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Alcoholism-related content in the MMPI: item analysis of alcoholics vs. normal and general psychiatric populations.

An analysis of alcoholism-related content in the MMPI was undertaken using an alcoholic population, a psychiatric population and two normal populations. The alcoholic and psychiatric groups were drawn from facilities in the Minneapolis-St. Paul area, and the normal populations were the Hathaway Adult Group and the Mayo Clinic nonpsychiatric patient group. A derivation study and a cross-validation resulted in the identification of three item pools: 1) that discriminate alcoholics from both normals and psychiatric patients, 2) items that discriminate alcoholics from normals only, 3) items that discriminate alcoholics from psychiatric patients only. Only seven items discriminate both male and female alcoholics from both normals and psychiatric patients. These items have substantial face validity. As the core of alcoholism-related content in the MMPI, they can serve as a stem for the development of scales with more specialized purposes.

Alcoholism

Modes of alcohol administration appropriate for the study of the role of alcohol in carcinogenesis.

The route of alcohol administration used in the experimental study of the role of alcohol in carcinogenesis should mimic the human condition: the p.o. route should, therefore, have major attention. This route appears in concord with epidemiological evidence of alcohol involvement in cancers of the upper digestive tract. The relative advantages of schedule-induced polydipsia, an alcohol solution as the sole fluid source, and an alcohol-containing fluid diet are assessed, as well as the intake of alcohol via the respired air. These routes allow a wide range of daily alcohol doses to be ingested, the largest resulting in continuous intoxication and the development of physical dependence. The equivocal resulta from various already published typical experiments are discussed, indicating the necessity of using a variety of appropriate dosages, dosage routes, and dosage forms in appropriate controls, as well as indicating the necessity of investigating the role of concentration and kind of alcoholic beverage in a variety of strains and species in both sexes and at various ages.

Administration, Oral

Alcoholic hyalin antigen (AHAg) and antibody (AHAb) in alcoholic hepatitis.

Complement fixation (CF) and immune adherence (IA) hemagglutination tests demonstrate antigen (Ag) and antibody (Ab) to alcoholic hyalin (AH) in serum of patients with alcoholic hepatitis. Immunoglobulins from postmortem liver of patients dying of alcoholic hepatitis show antibody activity against AH. Isolated purified AH was used to produce AHAb in rabbits. Rabbit antiserum was added to heat-inactivated human serum to detect AHAg; purified AH was added to serum and tissue elutes to detect AHAb. AHAg was present in serum of each of 15 patients with early phase alcoholic hepatitis in CF titers of 8 to 64 and IA titers of 16 to 2048. AHAg became negative within 3 to 5 weeks with abstinence from alcohol and was followed by transient appearance of AHAb. AHAb was present in 11 patients with advanced phases of alcoholic hepatitis in CF titers of 8 to 640 and IA titers of 16 to 4096. Four patients in this group exhibited concomitant AHAb and AHAg. Investigations of liver tissue elute reveal that patients with advanced alcoholic hepatitis or active alcoholic cirrhosis have AHAg-reactive immune complexes containing IgG and IgA immunoglobulins.

Animals

[Plasma ACTH, STH and other hormone levels in various groups under chlormethiazole, haloperidol or reserpine load in alchohol delirium, alcoholic hallucinations, and chronic alcoholism].

Studies of 135 men with safely diagnosed alcohol delirium mostly revealed increased ACTH blood values when sober and increased T4 values in about 1/3 of these patients. There is a correlation between the psychiatric clinical picture of the alcohol delirium and the ACTH content of the plasma. Under load with chloromethiazole, halperidole or with reserpine, there is a significant drop in the increased ACTH and T4 values. In an acute alcoholic hallucinosis (n=16) similar endocrinological changes as in most cases of safely diagnosed alcohol delirium were observed. In a chronic alcoholic hallucinosis (n=11) and in chronic alcoholics (n=31) the endocrinological values were similar to those of patients after alcohol delirium.

17-Hydroxycorticosteroids

Isolation of pi-alcohol dehydrogenase of human liver: is it a determinant of alcoholism?

HUMAN LIVER ALCOHOL DEHYDROGENASE (ALCOHOL: NAD(+) oxidoreductase, EC 1.1.1.1), homogeneous by physicochemical criteria, has been available in quantity only recently [Lange, L. G. & Vallee, B. L. (1976) Biochemistry 15, 4681-4686]. Until now, the biochemical basis of human alcohol metabolism had to be extrapolated from the properties and behavior of enzymes from other species, primarily horses and yeast. The biological determinants of human alcoholism have remained obscure, although recent evidence indicates a genetic predisposition, requiring delineation. A functionally distinct form of human liver alcohol dehydrogenase (ADH), which we have designated II-ADH, is provocative since, thus far, it seems to be unique to human beings. It has a high K(m) for ethanol and is remarkably insensitive (apparent K(I), 500 muM) to pyrazole and its derivatives, which are usually potent ADH inhibitors (K(I), 1 muM), a property that is the basis for the isolation of II-ADH. The affinity resin 4-[3-(N-6-aminocaproyl)aminopropyl]pyrazole-Sepharose binds all other known forms of ADH but not II-ADH, thereby separating it selectively by affinity chromatography. In turn, this has led to the establishment of its identity with that enzyme form which was previously known as the anodic band and characterized by a high K(m) for ethanol (20 mM at pH 7.5). The remarkable insensitivity of II-ADH to pyrazole inhibition has also permitted quantitation of its role in hepatic ethanol oxidation. At 5 mM ethanol, a saturating concentration for virtually all other forms of ADH, II-ADH contributes less than 15% to total ethanol oxidation. However, at intoxicating concentrations, e.g., 60 mM, it can account for as much as 40% of the total ethanol oxidation rate of liver, indicating a seemingly unique role for this enzyme form in ethanol elimination. Thus far, we have found the amount of II-ADH varies from liver to liver of individuals and is considerably more labile than the other molecular forms, phenomena whose inter- or independence requires further study. The isolation of human II-ADH advances efforts to recognize and understand biochemical mechanisms that may be biological determinants of alcoholism and alcohol-related disease states, now generally approached and managed largely as psychosocial disorders.

Alcohol Oxidoreductases

Plasma amino acid abnormalities in the alcoholic: respective role of alcohol, nutrition, and liver injury.

Plasma amino acid abnormalities are common in alcoholics, but the respective role of alcoholism, nutrition, and liver injury in producing these abnormalities is unknown. To elucidate this question, amino acids were measured in 56 alcoholics and 32 nonalcoholics with liver disease, and in an experimental model of alcoholic liver injury in the baboon. Dietary protein deficiency depressed branched-chain amino acids with a tendency to decreased alpha-amino-n-butyric acid. By contrast, chronic alcoholic consumption selectively increased these amino acids both in short term (2 to 4 weeks) studies in human beings and in 1 to 4-year studies in baboons. Moderate liver injury had no significant effects on these amino acids whereas advanced cirrhosis depressed branched-chain amino acids. Thus, plasma branched-chain amino acids and alpha-amino-n-butyric acid in the alcoholic are affected by at least three variables: dietary protein deficiency and advanced cirrhosis which tend to decrease these amino acids, and chronic alcohol consumption which tends to increase them.

Alcoholism

Readaptation time after photo stress. Alcohol-induced acute and post-alcohol 'hangover' changes in ocular readaptation time.

The effect of alcohol intake on readaptation time (RAT) after photo stress is studied. Ten healthy subjects were given 0.72 g alcohol per kg body weight to be consumed within 20 min. The tests were made during a total period of 11-12 h. The findings demonstrate that moderate blood alcohol concentrations induce definite changes in RAT. An average RAT-prolongation of 60-70% was seen during the acute phase of intoxication. RAT-prolongation ended before the blood alcohol concentration had reached zero, but did not have the same downward slope. Following a period of reduction, a new prolongation of RAT was observed. The lack of congruence between the RAT-curve and the blood alcohol curve in the acute phase of intoxication and the post-alcohol increase are discussed. It is concluded that the alcohol-induced RAT-changes probably are CNS-effects and that the equipment used constitutes a sensitive method of estimating these effects.

Adaptation, Ocular

[Panorama change in alcohol-criminality. Analysis of blood alcohol findings evaluated in the year 1965 and 1975 (author's transl)].

Evaluation of 8834 blood alcohol findings from individuals in police custody and suspect of criminal actions (3434 relate to the year 1965, 5400 to 1975). Classification of the findings according to the following aspects: blood alcohol concentrations in general and with regard to sex, profession, age and nature of the suspected offense--the findings of the two years (1965 and 1975) are compared and the individual results presented. The analysis suggests that: In young people of any age-group the absolute number of alcohol delicts shows a considerable increase during the last 10 years (1965--1975). In adults, with the exception of the 31--40 year age-group, there was no significant increase in these offences. Comparing the results of the individual delicts in 1965 and 1975 there was no significant difference in the level of the blood alcohol-concentration-groups. Unskilled workers were more frequently involved in nearly all alcohol-related crimes. In 1965 6,6% and in 1975 7,9% of alcohol-related offenses were committed by females. Compared with other districts in 1975 alcohol-criminality has increased significantly in the new suburban colonies of Hamburg (built since 1965) (public housing, high-rise housing).

Adolescent

Alcohol self-administration in monkeys (Macaca radiata): the effects of prior alcohol exposure.

Responding by 4 monkeys was maintained under a fixed ratio 10 (FR 10) schedule for either food, intravenous sucrose or alcohol. The 20 hr sessions were divided so that food was available during hours 1, 6, 11, 16 and alcohol or sucrose during hours 2-5, 7-10, 12-15, and 17-20. All animals failed to maintain responding for isocaloric sucrose but continued to respond for food during those sessions. Responding under alcohol conditions was positively accelerated in 2 animals that were not previously exposed to alcohol, whereas prior exposure to alcohol produced maximal response rates during the first alcohol test session. The effects of alcohol in all monkeys were to suppress responding maintained by food and this suppression could not be produced with programmed infusions of isocaloric sucrose.

Alcohol Drinking

Induction of alcohol withdrawal symptoms by nalorphine in chronic alcoholic patients.

The effect of nalorphine on eliciting symptoms of either alcohol or narcotic withdrawal was studied. Five male alcoholics were challenged with nalorphine and saline, both while sober and during alcohol ingestion. After nalorphine, pulse rate decreased in patients when sober, but increased when they were ingesting alcohol. Nalorphine administration resulted, during alcohol ingestion, but not in the sober state, in lacrimation, a symptom of narcotic withdrawal, in one patient, and in the following symptoms of alcohol or narcotic withdrawal in one or more patients: weakness, anorexia, insomnia, disorientation, and tremor. These findings suggest that morphine-like alkaloids play a role in the mediation of alcohol withdrawal symptoms.

Adult

Alcoholic hepatitis. Cell-mediated immunological response to alcoholic hyalin.

Immunological reactivity in alcoholic hepatitis has bben attributed to alcoholic hyalin, the histological hallmark of this disease. A purified isolate of alcoholic hyalin with electron microscopic, biochemical, and serological characteristics documented previously was added to lymphocytes from healthy subjects and patients with alcoholic hepatitis or other hepatic disorders. Production of migration inhibition factor (MIF) in response to this material was used as an index to lymphocyte reactivity. MIF was significantly increased in lymphocytes obtained from patients with alcoholic hepatis, as compared to the healthy controls (P less than 0.001), and persons with other liver diseases (P less than 0.005). These observations indicate that immunological hyperreactivity to alcoholic hyalin occurs in patients with alcoholic hepatitis; such activity may be of key importance in the pathogenesis or sequelae (or both) of this disease.

Alcoholism

The effect of cues of quantity visible and preference on drinking by alcoholic and non-alcoholic subjects.

When a glass (150 ml) of a preferred/non-preferred orange drink was visible alcoholic subjects drank less than non-alcoholics. When a glass+jug (900 ml) was visible the alcoholics drank significantly more than the non-alcoholics. The cues of quantity visible and preference had an additive effect on the alcoholics' consumption. The experiment was modelled on a study by Nisbett (1968 a) concerned with cues controlling food intake in obese and non-obese subjects. An analogy was drawn between overeating by the obese and overdrinking by alcoholics.

Alcohol Drinking

Kinetics and reaction mechanism of yeast alcohol dehydrogenase with long-chain primary alcohols.

Kinetic studies of yeast alcohol dehydrogenase with NAD+ and ethanol, hexanol or decanol as substrates invariably result in non-linear Lineweaver-Burk plots if the alcohol is the variable substrate. The kinetic coefficients determined from secondary plots are consistent with an 'equilibrium random-order' mechanism for extremely low alcohol concentrations and for all alcohols, the transformation of the ternary complexes being the rate-limiting step of the reaction. This mechanism also applies to long-chain substrates at high concentrations, whereas the rate of the ethanol-NAD+ reaction at high ethanol concentrations is determined by the dissociation of the enzyme-NADH complex. The dissociation constants for the enzyme-NAD+ complex and for the enzyme-alcohol complexes obtained from the kinetic quotients satisfactorily correspond to the dissociation constants obtained by use of other techniques. It is suggested that the non-linear curves may be attributed to a structural change in the enzyme itself, caused by the alcohol.

Albumins

Alcoholic hepatitis with and without alcoholic hyaline.

Sixteen cases of alcoholic hepatitis with alcoholic hyaline (Group I) and 13 cases without alcoholic hyaline (Group II) have been collected since 1970. These were most frequently found in the fifth decade in both groups. One female was found in Group I. Cases of about two-thirds of both groups were comsumers of 110 g or more of alcohol per day. No significant differences except fever and erythrocyte sedimentation rate were found in clinical and laboratory changes between both groups. Fatty change in liver biopsy specimens were more frequently seen in Group I than in Group II. The wedged hepatic venous pressure was markedly elevated in alcoholic hepatitis with cirrhosis and moderately elevated in alcoholic hepatitis without cirrhosis. Wedged hepatic venography showed the main portal trunk and extrahepatic collaterals, namely, reversal of the portal flow or such tendency in 2 out of 5 patients of Group I.

Adult

Continuities in the olfactory deficits of chronic alcoholics and alcoholics with the Korsakoff syndrome.

Olfactory dysfunction, a finding prevalent among alcoholic Korsakoff patients, was investigated in long-term alcoholics with Korsakoff's Syndrome. The results demonstrate that alcoholics are impaired on odor quality discrimination but performed normally on complex hue discriminations. These findings support the hypothesis that chronic alcoholics and alcoholic Korsakoff patients represent two points on a single continuum of cognitive deterioration associated with alcohol abuse.

Alcohol Amnestic Disorder

Auditory brain stem potentials in chronic alcohol intoxication and alcohol withdrawal.

Auditory brain stem evoked responses were in unrestrained rats during periods of acute and chronic alcohol intoxication, alcohol withdrawal, and recovery. Acute alcohol administration altered the auditory brain stem potentials by a prolongation of both peak latency and central conduction time, beginning with early peaks. Similar but lesser effects affecting only the latter peaks were observed during chronic alcohol intoxication. By contrast, alcohol withdrawal resulted in a decrease in the peak latencies of auditory brain stem potentials and a facilitation of central conduction time. Recovery of the auditory brain stem potentials to the normal form required at least three to four weeks. The present study provides the first quantitative data, to our knowledge, on manifestations of alcohol tolerance and withdrawal.

Acoustic Stimulation

Difference of hepatic circulation between alcoholic and non-alcoholic hepatic cirrhosis.

Comparisons were made of hepatic circulation between alcoholic and non-alcoholic cirrhosis. The wedged hepatic venous pressure and per cent intrahepatic shunt measured by the method of continuous infusion of D-galactose-1-14C were similarly markedly increased. On the other hand, the wedged hepatic venography showed the main portal trunk and extrahepatic collaterals, namely, the tendency of reverse or stagnant portal flow, more frequently in alcoholic cirrhosis than in non-alcoholic cirrhosis. The nodules shown by slow low-pressure hepatic sinusoidography were larger in non-alcoholic cirrhosis than in alcoholic cirrhosis.

Blood Pressure

Use of Michigan Alcoholism Screening Test with hospitalized alcoholics, psychiatric patients, drinking drivers, and social drinkers in New Zealand.

The Michigan Alcoholism Screening Test (MAST) has been validated on a wide range of American drinkers. In this study the MAST was administered to four groups of New Zealand males: 100 hospitalized alcoholics, 100 psychiatric inpatients, 70 convicted drinking drivers, and 55 social drinkers. All the diagnosed alcoholics scored in the test's alcoholic range, as did 83% of the drinking drivers. Seventy-six percent of psychiatric patients and 89% of social drinkers scored below 5. The MAST appears to be a valid instrument for use under New Zealand conditions, but the ability to discriminate between alcoholics and problem drinkers would be an added advantage.

Adult