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The interaction of ethanol with drugs becomes more and more important because of a constant increase of the consumption of both. While most of the commonly used drugs do not alter the elimination of alcohol there exist a number of drugs which influence the degradation of ethanol by inhibition of the acetaldehyddehydrogenase. In combination with alcohol these drugs lead to an antabus-like reaction. In respect to the influence of ethanol on the metabolic degradation of drugs it must be destinguished between acute and chronic effects of alcohol. Upon acute influence of ethanol we observe an increased efficiency of many drugs. Chronical influence of ethanol on the other hand leads to a reduced action of drugs by enzyme inhibition. Besides the interaction on the level of biotransformation the interaction on the receptor-level is important. This mechanism especially leads to an increased efficiency of drugs which influence the central-nervous system.

A comparative study of ethanol concentration was performed in body fluids of corpses. One group consisted of dead bodies without sings of putrefaction (160 cases), and the second group included 60 cases with advanced putrefaction. In the first group the concentration of ethanol in blood, cerebrospinal fluid, vitreous humour, inner ear fluid and urine (in 147 cases) was determined, whereas in the second group blood and inner car fluid was examined. The observed differences in ethanol distribution in examined materials were the basis for the development of models of ethanol distribution in the body. Distinct relations between the ethanol concentrations in blood and other fluids allow to assess the blood ethanol concentration on the basis of examination of other materials. It is important in the cases when blood is not available and putrefactional changes of blood can be a reason of misinterpretations. Such assays appear to be useful in forensic assessment of drunkness.

Malignancies of the skin, with an incidence of more than 200,000 newly registered cases/year, are the most frequently notified malignances in Germany. In Europe, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) account for about 30 cases/100,000 persons and 50-100 cases/100,000 persons, respectively. Ultraviolet (UV) exposure is the main risk factor to induce these cancers. Increased incidence rates were shown for persons having red/blonde hair as well as light eye colour, acquire sun burns easily, hardly tan and develop freckles. The majority of the malignancies and precursor lesions are acquired by UV exposure in leisure time. However, in highly occupationally UV-exposed outdoor workers, UV monitoring revealed that exposure levels are 2-3 times higher compared to the general population. Occupations likely to be highly exposed are farmers, forestry workers, gardeners, landscapers, fishermen and seafarers, construction workers, builders, tin smiths, sport teachers, mountain guides, etc. Recent metaanalyses showed that occupational UV exposure is a relevant and independent risk factor for SCC and to a lesser extent also for BCC. To prevent occupationally caused malignancies of the skin a significant reduction of occupationally acquired UV dosages in outdoor workers is mandatory. Relevant factors influencing the cumulative sun exposure in outdoor workers are the amount of UV exposure, the specific tasks to be performed in the sun as well as the UV protection habits of the workers. Besides adequate behavior, textile protection by headgear and clothing as well as the regular use of sunscreens and sun glasses are important.

In 109 drunken male drivers from the area of Rostock the marker of alcohol abuse CDT was superior to the established laboratory parametres gammaglutamyltransferase (GGT) and mean cell volume (MCV) concerning the diagnostic efficiency. The prerequisite for the high diagnostic evidence of the CDT is the quantification of the minor band and the definition of standards of valuation by comparative studies with defined groups of probands (alcoholics, normal population). The combination of the 3 parametres CDT/GGT/MCV gave in 67% of the examined drunken drivers more or less strong hints at chronic alcohol abuse. The BAC of 1.6/1000 as a base for the decision to cause a medical-psychological examination (in case of "poison-resistance") turned out in this study to be an interchangeable, incomprehensible value. In about two thirds of the examined drunken drivers laboratory findings were pathological also in case of BAC below 1.6/1000. According to the experiences existing so far the parametres-combination CDT/GGT is unreservedly suitable as a screening procedure for the registration of potential or manifest alcoholics. Because the examinations may be performed from the usual blood samples for the BAC-detection these laboratory parametres really offer themselves for questions of traffic medicine. Further investigations are necessary.

In Germany alcohol is responsible for 40--60 per cent of cases with chronic or chronic relapsing pancreatitis. The histologic lesions for a long time remain clinically asymptomatic. Their degree depends on the duration and the total amount of alcohol which is ingested. Promoters of alcoholic damage to the pancraes are a high intake of fat and protein and a genetic disposition. Acute application of alcohol leads to an inhibition of pancreatic secretion when the entrance of gastric acid into the duodenum is prevented. Otherwise a weak stimulation occurs with release of secretin. Chronic application of alcohol after a few months abolishes the initially seen inhibition and leads to an increase of enzyme secretion of the gland. The raised concentration of protein in the pancreatic juice is the cause of precipitation of protein plugs, and thus probably leads to the alterations which are typical for chronic pancreatitis.

Alcohol drinking induces acute and chronic lesions of the GI tract; some other GI disorders do occur more frequently in drinkers than in other persons. Alcoholics suffer from gastroesophageal reflux, Barrett's syndrome, exophageal cancer and Mallory-Weiss syndrome as well as from hemorrhagic erosive gastritis more often than normal. It is still unsettled if chronic gastritis can be due to alcohol drinking. Alcohol inhibits to some degree the absorption of water, electrolytes, disaccharides and vitamin B12 in the small intestine; it may as well impair intestinal motility and cause diarrhea. Many aspects of the effects of alcohol on the GI tract still remain to be elucidated. The main stay of therapy is abstenence.

The method of rebreathing and its particular importance to the estimation of blood alcohol concentration (BAC) are described. A face mask with an accompanying valve chamber to which a collection bag was attached proved to meet the requirements arising from the physiological exchange processes in rebreathed air. Practical tests in the laboratory revealed excellent agreement between the values obtained by direct measurements of breath alcohol by means of an IR-Spectrophotometer and those from stored samples. The application of the method described is of particular importance in cases of unconscious and benumbed patients, of sleeping and uncooperative patients and those with collapsed veins suspected of heavy alcohol intoxication. It has been proven to be an essential aid in differential diagnosis since it allows instantaneous determination and continuous monitoring of the BAC-level which aids in the observation of the reduction of this level. This was demonstrated in practice with 9 patients at the alcohol emergency clinic in Mainz on the carnival "Rosenmontag".

Review of literature. Already low dosis of alcohol damage gastric mucosa; alcohol especially causes erosions. In spite of acute damage there is no proven correlation between alcohol and chronic gastritis. HC1 secretion is stimulated by low dosis of alcohol only; higher dosis have no effect on acid secretion. Nevertheless beer or wine stimulate acid secretion very intensively by gastrin liberation. -Low concentrations of alcohol have no influence on gastric emptying, but higher concentrations delay emptying, solid meals more than liquid meals.

In a prospective study intrauterine growth retardation (IUGR) (less than 10. growth percentile at birth) was used as a predictor to diagnose intrauterine alcohol exposure. An interview about maternal alcohol consumption was performed prenatally--when IUGR was diagnosed by ultrasound--or postnatally. The children were followed up to 18 months of age. In 6/47 children we diagnosed various degrees of the Fetal Alcohol Syndrome FAS, with only one patient showing a full blown syndrome at birth. 5 patients could not be identified until the pediatric reexamination at the age of 8-18 months. IUGR and a maternal history of even moderate drinking during pregnancy should emphasize the possibility of an intrauterine alcohol damage, even in a normal child at birth.

A preliminary report is presented on the results achieved in the assessment and treatment of patients with intractable pain during the first six months experience gained following the appointment of a pain consultant at the Ludwig Boltzmann Institute of Clinical Oncology. Nerve blockade was carried out 106 times in 45 patients suffering from primary or secondary malignant disease and 71 times in 18 patients with other conditions; intrathecal instillation of 96% alcohol was performed once and 2 chordotomies were also performed. One patient needed antidepressive therapy. Major questions relating to this problem are discussed. Gratifyingly satisfactory results were observed in more than two thirds of the patients. These objective findings and the subjective impressions obtained from patients, their relatives and our personnel prompted us to continue with this type of treatment for pain and to increase our efforts in this direction.