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Now showing items 1 - 9 of 9

  • Serology versus ARMS-PCR in prospective HLA-class I typing for bone marrow transplantation

    T. Usichenko   A. Lattermann   G. Mueller-Eckhardt  

     While HLA class II alleles identification by means of complement mediated lymphocytotoxicity (serology) is almost replaced by DNA typing techniques, serology is still widely used for routine class I typing. The aim of this prospective study was to compare PCR-based Amplification Refractory Mutation System with serology in clinical HLA class I alleles assignment in patients receiving marrow transplants and their potential donors. The total discrepancy rate in 114 consecutively typed individuals for HLA-A and HLA-C alleles was only in favor of ARMS-PCR, whereas HLA-B typing was discrepant also in favor of serology. The discrepancies were higher in patients, particularily in those with acute lymphoblastic leukaemia, than in healthy individuals. We conclude, that ARMS-PCR is clearly superior to serology in definition of class I alleles, which might be of clinical importance particularly for bone marrow transplantation.
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  • Serology versus ARMS-PCR in prospective HLA-class I typing for bone marrow transplantation

    T. Usichenko   A. Lattermann and G. Mueller-Eckhardt  

     While HLA class II alleles identification by means of complement mediated lymphocytotoxicity (serology) is almost replaced by DNA typing techniques, serology is still widely used for routine class I typing. The aim of this prospective study was to compare PCR-based Amplification Refractory Mutation System with serology in clinical HLA class I alleles assignment in patients receiving marrow transplants and their potential donors. The total discrepancy rate in 114 consecutively typed individuals for HLA-A and HLA-C alleles was only in favor of ARMS-PCR, whereas HLA-B typing was discrepant also in favor of serology. The discrepancies were higher in patients, particularily in those with acute lymphoblastic leukaemia, than in healthy individuals. We conclude, that ARMS-PCR is clearly superior to serology in definition of class I alleles, which might be of clinical importance particularly for bone marrow transplantation.
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  • P302 Search for optimal protocol of temporal summation of experimental heat pain in healthy volunteers

    N. Moeller   H. Hacker   K. Hahnenkamp   T. Usichenko  

    Question Experimental human pain models are often insufficient to detect moderate effect of non-opioid analgesic drugs or hypoalgesic neuromodulation. Measurement of temporal summation of pain (TSP) is a promising tool for this purpose. The aim was to find out optimal stimulation parameters for a new protocol that consistently reproduces the TSP phenomenon. Material & methods Twenty healthy volunteers (15 females) underwent 4 sessions with different stimulation parameters with an interval of at least 48 h in-between. After determining the individual pain threshold temperature, pulsating heat stimuli were applied to the left ventral forearm with a ramp rate of 20°C/s and a frequency of 0.33 Hz using a CHEPS thermode (Medoc, Israel). Stimulation temperature, pulse duration and number of stimuli were changed among the conditions I–IV ( Table 1). Participants rated the perceived pain of the first and every 10th heat stimulation using a numeric rating scale 0–100. TSP was calculated as the difference between the lowest rating and the rating of the last stimulus and was compared among 4 conditions. Results Condition IV yielded the largest TSP effect (20 ± 3.1; mean ± SEM), which was higher than TSP effect of condition I (7.9 ± 2.2; p = 0.03) and II (6.8 ± 1.5; p = 0.012; Fig. 1). TSP effects of condition III and IV were comparable, however condition IV caused discomfort and intolerable pain in 9 participants; no one complained about discomfort during other conditions. Conclusion The protocol with high number of repeated stimuli and short pulse duration (<1.0 s) is feasible to reproduce TSP phenomenon. Heat stimulation with long pulse durations and high stimulation temperatures are not feasible in experimental human pain research.
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  • Acupuncture in Perioperative Analgesia: Evidence and Practice

    T. Usichenko  

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  • V33. Functional imaging of somatosensory finger representation and intracortical inhibition modulation in complex regional pain syndrome

    S. Strauss   M. Grothe   T. Usichenko   W. Byblow   M. Lotze  

    Neurophysiological pathology in CRPS type I is characterized by somatosensory and motor deficits. Transcranial magnetic stimulation (TMS) and functional MRI reveal decreased short intracortical inhibition (SICI) and smaller representation distance in the hand region of primary somatosensory cortex (S1) between the first and fifth digit in CRPS. Interestingly, an application of anesthetic cream to the forearm increases spatial tactile resolution (STR) and also SICI of hand muscles in healthy participants. As such, this intervention might be suited to reverse pathologic findings in CRPS patients and tested this in a double blinded placebo controlled study. In addition we used high spatial resolution fMRI of the thumb (D1) and pinky (D5) S1 BA 3b representation before and after intervention. Patients showed decreased STR over D1 (tip of thumb) on their affected side if compared to the unaffected side ( t = 2.31; p < 0.05). STR improved after anesthetic cream ( t = 3.0; p < 0.05) but not after placebo application. Pain intensity was not modulated after intervention. SICI was increased only after analgesic cream ( t = 2.22; p < 0.05) but not after placebo. We expect an association of D1–D5 distance and STR in our fMRI-data. In conclusion, temporary deafferentation of an area neighboring the CRPS-affected region can modulate neuropathological characteristics of CRPS and might be a promising strategy for therapeutic interventions.
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  • Auricular acupuncture vs. progressive muscle relaxation and no intervention for exam anxiety in medical students – A randomized controlled trial with non-randomized condition

    G. Schultz   C. Altenstein   C. Klausenitz   T. Hesse   H. Hacker   A. Petersmann   H.J. Hannich   K. Hahnenkamp   T. Usichenko  

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  • P083 Method for continuous multichannel measurement of impedance at the auricular sites innervated by various cranial nerves

    T. Usichenko   D. Gogola   T. Dermek   M. Teplan  

    Question External auricule receives afferent supply via vagal, trigeminal and cervical nerves ( Peuker and Filler, 2002 ). Reduced impedance of the auricular sites innervated by vagal and trigeminal nerves is associated with pain and malfunction of internal organs ( Oleson et al., 1980 ; Saku et al., 1993 ). The aim was to develop the robust method for continuous measurement of skin impedance at the sites of auricle, supplied by various cranial nerves. Methods Multichannel device for continuous impedance measurement, based on Atmel ATmega16 microprocessor with 1 kHz of probing alternating current frequency was controlled using Matlab environment via USB port. The device measures voltage difference between the reference electrode (right forearm) and the sites of interest (innervation areas of cranial nerves) and transforms the voltage values into impedance using the calibration measurements of known resistances. Surface ECG and stainless steel needle electrodes were used at the sites of interest on the right auricles of healthy volunteers. Impedance monitoring was performed at rest and under the heat pain stimuli, delivered via CHEPS thermode (MEDOC analyser, Israel). Results Reproducible stable data with the voltage of 1 V, current values of 100 μ A and impedance around 10 k Ω were acquired (Fig. 1 ), whereas invasive measurement yielded less variable data than non- invasive procedure. Heat pain stimulation led to differential reduction of the impedance in the sites of cranial nerve innervation (Fig. 2), whereas the decreased impedance recovered to the baseline values (Fig. 2 ). Conclusions The multichannel continuous measurement of impedance at the external auricle was feasible. Further investigations are warranted to clarify the differential impedance response from the auricular sites in healthy subjects under stress challenge and patients.
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  • P54. Differences in neuronal representation of mental rotation in CRPS patients and healthy controls

    M. Kohler   S. Strauß   U. Horn   T. Usichenko   I. Langner   M. Domin   M. Lotze  

    Spatial integration of the body matrix, especially representation of the affected side is reduced in patients suffering from complex regional pain syndrome (CRPS; Moseley et al., 2009 ). The parietal sulcus integrates multimodal sensory input to spatial aspects of the own body and is therefore essential for processing mental rotation (MR) (Lebon et al., 2012). Since the training of MR has turned out to be among the effective therapy strategies for CRPS (Graded motor imagery; GMI; Moseley et al., 2006), MR is also important for the pathophysiological understanding of CRPS. The aim of this study was to point out differences in neural representation of MR in a group of CRPS patients and healthy controls. Therefore we included 15 CRPS patients (DASH-Avg.: 51.54; CSS: 12.39; pain intensity 4.36 of 10 VAS; age: 58 years; CRPS duration 21 ± 20 months) and 15 age-/gender matched healthy controls. We assessed behavioral (reaction time in MR for both hands), clinical (CRPS-severity, somatosensory and motor function) and MRI (T1, fMRI during MR, connectivity during rest) data. Our data of reaction time in patient group showed a bilateral MR delay compared to healthy controls ( t (28) = 2.39; p  = 0.02). There was no lateralization effect. As expected (Berneiser et al., 2017) for healthy controls fMRI demonstrated an active network from visual recognition (occipital cortex (OC)), parietal sulcus (PS), and primary motor cortex (M1). The same network was less expressed in activation magnitude in CRPS patients (pFWE corrected for ROI-analysis). Correlation analysis between clinical aspects, MRI data and connectivity measures (DCM: OCG-PS-M1) are still being evaluated.
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  • Auricular Acupuncture vs. Progressive Muscle Relaxation and vs. no Intervention for Exam Anxiety in Medical Students - A Randomized Controlled Trial

    G. Schultz   C. Altenstein   C. Klausenitz   T. Heße   H. Hacker   A. Petersmann   H.J. Hannich   K. Hahnenkamp   T. Usichenko  

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