INTRODUÇÃO: A nefrectomia radical está associada com algum grau de comprometimento da função do rim remanescente em pacientes com câncer renal. A etiologia da insuficiência renal crônica (IRC) nesses casos é complexa, tem prevalência relativamente alta e existem poucas alternativas terapêuticas quando ela se estabelece. Métodos que permitem prever o aparecimento desse quadro e possibilitem condutas terapêuticas que minimizem e retardem a perda de função renal são altamente desejáveis. OBJETIVOS: Em pacientes submetidos à nefrectomia radical: 1. Objetivo primário: Avaliar o impacto de alterações do parênquima renal não neoplásico, dados demográficos, clínicos e laboratoriais sobre o desenvolvimento de insuficiência renal crônica. 2. Objetivo secundário: Correlacionar alterações do parênquima renal não neoplásico, dados demográficos, clínicos e laboratoriais com a variação da taxa de filtração glomerular estimada pré e pós-operatória. MÉTODOS: Foram selecionados 65 pacientes submetidos à nefrectomia radical por quadros de carcinoma de células renais. Nesses casos, procedeu-se a análise histológica do parênquima renal não neoplásico e as alterações encontradas foram correlacionadas com o aparecimento subsequente de IRC. Para avaliação da função renal, foi utilizada a taxa de filtração glomerular estimada (TFGe) por meio da fórmula MDRD (Modification of Diet in Renal Disease) pré-operatória e última consulta. O estado do parênquima renal não neoplásico foi avaliado por meio de parâmetros histológicos: 1. Presença de glomerulosclerose, calculada pelo número total de glomérulos escleróticos dividido pelo número total de glomérulos avaliados, e expressa em porcentagem e presença de glomérulos hialinizados; 2. Alterações vasculares com a presença de arteriolosclerose. A extensão da oclusão arterial foi quantificada em três grupos: menos de 25%, 26% a 50% e acima de 50%. 3. Presença de fibrose intersticial e atrofia tubular. O impacto destas alterações no comportamento da função renal foi avaliado por meio do desenvolvimento IRC, definida com uma TFGe menor que 60ml/minuto/1,73m2 na avaliação mais recente e de acordo com os protocolos do Kidney Disease Outcomes Quality Initiative. RESULTADOS: Após um seguimento médio de 49,06 meses, foi observado uma queda média de 26,52% na função renal nos pacientes submetidos à nefrectomia radical. Trinta e cinco dos 65 pacientes evoluíram para IRC. Em uma análise univariada, presença de glomerulosclerose (OR=3,8), arteriosclerose (OR=3.3), fibrose intersticial (OR=3.8), hipertensão arterial (OR=3.7), Diabetes Mellitus (OR=11.6) e idade maior que 60 anos (OR=3.4) associaram-se à evolução para IRC (p < 0.05). Em uma regressão logística multivariada, índice de comorbidade de Charlson (OR= 2,3), GS (OR= 1,2) e TFGe pré-operatória (OR= 0,96) foram estatisticamente significantes. Para cada 2,5% de aumento de alterações glomérulos, houve uma diminuição percentual de 28% da TFGe. CONCLUSÕES: Alterações histológicas do parênquima renal não neoplásico e parâmetros clínicos podem ser utilizados para predizer pacientes que evoluirão para IRC após uma nefrectomia radical / INTRODUCTION: Radical nephrectomy is inevitably associated with a variable renal function decrease. Chronic Kidney disease (CKD) is highly prevalent and there are few options for treatment in end stage CKD. The goal, as urologist, should be on optimizing renal function after surgery and not just avoiding dialysis. OBJECTIVES: In patients submitted to radical nephrectomy: 1. Primary objective: Assess the association of histopathological parameters in non-neoplastic renal parenchyma with new onset chronic kidney disease after surgery. 2. Secondary objective: Assess the association of demographic and clinical parameters with new onset chronic kidney disease after surgery. METHODS: Data were extracted from 65 patients who underwent radical nephrectomy. Using The MDRD (Modification of Diet in Renal Disease) formula, we calculated the estimated glomerular filtration rate preoperatively and at last follow-up. The study end point was development of CKD, defined as an estimated glomerular filtration rate (eGFR) of less than 60ml/minute/1,73m2. A renal pathologist assessed three histological features in the nonneoplastic parenchyma, including global glomerulosclerosis, arteriosclerosis, interstitial fibrosis and tubular atrophy. For glomerulosclerosis assessment, the percent of affected glomeruli was determined. Arteriosclerosis or the extent of arterial luminal occlusion was graded into three groups, including 1-0% to 25%, 2-26% to 50% and 3-greater than 50%. Interstitial fibrosis and tubular atrophy were evaluated as absent/present. RESULTS: After a mean follow-up of 49,06 months, the eGFR rate decreased 26,52% after radical nephrectomy. Thirty five patients developed CKD. In a univariate analysis, the incidence of CKD was associated with glomerulosclerosis (OR=3,8), interstitial fibrosis (OR=3,8), arteriosclerosis (OR=3,3), hypertension (OR=3,7), Diabetes Mellitus (OR=11,6) and age (OR=3,4) after surgery. In a multivariate analysis, Charlson comorbidity index (OR= 2,3), glomerulosclerosis (OR= 1,2) and baseline eGFR(OR= 0,96) were associated with new onset CKD after radical nephrectomy. For each 2,5% increase in glomerular abnormality the eGFR rate decreased 28% from baseline. CONCLUSIONS: Histologic findings in the nonneoplasic tissue, in addition to clinical parameters, can be used to predict which patients are more likely to develop CKD after radical nephrectomy

Yazghulami is a South-East Iranian language spoken in the Pamir area of Tajikistan by about 9000 people. This study gives an account of the phonology of the language by describing contrastive segments and their distribution and realizations, as well as describing suprasegmental features such as syllable structure and stress patterns. Field research was carried out in a community of Yazghulami speakers in Dushanbe, the capital of Tajikistan, by recording, transcribing and annotating spoken language. Yazghulami is analyzed as having 8 vowel phonemes of which one pair contrasts in length, and 36 consonant phonemes with a considerable display of palatal, velar and uvular phonemes, of which a set of three labialized plosives and three labialized fricatives is found. The syllable structure of Yazghulami allows for clusters of no more than two consonants in the onset and two in the coda; clusters in both positions do not occur in one and the same syllable. The stress generally falls on the last syllable of a word, although when nouns are inflected with suffixes, the stress instead falls on the last syllable of the stem. With these results, a foundation for further efforts to develop and increase the status of this endangered language is laid. / Yazghulami är ett sydöst-iranskt språk som talas i Pamirområdet i Tadzjikistan av cirka 9000 personer. Studien redogör för språkets fonologi genom beskrivning av dess kontrastiva segment och hur dessa distribueras och realiseras, samt en beskrivning av dess suprasegmentella drag så som stavelsestruktur och betoningsmönster. Fältstudier bedrevs bland yazghulami-talare i Dusjanbe, Tadzjikistans huvudstad, genom inspelning, transkribering och annotering av talat språk. Analysen visar på att yazghulami har 8 vokalfonem, där ett par kontrasterar i längd, och 36 konsonantfonem med en nämnvärd uppsättning av palatala, velara och uvulara fonem, varav ett set med tre labialiserade klusiler och tre labialiserade frikativor. Stavelsestrukturen i yazghulami tillåter kluster med upp till två konsonanter i ansatsen och två i kodan, men kluster förekommer inte i båda positioner inom en och samma stavelse. Betoningen faller generellt på den sista stavelsen av ett ord, men för substantiv böjda med suffix faller betoningen istället på den sista stavelsen i stammen. Dessa resultat kommer ligga till grund för vidare arbete med att utveckla och öka statusen av detta hotade språk.

This study examines the influence of formal L2 English instruction (FEI) onpronunciation accuracy of similar and new vowels in the framework of Flege’s SpeechLearning Model (Flege, 1995a, 1999, 2002), focusing on selected segmentalpronunciation features produced by native German speakers. A spectral vowelproduction experiment was carried out with 24 German students who attend sixth, ninthand twelfth grade of a south German secondary school by the time this study wasconducted. Spectral characteristics of the similar vowel /ɛ/ and the new vowel /æ/,produced by each subject of the three groups (G6, G9, and G12), were compared tovowel data of native English speakers. In order to test the influence of formalinstruction on selected phonetic segments, which are known to cause difficulties fornative German learners of English, three native English listeners judged on a three pointscale the intelligibility of the segments produced. The results of the vowel experimentshowed significant influence of FEI on pronunciation accuracy of some characteristicsof the similar vowel /ɛ/ but not of the new vowel /æ/. The listener rating experimentshowed that FEI had on average no influence on pronunciation accuracy of the three L2English learner groups.

This study examines the influence of formal L2 English instruction (FEI) on pronunciation accuracy of similar and new vowels in the framework of Flege’s Speech Learning Model (Flege, 1995a, 1999, 2002), focusing on selected segmental pronunciation features produced by native German speakers. A spectral vowel production experiment was carried out with 24 German students who attend sixth, ninth and twelfth grade of a south German secondary school by the time this study was conducted. Spectral characteristics of the similar vowel /ɛ/ and the new vowel /æ/,produced by each subject of the three groups (G6, G9, and G12), were compared to vowel data of native English speakers. In order to test the influence of formal instruction on selected phonetic segments, which are known to cause difficulties for native German learners of English, three native English listeners judged on a three pointscale the intelligibility of the segments produced. The results of the vowel experiment showed significant influence of FEI on pronunciation accuracy of some characteristics of the similar vowel /ɛ/ but not of the new vowel /æ/. The listener rating experiment showed that FEI had on average no influence on pronunciation accuracy of the three L2 English learner groups.

This thesis deals with description of human hearing, audio and speech codecs, description of objective measure of quality and practical comparison of codecs. Chapter about audio codecs consists of description of lossless codec FLAC and lossy codecs MP3 and Ogg Vorbis. In chapter about speech codecs is description of linear predictive coding and G.729 and OPUS codecs. Evaluation of quality consists of description of segmental signal-to- noise ratio and perceptual evaluation of quality – WSS and PESQ. Last chapter deals with description od practical part of this thesis, that is comparison of memory and time consumption of audio codecs and perceptual evaluation of speech codecs quality.

The thesis deals with single channel and multiple channel algorithms for speech enhancement. The goal of this work is to perform the deep analysis of both single channel and multiple channel algorithms in sense of their behaviour in noisy environment of combat vehicles and platforms. Based on this analysis a new composite speech enhancement algorithm will be designed. This new approach is expected to increase quality of the processed speech in military communications systems. These systems are characterised by their operation under very noisy conditions where background noise is very high and signal-to-noise ratio extremely low. These noisy conditions are typical for the range of military and combat platforms and vehicles.

Background: In a retrospective study, risk factors for complications after the bridging of mandibular defects using reconstruction plates were reviewed. Especially the loosening of the plate-screw-mandible complex should be analyzed with a finite element model in order to reduce plate complications in future. Patients and Methods: We examined 60 patients who underwent a treatment with reconstruction plates after tumor resection during a period of 10 years. The problem of screw loosening was additionally reviewed by means of a finite element study, and a model for the loosening process was developed. Results: Our postoperative examination showed that 26 patients suffered from complications that required an early removal of the plate. These complications were oral or extraoral plate exposures, the looseness of screws with or without plate displacement, and plate fractures. Thereby, we noticed that maxillary and mandibular areas of opposing teeth, the size of the mandible defect, and the crossing of the orofacial midline are all risk factors for plate complications. On the basis of the finite element model, a modified arrangement of the screws was derived. Hence, a new type of resection plate was established. Conclusions: By repositioning the screw holes along the long axis of the plate, the transition from tensile force to torque force of the screws in the screw-plate-bone complex can be minimized. Thereby, the complication of screw loosening will be considerably reduced. / Hintergrund: In einer retrospektiven Studie wurden Risikofaktoren für Komplikationen nach Überbrückung von Unterkieferdefekten mit Rekonstruktionsplatten geprüft. Insbesondere die Lockerungsvorgänge des Schrauben- Platten-Unterkiefer-Verbundes sollten mit einer Finite- Elemente-Modellierung analysiert werden, um in Zukunft eine Reduzierung der Plattenkomplikationen erreichen zu können. Patienten und Methoden: Es wurden 60 Patienten untersucht, welche im Zeitraum von 10 Jahren im Rahmen von Tumoroperationen mit Rekonstruktionsplatten versorgt wurden. Das Problem der Lockerung der Plattenschrauben wurde zusätzlich mittels einer Finite-Elemente-Studie überprüft und ein Modell für den Lockerungsvorgang erarbeitet. Ergebnisse: Die Nachuntersuchungen ergaben, dass bei 26 Patienten die Platte wegen Komplikationen vorzeitig entfernt werden musste. Die Komplikationen traten als orale und extraorale Plattenfreilage, als Schraubenlockerung ohne oder mit Plattendislokationen und als Plattenbrüche auf. Dabei konnte festgestellt werden, dass bestehende Stützzonen des körpereigenen Restgebisses, die Größe des Unterkieferdefektes und dessen Mittellinienüberschreitung Risikofaktoren für Plattenkomplikationen darstellen. Anhand der Finite-Elemente-Modellierung wurde eine veränderte Schraubenanordnung abgeleitet. Daraus resultiert eine neue Form der Resektionsplatte. Schlussfolgerungen: Durch die Verschiebung der Schraubenlöcher aus der Längsachse der Platte kann der Übergang von der Zugbelastung zur Drehmomentbelastung der Schrauben im Schrauben-Platten-Knochen-Verbund der Platte minimiert werden. Dadurch werden Schraubenlockerungen als Komplikationen wesentlich seltener auftreten. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Pronunciation instruction in the TEFL classroom has long been a neglected area regardless of its importance for the students. The data in the literature shows that teachers are generally not ready to provide pronunciation instruction for a variety of reasons: lack of qualification and training, theoretical and practical knowledge, time and motivation. The present thesis explores the current situation of pronunciation instruction at a private language school in the Czech Republic using of classroom observations and teacher and student surveys. The results confirm the initial hypothesis that pronunciation instruction including pronunciation error correction is nearly non-existent or occurs sporadically in the classroom. Only one out of four teachers (T1) included explicit pronunciation information into his teaching. The only pronunciation error correction technique observed with the four teachers was a recast which proved to be ineffective in most cases. Even though the teachers and students are generally aware of the importance of pronunciation in foreign language acquisition, their individual beliefs and attitudes towards pronunciation learning and teaching greatly differ. Key words: pronunciation, TEFL, explicit instruction, segmental features, suprasegmental features, teacher and student cognition

Nephrotic syndrome (NS) is characterized by proteinuria, hypalbuminemia and edemas. It occurs during first and second glomerulopathies. This disease can be divided into two groups: primary (idiopathic) and secondary. The heredity of the familial nephrotic syndrome is autosomal dominant and autosomal recessive. There are four most important genes that condition the formation of hereditary nephrotic syndrome in adult patienst. These genes are ACTN4, CD2AP, NPHS2 and TRPC6. The gene ACTN4, which encodes protein α-actinin 4, is responsible for the autosomal dominant form of focal segmental glomerulosclerosis (FSGS). FSGS is included in first glomerulopathies. α-Actinin 4 was also researched for some types of carcinomas. There was performed the mutational analysis of the gene ACTN4 on the set of 48 patients with nephrotic syndrome in this diploma thesis. High resolution melting (HRM) analysis and sequencing selected samples were used during this mutation detection. During this process many published and unpublished SNPs and one unpublished candidate mutation that could have causal associations with FSGS were found.

Sowohl in der Human- als auch in der Veterinärmedizin existieren mittlerweile zahlreiche Therapieverfahren, die immer öfter komplementär zur Schulmedizin eingesetzt werden. Zu den in der Tiermedizin besonders häufig angewandten Verfahren zählen die Neuraltherapie und die Akupunktur. Aber auch die Transkutane Elektrische Nerven Stimulation (TENS) und die Stimulation myofaszialer Triggerpunkte werden zu den segmentalen Therapiemethoden gerechnet. Die Linderung chronischer Schmerzzustände steht beim Einsatz dieser Verfahren im Vordergrund. Muskuloskelettale Erkrankungen der Lendenwirbelsäule und Lendenregion sowie der Gliedmaßen stellen beim Hund eine häufige Indikation für den Einsatz eines neuraltherapeutischen Verfahrens dar. In diesem Zusammenhang wird die Regio lumbalis des Hundes sehr häufig für eine Therapie herangezogen. Die Wirkung einer neuraltherapeutischen Behandlung wird in diesem Bereich segmental über die Spinalnerven vermittelt. Ziel der vorliegenden Dissertation war es, die Regio lumbalis des Hundes insbesondere im Hinblick auf das Innervationsmuster der Hautnerven detailliert darzustellen. Die erhobenen Befunde sollten einen Beitrag zum besseren Verständnis der Wirkmechanismen der verschiedenen Therapietechniken leisten. Außerdem sollte nach einem möglichen morphologischen Korrelat zu den in der TCM definierten Akupunkturpunkten gesucht werden. Zu diesem Zweck wurden der Verlauf und die Verzweigung der Nerven des Lendenbereiches von n=12 formalinfixierten Hunden beginnend von der dorsalen Medianlinie dargestellt. Eine fotografische Dokumentation fand in drei Schichten statt: im Bereich der Fascia thoracolumbalis (a), auf Niveau der langen Rückenmuskulatur (b) und über den Procc. transversi (c). Des Weiteren wurde bei n=2 Tieren eine Präparation des subkutanen Innervationsmusters vorgenommen. Um die präparatorischen Ergebnisse interindividuell vergleichen zu können, wurden sog. Kaudalverschiebungsindizes entwickelt und für die einzelnen Spinalnerven berechnet. Spinalnerven, welche die Haut der Regio lumbalis innervierten, stammten aus den Rückenmarkssegmenten Th12 bis L5. Nervi cutanei der Dorsaläste besaßen alle Hunde, bei n=7 Tieren beteiligten sich auch Hautäste von Rr. ventrales aus den Segmenten L3 bis L5 an der Innervation des dorsalen Lendenbereiches. Die Anzahl der Hautnervenäste variierte individuell zwischen drei und sieben, wobei die Nerven bei den Tieren mit einer geringeren Anzahl aus den weiter kranial gelegenen Segmenten stammten. Der Verlauf, die Verzweigung sowie der Perforation der Nervi cutanei durch die Fascia thoracolumbalis zeigten eine sehr hohe individuelle Variabilität. Im Bereich der langen Rückenmuskulatur wurde dagegen ein vergleichbares und segmental regelmäßiges Innervationsmuster angetroffen. Bei der Präparation der subkutanen Nervenverläufe fiel ein sehr irreguläres und segmental nicht nachvollziehbares Muster auf. Bei allen untersuchten Hunden zeigten die Dorsaläste der Spinalnerven eine Kaudalverschiebung um mindestens eine Wirbelkörperlänge. Die in der vorliegenden Arbeit eingeführten Kaudalverschiebungsindizes ermöglichen einen interindividuellen Vergleich des Verlaufes der Spinalnerven der Regio lumbalis. Durch die errechneten Indizes ist eine graphische Darstellung und aussagekräftige Interpretation der morphologischen Ergebnisse gegeben. Die zum Teil hohe interindividuelle Variation im Innervationsmuster der Hautnerven des Lendenbereiches in den oberflächlichen Körperschichten lässt den Schluss zu, dass die Hautareale des Lendenbereiches nicht bei jedem Tier von demselben Spinalnerven innerviert werden. Das bedeutet, dass die Dermatome bei verschiedenen Individuen nicht identisch sind. Des Weiteren schließt die unterschiedliche Lokalisation der Nerven und ihrer Durchtrittstellen durch die Fascia thoracolumbalis ein morphologisches Korrelat zu den in der TCM festgelegten Akupunkturpunkten aus. Die bei allen Hunden regelmäßige Anordnung der Spinalnerven auf Niveau der langen Rückenmuskulatur deutet vielmehr darauf hin, dass ein in der Körperperipherie gesetzter Reiz unabhängig von einer genauen Punktlokalisation einen segmental in das Rückenmark vermittelten Effekt bei einer neuraltherapeutischen Behandlung zur Folge hat. Für eine erfolgreiche Therapie sind daher die profunde Kenntnis der Segmentanatomie sowie der neuroanatomischen Verschaltungswege unbedingt erforderlich. In Zukunft sollte mehr Augenmerk auf individuelle Unterschiede im Innervationsmuster gelegt werden, da diese einen möglichen Grund für die individuell variable oder auch ausbleibende Wirkung bei einer neuraltherapeutischen Behandlung darstellen können.