@article{BirgelLeschingerWegmannetal.2018, author = {Birgel, Stefan and Leschinger, Tim and Wegmann, Kilian and Staat, Manfred}, title = {Calculation of muscle forces and joint reaction loads in the shoulder area via an OpenSim based computer model}, series = {tm - Technisches Messen}, volume = {85}, journal = {tm - Technisches Messen}, number = {5}, publisher = {De Gruyter}, address = {Berlin}, issn = {2196-7113}, doi = {10.1515/teme-2017-0114}, pages = {321 -- 330}, year = {2018}, abstract = {Using the OpenSim software and verified anatomical data, a computer model for the calculation of biomechanical parameters is developed and used to determine the effect of a reattachment of the Supraspinatus muscle with a medial displacement of the muscle attachment point, which may be necessary for a rupture of the supraspinatus tendon. The results include the influence of the operation on basic biomechanical parameters such as the lever arm, as well as the calculated the muscle activations for the supraspinatus and deltoid. In addition, the influence on joint stability is examined by an analysis of the joint reaction force. The study provides a detailed description of the used model, as well as medical findings to a reattachment of the supraspinatus. Mit der Software OpenSim und {\"u}berpr{\"u}ften anatomischen Daten wird ein Computermodell zur Berechnung von biomechanischen Parametern entwickelt und genutzt, um den Effekt einer Refixierung des Supraspinatusmuskels mit einer medialen Verschiebung des Muskelansatzpunktes zu ermitteln, wie sie unter anderem nach einem Riss der Supraspinatussehne notwendig sein kann. Die Ergebnisse umfassen hierbei den Einfluss der Operation auf grundlegende biomechanische Parameter wie den Hebelarm sowie die berechneten Muskelaktivierungen f{\"u}r den Supraspinatus und Deltoideus. Zus{\"a}tzlich wird der Einfluss auf die Gelenkstabilit{\"a}t betrachtet und durch eine Analyse der Gelenkreaktionskraft untersucht. Die Studie bietet eine detaillierte Beschreibung des genutzten Modells, sowie medizinische Erkenntnisse zu einer Refixierung des Supraspinatus.}, language = {en} } @article{KetelhutGoellBraunsteinetal.2018, author = {Ketelhut, Maike and G{\"o}ll, Fabian and Braunstein, Bj{\"o}rn and Albracht, Kirsten and Abel, Dirk}, title = {Comparison of different training algorithms for the leg extension training with an industrial robot}, series = {Current Directions in Biomedical Engineering}, volume = {4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, issn = {2364-5504}, doi = {10.1515/cdbme-2018-0005}, pages = {17 -- 20}, year = {2018}, abstract = {In the past, different training scenarios have been developed and implemented on robotic research platforms, but no systematic analysis and comparison have been done so far. This paper deals with the comparison of an isokinematic (motion with constant velocity) and an isotonic (motion against constant weight) training algorithm. Both algorithms are designed for a robotic research platform consisting of a 3D force plate and a high payload industrial robot, which allows leg extension training with arbitrary six-dimensional motion trajectories. In the isokinematic as well as the isotonic training algorithm, individual paths are defined i n C artesian s pace by sufficient s upport p oses. I n t he i sotonic t raining s cenario, the trajectory is adapted to the measured force as the robot should only move along the trajectory as long as the force applied by the user exceeds a minimum threshold. In the isotonic training scenario however, the robot's acceleration is a function of the force applied by the user. To validate these findings, a simulative experiment with a simple linear trajectory is performed. For this purpose, the same force path is applied in both training scenarios. The results illustrate that the algorithms differ in the force dependent trajectory adaption.}, language = {en} } @article{BhattaraiStaat2018, author = {Bhattarai, Aroj and Staat, Manfred}, title = {Computational comparison of different textile implants to correct apical prolapse in females}, series = {Current Directions in Biomedical Engineering}, volume = {4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, doi = {10.1515/cdbme-2018-0159}, pages = {661 -- 664}, year = {2018}, abstract = {Prosthetic textile implants of different shapes, sizes and polymers are used to correct the apical prolapse after hysterectomy (removal of the uterus). The selection of the implant before or during minimally invasive surgery depends on the patient's anatomical defect, intended function after reconstruction and most importantly the surgeon's preference. Weakness or damage of the supporting tissues during childbirth, menopause or previous pelvic surgeries may put females in higher risk of prolapse. Numerical simulations of reconstructed pelvic floor with weakened tissues and organ supported by textile product models: DynaMesh®-PRS soft, DynaMesh®-PRP soft and DynaMesh®-CESA from FEG Textiletechnik mbH, Germany are compared.}, language = {en} } @article{JungStaatMueller2018, author = {Jung, Alexander and Staat, Manfred and M{\"u}ller, Wolfram}, title = {Corrigendum to "Flight style optimization in ski jumping on normal, large, and ski flying hills" [J. Biomech 47 (2014) 716-722]}, series = {Journals of Biomechanics}, journal = {Journals of Biomechanics}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0021-9290}, doi = {10.1016/j.jbiomech.2018.02.001}, pages = {313}, year = {2018}, language = {en} } @article{WerkhausenAlbrachtCroninetal.2018, author = {Werkhausen, Amelie and Albracht, Kirsten and Cronin, Neil J and Paulsen, G{\o}ran and Bojsen-M{\o}ller, Jens and Seynnes, Olivier R}, title = {Effect of training-induced changes in achilles tendon stiffness on muscle-tendon behavior during landing}, series = {Frontiers in physiology}, journal = {Frontiers in physiology}, number = {9}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2018.00794}, pages = {11 Seiten}, year = {2018}, abstract = {During rapid deceleration of the body, tendons buffer part of the elongation of the muscle-tendon unit (MTU), enabling safe energy dissipation via eccentric muscle contraction. Yet, the influence of changes in tendon stiffness within the physiological range upon these lengthening contractions is unknown. This study aimed to examine the effect of training-induced stiffening of the Achilles tendon on triceps surae muscle-tendon behavior during a landing task. Twenty-one male subjects were assigned to either a 10-week resistance-training program consisting of single-leg isometric plantarflexion (n = 11) or to a non-training control group (n = 10). Before and after the training period, plantarflexion force, peak Achilles tendon strain and stiffness were measured during isometric contractions, using a combination of dynamometry, ultrasound and kinematics data. Additionally, testing included a step-landing task, during which joint mechanics and lengths of gastrocnemius and soleus fascicles, Achilles tendon, and MTU were determined using synchronized ultrasound, kinematics and kinetics data collection. After training, plantarflexion strength and Achilles tendon stiffness increased (15 and 18\%, respectively), and tendon strain during landing remained similar. Likewise, lengthening and negative work produced by the gastrocnemius MTU did not change detectably. However, in the training group, gastrocnemius fascicle length was offset (8\%) to a longer length at touch down and, surprisingly, fascicle lengthening and velocity were reduced by 27 and 21\%, respectively. These changes were not observed for soleus fascicles when accounting for variation in task execution between tests. These results indicate that a training-induced increase in tendon stiffness does not noticeably affect the buffering action of the tendon when the MTU is rapidly stretched. Reductions in gastrocnemius fascicle lengthening and lengthening velocity during landing occurred independently from tendon strain. Future studies are required to provide insight into the mechanisms underpinning these observations and their influence on energy dissipation.}, language = {en} } @article{HeinkeKnickerAlbracht2018, author = {Heinke, Lars N. and Knicker, Axel J. and Albracht, Kirsten}, title = {Evaluation of passively induced shoulder stretch reflex using an isokinetic dynamometer in male overhead athletes}, series = {Isokinetics and Exercise Science}, volume = {26}, journal = {Isokinetics and Exercise Science}, number = {4}, publisher = {IOS Press}, address = {Amsterdam}, issn = {1878-5913}, doi = {10.3233/IES-184111}, pages = {265 -- 274}, year = {2018}, abstract = {BACKGROUND: Muscle stretch reflexes are widely considered to beneficially influence joint stability and power generation in the lower limbs. While in the upper limbs and especially in the muscles surrounding the shoulder joint such evidence is lacking. OBJECTIVE: To quantify the electromyographical response in the muscles crossing the shoulder of specifically trained overhead athletes to an anterior perturbation force. METHODS: Twenty healthy male participants performed six sets of different external shoulder rotation stretches on an isokinetic dynamometer over a range of amplitudes and muscle pre-activation moment levels. All stretches were applied with a dynamometer acceleration of 10,000∘/s2 and a velocity of 150∘/s. Electromyographical response was measured via sEMG. RESULTS: Consistent reflexes were not observed in all experimental conditions. The reflex latencies revealed a significant muscle main effect (F (2,228) = 99.31, p< 0.001; η2= 0.466; f= 0.934) and a pre-activation main effect (F (1,228) = 142.21, p< 0.001; η2= 0.384; f= 1.418). The stretch reflex amplitude yielded a significant pre-activation main effect (F (1,222) = 470.373, p< 0.001; η2= 0.679; f= 1.454). CONCLUSION: Short latency muscle reflexes showed a tendency to an anterior to posterior muscle recruitment whereby the main internal rotator muscles of the shoulder revealed the most consistent results.}, language = {en} } @article{LapitanRogatkinPersheyevetal.2018, author = {Lapitan, Denis G. and Rogatkin, Dmitrii A. and Persheyev, Sydulla K. and Kotliar, Konstantin}, title = {False spectra formation in the differential two-channel scheme of the laser Doppler flowmeter}, series = {Biomedizinische Technik}, volume = {63}, journal = {Biomedizinische Technik}, number = {4}, publisher = {De Gruyter}, address = {Berlin}, issn = {0013-5585}, doi = {10.1515/bmt-2017-0060}, pages = {439 -- 444}, year = {2018}, abstract = {Noise in the differential two-channel scheme of a classic laser Doppler flowmetry (LDF) instrument was studied. Formation of false spectral components in the output signal due to beating of electrical signals in the differential amplifier was found out. The improved block-diagram of the flowmeter was developed allowing to reduce the noise.}, language = {en} } @article{QuittmannMeskemperAbeletal.2018, author = {Quittmann, Oliver J. and Meskemper, Joshua and Abel, Thomas and Albracht, Kirsten and Foitschik, Tina and Rojas-Vega, Sandra and Str{\"u}der, Heiko K.}, title = {Kinematics and kinetics of handcycling propulsion at increasing workloads in able-bodied subjects}, series = {Sports Engineereing}, volume = {21}, journal = {Sports Engineereing}, number = {21}, publisher = {Springer Nature}, address = {Cham}, issn = {1460-2687}, doi = {10.1007/s12283-018-0269-y}, pages = {283 -- 294}, year = {2018}, abstract = {In Paralympic sports, biomechanical optimisation of movements and equipment seems to be promising for improving performance. In handcycling, information about the biomechanics of this sport is mainly provided by case studies. The aim of the current study was (1) to examine changes in handcycling propulsion kinematics and kinetics due to increasing workloads and (2) identify parameters that are associated with peak aerobic performance. Twelve non-disabled male competitive triathletes without handcycling experience voluntarily participated in the study. They performed an initial familiarisation protocol and incremental step test until exhaustion in a recumbent racing handcycle that was attached to an ergometer. During the incremental test, tangential crank kinetics, 3D joint kinematics, blood lactate and ratings of perceived exertion (local and global) were identified. As a performance criterion, the maximal power output during the step test (Pmax) was calculated and correlated with biomechanical parameters. For higher workloads, an increase in crank torque was observed that was even more pronounced in the pull phase than in the push phase. Furthermore, participants showed an increase in shoulder internal rotation and abduction and a decrease in elbow flexion and retroversion. These changes were negatively correlated with performance. At high workloads, it seems that power output is more limited by the transition from pull to push phase than at low workloads. It is suggested that successful athletes demonstrate small alterations of their kinematic profile due to increasing workloads. Future studies should replicate and expand the test spectrum (sprint and continuous loads) as well as use methods like surface electromyography (sEMG) with elite handcyclists.}, language = {de} } @article{BhattaraiStaat2018, author = {Bhattarai, Aroj and Staat, Manfred}, title = {Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions}, series = {Computational and Mathematical Methods in Medicine}, volume = {2018}, journal = {Computational and Mathematical Methods in Medicine}, number = {Article ID 9518076}, publisher = {Hindawi}, address = {New York, NY}, issn = {1748-6718}, doi = {10.1155/2018/9518076}, pages = {1 -- 16}, year = {2018}, abstract = {After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5\%), adipose tissue (85\%), and smooth muscle (5\%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females.}, language = {en} } @article{AlbannaKotliarLuekeetal.2018, author = {Albanna, Walid and Kotliar, Konstantin and L{\"u}ke, Jan Niklas and Alpdogan, Serdar and Conzen, Catharina and Lindauer, Ute and Clusmann, Hans and Hescheler, J{\"u}rgen and Vilser, Walthard and Schneider, Toni and Schubert, Gerrit Alexander}, title = {Non-invasive evaluation of neurovascular coupling in the murine retina by dynamic retinal vessel analysis}, series = {Plos one}, volume = {13}, journal = {Plos one}, number = {10}, publisher = {PLOS}, address = {San Francisco}, doi = {10.1371/journal.pone.0204689}, pages = {e0204689}, year = {2018}, abstract = {Background Impairment of neurovascular coupling (NVC) was recently reported in the context of subarachnoid hemorrhage and may correlate with disease severity and outcome. However, previous techniques to evaluate NVC required invasive procedures. Retinal vessels may represent an alternative option for non-invasive assessment of NVC. Methods A prototype of an adapted retinal vessel analyzer was used to assess retinal vessel diameter in mice. Dynamic vessel analysis (DVA) included an application of monochromatic flicker light impulses in predefined frequencies for evaluating NVC. All retinae were harvested after DVA and electroretinograms were performed. Results A total of 104 retinal scans were conducted in 21 male mice (90 scans). Quantitative arterial recordings were feasible only in a minority of animals, showing an emphasized reaction to flicker light impulses (8 mice; 14 scans). A characteristic venous response to flicker light, however, could observed in the majority of animals. Repeated measurements resulted in a significant decrease of baseline venous diameter (7 mice; 7 scans, p < 0.05). Ex-vivo electroretinograms, performed after in-vivo DVA, demonstrated a significant reduction of transretinal signaling in animals with repeated DVA (n = 6, p < 0.001). Conclusions To the best of our knowledge, this is the first non-invasive study assessing murine retinal vessel response to flicker light with characteristic changes in NVC. The imaging system can be used for basic research and enables the investigation of retinal vessel dimension and function in control mice and genetically modified animals.}, language = {en} } @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} } @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} } @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} } @article{DigelWehlitzKayseretal.2018, author = {Digel, Ilya and Wehlitz, V. and Kayser, Peter and Figiel-Lange, A. and Bassam, R. and Rundstedt, F. von}, title = {Suspension depletion approach for exemption of infected Solanum jasminoides cells from pospiviroids}, series = {Plant Pathology}, volume = {67}, journal = {Plant Pathology}, number = {2}, publisher = {Wiley}, address = {Oxford}, issn = {1365-3059}, doi = {10.1111/ppa.12750}, pages = {358 -- 365}, year = {2018}, abstract = {Despite numerous studies, viroid elimination from infected plants remains a very challenging task. This study introduces for the first time a novel 'suspension depletion' approach for exemption of Solanum jasminoides plants from viroids. The proposed method implies initial establishment of suspension cultures of the infected plant cells. The suspended cells were then physically treated (mild thermotherapy, 33 °C), which presumably delayed the replication of the viroid. The viroid concentration in the treated biomass was monitored weekly using pospiviroid-specific PCR. After 10-12 weeks of continuous treatment, a sufficient decrease in viroid concentration was observed such that the infection became undetectable by PCR. The treated single cells then gave rise to microcolonies on a solid culture medium and the obtained viroid-negative clones were further promoted to regenerate into viroid-free plants. Three years of accumulated experimental data suggests feasibility, broad applicability, and good efficacy of the proposed approach.}, language = {en} } @article{KeutmannStaatLaack2018, author = {Keutmann, Sabine and Staat, Manfred and Laack, Walter van}, title = {Untersuchung der thermischen Auswirkung von therapeutischem Ultraschall}, volume = {7}, number = {10}, publisher = {Deutscher {\"A}rzte-Verl.}, address = {K{\"o}ln}, issn = {2193-5793}, pages = {518 -- 522}, year = {2018}, abstract = {Zusammenfassung: In der Orthop{\"a}die z{\"a}hlt der therapeutische Ultraschall als Mittel zur Pr{\"a}vention und Therapiebegleitung. Er hat mechanische, thermische und physiko-chemische Auswirkungen auf den menschlichen K{\"o}rper. Um mehr Erkenntnisse {\"u}ber die thermischen Auswirkungen zu erlangen, wurden Versuche an einem Hydrogel-Phantom und an Probanden durchgef{\"u}hrt. Dabei entstand eine signifikante Erw{\"a}rmung des Gewebes, welche beim Probandenversuch an der Oberfl{\"a}che und beim Hydrogelversuch in der Tiefe gemessen wurde. Summary: In orthopaedics, therapeutic ultrasound is a tool of prevention and therapy support. It has mechanical, thermal and physico-chemical effects on the human body. Tests with a hydrogel phantom and with human probands have been performed in order to obtain more knowledge about their thermal effects. Both tests measured temperature increases in cell tissue, on the surface with the human proband test and in depth with the hydrogel phantom test.}, language = {de} } @article{KotliarLanzl2018, author = {Kotliar, Konstantin and Lanzl, Ines}, title = {Vaskul{\"a}re Biomarker der retinalen Gef{\"a}βanalyse}, series = {Klinische Monatsbl{\"a}tter fur Augenheilkunde}, volume = {235}, journal = {Klinische Monatsbl{\"a}tter fur Augenheilkunde}, number = {12}, publisher = {Thieme}, address = {Stuttgart}, issn = {0023-2165}, doi = {10.1055/a-0774-7987}, pages = {1352 -- 1359}, year = {2018}, abstract = {Mit modernen nicht invasiven bildgebenden Verfahren lassen sich anhand der Fundusfotografie bzw. der optischen Verfilmung Aspekte der funktionellen und strukturellen retinalen Gef{\"a}ßver{\"a}nderungen objektiv untersuchen. Der Zustand und das Verhalten retinaler Gef{\"a}ße beeinflussen im pr{\"a}-, post- und kapillaren Bereich den Blutfluss und str{\"o}mungsbedingte Stoffwechselverh{\"a}ltnisse passiv und aktiv {\"u}ber den Gef{\"a}ßdurchmesser. Retinale Gef{\"a}ße gleichen von Aufbau und Funktion den zerebralen Gef{\"a}ßen und spiegeln den Zustand der Mikrozirkulation wider. Mithilfe von aus den Gef{\"a}ßweiten berechneten Biomarkern soll eine Aussage {\"u}ber die Prognose von systemischen vaskul{\"a}r bedingten Erkrankungen getroffen werden. Die statische retinale Gef{\"a}ßanalyse befasst sich mit der Untersuchung des Zustandes der pr{\"a}- und postkapillaren Gef{\"a}ßdurchmesser der retinalen Mikrozirkulation anhand einer optischen Fundusaufnahme. Bei der dynamischen retinalen Gef{\"a}ßanalyse wird der L{\"a}ngsschnitt eines retinalen Gef{\"a}ßes nicht invasiv funktionell und strukturell {\"u}ber einen Zeitraum vor, w{\"a}hrend und nach einer spezifischen vaskul{\"a}ren Stimulation untersucht. Die genaue Methodologie der Auswertung und die Bezeichnung der Parameter variieren bei unterschiedlichen Ans{\"a}tzen. Mittels retinaler Gef{\"a}ßanalyse wurden bislang mehrere klinische Querschnitts- und Interventionsstudien in der Augenheilkunde und anderen Fachgebieten, inkl. Kardiologie, Neurologie, Neurochirurgie, Nephrologie, Gyn{\"a}kologie, Sportmedizin, Diabetologie, Hypertensiologie usw. durchgef{\"u}hrt. Mit der statischen retinalen Gef{\"a}ßanalyse steht eine kosteng{\"u}nstige, reproduzierbare, nicht invasive Screeningtechnik zur Verf{\"u}gung, um eine prognostische Aussage {\"u}ber die Gef{\"a}ßgesundheit eines individuellen Patienten zu treffen. Die dynamische retinale Gef{\"a}ßanalyse besitzt ein weiteres diagnostisches Anwendungsspektrum als die statische, da sie das Verhalten retinaler Gef{\"a}ße zeitkontinuierlich untersucht. Die Evaluation vaskul{\"a}rer Erkrankungen sowie zerebro- bzw. kardiovaskul{\"a}rer Morbidit{\"a}t und Mortalit{\"a}t mittels mehrerer methodologischer Modalit{\"a}ten retinaler Gef{\"a}ßanalyse mit ihren jeweiligen quantitativen Biomarkern bietet eine zukunftstr{\"a}chtige diagnostische Perspektive. Die interdisziplin{\"a}re klinische Anwendung dieser vaskul{\"a}ren Biomarker gewinnt zunehmend an Bedeutung, sowohl in der Augenheilkunde als auch in anderen Fachgebieten.}, language = {de} } @article{ConzenAlbannaWeissetal.2018, author = {Conzen, Catharina and Albanna, Walid and Weiss, Miriam and K{\"u}rten, David and Vilser, Walthard and Kotliar, Konstantin and Z{\"a}ske, Charlotte and Clusmann, Hans and Schubert, Gerrit Alexander}, title = {Vasoconstriction and Impairment of Neurovascular Coupling after Subarachnoid Hemorrhage: a Descriptive Analysis of Retinal Changes}, series = {Translational Stroke Research}, journal = {Translational Stroke Research}, number = {9}, publisher = {Springer Nature}, address = {Cham}, issn = {1868-601X}, doi = {10.1007/s12975-017-0585-8}, pages = {284 -- 293}, year = {2018}, abstract = {Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5-14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C). Data was acquired using a Retinal Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and NVC using flicker-light excitation. Diameter of retinal vessels—central retinal arteriolar and venular equivalent—was significantly reduced in the acute phase (p < 0.001) with gradual improvement in group B (p < 0.05). Arterial NVC of group A was significantly impaired with diminished dilatation (p < 0.001) and reduced area under the curve (p < 0.01) when compared to group C. Group B showed persistent prolonged latency of arterial dilation (p < 0.05). Venous NVC was significantly delayed after SAH compared to group C (A p < 0.001; B p < 0.05). To our knowledge, this is the first clinical study to document retinal vasoconstriction and impairment of NVC in patients with SAH. Using non-invasive RVA as a translational approach, characteristic patterns of compromise were detected for the arterial and venous compartment of the neurovascular unit in a time-dependent fashion. Recruitment will continue to facilitate a correlation analysis with clinical course and outcome.}, language = {en} }