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 - 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 - http://dx.doi.org/10.1097/DSS.0000000000001615 IS - 44 (12) SP - 1525 EP - 1536 PB - Wolters Kluwer ER - TY - JOUR A1 - Hamou, Hussam Aldin A1 - Kotliar, Konstantin A1 - Tan, Sonny Kian A1 - Weiß, Christel A1 - Blume, Christian A1 - Clusmann, Hans A1 - Schubert, Gerrit Alexander A1 - Albanna, Walid T1 - Surgical nuances and placement of subgaleal drains for supratentorial procedures—a prospective analysis of efficacy and outcome in 150 craniotomies JF - Acta Neurochirurgica N2 - Background For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set. Method We prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up. Results Early subgaleal fluid collection was observed in 36.7% (2.8% at the late follow-up), and impaired wound healing was recorded in 3.3% of all cases, with an overall need for operative revision of 6.7%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05). Conclusions Based on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design. Y1 - 2020 U6 - http://dx.doi.org/10.1007/s00701-019-04196-6 SN - 0942-0940 VL - 2020 IS - 162 SP - 729 EP - 736 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Zerlin, Kay A1 - Kasischke, Nicole A1 - Digel, Ilya A1 - Maggakis-Kelemen, Christina A1 - Temiz Artmann, Aysegül A1 - Porst, Dariusz A1 - Kayser, Peter A1 - Linder, Peter A1 - Artmann, Gerhard T1 - Structural transition temperature of hemoglobins correlates with species’ body temperature JF - European Biophysics Journal. 37 (2007), H. 1 Y1 - 2007 SN - 1432-1017 SP - 1 EP - 10 ER - TY - JOUR A1 - Pressler, Axel A1 - Esefeld, Katrin A1 - Scherr, Johannes A1 - Ali, Mohammad A1 - Hanssen, Henner A1 - Kotliar, Konstantin A1 - Lanzl, Ines A1 - Halle, Martin A1 - Kaemmerer, Harald A1 - Schmidt-Trucksäss, Arno A1 - Hager, Alfred T1 - Structural alterations of retinal arterioles in adults late after repair of aortic isthmic coarctation JF - The American Journal of Cardiology N2 - Patients after coarctation repair still have an increased risk of cardiovascular or cerebrovascular events. This has been explained by the persisting hypertension and alterations in the peripheral vessels. However, involvement of the central vessels such as the retinal arteries is virtually unknown. A total of 34 patients after coarctation repair (22 men and 12 women; 23 to 58 years old, age range 0 to 32 years at surgical repair) and 34 nonhypertensive controls underwent structural and functional retinal vessel analysis. Using structural analysis, the vessel diameters were measured. Using functional analysis, the endothelium-dependent vessel dilation in response to flicker light stimulation was assessed. In the patients after coarctation repair, the retinal arteriolar diameter was significantly reduced compared to that of the controls (median 182 μm, first to third quartile 171 to 197; vs 197 μm, first to third quartile 193 to 206; p <0.001). These findings were independent of the peripheral blood pressure and age at intervention. No differences were found for venules. The functional analysis findings were not different between the patients and controls (maximum dilation 3.5%, first to third quartile 2.1% to 4.5% vs 3.6%, first to third quartile 2.2% to 4.3%; p = 0.81), indicating preserved autoregulative mechanisms. In conclusion, the retinal artery diameter is reduced in patients after coarctation repair, independent of their current blood pressure level and age at intervention. As a structural marker of chronic vessel damage associated with past, current, or future hypertension, retinal arteriolar narrowing has been linked to stroke incidence. These results indicate an involvement of cerebral microcirculation in aortic coarctation, despite timely repair, and might contribute to explain the increased rate of cerebrovascular events in such patients. Y1 - 2010 U6 - http://dx.doi.org/10.1016/j.amjcard.2009.10.070 SN - 0002-9149 VL - 105 IS - 5 SP - 740 EP - 744 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Frotscher, Ralf A1 - Staat, Manfred T1 - Stresses produced by different textile mesh implants in a tissue equivalent JF - BioNanoMaterials N2 - Two single-incision mini-slings used for treating urinary incontinence in women are compared with respect to the stresses they produce in their surrounding tissue. In an earlier paper we experimentally observed that these implants produce considerably different stress distributions in a muscle tissue equivalent. Here we perform 2D finite element analyses to compare the shear stresses and normal stresses in the tissue equivalent for the two meshes and to investigate their failure behavior. The results clearly show that the Gynecare TVT fails for increasing loads in a zipper-like manner because it gradually debonds from the surrounding tissue. Contrary to that, the tissue at the ends of the DynaMesh-SIS direct may rupture but only at higher loads. The simulation results are in good agreement with the experimental observations thus the computational model helps to interpret the experimental results and provides a tool for qualitative evaluation of mesh implants. Y1 - 2014 U6 - http://dx.doi.org/10.1515/bnm-2014-0003 SN - 2191-4672 (E-Journal); 2193-066X (E-Journal); 0011-8656 (Print); 1616-0177 (Print); 2193-0651 (Print) VL - 15 IS - 1-2 SP - 25 EP - 30 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Kappmeyer, K. A1 - Kotliar, Konstantin A1 - Lanzl, I. M. T1 - Spielen von Blasinstrumenten und Augeninnendruck JF - Zeitschrift für praktische Augenheilkunde & augenärztliche Fortbildung : ZPA Y1 - 2009 SN - 1436-0322 VL - Bd. 30 SP - 169 EP - 171 ER - TY - JOUR A1 - Turaliyeva, M. A1 - Yeshibaev, A. A1 - Saparbekova, A. A1 - Akynova, L. A1 - Abildayeva, R. A1 - Sadenova, M. A1 - Sartayeva, K. A1 - Schieffer, Andre A1 - Digel, Ilya T1 - Species composition and injuriousness of stranger xylophilous fauna affecting indigenous urban dendroflora of Central Asia JF - Asian journal of microbiology, biotechnology & environmental sciences : AJMBES N2 - At the present time, one of the most serious environmental problems of Central Asia and South Kazakhstan is the ongoing large-scale deterioration of principal urban tree populations. Several major centers of massive spread of invasive plant pests have been found in urban dendroflora of this region. The degree of damage of seven most wide-spread aboriginal tree species was found to range from 21.4±1.1 to 85.4±1.8%. In particular, the integrity of the native communities of sycamore (Platanus spp.), willow (Salix spp.), poplar (Populus spp.) and elm (Ulmus spp.) is highly endangered. Our taxonomic analysis of the most dangerous tree pests of the region has revealed them as neobiontic xylophilous insects such as Cossus cossus L. (Order: Lepidoptera L.) Monochamus urussovi Fisch., Monochamus sutor L., Acanthocinus aedelis L. and Ñetonia aureate L. (Order: Coleoptera L.). We relate the origin of this threatening trend with the import of industrial wood in the mid 90’s of the last century that was associated with high degree of the constructional work in the region. Because of the absence of efficient natural predators of the pest species, the application of microbiological methods of the pest control and limitation is suggested. Y1 - 2016 SN - 0972-3005 VL - 18 IS - 2 SP - 359 EP - 366 PB - EM International ER - TY - JOUR A1 - Grundmann, Jan Thimo A1 - Dachwald, Bernd A1 - Grimm, Christian D. A1 - Kahle, Ralph A1 - Koch, Aaron Dexter A1 - Krause, Christian A1 - Lange, Caroline A1 - Quantius, Dominik A1 - Ulamec, Stephan T1 - Spacecraft for Hypervelocity Impact Research – An Overview of Capabilities, Constraints and the Challenges of Getting There JF - Procedia Engineering Y1 - 2015 U6 - http://dx.doi.org/10.1016/j.proeng.2015.04.021 SN - 1877-7058 N1 - Proceedings of the 2015 Hypervelocity Impact Symposium (HVIS 2015) VL - Vol. 103 SP - 151 EP - 158 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Staat, Manfred T1 - Some Achievements of the European Project LISA for FEM Based Limit and Shakedown Analysis JF - Computational mechanics : developments and applications, 2002 : presented at the 2002 ASME Pressure Vessels and Piping Conference, Vancouver, British Columbia, Canada, August 5 - 9. / Badie, N. [ed] Y1 - 2002 SN - 0791846520 N1 - Serie PVP ; vol. 441. SP - 177 EP - 185 PB - American Society of Mechanical Engineers CY - New York ER - TY - JOUR A1 - Peloni, Alessandro A1 - Ceriotti, Matteo A1 - Dachwald, Bernd T1 - Solar-sail trajectory design for a multiple near-earth-asteroid rendezvous mission JF - Journal of Guidance, Control, and Dynamics N2 - The scientific interest for near-Earth asteroids as well as the interest in potentially hazardous asteroids from the perspective of planetary defense led the space community to focus on near-Earth asteroid mission studies. A multiple near-Earth asteroid rendezvous mission with close-up observations of several objects can help to improve the characterization of these asteroids. This work explores the design of a solar-sail spacecraft for such a mission, focusing on the search of possible sequences of encounters and the trajectory optimization. This is done in two sequential steps: a sequence search by means of a simplified trajectory model and a set of heuristic rules based on astrodynamics, and a subsequent optimization phase. A shape-based approach for solar sailing has been developed and is used for the first phase. The effectiveness of the proposed approach is demonstrated through a fully optimized multiple near-Earth asteroid rendezvous mission. The results show that it is possible to visit five near-Earth asteroids within 10 years with near-term solar-sail technology. Y1 - 2016 U6 - http://dx.doi.org/10.2514/1.G000470 SN - 0731-5090 VL - 39 IS - 12 SP - 2712 EP - 2724 PB - AIAA CY - Reston, Va. ER - TY - JOUR A1 - Dachwald, Bernd A1 - Seboldt, W. T1 - Solar Sails — Propellantless Propulsion for Near- and Medium-Term Deep-Space Missions / W. Seboldt ; B. Dachwald JF - Advanced Propulsion Systems and Technologies, Today to 2020 / Claudio Bruno (ed.) ... - (Progress in Astronautics and Aeronautics Series ; 223) Y1 - 2008 SN - 978-1-56347-929-8 N1 - ISBN 10: 1-56347-929-X ; American Institute of Aeronautics and Astronautics PB - AIAA CY - Reston, Va. ER - TY - JOUR A1 - Dachwald, Bernd A1 - Seboldt, W. T1 - Solar Sails for Near- and Medium-Term Scientific Deep Space Missions / W. Sebolt ; B. Dachwald JF - In-space propulsion : edited book of proceedings of the 10-IWCP, the 10th International Workshop on Combustion and Propulsion held in Lerici, La Spezia, Italy, 21-25 September 2003 / [ed.: Luigi T. DeLuca] Y1 - 2005 N1 - Paper 31 ; International workshop on combustion and propulsion <10, 2003, Lerici> PB - SP Lab, Politecnico di Milano CY - Milano ER - TY - JOUR A1 - Dachwald, Bernd A1 - Kahle, Ralph A1 - Wie, Bong T1 - Solar Sailing Kinetic Energy Impactor (KEI) Mission Design Tradeoffs for Impacting and Deflecting Asteroid 99942 Apophis JF - AIAA Guidance, Navigation, and Control Conference & Exhibit - AIAA Atmospheric Flight Mechanics Conference & Exhibit - AIAA Modeling and Simulation Technologies Conference & Exhibit - AIAA/AAS Astrodynamics Specialist Conference & Exhibit : [21 - 24 August 2006, Keystone, Colorado ; papers]. - (AIAA meeting papers on disc ; [11.]2006,19-20 ) Y1 - 2006 SN - 1-56347-802-1 N1 - American Institute of Aeronautics and Astronautics ; American Astronautical Society ; AIAA/AAS Astrodynamics Specialist Conference & Exhibit <2006, Keystone, Colo.> ; AIAA paper number: AIAA-2006-6178 SP - 1 EP - 20 PB - American Institute of Aeronautics and Astronautics CY - Reston, Va. ER - TY - JOUR A1 - Dachwald, Bernd A1 - Seboldt, Wolfgang T1 - Solar sailcraft of the first generation technology development / Seboldt, Wolfgang ; Dachwald, Bernd Y1 - 2003 N1 - 54th International Astronautical Congress of the International Astronautical Federation, the International Academy of Astronautics, and the International Institute of Space Law 29 September - 3 October 2003, Bremen, Germany IAC-03-S.03 ER - TY - JOUR A1 - Dachwald, Bernd A1 - Seboldt, Wolfgang T1 - Solar sailcraft of the first generation mission applications to near-earth asteroids Y1 - 2003 N1 - 54th International Astronautical Congress of the International Astronautical Federation, the International Academy of Astronautics, and the International Institute of Space Law 29 September - 3 October 2003, Bremen, Germany IAC-03-Q.5.06 ER - TY - JOUR A1 - Dachwald, Bernd A1 - Ohndorf, A. A1 - Wie, Bong T1 - Solar Sail Trajectory Optimization for the Solar Polar Imager (SPI) Mission JF - AIAA Guidance, Navigation, and Control Conference & Exhibit - AIAA Atmospheric Flight Mechanics Conference & Exhibit - AIAA Modeling and Simulation Technologies Conference & Exhibit - AIAA/AAS Astrodynamics Specialist Conference & Exhibit : [21 - 24 August 2006, Keystone, Colorado ; papers]. - (AIAA meeting papers on disc ; [11.]2006,19-20 ) Y1 - 2006 SN - 1-56347-802-1 N1 - American Institute of Aeronautics and Astronautics ; American Astronautical Society ; AIAA/AAS Astrodynamics Specialist Conference & Exhibit <2006, Keystone, Colo.> ; AIAA paper number: AIAA-2006-6177 PB - American Institute of Aeronautics and Astronautics CY - Reston, Va. ER - TY - JOUR A1 - Dachwald, Bernd A1 - Wie, Bong T1 - Solar Sail Trajectory Optimization for Intercepting, Impacting, and Deflecting Near-Earth Asteroids JF - AIAA Guidance, Navigation and Control Conference and Exhibit - AIAA Modeling and Simulation Technologies Conference and Exhibit - AIAA Atmospheric Flight Mechanics Conference and Exhibit : [San Francisco, California, 15 - 18 August 2005 ; papers]. - (AIAA meeting papers on disc ; [10.]2005,16-17) Y1 - 2005 SN - 1-56347-765-3 N1 - American Institute of Aeronautics and Astronautics ; AIAA Guidance, Navigation, and Control Conference and Exhibit <2005, San Francisco, Calif.> ; AIAA paper number: AIAA-2006-6176 PB - American Institute of Aeronautics and Astronautics CY - Reston, Va. ER - TY - JOUR A1 - Dachwald, Bernd A1 - Seboldt, W. A1 - Lämmerzahl, W. T1 - Solar Sail Propulsion: An Enabling Technology for Fundamental Physics Missions JF - Lasers, Clocks and Drag Free Control : Exploration of Relativistic Gravity in Space / by Hansjörg Dittus ..., eds. - ( Astrophysics and Space Science Library ; 349) Y1 - 2008 SN - 978-3-540-34376-9 SP - 379 EP - 398 PB - Springer CY - Berlin [u.a.] ER - TY - JOUR A1 - Dachwald, Bernd A1 - Wi, Bong T1 - Solar Sail Kinetic Energy Impactor Trajectory Optimization for an Asteroid-Deflection Mission JF - Journal of Spacecraft and Rockets. 44 (2007), H. 4 Y1 - 2007 SN - 0022-4650 N1 - 2. ISSN: 1533-6794 SP - 755 EP - 764 ER -