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Ploner M, Gardetto A, Ploner F, Scharl M, Shoap S, Bäcker HC. Foreign rectal body - Systematic review and meta-analysis. Acta Gastroenterol Belg 2020; 83:61-65. [PMID: 32233273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Self-inserted foreign rectal bodies are an infrequent occurrence, however they present a serious dilemma to the surgeon, due to the variety of objects, and the difficulty of extraction. The purpose of this study is to give a comprehensive review of the literature regarding the epidemiology, diagnostic tools and therapeutic approaches of foreign rectal body insertion. METHODS A comprehensive systematic literature review on Pubmed/ Medline and Google for 'foreign bodies' was performed on January 14th 2018. A meta-analysis was carried out to evaluate the epidemiology, diagnostics and therapeutic techniques. 1,551 abstracts were identified, of which 54 articles were included. RESULTS The motivation of foreign rectal body insertion is mostly sexual stimulation. Patients are typically young and predominantly male, with a male to female ratio of 6:1. Sexual devices (35.7%, n=108) and glass objects (17.5%, n=53) are the most commonly self-inserted rectal foreign bodies. Patient history should be taken sensitively after diagnostic evaluation and identification of the object. Removal was performed under general anesthesia in 45.2% (n=95) and sedation in 29.0% (n=61). The total complication rate was described to be 30.4%. CONCLUSIONS Diagnostics must be performed with caution in order to rule out perforation and establish a treatment algorithm. Manual transanal extraction under sedation or general anesthesia may be performed in conjunction with cautious abdominal compression. Because of the variety of objects, i.e. in form and material, each case must be treated individually. Sometimes creativity and surgeon imagination may be required, although different algorithms have been established.
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Affiliation(s)
- M Ploner
- Department of Anesthesiology and Intensiver Care, Cantonal Spital Lucerne, Lucerne, Switzerland
| | - A Gardetto
- Department of Plastic Surgery, Hospital Sterzing, Sterzing, South Tirol, Italy
| | - F Ploner
- Department of Anesthesiology and Emergency Medicine, Hospital Sterzing, South Tirol, Italy
| | - M Scharl
- Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Swetzerland
| | - S Shoap
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, USA
| | - H C Bäcker
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, USA
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Ploner M, Löffel LM, Schüpfer G, Besmer I, Konrad CJ. [Accidental central venous administation of 0.1 % chlorhexidine mouthwash]. Anaesthesist 2018; 67:204-208. [PMID: 29352364 DOI: 10.1007/s00101-018-0408-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/09/2017] [Accepted: 12/14/2017] [Indexed: 11/24/2022]
Abstract
Medication errors are frequent and a serious safety concern. Chlorhexidine (CHX) is used daily in healthcare as a disinfectant. Its accidental intravascular injection is scarcely described. Serious complications, such as acute respiratory distress syndrome (ARDS) could be a consequence. We describe a case of central venous administration of 0.1% CHX mouthwash, its potential complications and possibilities of treatment. In contrast to another case report our patient had no detectable adverse side effects. The immediate hemofiltration and cleansing of the i. v. line may have contributed to this favorable outcome.
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Affiliation(s)
- M Ploner
- Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Kantonsspital Luzern, Luzern 16, Luzern, Schweiz. .,Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Freiburgstrasse, 3010, Bern, Schweiz.
| | - L M Löffel
- Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Kantonsspital Luzern, Luzern 16, Luzern, Schweiz.,Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Freiburgstrasse, 3010, Bern, Schweiz
| | - G Schüpfer
- Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Kantonsspital Luzern, Luzern 16, Luzern, Schweiz
| | - I Besmer
- Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Kantonsspital Luzern, Luzern 16, Luzern, Schweiz
| | - C J Konrad
- Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Kantonsspital Luzern, Luzern 16, Luzern, Schweiz
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Ploner M. Integration of MRI and EEG in pain reserach. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0029-1246613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schulz E, Tiemann L, Ploner M. Neurophysiological correlates of the subjective pain experience. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tiemann L, Schulz E, Ploner M. Schmerz beansprucht Aufmerksamkeit – eine EEG- und verhaltensbasierte Studie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keeser D, Tiemann L, Valet M, Schulz E, Ploner M, Kalckreuth A, Padberg F, Toelle T. Preliminary EEG and low resolution electromagnetic tomography correlates of migraine therapy. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ploner M, Lee M, Wiech K, Bingel U, Tracey I. Prestimulus cerebral connectivity determines pain perception in humans. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schulz E, Tiemann L, Ploner M. Neurophysiologische Korrelate der subjektiven Schmerzverarbeitung. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tiemann L, Schulz E, Ploner M. Schmerz beansprucht Aufmerksamkeit – Eine EEG- und verhaltensbasierte Studie. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ploner M, Schoffelen J, Schnitzler A, Gross J. Functional integration within the human pain system as revealed by Granger causality. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Angermayr B, Luca A, König F, Bertolini G, Ploner M, Gridelli B, Ulbrich G, Reiberger T, Bosch J, Peck-Radosavljevic M. Aetiology of cirrhosis of the liver has an impact on survival predicted by the Model of End-stage Liver Disease score. Eur J Clin Invest 2009; 39:65-71. [PMID: 19087131 DOI: 10.1111/j.1365-2362.2008.02063.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Originally, aetiology of liver disease has been incorporated into the computation of the Model of End-stage Liver Disease (MELD) score. Clinical observations prompted us to hypothesize that patients with viral and alcoholic cirrhosis may differ in predicted survival rates. Until now, no large representative studies evaluated the impact of aetiology on long-term survival predicted by the Child-Pugh and MELD scores. MATERIALS AND METHODS Four hundred and ninety-three patients who underwent transjugular intrahepatic portosystemic shunt implantation in Vienna, Austria, and Palermo, Italy, were included in this retrospective study. The main analyses were a logistic regression model and a Cox proportional hazards regression model calculating the interaction of the aetiology with the scores. RESULTS Both groups had similar survival rates (median 1377 and 1721 days for viral and alcoholic cirrhosis, respectively; P = 0.58), but patients with viral cirrhosis had significantly lower MELD scores (P = 0.002). In the Cox analysis, aetiology had a significant impact on the prediction of overall survival by MELD score. For 3-month survival, MELD score was adequately predictive for both groups. For 1-year survival, aetiology had a significant impact on survival, indicating that patients with identical scores but different aetiologies differed in survival rates. When stratifying patients into high- and low-risk patients (MELD < 16 vs. MELD >or= 16), aetiology of cirrhosis had no impact on the predictive value for low-risk patients; high-risk-patients (MELD >or= 16) with viral cirrhosis had significantly lower survival rates than patients with alcoholic cirrhosis and identical scores. With regard to Child-Pugh Score, no significant differences between the two patient groups and in the prediction of 3-month and 1-year survival could be observed. CONCLUSIONS Our study suggests that aetiology of cirrhosis has an impact on 1-year survival predicted by the MELD score. This becomes more apparent in patients with advanced stage of liver disease (MELD >or= 16). Since MELD score is used for ranking patients for liver transplantation and waiting times are regularly longer than 3 months, our observations suggest that with increasing time on the waiting list and severity of disease, patients with viral cirrhosis may have a disadvantage in the current allocation policy.
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Affiliation(s)
- B Angermayr
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Ploner M, Schoffelen J, Schnitzler A, Gross J. MEG-Untersuchungen zur funktionellen Organisation der Schmerzverarbeitung im menschlichen Gehirn. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sporn E, Kubin K, Hoblaj T, Ploner M, Böhmig HJ, Nanobashvili J, Huk I, Prager MR, Polterauer P. Dacron grafts dilate more than Stretch PTFE grafts after abdominal aortic aneurysm repair – long-term results of a prospective randomized trial. Eur Surg 2008. [DOI: 10.1007/s10353-007-0375-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Timmermann L, Butz M, Gross J, Ploner M, Südmeyer M, Kircheis G, Häussinger D, Schnitzler A. Impaired cerebral oscillatory processing in hepatic encephalopathy. Clin Neurophysiol 2007; 119:265-72. [PMID: 18055256 DOI: 10.1016/j.clinph.2007.09.138] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 07/16/2007] [Accepted: 09/23/2007] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Hepatic encephalopathy (HE) is characterized by neuropsychological and motor deficits. The present study tested the hypothesis that worsening of motor and sensory symptoms of HE results from a common basic deficit in the cerebral oscillatory processing within the human motor and visual system. METHODS We investigated in 32 patients with liver cirrhosis and HE grades 0-2 critical flicker frequency (CFF) and cortico-muscular (M1-EMG) coherence as a measure of coupling between the surface EMGs of hand muscles and primary motor cortex (M1) activity recorded non-invasively with magnetoencephalography (MEG) during forearm elevation. RESULTS Patients with HE-grade 2 developed excessive M1-EMG coherence at low frequencies. In contrast, maximum M1-EMG coherence in patients with no HE showed frequency and amplitude in the physiological range. CFF was continuously reduced with worsening grades of HE. Correlation analysis revealed significant correlation between the frequency of M1-EMG coherence and CFF. CONCLUSIONS Taken together, we demonstrate that increased grades of HE lead to a pathological M1-EMG drive which is reduced in frequency. These effects are correlated with an impaired perception of oscillatory visual stimuli. SIGNIFICANCE The results suggest that pathological oscillatory neural processing in different human cerebral systems may represent a basic mechanism for the clinical manifestation of HE.
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Affiliation(s)
- L Timmermann
- Department of Neurology, University Hospital Cologne, Germany.
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Ploner M, Gross J, Timmermann L, Pollok B, Schnitzler A. Oscillatory activity reflects the excitability of the human somatosensory system. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ploner M, Gross J, Timmermann L, Schnitzler A. Induzierte Gamma-Oszillationen im primären somatosensorischen Kortex als Korrelat der Schmerzwahrnehmung. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ploner M, Gross J, Timmermann L, Schnitzler A. Schmerzverarbeitung ist schneller als taktile Verarbeitung im menschlichen Gehirn. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wojtecki L, Timmermann L, Elben S, Jörgens S, Südmeyer M, Groiss S, Ploner M, Maarouf M, Voges J, Sturm V, Niedeggen M, Schnitzler A. Modulierbarkeit von Zeitwahrnehmung durch Tiefe Hirnstimulation des Nucleus subthalamicus bei Patienten mit Morbus Parkinson. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Albrecht P, Groiss S, Ploner M, Otto M, Hartung HP, Hemmer B, Methner A. Erhöhte Caspase-3 und -7 Aktivität im Liquor von Patienten mit Creutzfeld-Jakob Erkrankung korreliert mit Klinik und verbleibender Lebensdauer. Akt Neurol 2007. [DOI: 10.1055/s-2007-987606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reck C, Florin E, Gross J, Ostrowski S, Krause H, Groiss S, Wojtecki L, Ploner M, Südmeyer M, Voges J, Maarouf M, Lehrke R, Treuer H, Fink GR, Sturm V, Schnitzler A, Timmermann L. Räumliche und zeitlich-dynamische Kohärenzanalyse zwischen lokalen Feldpotentialen im Nucleus subthalamicus und Tremor EMG Aktivität bei Patienten mit idiopathischem Morbus Parkinson. Akt Neurol 2007. [DOI: 10.1055/s-2007-987671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Florin E, Reck C, Gross J, Ostrowski S, Krause H, Groiss S, Wojtecki L, Ploner M, Südmeyer M, Voges J, Maarouf M, Lehrke R, Treuer H, Fink GR, Sturm V, Schnitzler A, Timmermann L. Efferente und afferente Kausalitätsbeziehungen zwischen lokalen Feldpotentialen im Nucleus ventralis intermedius thalami und EMG-Aktivität bei Patienten mit Multiple Sklerose Tremor. Akt Neurol 2007. [DOI: 10.1055/s-2007-987559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gross J, Schnitzler A, Timmermann L, Ploner M. 310 PAIN-INDUCED GAMMA-ACTIVITY IN HUMAN PRIMARY SOMATOSENSORY CORTEX REFLECTS PAIN PERCEPTION. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60313-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ploner M, Gross J, Timmermann L, Schnitzler A. 309 PAIN PROCESSING IS FASTER THAN TACTILE PROCESSING IN THE HUMAN BRAIN. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ploner M, Gross J, Timmermann L, Pollok B, Schnitzler A. Oscillatory activity reflects the excitability of the human somatosensory system. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Platzen J, Pollok B, Gross J, Schnitzler A, Ploner M. Charakterisierung schmerzinduzierter kortikaler Erregbarkeitsveränderungen. Akt Neurol 2006. [DOI: 10.1055/s-2006-953089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Braun M, Ostrowski S, Pollok B, Groiss S, Wojtecki L, Krause H, Gross J, Butz M, Südmeyer M, Ploner M, Schnitzler A, Timmermann L. Einfluss von L-Dopa und Stimulation des Ncl. subthalamicus auf die Diadochokinese bei Patienten mit M. Parkinson. Akt Neurol 2006. [DOI: 10.1055/s-2006-953231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Timmermann L, Reck C, Gross J, Ostrowski S, Krause H, Groiss S, Wojtecki L, Ploner M, Südmeyer M, Voges J, Sturm V, Schnitzler A. Zeitlich-räumliche Kohärenzanalyse zwischen LFPs im VIM und Tremor EMG Aktivität bei einer Patientin mit Multiple Sklerose. Akt Neurol 2006. [DOI: 10.1055/s-2006-953235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Reck C, Gross J, Ostrowski S, Krause H, Groiss S, Wojtecki L, Ploner M, Südmeyer M, Voges J, Sturm V, Schnitzler A, Timmermann L. Räumliche Kohärenzanalyse zwischen lokalen Feldpotentialen im Nucleus ventralis intermedius thalami und Tremor EMG Aktivität bei einem Patienten mit Multiple Sklerose. Akt Neurol 2006. [DOI: 10.1055/s-2006-953234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ploner M, Gross J, Timmermann L, Pollok B, Schnitzler A. Pain suppresses spontaneous brain rhythms. Akt Neurol 2005. [DOI: 10.1055/s-2005-919454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Timmermann L, Groiss S, Butz M, Braun M, Südmeyer M, Ploner M, Wojtecki L, Dambe R, Schleucher R, Kircheis G, Häussinger D, Schnitzler A. Ataxia and tremor in patients with liver cirrhosis and minimal hepatic encephalopathy. Akt Neurol 2005. [DOI: 10.1055/s-2005-919372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tzou CHJ, Giovanoli P, Ploner M, Frey M. Are there ethnic differences of facial movements between Europeans and Asians? ACTA ACUST UNITED AC 2005; 58:183-95. [PMID: 15710113 DOI: 10.1016/j.bjps.2004.10.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2004] [Accepted: 10/19/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE Due to the widespread use of Free Functional Muscle Transplant (FFMT) around the world to reanimate the paralysed face, it is important to be aware of ethnic differences in facial movements. METHODS AND MATERIAL Participants in this study were born in Taiwan (n=24) and Austria (n=24). Analyses were conducted applying the digitised three-dimensional video-analysis system. All 48 subjects have never undergone any treatments in the face nor did they have previous histories of craniofacial anomalies. RESULTS In general, Europeans were observed to have larger facial movements than Asians, from 0.4 mm (e.g. 5.7%) up to 3.9 mm (e.g. 30.3%), on average 1.3 mm+/-0.82 SD (e.g. 20.6%). Particularly the eyebrow, nose and mouth regions show statistically significant larger excursions on average 1.4 mm (e.g. 19.9%), 1.3 mm (e.g. 34.6%) and 3.0 mm (e.g. 30.3%). One exception is in the eye region, where Asians have a larger excursion (1.4 mm, e.g. 15.8%) of the eyelids, due to the larger distances between the upper and lower eyelids in the rest position. CONCLUSION Europeans have generally larger facial movements than Asians. Particularly the eyebrow, nose and mouth regions show statistically significant larger excursions; exception must be made to the eye region, where Asians have a larger excursion of the eyelids. This is the first step to gather essential information about the ethnical differences in facial movements, a factor that should be considered as FFMT is becoming more popular worldwide.
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Affiliation(s)
- C H J Tzou
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Vienna, General Hospital Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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Puhalla H, Gruenberger T, Pokorny H, Ploner M, Bareck E, Depisch D, Zacherl J, Bischof G. Influence of laparoscopy on survival after surgery for gallbladder carcinoma: a matched-pair analysis. Eur Surg 2004. [DOI: 10.1007/s10353-004-0089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Contrary to the traditional view that the cerebral cortex is not involved in pain perception an extensive cortical network associated with pain processing has been revealed during the past decades. This network consistently includes the primary (S1) and secondary somatosensory cortices (S2), the insular cortex, and the anterior cingulate cortex (ACC). These cortical areas are organized in parallel and contribute to different dimensions of pain experience. The S1 cortex is mainly involved in discriminative aspects of pain, while the S2 cortex seems to have an important role in cognitive aspects of pain perception. The insula has been proposed to be involved in autonomic reactions to noxious stimuli and in pain-related learning and memory. The ACC is closely related to pain affect and may subserve the integration of general affect, cognition, and response selection. Furthermore, first pain appears to be particularly related to activation of S1 whereas second pain is closely related to ACC activation.
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Affiliation(s)
- M Ploner
- Neurologische Klinik, Heinrich-Heine-Universität, Düsseldorf.
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Ploner M, Schnitzler A. Spatial and Temporal Characteristics of Pain Processing in the Human Brain. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-832125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The aim of this study was to determine the mean distances of facial movements in 24 healthy individuals aged between 22 and 70 years, using the digitised three-dimensional video-analysis system developed by Frey et al. The subjects were divided into three groups of eight. The first group consisted of individuals aged between 20 and 30 years (mean+/-s.d.=25.0+/-2.33 years). Subjects in the second group were aged between 40 and 50 years (mean+/-s.d.=46.8+/-2.53 years), and the third group consisted of subjects aged between 60 and 70 years (mean+/-s.d.=63.6+/-3.07 years). In all groups the sexes were equally represented. No subject had had treatment to the face, nor did they have paralysis, scars or diseases of the skin. Males showed larger movements of the face than females, on average by 1.40+/-0.73 mm (15.08%). Subjects aged between 60 and 70 years demonstrated the largest movements of the face. The evaluation of facial movements in 24 healthy volunteers showed that sex and age affect facial dynamics. Thus study generated three-dimensional standard values for healthy facial movements.
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Affiliation(s)
- P Giovanoli
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Vienna, Austria.
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36
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Ploner M, Pollok B, Schnitzler A. Interaktionen zwischen Schmerz und Berührung in den somatosensorischen Kortizes des Menschen. KLIN NEUROPHYSIOL 2003. [DOI: 10.1055/s-2003-816511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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37
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Puhalla H, Wild T, Bareck E, Pokorny H, Ploner M, Soliman T, Stremitzer S, Depisch D, Laengle F, Gruenberger T. Long-term follow-up of surgically treated gallbladder cancer patients. Eur J Surg Oncol 2002; 28:857-63. [PMID: 12477478 DOI: 10.1053/ejso.2002.1301] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS Palliative attempts have traditionally led treatment of gallbladder cancer but resection offers the only chance for long-term survival. This study investigates the impact of surgery with curative intent in gallbladder cancer treatment and evaluates prognostic factors for survival. METHODS Two hundred and sixty-seven patients were admitted for surgical therapy. Sixty received resection with curative intent and form the basis of this analysis. RESULTS R0 resection (n=45) was a highly significant independent survival predictor (P<0.001). All 5-year survivors (n=10) had tumour-free resection margins. Early T stage (P=0.017) and highly differentiated cancer (P=0.008) had a significant better outcome. Nodal spreading increased by local tumour extension and lymphatic involvement decreased patient survival (P=0.018). Patients' age (>75 years) was without influence on long-term survival. CONCLUSIONS Long-term survival is possible both in elderly patients and in advanced cancer.
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Affiliation(s)
- H Puhalla
- Department of General Surgery, University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
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38
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Zuckermann A, Ploner M, Czerny M, Keziban U, Birsan T, Laufer G, Wolner E, Grimm M. Low incidence of graft arteriosclerosis after cardiac transplantation: risk factor analysis for patients with induction therapy. Transplant Proc 2002; 34:1869-71. [PMID: 12176608 DOI: 10.1016/s0041-1345(02)03103-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Zuckermann
- Department of Cardiothoracic Surgery, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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39
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Devyatko E, Ploner M, Zuckermann A, Jaksch P, Tschernko E, Klepetko W, Wisser W. Value of mycophenolic acid trough level monitoring after lung transplantation. Transplant Proc 2002; 34:1881-3. [PMID: 12176612 DOI: 10.1016/s0041-1345(02)03107-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elena Devyatko
- Department of Clinical Pharmacology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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40
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Abstract
Blood samples of 200 patients with thermal injuries were drawn apparently to determine the trend of the cholinesterase activity. In relation to the severity of the injury, a characteristic decrease was noted during the first days after admission. A recovery to normal values was achieved in all survivors (150 patients) after a proportionate period of time, but in the group of non-survivors (50 patients), no complete recovery to normal levels was found. Furthermore, a significant relationship between serum cholinesterase activity and the severity of morbidity was detected, the fall of the cholinesterase activity at the very beginning was significantly higher (P<0.004) in patients who died (1.3kU/l) than in patients who survived (0.7kU/l). Already 24h after admission, the mean activity was significantly lower (P<0.003) in non-survivors (2.5kU/l) than in survivors (3.2kU/l). It seems that the serum cholinesterase is a sensitive indicator for the morbidity of patients with severe burn injuries.
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Affiliation(s)
- L-P Kamolz
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical School, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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41
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Manhart N, Akomeah R, Bergmeister H, Spittler A, Ploner M, Roth E. Administration of proteolytic enzymes bromelain and trypsin diminish the number of CD4+ cells and the interferon-gamma response in Peyer's patches and spleen in endotoxemic balb/c mice. Cell Immunol 2002; 215:113-9. [PMID: 12202148 DOI: 10.1016/s0008-8749(02)00019-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Recent publications revealed that bromelain exerts a marked effect on T-cell response by inhibiting T-cell signal transduction. These experimental studies may help to explain former clinical investigations showing that Phlogenzym (PHL), a preparation consisting of the proteases bromelain and trypsin and the antioxidant rutosid, ameliorate certain diseases with an underlying inflammatory process. In this study, we showed that orally administered PHL significantly reduced lymphocyte subpopulations in Peyer's patches (PPs) of healthy and endotoxemic mice. Similarly, the number of splenic lymphocytes in endotoxin-boostered mice was significantly lowered by PHL. The effect of PHL was more pronounced on T cells than on B cells leading especially to a diminution of CD4+ cells. Moreover, PHL pretreatment decreased IFN-gamma mRNA in PPs and spleen of endotoxemic mice. These results reveal that PHL may ameliorate inflammatory process by reducing the number of CD4+ cells and by diminishing INF-gamma mRNA levels.
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Affiliation(s)
- N Manhart
- Department of Surgical Research, University Vienna, Austria.
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42
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Kröner A, Seitelberger R, Schirnhofer J, Bernecker O, Mallinger R, Hallström S, Ploner M, Podesser BK. Diltiazem during reperfusion preserves high energy phosphates by protection of mitochondrial integrity. Eur J Cardiothorac Surg 2002; 21:224-31. [PMID: 11825728 DOI: 10.1016/s1010-7940(01)01110-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study evaluates the effects of diltiazem administered during reperfusion on hemodynamic, metabolic, and ultrastructural postischemic outcome. METHODS Hearts of 38 adult White New Zealand rabbits underwent 60 min of global cold ischemia followed by 40 min of reperfusion in an erythrocyte perfused isolated working heart model. Hearts were randomly assigned to four groups and received diltiazem (0.1, 0.25, and 0.5 micromol/l) during reperfusion only, or served as control. RESULTS The postischemic time courses of heart rate, aortic flow, and external stroke work clearly reflected the dose-dependent negative chronotropic and inotropic efficacy of diltiazem in the two higher concentrations. High energy phosphates (HEP) determined from myocardial biopsies taken after 40 min of reperfusion were significantly better preserved in all treatment groups compared to control hearts. Similarly ultrastructural grading of mitochondria and myofilaments revealed a significant reduction of reperfusion injury in hearts that received diltiazem compared to control. CONCLUSIONS Diltiazem protects mitochondrial integrity and function, thereby preserving myocardial HEP levels. Only low dose diltiazem (0.1 micromol/l) during reperfusion combines both, optimal mitochondrial preservation with minimal changes in hemodynamics.
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Affiliation(s)
- A Kröner
- Department of Cardiothoracic Surgery, AKH Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Abstract
INTRODUCTION There are various options for the treatment of gallbladder carcinoma; however, only radical resection offers a chance for prolonged survival. METHODS The aim of this study was to analyze retrospectively patients suffering from gallbladder carcinoma in a central hospital in Austria. From 1986 to 1999, 77 patients were treated in this surgical department. The median age of the patients was 71.3 years. RESULTS In 28 patients the cancer was resected and 22 persons underwent palliative surgery. An explorative laparotomy was performed in 16 patients. Eleven patients had no surgical therapy, 10 persons received gemcitabine or a combination chemotherapy regimen consisting of leucoverin, 5-fluorouracil and mitomycin C. The median survival of patients without chemotherapy following radical resection (n = 15) was 10.7 months (one patient with metastatic cancer was excluded) and for patients with tumor remaining margins (n = 8) 3.2 months (P = 0.023). Without chemotherapy the median patient survival following palliative resection (n = 17) and explorative laparotomy (n = 15) was 1.5 months and 2.1 months. The median survival without surgical therapy was 1.6 months. Chemotherapy was administered to four of the resected patients (median survival 16.5 months), in five patients following palliative surgery and in one patient after explorative laparotomy (median survival 4.3 months) (P = 0.034). In a multivariate analysis, tumor resection (P = 0.034) and tumor-free resection margins (P = 0.025) proved to be the most important determinants for patient survival. CONCLUSION Tumor resection is the most important factor for a prolonged patient survival. Following radical resection in an early tumor stage and combining this approach with an established chemotherapy, patient survival could be increased significantly.
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Affiliation(s)
- H Puhalla
- Chirurgische Abteilung, Allgemeines öffentliches Krankenhaus, Wiener Neustadt, Osterrreich
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Kretschmer G, Holzenbein T, Bergmann M, Winkler T, Aslim E, Ploner M, Agstner I. Der geriatrische Patient aus chirurgischer Sicht - Periphere arterielle Verschlusskrankheit. Eur Surg 2001. [DOI: 10.1046/j.1563-2563.2001.01176.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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45
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Sandner SE, Wieselthaler G, Zuckermann A, Taghavi S, Schmidinger H, Pacher R, Ploner M, Laufer G, Wolner E, Grimm M. Survival benefit of the implantable cardioverter-defibrillator in patients on the waiting list for cardiac transplantation. Circulation 2001; 104:I171-6. [PMID: 11568051 DOI: 10.1161/hc37t1.094916] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The implantable cardioverter-defibrillator (ICD) effectively reduces sudden cardiac death in patients with severe LV dysfunction. Effect of ICD therapy on total mortality in patients on the waiting list for cardiac transplantation is still uncertain. METHODS AND RESULTS We retrospectively analyzed 854 unselected consecutive patients (ICD therapy, n=102; 11.9%) on the waiting list for cardiac transplantation between January 1992 and March 2000. Actuarial 12-month total mortality rate on the waiting list was 24.2%; sudden cardiac death was the predominant mode of death (66.7% of total deaths). Kaplan-Meier analysis revealed improved survival for ICD (total mortality, 13.2%) compared with non-ICD (total mortality, 25.8%) patients (log rank, P=0.03). No event of sudden death occurred in ICD patients, whereas in non-ICD patients, 12-month sudden death rate was 20.1% (P=0.0001). Nonsudden death rates did not differ between ICD and non-ICD patients (P=0.16). A Cox proportional hazards model demonstrated that absence of an ICD was a powerful independent predictor of total mortality (P=0.02; relative risk, 2.22; 95% confidence interval, 1.16 to 4.17) and sudden cardiac death (P<0.0001; infinite relative risk) on the waiting list. CONCLUSIONS ICD therapy, because it prevents sudden cardiac death, significantly improves survival on the waiting list for cardiac transplantation. The present study supports the use of ICDs as a bridge to transplantation in patients who are at risk of sudden cardiac death. Prospective randomized trials are needed to evaluate the potential benefit of prophylactic ICD therapy as a bridge to transplantation in all patients on cardiac transplant waiting lists.
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Affiliation(s)
- S E Sandner
- Department of Cardiothoracic Surgery, Vienna University Hospital, Vienna, Austria
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46
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Timmermann L, Ploner M, Haucke K, Schmitz F, Baltissen R, Schnitzler A. Differential coding of pain intensity in the human primary and secondary somatosensory cortex. J Neurophysiol 2001; 86:1499-503. [PMID: 11535693 DOI: 10.1152/jn.2001.86.3.1499] [Citation(s) in RCA: 199] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The primary (SI) and secondary (SII) somatosensory cortices have been shown to participate in human pain processing. However, in humans it is unclear how SI and SII contribute to the encoding of nociceptive stimulus intensity. Using magnetoencephalography (MEG) we recorded responses in SI and SII in eight healthy humans to four different intensities of selectively nociceptive laser stimuli delivered to the dorsum of the right hand. Subjects' pain ratings correlated highly with the applied stimulus intensity. Activation of contralateral SI and bilateral SII showed a significant positive correlation with stimulus intensity. However, the type of dependence on stimulus intensity was different for SI and SII. The relation between SI activity and stimulus intensity resembled an exponential function and matched closely the subjects' pain ratings. In contrast, SII activity showed an S-shaped function with a sharp increase in amplitude only at a stimulus intensity well above pain threshold. The activation pattern of SI suggests participation of SI in the discriminative perception of pain intensity. In contrast, the all-or-none-like activation pattern of SII points against a significant contribution of SII to the sensory-discriminative aspects of pain perception. Instead, SII may subserve recognition of the noxious nature and attention toward painful stimuli.
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Affiliation(s)
- L Timmermann
- Department of Neurology, Heinrich-Heine-University, Moorenstrasse 5, 40225 Dusseldorf, Germany
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47
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Kocher AA, Schlechta B, Ehrlich M, Ploner M, Khazen C, Schuster MP, Ankersmit J, Grimm M, Wolner E, Laufer G, Lassnigg A, Bonaros N. Effect of ABO blood type matching in cardiac transplant recipients. Transplant Proc 2001; 33:2752-4. [PMID: 11498148 DOI: 10.1016/s0041-1345(01)02179-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- A A Kocher
- Department of Cardiothoracic Surgery, Division of Surgery, General Hospital Vienna, University of Vienna, Austria
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Kocher AA, Funovics M, Khazen C, Ploner M, Ehrlich M, Schlechta B, Nourani F, Ankersmit J, Wolner E, Laufer G. Etiology of pulmonary nodules after heart transplantation. Transplant Proc 2001; 33:2757-8. [PMID: 11498150 DOI: 10.1016/s0041-1345(01)02181-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- A A Kocher
- Department of Cardiothoracic Surgery, Division of Surgery, General Hospital Vienna, University of Vienna, Austria
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49
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Schlechta B, Kocher AA, Ehrlich M, Ankersmit J, Ploner M, Walch K, Nourani F, Czerny M, Wolner E, Grimm M. Heart retransplantation: institutional results of a series of 31 cases. Transplant Proc 2001; 33:2759-61. [PMID: 11498151 DOI: 10.1016/s0041-1345(01)02182-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- B Schlechta
- Division of Cardiothoracic Surgery, Department of Surgery, University of Vienna, Vienna, Austria
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50
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Schlechta B, Kocher AA, Ehrlich M, Ankersmit J, Ploner M, Walch K, Nourani F, Czerny M, Wolner E, Wollenek G, Grimm M. Outcome of pediatric heart transplantation: an analysis of 27 cases. Transplant Proc 2001; 33:2834-5. [PMID: 11498179 DOI: 10.1016/s0041-1345(01)02210-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- B Schlechta
- Division of Cardiothoracic Surgery, Department of Surgery, University of Vienna, Vienna, Austria
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