Minimal change disease (MCD) and primary (idiopathic) focal segmental glomerulosclerosis (1FSGS), referred to collectively as “primary podocytopathies”, are major causes of nephrotic syndrome in children and adults, and are thought to be due to direct podocyte damage visible only at the electron microscopic level. Lupus podocytopathy (LP) is a newly recognized entity that involves severe podocyte injury in the setting of systemic lupus erythematosus, in the complete absence of peripheral capillary wall immune deposits. All of these pathologic diagnoses hinge on the ultrastructural finding of severe podocyte injury and foot process effacement. In addition to these ultrastructural changes, we have observed the presence of fine granular anti-IgG antibody immunoreactivity on podocyte cell bodies in kidney biopsies of patients with MCD, LP, and some patients with the tip lesion variant and NOS variants of 1FSGS. To validate this finding, we compared antibody staining from primary podocytopathy biopsies with those in biopsies from patients with other disease states, including lesions associated with severe podocyte injury in the absence of immune deposits: secondary (adaptive) focal segmental glomerulosclerosis, thin basement membrane disease, diabetic nephropathy, and renal amyloidosis. We found that a fine granular pattern of anti-IgG immunoreactivity on podocyte cell bodies is a specific morphologic feature of the primary podocytopathies, including virtually all cases of MCD that we encountered, some instances of tip lesion variant and NOS variant of 1FSGS, and one cases of LP. The antigen targeted by the anti-IgG immunostaining in these biopsies exhibited one of several oligoclonal IgG heavy chain subtype plus light chain profiles. Ultra-high resolution microscopy revealed fine linear anti-IgG staining along filtration slit diaphragms, suggesting that IgG deposition may potentially be targeting a filtration slit-associated antigen such as podocin. Our findings suggest the possibility of a direct antibody-mediated mechanism of podocyte injury in the primary podocytopathies, one that potentially targets podocyte-specific protein structures, and which may provide a specific and more rapid diagnostic marker for this group of diseases. The findings also suggest an etiologic relationship between MCD and some instances of 1FSGS.

In dieser Studie wurden Daten zur minimalinvasiven dorsalen Versorgung instabiler Frakturen der thorakolumbalen Wirbelsäule in Kombination mit Kyphoplastie erhoben. Das Patientenkollektiv umfasst 64 Patienten, welche im Zeitraum von 6/2009 bis 5/2011 an 67 Frakturen versorgt wurden. Das Durchschnittsalter bei Operation betrug 71,3 ± 8,9 Jahre. Es wurden hierzu die mono- und bisegmentalen Grund-Deckplatten-Winkel präoperativ, postoperativ sowie an drei Nachuntersuchungszeitpunkten (6w, 3–6m, >9m) bestimmt. Weiterhin wurden mittels der Visuellen-Analog-Skala die Beschwerden vor dem Unfall und unmittelbar vor der Operation retrospektiv erhoben. Das funktionelle Ergebnis wurde am dritten Nachuntersuchungszeitpunkt mittels der VAS-Pain und des VAS-Wirbelsäulenscores der Arbeitsgemeinschaft „Wirbelsäule“ der DGU ermittelt. Außerdem wurde nach einer regelmäßigen Schmerzmitteleinnahme zu den Zeitpunkten „vor dem Unfall“, „direkt nach dem Unfall“ und „zurzeit“ gefragt. Es konnten in anderen Studien schon einige Vorteile der minimalinvasiven dorsalen Stabilisierung hinsichtlich eines geringeren Blutverlustes, eines geringeren Gewebetraumas mit weniger postoperativer Schmerzen, einer besseren postoperativen Muskelfunktion, eines besseren kosmetischen Ergebnisses, schnellerer Mobilisierung sowie geringeren operativen Komplikationen gezeigt werden. Bisher gibt es aber keine Langzeitdaten, welche die funktionellen Ergebnisse und die Wiederaufrichtung oder den Korrekturverlust einer minimalinvasiven dorsalen Instrumentierung mit zeitgleicher Kyphoplastie von traumatischen Frakturen der thorakalen und lumbalen Wirbelsäule beschreiben. Hierbei konnten zu einem offen operierten Vergleichskollektiv keine signifikanten Unterschiede bzgl. der Wiederaufrichtung (5.2 ± 5.2 Grad perkutan vs. 6.4 ± 3.3 Grad offen, GDW bisegmental ermittelt) und des Korrekturverlustes des Grund-Deckplatten-Winkels gefunden werden (5.2 ± 5.6 Grad perkutan vs. 6.1 ± 2.4 Grad offen bei 3. NU, GDW bisegmental ermittelt). Signifikante Unterschiede ergaben sich aber bei den funktionellen Ergebnissen (VAS-Wirbelsäulenscore der Arbeitsgemeinschaft „Wirbelsäule“ der DGU) zugunsten des minimalinvasiv versorgten Kollektivs zum Zeitpunkt der dritten Nachuntersuchung. / Between 06/2009 and 05/2011 a total of 64 patients (age ⌀ 71.3 ± 8.9 y) with 67 instrumented fractures of the thoracic and lumbar spine have been included in this study. A combination of kyphoplasty and minimal invasive posterior instrumentation was carried out in all cases. The mono- and/or bisegmental endplate angle were measured preop., immediately postop., after 6w, 3-6m and >9m. The pain visual analogue scale (pain VAS) and regular analgesia requirement were determined pre- and postop., the VAS spine score, pain VAS and regular analgesia requirement also >9m. A lot of advantages of the minimal invasive posterior instrumentation have been reported in previous studies (reduction of blood loss, faster rehabilitation, less muscle atrophy, less postoperative pain, better cosmetic results) but there are no long term results concerning the functional outcome, the restoration of the sagittal profile and the loss of correction. There was no significant difference between this group (kyphoplasty + minimal invasive posterior instrumentation) in comparison to a kyphoplasty + classic open procedure group in the aspects of radiographic results. The average correction of the sagittal profile was 5.2 ± 5.2° (open procedure: 6.4 ± 3.3°). The mean loss of correction was 5.2 ± 5.6° after >9m (open procedure: 6.1 ± 2.4°). However, the minimally invasive group was found to have a significantly better functional outcome after > 9m (VAS spine score: minimal invasive 74.2 ± 19.5 vs. open procedure 57.9 ± 7.9).

In einer ständig älter werdenden Bevölkerung, in der auch die Senioren einen unverändert hohen Anspruch an ihre Lebensqualität aufrechterhalten, kommt dem Ersatz verschlissener Gelenke und hier besonders der Hüftendoprothetik eine ständig wachsende Bedeutung zu. Ausgehend von den Erfolgen der minimal-invasiven Chirurgie in anderen chirurgischen Disziplinen entwickelte sich dieser Zweig seit Beginn des Jahrtausendes auch in der Hüftchirurgie: 2005 stellte Rachbauer eine minimal-invasive Variante des seit 1887 bekannten anterioren Zugangs zur Hüfttotalendoprothesenimplantation vor. Zum kurzfristigen postoperativen Intervall existieren bereits zahlreiche Studien. Hier zeigt der anteriore Zugang entscheidende Vorteile im Vergleich zu anderen Zugängen. Hervorzuheben sind ein geringeres postoperatives Schmerzausmaß, eine kürzere stationäre Liegedauer und eine schnellere Rehabiliation. Ein gravierender Nachteil des anterioren Zugangs besteht darin, dass er aufgrund des schmalen Operationskanals eine hohe Qualifikation des Operateurs erfordert und mit einer anfänglich erhöhten Komplikationsrate vergesellschaftet sein kann. Ziel der vorliegenden Arbeit war es, die Resultate des minimal-invasiven anterioren Zugangs in einem mittelfristigen postoperativen Intervall mit den Resultaten des lateralen Zugangs, den man als eine weithin etablierte konventionelle Methode betrachten kann, zu vergleichen. Untersucht wurden 85 über einen minimal-invasiven anterioren Zugang implantierte primäre Hüfttotalendoprothesen nach durchschnittlich 3,7 Jahren post operationem, denen 86 Fälle mit einem lateralen Zugang nach durchschnittlich 5,5 Jahren entgegengestellt wurden. Beide Gruppen unterschieden sich nicht signifikant in Alter und Geschlechterverteilung. Der signifikante Unterschied der Nachuntersuchungsintervalle ist ohne Relevanz, da sich sich beide Gruppen in einer komplikationsarmen postoperativen Phase befinden, die in etwa vom 2. bis zum 10. Postoperativen Jahr geht. Die Gruppen wurden in Funktion (HHS), Aktivität (UCLA activity score), Schmerzen (abgeleitet aus dem HHS), Komplikationsraten und Gesundheitsempfinden (SF-36) miteinander verglichen. Die vorliegende Arbeit kam zu den folgenden Ergebnissen über den mittelfristigen Zeitraum: Die Unterschiede in der Funktion waren marginal, die HHS-Durchschnittswerte in beiden Gruppen waren exzellent und nicht signifikant unterschiedlich. Ebenso zeigten beide Gruppen gleichwertige Ergebnisse im subjektiven Gesundheitsempfinden (SF-36). Ein weiteres wichtiges Erfolgskriterium war die Frage nach der durch die Operation erreichten Aktivität. Hier fand sich eine Diskrepanz zwischen UCLA und TWB. Der UCLA ist zur Aktivitätsmessung weit verbreitet. Im UCLA zeigten sich die Patienten der lateralen Gruppe aktiver. Der TWB ergab gleiche Aktivität in beiden Gruppen. Nach dem eingehenden Vergleich beider Fragebögen, kamen wir in dieser Arbeit jedoch zu der Auffassung, dass der UCLA zwar als ein schnell erhebbarer Test für den klinischen Alltag praktisch ist, der wesentlich aufwendigere TWB aber zuverlässigere Ergebnisse liefert. Die Komplikationsraten waren in beiden Gruppen gering. Die Wahrscheinlichkeit, eine der erfassten Komplikationen zu erleiden, betrug 10,7% für den minimal-invasiven und 10,5% für den klassischen Zugang. Um aber nicht nur die Quantität, sondern auch die Qualität der aufgetretenen Komplikationen erfassen zu können, wurde in dieser Arbeit der Komplikationsindex eingeführt, der die registrierten Komplikationen in Gruppen verschiedener Schweregrade unterteilt. Eine schwere Komplikation floss mit 10 Punkten, eine mittlere mit 5 und eine leichte Komplikation mit einem Punkt in den Komplikationsindex ein. Der anteriore Zugang zeigte so mit insgesamt 26 Punkten einen deutlich geringeren Komplikationsindex als der laterale mit insgesamt 60 Punkten. Dem entsprach eine Reoperationsrate von 1,2% unter den anterioren Patienten im Vergleich zu 3,3% bei den lateralen. Die Schaft- und die Pfannenüberlebensrate lag in beiden Gruppen bei 100%. Zusammenfassend zeigt die vorliegende Arbeit, dass der anteriore Zugang viele Vorteile gegenüber dem lateralen Zugang aufweist. Die entscheidenden Unterschiede finden sich im kurzfristigen postoperativen Zeitraum. Zu einem mittelfristigen Zeitpunkt erzielen beide Zugänge gleichwertige Ergebnisse. Welche langfristigen Resultate das noch relativ junge Verfahren des minimal-invasiven anterioren Zugangs hervorbringen wird, muss durch künftige prospektiv randomisierte Studien großer Fallzahlen belegt werden. / In an aging society in which senior citizens expect to maintain a high quality of living the replacement of arthrotic joints and especially hip arthroplasty becomes more and more important. Influenced by the success in other surgical disciplines minimally invasive methods have been developing in hip surgery since the turn of the millennium. This dissertation aimed to compare the results of the minimally-invasive approach as introduced by Rachbauer in 2005 to the lateral approach described by Bauer. We compared 86 total hip implants 3,7 years after implantation via an anterior approach to 86 implants 5,5 years after implantation via a lateral approach. Both groups were similar in mean age and distribution of the sexes. The lengths of the postoperative intervals were significantly different, nevertheless both groups were in a postoperative phase that shows little complication rates and ranges from the second until the tenth postoperative year. The difference was therefore regarded as irrelevant. Both groups were surveyed in function (HHS), activity (UCLA activity score, TWB), pain (derived from HHS), complication rates and individual health perception (SF-36). Existing studies have shown good short term postoperative results for the anterior approach in comparision to classical approaches. Ist main advantages are lower postoperative pain, shorter length of stationary stay and shorter duration of rehabilitation. A major disadvantage oft he anterior approach is the requirement of a high skill set by the surgeon that can be linked to an initially higher probability of complications. This clinical trial found the following midterm results: There was no difference in Function and health perception between the groups. Both groups had excellent results in the HHS and similar results in the SF-36. The activity displayed by the UCLA activity score was significantly higher in the lateral group. On the contrary the TWB showed the same amount of steps in both groups. Facing this discrepancy we examined the two questionnaires and concluded that the UCLA activity score is a quickly assessable and therefore clinically easily usable questionnaire. The TWB on the other hand is considerably more difficult to assess and is very time consuming. However it is a better measurement to mirror a patient´s activity than the UCLA. Therefore we considered both groups as equal in activity. The overall complication rate was the same in both groups: 10,5% in the lateral and 10,7% in the anterior group. However there was a difference in the severity of the registered complications. In order to take in account both quantity as well as quality, we divided the registered complications into three complication groups: serious, medium and light. The complication index was then calculated by awarding 10 points to a serious, 5 to a medium and 1 point to a light complication. In this system the anterior groups gathered 26 points, whereas the lateral group had a considerably higher complication index of 60. The reoperation rate was 1,2% in the anterior group as compared to 3,3% in the lateral. The survival rate of the femoral and the acetabular components in both groups was 100%. In conclusion this clinical trial showed great advantages of the anterior approach when compared to the lateral. The deciding differences are found in the short term postoperative interval. The midterm results are similar for both approaches. It is yet to be shown what the long term results of the relatively young method of the minimally-invasive anterior approach will be. Randomised prospective clinical trials of large case numbers will have to be conducted.

Mesoporous silica crystals have a large variety of structures mainly due to the versatility of their structure template. The configuration and the chemical state of the templating micellar surfactants, together with the kinetic process of silica will determine the final outcome of the synthesis. Increasing the understanding of the complex formation processes involved will enable a possibilityto fine tune the material for specific uses, today focused into the fields of photoniccrystals, drug delivery, catalysis and separation technology. In this thesis emphasis is put on (1) increasing the understanding the formation mechanism yielding the different species of mesoporous silica crystals through an in depth study of quasicrystallinity (2) Characterization and description of the structural complexity through various characterization techniquesand also by studying the kinetic structural transformation phenomenon related to the minimal G- and D-surfaces. (3) The structural studies of the versatile surfactant liquid crystals for establishing a thermodynamically stable basis to evaluate the kinetic mesoporous silica growth processes. Furthermorethe thesis both enlightens the possibilities of and contributes to the developmentof electron microscopy characterization techniques. In these studies, electron microscopy is largely employed in the characterization to give a thorough picture of the mesoporous structures. This is combined with the sample preparation techniques cross-section polishing and ionslicing. Low voltage scanning electron microscopy is utilized for studying the surfaces and cross-sections of various materials at the limit of the resolution. Here, a deep understanding of the electron beam-material interaction is used for a better interpretation of the detected signals. Transmission electron microscopyis combined with electron crystallographic reconstruction to yield a three dimensional structural model. For determination of the quasicrystallinity level for a structure of dodecagonal tiling, revealed in the scope of this study,a phason strain analysis was made. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 7: Manuscript.</p>

System requirements: Adobe Acrobat Reader. Includes bibliographical references (p. 47-53).

Zugl.: Karlsruhe, Univ., Diss., 2009 / Hergestellt on demand. - Zusätzliches Online-Angebot unter http://uvka.ubka.uni-karlsruhe.de/shop/isbn/978-3-86644-465-2

This report presents a comprehensive review of efficacy studies for minimal contrasts therapy and maximal oppositions therapy. The target population was defined as children with phonological disorders who had no co-occurring impairments in hearing, receptive language, speech articulation, or oral-motor structure and function. Thirty three minimal contrasts studies from 1981 to 2008 and six maximal oppositions studies from 1990 to 2008 were identified. No studies from 2009 to 2012 were found. The majority of the studies were either Level III (descriptive studies, 34.2%) or Level IIb (quasi-experimental studies, 57.9%). Twenty three studies reported treatment duration, which ranged from six to 58 hours. Based on reports of treatment success and generalization to new linguistic and communicative contexts, it was found that minimal contrasts therapy has greater support in the literature. Additional studies using a uniform methodology will be needed to establish the validity of maximal oppositions therapy. Recommendations are made for future studies of minimal contrasts and maximal oppositions. / text

Minimalist music has now become ubiquitous in film, found in everything from PBS advertisements to big-budget studio movies like A Beautiful Mind. This presents a number of questions: what kind of films use the technique, how does its deployment compare to the classical Hollywood score, and how does it function? This dissertation is intended to address these issues by examining what minimalism has come to mean in films that have become part of popular culture. I detail how the musical technique intersects with the model of the classical Hollywood film score, and, by exploring the film music of Steve Reich, Terry Riley, Philip Glass, Michael Nyman, and "nonminimalist" composers, give a history of minimalism's use on the score from its avant-garde origins in the 1960s to its commercial appropriations in the 1990s and 2000s. Utilizing Nicholas Cook's idea of "enabling similarity" from his book Analysing Musical Multimedia and Rebecca Leydon's minimalist tropes from her Music Theory Online article "Toward a Typology of Musical Tropes," I provide detailed analyses of ten films employing minimalist techniques (Koyaanisqatsi, The Terminator, A.I.: Artificial Intelligence, Solaris, Kundun, A Beautiful Mind, Proof, The Truman Show, Gattaca, and The Thin Blue Line), showing how musical meaning in these films is tied to minimalism's particular stylistic attributes. Through the repeated linkage of minimalism with the Other, the mathematical mind, and dystopia, these meanings have the possibility--like the socially-encoded meanings of the classical score--of becoming enculturated. / text

The intention of this project is to research the potential of emergent technologies for developing sustainable composites for the building industry. It is divided into three parts: Part 1 Identifies emergent practices which are being applied to the development of new sustainable building prototypes such as developments using nanotechnologies, the influence of biomimetics, the development of intelligent interactive systems and the use of digital technologies to generate complex cellular structural systems. Part 2 Outlines existing processes involved in selecting and manufacturing prototypes, as many existing processes have been opportunistically applied to emergent practices to generate innovative sustainable prototypes. Part 3 By synthesising the research gathered in the previous parts of this thesis, this section documents the design process for developing a sustainable building system. The design is based on a minimal surface structure to reduce materiality and to optimise strength and its manufacturing process exploits emergent and existing technologies for its generation.

The intention of this project is to research the potential of emergent technologies for developing sustainable composites for the building industry. It is divided into three parts: Part 1 Identifies emergent practices which are being applied to the development of new sustainable building prototypes such as developments using nanotechnologies, the influence of biomimetics, the development of intelligent interactive systems and the use of digital technologies to generate complex cellular structural systems. Part 2 Outlines existing processes involved in selecting and manufacturing prototypes, as many existing processes have been opportunistically applied to emergent practices to generate innovative sustainable prototypes. Part 3 By synthesising the research gathered in the previous parts of this thesis, this section documents the design process for developing a sustainable building system. The design is based on a minimal surface structure to reduce materiality and to optimise strength and its manufacturing process exploits emergent and existing technologies for its generation.