri khronicheskom alkogolizme.

On the basis of examination of 50 alcoholics the authors have established that alcoholism is associated with impairments of the aggregational properties of blood erythrocytes expressed in a persistent and marked increase of aggregation and the appearance of enlarged massive aggregates. The severity of aggregation disturbances depends not only on the presence of the abstinence syndrome but is also closely related to the stage of alcoholism, becoming more gross in the progressive course with signs of encephalopathy, and directly correlates with severity of psychotic symptoms.

[Status of erythrocytes and erythropoiesis in alcoholics]. / Sostoianie krasnoi krovi i éritropoéza u bol'nykh alkogolizmom.

To identify changes in the status of red blood and erythropoiesis in alcoholism, the authors examined three groups of patients aged 18 to 60 years: (1) 146 patients with stage II alcoholism; (2) 97 patients with acute alcoholic hallucinosis; and (3) 76 patients with delirium tremens. The examination revealed a considerable tension of erythropoiesis and erythrodieresis, this being a compensatory response to prolonged and severe hypoxia. At the beginnings of the disease the amount of erythrocytes and total hemoglobin tended to increase, then with the development of psychoses it dramatically decreased resulting in anemia. With disease progression the mean volume of erythrocytes tended to increase consistently reaching the highest values in delirium. This may serve as one of the diagnostic markers of alcoholism to be used in combination with other laboratory tests and clinical findings. The identified decrease in the insulin depositing function of erythrocytes may also indicate that the pancreas has also been involved in the pathological process.

[ Indicators of thiamine content and energy homeostasis in alcoholic psychosis]. / Pokazateli obespechennosti tiaminom i 'energeticheskogo gomeostaza organizma pri alkogol'nyx psikhozakh.

In dynamics of acute alcoholic psychoses--delirium and hallucinosis-- considerable deficit of thiamine in the organisms of ill people that can not be compensated while desintoxicative treatment and signs of energy homeostasis changes and of deterioration of tissues reserves depending on the type of psychoses were determined. Pathogenic peculiarities of the revealed disorders were analysed, possible compensative mechanisms connected in particular with the rise of pyruvate utilization speed and activation of glyconeogenesis while leaving the psychotic state were considered.

[The thiamine index as an integral indicator of the body allowance of vitamin B1]. / Tiaminovyi indeks kak integral'nyi pokazatel' obespechennosti organizma vitaminom B1.

One of the most wide-spread methods of evaluation of thiamine content in the body is determination of the activity of the thiamine pyrophosphate-dependent enzyme--transketolase--and so-called TPP-effect (the quantitative measure of unsaturation of transketolase with coenzyme). Absence of distinct correlation between the parameters in a number of cases calls for a search for the integral coefficient less dependent on the original dynamics of the given markers. Thus, we propose to use the thiamine index calculated by means of division of transketolase activity index expressed in absolute units by TPP-effect index expressed in relative units. The examples of thiamine index calculation and peculiarities of its interpretation with consideration of dynamic state of chronic alcoholics in abstinence and of patients with acute alcohol psychoses are shown.