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Biomedical subjects

C Mundt

Publications and source records attributed to C Mundt.

At least 37 records · Page 2Linked to original sources
PubMed1999

[The evaluation of research performance in psychiatry. Potential and pitfalls of bibliometric analysis].

Recent scientific and economic developments have emphasized the need for objective and operationalized criteria for the evaluation of collective and individual research performance. In this context the present article discusses the possibilities and limitations of bibliometric analysis in the evaluation of psychiatric research. Taking into account recent scientometric knowledge, the potentials and pitfalls of the so called impact factor are critically discussed with respect to its usefulness in the evaluation of psychiatric research performance in Germany. A major criticism arises from the observation that the unreflecting use of the impact factor may overemphasize quantitative aspects to the disadvantage of qualitative aspects of research. This may however lead to unwanted distortions and misjudgements. The critical analysis of the current use of scientometric indices in the evaluation process emphasizes the need for alternative criteria, which should take into account disciplinary as well as national idiosyncrasis. Accordingly, the authors aim to induce and contribute to a discussion process within the scientific community, which may lead to a more appropriate evaluation of psychiatric research performance.

Bibliometrics↗
PubMed1999

[Critical life events during the course of 2 years of 'major depression.' A prospective study with inpatients].

A number of studies has shown a significant relationship between life events/life conditions and depression. However, there is only a small number of studies investigating the effect of life events/life conditions in patients with severe depression from the endogenous subtype. The results are inconsistent. The present study examines the significance of the patients' life events/life conditions for the two year outcome of the illness in a prospective study with assessments every three months. Patients are compared to healthy controls with regard to the period three months prior to the admission to the hospital at the index episode. The results confirm the importance of life events and life conditions for the long term outcome of depressed patients with endogenous subtype respectively severe major depression in-patients. Relapsers show considerably more undesirable life conditions than non-relapsers three to six months prior to their relapse. Depressed patients indicate significantly more undesirable life events and life conditions and fewer desirable life conditions in comparison to the control group for the time span three months prior to their hospitalization. Clinical implications are discussed.

Adult↗
PubMed1999

[Modulation of oxidative stresses in human aging skin].

Oxidative stress (UV irradiation, free radicals) plays a significant role in aging. Coenzyme Q10 (CoQ10) and exogenously applied antioxidants can significantly reduce the formation of oxidative stress with increasing age. In our in vitro and in vivo experiments concerning the parameters of ultraweak photon emission (UPE), intracellular thiol status, mitochondrial membrane potential and cell vitality, we demonstrated a diminished resistance in keratinocytes of old donors against UV irradiation. This reduced epidermal resistance against oxidative stressors, i.e. UV irradiation, can be improved by topical application of CoQ10 and antioxidants like alpha-glucosylrutin (15). Furthermore, our in vivo investigations show that wrinkles around the region of the eyes ("crow feet") could be reduced by long-term application of CoQ10.

Aged↗
PubMed1999

Asymptomatic pancreatitis associated with clozapine.

Besides the well-known adverse effects of clozapine, such as granulocytopenia, tiredness and hypersalivation, acute pancreatitis is known to be a very rare complication of the drug. In the literature a total of five case reports have been published so far. We report a case of asymptomatic pancreatitis subsequent to clozapine treatment at therapeutic doses in a 38-year-old male patient with chronic paranoid-hallucinatory schizophrenia. The patient was rehospitalized after an acute exacerbation of the psychosis subsequent to an attempt to change medication on an outpatient basis. Treatment with clozapine was initiated again. During phases of progressively increasing the clozapine dose, serum levels of amylase and lipase were increased; after maintaining daily doses of clozapine of 300 mg and/or 600 mg the pancreatic enzymes normalized quickly within a few days. The patient did not report any pancreas-related complaints, nor did specific diagnostic studies produce any indicative result, only a minor thickening of the head and body of the pancreas in the ultrasound. It is assumed that the phenomenon of subclinical, asymptomatic pancreatitis during increasing dosage of clozapine occurs more often than previously supposed. The monitoring of serum amylase levels during slow increase in clozapine is recommended; if leukocytosis or eosinophilia is present, the possibility of even a subclinical and asymptomatic pancreatitis should be considered.

Adult↗
PubMed1998

[Time perception and time estimation in depressive patients].

Subjective time-experience and objective time-estimation were examined in 20 endogenous, 20 neurotic depressives, and 15 healthy volunteers. Subjective experience of past and anticipated future time was more extended in both depressive groups than in healthy controls. Objective time estimation differed between depressives and controls concerning relatively long time spans whereas very short time spans were correctly estimated also by depressives. There were no significant differences between endogenous and neurotic depressives. The perception of extended time normalized during treatment. The depressives' time perception, differences correlated with the extent of depressive psychopathological symptoms and--to a lesser degree--with retardation. The findings support the hypotheses of anthropological phenomenology concerning disturbed time perception and estimation in depressives. Amelioration of experienced time-extension in intentionally structured time spans compared to empty time spans suggests psychotherapeutic consequences in the sense of Lewinsohn.

Adult↗
PubMed1998

[Schizophrenia concepts in Soviet and Russian psychiatry].

Concepts of schizophrenia of the Soviet Russian school are presented. They are historically based upon the broad concepts of schizophrenia by Kraepelin and Bleuler. The relationships to the German concept of "Einheitspsychose" (unitary psychosis) is emphasized. Along with the discussion of correspondence to and differences with Western diagnostic systems (DSM, ICD) it is pointed out that the old Soviet system of classification extends to psychotic and also non-psychotic forms which in ICD-10 are not attributed to schizophrenia, but to other categories. Differential-diagnostic criteria of sluggish schizophrenia and neurosis, such as positive psychopathological symptoms, thought disturbances and changes in personality, will be delineated. Furthermore, recent developments in Russian psychiatry and modifications in Russian schizophrenia concepts will be exemplified by the concept of "psychic diathesis."

Cross-Cultural Comparison↗
PubMed1998

["Expressed emotion", marital quality and risk of recurrence in depressed patients].

Long-term course of depression appears to be clearly correlated to marital quality and quality of the relationship with spouses. Aim of the present study is the replication of results, indicating that expressed emotion (EE) is an important factor in prediction of relapse in depression. Additionally, the correlation between EE shown by spouses and the severeness of depressive symptomatology as well as the importance of martial quality as seen by patients for relapse are investigated. Results of our study indicate that spouses EE does not predict relapse, and status of EE does not correlate with the extent of depressive symptoms. However, patient self ratings of satisfaction with marital relationship and of perceived criticism are related to relapse frequency. Additionally, discrepant ratings of marital satisfaction given by spouses predict relapse to some extent. Implications for research in affective disorders and clinical practice are discussed.

Adult↗
PubMed1998

Severe akathisia during olanzapine treatment of acute schizophrenia.

Olanzapine is a newly developed atypical neuroleptic with a marked affinity to the 5-HT2, D2 and D4 dopamine receptors. Like other atypical neuroleptics olanzapine is considered to show a reduced prevalence of extrapyramidal side effects when compared to classical neuroleptic drugs. We report on three patients with acute schizophrenia, who developed severe akathisia during treatment with olanzapine (20-25 mg/d). In two of these cases akathisia resolved after withdrawal of olanzapine and substitution by a classical or an atypical neuroleptic agent, respectively. In one of these patients olanzapine was well tolerated when reintroduced in combination with lorazepam after complete remission of akathisia. In the third patient akathisia was sufficiently controlled by dose reduction. Akathisia is generally considered to result from D2 dopamine receptor antagonism. In the case of atypical neuroleptics such as olanzapine a low but still considerable D2 dopamine receptor occupancy may be compensated by the 5-HT2 antagonism. However, this mechanism may fail under certain circumstances, in particular if D2 dopamine antagonism exceeds a certain threshold. One should therefore be aware of possible extrapyramidal side effects with olanzapine that are reduced compared to classical neuroleptic drugs but not completely eliminated.

Adult↗
PubMed1998

The influence of psychopathology, personality, and marital interaction on the short-term course of major depression.

By means of an aggregated variables design the domains of 'psychopathology', 'personality', and 'social interaction' were weighted according to their impact on the 2-year course of 50 patients with unipolar major depression. Preindex course ranked highest, asthenic personality second. Variables of social interaction disappeared in the second-order logistic regression. These findings fit in well with the recent literature. They are interpreted in terms of habituation processes and residual personality changes which lower the vulnerability threshold for relapse and unfavorable course. As a consequence of this conclusion early relapse prevention would be most important.

Adult↗
PubMed1998

The 20kD protein of human [U4/U6.U5] tri-snRNPs is a novel cyclophilin that forms a complex with the U4/U6-specific 60kD and 90kD proteins.

Cyclophilins (Cyps) catalyze the cis/trans isomerization of peptidyl-prolyl bonds, a rate-limiting step in protein folding. In some cases, cyclophilins have also been shown to form stable complexes with specific proteins in vivo and may thus also act as chaperone-like molecules. We have characterized the 20kD protein of the spliceosomal 25S [U4/U6.U5] tri-snRNP complex from HeLa cells and show that it is a novel human cyclophilin (denoted SnuCyp-20). Purified [U4/U6.U5] tri-snRNPs, but not U1, U2, or U5 snRNPs, exhibit peptidyl-prolyl cis/trans isomerase activity in vitro, which is cyclosporin A-sensitive, suggesting that SnuCyp-20 is an active isomerase. Consistent with its specific association with tri-snRNPs in vitro, immunofluorescence microscopy studies showed that SnuCyp-20 is predominantly located in the nucleus, where it colocalizes in situ with typical snRNP-containing structures referred to as nuclear speckles. As a first step toward the identification of possible targets of SnuCyp-20, we have investigated the interaction of SnuCyp-20 with other proteins of the tri-snRNP. Fractionation of RNA-free protein complexes dissociated from isolated tri-snRNPs by treatment with high salt revealed that SnuCyp-20 is part of a biochemically stable heteromer containing additionally the U4/U6-specific 60kD and 90kD proteins. By coimmunoprecipitation experiments performed with in vitro-translated proteins, we could further demonstrate a direct interaction between SnuCyp-20 and the 60kD protein, but failed to detect a protein complex containing the 90kD protein. The formation of a stable SnuCyp-20/60kD/90kD heteromer may thus require additional factors not present in our in vitro reconstitution system. We discuss possible roles of SnuCyp-20 in the assembly of [U4/U6.U5] tri-snRNPs and/or in conformational changes occurring during the splicing process.

Amino Acid Sequence↗
PubMed1998

[Psychotherapy aspects of inpatient treatment of adolescents with acute psychiatric illnesses].

In the inpatient treatment of acute psychiatric episodes in children and adolescents, the psychiatrist must set up an initial treatment plan incorporating one or more psychotherapeutic modalities and adapt this plan to the patient's clinical course. This article summarises the clinical experience of a model unit at the University of Heidelberg, the result of a collaboration between the Department of General Psychiatry and the Department of Child and Adolescent Psychiatry at the Clinic of Psychiatry. A series of 116 adolescent admissions was reviewed for clinical diagnosis, the nature and frequency of psychotherapeutic modalities, and the role of family involvement in patient care. Differential and adaptative approaches to the selection of treatment modalities in the context of an acute care setting are emphasised.

Acute Disease↗
PubMed1997

Two cases of deep vein thrombosis associated with a combined paroxetine and zotepine therapy.

Thromboembolic events arising as a side-effect of neuroleptic and thymoleptic therapy, although rare, represent serious complications. We report on two patients suffering from an acute deep vein thrombosis after administration of a combined therapy with paroxetine and zotepine. The absence of common risk factors for the development of venous thrombosis in both patients led us to reconsider the potential impact that the drugs administered may have on thrombogenesis. Possible influences of the neuroleptic and thymoleptic therapy on the coagulation system are discussed. Although the clinical observations do not necessarily imply a strict causal relationship between drug administration and thrombosis, there are features of these two cases that should enhance our awareness of the possibility of thrombotic events occurring as a consequence of neuroleptic and thymoleptic therapy.

Aged↗
PubMed1997

Personality and endogenous/major depression: an empirical approach to typus melancholicus. 2. Validation of typus melancholicus core-properties by personality inventory scales.

The purpose of this study was to objectify some of the personality dimensions of the typus melancholicus (TM) personality formation in endogenous depressives and to compare the consistency of the term used in questionnaires with the original concept as delineated in our preceding paper. The prevalence of TM in endogenous-depressive inpatients was 51% for patients with clearly salient TM features. In addition 25% of the sample showed TM features to a minor extent. These findings are consistent with the literature. MMPI and MPI could not separate TM and non-typus melancholicus (NTM) in univariate analyses. However, the Munich Personality Test (MPT) contributes to validating the TM concept. TM depressives scored significantly higher in MPT subscales rigidity and norm orientation. According to its item structure the MPT rigidity subscore can be considered to conceptually encompass hypernomia, i.e. the patient's incapacity to change the norms that were once adopted. Based on the characteristics of item formulations in the MPT subscore norm orientation it was hypothesized that this subscore corresponds to the concept of heteronomia, i.e. conformism towards externally determined and uncritically followed social norms. Since MPT norm orientation in TM does not covariate with control scales of the other inventories used in this study, it is likely that MPT norm orientation refers to the TM patient's sincere commitment to social norms rather than to a sham reaction in the sense of a lie scale. There was no consistent indication that TM shows lower neuroticism scores than NTM.

Adult↗
PubMed1997

[Utilization of ambulatory psychotherapy by patients with endogenous depression after inpatient psychiatric treatment].

The long-term course of major depressive disorder is often accompanied by relapses or chronicity. Since psychosocial factors have been shown to be important predictors for the long-term outcome, psychotherapy along with drug therapy belongs to the standard methods of treatment. In spite of the effectiveness of psychotherapy, only some of the inpatients are treated with outpatient psychotherapy after hospital discharge. Within the framework of the Heidelberg depression study the authors examined what kind of, how many and for how long endogenously depressed patients sought out-patient psychotherapy after an inpatient treatment in a two-year follow-up. During the follow-up one half of patients were treated with outpatient psychotherapy. They were found to be younger, had suffered from more previous episodes, and their personality was more disturbed than those who had not undergone psychotherapy. The Expressed Emotion index did not make any further difference, whereas certain aspects of partnership quality did. The distinction between the two groups of patients is discussed regarding possible selection processes by treatment indication. It is pointed out that research on synergistic cooperation between members of the mental health services is highly desirable.

Adult↗
PubMed1997

The human U5 snRNP-specific 100-kD protein is an RS domain-containing, putative RNA helicase with significant homology to the yeast splicing factor Prp28p.

Through UV-crosslinking experiments, we previously provided evidence suggesting that a U5 snRNP protein with a molecular weight in the 100-kDa range is an ATP-binding protein (Laggerbauer B, Lauber J, Lührmann R, 1996, Nucleic Acid Res 24:868-875). Separation of HeLa U5 snRNP proteins on 2D gels revealed multiple variants with apparent molecular masses of 100 kDa. Subsequent microsequencing of these variants led to the isolation of a cDNA encoding a protein with an N-terminal RS domain and a C-terminal domain that contains all of the conserved motifs characteristic of members of the DEAD-box family of RNA-stimulated ATPases and RNA helicases. Antibodies raised against cDNA-encoded 100-kDa protein specifically recognized native U5-100kD both on immunoblots and in purified HeLa U5 snRNPs or [U4/U6.U5] tri-snRNP complexes, confirming that the bona fide 100-kDa cDNA had been isolated. In vitro phosphorylation studies demonstrated that U5-100kD can serve as a substrate for both Clk/Sty and the U1 snRNP-associated kinase, and further suggested that the multiple U5-100kD variants observed on 2D gels represent differentially phosphorylated forms of the protein. A database homology search revealed a significant degree of homology (60% similarity, 37% identity) between the Saccharomyces cerevisiae splicing factor, Prp28p, which lacks an N-terminal RS domain, and the C-terminal domain of U5-100kD. Consistent with their designation as structural homologues, anti-Prp28 antibodies recognized specifically the human U5-100kD protein on immunoblots. Together with the DEXH-box U5-200kD protein (Lauber J et al., 1996, EMBO J 15:4001-4015), U5-100kD is the second example of a putative RNA helicase that is tightly associated with the U5 snRNP. Given the recent identification of the U5-116kD protein as a homologue of the ribosomal translocase EF-2 (Fabrizio P, Laggerbauer B, Lauber J, Lane WS, Lührmann R, 1997, EMBO J 16:4092-4106), at least three integral U5 snRNP proteins thus potentially facilitate conformational changes in the spliceosome during nuclear pre-mRNA splicing.

Amino Acid Sequence↗
PubMed1996

Farmer's lung: patients' IgG2 antibodies specifically recognize Saccharopolyspora rectivirgula proteins and carbohydrate structures.

Farmer's lung is a frequent form of extrinsic allergic alveolitis. In Europe and Northern America the main source of the antigenic components that induce farmer's lung is the bacterium Saccharopolyspora rectivirgula (Micropolyspora faeni). It remains unclear, however, which S. rectivirgula components are responsible for the disease. We approached these problems by investigating the serologic reaction of patients with farmer's lung and demonstrated specific binding of patients' IgG2 to S. rectivirgula antigens. No such antibodies were found in exposed, unaffected subjects. Thus IgG2 antibodies reacting with S. rectivirgula antigens are useful for the serologic diagnosis of patients with farmer's lung and for the isolation of disease-causing antigens. After separation of S. rectivirgula extract on concanavalin A-Sepharose (Pharmacia, Uppsala, Sweden), we found that approximately one third of the patients' IgG2 reactivity occurred with nonglycosylated proteins. Among these, we characterized two major acidic proteins with molecular weights of 12 and 30 kd, respectively, and with identical N-terminal sequences. Approximately two thirds of the patients' IgG2 reactivity was observed against concanavalin A-binding glycoproteins that contained mainly glucose, mannose, and galactose residues. Deglycosylation of the concanavalin A-bound fraction indicated that most of the IgG2 reactivity occurred with the carbohydrate components.

Amino Acid Sequence↗
PubMed1996

[Psychotherapy of depressive disorders: on theoretical background and practice relevance].

In the psychotherapy of depression a knowledge of causative factors is essential for both practical aspects of interventions and the design of refined outcome studies. Outcome studies, which should go beyond simple pre-post comparisons, require such detailed hypotheses about the underlying pathogenetic mechanism which is addressed by a therapeutic technique. Thus, for this purpose psychopathological classification has to be supplemented by a pathogenetic classification. In the first section of this paper the most influential conceptual models of depression are discussed, including loss and grief, inhibited and reversed aggression, disturbed attachment, narcissistic crisis, the disturbed "prolepsis", structural dynamic restriction, learned helplessness, the social role model and Brown's sociological 3-factor model. In the second part, a reduction to three models is suggested and elucidated--the melancholic type, the narcissistic structure and depressive structure--in order to achieve a selection of specific intervention strategies. These are explained by a number of case vignettes. This pathogenetic structural diagnosis should be worked out in addition to the cross-sectional psychotherapeutic work. An additional "staging" of the long-term course provides more precision to the pathogenetic focus and accordingly to the selection of an adequate intervention strategy. In the third section the empirical literature is reviewed of those studies which have adopted objective assessment methods. No consensus has yet been found regarding appropriate methods and results are still rather inconsistent. We emphasize the necessity for a pathogenetic focus agreed upon by both patient and therapist and the consideration of the psychotherapeutic impact of biological treatment components with regard to self-image, allocation of heteronomy, and the patient's disease concept.

Adult↗