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Prof. Dr. med. Michele Curatolo E-mail

Principal investigators for individual studies: Dr. Alban Neziri, Jürg Schliessbach, Dr. A. Siegenthaler, Dr. Konrad Streitberger, Dr. Pascal Vuilleumier.

Description. The project investigates translational aspects related with alterations in pain processing in patients with chronic pain. The following issues are addressed:

• Definition of criteria for the diagnosis of altered nociception in individual patients
• Prognostic value of measures of altered nociception for the development of chronic pain
• Epidemiology of generalized central hypersensitivity and alteration of endogenous pain modulation in patients with chronic pain
• Value of assessing mechanical hyperalgesia for the diagnosis of zygapophysial joint pain
• Clinical impact of generalized pain sensitivity on the value of disc stimulation (discography) in the diagnosis of discogenic pain
• Linking altered nociception and genetic characteristics to drug efficacy
• Investigation of new pharmacological approaches to modulate neuroplasticity in humans
• Effect of acupuncture on endogenous pain modulation

Principal investigators for individual studies: Jürg Schliessbach, Dr. Patrick Willimann.

The following studies are being performed:

• Local injections for the diagnosis of primary muscle pain
• Selective nerve block for the diagnosis of discogenic pain
• Block of the articular branches of the obturator nerve for the diagnosis of hip pain

Principal investigator: Dr. Andreas Siegenthaler

Description. A new model for optimal combination of different drugs in individual patients is under development. At present, data on the action profile of individual drugs are being collected. Validation of the optimization method in vitro is performed in cooperation at the University Hospital of Vienna (Dr. G. Sveticic).

Principal investigator: Dr. Andreas Siegenthaler

The following projects are running:

• Ability by ultrasound to visualize and block the nerves that supply the cervical zygapophysial joints in patients with chronic pain
• A new method of radiofrequency denervation of the cervical zygapophysial joints by previous ultrasound localization of the nerves

Further projects in the field of ultrasound: Link to web site of Urs Eichenberger is coming soon

Principal investigator: Dr. Konrad Streitberger

This pilot study investigates the correlates for the success of radiofrequency denervation of the lumbar zygapophysial joints.

• Prof. Lars Arendt-Nielsen, Prof. Ole K. Andersen and Prof. Thomas Graven-Nielsen, Centre for Sensory-Motor Interaction of the University of Aalborg, Denmark.
• Antonello Caruso, Automatic Control Laboratory, Swiss Federal Institute of Technology, ETH-Centre, Zurich. Dr. G. Sveticic, University Hospital of Vienna.
• Dr. Isabelle Decosterd and Dr. Marc Suter, Department of Anaesthesiology of the University of Lausanne, Switzerland
• Prof. Jules Desmeules and Dr. Marie Besson, Department of Clinical Pharmacology of the University of Geneva, Switzerland
• Prof. Anthony H. Dickenson, Institute of Pharmacology of the University College London, United Kingdom.
• Prof. Dr. Peter Jüni, Institute for Social and Preventive Medicine of the University of Bern.

• Dr. Konrad Maurer, Institut of Anaesthesiology, University of Zurich, Switzerland

• PD Dr. Arto Nirkko, Department of Neurology of the University of Bern, Inselspital.
• Prof. Bogdan Radanov, Pain Centre of the Clinic Wilhelm Schulthess, Zurich.
• Prof. Pasquale Scaramozzino, SOAS University of London, United Kingdom.
• Dr. Gorazd Sveticic, Department of Anaesthesiology, University of Vienna, Austria.

• Prof. Hanns-Ulrich Zeilhofer, Institute of Pharmacology of the University of Zürich, Switzerland

• Swiss Science National Foundation. Related publications:  LINK
• European Federation of IASP Chapters (Grant EFIC-Grünenthal).
• Foundation for Research in Anaesthesia and Intensive Care, Bern, Switzerland.

• Mundipharma Medical Company.

• Scientific Funds of the University Department of Anaesthesiology and Pain Therapy, Inselspital Bern, Switzerland.

 

 

Principal investigators: Dr. Sebastian Brandt, Dr. Oliver Kimberger, Dr. Sandra Eipeldauer, Eliana Koepfli,

Description: This sub-project investigates effects of Norepinephrine on microcirculatory blood flow, tissue oxygen tension and metabolic changes in the intestinal tract in the immediate postoperative course.
The following issues are in the focus of the study:

• Changes of regional blood flow to the small bowel, kidney and liver.
• Metabolic effects of Norepinephrine administration in the portal, renal and hepatic venous blood.
• Microcirculatory and tissue oxygen tension changes in the small and large bowel, the kidney and liver.
• Effects of different doses of Norepinephrine on perfusion and tissue oxygenation of a distal colon anastomosis.
• Histopathological changes in the tissues under investigation.
• Differences of centrally versus peripherally measured blood pressure.

Principal investigators: Sebastian Brandt, Oliver Kimberger, Eliana Koepfli

Description: This sub-project investigates effects of epidural anesthesia in the perioperative setting.

The following issues are in the focus of the study:

• Effects of epidural anesthesia on systemic hemodynamics and systemic blood flow.
• Postoperative changes in mixed venous oxygen saturation with and without epidural anesthesia.
• Changes of hepato-splanchnic and renal blood flow in the immediate postoperative period.
• Effects on microcirculatory blood flow and tissue oxygen tension of a colon anastomosis.

Principal investigators: Dr. Sebastian Brandt, Andrin Plebani, Volker Hartwich

Description: This project investigates the reliability and accuracy of several commercially available Cardiac output measurement devices under several different hemodynamic conditions such as i.e. cardiac tamponade or hemorrhagic shock.

• Prof. Gisli H. Sigurdsson, Director and chair Department of Anaesthesia and Intensive care, University hospital, Landspitali Hospital Reykajvik, Iceland
• Dr. Oliver Kimberger, Department of Anesthesia, General Intensive Care and
• Pain control , Medical University of Vienna, Austria,
• Prof. Jukka Takala and Prof. Stephan Jakob, Department of Intensive care, University hospital and University of Bern, Inselspital, Bern Switzerland.

Hiltebrand, Brandt, Kimberger

Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon

Effects of Endotoxin and Catecholamines on Hepatic Mitochondrial Respiration 

Automatic algorithm for monitoring systolic pressure variation and difference in pulse pressure

Hemodynamic Parameters Change Earlier Than Tissue Oxygen Tension in Hemorrhage

Crystalloids versus colloids for goal-directed fluid therapy in major surgery

 

 

 

 

Prof. Dr. med. Robert Greif, MME E-mail

RCTs comparing the efficacy of new supraglottic airway devices, fiberoptic intubation, and rigid fiberoptic stilts in simulated difficult airway situations.
Working Group: L. Theiler, N. Urwyler, M. Kleine-Brüggeney, Thomas Merkt, Reto Basciani, M. Wipfli, Hendrik Fischer

Evaluation of the efficacy of iv-THC on PONV, genetic influence of polimorphisms on pharmacokinetics.
Working Group: L. Theiler, M. Kleine-Brüggeney, Thomas Merkt, cooperation with W. Bernhard, Inst. Legal Medizin, University of Bern, H. Sachs, Forensic and Toxicologic Center, Munich

Evaluation of POC-Devices (measuring PT, and Thrombelastograpy) at the OR and ICU-setting and its influence on the use of bloodproducts
Dr. Natalie Urwyler, cooperation with PD Dr. A. Lorenzo Dept. Hematology, and Prof. P. Jüni, Clinical Trail Unit, ISPM, University of Bern

Laboratory investigations about possible interactions of  commonly used i.v. drugs in anesthesia.
Michel Braun, R. Lauber, cooperation with Dr. K. Nemec, Hospital Pharmacy, Donauspital Vienna Austria and Dr. J. Goette, Inst. F. Hospital Pharmacy

 

 

 

PD Dr. med. Martin Luginbühl E-mail

Current hypnotic and opioid concentrations are predicted based on published models on pharmacokinetics and interaction pharmacodynamics and are presented to the anaesthesiologist either in a concentration based two dimensional plot or as a nociceptive stimulus response index in a time-based manner. The concentrations are related to published hypnotic – opioid interaction isoboles to enable the anaesthesiologist to administer hypnotics and opioids on a rational basis.
Main author: Peter M. Schumacher, PhD, Dr. sc. techn.
Cooperation: Prof. M. Stryus, Department of Anaesthesia, Ghent University Hospital, Belgium and Dr. med. S. Stahlkopf and co-workers, Dräger Medical, Lübeck, Germany

The presence of pain may increase spontaneous respiration, whereas opioids induce potentially severe respiratory depression. It is not known in how far postoperative pain antagonizes opioids induced respiratory depression. In an on-going study remifentanil induced respiratory depression before and after major orthopaedic surgery is compared.
Main author: Martin Luginbühl, PD Dr. med.
Cooperation: Antonello Caruso and Manfred Morari, Professor, Automatic Control Laboratory, Swiss Federal Institute of Technology (ETH)
Peter M. Schumacher, M Sc Techn, Ph.D. SenTec AG, Therwil, Switzerland

The limitation of propofol used in conscious sedation is respiratory depression and airway collapse. The effect site propofol concentration inducing sedation and respiratory depression are both in a similar range. We are developing a control algorithm to automatically administer propofol for sedation using transcutaneous CO2 as controlled variable for a clinical proof of concept study.
Main author: Peter M. Schumacher, PhD, Dr. sc. techn.
Cooperation: Antonello Caruso, and Manfred Morari, Professor, Automatic Control Laboratory, Swiss Federal Institute of Technology (ETH)
Peter M. Schumacher, M Sc Techn, Ph.D. SenTec AG, Therwil, Switzerland

http://www.sentec.ch
http://www.amca2005.unibe.ch
http://control.ee.ethz.ch  

 

 

 

Dr. med. Andreas Vogt E-mail

The multiple inert gas elimination technique (MIGET) was developed for the measurement of shunt and V_A’/Q’ distributions. Micropore membrane inlet mass spectrometry (MMIMS), instead of gas chromatography (GC), has been introduced for inert gas measurement and shunt determination. The single-pore version of MMIMS correlated well with Riley shunt during oxygen breathing in a porcine lavage lung model. (Anesth Analg 2009;X:●●●–●●●)

A multi pore probe as further refinement has been implemented in this developing technology to achieve an accuracy equivalent to conventional MIGET.

Multi frequency phase fluorimetry (MFPF-100, TauTheta, USA) is a recently presented technique for the measurement of oxygen partial pressure. Multi frequency phase fluorimetry provides accurate reproducibility for oxygen partial pressure measurements and agreement with Clark type sensor analysis as gold standard is acceptable.

PaO2 oscillations, detected near the left ventricular outflow tract, proceeded to the aortic bifurcation, but not to the central venous system. Further studies are planned to evaluate the impact of PaO2 oscillations in ARDS.

B. Duenges¹, PhD, M. Bodenstein¹, M.D., H. Wang¹, M.D., PhD, St. Böhme¹, M.S., B. Röhrig^2, PhD, J. E. Baumgardner³, M.D., PhD, K. Markstaller¹, M.D., PhD

1 Department of Anaesthesiology, Johannes Gutenberg-University, Mainz, Germany

2 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg-University, Mainz, Germany

3 Oscillogy®, LLC, Folsom PA

German Research Foundation DFG Ma 2398 / 3, Swiss National Foundation SNF POIB - 117065 / 1 and an institutional grant of the Department of Anaesthesiology, Inselspital, Bern University Hospital, and University of Bern

All experiments were performed at the Department of Anaesthesiology, Johannes Gutenberg - University, Mainz Germany (Chair: Univ. - Prof. C. Werner).

 

 

 

Prof. Dr. med. Frank Stüber E-mail

 

 

PD Dr. med. Lutz Lehmann E-mail

 

 

Dr. med. Malte Book E-mail

 

In two unrelated individuals the vast majority of the human genome sequence is identical. However, the rare interindividual variations in our genotype cause our different phenotypes. These differences are not limited to a human’s look, character or skills. Phenotypic differences also contain differences in the susceptibility for, or the course of, complex diseases, different kinetics of physiologic processes or different quantitative physiologic functions. An impressive example for the heritability of susceptibility was reported in 1988: The death due to infection is heritable if one parent died due to infection in the first 50 years of life. This association was shown to be much stronger compared to the usual suspects such as cancer or cardio circulatory events. Another example is that the metabolization of opioids which determines the duration of the drug effect partially depends on the individual genetic background.

The usage of individual genetic data offers the opportunity to individualize medical treatment in a completely new perception. The group of Professor Stüber is working with different project in this field.

The overall frequency of SNPs is about 1 to 1,000 to 1 to 1200 base pairs in the human genome with the most frequent being a C to T substitution. These polymorphisms are located in the entire genome. Today’s technical tools allow the characterization of 1,000,000 SNP in parallel. By using the information of so called tag-SNPs founded on linkage disequilibrium in haplotype blocks, these data can be equalized to a whole genome SNP scan. Our group has running projects in the field of severe trauma, inflammation and sepsis.

Deletions, insertions, duplications and complex multi site variants are termed as copy number polymorphisms and the length is defined as a DNA segment that is 1kb or longer and present a variable copy number in comparison with a reference genome. The importance and the consequences of these genetic variants became clear in 2003. Hollox and co workers reported about three genes on chromosome 8p23.1 which are polymorphic in copy number. In 2006 Redon and co workers reported about a first-generation CNV map of the human genome. This map was established in the 270 individuals from the HapMap population. They detected 1,447 copy number variable regions covering 12% of the human genome. One of the key questions is whether different copy numbers result in modifying gene transcription and protein release. Our group is working in the field of CNVs with a project in human Defensins which are antimicrobial molecules acting in the innate immune system and another project is working on enzymes of the Cytochrome P450 system involved in drug metabolization.

The (semi-) quantification of the genome wide gene expression in complex diseases or specific therapeutical procedures allows the discovery of the involved pathophysiological processes. This method enables researchers to define phenotypes much more precise than just by the clinical diagnosis “inflammation”. The combination of genome wide genotype data with gene expression data might improve our knowledge about individuals being at risk for special phenotypes such as hyperinflammation or wound infections. We are going to start a project assessing the gene expression in patients with hyperinflammation.

 

 

 

Prof. Dr. med. Balthasar Eberle e-mail
Curriculum Vitae

 

 

Dr. Alban Neziri, wissenschaftlicher Mitarbeiter   E - Mail

Anja Conrad, Study Nurse E - Mail
Volker Hartwich, Study Nurse E - Mail

Labor
Dr. Rolf Lauber, Chemiker   E - Mail
Sibylle Rohrbach Wirthmüller, Chemielaborantin EFZ E - Mail
Marcel Schiff, Laborleiter E - Mail
Xianghong Zhang, Doktorand E - Mail
Lan Zhang, Doktorandin E - Mail

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