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 - https://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 - 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 - https://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 - JOUR A1 - Quittmann, Oliver J. A1 - Meskemper, Joshua A1 - Abel, Thomas A1 - Albracht, Kirsten A1 - Foitschik, Tina A1 - Rojas-Vega, Sandra A1 - Strüder, Heiko K. T1 - Kinematics and kinetics of handcycling propulsion at increasing workloads in able-bodied subjects JF - Sports Engineereing N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1007/s12283-018-0269-y SN - 1460-2687 VL - 21 IS - 21 SP - 283 EP - 294 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Conzen, Catharina A1 - Albanna, Walid A1 - Weiss, Miriam A1 - Kürten, David A1 - Vilser, Walthard A1 - Kotliar, Konstantin A1 - Zäske, Charlotte A1 - Clusmann, Hans A1 - Schubert, Gerrit Alexander T1 - Vasoconstriction and Impairment of Neurovascular Coupling after Subarachnoid Hemorrhage: a Descriptive Analysis of Retinal Changes JF - Translational Stroke Research N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1007/s12975-017-0585-8 SN - 1868-601X IS - 9 SP - 284 EP - 293 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Heinke, Lars N. A1 - Knicker, Axel J. A1 - Albracht, Kirsten T1 - Evaluation of passively induced shoulder stretch reflex using an isokinetic dynamometer in male overhead athletes JF - Isokinetics and Exercise Science N2 - 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. Y1 - 2018 U6 - https://doi.org/10.3233/IES-184111 SN - 1878-5913 VL - 26 IS - 4 SP - 265 EP - 274 PB - IOS Press CY - Amsterdam ER - TY - JOUR A1 - Kotliar, Konstantin A1 - Lanzl, Ines T1 - Vaskuläre Biomarker der retinalen Gefäβanalyse T1 - Vascular Biomarkers in Retinal Vessel Analysis JF - Klinische Monatsblätter fur Augenheilkunde N2 - Mit modernen nicht invasiven bildgebenden Verfahren lassen sich anhand der Fundusfotografie bzw. der optischen Verfilmung Aspekte der funktionellen und strukturellen retinalen Gefäßveränderungen objektiv untersuchen. Der Zustand und das Verhalten retinaler Gefäße beeinflussen im prä-, post- und kapillaren Bereich den Blutfluss und strömungsbedingte Stoffwechselverhältnisse passiv und aktiv über den Gefäßdurchmesser. Retinale Gefäße gleichen von Aufbau und Funktion den zerebralen Gefäßen und spiegeln den Zustand der Mikrozirkulation wider. Mithilfe von aus den Gefäßweiten berechneten Biomarkern soll eine Aussage über die Prognose von systemischen vaskulär bedingten Erkrankungen getroffen werden. Die statische retinale Gefäßanalyse befasst sich mit der Untersuchung des Zustandes der prä- und postkapillaren Gefäßdurchmesser der retinalen Mikrozirkulation anhand einer optischen Fundusaufnahme. Bei der dynamischen retinalen Gefäßanalyse wird der Längsschnitt eines retinalen Gefäßes nicht invasiv funktionell und strukturell über einen Zeitraum vor, während und nach einer spezifischen vaskulären Stimulation untersucht. Die genaue Methodologie der Auswertung und die Bezeichnung der Parameter variieren bei unterschiedlichen Ansätzen. Mittels retinaler Gefäßanalyse wurden bislang mehrere klinische Querschnitts- und Interventionsstudien in der Augenheilkunde und anderen Fachgebieten, inkl. Kardiologie, Neurologie, Neurochirurgie, Nephrologie, Gynäkologie, Sportmedizin, Diabetologie, Hypertensiologie usw. durchgeführt. Mit der statischen retinalen Gefäßanalyse steht eine kostengünstige, reproduzierbare, nicht invasive Screeningtechnik zur Verfügung, um eine prognostische Aussage über die Gefäßgesundheit eines individuellen Patienten zu treffen. Die dynamische retinale Gefäßanalyse besitzt ein weiteres diagnostisches Anwendungsspektrum als die statische, da sie das Verhalten retinaler Gefäße zeitkontinuierlich untersucht. Die Evaluation vaskulärer Erkrankungen sowie zerebro- bzw. kardiovaskulärer Morbidität und Mortalität mittels mehrerer methodologischer Modalitäten retinaler Gefäßanalyse mit ihren jeweiligen quantitativen Biomarkern bietet eine zukunftsträchtige diagnostische Perspektive. Die interdisziplinäre klinische Anwendung dieser vaskulären Biomarker gewinnt zunehmend an Bedeutung, sowohl in der Augenheilkunde als auch in anderen Fachgebieten. Y1 - 2018 U6 - https://doi.org/10.1055/a-0774-7987 SN - 0023-2165 VL - 235 IS - 12 SP - 1352 EP - 1359 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Lapitan, Denis G. A1 - Rogatkin, Dmitrii A. A1 - Persheyev, Sydulla K. A1 - Kotliar, Konstantin T1 - False spectra formation in the differential two-channel scheme of the laser Doppler flowmeter JF - Biomedizinische Technik N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1515/bmt-2017-0060 SN - 0013-5585 VL - 63 IS - 4 SP - 439 EP - 444 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Albanna, Walid A1 - Kotliar, Konstantin A1 - Lüke, Jan Niklas A1 - Alpdogan, Serdar A1 - Conzen, Catharina A1 - Lindauer, Ute A1 - Clusmann, Hans A1 - Hescheler, Jürgen A1 - Vilser, Walthard A1 - Schneider, Toni A1 - Schubert, Gerrit Alexander T1 - Non-invasive evaluation of neurovascular coupling in the murine retina by dynamic retinal vessel analysis JF - Plos one N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1371/journal.pone.0204689 VL - 13 IS - 10 PB - PLOS CY - San Francisco ER - TY - JOUR A1 - Balakirski, Galina A1 - Kotliar, Konstantin A1 - Pauly, Karolin J. A1 - Krings, Laura K. A1 - Rübben, Albert A1 - Baron, Jens M. A1 - Schmitt, Laurenz T1 - Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience JF - Dermatologic Surgery N2 - 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. Y1 - 2018 U6 - https://doi.org/10.1097/DSS.0000000000001615 IS - 44 (12) SP - 1525 EP - 1536 PB - Wolters Kluwer ER - TY - JOUR A1 - Rittweger, Jörn A1 - Albracht, Kirsten A1 - Flück, Martin A1 - Ruoss, Severin A1 - Brocca, Lorenza A1 - Longa, Emanuela A1 - Moriggi, Manuela A1 - Seynnes, Olivier A1 - Di Giulio, Irene A1 - Tenori, Leonardo A1 - Vignoli, Alessia A1 - Capri, Miriam A1 - Gelfi, Cecilia A1 - Luchinat, Claudio A1 - Franceschi, Claudio A1 - Bottinelli, Roberto A1 - Cerretelli, Paolo A1 - Narici, Marco T1 - Sarcolab pilot study into skeletal muscle’s adaptation to longterm spaceflight JF - npj Microgravity Y1 - 2018 U6 - https://doi.org/10.1038/s41526-018-0052-1 SN - 2373-8065 VL - 4 IS - 1 SP - 1 EP - 9 PB - Nature Portfolio ER -