Petra Innerhofer, D Friès, Antón Klingler, Werner Streif,
Editor—As the influence of i.v. fluids on the coagulation system is of importance and also sustains the discussion on optimal fluid therapy, we would like to comment on the results reported by Ng and colleagues1Ng KFJ Lam CCK Chan LC In vivo effect of haemodilution with saline on coagulation: a randomized trial.Br J Anaesth. 2002; 88: 475-480Crossref PubMed Scopus (151) Google Scholar and the suggestions presented in the accompanying editorial.2Ruttmann TG Haemodilution enhances coagulation.Br J ...
Tópico(s): Hemodynamic Monitoring and Therapy
2002 - Elsevier BV | British Journal of Anaesthesia
Markus Mittermayr, Corinna Velik‐Salchner, Berndt Stalzer, Josef Margreiter, Antón Klingler, Werner Streif, D Friès, Petra Innerhofer,
Our goal of this study was to determine whether protamine's effects on coagulation can be detected and differentiated from those of heparin when using thrombelastometry (ROTEM).To reverse the effects of heparin after cardiopulmonary bypass (CPB), 22 consecutive patients undergoing aortocoronary bypass graft surgery were included. According to clinical routine, all patients received a first dose of protamine calculated from the total amount of heparin given; additional protamine (70 U/kg) was administered ...
Tópico(s): Antiplatelet Therapy and Cardiovascular Diseases
2009 - Lippincott Williams & Wilkins | Anesthesia & Analgesia
D Friès, Thorsten Haas, Antón Klingler, Werner Streif, G. Klima, Judith Martini, Horst G. Wagner-Berger, Petra Innerhofer,
This study was conducted to assess whether the combined administration of fibrinogen and prothrombin complex concentrate (PCC) enables the reversal of dilutional coagulopathy resulting from intended blood loss and fluid replacement, and whether this treatment reduces further blood loss and mortality.In 20 anaesthetized pigs, approximately 65% of the estimated blood volume was withdrawn and replaced with the same amount of hydroxyethyl starch (6% HES 130/0.4) to mimic blood loss and to develop a dilutional ...
Tópico(s): Blood transfusion and management
2006 - Elsevier BV | British Journal of Anaesthesia
D Friès, Anette C. Krismer, Antón Klingler, Werner Streif, G. Klima, Volker Wenzel, Thorsten Haas, Petra Innerhofer,
BackgroundThis study was conducted to determine whether replacement of fibrinogen is useful in reversing dilutional coagulopathy following severe haemorrhage and administration of colloids.MethodsIn 14 anaesthetized pigs, approximately 65% of the estimated blood volume was withdrawn and replaced with the same amount of gelatin solution to achieve dilutional coagulopathy. Animals were randomized to receive either 250 mg kg−1 fibrinogen (n=7) or normal saline (n=7). A standardized liver injury was then ...
Tópico(s): Blood transfusion and management
2005 - Elsevier BV | British Journal of Anaesthesia
Markus Mittermayr, Josef Margreiter, Corinna Velik‐Salchner, Antón Klingler, Werner Streif, D Friès, Petra Innerhofer,
Precise coagulation monitoring might help prevent heparin-protamine mismatch and thus decrease postoperative blood loss. We therefore measured coagulation time (CT) by modified thrombelastography (Rotem) as a possible differential monitor of the effects of heparin and protamine.Undiluted and diluted blood samples from 26 healthy volunteers were spiked with increasing concentrations of heparin (0.1, 0.2, 0.4, 0.8 and 1 U ml(-1)). In addition, undiluted blood was spiked with protamine hydrochloride (0. ...
Tópico(s): Sepsis Diagnosis and Treatment
2005 - Elsevier BV | British Journal of Anaesthesia
P. Springer, B. Stöhr, Salvatore Giacomuzzi, Gerd Bodner, Amy Mercantini Klingler, Werner Jaschke, Dieter zur Nedden,
Tópico(s): Digital Radiography and Breast Imaging
2000 - Springer Science+Business Media | European Radiology
Alberto Zullo, Werner Klingler, Claudia De Sarno, M.L. Ferrara, Giuliana Fortunato, Giuseppa Perrotta, E Gravino, Rosella Di Noto, Frank Lehmann‐Horn, W. Melzer, Francesco Salvatore, Antonella Carsana,
Mutations in the RYR1 gene are linked to malignant hyperthermia (MH), central core disease and multi-minicore disease. We screened by DHPLC the RYR1 gene in 24 subjects for mutations, and characterized functional alterations caused by some RYR1 variants. Three novel sequence variants and twenty novel polymorphisms were identified. Immortalized lymphoblastoid cell lines from patients with RYR1 variants and from controls were stimulated with 4-chloro-m-cresol (4-CmC) and the rate of extracellular acidification ...
Tópico(s): Cardiac electrophysiology and arrhythmias
2009 - Wiley | Human Mutation
Werner Klingler, Henrik Rueffert, Frank Lehmann‐Horn, Thierry Girard, Philip M. Hopkins,
In this article, we analyze myopathies with cores, for which an association to malignant hyperthermia (MH) has been suggested. We discuss the clinical features, the underlying genetic defects, subsequent effects on cellular calcium metabolism, and in vitro muscle responses to MH triggers. We describe in detail central core disease, multiminicore disease, and nemaline rod myopathy. We categorize the diseases according to the affected proteins and discuss the risk for MH, which is high or theoretically ...
Tópico(s): Advanced MRI Techniques and Applications
2009 - Lippincott Williams & Wilkins | Anesthesia & Analgesia
Robert Schleip, Adjo Zorn, Werner Klingler,
Objectives: To highlight the load bearing functions of fascial tissues and their proneness to micro tearing during physiological or excessive loading, to review histological evidence for a proprioceptive as well as nociceptive innervation of fascia, and to emphasize the potential role of injury, inflammation, and/or neural sensitization of the posterior layer of the human lumbar fascia in non-specific low back pain.Findings: In addition to a tensional load bearing function of tendons and ligaments, ...
Tópico(s): Shoulder Injury and Treatment
2010 - Informa | Journal of Musculoskeletal Pain
Robert Schleip, Andry Vleeming, Frank Lehmann‐Horn, Werner Klingler,
In his article Panjabi gives a concise overview on the current knowledge and understanding of low back and neck pain [12]. He introduces the hypothesis that chronic back pain originates from subfailure injuries of three types of spinal ligamentous structures and their embedded mechanoreceptors: namely the spinal ligaments, the disc annulus and the facet capsules. These injured tissues then send out corrupted transducer signals to the neuromuscular control unit, and as a result corrupted muscle response ...
Tópico(s): Spine and Intervertebral Disc Pathology
2007 - Springer Science+Business Media | European Spine Journal
Robert Schleip, Lutz Duerselen, Andry Vleeming, I.L. Naylor, Frank Lehmann‐Horn, Adjo Zorn, Heike Jaeger, Werner Klingler,
This study examined a potential cellular basis for strain hardening of fascial tissues: an increase in stiffness induced by stretch and subsequent rest. Mice lumbodorsal fascia were isometrically stretched for 15 min followed by 30 min rest (n=16). An increase in stiffness was observed in the majority of samples, including the nonviable control samples. Investigations with porcine lumbar fascia explored hydration changes as an explanation (n=24). Subject to similar loading procedures, tissues showed ...
Tópico(s): Sports injuries and prevention
2011 - Elsevier BV | Journal of Bodywork and Movement Therapies
Frank Lehmann‐Horn, Werner Klingler, Karin Jurkat‐Rott,
Department of Neurophysiology, Ulm University, Ulm, Germany. frank.lehmann-horn@uni-ulm.deSUSCEPTIBILITY to malignant hyperthermia (MH) is viewed as a pharmacogenetic trait dependent on exposure to inhalational anesthetics.1,2Outside of the operating room, individuals susceptible to MH are usually asymptomatic. Events that occurred in the absence of anesthetics have been reported over the years and were originally termed awake episodes.3In this issue of ANESTHESIOLOGY, two cases of nonanesthetic ...
Tópico(s): Neuroscience and Neuropharmacology Research
2011 - Lippincott Williams & Wilkins | Anesthesiology
Thorsten Holsträter, Michael Georgieff, Karl J. Föhr, Werner Klingler, Miriam Uhl, Tobias Walker, Sarah Köster, Georg Grön, Oliver Adolph,
Both central sensitization after peripheral tissue injury and the development of opioid tolerance involve activation of N-methyl-D-aspartate (NMDA) receptors. At subanesthetic doses the NMDA receptor antagonist xenon suppresses pain-evoked sensitization of pain-processing areas in the central nervous system. Although numerous studies describe the effect of NMDA receptor antagonists on postoperative pain, clinical studies elucidating their intraoperative analgesic potency when applied in a low dosage ...
Tópico(s): Anesthesia and Pain Management
2011 - Lippincott Williams & Wilkins | Anesthesiology
Robert Schleip, Werner Klingler, F. Lehmann‐Horn,
Summary With immunohistological analysis we demonstrate the presence of myofibroblasts in normal human fasciae, particularly the fascia lata, plantar fascia, and the lumbar fascia. Density was found to be highest in the lumbar fascia and seems to be positively related to physical activity. For in vitro contraction tests we suspended strips of lumbar fascia from rats in an organ bath and measured for responsiveness to potential contractile agonists. With the H1 antagonist mepyramine there were clear ...
Tópico(s): Musculoskeletal pain and rehabilitation
2006 - Elsevier BV | Journal of Biomechanics
Robert Schleip, Heike Jäger, Werner Klingler,
Tópico(s): Therapeutic Uses of Natural Elements
2012 - Elsevier BV | Journal of Bodywork and Movement Therapies
Robert Schleip, I.L. Naylor, Daniel Ursu, W. Melzer, Adjo Zorn, Hans‐Joachim Wilke, Frank Lehmann‐Horn, Werner Klingler,
The article introduces the hypothesis that intramuscular connective tissue, in particular the fascial layer known as the perimysium, may be capable of active contraction and consequently influence passive muscle stiffness, especially in tonic muscles. Passive muscle stiffness is also referred to as passive elasticity, passive muscular compliance, passive extensibility, resting tension, or passive muscle tone. Evidence for the hypothesis is based on five indications: (1) tonic muscles contain more ...
Tópico(s): Musicians’ Health and Performance
2005 - Elsevier BV | Medical Hypotheses
Werner Klingler, Frank Lehmann‐Horn, Karin Jurkat‐Rott,
The purpose of this review is to alert non-anaesthesiologists to the various complications from which patients with neuromuscular disorders and those susceptible to malignant hyperthermia can suffer during anaesthesia. The patient's outcome correlates with the quality of consultation between anaesthesiologists, surgeons, neurologists and cardiologists. Special precautions must be taken, since many anaesthetics and muscle relaxants can aggravate the clinical features or trigger life-threatening reactions. ...
Tópico(s): Peripheral Neuropathies and Disorders
2005 - Elsevier BV | Neuromuscular Disorders
Werner Klingler, J.J.A. Heffron, Karin Jurkat‐Rott, Grainne O’Sullivan, Andreas Alt, Friedrich Schlesinger, Johannes Bufler, Frank Lehmann‐Horn,
Adverse 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) effects are usually ascribed to neurotransmitter release in the central nervous system. Since clinical features such as fasciculations, muscle cramps, rapidly progressing hyperthermia, hyperkalemia, and rhabdomyolysis point to the skeletal muscle as additional target, we studied the effects of MDMA on native and cultured skeletal muscle. We addressed the question whether malignant hyperthermia (MH)-susceptible (MHS) muscle is predisposed to ...
Tópico(s): Psychedelics and Drug Studies
2005 - American Society for Pharmacology and Experimental Therapeutics | Journal of Pharmacology and Experimental Therapeutics
Robert Schleip, Werner Klingler, F. Lehmann‐Horn,
Dense connective tissue sheets, commonly known as fascia, play an important role as force transmitters in human posture and movement regulation. Fascia is usually seen as having a passive role, transmitting mechanical tension which is generated by muscle activity or external forces. However, there is some evidence to suggest that fascia may be able to actively contract in a smooth muscle-like manner and consequently influence musculoskeletal dynamics. General support for this hypothesis came with ...
Tópico(s): Therapeutic Uses of Natural Elements
2005 - Elsevier BV | Medical Hypotheses
C Baur, Werner Klingler, Karin Jurkat‐Rott, G. Froeba, Elmar Schoch, T. Marx, Michael Georgieff, F. Lehmann‐Horn,
Tópico(s): Anesthesia and Sedative Agents
2000 - Elsevier BV | British Journal of Anaesthesia
C Baur, L. Bellon, Peter Felleiter, M. Fiege, Ruth Fricker, Klaus P.E. Glahn, J.J.A. Heffron, Annegret Herrmann-Frank, Karin Jurkat‐Rott, Werner Klingler, Mary Lehane, Helle Ørding, Vincenzo Tegazzin, Frank Wappler, Michael Georgieff, F. Lehmann‐Horn,
Standardization of the in vitro contracture test (IVCT) for malignant hyperthermia (MH) susceptibility has resulted in very rare false negative tests. However, false positive results stigmatizing the patient seem to be more frequent than false negative results and make supplementary tests desirable. This multicenter approach studied the usefulness of an IVCT with 4-chloro-m-cresol (4-CmC), a ryanodine receptor-specific agonist for a better definition of MH susceptibility. Diagnosis made by the standard ...
Tópico(s): Forensic Entomology and Diptera Studies
2000 - Lippincott Williams & Wilkins | Anesthesia & Analgesia
Robert Schleip, Franz Mechsner, Adjo Zorn, Werner Klingler,
There can be no doubt that the article by Turvey and Fonseca (2014) suggests an important reorientation in the field of motor control research. Up to now, most models in this field separate the pas...
Tópico(s): Effects of Vibration on Health
2014 - Taylor & Francis | Journal of Motor Behavior
Werner Klingler, Martina Velders, Kerstin Hoppe, M. Pedro, Robert Schleip,
Tópico(s): Medical research and treatments
2014 - Springer Science+Business Media | Current Pain and Headache Reports
Werner Klingler, Sebastian Heiderich, Thierry Girard, E Gravino, J.J.A. Heffron, Stephan Johannsen, Karin Jurkat‐Rott, Henrik Rüffert, Frank Schuster, M.M.J. Snoeck, Vincenzo Sorrentino, Vincenzo Tegazzin, Frank Lehmann‐Horn,
Malignant hyperthermia (MH) is a rare pharmacogenetic disorder which is characterized by life-threatening metabolic crises during general anesthesia. Classical triggering substances are volatile anesthetics and succinylcholine (SCh). The molecular basis of MH is excessive release of Ca2+ in skeletal muscle principally by a mutated ryanodine receptor type 1 (RyR1). To identify factors explaining the variable phenotypic presentation and complex pathomechanism, we analyzed proven MH events in terms of ...
Tópico(s): Nicotinic Acetylcholine Receptors Study
2014 - BioMed Central | Orphanet Journal of Rare Diseases
Christoph Selig, Christian Riegger, Burkhard Dirks, Michael Pawlik, Timo Seyfried, Werner Klingler,
Tópico(s): Traumatic Brain Injury Research
2013 - Elsevier BV | Resuscitation
Holger Lerche, Christian Biervert, Alexi K. Alekov, Lothar Schleithoff, Martin Lindner, Werner Klingler, Frank Bretschneider, Nenad Mitrović, Karin Jurkat‐Rott, Harald Bode, F. Lehmann‐Horn, Ortrud K. Steinlein,
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 ...
Tópico(s): Neuroscience and Neuropharmacology Research
1999 - Wiley | Annals of Neurology
Jan Wilke, Robert Schleip, Werner Klingler, Carla Stecco,
The lumbodorsal fascia (LF) has been proposed to represent a possible source of idiopathic low back pain. In fact, histological studies have demonstrated the presence of nociceptive free nerve endings within the LF, which, furthermore, appear to exhibit morphological changes in patients with chronic low back pain. However, it is unclear how these characteristics relate to the aetiology of the pain. In vivo elicitation of back pain via experimental stimulation of the LF suggests that dorsal horn neurons ...
Tópico(s): Pain Mechanisms and Treatments
2017 - Hindawi Publishing Corporation | BioMed Research International
Alberto Zullo, Francesco Paolo Mancini, Robert Schleip, Scott Wearing, L’Hocine Yahia, Werner Klingler,
Muscle and connective tissues are structures that provide stability and movement to organisms belonging to the animal kingdom. Fascia and muscle tissues structurally and functionally integrate to form a musculofascial system with exceptional biomechanical properties, which allow animals to accomplish complex tasks. Mechanical overload through intense exercise or injury, however, may damage these tissues over the course of a lifetime. Although mammalian skeletal muscle and fascia both retain a good ...
Tópico(s): Dietary Effects on Health
2017 - | Journal of Gerontology and Geriatrics
Sebastian Heiderich, Christian Thoben, Nils Dennhardt, Wolfgang Koppert, Terence Krauß, Robert Sümpelmann, Stefan Zimmermann, Werner Klingler,
Volatile anaesthetics are a potential hazard during occupational exposure, pregnancy or in individuals with existing disposition to malignant hyperthermia. Anaesthetic waste gas concentration in postanaesthesia care units (PACU) has rarely been investigated.The current study aims to assess concentrations of volatile anaesthetics in relation to room size, number of patients and ventilator settings in different PACUs.A prospective observational study.Two different PACUs of the Hannover Medical School ( ...
Tópico(s): Anesthesia and Sedative Agents
2018 - Lippincott Williams & Wilkins | European Journal of Anaesthesiology
Carla Alessandra Avila Gonzalez, Mark Driscoll, Robert Schleip, Scott Wearing, Eric Jacobson, Tom Findley, Werner Klingler,
Basic sciences are the backbone of every clear understanding of how the body is composed and how different structures and functions are connected with each other. It is obvious that there is a huge variability in human beings - not only in terms of the outer appearance such as measurements of height, weight, muscle mass and other physical properties, but also with respect to metabolic and functional parameters. This article highlights recent developments of research activities in the field of fascia ...
Tópico(s): Infrared Thermography in Medicine
2018 - Elsevier BV | Journal of Bodywork and Movement Therapies