Estrogen receptor mediated activity in bankside groundwater, with flood suspended particulate matter and floodplain soil - an approach combining tracer substance, bioassay and target analysis.

Bankside groundwater is widely used as drinking water resource and, therefore, contamination has to be avoided. In the European Union groundwater protection is explicit subject to Water Framework Directive. While groundwater pollution may originate from different sources, this study investigated on impacts via flood events. Groundwater was sampled with increasing distance to the river Rhine near Karlsruhe, Germany. Samples were HPLC-MS-MS analyzed for the river contaminant carbamazepine to indicate river water infiltration, giving permanent presence in 250 m distance to the river (14-47 µg L⁻¹). Following a flood event, concentrations of about 16-20 µg L⁻¹ could also be detected in a distance of 750 m to the river. Furthermore, estrogenic activity as determined with the Yeast Estrogen Screen assay was determined to increase up to a 17ß-ethinylestradiol equivalent concentration (E-EQ)=2.9 ng L⁻¹ near the river, while activity was initially measured following the flood with up to E-EQ=2.6 ng L⁻¹ in 750 m distance. Detections were delayed with increasing distance to the river indicating river water expansion into the aquifer. Flood suspended matter and floodplain soil were fractionated and analyzed for estrogenic activity in parallel giving up to 1.4 ng g⁻¹ and up to 0.7 ng g⁻¹, respectively. Target analysis focusing on known estrogenic active substances only explained < 1% of measured activities. Nevertheless, river water infiltration was shown deep into bankside groundwater, thus, impacting groundwater quality. Therefore, flood events have to be in the focus when aiming for groundwater and drinking water protection as well as for implementation of Water Framework Directive.

Effect-directed analysis of Ah receptor-mediated activities caused by PAHs in suspended particulate matter sampled in flood events.

Suspended particulate matter (SPM) sampled during a flood event in the year 2004 at the rivers Neckar and Rhine (Southwest Germany) was assessed for aryl hydrocarbon receptor (AhR)-mediated activities using EROD induction in the rainbow trout liver cell line RTL-W1. All EROD inductions were normalized to the positive control TCDD and given as bio-TEQ values. Since all samples indicated elevated AhR-mediated toxicities, an effect-directed analysis (EDA) was applied to identify substances causing the effects. In three primary fractions (F1 to F3) non-polar aliphatics, non-polar aromatic substances and more polar substances were separated. Fraction F2, co-eluting with non-polar polyaromatic substances (PACs) including polycyclic aromatic hydrocarbons (PAHs) gave highest AhR-agonistic effects and, thus, were sub-fractionated into seven secondary fractions (F2-1 to F2-7). Fraction F2-1, co-eluting with PCBs and PCDD/Fs, did not cause AhR-agonist activities. F2-2 to F2-4 containing PACs of less than 16 aromatic C-atoms produced minor activities. Highest inductions were detected with fraction F2-5 to F2-7, containing substances of more than 16 aromatic C-atoms (bio-TEQs up to approximately 4500 pg/g). Concentrations and relative potencies (REPs) of priority EPA-PAHs allowed the calculation of chemical toxicity equivalent concentrations (chem-TEQ values). Based on the chem-TEQs, EPA-PAHs explained between 5 and 58% of crude extract bio-TEQs from both rivers. Whereas fractions F2-1 to F2-4 indicated no biological activities, EPA-PAHs in fraction F2-5 to F2-7 accounted for 2 to 137% of AhR-related activities.

[Utilization of medical and psychosocial services by mentally ill homeless persons. Results of an epidemiological study]. / Die Inanspruchnahme medizinischer und psychosozialer Dienste durch psychisch erkrankte Obdachlose. Ergebnisse einer epidemiologischen Studie.

The aim of this study was to ascertain to what extent homeless, mentally ill subjects in Munich take advantage of available psychosocial services. To obtain a representative picture of the situation, the first step was to ascertain how many people in Munich are actually homeless. The next step was to ascertain what proportion of them are in need of psychotherapy. Using the standardized Diagnostic Interview Schedule (DIS), 146 men and 32 women were interviewed. The results according to the DSM-III demonstrated high lifelong and 6-month prevalence of psychic disturbances. Medical and social services were often enjoyed, but mostly over a short period of time in particularly critical situations. Continued treatment rarely followed. Women were treated more often than men. Elements such as age and level of education hardly influenced patients' seeking help. Despite a high prevalence of addictive disease, alcohol and drug clinics were rarely consulted. The increase in the number of diagnoses was paralleled by an increase in the number of patients seeking help. Most treatments involved schizophrenia and anxiety. By means of logistic regression models, predictors of the extent to which these services were used were analysed. We conclude that new clinical models are needed and that the aversion to the present care system is too great. Continued treatment occurs only rarely.

[Mental illness in homeless men and women in Munich]. / Psychische Erkrankung bei obdachlosen Männern und Frauen in München.

PURPOSE: Mental illness appears to be overrepresented among homeless individuals. The purpose of this study was the standardised assessment of mental illness in a representative sample of homeless men and of homeless women in the city of Munich, Germany. METHODS: In order to get a very good estimate of the population of homeless individuals in Munich, a pre-sampling survey was conducted. On the basis of this pre-sampling survey the size and relevant characteristics of the total population of homeless individuals in Munich were defined. Individuals of the sample were randomly selected from the population. 146 men and 32 women were interviewed using the Diagnostic Interview Schedule (DIS). RESULTS: Homeless men were on the average 43 years of age; most of them unmarried or divorced, had a relatively low degree of school education and a relatively long duration of homelessness. The prevalence of mental illness (lifetime) was very high: 91.8% had a substance abuse disorder (82.9% alcohol dependence), 41.8% had an affective disorder, 22.6% had an anxiety disorder and 12.4% suffered from schizophrenia. Of the homeless men in Munich 94.5% had at least one DIS/DSM-III axis I diagnosis 6-month prevalence data is also presented. CONCLUSIONS: The results confirm the findings of other studies in other countries of high rates of mental illness among homeless individuals. In comparison to a study in Los Angeles using the same methodology, prevalence rates were even higher in Munich. Implications for health care planning are discussed.

Alcoholism among homeless men in Munich, Germany.

Probably in association with changes in the economic structure and high unemployment rates in western industrialized countries, homelessness is becoming more apparent publicly and receiving increased media attention. More studies on the issue of mental illness and homelessness have been performed in recent years in North America while hardly any representative and reliable data exists concerning Germany and some other European countries. The aim of our study was 1) to assess alcohol abuse and dependency as well as other mental disorders in a representative sample of homeless men in Munich using reliable methods of case identification (Diagnostic Interview Schedule [DIS and DIS/DSM-III diagnoses); 2) to compare homeless alcoholics with homeless non-alcoholics in our sample on relevant variables and issues and 3) to compare our data from the sample of homeless men in Munich with data obtained by others using the same case identification procedure (DIS/DSM-III diagnoses). According to our results, the lifetime prevalence of any DIS/DSM-III Axis I diagnoses was 94.5% and the lifetime prevalence of substance use disorder was 91.8%. The single most prevalent diagnosis among homeless males in Munich was alcohol dependency (lifetime 82.9%), while alcohol abuse (lifetime 8.2%) and drug abuse/dependency were considerably lower (lifetime 17.8%). Data show that alcoholism and its consequences were more severe in the Munich as compared to the Los Angeles homeless sample. Homeless alcoholics showed a high comorbidity with other mental disorders (lifetime) such as affective disorders (44.4%), anxiety disorders (22.6%), drug abuse/dependence (18.8%) and schizophrenia (12.0%); 64% of those with alcoholism at some time during their life had at least one other lifetime mental disorder. Alcohol-related patterns of living and symptoms as well as social or role functioning are described for homeless alcoholics in Munich and compared with data from other relevant studies. Considering the extremely high prevalence of alcohol dependence frequently in combination with other mental disorders, the use of alcohol rehabilitation and other services as well as self-help groups was minimum among Munich homeless alcoholics. New concepts to deal with these problems are needed and if they exist, they need to be implemented.

Mental illness in a representative sample of homeless men in Munich, Germany.

The aim of the study was to reliably assess the 6-month and lifetime prevalence of mental illness according to DSM-III criteria in a representative sample of homeless individuals in the city of Munich, Germany. Because the characteristics of the homeless population were unknown, we first conducted a pre-sampling survey to determine a proportionate allocation of the main interviews in three nested sampling strata. For the pre-sampling we approached 300 males, who appeared to be homeless, for a brief interview; of these, 271 were homeless according to our definition and were allocated to one of three sectors ("shelter", "meal services", "outdoor"). Thereafter, we randomly sampled homeless males in these three strata until the indicated allocations were met. The Diagnostic Interview Schedule (DIS) was used for diagnostic classification according to DSM-III in the main interview. Results from this representative urban sample show that the mean age of the homeless males was 43 years; most were unmarried or divorced, had a relatively low level of school education and a long duration of homelessness. Based on the main interviews with 146 homeless males the following lifetime prevalence rates were obtained: 91.8% for substance use disorder (82.9% alcohol dependence), 41.8% for affective disorders, 22.6% for anxiety disorders and 12.4% for schizophrenia. Of the homeless males in Munich, 94.5% had at least one DIS/DSM-III axis I diagnosis. Six-month prevalence data is also presented. Results are compared with those of a very similar study on homeless individuals in Los Angeles, which also used DIS/DSM-III diagnoses. In comparison with representative community samples in the United States and in Germany, mental illness was much more frequent among homeless individuals in Munich as well as in Los Angeles. Implications for health care planning are discussed.

Vocal mimicry of computer-generated sounds and vocal labeling of objects by a bottlenosed dolphin, Tursiops truncatus.

A bottlenosed dolphin (Tursiops truncatus) was trained to mimic computer-generated "model" sounds, using a whistle mode of vocalization. Prior to training, the whistle sounds of this dolphin were limited to a few stereotyped forms, none of which resembled the model sounds. After training, high-fidelity imitations were obtained of model sounds having (a) moderately or widely swept, slow-rate frequency modulation (1-2 Hz), (b) narrowly or moderately swept frequency modulation at moderate to rapid rates (3-11 Hz), (c) square-wave frequency transitions, and (d) unmodulated (pure-tone) waveforms. New models, not heard previously, could be mimicked immediately, often with good fidelity, including mimicry of amplitude variation that had not been explicitly reinforced during training. Subsets of familiar models were mimicked with high reliability in repeated tests. In additional training, control of the mimic response was transferred from the acoustic model to objects shown the dolphin (e.g., a ball or a hoop) so that, in effect, the dolphin gave unique vocal labels to those objects. In a test of accuracy and reliability of labeling, correct vocal labels were given on 91% of 167 trials comprised of five different objects presented in random order. The dolphin's ability for vocal mimicry compared favorably with that of the more versatile mimic birds, and it contrasted sharply with the apparent lack of vocal mimicry ability in terrestrial mammals other than humans. The ability to label objects vocally was similar to abilities shown for some birds and similar, in principle, to abilities of great apes trained in visual languages to label objects through gestures or other visual symbols.

Outcome of operations for upper gastrointestinal tract bleeding.

The outcome of operations for upper gastrointestinal tract bleeding during a six-year period was compared with that of the previous four years, in which indications for operation and guidelines for surgical procedures were similar. Between 1973 and 1978, 392 patients were hospitalized for hemorrhage. Endoscopy diagnosed a bleeding lesion in 92% of 234 patients studied. Of 75 patients (19%) who required operation for uncontrollable hemorrhage, 20 (27%) died and two (3%) rebled postoperatively. Most deaths (80%) were caused by esophageal variceal bleeding. Among 47 patients with nonvariceal hemorrhage, mortality was only 9%. No patient with stress ulcer bleeding was encountered. Compared with our 1969 to 1972 experience, the present study shows no improvement in overall mortality. Rebleeding was less frequent than earlier. The most significant differences in outcome were decreased mortality in alcoholic gastritis patients, no deaths from stress ulcer, and increased mortality after portosystemic shunting. Endoscopy, used frequently from 1973 to 1978, helped to improve preoperative diagnostic rates (85% vs 65%). Combined with innovations in nonoperative treatment, such as infusion of vasopressin, it did not appear to decrease the proportion of patients requiring operation.

The routine use of positive end-expiratory pressure after open heart surgery.

Because atelectasis of the left lower lobe is a frequent complication of open heart surgery, we evaluated the efficacy of routine therapy with positive end-expiratory pressure (PEEP) to prevent this complication. Twenty-four patients were randomly assigned to either a group receiving therapy with PEEP (ten patients) or to a group with no PEEP (14 patients). The two groups could not be distinguished by age, weight, the forced expiratory volume in one second (FEV1), the ratio of FEV1 over the forced vital capacity, the time on the pump, the units of blood transfused, the tidal volume, or the hours of mechanical ventilation. There was no significant roentgenographic difference between the two groups in either the degree or frequency of left lower lobe atelectasis. While the arterial-alveolar ratios tended to improve over time in those patients receiving therapy with PEEP, this improvement was not clinically significant. No complications were encountered with the use of PEEP. We conclude that the routine use of PEEP following open heart surgery is safe but offers no advantage over standard ventilatory techniques.

Stimulus and procedural determinants of the forgetting of conditioned fear.

Two studies investigated factors believed to influence the retention of acquired fear in rats. The results show clearly that the lack of forgetting over 24-hr interval reported by previous investigators is due to a depression of performance on the immediate test (3-min retention interval) resulting from the procedure of not handling the rats during conditioning but then handling them on every trial during the retention test. In accord with the McAllister's interpretation of related results, the depression of performance after short retention intervals may be due to a lack of generalization from training to the testing situation. As the retention interval is lengthened, the amount of generalization increases and escape performance improves on a relative basis. The nature of the retention function may be severely distorted by selection of an inappropriate paradigm for its evaluation.