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LIVER TRANSPLANTATION AND THE ALCOHOLIC PATIENT
SHERMAN, DAVID
WILLIAMS, ROGER
Commentary
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/141
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Copyright (C) 1995, Medical Council on Alcohol
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ALCOHOL PROBLEMS AND ANXIETY DISORDERS--A CRITICAL REVIEW
ALLAN, CAROLE A.
Invited Reviews
The assumption that, within clinical populations, anxiety reduction is a major factor in the aetiology of drinking problems no longer appears to be a plausible explanation of the available data. There are many studies which document the occurrence of anxiety symptoms in problem drinkers but the difficulty lies in deciding which comes first, the alcohol problem or the anxiety. Evidence is reviewed which indicates that anxiety is likely, in most instances, to be a consequence rather than a cause of heavy drinking. This has implications for the treatment of patients with both disorders. The assessment and management of patients with a ‘dual-diagnosis’ of alcohol dependence and anxiety is discussed in the light of these findings.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/145
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Copyright (C) 1995, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:30/2/1532015-05-19HighWireOUPalcalc:30:2
NOMENCLATURE OF ALCOHOL DEHYDROGENASES
JÖRNVALL, HANS
HÖÖG, JAN-OLOV
Invited Reviews
Six different classes of mammalian alcohol dehydrogenase have been characterized. Most, if not all, are common to humans, mammals and many vertebrates, which therefore share class distinctions in general. Amino acid residue identities between classes are at the 60% level (70% in the case of one pair, class I/IV), whereas those for mammalian species variants within a class are still more extensive. Isozymes, derived from the most recent level of gene duplications, have been reported for class I (in seven species) and class III (in one species) thus far. In humans, the system appears to account for at least eight genes (<it>ADHI</it>-8), with corresponding subunits. Nomenclature is reviewed and suggested for alcohol dehydrogenases in nature, for the human enzyme system and for the mammalian forms.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/153
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Copyright (C) 1995, Medical Council on Alcohol
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CAROTENOID, RETINOID AND VITAMIN E STATUS OF THE OROPHARYNGEAL MUCOSA IN THE ALCOHOLIC
LEO, M. A.
SEITZ, H. K.
MAIER, H.
LIEBER, C. S.
Original articles
Concentrations of carotenoids, retinoids and tocopherols were determined in the homogenate of macroscopically normal appearing oropharyngeal mucosa from 10 chronic alcoholics and from 11 control patients. All the alcoholics except one had oropharyngeal cancer. No significant difference was found in tissue levels of carotenoids and tocopherols between alcoholics and controls. Furthermore, in seven of 11 controls, retinol was undetectable in the oropharyngeal mucosa, while in the alcoholics only two out of 10 had unmeasurable retinol levels. These results do not support the concept that ethanol-associated oropharyngeal carcinogenesis is due, at least in part, to local deficiencies in retinoids, carotenoids or α-tocopherols.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/163
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Copyright (C) 1995, Medical Council on Alcohol
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EVALUATION OF CARBOHYDRATE-DEFICIENT TRANSFERRIN FOR DETECTION OF ALCOHOL ABUSE IN PATIENTS WITH LIVER DYSFUNCTION
STAUBER, RUDOLF E.
STEPAN, VINZENZ
TRAUNER, MICHAEL
WILDERS-TRUSCHNIG, MARTIE
LEB, GEORG
KREJS, GUENTER J.
Original articles
The determination of carbohydrate-deficient transferrin (CDT) in serum has been suggested as a marker of alcohol abuse. We evaluated serum CDT in 199 patients admitted to our Department of Medicine using a commercially available radioimmunoassay kit for CDT. A history of alcohol consumption was obtained quantitatively by a self-administered questionnaire and qualitatively by the Munich Alcoholism Test. Using a cut-off level of 60 g ethanol per day according to the information from the questionnaire, CDT had a sensitivity of 70% and a specificity of 84%. False-positive values were primarily encountered in cases of hepatic malignoma, primary biliary cirrhosis and chronic hepatitis C. The sensitivity and specificity of CDT was superior to two other markers of chronic ethanol consumption, serum gamma-glutamyltransferase and mean cell volume, and thus proved to be the best single laboratory test for the detection of alcohol abuse.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/171
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Copyright (C) 1995, Medical Council on Alcohol
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PREVALENCE AND CORRELATES OF DSM-IV AND ICD-10 ALCOHOL DEPENDENCE: 1990 US NATIONAL ALCOHOL SURVEY
CAETANO, RAUL
TAM, TAMMY W.
Original articles
This paper describes DSM-IV and ICD-10 alcohol dependence prevalence rates and sociodemographic and drinking correlates. The sample under analysis (<it>n</it> = 2058) constitutes a multicluster probability sample of the US adult household population. The study response rate is 71%. The prevalence rate for current (past 12 month) DSM-IV alcohol dependence is 3.9%, and for current ICD-10 it is 5.5%. Agreement between DSM-IV and ICD-10 on whether respondents are dependent or not is less than optimal (Kappa = 0.67). The predictors of ICD-10 alcohol dependence are the frequency of drinking five or more drinks on occasion and age (inverse relationship). For DSM-IV alcohol dependence the correlates are drinking five or more drinks on occasion, being unemployed and age (also an inverse relationship). Differences in results underline the importance of understanding the variations among DSM-IV and ICD-10 criteria for alcohol dependence and the implications of these differences for epidemiological research. The high prevalence of dependence among young men may be the result of recognizing consequences of episodic heavy drinking as signs of alcohol dependence.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/177
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Copyright (C) 1995, Medical Council on Alcohol
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ETHANOL INDUCES HETEROGENEOUS REDUCTION OF CYTOCHROME aa3 WITHIN PERFUSED RAT LIVER LOBULE ASSESSED USING MICROSPECTROSCOPY
CHEN, SHENG-SONG
YOSHIHARA, HARUMASA
SEIYAMA, AKITOSHI
HARADA, NOBORU
KAWANO, SUNAO
TSUJI, SHINGO
FUSAMOTO, HIDEYUKI
KAMADA, TAKENOBU
SHIGA, TAKESHI
Original articles
The redox state of cytochrome <it>aa</it><inf>3</inf> was measured at microspots (20μm diameter) within the lobule of perfused rat livers, using reflectance microspectroscopy, and the effect of ethanol infusion on sublobular distribution of the redox states was evaluated. A sigmoidal relationship was observed between oxygen delivery and the reduction of cytochrome <it>aa</it><inf>3</inf> in both the periportal and pericentral regions of the liver lobule when the influent O<inf>2</inf> concentration was decreased in a graduated manner. This sigmoidal curve was shifted to the more reduced state by ethanol infusion, with ethanol (25–100mM) increasing the degree of cytochrome <it>aa</it><inf>3</inf> reduction in a dose-dependent manner according to the distance from the periportal region along a sinusoid. This increase was spatially heterogeneous within a liver lobule. These data indicate that ethanol accelerates cytochrome <it>aa</it><inf>3</inf> reduction, with a distinct gradient of reduction along sinusoids but a heterogeneous distribution within the liver lobule.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/187
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Copyright (C) 1995, Medical Council on Alcohol
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MODERATE ALCOHOL CONSUMPTION AND SPONTANEOUS ABORTION
CAVALLO, FRANCO
RUSSO, ROBERTO
ZOTTI, CARLA
CAMERLENGO, ANNA
RUGGENINI, ANGELA MOIRAGHI
Original articles
A prospective study was carried out on 546 women interviewed during pregnancy about their drinking habits, in order to evaluate the association between alcohol consumption during pregnancy and spontaneous abortion. Pregnancy outcome (normal or abortion) was analysed as a dependent variable in a multivariate model where different levels of drinking were taken into consideration as independent-effect variables. A significant increase in the risk of abortion was observed in the 30 + age category and in the higher parity category; no significant trend was evidenced for alcoholic variables, even after controlling for the other potentially confounding variables. The possible underestimation of alcohol consumption, due to reluctance in declaring real consumption by the women interviewed, is discussed. It is concluded that, on the basis of these and other data reported in the literature, a low level of alcohol consumption during pregnancy does not appear to be a significant risk for abortion.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/195
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SKELETAL MUSCLE PROTEASE ACTIVITIES ARE UNALTERED IN CIRRHOTIC RATS BUT ALTERED IN RESPONSE TO ETHANOL AND ACETALDEHYDE IN VITRO
COOK, ELISABETH B.
GOVE, CHRISTOPHER D.
PANOS, MARIOS Z.
WILLIAMS, ROGER
PREEDY, VICTOR R.
Original articles
This study was carried out in an attempt to differentiate between the contribution of liver impairment and direct actions of alcohol in myopathy of alcoholic liver disease. Using an animal model of cirrhosis we have previously shown that protein synthetic potential in muscle was not significantly altered. We therefore investigated the possibility that muscle degradation is increased. Cirrhosis was induced by carbon tetrachloride gavage in male rats receiving phenobarbitone in their drinking water. Controls were given phenobarbitone alone. After 135 days the free, latent and total activities of the lysosomal enzymes cathepsin B and cathepsin D in gastrocnemius muscle were unaffected by the induction of experimental cirrhosis when expressed relative to tissue wet weight, protein or DNA. The non-lysosomal enzyme neutral protease was also measured in gastrocnemius muscle from control and cirrhotic rats. There was no difference between the two groups in the free, latent or total activities. Addition of ethanol and acetaldehyde to the assay mixtures in some cases significantly altered the relative activities of the proteases in latent and free compartments of the cirrhotic tissues. In control tissues a different pattern of response emerged. It is concluded that in cirrhosis, at least in the carbon tetrachloride-induced rat model, there is no change of the activity of cathepsin B and D and the neutral protease activity in gastrocnemius. Small but significant effects of ethanol and its metabolite acetaldehyde on latent and free muscle protease activity were demonstrated.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/203
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Copyright (C) 1995, Medical Council on Alcohol
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THE ACUTE EFFECTS OF ETHANOL AND ACETALDEHYDE ON THE SYNTHESIS OF MIXED AND CONTRACTILE PROTEINS OF THE JEJUNUM
MARWAY, JASPAUL S.
PREEDY, VICTOR R.
Original articles
An investigation was made into the acute effects of ethanol and acetaldehyde with or without enzyme inhibitors of alcohol dehydrogenase (4-methylpyrazole) and aldehyde dehydrogenase (cyanamide) on fractional rates of protein synthesis of mixed and contractile proteins of the jejunum. Ethanol decreased the fractional rates of mixed and contractile protein synthesis (i.e. k<inf>o</inf> defined as the percentage of tissue protein renewed each day) by -25%. Pretreatment with 4-methylpyrazole followed by treatment with ethanol further reduced mixed and contractile k<inf>o</inf> by -30%, when compared with saline plus saline and 4-methylpyrazole plus saline groups. The greatest reductions in k<inf>o</inf> of mixed and contractile proteins occurred with cyanamide pretreatment followed by ethanol treatment: mixed and contractile protein k<inf>o</inf> in the cyanamide plus ethanol group decreased by -60% when compared with saline plus saline and cyanamide plus saline groups, whereas k<inf>o</inf> decreased by -45% when compared with the saline plus ethanol injected group. Acetaldehyde treatment alone caused no significant inhibition of protein synthesis. However, 4-methylpyrazole pretreatment plus acetaldehyde treatment significantly reduced mixed and contractile k<inf>o</inf> by -20% when compared with the saline group, and by -15% when compared with the 4-methylpyrazole plus saline and saline plus acetaldehyde groups. These data show that ethanol alone and perhaps high levels of acetaldehyde may be responsible for the inhibition of intestinal protein synthesis and related pathological derangements, e.g. motility disturbances due to loss of contractile proteins.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/211
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Copyright (C) 1995, Medical Council on Alcohol
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THE EFFECTS OF ETHANOL, 3,5,3'-TRIIODOTHYRONINE (T3) AND OESTRADIOL (E2) ON THYROID HORMONE NUCLEAR RECEPTOR EXPRESSION IN HUMAN HEPATOCYTE PRIMARY CULTURES
BURRA, P.
FITCH, N. J. S.
KAPADI, A.
FRANKLYN, J. A.
SHEPPARD, M. C.
RAMSDEN, D. B.
ELIAS, E.
Original articles
The possibility that ethanol regulated the expression of thyroid hormone receptor mRNA levels was explored in a model involving human hepatocyte primary culture. Ethanol (20.50 and 100 mM for 24h was found to have no effect on the steady-state levels of either triiodothyronine (T<inf>3</inf>) receptor α<inf>1</inf> or α<inf>2</inf> mRNAs. In contrast both T<inf>3</inf>(1.10 and 100nM) and oestradiol (0.1, 1 and 10ng/ml) treatments affected either one or both of these mRNA levels in a complex manner, showing that the model was capable of responding to other stimuli. Triiodothyronine receptor β1 mRNA was not assayed. The hypermetabolic effects of long-term ethanol consumption in humans appears not to be due to the direct effect of ethanol on the regulation of these receptors.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/219
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Copyright (C) 1995, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:30/2/2232015-05-19HighWireOUPalcalc:30:2
VASOPRESSIN SECRETION AND MEMORY IMPAIRMENT IN ALCOHOLIC KORSAKOFF'S SYNDROME
EMSLEY, ROBIN A.
ROBERTS, MIMI C.
AALBERS, COR
TALJAARD, FRANS J. J.
KAPNIAS, SHARON
PIETERS, HUIBRIE C.
KOTZE, THEUNS J. V. W.
Original articles
The response of arginine vasopressin (AVP) to an intravenous hypertonic saline infusion was investigated in 19 patients with alcoholic Korsakoff's syndrome, 17 non-amnesic alcoholics and 21 non-alcoholic controls. Compared with non-alcoholic controls the Korsakoff patients had elevated basal AVP levels and showed erratic fluctuation of AVP secretion, not related to changes in serum sodium levels. The non-amnesic alcoholics had a similar, but less severe derangement. Neuropsychological tests revealed significant correlations between basal AVP levels and memory performance in the non-amnesic alcoholics, raising the possibility of a common lesion—most likely in the diencephalon—lor memory impairment and AVP dysregulation in chronic alcoholics.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/223
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Copyright (C) 1995, Medical Council on Alcohol
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EFFECTS OF VOLUNTARY ETHANOL INGESTION ON THE POMC GENE EXPRESSION IN THE RAT PITUITARY AND ON THE PLASMA {beta}-ENDORPHIN CONTENT
WINKLER, ANETT
ROSKE, IRMGARD
FURKERT, JENS
FICKEL, JÖRNS
MELZIG, MATTHIAS F.
Original articles
Studies investigating the influence of chronic ethanol treatment on the β-endorphin content and the proopiomelanocortin (POMC) gene expression in the rat pituitary revealed contradictory results. Because of this we decided to start a more complex study to investigate the effects of isolation stress, chronic ethanol treatment and voluntary ethanol consumption on the POMC mRNA level in the rat pituitary. The immediately prepared total RNA from rat pituitaries was used in hybridization experiments (Northern- and Dot-blots). The results suggest a correlation between the POMC gene expression and the different fashions of ‘living conditions’ tested. So the POMC gene expression in long-term alcohol-treated animals was decreased supporting the theory of β-endorphin deficiency in alcoholism. More interestingly, data obtained from the group of voluntary ethanol consumption suggest an inverse correlation between total ethanol ingestion and POMC gene expression. This indicates the importance of the method of ethanol administration. Consistent with a decreased POMC gene expression in the pituitary during chronic ethanol treatment are previous studies showing a decrease in the plasma β-endorphin content in such situations. Surprisingly, in the present study the plasma β-endorphin levels measured by radioimmunoassay were only slightly decreased in chronically ethanol-treated rats. This may be due to dysregulatory effects of ethanol on post-translational processing, degradation and/or release of β-endorphin.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/231
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Copyright (C) 1995, Medical Council on Alcohol
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DOUBLE-BLIND RANDOMIZED MULTICENTRE TRIAL OF ACAMPROSATE IN MAINTAINING ABSTINENCE FROM ALCOHOL
PAILLE, FRANÇOIS M.
GUELFI, JULIEN D.
PERKINS, ALAN C.
ROYER, RENÉ J.
STERU, LUCIEN
PAROT, PHILIPPE
Original articles
A prospective placebo-controlled, randomized double-blind study of Acamprosate at two dose levels in alcohol-dependent patients followed up for 12 months was performed. After detoxification, each of the 538 patients included was randomly assigned to one of three groups: 177 patients received placebo, 188 received Acamprosate at 1.3 g/day (low dose group) and 173 received 2.0g/day (high dose group) for 12 months. This was followed by a single blind 6 month period on placebo. The patients' mean age was 43.2 ± 8.6 years. Their mean daily alcohol intake was high (nearly 200g/day) and of long duration (9.5 ± 7.1 years). Abstinence figures followed the order high dose>low dose>placebo. The difference was significant at 6 months (<it>P</it> ≤ 0.02) but not at 12 months (<it>P</it> = 0.096). The number of days of continuous abstinence after detoxification was 153 ± 197 for the high-dose group versus 102 ± 165 for the placebo group (<it>P</it> = 0.005), with the lose-dose group reporting 135 ± 189 days. Clinic attendance was significantly better in the Acamprosate groups than in the placebo group at 6 months (<it>P</it> = 0.002) and 12 months (<it>P</it> = 0.005). During the 6-month post-treatment period, no increased relapse rate or residual drug effect was observed. The side effect profile for Acamprosate was good compared with controls with only diarrhoea being reported more frequently (<it>P</it> <0.01). This study confirms the pharmacological efficacy of Acamprosate and its good acceptability. As an adjunct to psychotherapy, this study supports the inclusion of Acamprosate in a strategy for treating alcoholism.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/239
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Copyright (C) 1995, Medical Council on Alcohol
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CEREBRAL MEMBRANES ISOLATED FROM RATS CONSUMING ETHANOL OR GESTATIONALLY EXPOSED TO ETHANOL HAVE INCREASED SUSCEPTIBILITY TO MODULATION BY ETHANOL
SAMYNATHAN, YASMIN M.
ALI, SYED F.
BONDY, STEPHEN C.
Original articles
The actions of ethanol on membrane fluidity were examined. All assays were carried out using fluorescence techniques in the P<inf>2</inf> fraction of crude synaptosomes isolated from rat brain. Subchronic treatment of rats with ethanol revealed a significant increase in order at the membrane interior. <it>In vitro</it> addition of ethanol to P<inf>2</inf> fractions prepared from treated rats revealed a significant rise in fluidity at the membrane core that was not found in corresponding P<inf>2</inf> fractions from untreated rats. The withdrawal of ethanol from subchronically treated rats revealed no significant alterations in membrane fluidity. However, <it>in vitro</it> addition of ethanol to P<inf>2</inf> fractions prepared from these animals produced an increase in fluidity at the membrane centre. This effect was not observed in corresponding control rats. Rat pups that were gestationally exposed to ethanol also failed to show any significant differences in membrane fluidity compared with control rats. However, <it>in vitro</it> addition of a challenge dose of ethanol to P<inf>2</inf> fractions resulted in a significant rise in fluidity not found in pups from untreated mothers. These findings suggest that the process of adaptation to chronic ethanol may be dissected into two separable events: one frequently reported effect that alters membrane fluidity and one that modulates membrane susceptibility to ethanol-induced perturbations.
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/249
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THE FETAL ALCOHOL SYNDROME AND FETAL ALCOHOL EFFECTS ON IMMUNE COMPETENCE
CHIAPPELLI, FRANCESCO
TAYLOR, ANNA N.
Letters to the Editor
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/259
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ALCOHOL AND URICAEMIA
SHAPER, A. G.
Letters to the Editor
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/263
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BOOK REVIEWS
MADDEN, J. S.
Book reviews
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/265-a
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BOOK REVIEWS
MADDEN, J. S.
Book reviews
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/265
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BOOK REVIEWS
MARSHALL, JANE
Book reviews
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/266
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Copyright (C) 1995, Medical Council on Alcohol
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CALENDAR
Calendar
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/267
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Copyright (C) 1995, Medical Council on Alcohol
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THE BRITISH DOCTORS' AND DENTISTS' GROUP
Notices
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/268-a
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MEDICAL COUNCIL ON ALCOHOLISM SUBSCRIPTION RATES 1995
Notices
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/268
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ANNOUNCEMENT; 5th CONGRESS OF THE EUROPEAN SOCIETY FOR BIOMEDICAL RESEARCH ON ALCOHOLISM (ESBRA)
ESBRA News
Oxford University Press
1995-03-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/30/2/269
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Copyright (C) 1995, Medical Council on Alcohol