[Rate of ethanol elimination in alcoholics with special reference to variants of maximal values for legal calculation of blood alcohol concentration]. / Die Athanol-Eliminationsgeschwindigkeit bei Alkoholikern unter besonderer Berücksichtigung der Maximalwertvariante der forensischen BAK-Rückrechnung.

The ethanol elimination rate was measured in 15 male alcoholics who had come to the Psychiatric Clinic of the University of Tübingen as in-patients. Over the course of several hours between 3 and 5 blood samples were taken in the post-absorption phase. The hourly elimination rate, calculated by lines of regression, gave a mean value of 0.224 g/kg (s = 0.038 g/kg). This was significantly higher than the elimination rate for non-alcoholics calculated from drinking experiments found in the literature (p less than 0.001). In addition 2 blood samples were taken several hours apart from each of 39 alcoholics. Based on the results of the analysis of the second blood sample, the value of the first blood sample was calculated back using the maximum value formula employed in foro. The calculated maximum values were compared to the analysis values. In 8 cases the analysis value was higher than the calculated maximum value, exceeding it by as much as 0.74 g/kg. It should be considered whether the formula currently employed to calculate the maximum BAC is sufficiently accurate in alcoholic to exclude possible false detrimental values.

[Case report. Treatment of the gillworm disease (Dactylogyrosis) of some South American cichlids and catfish]. / Beobachtungen zur Behandlung des Kiemenwurmbefalls (Dactylogyrose) bei einigen südamerikanischen Buntbarschen und Welsen.

The infection with gillworms (Dactylogyrus sp.) causes severe problems in the keeping and breeding of tropical ornamental fishes, e.g. Discus (Symphisodon aequifasciata). Treatment of gillworm disease with different drugs has been shown in the past to be insufficient. Therefore, the effectiveness of a long-term use of praziquantel was evaluated in ornamental fish. Cumulative doses up to 10 mg praziquantel/l water were tolerated without side-effects by Angel Fish (Pterophyllum scalare), Discus, and a variety of catfish species (Ancistrus sp., Corydoras sp.). It was found appropriate to start with a dosage of 2.5 mg/l and to add the same dosage every other day several times. All adult parasites and larvae were killed by this treatment. For the complete elimination of the Dactylogyridae-population in a closed aquarium system, 3 therapy-cycles (duration: 5-6 d, accumulated dosage: 2.5 mg/l/d) prooved to be effective. It was important to interrupt the therapy-cycles with intervals without medication (1 to 4 weeks).

[Chronobiologic aspects of autogenic training. Thermometric findings of autogenic training in relation to diurnal periodicity in autonomic dystonia patients]. / Chronobiologische Aspekte beim Autogenen Training. Thermometrische Befunde beim autogenen Training in Abhängigkeit von der Tagesperiodik bei vegetativ dystonen Patienten.

In a cohort of patients suffering from neuro-dystonia a group of test subjects well acquainted with the techniques of autogenous training and another consisting of patients unfamiliar with these techniques were compared with regard to the rise in the skin temperature in their fingers at various times of the day. Furthermore, the connection between the personal perception of warmth of the test subjects during autogenous training and the actually measured increase the temperature was observed: 1. In the test group as well as among the controls two different patterns of reaction with regard to diurnal fluctuations of the skin temperature occurred which were interpreted as so-called "morning types" and "evening types" respectively. 2. The increase in temperature induced by autogenous training in the test group was always higher than the one in the group of controls. 3. Subject to the circadian reaction pattern of the skin temperature there were fluctuations related to the actual time of day with regard to the increases in temperature induced by autogenous training. 4. There was merely a "slight" correlation between the personal experience or warmth and the measured temperature increase, and the intensity of the temperature experience seems to be influenced more by the relative initial value of the skin temperature than by the objectifyable temperature increase. These results are discussed with regard to practical consequences for the acquisition of autogenous training and its therapeutic application with neuro-dystonic patients.

[Autogenic training in geriatric psychiatry patients]. / Autogenes Training bei gerontopsychiatrischen Patienten.

Autogenic training (a.t.) as an additional therapeutic method was applied to 20 psychogeriatric inpatients in daily exercises. The patients were suffering from major depression, dementia, psychoneurotic disorders and Parkinson's disease. By using only the basic exercises, supported by some learning helps, 14 out of the 20 patients were able to learn and practice a.t. with quite good success, especially in the treatment of sleep disorders and restless states. Involving the nursal staff proved to be of great importance. Finally special aspects of the application of a.t. in psychogeriatric inpatients are discussed.

[Dependency outcome of alcohol-dependent patients after inpatient detoxification and motivation treatment]. / Zum Krankheitsverlauf Alkoholabhängiger nach einer stationären Entgiftungs- und Motivationsbehandlung.

In addition to psychiatric outpatient treatment, the detoxification of alcoholics in psychiatric hospitals is an important link between medical detoxification and psychosocial inpatient treatment aiming at abstinence. Integrated models of inpatient detoxification and motivation therapy focus on improvement of the motivation of patients towards further treatment of their alcoholism and towards abstinence. In our study 529 alcoholics underwent such treatment lasting between 2 to 3 weeks. A total of 469 patients (89%) were followed up after 8 months; 242 alcoholics (52% of the follow-up sample; 46% of the whole sample) achieved the treatment goal and started further treatment, mainly as inpatients. Fifty-four of these patients relapsed before they started further alcoholism treatment, but achieved abstinence afterwards; 60 (25%) of these 242 patients relapsed after the specific alcoholism therapy; 227 alcoholics did not start further treatment after the initial detoxification and motivation therapy. In this subpopulation, 113 (50%) relapsed during the follow-up period. Although this is not a controlled study, it can be concluded that integrated inpatient detoxification and motivation therapy has positive effects on the treatment behavior of alcoholic patients and enhances the probability of further abstinence.

[Use of supportive autogenic training in multiple morbidity in geriatric psychiatry patients]. / Der Einsatz von supportivem autogenem Training bei multimorbiden, gerontopsychiatrischen Patienten.

23 multimorbid, geronto-psychiatric patients, aged 60 years or older, participated in a "supportive" course of autogenic training according to Schultz. Participating in the course an average of 7 +/- 3 weeks, 17 (76%) of the subjects were able to learn the training. In general, subjects reported a better general condition after the training sessions, measured with visual analogue scales (p < 0.001). The psychopathological status improved significantly during the time of the course (BPRS: p < 0.001; GDS: p < 0.001). No significant change was found in the cognitive state (MMSE) and the statements on the "list of complaints" ("Beschwerdenliste"). The global training success was better in the psychopathological less affected than in the more severely ill (BPRS prior r = 0.64, p = 0.001, GDS prior r = 0.46, p < 0.05). No correlation was found between training success and age, number of somatic diseases, number of medication, MMSE and the "Beschwerdenliste". Autogenic training is a useful component in psychotherapeutic and psychiatric therapy for elderly multimorbid in- and outpatients. A half-open group, two therapy sessions per week, reciting the training formulae aloud, a structured, simple setting and co-therapists proved to be worthwhile.

[Recent viewpoints in the theory and practice of autogenic training]. / Neuere Gesichtspunkte in Theorie und Praxis des autogenen Trainings.

The authors give a brief review over papers presented on the "International Symposion on Autogenic Training" in Berlin, March 1988. A study based on empirical data from 48 managers was presented, showing how Autogenic Training (AT) could reduce cardiovascular riskfactors, e.g. cardiac-functions and levels of bloodcholesterol and -triglycerids (Carruthers). Of high actual importance was a report about grouptherapy with AIDS-patients, in which AT played a big role. The quality of life of the patients was improved considerably (Kermani). A multidimensional therapeutic approach combining psychopharmaca, AT and psychoanalytic grouptherapy was presented (Barolin). In the field of psychophysiology there was a report about a thermometric study carried out with a group of psychovegetative impaired patients demonstrating the "vasodilatatory potence" of the AT (Stetter). Müller-Hegemann reported about misunderstandings in teaching AT and made some remarks in the changing of tension and relaxation in human life being influenced by practicing AT and physical training.

[Results of integrated inpatient detoxification and motivation treatment of alcohol dependent patients]. / Ergebnisse integrierter stationärer Entzugs- und Motivationsbehandlung alkoholabhängiger Patienten.

During the course of the disease many alcoholic patients are detoxified on an inpatient basis. Detoxification lasts for some days to 2 or 3 weeks. The treatment goal of abstinence usually cannot be achieved by detoxification alone. Therefore a qualified detoxification should consist of a medical treatment, a careful (psychiatric) diagnostic process and a psychotherapeutic treatment aiming at motivation for further treatment. The described program integrates these components. The psychotherapeutic approach is emphatic and directive, trying to convince all patients to apply for further alcoholism treatment. Follow-up data of 120 of the initial 130 patients eight months after detoxification showed, that 68 patients (57%) started further treatment, most of them as inpatients. In the group of prognostic unfavourable patients, who had not received any disease related counseling before detoxification (77% of the sample), 47% started further alcoholism treatment.

Rapid recovery from cognitive deficits in abstinent alcoholics: a controlled test-retest study.

The pattern of cognitive deficits and their time-dependent recovery were investigated in a cohort of 49 male alcohol-dependent patients using a repeated measurement design with 49 healthy male controls matched for age, education, and marital status. We combined parts of the Halstead Reitan Battery and the Wechsler Memory Scale with tests that are widely used in German-speaking countries. Patients were tested in the first week (T1) and 5 weeks later (T2) at the end of the in-patient treatment programme. Matched controls were tested also at T1 and T2, which enabled us to take learning effects into account. At T1, the patients showed distinct cognitive deficits on 5 of 12 neuropsychological parameters (perceptual-motor speed, verbal short-term memory, verbal knowledge, non-verbal reasoning, spatial imagination). At T2, significant improvements had occurred in four of the five dysfunctional domains with a significant difference remaining in verbal short-term memory. Duration of dependency and length of abstinence prior to testing had no essential effects on neuropsychological functions. Our results provide evidence for the well-established fact that chronic alcoholism has detrimental effects on cognitive performance, but that performance improves with neuropsychological recovery which occurs rapidly within weeks when abstinence is maintained. Cognitive deficits seem to be similar across different studies and cultures.

Autogenes Training - Qualitative Meta-Analyse kontrollierter klinischer Studien und Beziehungen zur Naturheilkunde.

Autogenic Training - Qualitative Meta-Analysis of Controlled Clinical Studies and Relation to NaturopathyAutogenic training is a relaxation technique based on autosuggestions and practice in the perception of 'natural' relaxating processes of the body with an increasing calm basic attitude. The psycho-physiological changes that occur after periodical exercises can be explained by a plausible model which has been empirically proved in many of its aspects. With regard to methodological aspects the present study deals with the qualitative meta-analysis of 64 controlled clinical studies from 1952 to 1997. The clinical effect of autogenic training on the main symptoms as exclusive or at least central psychotherapeutic intervention (partly in combination with a somatic basic therapy) was evaluated. It was proved that autogenic training has positive effects on psychosomatic disorders (hypertension, asthma, intestinal diseases, 'vegetative dystonia', glaucoma, atopic eczema), on preparation for childbirth, sleep disorders and anxiety disorders. A positive effect can also be expected in case of headaches and Raynaud's disease, however, other relaxation techniques seem to be superior in these cases. Moreover, positive effects on the mood (e. g. depressive symptoms) and the general subjective condition (e. g. 'quality of life') have been proved by many studies. Hence indications can be derived according to the basic rules of evidence-based medicine. Nevertheless there are contraindications, for instance regarding exogenous, acute schizophrenic or affective psychosis. Beyond that the preparedness to therapy of many patients can be improved if the therapeutic offers are enlarged by autogenic training as a 'low level' offer. Autogenic training is an effective and useful component of preventive, rehabilitative or therapeutic interventions and can last but not least be part of therapeutic interventions which include naturopathy.

Urinary dolichol--a doubtful marker of alcoholism.

The purpose of this study was to replicate the results of Pullarkat and Raguthu and Roine et al. who found elevated levels of urinary dolichol (long-chain 2,3-dihydropolyprenols) in chronic alcoholic patients. We investigated a sample of 21 alcohol-dependent inpatients voluntarily entering detoxification treatment. Urinary dolichol was only slightly increased as compared to 21 healthy controls. When dolichol was related to urinary creatinine no differences between alcoholic patients and controls could be found. Under conditions of confirmed abstinence the slightly elevated levels of dolichol returned to normal within 2 weeks. Compared with the sensitivity of gamma-glutamyltransferase which ranges from 72-85%, the value of urinary dolichol (sensitivity 9-19%) as a biochemical marker of alcoholism must be doubted.

New materials for optical thin films.

New materials for optical thin films are presented. Zirconium oxide, titanium oxide, cerie oxide, and hafnium oxide in the form of black tablets or cones of various sizes for the electron beam evaporation technique were developed. These materials are oxygen depleted and give an uniform melt during the evaporation to give reproducible evaporation characteristics. A new mixture consisting of ZrO(2) and ZrTiO(4) for the production of high index layers is described. The evaporation conditions of the substance and the properties of thin layers of the mixture are given. The refractive index is 2.15 at 500 nm. The transmittance range is 0.4-7 microm. The layers are optically homogeneous. The application of layers of this mixture in a three-layer antireflection coating is described.

[Ambulatory short-term therapy of anxiety patients with autogenic training and hypnosis. Results of treatment and 3 months follow-up]. / Ambulante Kurztherapie von Angstpatienten mit autogenem Training und Hypnose. Behandlungsergebnisse und 3-Monats-Katamnese.

The aim of the study was to examine the effects of a short-term outpatient treatment (6 sessions à 90 minutes) with autogenic training (Schultz 1932) or hypnosis (Erickson and Rossi 1979), concerning patients with anxiety- and panic disorders (according to DSM-III-R and ICD-10-criteria). 27 Outpatients were recruited by newspaper articles. Most of them had not been treated before. Both short-term treatments consisted of 6 weekly group sessions (4-6 patients). Psychological examinations were carried out before and after treatment and at a follow-up after 3 months. Trait anxiety (STAI-X2) and psychosomatic complaints (BfS/BL') decreased in both groups significantly after treatment. This therapeutic effect was stable during the following 3 months. The frequency of panic attacks decreased as well under treatment, and this effect was even more marked during the 3 month following treatment. The therapeutic success was influenced by the frequency of autosuggestive exercises carried out by the patients at home. This form of short-term treatment is not sufficient for all patients with anxiety disorders but the results of that study encourage to use short-term interventions with autogenic training and hypnosis as initial therapeutic approaches for such patients and to combine them with other therapeutic interventions.

Distraction resulting from disease related words in alcohol-dependent inpatients: a controlled dichotic listening study.

To test whether alcoholics develop an information processing bias towards disease-related stimuli, 30 alcoholic inpatients and 30 controls were administered a dichotic listening task. Three different stimulus types were presented to the right (ignored) channel: neutral words, rare neutral words and alcohol-related words. The hypothesized information processing bias should cause patients to make disproportionally more shadowing errors in the third condition. An ANOVA revealed a significant condition effect (P < 0.001), a tendency towards a group effect (P = 0.09) and a significant interaction (P < 0.01) in the expected direction. There was a marked increase of errors in alcoholics when disease-related stimuli were presented compared to the neutral conditions and to the controls.

Effects of disease-related cues in alcoholic inpatients: results of a controlled "Alcohol Stroop" study.

We tested the hypothesis that alcoholics develop a disease-related attentional bias. Therefore, alcohol-related, but task-irrelevant, words should cause a specific perceptual-processing bias. We investigated this by using a special color-naming task. We subjected 40 male alcohol-dependent inpatients and 40 healthy male controls (matched according to age and verbal IQ) to a modified card version of the Stroop color-naming task that consisted of a neutral and an alcohol word condition ("Alcohol Stroop"). Alcoholic inpatients performed significantly poorer than the control group under the critical experimental condition (color-naming of disease-related words), as compared with the noncritical condition (color-naming of neutral words; p = 0.03). Concerning the possible neuropsychological impairment of the patients, no effects could be found on the reaction time of the "Standard Stroop" using only neutral words (i.e., color-naming of incongruent color words administered without time limitation). The information processing bias on the "Alcohol Stroop" thus qualifies as a cognitive process, which is independent from putative neuropsychological deficits of alcoholic patients and might represent an essential feature of alcoholic psychopathology. The "Alcohol Stroop" contributes to the experimental psychopathology of alcoholism.

Self-regulation of slow cortical potentials in psychiatric patients: alcohol dependency.

Ten unmediated alcohol-dependent male inpatients participated in a Slow Cortical Potential (SCP) self-regulation task utilizing biofeedback and instrumental conditioning. These patients were hospitalized for treatment of alcohol dependency after chronic abuse of alcoholic beverages. Somatic withdrawal symptomatology had occurred recently and the patients were free of any withdrawal symptoms of the autonomic nervous system. Immediately after hospitalization patients were unable to control their SCPs without the reinforcement of immediate feedback across 4 sessions. Seven patients participated in a fifth session an average of 4 months later. Six out of these 7 patients had not had a relapse at the follow-up. In the fifth session these patients were immediately able to differentiate between the required negativity and negativity suppression, whereas the seventh patient, who had relapsed, was unable to control his brain potentials successfully. Results are further evidence that some of the frontocortical dysfunctions in alcohol-dependent patients are reversible. This could covary with a morphological restitution of the cortex.

[Thiamine deficiency and brain atrophy in alcoholic patients]. / Thiaminmangel und Hirnatrophie bei Alkoholabhängigen.

CT brain scans of 65 alcohol-dependent inpatients were compared before and after 6 weeks of confirmed abstinence. Linear measurements revealed a significant reduction of the enlargement of the ventricular system in accordance with the re-expansion of the brain after alcohol abstinence (ANOVA, significant time effects). 22 patients showed a moderate or severe thiamine deficiency. CT findings on thiamine-deficient patients did not differ from those on patients without thiamine deficiency (ANOVA, no significant group effects). Correlations between thiamine deficiency and subcortical atrophy before treatment were not significant. The results are discussed in relation to the pathogenesis of reversible brain shrinkage in chronic alcoholics.