Biomedical subjects

C Mundt

Publications and source records attributed to C Mundt.

At least 19 recordsLinked to original sources

PubMed2006

Influence of applied quantity of sunscreen products on the sun protection factor--a multicenter study organized by the DGK Task Force Sun Protection.

It is often debated that the protection against solar-induced erythema under real conditions is dependent upon the amount of sunscreen applied. It is believed that when too little is applied a lower sun protection than indicated on the label will result. The aim of this study was to quantify this effect. In this multicenter study, the influence of three different amounts (0.5, 1.0, 2.0 mg/cm(2)) of three commercial sunscreen products in three reliable test centers was investigated according to the test protocol of The International Sun Protection Factor Test Method. The main result was a linear dependence of the SPF on the quantity applied. Taking into consideration the volunteer-specific variations, an exponential dependence of confidence interval of the in vivo SPF and amount applied was found. The highest amount applied (2.0 mg/cm(2)) was linked to the lowest confidence intervals. Thus, from the point of view of producing reliable and reproducible in vivo results under laboratory conditions, the recommendation of this multicenter study is an application quantity of 2.0 mg/cm(2).

Confidence Intervals↗

PubMed2006

Change in lean body mass is a major determinant of change in areal bone mineral density of the proximal femur: a 12-year observational study.

Our objective was to assess the contribution of lean body mass (LBM) and fat body mass (FBM) to areal bone mineral density (aBMD) in women during the years surrounding menopause. We used a 12-year observational design. Participants included 75 Caucasian women who were premenopausal, 53 of whom were available for follow-up. There were two measurement periods: baseline and 12-year follow-up. At both measurement periods, bone mineral content and aBMD of the proximal femur, posterior-anterior lumbar spine, and total body was assessed using dual-energy X-ray absorptiometry (DXA). LBM and FBM were derived from the total-body scans. General health, including current menopausal status, hormone replace therapy use, medication use, and physical activity, was assessed by questionnaires. At the end of the study, 44% of the women were postmenopausal. After controlling for baseline aBMD, current menopausal status, and current hormone replacement therapy, we found that change in LBM was independently associated with change in aBMD of the proximal femur (P = 0.001). The cross-sectional analyses also indicated that LBM was a significant determinant of aBMD of all three DXA-scanned sites at both baseline and follow-up. These novel longitudinal data highlight the important contribution of LBM to the maintenance of proximal femur bone mass at a key time in women's life span, the years surrounding menopause.

Absorptiometry, Photon↗

PubMed2006

[Treatment utilisation of a psychoeducational group for relatives of patients with affective disorders].

The relevance of family interactions in the course of affective disorders has been well described. In contrast to the situation regarding schizophrenic disorders, there are few systematic concepts for involvement of the relatives of patients with affective disorders in treatment. The goal of this study was the development and evaluation of a standardised psychoeducational treatment programme. We determined the number and characteristics of relatives accepting the offer of such a group. Relatives of almost half of 55 patients with major depression and a bipolar disorder participated in the group. Relatives of male patients were more likely to take part than relatives of female patients. Relatives of patients with a bipolar disorder were more likely to take part than relatives of patients with unipolar depression. The patients whose relatives attended the group showed a more favourable understanding of the illness and more knowledge about affective disorders, but on the other hand, felt themselves to be more strongly criticised by their relatives and had less social support than the other patients. These results emphasise the importance of differential family-focused treatment modalities in affective disorders.

Adaptation, Psychological↗

PubMed2006

[Personality, personality disorders and depression].

Personality is one of most frequently investigated fields in depression research and, despite changes in research paradigms, has not lost its relevance. Numerous results concerning the conceptualization of conspicuous personality traits, their aetiopathogenetic significance, and their effect on treatment and course have contributed to a better understanding of depression. Genetics and neurobiology provide new incentives for research in this field. We present an overview of aspects relevant to personality research in depression including personality types, personality traits, temperament factors, and personality disorders. Especially results on personality factors' effect on treatment and course of depression, integrating these results with different personality models in depression, and their consequences to treatment and further research of personality traits in depression are discussed.

Depression↗

PubMed2005

[Executive control functions and neuropsychiatric disorders -- perspectives for research und clinical practice].

Executive control functions are higher cognitive functions for complex goal-oriented behavior in situations where routine mechanisms are not available or inappropriate. In clinical practice executive dysfunction presents with deficits in cognitive function as well as social behavior and drive. Executive control functions rely on intact networks involving prefrontal cortex and subcortical structures, which can be modulated by monoaminergic neurotransmitters. Deficits of executive control have been described in a variety of neuropsychiatric disorders. We present a review of the findings with a focus on movement disorders, schizophrenia and affective disorders. We emphasize similarities between these disorders regarding the pathophysiology of fronto-subcortical networks. Based on these similarities, principles of pharmacological and rehabilitative strategies can be applied to the treatment of executive deficits in a variety of neuropsychiatric disorders without being specific for one disease. Since executive dysfunction is highly relevant to prognosis, controlled trials of these treatments are urgently needed.

Basal Ganglia Diseases↗

PubMed2005

[Consequences of nosographic and trans-nosological concepts of schizophrenia].

This essay starts with a brief remark about the -- necessary -- de-tours of the historical pathway to the concept of schizophrenia. The first part on nosographic approaches then describes the results of cross-sectional and longitudinal psychopathological symptom-assembling, subgrouping by factorial analyses, and the cross-cultural stability of the emerging disease concept: The human idiopathic syndrome of structural mental decline in its clinical variegation. The second part about de-nosological approaches provides an account of the clinical concepts of basic symptoms, spectrum disorders, neuropsychological deficits and their genetic family loading. Genetics of neuropsychological deficits demonstrate in detail that risk and protective factors to schizophrenia are genetically closely enmeshed. Higher familial loading of some neuropsychological deficits compared to the actual disease itself points at the dilemma that functional psychopathology deepens causal understanding and yet looses specificity for the disease syndrome. The concluding part of this essay emphasizes some sequelae of de-nosological approaches: Better tools for earlier recognition treatment and prevention; ego-distal concepts of basic dysfunctions rather than the previous ego-proximal concepts, hence better self-esteem, insight, and de-stigmatization for patients.

History, 20th Century↗

PubMed2004

[Psychotherapy for postpartum depression with a focus on mother-infant interaction].

In the treatment of mothers with postpartum depression, mother-infant interaction plays a central role. It is well known that babies are very sensitive to their mothers' emotional state. This sensitivity during the first months of life is fundamental to understanding the influence of maternal psychiatric disorders and especially of postpartum depression, as the most frequent, on children's development. The specific situation of young mothers requires adaptation of psychotherapeutic approaches to their needs. In connection with an overview of these issues, models of mother-infant treatment as well as evaluation studies are discussed. Finally, an integrated treatment approach for postpartum depression including mother-infant-centered interventions is presented.

Child of Impaired Parents↗

PubMed2003

Complex formation of sericoside with hydrophilic cyclodextrins: improvement of solubility and skin penetration in topical emulsion based formulations.

The main objective of this study was to devise novel methods for improving the solubility of the anti-inflammatory triterpenoid sericoside, the main component of Terminalia sericea extract, thus enabling its incorporation into topical formulations. Sericoside was stabilized by complex formation with hydrophilic derivatives of beta- and gamma-cyclodextrins in a molar ratio of 1.0:1.1. The complex of extract and cyclodextrin was equilibrated in water at 25 degrees C for approximately 24 h. The dehydrated complexes of T. sericea extract and cyclodextrin were characterized by differential scanning calorimetry, thermogravimetry analysis and X-ray diffraction. Complex formation with beta-cyclodextrin as well as gamma-cyclodextrin derivatives was detectable using these three analytical tools; however, only complexes with gamma-cyclodextrin derivatives showed stability upon storage after incorporation into topical o/w or w/o formulations. Furthermore, a T. sericea extract/gamma-cyclodextrin complex incorporated in an o/w formulation resulted in a 2.6-fold higher percutaneous penetration of sericoside in in vitro excised pig skin as compared to pure T. sericea extract. For the first time, the virtually insoluble anti-inflammatory active sericoside was incorporated into a topical emulsion based formulation in a stable manner, resulting in efficient skin penetration.

Administration, Topical↗

PubMed2002

[Temperament and affective disorders. The TEMPS-A Scale as a convergence of European and US-American concepts].

In temperament research, three traditions can be found: (1) in psychiatry or psychopathology, (2) in neurobiology, and (3) in developmental psychology. After giving an overview, we present results and theories concerning the relation between temperament and affective disorders. Based on Kraepelin's concept of the fundamental states ("Grundszustände"), we describe four types of temperament: hyperthymic (manic), depressive, irritable, and cyclothymic. A fifth anxious temperament is added. Clinical description and scientific implications are described in the light of recent work by Akiskal and the German version of the TEMPS-A scale, a self-report questionnaire for assessing temperament.

Anxiety Disorders↗

PubMed2002

[Psychodynamic therapy approaches in depressive disorders. Pathogenesis models and empirical principles].

Targets for psychodynamic psychotherapy are the core conflictual relational mode and its consequences for mood, social behaviour, and self image. Libido- and conflict-based concepts of the relational mode are increasingly being replaced by the concept of intersubjectivity, which includes also nonconflictual, healthy modes of relations as a basic human mental task. According to recent mother-infant interaction research, the psychotherapeutic effect on the relational mode can be interpreted in terms of procedural learning rather than insight-oriented discourse. The mother-infant paradigm is a particularly suitable research paradigm to elucidate unconscious procedural acquisition of mental representations of dyadic interactional styles. Procedural learning requires a more active corrective style of interacting on the therapist's side, beyond abstinence and control of countertransference. Evaluative studies show that psychodynamic psychotherapy of depression is nearly as effective as cognitive behaviour therapy (CBT) and interpersonal therapy (IPT).

Adult↗

PubMed2002

[Victims of Nazi euthanasia, the so-called T4 action. First results of a project at the German Federal Archives to disclose records of killed patients].

In 1990, previously unknown documents dated from the Nazi era were found in Berlin. They had been preserved in the central archives of the Ministry for State Security (MfS), the secret service of the now former German Democratic Republic (GDR). Nearly 30,000 psychiatric patient files turned out to comprise the smaller part of the records of patients who had been murdered in the 1940/41 "T4 action". More than 70,000 patients of psychiatric asylums were killed by gas in this first campaign of extermination during Nazism, and their files were believed to have been lost. Based on a project to be funded by the German Research Association, this paper offers a brief survey of the developments in historical research about Nazi "euthanasia" and the theories interpreting historical information. The paper will also present a research project dedicated to the memory of the victims of the "T4 action" and to the rediscovered files now conserved in the German Federal Archives in Berlin. The aim is to offer a systematic analysis of 3,000 records in an effort to contribute to the perception of the victims as individuals. The analysis will also include an examination of the selection criteria stipulated by the Nazi psychiatrists (hereditary illness, incurability, and incapacity to work productively) to select patients for extermination. In this way, the decision-making process, criteria, and motives that led to the killing should become more clear. This empirical analysis will help to answer questions concerning the proportion of eugenic and economic motivations and the Nazi rationale behind the extermination campaigns. The project will build upon an earlier preliminary study of a nonrepresentative sample of 185 files. As a preliminary result, it can be said that most of the victims had been hospitalised over long terms and classified as schizophrenic or feeble-minded. A third of the patients killed were considered invalid and not working, and almost 50% were described as working "mechanically". Five per cent of the victims were working "productively".

Crime Victims↗

PubMed2002

[Effect of personality factors and structure on the course of major depression].

The extent to which personality characteristics predict the course of severe depression has been controversially discussed. In a sample of 50 depressed inpatients, the significance of personality characteristics for the prediction of relapse was studied prospectively over 2 years. More than half of the patients studied suffered relapses within this period. Well-known predictors such as the number of previous episodes were confirmed. The personality characteristics studied showed different predictive effects at 1- and 2-year follow-up. Neurosis proved predictive of the 1-year course and outcome but not the 2-year course. In the 2nd year of follow-up, a melancholic personality structure was associated with favourable outcome. This personality type therefore seems to be more appropriate as a predictor of long-term outcome. Comparison with predictive factors described earlier showed that in this study, personality traits influence outcome independently and were not confused by other predictors. Implications for relapse prevention and psychotherapeutic management are discussed.

Adult↗

PubMed2002

H(2)-histamine antagonist (famotidine) induced adverse CNS reactions with long-standing secondary mania and epileptic seizures.

We report on the case of a 65-year-old female who was treated for one week with famotidine, a reversible H(2)-histamine antagonist, due to gastric pain. Shortly after treatment began, she presented manic symptoms and developed two generalized seizures, after which famotidine was discontinued. Manic symptoms were present for three months; intermittent treatment with both carbamazepine and antipsychotic medication was necessary before her mental status was completely restored. While cimetidine and ranitidine are known to cause secondary mania, this symptom has not been described for famotidine. CNS side effects are usually short-lived and respond to discontinuation of the drug, which was not the case in our patient. During a follow-up period that has so far lasted four years, the patient has been stable without any psychiatric medication. Adjusting the maintenance dosage of H(2)-histamine antagonists has been recommended in elderly patients since age-related reduction in renal plasma flow, glomerular filtration rate and renal tubular function may be present, which can in turn elevate histamine levels in plasma and cerebrospinal fluid. Our patient, however, had normal renal function and was free of organic or psychiatric diseases, so what pathogenetic mechanism led to the remarkably long standing manic syndrome after a relatively short course of famotidine remained unknown; famotidine seems to cause the same spectrum of adverse central nervous system (CNS) reactions as other H(2)-histamine antagonists.

Aged↗

PubMed2001

Investigations on the carbohydrate moieties of glycoprotein allergens.

Many allergens are glycoproteins and their carbohydrate structure can contribute to the IgE reactivity. Therefore it is of great interest to study the carbohydrate structures of these particular antigens. Here, we present an overview of methods combining basic procedures in glycochemistry with various applications of electrophoresis that allow investigating single allergens in crude extracts. Various allergen extracts, e.g. from tomato, grass pollen and bacteria were analysed and the suitability of the tests are discussed.

Allergens↗

PubMed2001

Loss of precursor B cell expansion but not allelic exclusion in VpreB1/VpreB2 double-deficient mice.

The pre-B cell receptor consists of immunoglobulin (Ig) mu heavy chains and surrogate light chain, i.e., the VpreB and lambda5 proteins. To analyze the role of the two VpreB proteins, mice lacking the VpreB1 and VpreB2 genes were generated. VpreB1(-/-) VpreB2(-/-) mice were impaired in their B cell development at the transition from pre-BI to large pre-BII cells. Pre-BII cells did not expand by proliferation, consequently 40-fold less small pre-BII and immature B cells were found in bone marrow, and the generation of immature and mature conventional B cells in spleen appeared reduced. In addition, only low numbers of B-1a cells were detected in the peritoneum. Surprisingly, Ig heavy chain allelic exclusion was still active, apparently ruling out a signaling role of a VpreB1/VpreB2-containing receptor in this process.

Alleles↗

PubMed2001

[Prospects in psychotherapy research].

The point of departure for this discussion is a critical review of the philosophy of randomized controlled trials (RCT) and their specific errors when applied to psychotherapeutic methods. There is a gap between the highly artificial settings of psychotherapy RCT and naturalistic psychotherapy procedures, which are grounded more in personality than in technique, less regulated, and mostly eclectic. Although RCT are necessary for general assessments of efficacy, they should be complemented by efficiency studies and evaluation of whole health care systems which include psychotherapy. We argue against overstretching the analogy of good clinical practice (GCP) research for the purpose of admitting new psychotropic drugs to psychotherapy research. A rational approach to psychotherapy for indication, quality ascertainment, and allocation of resources needs research which is methodologically explicable, replicable, and relevant to practice. The Cochrane Collaboration is a means of distributing such knowledge and making it work for practitioners. However, Cochrane also sheds light on psychological and practical obstacles which must be overcome before public health care systems can utilize new scientific results. The discussion of disorder-specific psychotherapy versus general psychotherapy ends by emphasizing the importance of more detailed psychopathology and pathopsychology of dysfunctions that cannot be sufficiently explained in manuals. Such dysfunctions--not necessarily specific for diagnoses or abnormality at all--can then be matched to specific psychotherapy tools. Further innovations can be expected from neurosciences, and some of the most promising paradigms are discussed. Finally, the lasting importance of hermeneutics is stressed not only with regard to the generation of new hypotheses but also to guiding the psychotherapeutic process.

Evidence-Based Medicine↗

PubMed2000

Reconfirming the role of life events for the timing of depressive episodes. A two-year prospective follow-up study.

BACKGROUND: Since the 1960s the association of stressful life events and depression seemed to be firmly established. However, a few recent studies did not confirm those earlier findings. One of the reasons discussed for the inconsistencies was the sampling of milder depressed neurotic out-patients in the earlier studies vs. more severely ill endogenous type in-patients in recent studies. METHODS: This investigation was carried out with 50 consecutively admitted in-patients with endogenous depression according to ICD 9 and unipolar major depression according to DSM-III-R as ascertained by SCID. The control sample consisted of 26 healthy volunteers. Life events and chronic distressing life conditions were recorded with the Munich Interview for the Assessment of Life Events and Conditions (MEL) every 3 months over a period of 2 years along with psychopathological symptoms and recurrencies. Hence the design was prospective in the sense that life events were recorded for one 3-month cross-section, the depressive reaction for the subsequent one. BDI scores taken at the respective cross section were used to control for depressive bias of the subjective part of the patient's life event evaluation. RESULTS: Three months prior to the index hospitalization patients were more often affected by life events and conditions than controls. The number of stressful conditions prior to the index hospitalization indicated the time to relapse after discharge. Controls showed more desirable positive conditions than patients. Relapse patients suffered more often stressful life events and conditions than non-relapsers 3 months prior to their relapse. Multivariate analysis indicates that the cumulative number of life events within the 2-year course is the best predictor of the BDI score at the end of the follow-up period. LIMITATIONS: Since the subjective component of life event assessment by MEL displayed a higher impact on the course of depression than the objective part of the assessment, confounding of subjective ratings, attributional styles, and depressive symptoms may be a problem although controlled for in this study. CONCLUSION: The results support the importance of stressful life events and chronic distressing conditions for the 2-year course and outcome of major depression in an in-patient sample. Since the overall consistency of significant results was more pronounced in the subjective than in the objective part of the MEL the results fit best a circular pathogenetic model of interactions between life events, their individual evaluation by the patient, and depressive symptoms.

Adult↗

PubMed2000

High sensitivity detection of JC-virus DNA in postmortem brain tissue by in situ PCR.

Opportunistic infection of the central nervous system by human polyomavirus JC can cause a devastating disease, progressive multifocal leukoencephalopathy (PML). To gain new neuropathological insights into JC-virus (JCV) infection patterns in PML at the light microscopic level, the highly sensitive indirect in situ polymerase chain reaction (in situ PCR) was employed in up to 15-year old formalin-fixed and paraffin-embedded postmortem brain tissue derived from nine AIDS patients with PML. In situ PCR, in which target DNA is amplified intracellularly and detected by a specific labelled probe in morphologically intact tissue, was compared with conventional in situ hybridization (ISH). Validity was ensured by the inclusion of 13 controls. JCV detection with in situ PCR proved to be highly sensitive since in all nine brain samples the number of positive cells exceeded the ISH results by 2-3-fold. Whereas by routine staining the brain tissue of each individual patient showed regions with severe, mild or no involvement by PML, improved detection of JCV DNA by in situ PCR allowed a regrading into five different degrees of JCV infection. Significant myelin staining was observed, suggesting that cell-to-cell contact may not be the only means of virus spread but that new cells could also be infected by virus released after cell lysis. Furthermore, using in situ PCR hitherto unreported intracellular distribution patterns of JCV DNA in oligodendro- and astrocytes were observed by light microscopy.

AIDS-Related Opportunistic Infections↗