@article{HorbachStaat2018, author = {Horbach, Andreas and Staat, Manfred}, title = {Optical strain measurement for the modeling of surgical meshes and their porosity}, series = {Current Directions in Biomedical Engineering}, volume = {Band 4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, issn = {2364-5504}, doi = {10.1515/cdbme-2018-0045}, pages = {181 -- 184}, year = {2018}, abstract = {The porosity of surgical meshes makes them flexible for large elastic deformation and establishes the healing conditions of good tissue in growth. The biomechanic modeling of orthotropic and compressible materials requires new materials models and simulstaneoaus fit of deformation in the load direction as well as trannsversely to to load. This nonlinear modeling can be achieved by an optical deformation measurement. At the same time the full field deformation measurement allows the dermination of the change of porosity with deformation. Also the socalled effective porosity, which has been defined to asses the tisssue interatcion with the mesh implants, can be determined from the global deformation of the surgical meshes.}, language = {en} } @article{KohlerKirschnerHermannsStaatetal.2018, author = {Kohler, Annette and Kirschner-Hermanns, Ruth and Staat, Manfred and Brehmer, Bernhard}, title = {Pathogenese, funktionelle und anatomische Aspekte der weiblichen Belastungsinkontinenz}, series = {Aktuelle Urologie}, volume = {49}, journal = {Aktuelle Urologie}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {1438-8820}, doi = {10.1055/s-0043-120616}, pages = {47 -- 51}, year = {2018}, abstract = {Der vorliegende Artikel fokussiert sich auf die weibliche Belastungsinkontinenz als Insuffizienz der Speicherfunktion der Blase, auch wenn im klinischen Alltag die Harninkontinenz der Frau h{\"a}ufig verschiedene Ursachen hat und insbesondere eine Belastungsinkontinenz im Alter und bei neurologischer Komorbidit{\"a}t nur selten isoliert vorkommt. Das kleine Becken der Frau ist sowohl als Funktions- als auch als strukturelle Einheit zu betrachten. Dabei unterliegen bei der Frau Blase, Harnr{\"o}hre, Geb{\"a}rmutter und Enddarm sowie die muskul{\"a}ren und ligament{\"o}sen Strukturen des kleinen Beckens durch Fertilit{\"a}tsphase, m{\"o}gliche Schwangerschaften, Geburten und Menopausen-Phase, {\"u}ber das „normale Altern" hinaus, gravierenden Ver{\"a}nderungen. This article focuses on female stress incontinence in the form of pelvic floor dysfunction and urethral sphincter deficiency, although isolated stress incontinence accounts for less than half of all incontinence cases. Especially in women of old age and those with neurological comorbidities, the causes of incontinence are mostly multifactorial. Also it has to be considered that the female bladder, urethra, uterus and rectum as well as the muscular and ligamentous structures of the female pelvis minor are affected by phases of fertility, possible pregnancies, births and menopause in addition to the normal ageing process.}, language = {de} } @inproceedings{BhattaraiStaat2018, author = {Bhattarai, Aroj and Staat, Manfred}, title = {Pectopexy to repair vaginal vault prolapse: a finite element approach}, series = {Proceedings CMBBE 2018}, booktitle = {Proceedings CMBBE 2018}, editor = {Fernandes, P.R. and Tavares, J. M.}, year = {2018}, abstract = {The vaginal prolapse after hysterectomy (removal of the uterus) is often associated with the prolapse of the vaginal vault, rectum, bladder, urethra or small bowel. Minimally invasive surgery such as laparoscopic sacrocolpopexy and pectopexy are widely performed for the treatment of the vaginal prolapse with weakly supported vaginal vault after hysterectomy using prosthetic mesh implants to support (or strengthen) lax apical ligaments. Implants of different shape, size and polymers are selected depending on the patient's anatomy and the surgeon's preference. In this computational study on pectopexy, DynaMesh®-PRP soft, GYNECARE GYNEMESH® PS Nonabsorbable PROLENE® soft and Ultrapro® are tested in a 3D finite element model of the female pelvic floor. The mesh model is implanted into the extraperitoneal space and sutured to the vaginal stump with a bilateral fixation to the iliopectineal ligament at both sides. Numerical simulations are conducted at rest, after surgery and during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues and prosthetic meshes are modeled as incompressible, isotropic hyperelastic materials. The positions of the organs are calculated with respect to the pubococcygeal line (PCL) for female pelvic floor at rest, after repair and during Valsalva maneuver using the three meshes.}, language = {en} } @article{CiritsisHorbachStaatetal.2018, author = {Ciritsis, Alexander and Horbach, Andreas and Staat, Manfred and Kuhl, Christiane K. and Kraemer, Nils Andreas}, title = {Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo}, series = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials}, volume = {106}, journal = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials}, number = {2}, publisher = {Wiley}, address = {New York, NY}, issn = {1552-4981}, doi = {10.1002/jbm.b.33877}, pages = {827 -- 833}, year = {2018}, abstract = {Purpose In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model. Material and Methods Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio). Results In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm2 (± 5.7 cm2) at 0 mmHg pneumoperitoneum and 274.6 cm2 (± 5.2 cm2) at 15 mmHg; for PVDF the mean areas were 205.5 cm2 (± 8.8 cm2) and 221.5 cm2 (± 11.8 cm2), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4\% for TPU and of 1.2\% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF. Conclusion The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 827-833, 2018.}, language = {en} } @article{RittwegerAlbrachtFluecketal.2018, author = {Rittweger, J{\"o}rn and Albracht, Kirsten and Fl{\"u}ck, Martin and Ruoss, Severin and Brocca, Lorenza and Longa, Emanuela and Moriggi, Manuela and Seynnes, Olivier and Di Giulio, Irene and Tenori, Leonardo and Vignoli, Alessia and Capri, Miriam and Gelfi, Cecilia and Luchinat, Claudio and Franceschi, Claudio and Bottinelli, Roberto and Cerretelli, Paolo and Narici, Marco}, title = {Sarcolab pilot study into skeletal muscle's adaptation to longterm spaceflight}, series = {npj Microgravity}, volume = {4}, journal = {npj Microgravity}, number = {1}, publisher = {Nature Portfolio}, issn = {2373-8065}, doi = {10.1038/s41526-018-0052-1}, pages = {1 -- 9}, year = {2018}, language = {en} } @inproceedings{WaldmannVeraDachwaldetal.2018, author = {Waldmann, Christoph and Vera, Jean-Pierre de and Dachwald, Bernd and Strasdeit, Henry and Sohl, Frank and Hanff, Hendrik and Kowalski, Julia and Heinen, Dirk and Macht, Sabine and Bestmann, Ulf and Meckel, Sebastian and Hildebrandt, Marc and Funke, Oliver and Gehrt, Jan-J{\"o}ran}, title = {Search for life in ice-covered oceans and lakes beyond Earth}, series = {2018 IEEE/OES Autonomous Underwater Vehicle Workshop, Proceedings November 2018, Article number 8729761}, booktitle = {2018 IEEE/OES Autonomous Underwater Vehicle Workshop, Proceedings November 2018, Article number 8729761}, doi = {10.1109/AUV.2018.8729761}, year = {2018}, abstract = {The quest for life on other planets is closely connected with the search for water in liquid state. Recent discoveries of deep oceans on icy moons like Europa and Enceladus have spurred an intensive discussion about how these waters can be accessed. The challenge of this endeavor lies in the unforeseeable requirements on instrumental characteristics both with respect to the scientific and technical methods. The TRIPLE/nanoAUV initiative is aiming at developing a mission concept for exploring exo-oceans and demonstrating the achievements in an earth-analogue context, exploring the ocean under the ice shield of Antarctica and lakes like Dome-C on the Antarctic continent.}, language = {en} } @inproceedings{GrundmannBauerBieleetal.2018, author = {Grundmann, Jan Thimo and Bauer, Waldemar and Biele, Jens and Boden, Ralf and Ceriotti, Matteo and Cordero, Federico and Dachwald, Bernd and Dumont, Etienne and Grimm, Christian D. and Herč{\´i}k, David and Ho, Tra-Mi and Jahnke, Rico and Koch, Aaron D and Koncz, Alexander and Krause, Christian and Lange, Caroline and Lichtenheldt, Roy and Maiwald, Volker and Mikschl, Tobias and Mikulz, Eugen and Montenegro, Sergio and Pelivan, Ivanka and Peloni, Alessandro and Quantius, Dominik and Reershemius, Siebo and Renger, Thomas and Riemann, Johannes and Ruffer, Michael and Sasaki, Kaname and Schmitz, Nicole and Seboldt, Wolfgang and Seefeldt, Patric and Spietz, Peter and Spr{\"o}witz, Tom and Sznajder, Maciej and Tardivel, Simon and T{\´o}th, Norbert and Wejmo, Elisabet and Wolff, Friederike and Ziach, Christian}, title = {Small spacecraft based multiple near-earth asteroid rendezvous and landing with near-term solar sails and 'Now-Term 'technologies}, series = {69 th International Astronautical Congress (IAC)}, booktitle = {69 th International Astronautical Congress (IAC)}, pages = {1 -- 18}, year = {2018}, abstract = {Physical interaction with small solar system bodies (SSSB) is the next step in planetary science, planetary in-situ resource utilization (ISRU), and planetary defense (PD). It requires a broader understanding of the surface properties of the target objects, with particular interest focused on those near Earth. Knowledge of composition, multi-scale surface structure, thermal response, and interior structure is required to design, validate and operate missions addressing these three fields. The current level of understanding is occasionally simplified into the phrase, "If you've seen one asteroid, you've seen one asteroid", meaning that the in-situ characterization of SSSBs has yet to cross the threshold towards a robust and stable scheme of classification. This would enable generic features in spacecraft design, particularly for ISRU and science missions. Currently, it is necessary to characterize any potential target object sufficiently by a dedicated pre-cursor mission to design the mission which then interacts with the object in a complex fashion. To open up strategic approaches, much broader in-depth characterization of potential target objects would be highly desirable. In SSSB science missions, MASCOT-like nano-landers and instrument carriers which integrate at the instrument level to their mothership have met interest. By its size, MASCOT is compatible with small interplanetary missions. The DLR-ESTEC Gossamer Roadmap Science Working Groups' studies identified Multiple Near-Earth asteroid (NEA) Rendezvous (MNR) as one of the space science missions only feasible with solar sail propulsion. The Solar Polar Orbiter (SPO) study showed the ability to access any inclination, theDisplaced-L1 (DL1) mission operates close to Earth, where objects of interest to PD and for ISRU reside. Other studies outline the unique capability of solar sails to provide access to all SSSB, at least within the orbit of Jupiter, and significant progress has been made to explore the performance envelope of near-term solar sails for MNR. However, it is difficult for sailcraft to interact physically with a SSSB. We expand and extend the philosophy of the recently qualified DLR Gossamer solar sail deployment technology using efficient multiple sub-spacecraft integration to also include landers for one-way in-situ investigations and sample-return missions by synergetic integration and operation of sail and lander. The MASCOT design concept and its characteristic features have created an ideal counterpart for thisand has already been adapted to the needs of the AIM spacecraft, former part of the NASA-ESA AIDA missionDesigning the 69th International Astronautical Congress (IAC), Bremen, Germany, 1-5 October 2018. IAC-18-F1.2.3 Page 2 of 17 combined spacecraft for piggy-back launch accommodation enables low-cost massively parallel access to the NEA population.}, language = {en} } @inproceedings{GrundmannBauerBorchersetal.2018, author = {Grundmann, Jan Thimo and Bauer, Waldemar and Borchers, Kai and Dumont, Etienne and Grimm, Christian D. and Ho, Tra-Mi and Jahnke, Rico and Lange, Caroline and Maiwald, Volker and Mikulz, Eugen and Quantius, Dominik and Reershemius, Siebo and Renger, Thomas and Riemann, Johannes and Sasaki, Kaname and Seefeldt, Patric and Spietz, Peter and Spr{\"o}witz, Tom and Toth, Norbert and Wejmo, Elisabet and Biele, Jens and Krause, Christian and Cerotti, Matteo and Peloni, Alessandro and Dachwald, Bernd}, title = {Small Spacecraft Solar Sailing for Small Solar System Body Multiple Rendezvous and Landing}, series = {2018 IEEE Aerospace Conference : 3-10 March 2018}, booktitle = {2018 IEEE Aerospace Conference : 3-10 March 2018}, isbn = {978-1-5386-2014-4}, pages = {20 Seiten}, year = {2018}, language = {en} } @article{BalakirskiKotliarPaulyetal.2018, author = {Balakirski, Galina and Kotliar, Konstantin and Pauly, Karolin J. and Krings, Laura K. and R{\"u}bben, Albert and Baron, Jens M. and Schmitt, Laurenz}, title = {Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience}, series = {Dermatologic Surgery}, journal = {Dermatologic Surgery}, number = {44 (12)}, publisher = {Wolters Kluwer}, doi = {10.1097/DSS.0000000000001615}, pages = {1525 -- 1536}, year = {2018}, abstract = {BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7\% (19/284) of the cases. In 95\% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. The available data on complications after dermatologic surgery have improved over the past years. Particularly, additional risk factors have been identified for surgical site infections (SSI). Purulent surgical sites, older age, involvement of head, neck, and acral regions, and also the involvement of less experienced surgeons have been reported to increase the risk of the SSI after dermatologic surgeries.1 In general, the incidence of SSI after skin surgery is considered to be low.1,2 However, antibiotics in dermatologic surgeries, especially in the perioperative setting, seem to be overused,3,4 particularly regarding developing antibiotic resistances and side effects. Immunosuppression has been recommended to be taken into consideration as an additional indication for antibiotic prophylaxis to prevent SSI after skin surgery in special cases.5,6 However, these recommendations do not specify the exact dermatologic surgeries, and were not specifically developed for dermatologic surgery patients and treatments, but adopted from other surgical fields.6 According to the survey conducted on American College of Mohs Surgery members in 2012, 13\% to 29\% of the surgeons administered antibiotic prophylaxis to immunocompromised patients to prevent SSI while performing dermatologic surgery on noninfected skin,3 although this was not recommended by Journal of the American Academy of Dermatology Advisory Statement. Indeed, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. However, it is possible that due to the insufficient evidence on the risk of SSI occurrence in this patient group, dermatologic surgeons tend to overuse perioperative antibiotic prophylaxis. To make specific recommendations on the use of antibiotic prophylaxis in immunosuppressed patients in the field of skin surgery, more information about the incidence of SSI after dermatologic surgery in these patients is needed. The aim of this study was to fill this data gap by investigating whether there is an increased risk of SSI after skin surgery in immunocompromised patients compared with immunocompetent patients.}, language = {en} } @article{BhattaraiJabbariAndingetal.2018, author = {Bhattarai, Aroj and Jabbari, Medisa and Anding, Ralf and Staat, Manfred}, title = {Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis}, series = {tm - Technisches Messen}, volume = {85}, journal = {tm - Technisches Messen}, number = {5}, publisher = {De Gruyter}, address = {Berlin}, issn = {2196-7113}, doi = {10.1515/teme-2017-0115}, pages = {331 -- 342}, year = {2018}, abstract = {Particularly multiparous elderly women may suffer from vaginal vault prolapse after hysterectomy due to weak support from lax apical ligaments. A decreased amount of estrogen and progesterone in older age is assumed to remodel the collagen thereby reducing tissue stiffness. Sacrocolpopexy is either performed as open or laparoscopic surgery using prosthetic mesh implants to substitute lax ligaments. Y-shaped mesh models (DynaMesh, Gynemesh, and Ultrapro) are implanted in a 3D female pelvic floor finite element model in the extraperitoneal space from the vaginal cuff to the first sacral (S1) bone below promontory. Numerical simulations are conducted during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues are modeled as incompressible, isotropic hyperelastic materials whereas the meshes are modeled either as orthotropic linear elastic or as isotropic hyperlastic materials. The positions of the vaginal cuff and the bladder base are calculated from the pubococcygeal line for female pelvic floor at rest, for prolapse and after repair using the three meshes. Due to mesh mechanics and mesh pore deformation along the loaded direction, the DynaMesh with regular rectangular mesh pores is found to provide better mechanical support to the organs than the Gynemesh and the Ultrapro with irregular hexagonal mesh pores. Insbesondere {\"a}ltere, mehrgeb{\"a}hrende Frauen leiden h{\"a}ufiger an einem Scheidenvorfall nach einer Hysterektomie aufgrund der schwachen Unterst{\"u}tzung durch laxe apikale B{\"a}nder. Es wird angenommen, dass eine verringerte Menge an {\"O}strogen und Progesteron im h{\"o}heren Alter das Kollagen umformt, wodurch die Gewebesteifigkeit reduziert wird. Die Sakrokolpopexie ist eine offene oder laparoskopische Operation, die mit prothetischen Netzimplantaten durchgef{\"u}hrt wird, um laxe B{\"a}nder zu ersetzen. Y-f{\"o}rmige Netzmodelle (DynaMesh, Gynemesh und Ultrapro) werden in einem 3D-Modell des weiblichen Beckenbodens im extraperitonealen Raum vom Vaginalstumpf bis zum Promontorium implantiert. Numerische Simulationen werden w{\"a}hrend des Valsalva-Man{\"o}vers mit geschw{\"a}chtem Gewebe durchgef{\"u}hrt, das durch eine reduzierte Gewebesteifigkeit modelliert wird. Die Gewebe werden als inkompressible, isotrop hyperelastische Materialien modelliert, w{\"a}hrend die Netze entweder als orthotrope linear elastische oder als isotrope hyperlastische Materialien modelliert werden. Die Positionen des Vaginalstumpfs, der Blase und der Harnr{\"o}hrenachse werden anhand der Pubococcygeallinie aus der Ruhelage, f{\"u}r den Prolaps und nach der Reparatur unter Verwendung der drei Netze berechnet. Aufgrund der Netzmechanik und der Netzporenverformung bietet das DynaMesh mit regelm{\"a}ßigen rechteckigen Netzporen eine bessere mechanische Unterst{\"u}tzung und eine Neupositionierung des Scheidengew{\"o}lbes, der Blase und der Urethraachse als Gynemesh und Ultrapro mit unregelm{\"a}ßigen hexagonalen Netzporen.}, language = {en} }