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We evaluate the hypothesis of no geographic structure in the Huchen ( Hucho hucho), a large, predatory salmonid endemic to the Danube basin. Forty-seven individuals sampled from throughout the Huchen's native range were genetically characterized. Extremely limited sequence diversity across 1,800 bases of mtDNA (the complete control region and partial NADH-1 subunit) evidenced by four closely related mtDNA haplotypes was found. Nonetheless, the geographic distribution of mtDNA repeats (5-10, 82-bp long copies per individual) as well as allelic diversity across two microsatellite loci indicated large-scale geographic structure between the north-western (Austria and Slovenia) distribution area and eastern (Slovakia and Ukraine) or southern (Bosnia-Herzegovina and Montenegro) sample sites. An extremely slow rate of substitution for the H. hucho mtDNA is considered along with the alternative hypotheses to explain the limited mtDNA diversity. Considering the regional genetic structure implied by our data, we advocate restrictions on the transport of brood fish or yearlings across the range of the species distribution and sale of Huchen across international boundaries. Future genetic analysis to support local conservation and monitoring efforts must focus on developing a high-resolution screen that may be applied to identify hatchery versus naturally reproduced individuals in the wild. [ABSTRACT FROM AUTHOR]

We hypothesized that there is spatio-temporal genetic (mtDNA) structure of native and introduced larval whitefish ( Coregonus sp.) in two Austrian lakes (Traunsee and Hallstättersee). Larval whitefish were sampled from 12 sites in each lake and screened for variation in the mtDNA NADH-1 gene. Based on the sequencing of adult fish together with existing GenBank sequences, an RFLP protocol was developed to assign haplotypes from larval samples into one of two divergent lineages. All but one site (pelagic) in Traunsee contained both haplotypes, thus there was no support for spatial segregation of mtDNA groups in that lake. However, weekly sampling from December to May in Traunsee revealed a temporal pattern, with the native haplotypes dominating in December and January before the appearance of the introduced Baltic clade. In Hallstättersee, only three of the 12 sites sampled revealed haplotypes from the introduced clade and thus spatial segregation seems operative on that lake. Our results imply that differences in the spawning ecology of the two groups maintain sufficient reproductive isolation to be reflected in distinct larval occurrence in space and time highly consistent with genetic differences on the mtDNA level. If the two lineages were highly introgressed, we would expect to find little or no correspondence between spatio-temporal patterns in larval distribution and the differentiated mtDNA lineages. [ABSTRACT FROM AUTHOR]

Presents enhanced phylogeographic information on Austrian brown trout populations derived from mitochondrial control region sequences. Derivation of phylogeographic information from DNA sequences of the control region; Identification of two mitochondrial lineages in Austria by parsimony and neighbor-joining methods; Enhancement of the detection of genetic diversity in lineages by additional sequence information.

Abstract Mitochondrial haplotype diversity in 27 populations of brown trout, Salmo trutta L., in Austria was investigated by sequencing the 5′ end of the mitochondrial DNA (mtDNA) control region. Although all populations are within the Danube drainage, 44% of all individuals carried Atlantic basin haplotypes. It is argued that the presence of these haplotypes in Austria primarily reflects introgression stemming from the stocking of hatchery-reared fish. However, several lines of evidence suggest that some natural colonization from Atlantic lineages may have contributed to the present haplotype diversity. Nonetheless, the more diverse Danubian clade is represented by regionally distinct haplotype diversity that should be protected from the continued introduction of domesticated strains of exogenous fish. [ABSTRACT FROM AUTHOR]

Weirs and traps were used to monitor the movement of two strains of stocked brown trout, Salmo trutta L. Within 24 h of stocking, 15% (n = 13) of a Danish strain and 21% (n = 19) of a hybrid strain moved at least 100 m from their release site. In the following 5–6 days, no further movement was found for Danish fish, but hybrid fish continued to move, totaling 32% (n = 29) of the fish stocked. During this same period, 36 wild brown trout (≈ 3.5% of the population) were captured, moving over the weirs. Two weeks later, and one week after a flood, 70% (n = 59) of the Danish strain were recovered within their release sites and 89% (n = 76) were recovered during an electric fishing survey within the 3.5-km-long experimental area. In contrast, 43% (n = 31) of the hybrid strain were recaptured in their release sites and 49% (n = 45) within the experimental area. The total recapture of wild adult fish was only 16% (n = 41). The flooding event was insignificant in comparison with strain-specific behaviours in determining patterns of movement and residency.Austria, brown trout, floods, movement, stocking. [ABSTRACT FROM AUTHOR]

Introduction: Two randomized trials demonstrated a survival benefit of triplet therapy (androgen deprivation therapy [ADT]) plus androgen receptor pathway inhibitor [ARPI] plus docetaxel) over doublet therapy (ADT plus docetaxel), thus changing treatment strategies in metastatic hormonesensitive prostate cancer (mHSPC)., Patients and Methods: We conducted the first real-world analysis comprising 97 mHSPC patients from 16 Austrian medical centers, among them 79.4% of patients received abiraterone and 17.5% darolutamide treatment. Baseline characteristics and clinical parameters during triplet therapy were documented. Mann-Whitney U test for continuous or X²-test for categorical variables was used. Variables on progression were tested using logistic regression analysis and tabulated as hazard ratios (HR), 95% confidence interval (CI)., Results: Of 83.5% patients with synchronous and 16.5% with metachronous disease were included. 83.5% had high-volume disease diagnosed by conventional imaging (48.9%) or PSMA PET-CT (51.1%). While docetaxel and ARPI were administered consistent with pivotal trials, prednisolone, prophylactic gCSF and osteoprotective agents were not applied guideline conform in 32.5%, 37%, and 24.3% of patients, respectively. Importantly, a nonsimultaneous onset of chemotherapy and ARPI, performed in 44.3% of patients, was associated with significantly worse treatment response (P = .015, HR 0.245). Starting ARPI before chemotherapy was associated with significantly higher probability for progression (P = .023, HR 15.781) than vice versa. Strikingly, 15.6% (abiraterone) and 25.5% (darolutamide) low-volume patients as well as 14.4% (abiraterone) and 17.6% (darolutamide) metachronous patients received triplet therapy. Adverse events (AE) occurred in 61.9% with grade 3 to 5 in 15% of patient without age-related differences. All patients achieved a PSA decline of 99% and imaging response was confirmed in 88% of abiraterone and 75% of darolutamide patients., Conclusions: Triplet therapy arrived in clinical practice primarily for synchronous high-volume mHSPC. Regardless of selected therapy regimen, treatment is highly effective and tolerable. Preferably therapy should be administered simultaneously, however if not possible, chemotherapy should be started first., Competing Interests: Disclosure All authors declare that there are no conflicts of interest. The study was performed in accordance with the local ethical standards., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Per- and polyfluoroalkyl substances (PFAS) are a large group of persistent industrial chemicals that can harm reproductive health. PFAS levels were analysed to determine the current sources of exposure and possible associations between prenatal PFAS exposure and adverse pregnancy outcome. Samples from 136 mother-newborn pairs recruited between 2017 and 2019 were analysed for the presence of 31 target PFAS in maternal serum, umbilical cord serum, and placental tissue by high-performance liquid chromatography coupled to a tandem mass spectrometer. Questionnaires and medical records were used to survey sources of exposure and pregnancy outcome, including small for gestational age (SGA), fetal growth restriction (FGR), preeclampsia (PE), preterm birth, large for gestational age (LGA) and gestational diabetes mellitus (GDM). Data were analysed for individual PFAS and sum4PFAS (sum of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS), and perfluorooctane sulfonate (PFOS) serum levels) in logistic regression analyses and categorical regression analyses. Compared to data from a previous Viennese study in 2010-12, sum4PFAS levels were generally lower. Sum4PFAS serum levels of three women (2.2%) exceeded 6.9 µg/L, a level that corresponds to the recently established tolerable weekly intake (TWI) of EFSA for nursing mothers aged 35 years; in the 2010/2012 study it was 13.6%. The large contribution of unidentified extractable organofluorine (EOF) fractions to total PFAS exposure is a concern. Study site, mean maternal corpuscular hemoglobin (MCH), use of facial lotion, and owning upholstered furniture were significantly influencing maternal exposure. While no effect of sum4PFAS on pregnancy outcome could be detected, we found highest placental PFDA levels in SGA births. PFHxS levels in umbilical cord and placenta were highest in preterm births. Further studies are needed to elucidate the relationship of prenatal PFAS exposure and pregnancy outcome, in particular to confirm whether and how placental PFDA levels may contribute to an increased risk for SGA., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

In 85 Austrian school children aged 6-10 years, two multi-analyte LC-MS/MS methods were used to study the concentrations of 33 chemical substances in urine, including per- and polyfluorinated alkylated substances (PFAS), bisphenols, parabens, benzophenones, triclosan, polycyclic aromatic hydrocarbon metabolites, and cotinine. Each of the children was exposed to 14-21 substances simultaneously. Correlations were found between compounds of the same and of divergent substance groups supporting the strong need to consider multiple exposures and mixture effects. Eight compounds, including perfluorohexanoic acid (PFHxA), perfluorononanoic acid (PFOA), methyl paraben (n-MeP), ethyl paraben (n-EtP), propyl paraben (n-PrP), benzophenone-1 (BP-1), 2-naphthol, and 3-hydroxyphenanthrene were detected in all urine samples. In the PFAS group the medians of detectable substances ranged between <0.0005 μg/l for perfluorononanoic acid (PFNA) and 0.004 μg/l for PFHxA. For other environmental contaminants investigated, a maximum urinary level of 893 μg/l was identified for n-MeP. The highest median value was 2.5 μg/l for 2-naphthol. Daily intakes were calculated for bisphenol A (BPA), triclosan (TCS), and four parabens. These values did not exceed the tolerable or acceptable daily intakes currently in force. Based on a recently proposed TDI for BPA, daily intakes of all children exceeded this value. A cumulative risk assessment was conducted for four parabens not showing exceedances of acceptable exposures. The results demonstrate simultaneous exposure to several different chemicals, with the majority showing impact on the endocrine system being of particular concern with respect to mixture effects. Further assessments with a stronger focus on mixtures are warranted. The results also highlight the need of policy actions as foreseen in the EU Chemicals Strategy for Sustainability., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Systematic, continuous mosquito surveillance is considered the most reliable tool to predict the spread and establishment of alien mosquito species such as the Asian tiger mosquito (Aedes albopictus), Japanese bush mosquito (Aedes japonicus), and the transmission risk of mosquito-borne arboviruses to humans. Only single individuals of Ae. albopictus have been found in Austria so far. However, it is likely that the species will be able to establish populations in the future due to global trade and traffic as well as increasing temperatures in the course of global climate change. In summer 2017, a project surveilling the oviposition of newly introduced Aedes mosquitoes, using ovitraps, was set up by means of citizen scientists and researchers and was performed in six federal provinces of Austria-Tyrol, Carinthia, Vienna, Lower Austria, Styria, and Burgenland. Eggs of Ae. albopictus were identified in Tyrol during the months August and September, while Ae. japonicus was found in Lower Austria, Styria, and Burgenland. In Vienna and Carinthia, all ovitraps were negative for Aedes eggs; however, Ae. japonicus was found for the first time in Vienna in July 2017 during routine sampling of adult mosquitoes. With this project, we demonstrated the benefits of citizen scientists for ovitrap-based mosquito surveillance. The finding of Ae. albopictus eggs in Northern Tyrol is not yet a proof of the establishment of a self-sustaining population, although it indicates the ongoing introduction of this species along main traffic routes from Italy, where this mosquito is well established. The risk of establishment of the tiger mosquito in the Lower Inn Valley is therefore a given and informing the public about preventive measures to hinder and delay this development is highly recommended.

Objective: To expand the clinical and genetic spectrum of nemaline myopathy 10 by a series of Austrian and German patients with a milder disease course and missense mutations in LMOD3 ., Methods: We characterized the clinical features and the genetic status of 4 unrelated adolescent or adult patients with nemaline myopathy., Results: The 4 patients showed a relatively mild disease course. They all have survived into adulthood, 3 of 4 have remained ambulatory, and all showed marked facial weakness. Muscle biopsy specimens gave evidence of nemaline bodies. All patients were unrelated but originated from Austria (Tyrol and Upper Austria) and Southern Germany (Bavaria). All patients carried the missense variant c.1648C>T, p.(Leu550Phe) in the LMOD3 gene, either on both alleles or in trans with another missense variant (c.1004A>G, p.Gln335Arg). Both variants were not reported previously., Conclusions: In 2014, a severe form of congenital nemaline myopathy caused by disrupting mutations in LMOD3 was identified and denoted as NEM10. Unlike the previously reported patients, who had a severe clinical picture with a substantial risk of early death, our patients showed a relatively mild disease course. As the missense variant c.1648C>T is located further downstream compared to all previously published LMOD3 mutations, it might be associated with higher protein expression compared to the reported loss-of-function mutations. The apparent clusters of 2 mild mutations in Germany and Austria in 4 unrelated families may be explained by a founder effect., (© 2018 American Academy of Neurology.)

Reference values (RV 95 ) are statistically derived values comprising the rounded 95th percentiles within the 95% confidence interval and indicate the upper margin of background exposure to chemical substances in a population at a given time period. Based on representative national human biomonitoring data on several urinary phthalate metabolites in children, adolescents and adults from 2010 to 2011, RV 95 were derived for the Austrian population based on a IUPAC guideline and the recommendation of the German Human Biomonitoring Commission. The RV 95 (rounded values) for phthalate metabolites in children and adolescents aged 6-15 years are 110 μg/l (confidence interval of 95th population percentile: 83.7-163) for mono-ethyl phthalate (MEP), 45 μg/l (40.9-60.6) for mono-n-butyl phthalate (MnBP), 130 μg/l (126-161) for mono-isobutyl phthalate (MiBP), 25 μg/l (17.8-33.6) for mono-benzyl phthalate (MBzP), 100 μg/l (94.0-126) for the sum of the di(2-ethylhexyl) phthalate (DEHP) metabolites including mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP) and mono(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP), and 1.5 μg/l (0.64-1.6) for mono-cyclohexyl phthalate (MCHP). In adults aged 18-81 years, RV 95 are 440 μg/l (353-636) for MEP, 40 μg/l (33.1-52.1) for MnBP, 110 μg/l (87.3-118) for MiBP, 10 μg/l (7.2-11.8) for MBzP, 50 μg/l (44.6-68.3) for the sum of MEHP, 5OH-MEHP, 5oxo-MEHP and 5cx-MEPP, and 1.5 μg/l (0.95-1.8) for MCHP. For almost all investigated metabolites, children and adolescents exhibit higher RV 95 than adults, with the exceptions being MEP and MCHP. Compared to available RV 95 for Germany and Canada, Austrian values are lower for all investigated population groups., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

This study forms the first report on analyzing fullerenes in the Austrian environment and cosmetic products available on the Austrian market. We developed, optimized, and validated a novel method for the analysis of C 60 and C 70 fullerenes and N-methylfulleropyrrolidine C 60 (NMFP) for measuring sensitivities in the low nanograms per liter range in order to prove their presence in the environment (12 wastewater- and 12 sewage sludge samples) and in 11 selected fullerene-containing cosmetic products from three different brands. The optimized method relies on a liquid-liquid extraction (LLE) or solid-liquid extraction (SLE) and, for the first time, introduced the Carrez-clarification, followed by liquid chromatography (LC) and coupled to a hybrid triple quadrupole mass spectrometry (MS) quantification. The total variability of the new established LC-MS/MS method based on all the tested matrices was below 10%. We found recoveries generally higher than 70% for both tap water and surface water. The limits of quantitation (LOQ) for the wastewater samples were measured to be from 0.8 to 1.6 ng/L, for the sewage sludge samples, from 1.4 to 2.6 ng/g DM (drymass), and for the cosmetic samples from 0.2 to 0.4 ng/g. None of the analyzed samples of wastewater or sewage sludge samples contained fullerenes. But in 70% of the tested cosmetics, fullerene concentrations between 10 and 340 ng/g were detected. These values were much lower than concentrations causing toxicity in water animals.

Phthalates are a class of chemicals widely used as plasticisers in a multitude of common consumer products. Through contact with such products, people are regularly exposed to phthalates, which are suspected to contribute to adverse health effects, particularly in the reproductive system. In the present study, 14 urinary phthalate metabolites of 10 parent phthalates were analysed by HPLC-MS/MS among the Austrian population aged 6-15 and 18-81 years in order to assess phthalate exposure. In the total study population, ranges of urinary phthalate metabolite concentrations were n.d.-2,105 μg/l (median 25 μg/l) for monoethyl phthalate (MEP), n.d.-88 μg/l (10 μg/l) for mono-n-butyl phthalate (MnBP), n.d.-248 μg/l (28 μg/l) for mono-isobutyl phthalate (MiBP), n.d.-57 μg/l (1.8 μg/l) for mono-benzyl phthalate (MBzP), n.d.-20 μg/l (n.d.) for mono-(2-ethylhexyl) phthalate (MEHP), n.d.-80 μg/l (2.6 μg/l) for mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), n.d.-57 μg/l (1.9 μg/l) for mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), n.d.-219 μg/l (11 μg/l) for mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), n.d.-188 μg/l (1.6 μg/l) for 3-carboxy-mono-proply phthalate (3 cx-MPP), n.d.-5.5 μg/l (n.d.) for mono-cyclohexyl phthalate (MCHP), n.d.-4.5 μg/l (n.d.) for mono-n-pentyl phthalate (MnPeP), n.d.-3.4 μg/l (n.d.) for mono-n-octyl phthalate (MnOP), n.d.-13 μg/l (n.d.) for mono-isononyl phthalate (MiNP), and n.d.-1.1 μg/l (n.d.) for mono-isodecyl phthalate (MiDP). Generally, children exhibited higher levels of exposure to the majority of investigated phthalates, except to MEP, which was found in higher concentrations in adults and senior citizens at a maximum concentration of 2,105 μg/l. Individual daily intakes were estimated based on urinary creatinine and urinary volume excretion and were then compared to acceptable exposure levels, leading to the identification of exceedances of mainly the Tolerable Daily Intakes (TDI), especially among children. The execution of a cumulative risk assessment based on Hazard Indices showed cause for concern mainly for children, as well as in rare cases for adults. Although phthalate exposure seems to have decreased in previous years, the wide distribution and existing exceedances of acceptable levels indicate that phthalate exposure should be further monitored in order to identify exposure sources and enable appropriate minimisation measures., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Humans are exposed to a broad variety of man-made chemicals. Human biomonitoring (HBM) data reveal the individual body burden irrespective of sources and routes of uptake. A first population-based study was started in Austria in 2008 and was finished at the end of May 2011. This cross sectional study aims at documenting the extent, the distribution and the determinants of human exposure to industrial chemicals as well as proving the feasibility of a representative HBM study. Overall, 150 volunteers (50 families) were selected by stratified random sampling. Exposure to phthalates, trisphosphates, polybrominated diphenyl ethers (PBDE), bisphenol A (along with nonyl- and octyl phenol) and methyl mercury was assessed. Sixteen of 18 PBDE determined were detected above the limit of quantification (LOQ) in blood samples with #153 and #197 the most abundant species. Bisphenol A in urine was measured in a subsample of 25 with only 4 samples found above the LOQ. In 3 of 100 urine samples at least one of 8 trisphosphate compounds assessed was above the LOQ. These first analytical results of the human biomonitoring data show that the body burden of the Austrian population with respect to the assessed compounds is comparable to or even lower than in other European countries. Overall, the study revealed that in order to develop a feasible protocol for representative human biomonitoring studies procedures have to be optimized to allow for non-invasive sampling of body tissues in accordance with the main metabolic pathways. Procedures of participants' recruitment were, however, labor intensive and have to be improved., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

Gyrodactylus teuchis is a widespread parasite of wild and farmed salmonids throughout Europe. It has been frequently confused with the notifiable pathogen G. salaris, to which it bears a striking morphological similarity. The species is frequently referred to as 'cryptic', and diagnoses are primarily based on molecular evidence. We provide the first comprehensive re-description of G. teuchis from a natural wild brown trout population in the Danube watershed, based on the state of the art morphometrics in addition to standard molecular markers. We demonstrate that despite the lack of uni-variate diagnostic character measurements, G. teuchis can be reliably distinguished from G. salaris using multivariate morphological approaches such as Principal Component Analysis or Canonical Variate Analysis, suggesting that automated diagnostic approaches for G. salaris can be modified to take account of potential G. teuchis in samples. This is the first record of G. teuchis from a host population unlikely to have been modified by human stocking efforts. The morphological variability observed in the samples collected from one site on 1 day reflects the overall level of variation reported for European G. teuchis. We also report new sequence variants of the internal transcribed spacer (ITS-1) of the nuclear ribosomal gene cluster with evidence for intra-individual heterogeneity of ITS-1 within this population of G. teuchis., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Translocations of Baltic whitefish (Coregonus sp.) into Austrian Alpine lakes have created 'artificial hybrid zones', threatening the genetic integrity of native lineages. We evaluate the genetic structure of Coregonus in Austrian lakes and characterize hybridization and introgression between native and introduced lineages. Fifteen populations (N=747) were assessed for allelic variation at eight microsatellite loci and a reduced set (N=253) for variation across two mtDNA genes (cyt b and NADH-3). Bayesian approaches were used to estimate individual admixture proportions (q-values) and classify genotypes as native, introduced or hybrids. q-value distributions varied among populations highlighting differential hybridization and introgression histories. Many lakes revealed a clear distinction between native and introduced genotypes despite hybridization, whereas some locations revealed hybrid swarms. Genetic structure among lakes was congruent with morphological divergence and novelty raising speculation of multiple taxa, including a population south of the Alps, outside the putative native range of Coregonus. Although statistically congruent with inferences based on nuclear markers, mitochondrial haplotype data was not diagnostic with respect to native and non-native lineages, supporting that the Alpine region was colonized post-glacially by an admixture of mtDNA lineages, which coalesce >1 Ma. Mechanisms promoting or eroding lineage isolation are discussed, as well as a high potential to conserve native Alpine lineages despite the extensive historical use of introduced Baltic stocks., (© 2010 Blackwell Publishing Ltd.)

Airway responsiveness is an objectively measurable clinical trait related to the presence of asthma. Although risk factors for this trait have been evaluated cross-sectionally, little is known about its longitudinal predictors. A population cohort of 539 children, aged 8 yrs at the start of follow-up, underwent 3-7 bronchial challenge tests spaced at 3-9 month intervals. Airway responsiveness was assessed by a single-step distilled water challenge. To investigate responsiveness as a continuous trait, the ratio of the postchallenge to prechallenge forced expiratory volume in one second was calculated. A child's repeated ratios were then regressed on the time of follow-up. The resulting child-specific regression coefficient was the outcome variable to assess longitudinal predictors of airway responsiveness (AR). Results were based on 2,267 repeated challenge tests, and indicated an overall decrease in responsiveness. Children with a diagnosis of asthma (mean+/-SD, longitudinal change in AR + yr(-1): -0.060+/-0.149), those with a positive skin-prick test (-0.018+/-0.106) and those with reported exposure to maternal smoking (-0.004+/-0.083) demonstrated increased airway responsiveness over time. All of these changes in airway responsiveness were found to be significant in multiple linear regression analysis (p<0.05). Stratified analysis further indicated that the effect of maternal smoking was observed primarily in nonatopic children and was greatest at an exposure level of > or =10 cigarettes x day(-1). In conclusion, atopy and exposure to maternal smoking can predict longitudinal change in childhood airway responsiveness.

The first HIV test among intravenous drug users (IVDUs) at the AIDS clinic and/or the drug dependency clinic of the University of Innsbruck was the basis for the calculation of the proportions of those testing HIV seropositive annually over the period 1985-1990. The numbers testing HIV seropositive at the drug dependency clinic declined drastically, from 72.2% in 1985 to 12.5% in 1990 (chi 2 = 29.62, p less than 0.0001), whereas they rose at the AIDS clinic during this period, from 48.4% to 100% (chi 2 = 5.82, p = 0.016). Overall 132 of the 268 (49.2%) individuals examined tested HIV seropositive. There were 102 individuals of the original 146 seronegative IVDUs who were retested, for an overall incidence rate of HIV seroconversion of 5.8/100 persons-years. Risk of seroconversion was associated with a steady sexual partnership with an HIV seropositive IVDU and with an age of less than or equal to 25 years at study entry (13.1 versus 8.7/100 persons-years). No seroconversions occurred in the subgroup of patients treated by the methadone maintenance treatment program. The cumulative incidence (Kaplan-Meier) rate for HIV seropositivity after 64 months was 22%, lower than the proportions testing HIV seropositive found in 1985 at each of the two clinics, which suggests that the speed of the spread of the epidemic of HIV infection among IVDUs has slowed in our region. Counseling of IVDUs should emphasize the risks of sexual acquisition, particularly among persons with steady relationships who may not perceive their risk.

Freud's experience on the Acropolis is reviewed and reappraised. Also, the experience of Elie Wiesel at the Wall in Jerusalem and Patient X's reaction visiting an Egyptian temple are examined. Carl Jung's wish to go to Rome and his inability to do so are noted. The aim of the paper is to offer deeper understanding about intense reactions many sensitive and creative people experience over travel to special places. These places are treated as idealized and ambivalently loved transference objects. Normal anticipatory pleasure prior to the trip is impaired and reality pleasure at the site cannot be enjoyed. When these spots are reached, ego regression is initiated by the intolerably intense narcissistic pleasure mobilized by the gratification of fantasies that were felt to be unrealizable. The fantasies can be conscious or unconscious and from oedipal as well as preoedipal and postoedipal developmental levels; however, they always involve the fulfillment of overwhelmingly powerful wishes. The deep ego regression, archaic fantasies, and the complex defenses mobilized are frightening since there may also be concern about ego dissolution or irreversible transformation. One highly adaptive solution which helps master these conflictual and developmental experiences is creative ego activity. While maintaining integrity for the individual ego and enhancing the self, creative work and accomplishment also enrich and advance the cultural process.