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Biomedical subjects

Matthias Rose

Publications and source records attributed to Matthias Rose.

At least 19 recordsLinked to original sources
PubMed2006

[Standardized diagnosing: computer-assisted (CIDI) diagnoses compared to clinically-judged diagnoses in a psychosomatic setting].

BACKGROUND: Within the past two decades, there has been an increasing trend towards the use of empirically-based, standardized instruments to diagnose mental disorders. The purpose of this study was to investigate the congruence between clinically-derived and standardized computerized diagnoses using the Composite International Diagnostic Interview (CIDI) in a psychosomatic setting. PATIENTS AND METHODS: N = 230 inpatients treated at the Department of Psychosomatic Medicine, Charité Berlin, were diagnosed for mental disorders by experienced clinicians and by the CIDI according to the diagnostic criteria of ICD-10 and DSM-IV. RESULTS: Congruence between computerized and clinically-derived diagnoses for all mental disorders was fair to poor (kappa = 0.0 - 0.33). The diagnostic congruence of somatoform (F45), anxiety (F40 - 41), depressive (F32 - 34), eating (F50) and dissociative disorders (F44) and disorders due to psychoactive substance use (F10 - 19) was fairly low (kappa = 0.19 - 0.33). Diagnostic congruence of diagnoses of reactions to severe stress (F43) and obsessive compulsive disorders (F42) was particularly poor (kappa = 0.0 - 0.01). CONCLUSION: Overall diagnostic congruence between computerized and clinical diagnostics was unsatisfactory. Thus, the validity of computer-assisted standardized interviews - like the CIDI - is questionable in a psychosomatic setting.

Adult↗
PubMed2005

Determinants of the quality of life of patients with congenital heart disease.

OBJECTIVE: The improvement of the quality of life of chronically ill patients has become an important goal in treatment. However, it is seldom taken into account that many other factors, in addition to somatic factors, have an influence on the quality of life of patients. Using patients with congenital heart defects as an example, we examined the relative significance of biological factors, compared to psychological and social factors, for the various quality of life dimensions. RESEARCH DESIGN AND METHODS: One hundred and eleven patients (aged 33+/-12 years) with different degrees of cardiac dysfunction were examined (NYHA 0: 2 I: 56, II: 38, III: 13, IV: 2). All patients for whom there was no contra-indication underwent a treadmill ergometry in order to determine their level of cardiopulmonary functioning (peak oxygen consumption: VO2max). All patients were asked to fill out questionnaires concerning their quality of life (WHOQOL-Bref), their cardiac complaints (Giessener Complaint Questionnaire GBB), their personality traits (Giessen Test GTS), and the social support they experience (Social Support Questionnaire SOZU-k22). The data were analyzed using a linear structural equation model (SEM). RESULTS: In all aspects but the social domain, the HRQL of CgHD patients was significantly diminished compared to the normal population. The SEM proposed was valid, showing good indices of fit (chi2 = 1.18; p = 0.55; AGFI = 0.92). The level of cardiopulmonary functioning was most significant for the reporting of specific cardiac complaints (beta = -28) and for the physical component of the general HRQL (beta = 32), although the former was also influenced by a depressed disposition (beta = -0.20) and the extent of social support experienced (beta = 0.18). The objective findings, however, had virtually no individual significance for the psychological (beta = 0.09) and social domains (beta = -0.02). These HRQL domains are primarily influenced by depressive personality traits (beta= -26/-0.16) and the social support experienced (beta = 0.51/0.51). CONCLUSIONS: The patient's organic dysfunction primarily determines illness-specific complaints but has little relevance for the psychological and social aspects of the HRQL. These aspects are predominantly determined by the patient's depressive disposition and by the experienced social support. A successful therapy should therefore take biological as well as psycho-social determinants of the quality of life into account.

Adult↗
PubMed2005

Development of a computer-adaptive test for depression (D-CAT).

Depression is one of the most prevalent mental health problems and measuring depressive symptoms becomes increasingly important in science as well as medical practice. Computer Adaptive Tests (CAT) based on the Item Response Theory (IRT) promise to enhance measurement precision and reduce respondent's burden. Our aim was to develop a CAT application to measure depressive symptoms. Three thousand two hundred seventy psychosomatic patients answered an overall of 11 mental health questionnaires at the University Clinic in Berlin. Three independent reviewers rated 144 items out of these questionnaires as indicative of depressive symptoms. All items underwent six empirical steps to analyze unidimensionality, local independence and item discrimination. Finally 64 items could be used to calculate item parameters applying a Generalized Partial Credit Model (GPCM). CAT scores were estimated using an 'expected a posteriori' algorithm (EAP). Two simulation experiments showed that for theta values within the range of 2SD around the mean (98% of the cases), the latent trait can be estimated out of approximately six items with a predefined standard error of [Symbol: see text] 0.32 (reliability rho [Symbol: see text] 0.90). The CAT-scores correlated high with scores of all depression items (r = 0.95), with the Beck Depression Inventory (r = 0.79) and with a CES-D 8 item short form (r = 0.76). We conclude that the Depression-CAT measures depressive symptoms with high precision and low respondent burden.

Adolescent↗
PubMed2005

Autodestructive syndromes.

BACKGROUND: The phenomenon 'autodestructive behaviour' is becoming an increasingly serious disease and cost factor in a wide range of medical fields. The present paper presents a survey of the literature on autodestructive behaviour, excluding psychotic, substance-induced or organic brain disorders. Starting out with a conceptual overview, the paper goes on to look into the epidemiology of autodestructive behaviour and the forms in which it manifests itself. METHOD: A literature search was conducted in Medline, Psycinfo and Psyndex using the search terms 'artifact', 'artificially induced', 'autodestructive', 'self-mutilation', 'factitious', 'self-harm', 'self-induced', 'self-inflicted', 'self-injuring' and 'self-mutilation' for the period from 1977 to 2003. RESULTS: Five of a total of 18 empirical studies describe the simultaneous occurrence of direct and indirect forms of autodestructive behaviour. Reported prevalence rates range from 0.032% to 9.36%. The ratio of females to males was found to be 2:1 (average age: 31.5 years; SD: 9.3 years); in contrast, the gender ratio was reversed for Munchausen's syndrome. The case history data presented are patchy and differ in terms of their priorities. We found a large number of codiagnoses, which seems to indicate that personality and dependence disorders, or substance misuse, are characteristic of both direct and indirect forms of autodestructive behaviour. CONCLUSIONS: The task at hand is to use a yet-to-be-developed nomenclature and adequately operational diagnostic criteria to work out standardised survey instruments that do justice to the heterogeneity of this disorder complex.

Comorbidity↗
PubMed2003

Catabolite degradation of fructose-1,6-bisphosphatase in the yeast Saccharomyces cerevisiae: a genome-wide screen identifies eight novel GID genes and indicates the existence of two degradation pathways.

Metabolic adaptation of Saccharomyces cerevisiae cells from a nonfermentable carbon source to glucose induces selective, rapid breakdown of the gluconeogenetic key enzyme fructose-1,6-bisphosphatase (FBPase), a process called catabolite degradation. Herein, we identify eight novel GID genes required for proteasome-dependent catabolite degradation of FBPase. Four yeast proteins contain the CTLH domain of unknown function. All of them are Gid proteins. The site of catabolite degradation has been controversial until now. Two FBPase degradation pathways have been described, one dependent on the cytosolic ubiquitin-proteasome machinery, and the other dependent on vacuolar proteolysis. Interestingly, three of the novel Gid proteins involved in ubiquitin-proteasome-dependent degradation have also been reported by others to affect the vacuolar degradation pathway. As shown herein, additional genes suggested to be essential for vacuolar degradation are unnecessary for proteasome-dependent degradation. These data raise the question as to whether two FBPase degradation pathways exist that share components. Detailed characterization of Gid2p demonstrates that it is part of a soluble, cytosolic protein complex of at least 600 kDa. Gid2p is necessary for FBPase ubiquitination. Our studies have not revealed any involvement of vesicular intermediates in proteasome-dependent FBPase degradation. The influence of Ubp14p, a deubiquitinating enzyme, on proteasome-dependent catabolite degradation was further uncovered.

Base Sequence↗
PubMed2003

[Disturbed regulation of self-esteem in patients with overt versus covert self-destructive behaviour].

OBJECTIVES: According to psychoanalytic models self-harming patients are characterised by an unstable self-system and a disturbed regulation of self-esteem. This is presumed to be denied or dissociated to a greater degree by those who harm themselves secretly (factitious patients) as compared to those who show open self-harm. It is hypothesised and empirically tested that self-destructive patients have more profound disorders of narcissistic self-regulation than patients without self-destruction, and that this should be more evident in patients with overt self-destructive behaviour. METHODS: The sample consists of 354 psychosomatic patients, 32 of whom demonstrated self-destructive behaviour (18 exclusively overt and 6 exclusively covert types of behaviour, according to Willenberg et al.). The narcissism inventory was applied. RESULTS: Self-destructive patients showed higher levels on the "threatened self"-dimension than psychosomatic patients without self-harm. Overtly self-harming patients showed a higher degree of narcissistic self-regulation than covertly self-destructive patients. CONCLUSIONS: This supports theoretical assumptions of a disturbed regulation of self-esteem in self-destructive patients, especially in overtly self-harming patients.

Adolescent↗
PubMed2002

Functional profiling of the Saccharomyces cerevisiae genome.

Determining the effect of gene deletion is a fundamental approach to understanding gene function. Conventional genetic screens exhibit biases, and genes contributing to a phenotype are often missed. We systematically constructed a nearly complete collection of gene-deletion mutants (96% of annotated open reading frames, or ORFs) of the yeast Saccharomyces cerevisiae. DNA sequences dubbed 'molecular bar codes' uniquely identify each strain, enabling their growth to be analysed in parallel and the fitness contribution of each gene to be quantitatively assessed by hybridization to high-density oligonucleotide arrays. We show that previously known and new genes are necessary for optimal growth under six well-studied conditions: high salt, sorbitol, galactose, pH 8, minimal medium and nystatin treatment. Less than 7% of genes that exhibit a significant increase in messenger RNA expression are also required for optimal growth in four of the tested conditions. Our results validate the yeast gene-deletion collection as a valuable resource for functional genomics.

Cell Size↗
PubMed2002

Psychosomatic interrelations following liver transplantation.

It is well described that quality of life (QoL) improved after liver transplantation. The aim of the present study was to investigate how psychosocial parameters develop after liver transplantation (LTX) and whether post-operative complaints are the result of osteoporosis or patient somatization. The prospective study looks into biomedical and psychosocial parameters of 82 LTX patients before, 1 and 3 yrs after transplantation. Osteoporosis was measured by bone mineral density (BMD) and psychosocial parameters were assessed with validated questionnaires measuring complaints, mood and overall QoL. Overall QoL and mood improved after liver transplantation, while back and limb pain increased continuously. Back and limb pain were highly correlated with reduced bone density and high values for tiredness and depressive anxiety. Back and limb pain of patients following liver transplantation may indicate the development of a post-operative depression in some cases. The treatment offered by an essentially biologically based medicine may promote the manifestation of this depression as a somatization disorder.

Adolescent↗
PubMed2002

[Predicting long-term outcome of in-patient psychosomatic treatment].

Abstract. The outcome of in-patient psychosomatic treatment was evaluated by longitudinal assessment at hospital admission, discharge, and 1-year-follow-up. Out of n = 1829 patients, n = 712 responded (38.9 %). Response rates co-varied with duration of in-patient treatment. Responder-analyses characterise the sample as fairly representative. Outcome criteria included standardised measures of complaints, mood quality, global quality of life, life satisfaction, everyday functioning, and social integration. Disease-related parameters (duration of illness, medical certification, number of doctors consulted, number of somatic resp. psychosocial diagnoses) and generalised outcome expectancies (self-efficacy, optimism, pessimism) were included as predictors. Patients' retrospective estimations at follow-up as well as longitudinal assessments show a successful and mostly stable therapy outcome. Negative moods and complaints show a new increase at follow-up, though, still remaining below the level at hospital admission. Although there is much accordance among the diagnostic groups, patients with anxiety disorders (ICD-10: F40/41) and patients with adaptation disorders (F43) show distinctly varying courses. Regression analyses yield specific correlations between disease-related parameters and long-term outcome: Duration of treatment does not predict treatment outcome. The number of somatic diagnoses is a predictor of complaints, the number of psychosocial diagnoses a predictor of negative moods at follow-up. Pessimism and - to a lesser degree - self-efficacy prove to significantly predict numerous outcome criteria. Generalised expectancies should be considered in the process of prognosis and differential indication.

Follow-Up Studies↗
PubMed2002

T-cell immune parameters and depression in patients with Crohn's disease.

GOALS: The causes of Crohn's disease (CD) are still considered to be unknown. It is likely that an immune defect leads to an increase in T helper 1 (Th1) cytokine responses, which may then contribute to the characteristic morphologic changes. Increased values in distinct immune activation parameters connected with a Th1 immune response have also been found in patients who are depressed. Because various clinical observations have asserted that a depressive disposition may have some connection with the development of CD, we examined whether a relationship exists between T-cell activation parameters and depressive personality characteristics in patients with CD. STUDY: Seventy-one patients (62% women; age, 38 +/- 13 years) with CD (23 with CD Activity Index [CDAI] >150 and 48 with CDAI < or =150) were included in this study. Sixty patients were re-examined after 4.4 +/- 1.8 months. The T cell parameters CD2, CD3, CD26, CD28, and CD95 and the activity of dipeptidyl peptidase IV (DPP IV) in serum were examined in the peripheral blood. The patient's subjective health status was assessed by means of a standardized psychometric instrument (Short-form Inflammatory Bowel Disease Questionnaire [SIBDQ]). The presence of various characteristics indicative of a depressed mood was also assessed (Center of Epidemiological Studies-Depression Scale, Berliner Stimmungsfragebogen), as well as indicators of a personality disposed to depression (Giessentest) and a depressive illness coping strategy (Freiburger Krankheitsverarbeitungs-Fragebogen), all using the above-mentioned standardized instruments. RESULTS: The immune parameters connected with the activation of Th1 (CD25+, CD25+/CD26+) are increased in patients, depending on the stage of illness. In addition, DPP IV activity was significantly lower in patients with an active disease, as was their subjective health status (SIBDQ). A connection with an indicator of mental depression could not be found. CONCLUSION: The observed changes in immune parameters support the idea that morphologic changes could be connected with an increased Th1 response and that DPP IV activity could play an immunomodulatory role. A relationship between the measured immune parameters and individual characteristics of depression could not be found.

Adult↗
PubMed2002

The network of psychological variables in patients with diabetes and their importance for quality of life and metabolic control.

OBJECTIVE: The primary goals in treating patients with diabetes are maintaining blood glucose levels as close to normal as possible and making a relatively normal quality of life achievable. Both of these goals are influenced by a multitude of somatic and psychological factors that should be seen as building a complex network. We examined whether a mathematical model can be construed that can depict the relative significance of each factor for achieving these treatment goals. RESEARCH DESIGN AND METHODS: A total of 625 patients from 32 different treatment facilities were examined (224 type 1 and 401 type 2 diabetic patients) using HbA(1c) values (high-performance liquid chromatography), number of secondary illnesses, and standardized questionnaires with respect to health-related quality of life (World Health Organization Quality of Life questionnaire), coping behavior (Freiburger Illness-Coping Strategies questionnaire), diabetes-specific knowledge (Test of Diabetes-Specific Knowledge), doctor-patient relationship (Medical Interview Satisfaction Scale), and personality characteristics (Giessen Test and Assessment of Beliefs in Self-Efficacy and Optimism). The analyses were carried out by means of a structural equation model. RESULTS: The model proved to be valid (chi(2) = 88.5, df = 76, P = 0.16), showing a sound fit (adjusted goodness of fit [AGFI] = 0.94). It explained 62% of the variance of the quality of life and 5% of the HbA(1c) values. Subjects characterized by strong beliefs in their self-efficacy and an optimistic outlook on life were more likely to be satisfied with their doctor-patient relationships. They demonstrated more active coping behavior and proved to have a higher quality of life. Active coping behavior was the only psychological variable significant for the HbA(1c) values. CONCLUSIONS: It was possible to illustrate the various factors involved and their mutual dependency and significance for the treatment goals. Belief in self-efficacy and active coping behavior appear to have the greatest relevance for achieving the primary treatment goals.

Blood Glucose↗
PubMed2001

The 5-lipoxygenase promoter is regulated by DNA methylation.

5-lipoxygenase (5-LO), the key enzyme in leukotriene biosynthesis, is expressed in a tissue- and cell differentiation-specific manner. The 5-LO core promoter required for basal promoter activity has a unique (G+C)-rich sequence that contains five tandem Sp1 consensus sequences. The mechanisms involved in the regulation of cell type-specific 5-LO expression are unknown. Here we show that 5-LO expression is regulated by DNA methylation. Treatment of the 5-LO-negative cell lines U937 and HL-60TB with the demethylating agent 5-aza-2'-deoxycytidine (AdC) up-regulated expression of 5-LO primary transcripts and mature mRNA in a similar fashion, indicating that AdC stimulates 5-LO gene transcription. Analysis of the methylation status of the 5-LO promoter revealed that the core promoter region was methylated in U937 and HL-60TB cells, whereas it was unmethylated in the 5-LO-positive parent HL-60 cell line. Reporter gene assays with 5-LO promoter constructs gave up to 68- and 655-fold repression of 5-LO promoter activity in HeLa and Mono Mac 6 cells by methylation. 1,25-dihydroxyvitamin D(3) and transforming growth factor-beta (TGFbeta), potent inducers of the 5-LO pathway in myeloid cell lines, increased 5-LO RNA expression in HL-60TB and U937 cells, but co-treatment with AdC was required to achieve 5-LO expression levels in HL-60TB cells that were comparable with wild-type HL-60 cells. In reporter gene assays, 1,25-dihydroxyvitamin D(3) and TGFbeta were unable to induce promoter activity when the 5-LO promoter constructs were methylated, which suggests that 5-LO promoter demethylation is a prerequisite for the high level induction of 5-LO gene expression by 1,25-dihydroxyvitamin D(3) and TGFbeta and that the effects of both agents on 5-LO mRNA expression are not related to DNA methylation.

Arachidonate 5-Lipoxygenase↗
PubMed1999

Sequence analysis of three Bacillus cereus loci carrying PIcR-regulated genes encoding degradative enzymes and enterotoxin.

PIcR is a pleiotropic regulator of extracellular virulence factors in the opportunistic human pathogen Bacillus cereus and the entomopathogenic Bacillus thuringiensis, and is induced in cells entering stationary phase. Among the genes regulated by PIcR are: pIcA, encoding phosphatidylinositol-specific phospholipase C (PI-PLC); plc, encoding phosphatidylcholine-preferring phospholipase C (PC-PLC); nhe, encoding the non-haemolytic enterotoxin; hbl, encoding haemolytic enterotoxin BL (HBL); and genes specifying a putative S-layer like surface protein and a putative extracellular RNase. By analysing 37.1 kb of DNA sequence surrounding hbl, plcA and plcR, 28 ORFs were predicted. Three novel genes putatively regulated by PlcR and encoding a neutral protease (NprB), a subtilase family serine protease (Sfp) and a putative cell-wall hydrolase (Cwh) were identified. The corresponding sfp and cwh genes were located in the immediate upstream region of plcA and could both be regulated by a putative PlcR-binding site positioned between the inversely transcribed genes. Similarly, nprB was positioned directly upstream and transcribed in the opposite orientation to plcR. Genes surrounding plcA, plcR and hblCDAB that were lacking an upstream PlcR regulatory sequence did not appear to serve functions apparently related to PlcR and did not exhibit a conserved organization in Bacillus subtilis.

Amino Acid Sequence↗
PubMed1998

The yvsA-yvqA (293 degrees-289 degrees) region of the Bacillus subtilis chromosome containing genes involved in metal ion uptake and a putative sigma factor.

The region between yvsA (293 degrees) and yvqA (289 degrees) of the Bacillus subtilis chromosome has been sequenced within the framework of the B. subtilis 168 international sequencing programme. A primary analysis of the 42 ORFs identified in this 43 kb region is presented. The region included a high proportion of genes that did not show homology with genes in other bacteria. The identified ORFs showed homology to proteins involved in the transport of metal ions, two-component signal transducers, ATP-binding-cassette-type transporters and a sigma factor.

ATP-Binding Cassette Transporters↗
PubMedDate not supplied

Factitious disorders and pathological self-harm in a hospital population: an interdisciplinary challenge.

Factitious disorder, Munchausen's Syndrome, and deliberate self-harm have recently been conceptualized as different facets of self-destructive behavior. A descriptive typological classification has been presented by Willenberg et al., but has not yet been tested with a clinical sample. The instrument distinguishes between direct self-harm (e.g., self-inflicted wounds), self-induced disease (e.g., factitious fever), and indirect self-harm delegated to medical staff (e.g., repeated operations occasioned by feigned symptoms). All patients referred to the psychosomatic-psychotherapeutic liaison-consultation service or to the outpatients' department within 14 months (n = 995) and all patients discharged from in-patient psychosomatic-psychotherapeutic treatment within 2 months (n = 62) were assessed. Expert instruction and supervision were provided for the diagnosticians. The assessment was continued for a subsequent year, without special supervision (n = 1,058). Self-destructive behaviors were diagnosed in 7.5% of the cases in the first sample, with certainty (59.5%) or on suspicion (40.5%). In the subsequent sample without supervision, the rate reduced to 3.6%. Referrals had come from almost all clinical departments, including the emergency unit (26%), surgery, internal intensive care, endocrinology (9.5% each), neurology, infectiology, nephrology (7.1% each), dermatology, gastro-enterology, cardiology (4.8% each) and surgical intensive care (2.4%). The occurrence of pathological self-destructive phenomena is underrated when using only the ICD-criteria. The rate is influenced by diagnostic attention.

Adolescent↗