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Biomedical subjects

M Lindner

Publications and source records attributed to M Lindner.

At least 37 records · Page 2Linked to original sources
PubMed2000

Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica.

Centella asiatica is a medicinal plant that has been in use since prehistoric times. Its active constituents include pentacyclic triterpene derivatives. Studies have been conducted in particular to investigate the madecassosides and asiaticosides. In common with most traditional phytotherapeutic agents, Centella asiatica is used in folk medicine to treat a wide range of indications. In contrast to other medicinal plants, however, Centella asiatica has been subjected to quite extensive experimental and clinical investigations. Studies done in accordance with standardized scientific criteria have shown it to have a positive effect in the treatment of venous insufficiency and striae gravidarum. Centella asiatica also appears to be effective in the treatment of wound healing disturbances. At the present time, clinical studies aimed at investigating the sedative, analgesic, antidepressive, antimicrobial, antiviral and immunomodulatory effects that have been demonstrated experimentally, are still lacking. However, the therapeutic potential of this plant in terms of its efficacy and versatility is such that further detailed research would appear worthwhile.

Apiaceae↗
PubMed2000

August Gärtner and building, housing and communal hygiene 100 years of housing hygiene in Jena.

August Gärtner who had been called to the first Chair of Hygiene in Jena in 1886 has provided impulses decisive for the development of hygiene in the fields of construction, housing and communities. He has formulated important requirements for indoor climate, e.g. for heating, ventilation, indoor air temperature, indoor air humidity, avoidance of temperature asymmetry and thermal insulation of houses. His requirements to ensure adequate insulation, e.g. a ratio between window area and floor area of 1:8-1:10, have remained valid until today. Missing attention to his findings with regard to sewage disposal gained on the occasions of two typhoid outbreaks in Jena as early as in 1901 and 1915 resulted in the last water-borne typhoid outbreak in Germany in 1980, in the same place.

Environmental Medicine↗
PubMed2000

Progressive infantile neurodegeneration caused by 2-methyl-3-hydroxybutyryl-CoA dehydrogenase deficiency: a novel inborn error of branched-chain fatty acid and isoleucine metabolism.

We report a novel inborn error of metabolism identified in a child with an unusual neurodegenerative disease. The male patient was born at term and recovered well from a postnatal episode of metabolic decompensation and lactic acidosis. Psychomotor development in the first year of life was only moderately delayed. After 14 mo of age, there was progressive loss of mental and motor skills; at 2 years of age, he was severely retarded with marked restlessness, choreoathetoid movements, absence of directed hand movements, marked hypotonia and little reaction to external stimuli. Notable laboratory findings included marked elevations of urinary 2-methyl-3-hydroxybutyrate and tiglylglycine without elevation of 2-methylacetoacetate, mild elevations of lactate in CSF and blood, and a slightly abnormal acylcarnitine profile. These abnormalities became more apparent after isoleucine challenge. Enzyme studies showed absent activity of 2-methyl-3-hydroxybutyryl-CoA dehydrogenase (MHBD) in the mitochondrial oxidation of 2-methyl branched-chain fatty acids and isoleucine. Under dietary isoleucine restriction, neurologic symptoms stabilized over the next 7 months.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1999

[Percutaneous transvenous mitral valvuloplasty in a pregnant patient. Successful treatment of severe mitral stenosis].

HISTORY AND CLINICAL FINDINGS: A 31-year-old woman presented in the 25th week of pregnancy with ankle and pretibial oedema and increasing dyspnoea, ultimately in class IV (New York Heart Association classification). There were fine rales on auscultation and dullness on palpation over both lung bases. The heart rate was regular at 110/min. The first heart sound was very loud, and there was a mitral opening snap and a loud diastolic murmur maximal, over the cardiac apex. INVESTIGATIONS: The ECG showed sinus rhythm at a rate of 110/min, left axis deviation, incomplete right bundle branch block and P biatriale, but no other abnormalities. Echocardiography revealed biatrial enlargement and an enlarged right ventricle as well as pulmonary systolic hypertension of 100 mm Hg. Doppler sonography demonstrated severe mitral stenosis with a calculated mitral opening area of 0.9 cm2. DIAGNOSIS, TREATMENT AND COURSE: The symptoms improved only slightly under conservative drug treatment. The mitral valve changes, as noted sonographically, met the criteria for percutaneous transluminal balloon mitral valvoplasty (PTBMV), which was successfully performed. Afterwards the mitral opening area was 2.6 cm2 and pulmonary artery pressure gradually became normal. She was delivered without complication of a healthy child in the 39th week of pregnancy. CONCLUSION: PTBLMV is a relatively low-risk treatment in pregnant women with symptomatic mitral stenosis.

Adult↗
PubMed1999

A reduced K+ current due to a novel mutation in KCNQ2 causes neonatal convulsions.

Benign familial neonatal convulsions (BFNC) is a rare dominantly inherited epileptic syndrome characterized by frequent brief seizures within the first days of life. The disease is caused by mutations in one of two recently identified voltage-gated potassium channel genes, KCNQ2 or KCNQ3. Here, we describe a four-generation BFNC family carrying a novel mutation within the distal, unconserved C-terminal domain of KCNQ2, a 1-bp deletion, 2513delG, in codon 838 predicting substitution of the last seven and extension by another 56 amino acids. Three family members suffering from febrile but not from neonatal convulsions do not carry the mutation, confirming that febrile convulsions and BFNC are of different pathogenesis. Functional expression of the mutant channel in Xenopus oocytes revealed a reduction of the potassium current to 5% of the wild-type current, but the voltage sensitivity and kinetics were not significantly changed. To find out whether the loss of the last seven amino acids or the C-terminal extension because of 2513delG causes the phenotype, a second, artificial mutation was constructed yielding a stop codon at position 838. This truncation increased the potassium current by twofold compared with the wild type, indicating that the pathological extension produces the phenotype, and suggesting an important role of the distal, unconserved C-terminal domain of this channel. Our results indicate that BFNC is caused by a decreased potassium current impairing repolarization of the neuronal cell membrane, which results in hyperexcitability of the central nervous system.

Amino Acid Sequence↗
PubMed1999

A severely affected infant with absence of cysteinyl leukotrienes in cerebrospinal fluid: further evidence that leukotriene C4-synthesis deficiency is a new neurometabolic disorder.

Leukotrienes are potent oxygenated metabolites derived from the 5-lipoxygenase pathway of arachidonic acid metabolism. They comprise the cysteinyl leukotrienes (LTC4, LTD4, LTE4) and LTB4. The rate limiting step in the formation of cysteinyl leukotrienes is the conversion of LTA4 to LTC4 catalyzed by the enzyme LTC4 synthase. Recently, the first inborn error of leukotriene synthesis, LTC4-synthesis deficiency, has been identified in a patient with a fatal developmental syndrome. We report on an additional infant presenting with severe muscular hypotonia, symmetrical extension in the lower extremities and psychomotor retardation who died at the age of 6 months. Despite intensive investigations no specific diagnosis could be made. Leukotrienes were subsequently analyzed in the cerebrospinal fluid. Concentrations of LTC4, LTD4 and LTE4 were below the detection limit (< 5 pg/ml) whereas LTB4 was found to be in the upper normal range. The absence of cysteinyl leukotrienes with normal LTB4 concentration in cerebrospinal fluid is unique and seems to be pathognomonic for LTC4-synthesis deficiency. Our patient most likely represents the second case described so far with this condition. This report provides further evidence that LTC4-synthesis deficiency represents a new neurometabolic disorder.

Fatal Outcome↗
PubMed1998

Calcium content of the sarcoplasmic reticulum in isolated ventricular myocytes from patients with terminal heart failure.

Systolic [Ca2+]i-transients have been shown to be depressed in isolated ventricular myocytes from patients with terminal heart failure compared to controls. Experiments were performed in human ventricular cells to investigate whether this reduced systolic [Ca2+]i-transient may be due to a decreased Ca(2+)-content of the sarcoplasmic reticulum (SR). Single myocytes were isolated from left ventricular myocardium of patients with terminal heart failure undergoing cardiac transplantation. These results were compared to those obtained from cells of healthy donor hearts that were not suitable for transplantation for technical reasons. [Ca2+]i-transients were recorded from isolated cells under voltage clamp perfused internally with the Ca(2+)-indicator fura-2. The Ca(2+)-content of the SR was estimated by rapid extracellular application of caffeine (10 mM) to open the Ca(2+)-release channel of the SR and comparison of the caffeine-induced [Ca2+]i-transients in cells from patients with heart failure and from controls without heart failure. Upon steady-state depolarizations to +10 mV (maximum of the Ca(2+)-current), [Ca2+]i-transients in cells from patients with heart failure were significantly smaller than in myocytes from undiseased hearts (333 +/- 26 v 596 +/- 80 nM, P < 0.05). Application of caffeine caused a [Ca2+]i-transient that was always larger than during depolarization. Caffeine-induced [Ca2+]i-transients were significantly smaller in cells from diseased hearts compared with controls (970 +/- 129 v 2586 +/- 288 nM, P < 0.01). A positive correlation was found between left ventricular ejection fraction and caffeine-induced [Ca2+]i-transients in these cells. It is concluded, that depressed [Ca2+]i-transients in myocytes from patients with heart failure may be caused by a decreased Ca(2+)-content of the SR possibly due to an altered Ca(2+)-ATPase activity in these hearts. It is not necessary to postulate an additional defect of the Ca(2+)-release function of the SR to account for the alterations of intracellular (Ca2+]i-handling.

Adult↗
PubMed1998

[Danger of infection from communion cups--an underestimated risk?].

The problem of a risk of infection from the common use of chalices has been discussed controversially in literature. Opinions were mainly based on laboratory experiments and theoretical considerations. The authors examined bacterial counts and species existing under normal conditions after communion. For this purpose, contact samples were taken from the inside and outside of chalices at the rim. Staphylococci and alpha-haemolytic streptococci were found on all chalices examined. On more than 80%, there were apathogenic micrococci, nonhaemolytic streptococci, apathogenic neisseria and apathogenic corynebacteria as well as lactobacilli and bacilli. Staphylococcus aureus was found on 26.4% of chalices. Although the risk of infection for healthy persons from a commonly used chalice can be rated as low, it should not be underestimated for persons with reduced resistance and immunocompetence, or with reduced defences as a result of therapeutic measures. From the hygienic point of view, the most favourable approaches to avoid infection would be the use of individual chalices for all participants in the communion or the immersion of wafers or bread in wine or in grape juice by the priest (intinction).

Bacteria↗
PubMed1997

[Moisture and mold on the inner walls of prefabricated building slabs--investigating a strange cause].

Reasons for indoor-moisture beyond the normal level can be caused by penetrating dampness, condensation-water, and apartment misuse. A fall in the air temperature below the dew point in connection with moulding inside buildings becomes evident mostly at places like badly insulated outer-walls or room-corners. In a number of houses built between 1980 and 1983 in the so called "Plattenbauweise" (prefabricated slabs), exclusively the inner-walls were covered in mould around cracks in the walls. Examinations showed connections between the apartment and the outer-corridor with a slight exchange of air through the cracks. Warm, wet air escaped from the apartment into the outer-corridor, and cold air entered the apartment from the outer-corridor. This temporary fall below the dewpoint caused by suitable variation of temperature probably resulted in the building materials and wallpapers becoming damp, as well as the growth of mould.

Air Microbiology↗
PubMed1996

[Decision to use complementary medicine: fact oriented or irrational?].

PROBLEM AND OBJECTIVE: Complementary medicine is being used to varying extent in all industrial countries. There are incomplete data concerning efficacy, safety and costs of such treatment, while little is known about special features and motivation of those persons who choose complementary medicine. The aim of the study was to ascertain, among patients who use complementary medicine and those who prefer traditional medicine, any differences with regard to sociodemographic, disease-related and psychological characteristics and their life-style. PATIENTS AND METHODS: A total of 419 patients were studied by a standardised interview and questionnaire (168 items) and divided into two groups (group 1: those using conventional treatment [n - 197; 91 women, 106 men; average age 43.2 +/- 16.9 years]; group 2: those preferring complementary medicine [n = 222; 159 women, 63 men; average age 43.2 +/- 15.0 years]). They were recruited from specialist internal medical or generalist medical practice with or without offer of complementary medicine (additional term: natural healing methods). Statistical analysis was with Student's-t-test and the chi(2)-test [correction of gamma-test]. RESULTS: Those patients who chose to be treated by complementary medicine clearly differed from the others with respect to sociodemographic, disease-related and psychological characteristics, as well as life-style. The patient-doctor relationship also differed between the two groups. On average those of group 2 had a higher educational level (higher education: 10.3% in group 1; 15.9 in group 2) and lower risk factors (68.9% nonsmokers in group 1, 77.8% in group 2; alcohol abstinence: 33.2 vs 46.4%). Patients in both groups preferred conventional medicine for serious diseases (cardiac infarct; tumour; AIDS). CONCLUSIONS: In general, those patients who choose complementary medicine have a healthier life-style. As the number of these patients is on the increase. Since as yet the efficacy, risks and costs of complementary medicine have been inadequately investigated, research in this area should be intensified.

Adult↗
PubMed1996

[ICD diagnoses in university polyclinic naturopathy consultation].

In a special consulting office for complementary medicine, ambulatory patients interested in receiving adjuvant treatment with complementary medicine can obtain a relevant advice and critical information regarding non-evaluated therapies. Within the framework of a retrospective statistical analysis, the diagnosis documented over a period of 24 months in accordance with the 4-digit ICD code were evaluated. In particular patients with chronic and/or functional illnesses had additional treatment needs. The exponential growth in the numbers of patients during the course of the observation period illustrates the increasing importance of complementary medical measures. However, in view of the considerable political significance of the cost factor and the possible risks of the treatment, only properly evaluated complementary medical therapies should be employed.

Adolescent↗
PubMed1996

Geographic distribution and origin of CFTR mutations in Germany.

The geographic distribution and origin of CFTR mutations in Germany was evaluated in 658 three-generation families with cystic fibrosis (CF). Fifty different mutations were detected on 1305 parental CF chromosomes from 22 European countries and overseas. The major mutation. delta F508 was identified on 71.5% of all CF chromosomes, followed by R553X (1.8%), N1303K (1.3%), G542X (1.1%), G551D (0.8%) and R347P (0.8%). According to the grandparents' birthplace, 74% of CF chromosomes had their origin in Germany; the delta F508 percentage was 77%, 75%, 70% and 62% in northern, southern, western and eastern Germany, respectively. Ten or more mutant alleles in the investigated CF gene pool originated from Austria, the Czech Republic, Poland, Russia, Turkey and the Ukraine. This widespread geographic origin of CFTR mutations in today's Germany reflects the many demographic changes and migrations in Central Europe during the 20th century.

Cystic Fibrosis↗
PubMed1994

[Contact regulation thermography: a useful diagnostic procedure?].

Contact regulation thermography is one of the unconventional medical diagnostic procedures, and is based on the individual adaptive behavior of the subject with respect to temperature. Its proponents believe that a specific medical diagnosis can be established on the basis of varying temperature differences. Studies carried out to date have produced mixed results. The increasing use of this procedure, not only in complementary medicine, makes it necessary to undertake a critical examination of the method. Care-providing physicians should question their patients about other unconventional medical diagnostic procedures to which they have been submitted, and inform them about the dubious nature of non-evaluated methods.

Body Temperature Regulation↗
PubMed1993

Acute jejunal ileus in intestinal lymphangiectasia.

A 26-year-old patient presented with epigastric pain of sudden onset and severe puffy swelling of both legs and forearms. An irregularly shaped nodular filling defect on selective jejunal films, severe hypoproteinemia, low IgG concentration, and lymphopenia were suggestive of primary intestinal lymphangiectasia with protein-losing enteropathy, and the patient was placed on a low-fat diet with medium-chain triglycerides. This initially improved his condition, but some weeks later he developed obstructive ileus of the small intestine. On laparotomy yellowish to whitish deposits were found to be present in some segments of the small intestine and a fist-sized mass 100 cm distal to the duodenojejunal flexure was resected without complications. Histologically, the submucosal lymphatics were dilated, and the jejunal wall showed extensive pseudocystic, intramural submucosal lymph edema with secondary bleeding and tight stenosis of the jejunal lumen. During the 14-month follow-up time after discharge the patient has been asymptomatic and working, on no treatment other than a low-fat diet with medium-chain triglycerides.

Acute Disease↗
PubMed1992

The spectrum of CFTR mutations in south-west German cystic fibrosis patients.

The cystic fibrosis transmembrane conductance regulator (CFTR) gene of 110 cystic fibrosis (CF) patients from the south-west of Germany was screened for 12 different mutations. This analysis resulted in an identification of 79% of all CF mutations and a complete genotype in 66% of the families. The most common mutation found was delta F508 (67%). Another 5 mutations accounted for a further 12.5% (4% G542X; 3% R553X; 3% N1303K; 2% 1717-1 G-->A; 0.5% G551D) whereas 6 mutations (R117H, A455E, delta I507, S549I, S549N, and R1162X) were not found. Fifty-four (49%) patients were delta F508 homozygotes and 18 (16.5%) were compound heterozygotes for delta F508 and one of the rarer mutations. These frequencies differ slightly from those found in the north of Germany and considerably from those reported from the south of Europe, which seems to be consistent with a north to south decline of the relative abundance of delta F508. Two patients, age 6 and 25 years, were compound heterozygotes for G542X and N1303K. The clinical features of the 6 year old were characterised by severe gastrointestinal and as yet only mild pulmonary complications whereas the 25 year old manifested severe pulmonary and gastrointestinal symptoms indicating that the N1303K mutation of the C-terminal CFTR nucleotide binding fold significantly impairs protein function in both the pancreas and the lungs.

Adolescent↗