A presente dissertação examina a cessão fiduciária do direito do acionista aos dividendos, bem como a titularidade fiduciária (garantia real) dela resultante. A razão para a análise desses institutos deve-se ao aumento no uso desta forma de garantia em operações financeiras complexas realizadas no mercado nacional. Primeiramente, é feita uma análise das diversas acepções (perfis) que o direito do acionista ao dividendo pode assumir no contexto do ordenamento jurídico nacional, para daí concluir que tal direito é passível de cessão tanto em sua condição de crédito, presente ou futuro (a depender, justamente, da existência ou não de lucros sociais já deliberados), quanto em sua condição de direito expectativo. Isto é, de direito que o acionista detém, a partir do momento em que se torna titular de ações, de vir a adquirir direitos de créditos de dividendos a serem distribuídos pela companhia de tempos em tempos. Em razão da necessidade da imediata constituição da garantia real, especialmente diante de uma eventual falência ou recuperação judicial do devedor, este trabalho conclui que a titularidade fiduciária deve recair sobre o direito expectativo aos dividendos, visto ser ele um direito já existente e que permite ao seu respectivo titular se tornar, direta e imediatamente, proprietário dos créditos de dividendos que vierem a ser futuramente distribuídos pela companhia, desde que estes estejam limitados a certos valores e/ou períodos previamente acordados entre o credor/financiador e o devedor/acionista. Ademais, apesar de ser um direito inerente à participação social, o destaque e a cessão autônoma do direito expectativo aos dividendos não conflita com o disposto no art. 28 da LSA. O presente estudo argumenta também que o credor fiduciário pode, nos termos do art. 113 da LSA, exercer certos direitos de voto na companhia, desde que (1) o objeto da garantia seja o direito expectativo aos dividendos e (2) a sua influência nas deliberações sociais restrinja-se a estabelecer a forma como o lucro social será apurado e distribuído pela sociedade. Por fim, é argumentado também que, por ser uma garantia que recai sobre direitos patrimoniais pagos em dinheiro, duas consequências imediatas revelam- se aplicáveis: (i) durante o período em que não existe qualquer inadimplemento ou vencimento regular da dívida garantida, os dividendos que vierem a ser pagos pela companhia deverão ser destinados ao acionista devedor, podendo o credor deles se beneficiar apenas quando existir o efetivo vencimento ou inadimplemento da dívida; e (ii) durante o período de inadimplemento ou na data de vencimento regular da dívida, o credor pode reter os recursos necessários à satisfação de seu crédito, desde que restitua o eventual excedente ao acionista devedor, não havendo, por isso, razão que justifique o enquadramento da excussão da garantia como sendo uma violação à proibição do pacto comissório, conforme prevista no Direito brasileiro. / This dissertation examines the fiduciary assignment of shareholders rights to dividends, as well as the fiduciary ownership (security interest) resulting from it. The reason for the analysis of these legal institutes comes from the increasing use of this type of security interest in complex financial transactions carried out in the local markets. Firstly, this works conducts the analysis of the various meanings (perspectives) which shareholders\' rights to dividends may have in different contexts of the Brazilian legal system, concluding that this right may be transferred either as a credit right, existing in the present or in the future (depending precisely on the existence of corporate profits already distributed or not), or as an expectance right. By this last one, we mean the right held by the shareholder as soon as he/she/it becomes the owner of the shares issued by a certain company that enables him/her/it to become the owner of the dividends distributed by the company from time to time. Due to the importance of the immediate granting of the security interest, especially in light of a possible bankruptcy or judicial reorganization process involving the debtor, this paper concludes that the fiduciary ownership should have the expectance right to dividends as its underlying asset. This is so because such right is already an existing right that allows the shareholder to become, directly and immediately, the owner of the dividends to be distributed by the company in the future, as long as those dividends are limited to certain amounts or periods previously agreed between the creditor/financier and the debtor/shareholder. Furthermore, despite being an inherent right to the equity stake, the detach of the expectance right to dividends from the shares which comes from, following by its assignment to other parties, does not conflict with the provision set forth in Section 28 of the Brazilian Corporation Act. This study also argues that the secured creditor may exercise certain voting rights in the company responsible for the payment of the dividends, pursuant to Section 113 of the Brazilian Corporation Act, provided that: (1) the underlying asset of the security interest is the expectance right to dividends; and (2) his/her/its influence in the companys decisions is limited to the manner according to which the corporate profits will be accounted and distributed by the company. Finally, it is also argued that, for being a security interest that has receivables as its underlying assets, two consequences turn out to be applicable. (i) Over the period in which there is no default or regular maturity of the secured debt, dividends paid by the company shall be allocated in favor of the shareholder/debtor. The creditor will be able to receive them in the maturity date or upon the occurrence of a default only. (ii) Over a default period or on the regular maturity date, the creditor may retain the necessary amount of dividends to satisfy his/her/its credit, provided that any excess cash shall be transferred to the shareholder/debtor, reason for which there are reasonable grounds to sustain that this foreclosure mechanism does not violate the non-retention of collateral assets convention rule (pacto comissório) provided under Brazilian law.

O presente trabalho tem por objetivo estudar o financiamento da política no Brasil por pessoas jurídicas, a fim de evocar os riscos que gera para o processo de escolha dos governantes e a fase governamental. A análise dessas questões dá-se por meio de quatro chaves. A primeira trata da capitalização dos partidos políticos e candidatos, a qual demanda fixação de limites por meio de ferramentas de regulação que buscam equilíbrio nas campanhas eleitorais e no financiamento das atividades dos partidos. A segunda versa sobre os dados de eleições nacionais e de pesquisas empíricas sobre o resultado da participação de pessoas jurídicas, correlacionando-o com os efeitos colaterais do financiamento, quais sejam, a corrupção e a influência do poder econômico. O exame de alguns escândalos tem relevância na atualidade, sobretudo diante da possibilidade de subsidiarem reformas que se apresentam necessárias. A terceira aborda soluções encontradas em outros países para equacionar os efeitos da participação das pessoas jurídicas, com destaque para o debate da questão atinente à liberdade de expressão. A pesquisa revela que a Justiça Eleitoral e a jurisdição constitucional brasileira tiveram papel decisivo na conformação do financiamento da política. A quarta consiste na análise crítica das regras do ordenamento brasileiro, inclusive as decorrentes da reforma política, que visam equacionar os problemas diagnosticados no estudo, e das decisões da jurisprudência que lidaram com o princípio da igualdade. Ao final, alinham-se vantagens e desvantagens do financiamento da política por pessoas jurídicas. / The present work aims to analyze the political financing by legal entities in Brazil in order to evoke the risks for the process of choosing the rulers and the period of governorship. The analysis of the issues considers four keys. The first is about the capitalization of the political parties and the candidates, which demands the fixing of limits through regulation tools to seek the balance in the electoral campaigns and in the financing of the parties activities. The second one concerns the data of the national elections and the empirical researches on the result of the participation of legal entities, correlating it with the side effects of financing, in other words corruption and the influence of the economic power. The exam of some scandals is relevant in the present time mainly considering the possibility of subsidizing reforms that are presented as necessary. The third point considers the other countries solutions to balance the effects of the legal entities contributions especially the discussion of the issue pertaining to freedom of expression. The research reveals that the Electoral Courts and the Brazilian constitutional jurisdiction had a decisive role shaping the political financing. The fourth key is the critical analyses of the Brazilian legal system, including the rules resulting from the political reform, which intended to solve the problems identified in the study, and the case law which dealt with principle of equality. In the end, there is an evaluation of the advantages and disadvantages of political financing by legal entities.

Le devenir des branches artérielles émergentes de la proximité d’un anévrysme intracrânien et couvertes par un stent à diversion de flux lors le traitement de l’anévrysme reste controversé. Une recherche animalière de caractère translationnel a été conduite afin d’élucider le rôle du flux collatéral dans les changements hémodynamiques apportés par un stent a diversion de flux. La couverture néointimale relative aux modifications hémodynamiques aux ostia de ces artères a été également évaluée. Pour atteindre notre objectif, nous avons cherché à quantifier les changements hémodynamiques dans les artères couvertes à leurs origines et à quantifier leur surface de couverture par le tissu endothélial à 3 mois après le placement du stent à diversion de flux dans un modèle animal porcin.Méthodes Suivant une analyse de pouvoir statistique a priori, deux groupes (A, B), chacun contenant sept porcs de race large white, ont été créés, suivant un modèle de flux de circulation artérielle terminale ou anastomotique. Groupe A correspondait à une configuration artérielle de type anastomotique pour l’artère Pharyngienne ascendante droite et groupe B à une configuration terminale concernant la même branche ; cette configuration terminale a été créée par l’occlusion endovasculaire sélective des apports artériels collatéraux pour le territoire de suppléance de l’artère Pharyngienne ascendante droite. Ensuite, pour chacun des 14 animaux, un stent à diversion de flux a été placé dans la carotide interne droite couvrant ainsi l’ostium de l’artère pharyngienne ascendante homolatérale. Pour mesurer les vélocités à l’origine de cette artère, une séquence IRM de contraste de phase tridimensionnelle avec une résolution temporelle (4D) a été utilisée. Des valeurs ont été obtenues avant et après stenting. Trois mois plus tard, un travail de prélèvement anatomique suivi d’une analyse par microscopie à balayage anatomique a été a été réalisé. Une quantification surfacique a été ainsi obtenue permettant de déterminer la perméabilité des ostia des artères pharyngienne ascendante. Les données ont été ainsi analysées grâce à des tests de statistique descriptive et comparative des deux groupes prédéterminés. Des tests paramétriques et non paramétriques ont également été obtenus. Résultats La faisabilité a pu être obtenue dans tous les spécimens utilisés. Nous n’avons déploré aucune mortalité immédiate ni aucune occlusion intra-stent relatives à la procédure. Les séquences IRM de diffusion ont témoigné de l’absence d’ischémie distale à la phase aigue après la mise en place du stent, Immédiatement, en post stenting, le flux moyen dans les artères pharyngiennes ascendantes droites du groupe a été réduit d’une façon significative, quand on le compare à la valeur moyenne en pré- stenting [P = 0.0008, pouvoir statistique: 0.9548]. Au contraire, le flux moyen dans les artères pharyngiennes ascendantes droites du groupe B est resté comparable à la valeur moyenne pré- stenting. Apres trois mois de suivi, la valeur moyenne de surface perméable était significativement plus élevée dans le groupe B (527,911 ± 306,229 μm2) que dans le groupe A (89,329 ± 59,762 μm2) [P< 0.01, power: 1.00], malgré la similarité les dimensions artérielles initiales (pré-stenting) dans les deux groupes. Une corrélation positive significative a été retrouvée entre les deux groupes concernant le flux moyen post stenting et la surface moyenne de couverture aux ostia, à trois mois de suivi. / The outcome of jailing arterial branches that emerge near intracranial aneurysms during flow-diverting stent deployment remains controversial. We report an animal research study aiming to elucidate the role of collateral supply in the hemodynamic changes and neointimal modifications resulting from jailing arteries with flow-diverting stents. To serve this purpose, we sought to quantify the hemodynamic changes at the jailed arterial branches immediately after stenting, as well as quantify the ostia surface values at three months post-stenting, in the presence or absence of collateral arterial flow. Methods After a priori power analysis, two groups (A, B), each containing seven large white swine, were created according to an animal flow model for terminal and anastomotic arterial circulation. Group A corresponded to an arterial configuration with anastomotic type of arterial supply for the territory of the right Ascending Pharyngeal artery (APhA) and group B to an arterial configuration of terminal type of arterial supply for the territory of the right APhA. Subsequently, all animals were stented by flow-diverting stents, jailing the right ascending pharyngeal arteries. Mean flow rates and velocities inside the jailed branches were quantified before and after stenting by time-resolved, 3D, phase contrast MRA. After three months the jailed ostia surface values were quantified on scanning electron microscopic images. The data were analyzed using descriptive statistics and group comparisons with parametric and non-parametric tests.Results Endovascular procedures were feasible, without in situ thrombus formation or ischemic DWI findings on post-procedure MRIs. Immediately following stenting, mean flow rate values at the jailed right ascending pharyngeal arteries were reduced in group A, as compared to the pre-stenting values [P = 0.0008, power: 0.9548]. In contrast, mean flow rates for group B remained similar to the pre-stenting values. At three months post-stenting, mean ostia surface values were significantly higher for group B (527,911 ± 306,229 μm2) than for group A (89,329 ± 59,762 μm2) [P< 0.01, power: 1.00], even though the initial dimensions of the jailed ostia were similar between groups. A statistically significant correlation was found between group (A or B), mean flow rates post-stenting and ostia surface values at three months. ConclusionWhen important collateral supply was present, jailing side arteries with flow-diverters resulted in an immediate, significant reduction in flow rate inside these arteries, as compared to the pre-stenting values. In contrast, when competitive flow was absent, jailing did not result in significant flow rate reductions inside the jailed arteries. Ostium surface values at three months were significantly higher in the terminal group of jailed arteries, compared to the anastomotic group and strongly correlated with the velocity value reductions post- stenting. Key words: flow-diverting stent, collateral arteries, endothelialization, ostium, embolization, magnetic resonance angiography, magnetic resonance imaging

本研究建立含資產價格泡沫的隨機動態一般均衡 (Dynamic Stochastic General Equilibrium, DSGE) 模型，並以此討論貨幣政策與總體審慎政策的效果。泡沫存在於不動產的股票價格上，且不動產與一般資本皆為生產要素。研究顯示，在隨機衝擊下，一般資本的投資與不動產投資呈現負相關。融資擔保率的調控為總體審慎政策的範疇，本文另研究融資擔保率對經濟變數的影響。結果顯示，當擔保率調升時，產出增加、泡沫減少且不動產的股價 (資產價格) 下跌。本文亦討論依循泰勒法則下的貨幣政策與總體審慎政策對產出與資產價格波動的影響；結果顯示，在經濟景氣時實施緊縮貨幣政策可同時減少資產價格與產出的波動，其效果優於總體審慎政策。 / This study established a Dynamic Stochastic General Equilibrium (DSGE) model, which contains asset bubble price, and employed DSGE to discuss the effect of the monetary policy and the macro-prudential policy. Bubbles exist in the stock price of the real estate. Real estate and general capital are both the factors of production. The study indicates that, under stochastic impulse, a negative correlation exists between the investment of the general capital and the investment of the real estate. The study also discusses the operation of the collateral rate, a perspective dealing with macro-prudential policy, and how it influences economic variables. The results present that when collateral rate rises, output increases, bubbles decreases and the stock price of real estate (asset price) declines. The study further investigates how monetary policy, which follows the Taylor rule, and macro-prudential policy affect the vibration of the output and the asset price. The result indicates that during economic prosperity, the implementation of tight monetary policy presents better effect than that of macro-prudential policy since it simultaneously decreases variances of output and asset price.

Submitted by Diogo Dias Teixeira (diogo@diasteixeira.com.br) on 2018-09-20T13:37:10Z No. of bitstreams: 1 20180920_trabalho_fgv_mestrado_vbibliotecadigital.doc: 333312 bytes, checksum: 4f9a22b754d1680d460aecd790f0e492 (MD5) / Rejected by Joana Martorini (joana.martorini@fgv.br), reason: Prezado Diogo, bom dia. Para aprovação de seu trabalho deverá ajustar as seguintes informações: 1- Submeter o trabalho em PDF 2- A palavra Getulio deverá estar sem acento. 3- Deverá inserir a baixo da ficha catalográfica o nome da pessoa que fez. Após os ajustes, submeter novamente. Att, Joana Alves on 2018-09-20T15:59:11Z (GMT) / Submitted by Diogo Dias Teixeira (diogo@diasteixeira.com.br) on 2018-09-20T16:46:21Z No. of bitstreams: 1 20180920_trabalho_fgv_mestrado_vbibliotecadigital.pdf: 614398 bytes, checksum: e1cf1d91b93e92fc7faf72b87bb655dc (MD5) / Approved for entry into archive by Joana Martorini (joana.martorini@fgv.br) on 2018-09-20T18:05:42Z (GMT) No. of bitstreams: 1 20180920_trabalho_fgv_mestrado_vbibliotecadigital.pdf: 614398 bytes, checksum: e1cf1d91b93e92fc7faf72b87bb655dc (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-09-21T12:18:58Z (GMT) No. of bitstreams: 1 20180920_trabalho_fgv_mestrado_vbibliotecadigital.pdf: 614398 bytes, checksum: e1cf1d91b93e92fc7faf72b87bb655dc (MD5) / Made available in DSpace on 2018-09-21T12:18:58Z (GMT). No. of bitstreams: 1 20180920_trabalho_fgv_mestrado_vbibliotecadigital.pdf: 614398 bytes, checksum: e1cf1d91b93e92fc7faf72b87bb655dc (MD5) Previous issue date: 2018-08-22 / O presente trabalho visa contribuir para a solução de questões inerentes à implementação de transações cujas obrigações estão, total ou parcialmente, garantidas por marcas, mediante alienação fiduciária, mais especificamente em relação aos possíveis impactos e obstáculos oriundos da legislação especial que regula a propriedade industrial, notadamente os pressupostos de legitimidade e universalidade da cessão, constantes dos artigos 134 e 135 da Lei 9.279/96, respectivamente. A primeira parte do trabalho expõe as restrições impostas pela legislação especial em casos de cessão de marcas, consubstanciadas nas exigências de ter o cessionário atividade compatível com a marca objeto da transação e ter todas as marcas idênticas ou similares contempladas na transação, e relaciona essas restrições à alienação fiduciária de marcas em garantia, que em alguma medida também envolve a transferência de determinados direitos do devedor para o credor fiduciário, o qual, por sua vez, muitas vezes não tem objeto social compatível com a marca tomada em garantia e não inclui na operação todas as marcas idênticas ou similares de titularidade do devedor. A segunda parte do trabalho estabelece uma comparação entre a cessão de marcas e a alienação fiduciária de marcas em garantia com o intuito de verificar se a equiparação é juridicamente adequada. Desse modo, visa essa etapa do estudo esclarecer se a legitimidade do credor e a universalidade da cessão são restrições de observância obrigatória para que se alcance todos os efeitos inerentes à propriedade fiduciária de marcas. Na terceira parte deste trabalho são apresentadas as conclusões e os efeitos práticos delas decorrentes, como aqueles oriundos da excussão da garantia e aqueles relacionados ao registro ou anotação do instrumento de garantia. / The value of most companies is currently related to their intangible assets, especially to their intellectual property rights. Among all of the available intellectual property assets, trademarks play a crucial role, not only in the composition of the company’s market value, but also in regards to its financing, often being used as a collateral to secure obligations (mainly within secured loans) and, thus, aiding the company to obtain financial resources from third parties. The Brazilian Law offers certain types of security interests, but only a few of them are compatible with intellectual property assets. From the compatible types, there is a singular form of pledge (fiduciary transfer) that results in the assignment of some of the ownership rights related to the trademark that has been adopted as a collateral. Due to its peculiar characteristics, the implementation of such fiduciary transfer may incur in a few legal issues – restrictions generally applied to trademark assignments - and the parties may be required to obtain a deeper understanding of such legal limitations if they intent to lawfully perform this specific kind of transaction. In this sense, the study aims to establish a proper and solid comparison between the referred pledge and a conventional trademark assignment, with the main objective of guiding practitioners through a path that overcomes possible legal restrictions. Furthermore, this study also covers the perfection of such security interest and its proceedings.

This diploma thesis deals with financial issues of immovable property acquision. Specifically, the residential property purchase using mortgage. In this context, the suitability of the collateral is being assessed on the basis of a risk assessment. Subsequently, I determine the collateral value of the property using the comparative valuation method. The practical part includes financial records of six banks and an analysis of a selected segment of the residential real estate market. The theoretical part deals with immovable property valuation, the definition of entities in the real estate market and mortgage mechanism. The main output of the practical part is offered mortgage loans comparison and selection the most favourable of them.

Ziel der Studie war es zu analysieren, welchen Einfluss eine angiographisch sichtbare Kollateralisierung vor Revaskularisation bei Patienten mit einem akuten ST-Elevations-Myokardinfarkt (STEMI) und primärer perkutaner Koronarintervention (PCI) auf verschiedene in der kardialen Magnetresonanztomographie messbare Parameter und auf die klinische Prognose hat. Es wurden 235 Patienten mit STEMI und einem Symptombeginn <12 Stunden in die Analyse eingeschlossen. Alle Patienten wiesen einen funktionell insuffizienten antegraden Fluss in der Infarktarterie auf. Die Patienten wurden in zwei Gruppen unterteilt: Gruppe A mit fehlender oder nur geringer Kollateralversorgung (n=166) und Gruppe B mit einer signifikanten Kollateralisierung (n=69). Es wurden Infarktgröße, mikrovaskuläre Obstruktion und linksventrikuläre Funktion mittels Magnetresonanztomographie im Median 3 Tage nach dem Infarktereignis bestimmt sowie die Patienten über einen Zeitraum von >2 Jahren nachbeobachtet. Das Ausmaß der frühen mikrovaskulären Obstruktion war in Gruppe B signifikant geringer (3,3% gegenüber 2,1% der linksventrikuläre Masse, p = 0,009). Die mittels maximaler Kreatinkinase-MB-Ausschüttung gemessene Infarktgröße war in Gruppe B kleiner (p=0,02). Bei 227 Patienten (97%) wurde nach im Median 2,2 Jahren eine klinische Verlaufskontrolle durchgeführt. Insgesamt starben während des Kontrollzeitraums 25 Patienten: 22 Patienten (13,8%) der Gruppe A mit fehlender oder nur schwacher Kollateralisierung und 3 Patienten (4,4%) der Gruppe B mit signifikanter Kollateralversorgung vor Behandlungsbeginn (p=0,04). In Gruppe A traten 12 (7,5%) nicht-tödliche Reinfarkte auf im Vergleich zu 2 (2,9%) in Gruppe B (p=0,18). Ein kombinierter Endpunkt aus Tod oder nicht-tödlichem Reinfarkt trat in Gruppe B signifikant seltener auf als in Gruppe A (p=0,02). Zusammenfassend lässt sich formulieren, dass gut ausgebildete Kollateralgefäße vor einer Revaskularisation mittels PCI bei Patienten mit akuten STEMI mit einer schützenden Wirkung auf die koronare Mikrozirkulation und einem besseren Langzeit-Überleben assoziiert sind.:1 BIBLIOGRAPHISCHE BESCHREIBUNG 2 ABKÜRZUNGSVERZEICHNIS 3 EINFÜHRUNG 4 AUFGABENSTELLUNG 5 MATERIALIEN UND METHODEN 5.1 Überblick über das Studiendesign 5.2 Koronarintervention 5.3 Enzymatische Infarktgröße 5.4 Kardiale Magnetresonanztomographie 5.4.1 Linksventrikuläre Volumina und Ejektionsfraktion 5.4.2 Infarktgröße 5.4.3 Mikrovaskuläre Obstruktion 5.5 Klinisches Follow-up 5.6 Statistik 6 ERGEBNISSE 6.1 Patientencharakteristika 6.2 Enzymatische Infarktgröße 6.3 Magnetresonanztomographie 6.4 Klinische Ereignisse im Langzeitverlauf 6.5 Prädiktoren klinischer Ereignisse 6.5.1 Univariate Cox-Regressions-Analyse 6.5.2 Multivariate Cox-Regressions-Analyse 6.6 Klinische Ergebnisse in Abhängigkeit von der Zeit zwischen Symptombeginn und Reperfusion 6.7 Magnetresonanztomographische Ergebnisse in Abhängigkeit von der Zeit zwischen Symptombeginn und Reperfusion 7 DISKUSSION 7.1 Limitationen 8 ZUSAMMENFASSUNG DER ARBEIT 9 LITERATURVERZEICHNIS 10 DANKSAGUNG 11 ERKLÄRUNG ÜBER DIE EIGENSTÄNDIGE ABFASSUNG DER ARBEIT 12 LEBENSLAUF 13 PUBLIKATIONEN

Ziel der Studie war es zu analysieren, welchen Einfluss eine angiographisch sichtbare Kollateralisierung vor Revaskularisation bei Patienten mit einem akuten ST-Elevations-Myokardinfarkt (STEMI) und primärer perkutaner Koronarintervention (PCI) auf verschiedene in der kardialen Magnetresonanztomographie messbare Parameter und auf die klinische Prognose hat. Es wurden 235 Patienten mit STEMI und einem Symptombeginn <12 Stunden in die Analyse eingeschlossen. Alle Patienten wiesen einen funktionell insuffizienten antegraden Fluss in der Infarktarterie auf. Die Patienten wurden in zwei Gruppen unterteilt: Gruppe A mit fehlender oder nur geringer Kollateralversorgung (n=166) und Gruppe B mit einer signifikanten Kollateralisierung (n=69). Es wurden Infarktgröße, mikrovaskuläre Obstruktion und linksventrikuläre Funktion mittels Magnetresonanztomographie im Median 3 Tage nach dem Infarktereignis bestimmt sowie die Patienten über einen Zeitraum von >2 Jahren nachbeobachtet. Das Ausmaß der frühen mikrovaskulären Obstruktion war in Gruppe B signifikant geringer (3,3% gegenüber 2,1% der linksventrikuläre Masse, p = 0,009). Die mittels maximaler Kreatinkinase-MB-Ausschüttung gemessene Infarktgröße war in Gruppe B kleiner (p=0,02). Bei 227 Patienten (97%) wurde nach im Median 2,2 Jahren eine klinische Verlaufskontrolle durchgeführt. Insgesamt starben während des Kontrollzeitraums 25 Patienten: 22 Patienten (13,8%) der Gruppe A mit fehlender oder nur schwacher Kollateralisierung und 3 Patienten (4,4%) der Gruppe B mit signifikanter Kollateralversorgung vor Behandlungsbeginn (p=0,04). In Gruppe A traten 12 (7,5%) nicht-tödliche Reinfarkte auf im Vergleich zu 2 (2,9%) in Gruppe B (p=0,18). Ein kombinierter Endpunkt aus Tod oder nicht-tödlichem Reinfarkt trat in Gruppe B signifikant seltener auf als in Gruppe A (p=0,02). Zusammenfassend lässt sich formulieren, dass gut ausgebildete Kollateralgefäße vor einer Revaskularisation mittels PCI bei Patienten mit akuten STEMI mit einer schützenden Wirkung auf die koronare Mikrozirkulation und einem besseren Langzeit-Überleben assoziiert sind.:1 BIBLIOGRAPHISCHE BESCHREIBUNG 2 ABKÜRZUNGSVERZEICHNIS 3 EINFÜHRUNG 4 AUFGABENSTELLUNG 5 MATERIALIEN UND METHODEN 5.1 Überblick über das Studiendesign 5.2 Koronarintervention 5.3 Enzymatische Infarktgröße 5.4 Kardiale Magnetresonanztomographie 5.4.1 Linksventrikuläre Volumina und Ejektionsfraktion 5.4.2 Infarktgröße 5.4.3 Mikrovaskuläre Obstruktion 5.5 Klinisches Follow-up 5.6 Statistik 6 ERGEBNISSE 6.1 Patientencharakteristika 6.2 Enzymatische Infarktgröße 6.3 Magnetresonanztomographie 6.4 Klinische Ereignisse im Langzeitverlauf 6.5 Prädiktoren klinischer Ereignisse 6.5.1 Univariate Cox-Regressions-Analyse 6.5.2 Multivariate Cox-Regressions-Analyse 6.6 Klinische Ergebnisse in Abhängigkeit von der Zeit zwischen Symptombeginn und Reperfusion 6.7 Magnetresonanztomographische Ergebnisse in Abhängigkeit von der Zeit zwischen Symptombeginn und Reperfusion 7 DISKUSSION 7.1 Limitationen 8 ZUSAMMENFASSUNG DER ARBEIT 9 LITERATURVERZEICHNIS 10 DANKSAGUNG 11 ERKLÄRUNG ÜBER DIE EIGENSTÄNDIGE ABFASSUNG DER ARBEIT 12 LEBENSLAUF 13 PUBLIKATIONEN

We prospectively evaluated 30 consecutive patients with echo-enhanced transcranial color-coded duplexsonography (TCCD) and correlative transfemoral digital subtraction angiography to assess the diagnostic efficacy of echo-enhanced TCCD for evaluation of collateral pathways through the circle of Willis in patients with limited acoustic bone windows and critical symptomatic carotid disease. Echo-enhanced TCCD detected collateral blood flow through the anterior communicating artery in 16 of 18 patients (sensitivity 89%, 95% CI 65–99%) and was false positive in one out of 12 patients without collateral flow (specificity 92%, 95% CI 59–100%). For the posterior communicating artery, sensitivity was 11/14 (79%, 95% CI 49–95%) and specificity was 15/16 (94%, 95% CI 70–100%). Echo-enhanced TCCD enables to study collateral blood flow through the communicating arteries of the circle of Willis with high sensitivity and specificity in patients with obstructions of the internal carotid artery and limited acoustic bone windows. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

La contrazione della formazione di imprese dopo la crisi finanziaria del 2008 è stata in parte determinata dall'inasprimento degli standard creditizi. Incorporare l'imperfezione del mercato del credito nei modelli DSGE è diventato un passo essenziale verso una migliore spiegazione di tali risultati. Nel primo capitolo, indago sul ruolo del finanziamento esterno nella creazione d'impresa. Sottolineo l'impatto del potere di mercato delle banche e la presenza di dispersione tra i tassi di interesse dei grandi e dei piccoli prestiti all'ingresso. Pertanto, sviluppo un modello DSGE che collega l'ingresso dell'impresa al sistema bancario imperfetto e introduco costi di prestito eterogenei per operatori storici e nuovi. Il modello prevede un impatto amplificato degli shock reali e finanziari e mostra una maggiore volatilità man mano che lo spread dei tassi di interesse si allarga. In linea con l'evidenza, la versione sticky-price produce un'entrata prociclica in risposta allo shock monetario espansivo. Nel secondo capitolo, mi concentro sull'interazione tra i prezzi delle case, le insolvenze sui prestiti e l'ingresso di imprese. Presento prove SVAR che rivelano una risposta prociclica positiva della nascita allo shock dei prezzi delle case e una reazione negativa alle inadempienze sui prestiti. Quindi sviluppo un modello DSGE in grado di prevedere e spiegare queste risposte. L'endogeneità del vincolo collaterale e della creazione d'impresa è al centro del meccanismo del modello. Il modello genera dei secondi momenti ragionevolmente vicini alle controparti dei dati. / The contraction of business formation after 2008 financial crisis was driven partly by the tightened credit standards. Incorporating credit market imperfection to DSGE models became an essential step towards better explaining such outcomes. In the first chapter, I investigate the role of external financing in firm creation. I highlight the impact of bank market power, and the presence of dispersion between interest rates of large and small loans on entry. Therefore, I develop a DSGE model linking firm entry to imperfect banking system, and introduce heterogeneous borrowing costs for incumbents and entrants. The model predicts amplified impact of real and financial shocks, and exhibits higher volatility as the spread in interest rates gets wider. In line with evidence, the sticky-price version produces pro-cyclical entry in response to expansionary monetary shock. In the second chapter, I focus on the interaction between house prices, loan defaults, and firm entry. I present SVAR evidence that reveals positive pro-cyclical response of birth to house price shock, and negative reaction to loan defaults. Then I develop a DSGE model that is able to predict and explain these responses. The endogeneity of collateral constraint and firm creation is in the core of the model’s mechanism. The model generates some second moments that are reasonably close to their data counterparts.