High-power, longitudinally fiber-pumped, passively Q-switched Nd:YAG oscillator-amplifier.

A longitudinally fiber-pumped, passively Q-switched Nd:YAG laser oscillator-power amplifier system is reported with which a maximum pulse energy of 68 mJ was achieved at high pulse stability, beam quality, and efficiency. Therefore, a compact fiber-coupling interface was developed for stacked arrays of quasi-cw diode lasers, providing a pump power of 1 kW at the fiber end.

Dopamine and alcohol relapse: D1 and D2 antagonists increase relapse rates in animal studies and in clinical trials.

A considerable number of animal studies on the effects of dopaminergic agents on alcohol intake behavior have been performed. Acute alcohol administration in rats induces dopamine release in the caudate nucleus and in the nucleus accumbens, an effect related among others to reinforcement. It has been repeatedly suggested that D1 and D2 receptor activation mediates reward. As alcohol consumption and dopaminergic transmission seem to have a close relationship, all kinds of dopaminergic agents may be regarded as putative therapeutics for preventing relapse. In a prospective European double-blind multicenter clinical trial, comparing the D1, D2, D3 antagonist flupenthixol and placebo in 281 chronic alcohol-dependent patients (27.4% women), the application of the Lesch typology made an outcome differentiation possible. It could be shown in which patients flupenthixol administration was followed by a significantly higher relapse rate and in which patient groups no differences were found when compared to placebo.

German mental health legislation and alcoholism treatment: results of a retrospective long-term study in a Berlin state mental health hospital.

In 1985 German mental health legislation underwent a transformation. In accordance with an international trend, the State of Berlin, a pacesetter in this field, introduced a Law for Mentally Diseased Patients (Gesetz für psychisch Kranke). In contrast to the former Law for the Committal of the Mentally Ill and Substance Abusers (Gesetz über die Unterbringung von Geisteskranken und Süchtigen) healing and recovery are the main aims which the legislation focuses on with the intention of avoiding committal by excluding patients with mild disorders from involuntary admission. The Karl-Bonhoeffer-Mental-Health Hospital's Department for Dependency Disorders conducted a study on 3014 alcohol-dependent patients who were discharged between 1984-1990. The focus of the study was to determine predictors for involuntarily committal; patients were explored in respect to age, sex, length of stay, psychiatric disorders, their living situation and how they had been admitted. Moreover, attempts were made to discover whether the 1985 law had changed the patient profile or the frequency or length of treatment in comparison to the previously valid law.

The phenomenology of perceptual hallucinations in alcohol-induced delirium tremens.

In a qualified detoxication, states of anxiety caused by hallucinations can be specifically assimilated and psychologically reduced. Knowledge of the hallucinations experienced promotes the subsequent motivation phase. A semistandardized investigation of 64 patients with alcohol-induced delirium tremens was carried out over a period of 14 months in order to establish the nature of their perceptual hallucinations. Visual hallucinations predominated followed by auditory and tactile perceptual hallucinations. Amongst visual hallucinations pertaining to animals, the well-known 'white mice' were only reported once. Hallucinated cats, dogs, and snakes were most frequent, and were only then followed by mice (in general).

Hypothalamic-pituitary-thyroid (HPT) axis in chronic alcoholism. I. HPT axis in chronic alcoholics during withdrawal and after 3 weeks of abstinence.

Thyroxine (T4), free T4 (fT4), triiodothyronine (T3), free T3 (fT3), reverse T3 (rT3), thyrotropin (TSH), thyroxine binding globulin (TBG), and T3 uptake were measured in 14 chronic alcoholics during withdrawal and after 21 days of abstinence. Results were compared with those of 16 healthy volunteers. During withdrawal, the fT4 and fT3 concentrations were subnormal, whereas the respective protein-bound fractions were normal. T4, T3, and TBG increased during the abstinence period, T3 and TBG being significantly higher than in normals at the second measuring time. T3 uptake values fell, but remained well within the normal range at both measuring times. During abstinence, the fT3 levels remained significantly lower than in healthy subjects. rT3 concentrations decreased, but not significantly. The TSH values were normal throughout. These results showed numerous abnormalities in the hypothalamic-pituitary-thyroid axis in alcoholics, the reasons for which are as yet unclear. The following possible interpretations are suggested: 1. The abnormally low serum fT3 and fT4 levels during withdrawal might reflect an increase in tissue uptake. 2. The increases in T4--and partly those in T3--during abstinence seem to reflect increased binding by TBG, the level of which rose markedly for reasons as yet unknown. 3. If increases in TBG during abstinence are taken into account, the decreases in rT3 concentrations may reach the level of statistical significance. These falls in rT3 concentrations may reflect an increase in rT3 metabolization (deiodination) in various tissues, including the CNS, leading to a reduction in serum rT3 bioavailability. 4. Factors such as liver disease, protein caloric malnutrition, and "psychological stress" do not fully explain all these abnormalities. A direct effect of ethanol on intracellular thyroid hormone metabolism and/or function seems conceivable.

Empirical data for the purpose of multidimensional analysis of alcohol delinquency-related behaviour.

With the aim of determining the differences, if any, between voluntarily admitted alcohol-dependent patients and those treated in a forensic hospital with regard to criminal behaviour caused by alcohol, a study was conducted within a clinical section to analyse 41 patients confined under the provisions of the German Penal Code (StGB, section 64) and 55 patients who were admitted voluntarily. There is virtually no difference in the patterns of delinquency of the two groups; plain theft, fraud, defalcation and damage of property are predominant. This however, does not apply to acts of killing, which were exclusively found in patients who were treated in a forensic hospital, the frequency of delinquency being predominant in the latter group. According to anamnesis, a comprehensive list of questions containing more than 400 items as well as a series of test-psychological investigations, a psychic profile is elaborated by means of significant data or showing a tendency towards significance. In accordance with the result of operationalised diagnostics, only 51.2 per cent of the patients of confinement showed a primary alcohol dependence. As far as the other patients of the group (who had been wrongly confined within the meaning of the law) were concerned, the predominant diagnosis was a disturbed personality with accompanying alcohol abuse, whereas in the group of voluntarily admitted patients the proportion of primary alcohol dependence was 81.8 per cent.

[Benzodiazepines and barbiturates in chronic alcoholics and opiate addicts. An epidemiological study of hospitalized addicts]. / Benzodiazepine und Barbiturate bei chronischen Alkoholikern und Opiatabhängigen. Eine epidemiologische Studie an stationär aufgenommenen Suchtkranken.

In a prospective study of 282 chronic alcoholics and 67 opiate addicts, frequency and pattern of drug intake were determined by questioning and urinalysis on admission to a special unit of a psychiatric hospital. 20.2% of alcoholics and 44.8% of opiate addicts stated that they had taken psychotropic drugs before admission, women in both groups naming such drugs significantly more frequently than men. But taking into account results of urinalysis, 25.5% of alcoholics and 31.3% of opiate addicts were found to have taken benzodiazepines before hospital admission. 41.8% of opiate addicts either stated or were found to have taken barbiturates. High dosages of benzodiazepines were found in those alcoholics who had mentioned taking them. Thus in practice the treatment of addicts differs markedly from recommendations made by well-known experts. There is also a need to improve the clinical diagnosis and treatment of addicts.

[Tissue levels in human tonsils (tonsillae palatinae) following administration of different antibiotics (penicillin G, ampicillin, lincomycin)]. / Gewebsspiegel in menschlichen Tonsillen (Tonsillae palatinae) nach Applikation verschiedener Antibiotika (Penicillin G, Ampicillin, Lincomycin).

For determination of tissue levels of different antibiotics in human tonsils penicillin G, ampicillin or lincomycin is given i.v. to patients before tonsillectomy. The concentration of the individual substances is determined in tonsils and serum by agar diffusion method. The results are compared by diagrams of tissue and serum levels and statistically assessed. For therapeutic evaluation the absolute tissue levels at tonsillectomy are compared to the values of minimum inhibitory concentration (MIC) for most frequent germs in the stomato-maxillo-facial region. According to these results recommendations for antibiotic therapy of inflammatory processes of buccal cavity are given.