TY - CHAP A1 - Bhattarai, Aroj A1 - Frotscher, Ralf A1 - Staat, Manfred T1 - Computational Analysis of Pelvic Floor Dysfunction T2 - Women's Health and Biomechanics N2 - Pelvic floor dysfunction (PFD) is characterized by the failure of the levator ani (LA) muscle to maintain the pelvic hiatus, resulting in the descent of the pelvic organs below the pubococcygeal line. This chapter adopts the modified Humphrey material model to consider the effect of the muscle fiber on passive stretching of the LA muscle. The deformation of the LA muscle subjected to intra-abdominal pressure during Valsalva maneuver is compared with the magnetic resonance imaging (MRI) examination of a nulliparous female. Numerical result shows that the fiber-based Humphrey model simulates the muscle behavior better than isotropic constitutive models. Greater posterior movement of the LA muscle widens the levator hiatus due to lack of support from the anococcygeal ligament and the perineal structure as a consequence of birth-related injury and aging. Old and multiparous females with uncontrolled urogenital and rectal hiatus tend to develop PFDs such as prolapse and incontinence. KW - Pelvic muscle KW - Muscle fibers KW - Passive stretching KW - Pelvic floor dysfunction Y1 - 2018 SN - 978-3-319-71574-2 U6 - http://dx.doi.org/10.1007/978-3-319-71574-2_17 N1 - Lecture Notes in Computational Vision and Biomechanics, vol 29 SP - 217 EP - 230 PB - Springer CY - Cham ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Jabbari, Medisa A1 - Anding, Ralf A1 - Staat, Manfred T1 - Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis JF - tm - Technisches Messen N2 - 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 ältere, mehrgebährende Frauen leiden häufiger an einem Scheidenvorfall nach einer Hysterektomie aufgrund der schwachen Unterstützung durch laxe apikale Bänder. Es wird angenommen, dass eine verringerte Menge an Östrogen und Progesteron im höheren Alter das Kollagen umformt, wodurch die Gewebesteifigkeit reduziert wird. Die Sakrokolpopexie ist eine offene oder laparoskopische Operation, die mit prothetischen Netzimplantaten durchgeführt wird, um laxe Bänder zu ersetzen. Y-förmige 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 während des Valsalva-Manövers mit geschwächtem Gewebe durchgeführt, das durch eine reduzierte Gewebesteifigkeit modelliert wird. Die Gewebe werden als inkompressible, isotrop hyperelastische Materialien modelliert, während die Netze entweder als orthotrope linear elastische oder als isotrope hyperlastische Materialien modelliert werden. Die Positionen des Vaginalstumpfs, der Blase und der Harnröhrenachse werden anhand der Pubococcygeallinie aus der Ruhelage, für den Prolaps und nach der Reparatur unter Verwendung der drei Netze berechnet. Aufgrund der Netzmechanik und der Netzporenverformung bietet das DynaMesh mit regelmäßigen rechteckigen Netzporen eine bessere mechanische Unterstützung und eine Neupositionierung des Scheidengewölbes, der Blase und der Urethraachse als Gynemesh und Ultrapro mit unregelmäßigen hexagonalen Netzporen. Y1 - 2018 U6 - http://dx.doi.org/10.1515/teme-2017-0115 SN - 2196-7113 VL - 85 IS - 5 SP - 331 EP - 342 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Staat, Manfred T1 - Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions JF - Computational and Mathematical Methods in Medicine N2 - 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. Y1 - 2018 U6 - http://dx.doi.org/10.1155/2018/9518076 SN - 1748-6718 VL - 2018 IS - Article ID 9518076 SP - 1 EP - 16 PB - Hindawi CY - New York, NY ER - TY - CHAP A1 - Bhattarai, Aroj A1 - Staat, Manfred ED - Artmann, Gerhard ED - Temiz Artmann, Aysegül ED - Zhubanova, Azhar A. ED - Digel, Ilya T1 - Mechanics of soft tissue reactions to textile mesh implants T2 - Biological, Physical and Technical Basics of Cell Engineering N2 - For pelvic floor disorders that cannot be treated with non-surgical procedures, minimally invasive surgery has become a more frequent and safer repair procedure. More than 20 million prosthetic meshes are implanted each year worldwide. The simple selection of a single synthetic mesh construction for any level and type of pelvic floor dysfunctions without adopting the design to specific requirements increase the risks for mesh related complications. Adverse events are closely related to chronic foreign body reaction, with enhanced formation of scar tissue around the surgical meshes, manifested as pain, mesh erosion in adjacent structures (with organ tissue cut), mesh shrinkage, mesh rejection and eventually recurrence. Such events, especially scar formation depend on effective porosity of the mesh, which decreases discontinuously at a critical stretch when pore areas decrease making the surgical reconstruction ineffective that further augments the re-operation costs. The extent of fibrotic reaction is increased with higher amount of foreign body material, larger surface, small pore size or with inadequate textile elasticity. Standardized studies of different meshes are essential to evaluate influencing factors for the failure and success of the reconstruction. Measurements of elasticity and tensile strength have to consider the mesh anisotropy as result of the textile structure. An appropriate mesh then should show some integration with limited scar reaction and preserved pores that are filled with local fat tissue. This chapter reviews various tissue reactions to different monofilament mesh implants that are used for incontinence and hernia repairs and study their mechanical behavior. This helps to predict the functional and biological outcomes after tissue reinforcement with meshes and permits further optimization of the meshes for the specific indications to improve the success of the surgical treatment. Y1 - 2018 SN - 978-981-10-7904-7 U6 - http://dx.doi.org/10.1007/978-981-10-7904-7_11 SP - 251 EP - 275 PB - Springer CY - Singapore ER - TY - CHAP A1 - Bhattarai, Aroj A1 - Staat, Manfred ED - Fernandes, P.R. ED - Tavares, J. M. T1 - Pectopexy to repair vaginal vault prolapse: a finite element approach T2 - Proceedings CMBBE 2018 N2 - 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. Y1 - 2018 N1 - 15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization. CMBBE 2018. 26-29 March 2018, Lisbon, Portugal ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Staat, Manfred T1 - Computational comparison of different textile implants to correct apical prolapse in females JF - Current Directions in Biomedical Engineering N2 - 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. Y1 - 2018 U6 - http://dx.doi.org/10.1515/cdbme-2018-0159 VL - 4 IS - 1 SP - 661 EP - 664 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Birgel, Stefan A1 - Leschinger, Tim A1 - Wegmann, Kilian A1 - Staat, Manfred T1 - Calculation of muscle forces and joint reaction loads in the shoulder area via an OpenSim based computer model JF - tm - Technisches Messen N2 - 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 überprüften 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 für den Supraspinatus und Deltoideus. Zusätzlich wird der Einfluss auf die Gelenkstabilität 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. Y1 - 2018 U6 - http://dx.doi.org/10.1515/teme-2017-0114 SN - 2196-7113 VL - 85 IS - 5 SP - 321 EP - 330 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Ciritsis, Alexander A1 - Horbach, Andreas A1 - Staat, Manfred A1 - Kuhl, Christiane K. A1 - Kraemer, Nils Andreas T1 - Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo JF - Journal of Biomedical Materials Research: Part B: Applied Biomaterials N2 - 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. Y1 - 2018 U6 - http://dx.doi.org/10.1002/jbm.b.33877 SN - 1552-4981 VL - 106 IS - 2 SP - 827 EP - 833 PB - Wiley CY - New York, NY ER - TY - CHAP A1 - Duong, Minh Tuan A1 - Seifarth, Volker A1 - Temiz Artmann, Aysegül A1 - Artmann, Gerhard A1 - Staat, Manfred ED - Artmann, Gerhard ED - Temiz Artmann, Aysegül ED - Zhubanova, Azhar A. ED - Digel, Ilya T1 - Growth Modelling Promoting Mechanical Stimulation of Smooth Muscle Cells of Porcine Tubular Organs in a Fibrin-PVDF Scaffold T2 - Biological, Physical and Technical Basics of Cell Engineering N2 - Reconstructive surgery and tissue replacements like ureters or bladders reconstruction have been recently studied, taking into account growth and remodelling of cells since living cells are capable of growing, adapting, remodelling or degrading and restoring in order to deform and respond to stimuli. Hence, shapes of ureters or bladders and their microstructure change during growth and these changes strongly depend on external stimuli such as training. We present the mechanical stimulation of smooth muscle cells in a tubular fibrin-PVDFA scaffold and the modelling of the growth of tissue by stimuli. To this end, mechanotransduction was performed with a kyphoplasty balloon catheter that was guided through the lumen of the tubular structure. The bursting pressure was examined to compare the stability of the incubated tissue constructs. The results showed the significant changes on tissues with training by increasing the burst pressure as a characteristic mechanical property and the smooth muscle cells were more oriented with uniformly higher density. Besides, the computational growth models also exhibited the accurate tendencies of growth of the cells under different external stimuli. Such models may lead to design standards for the better layered tissue structure in reconstructing of tubular organs characterized as composite materials such as intestines, ureters and arteries. KW - Mechanical simulation KW - Growth modelling KW - Ureter KW - Bladder KW - Reconstruction Y1 - 2018 SN - 978-981-10-7904-7 U6 - http://dx.doi.org/10.1007/978-981-10-7904-7_9 SP - 209 EP - 232 PB - Springer CY - Singapore ER - TY - CHAP A1 - Frotscher, Ralf A1 - Staat, Manfred ED - Artmann, Gerhard ED - Temiz Artmann, Aysegül ED - Zhubanova, Azhar A. ED - Digel, Ilya T1 - Towards Patient-Specific Computational Modeling of hiPS-Derived Cardiomyocyte Function and Drug Action T2 - Biological, Physical and Technical Basics of Cell Engineering N2 - Human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) today are widely used for the investigation of normal electromechanical cardiac function, of cardiac medication and of mutations. Computational models are thus established that simulate the behavior of this kind of cells. This section first motivates the modeling of hiPS-CM and then presents and discusses several modeling approaches of microscopic and macroscopic constituents of human-induced pluripotent stem cell-derived and mature human cardiac tissue. The focus is led on the mapping of the computational results one can achieve with these models onto mature human cardiomyocyte models, the latter being the real matter of interest. Model adaptivity is the key feature that is discussed because it opens the way for modeling various biological effects like biological variability, medication, mutation and phenotypical expression. We compare the computational with experimental results with respect to normal cardiac function and with respect to inotropic and chronotropic drug effects. The section closes with a discussion on the status quo of the specificity of computational models and on what challenges have to be solved to reach patient-specificity. Y1 - 2018 SN - 978-981-10-7904-7 U6 - http://dx.doi.org/10.1007/978-981-10-7904-7_10 SP - 233 EP - 250 PB - Springer CY - Singapore ER - TY - JOUR A1 - Horbach, Andreas A1 - Staat, Manfred T1 - Optical strain measurement for the modeling of surgical meshes and their porosity JF - Current Directions in Biomedical Engineering N2 - 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. Y1 - 2018 U6 - http://dx.doi.org/10.1515/cdbme-2018-0045 SN - 2364-5504 VL - Band 4 IS - 1 SP - 181 EP - 184 PB - De Gruyter CY - Berlin ER - TY - CHAP A1 - Jung, Alexander A1 - Frotscher, Ralf A1 - Staat, Manfred T1 - Electromechanical model of hiPSC-derived ventricular cardiomyocytes cocultured with fibroblasts T2 - 6th European Conference on Computational Mechanics (ECCM 6), 7th European Conference on Computational Fluid Dynamics (ECFD 7), 11-15 June 2018, Glasgow, UK N2 - The CellDrum provides an experimental setup to study the mechanical effects of fibroblasts co-cultured with hiPSC-derived ventricular cardiomyocytes. Multi-scale computational models based on the Finite Element Method are developed. Coupled electrical cardiomyocyte-fibroblast models (cell level) are embedded into reaction-diffusion equations (tissue level) which compute the propagation of the action potential in the cardiac tissue. Electromechanical coupling is realised by an excitation-contraction model (cell level) and the active stress arising during contraction is added to the passive stress in the force balance, which determines the tissue displacement (tissue level). Tissue parameters in the model can be identified experimentally to the specific sample. Y1 - 2018 ER - TY - JOUR A1 - Jung, Alexander A1 - Müller, Wolfram A1 - Staat, Manfred T1 - Wind and fairness in ski jumping: A computer modelling analysis JF - Journal of Biomechanics N2 - Wind is closely associated with the discussion of fairness in ski jumping. To counter-act its influence on the jump length, the International Ski Federation (FIS) has introduced a wind compensation approach. We applied three differently accurate computer models of the flight phase with wind (M1, M2, and M3) to study the jump length effects of various wind scenarios. The previously used model M1 is accurate for wind blowing in direction of the flight path, but inaccuracies are to be expected for wind directions deviating from the tangent to the flight path. M2 considers the change of airflow direction, but it does not consider the associated change in the angle of attack of the skis which additionally modifies drag and lift area time functions. M3 predicts the length effect for all wind directions within the plane of the flight trajectory without any mathematical simplification. Prediction errors of M3 are determined only by the quality of the input data: wind velocity, drag and lift area functions, take-off velocity, and weight. For comparing the three models, drag and lift area functions of an optimized reference jump were used. Results obtained with M2, which is much easier to handle than M3, did not deviate noticeably when compared to predictions of the reference model M3. Therefore, we suggest to use M2 in future applications. A comparison of M2 predictions with the FIS wind compensation system showed substantial discrepancies, for instance: in the first flight phase, tailwind can increase jump length, and headwind can decrease it; this is opposite of what had been anticipated before and is not considered in the current wind compensation system in ski jumping. Y1 - 2018 U6 - http://dx.doi.org/10.1016/j.jbiomech.2018.05.001 SN - 0021-9290 IS - 75 SP - 147 EP - 153 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Jung, Alexander A1 - Staat, Manfred A1 - Müller, Wolfram T1 - Corrigendum to “Flight style optimization in ski jumping on normal, large, and ski flying hills” [J. Biomech 47 (2014) 716–722] JF - Journals of Biomechanics Y1 - 2018 U6 - http://dx.doi.org/10.1016/j.jbiomech.2018.02.001 SN - 0021-9290 N1 - refers to Journal of Biomechanics Vol 47, Issue 3, Pages 716-722: https://doi.org/10.1016/j.jbiomech.2013.11.021 SP - 313 PB - Elsevier CY - Amsterdam ER - TY - CHAP A1 - Kahmann, Stephanie Lucina A1 - Uschok, Stephan A1 - Wegmann, Kilian A1 - Müller, Lars-P. A1 - Staat, Manfred T1 - Biomechanical multibody model with refined kinematics of the elbow T2 - 6th European Conference on Computational Mechanics (ECCM 6), 7th European Conference on Computational Fluid Dynamics (ECFD 7), 11-15 June 2018, Glasgow, UK N2 - The overall objective of this study is to develop a new external fixator, which closely maps the native kinematics of the elbow to decrease the joint force resulting in reduced rehabilitation time and pain. An experimental setup was designed to determine the native kinematics of the elbow during flexion of cadaveric arms. As a preliminary study, data from literature was used to modify a published biomechanical model for the calculation of the joint and muscle forces. They were compared to the original model and the effect of the kinematic refinement was evaluated. Furthermore, the obtained muscle forces were determined in order to apply them in the experimental setup. The joint forces in the modified model differed slightly from the forces in the original model. The muscle force curves changed particularly for small flexion angles but their magnitude for larger angles was consistent. Y1 - 2018 ER - TY - JOUR A1 - Keutmann, Sabine A1 - Staat, Manfred A1 - Laack, Walter van T1 - Untersuchung der thermischen Auswirkung von therapeutischem Ultraschall N2 - Zusammenfassung: In der Orthopädie zählt der therapeutische Ultraschall als Mittel zur Prävention und Therapiebegleitung. Er hat mechanische, thermische und physiko-chemische Auswirkungen auf den menschlichen Körper. Um mehr Erkenntnisse über die thermischen Auswirkungen zu erlangen, wurden Versuche an einem Hydrogel-Phantom und an Probanden durchgeführt. Dabei entstand eine signifikante Erwärmung des Gewebes, welche beim Probandenversuch an der Oberfläche 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. T2 - Research about the thermal effects of therapeutic ultrasound Y1 - 2018 SN - 2193-5793 SN - 2193-5785 (Druckausgabe) VL - 7 IS - 10 SP - 518 EP - 522 PB - Deutscher Ärzte-Verl. CY - Köln ER - TY - JOUR A1 - Kohler, Annette A1 - Kirschner-Hermanns, Ruth A1 - Staat, Manfred A1 - Brehmer, Bernhard T1 - Pathogenese, funktionelle und anatomische Aspekte der weiblichen Belastungsinkontinenz T1 - Female stress incontinence: aspects of pathogenesis and functional anatomy JF - Aktuelle Urologie N2 - Der vorliegende Artikel fokussiert sich auf die weibliche Belastungsinkontinenz als Insuffizienz der Speicherfunktion der Blase, auch wenn im klinischen Alltag die Harninkontinenz der Frau häufig verschiedene Ursachen hat und insbesondere eine Belastungsinkontinenz im Alter und bei neurologischer Komorbidität 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, Harnröhre, Gebärmutter und Enddarm sowie die muskulären und ligamentösen Strukturen des kleinen Beckens durch Fertilitätsphase, mögliche Schwangerschaften, Geburten und Menopausen-Phase, über das „normale Altern“ hinaus, gravierenden Veränderungen. 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. Y1 - 2018 U6 - http://dx.doi.org/10.1055/s-0043-120616 SN - 1438-8820 VL - 49 IS - 1 SP - 47 EP - 51 PB - Thieme CY - Stuttgart ER - TY - CHAP A1 - Tran, Ngoc Trinh A1 - Matthies, Hermann G. A1 - Stavroulakis, Georgios Eleftherios A1 - Staat, Manfred T1 - Direct plastic structural design by chance constrained programming T2 - 6th European Conference on Computational Mechanics (ECCM 6), 7th European Conference on Computational Fluid Dynamics (ECFD 7), 11-15 June 2018, Glasgow, UK N2 - We propose a stochastic programming method to analyse limit and shakedown of structures under random strength with lognormal distribution. In this investigation a dual chance constrained programming algorithm is developed to calculate simultaneously both the upper and lower bounds of the plastic collapse limit or the shakedown limit. The edge-based smoothed finite element method (ES-FEM) using three-node linear triangular elements is used. Y1 - 2018 ER -