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This thesis deals with stress strain analysis of an aortic abdominal aneurysm (AAA) and the influence of its contact with the spine on the extreme wall stress. The influence was tested on the idealized geometry, as well as on ten patient specific geometries obtained from computer tomography (CT-A) scans. Hyperelastic constitutive models were used for the AAA wall and intraluminal thrombus (ILT) tissue description. The prestress algorithm was used for reconstruction of the unloaded geometry to get more trustworthy results against the geometry from CT which was obtained under the blood pressure. Statistical analysis was used for the results evaluation. The maximal increase of peak wall stress was as high as 81 %.

This master's thesis focuses on detection of pathological vertebrae in spinal CT utilized by machine learning. Theoretical part describes anatomy of the spine and occurrence of pathologies in CT image data, contains an overview of existing methods intended for automated detection of pathological vertebrae. Practical part devotes to design a computer aided detection systems to identify pathological vertebrae and to classify a type of pathology. Designed classification system is based on using neural network, which performs classification step and on principal component analysis (PCA), which is used to reducing the original number of observation features. For completing this task were used real data. Conclusion contains evaluation of obtained results.

The aim of this work was the development of algorithms for detection segmentation and classification of difficult to define bone metastatic cancerous lesions from spinal CT image data. For this purpose, the patient database was created and annotated by medical experts. Successively, three methods were proposed and developed; the first of them is based on the reworking and combination of methods developed during the preceding project phase, the second method is a fast variant based on the fuzzy k-means cluster analysis, the third method uses modern machine learning algorithms, specifically deep learning of convolutional neural networks. Further, an approach that elaborates the results by a subsequent random forest based meta-analysis of detected lesion candidates was proposed. The achieved results were objectively evaluated and compared with results achieved by algorithms published by other authors. The evaluation was done by two objective methodologies, technical voxel-based and clinical object-based ones. The achieved results were subsequently evaluated and discussed.

This diploma thesis is focused on time-development analysis of treated lesion in CT data. The theoretical part of the thesis deals with the anatomy, physiology, and pathophysiology of the spine and vertebral bodies. It further describes diagnostic and therapeutic options for the detection and treatment of spinal lesions. It contains an overview of the current state of usage of time-development analysis in oncology. The problems of the available databases are discussed and new databases are created for subsequent analysis. Futhermore, the methodology of time-development analysis according to the shape characterization and the size of the vertebral involvement is proposed. The proposed methodological approaches to feature extraction are applied to the created databases. Their choice and suitability is discussed, including their potential for possible usege in clinical practice of monitoring the development and derivation of characteristic dependences of features on the patient's prognosis.

Les épines dendritiques sont de petites protrusions post-synaptiques présentant des changements morphologiques corrélés avec la plasticité synaptique. Elles ont pour origine les filopodes dendritiques qui s’élargissent lors du contact avec l’axone. Ces changements morphologiques impliquent une grande variété de molécules dont des protéines associées à l’actine et des protéines d’adhésion. Cependant, comment ces différentes protéines sont coordonnées dans le temps et l’espace est encore largement méconnu. De plus, les techniques de microscopie conventionnelle ne permettent pas d’étudier l’organisation et la dynamique de ces protéines dans les épines dont la taille est proche de la limite de resolution. L’objectif de ma thèse a donc été d’explorer le rôle des protéines associées à l’actine ainsi que celui des protéines d’adhésion N-cadhérines dans l’organisation et la dynamique du cytosquelette d’actine des épines dendritiques. Dans une première étude, nous avons suivi la motilité des filopodes et épines dendritiques de neurones en visualisant l’actine-GFP. Nous avons couplé cette approche avec : 1) une technique de piégeage optique de microsphères recouvertes de N-cadhérines ou des substrats micro-imprimés également recouverts de N-cadhérines afin de contrôler temporellement et spatialement les adhésions cadhérine-cadhérine, 2) la stimulation pharmacologique de la myosine II afin d’induire la contraction F-actine/myosine et 3) l’expression de mutants de N-cadhérine non adhésifs. Nous avons ainsi démontré que la stabilisation des filopodes en épines était dépendante de l’engagement d’un embrayage moléculaire entre les adhésions trans-synaptiques N-cadhérine et le flux rétrograde d’actine généré par les myosines II. Dans une deuxième étude, nous avons utilisé la microscopie super-résolutive (PALM et dSTORM) et le suivi de protéines individuelles (sptPALM) pour étudier l’organisation et la dynamique à l’échelle nanométrique des protéines à l’origine des réseaux d’actine branchés dans les épines. Ainsi, nous avons caractérisé la localisation et la dynamique de l’actine, du complexe Arp2/3, du complexe WAVE, d’IRSp53, de VASP et de Rac-1. Nous avons montré que, contrairement aux structures motiles classiques comme lamellipode, le réseau d’actine branché dans les épines n’ést pas formé aux extrémités protrusives puis incorporé dans un flux rétrograde d’actine. Ce réseau est initié à la PSD puis croît vers l’extérieur afin de générer les protrusions membranaires responsablent des changements morphologiques de l’épine. Nos résultats montrent également qu’un contrôle strict de l’activité de Rac-1 est nécessaire au maintien de la morphologie des épines dendritiques et de l’architecture du réseau d’actine branché. L’ensemble de mon travail souligne l’importance du rôle de l’organisation à l’échelle nanométrique du réseau d’actine branché et des adhésions N-cadhérine dans la dynamique et la formation des épines dendritiques. Ces résultats pourraient avoir un rôle important dans la compréhension des changements morphologiques lors de la plasticité synaptique. / Dendritic spines are tiny post-synaptic protrusions exhibiting changes in morphology correlated with synaptic plasticity. They originate from motile dendritic filopodia, which enlarge after contacting axons. These morphological changes involve a wide number of molecular actors, including actin-binding proteins, and adhesion molecules. However, how these various molecular components are coordinated temporally and spatially to tune changes in spine shape remains unclear. Furthermore, conventional photonic microscopy techniques could not achieved the spatial resolution required to study the dynamic nanoscale organization of these proteins within the micron size dendritic spines. The objective of my Ph.D. was to unravel how actin-binding proteins and N-cadherin adhesion regulate the organization and dynamics of F-actin network in dendritic spines. In a first study, we measured the motility of dendritic filopodia and spines by time lapse imaging of actin-GFP in primary hippocampal neurons. We combined those measurements with: 1) manipulation of N-cadherin coated beads with optical tweezers, or micropatterns to control the timing and location of nascent N-cadherin adhesions, 2) pharmacological stimulation of myosin II to trigger contraction of the F-actin/myosin network and 3) expression of non-adhesive N-cadherin mutants to compete for the interaction between N-cadherin adhesion and F-actin. Using these different approaches we demonstrated that the stabilization of dendritic filopodia into mature spines was dependent on the engagement of a molecular clutch between trans-synaptic N-cadherin adhesions and the myosin driven F-actin flow. In a second study, we used super resolution microscopy (PALM and dSTORM) and single protein tracking (sptPALM) to study the dynamic nanoscale organizations of branched actin networks within dendritic spines. Using these technics, we characterized within dendritic spines, the localization and dynamics of actin, Arp2/3 complex, WAVE complex, IRSp53, VASP and Rac-1. We established that, opposite to classical motile structures such as the lamellipodium, branched F-actin networks in dendritic spines are not formed at the tip of membrane protrusions and incorporated in a retrograde flow. On the contrary, they are growing outwards from the PSD generating membrane protrusions responsible for spine motility. We also show that a thigh control of Rac1 activity is required to maintain dendritic spine morphology and branched actin network organization. Altogether, these studies point out the role of the nanoscale functional organization of F-actin networks and its linkage to adhesion proteins in the regulation of dendritic spine formation and dynamics. These findings may have important implications in the understanding of spine morphology changes driven by synaptic activity.

Die pyogene Spondylodiszitis als bakterielle Osteomyelitis der Wirbelsäule ist eine seltene Entität der bakteriell-entzündlichen Pathologien des Stütz- und Bewegungsapparates. Trotz adäquater Behandlungsstrategien, wird auch heute noch eine Mortalitätsrate von 5% bis 20% beschrieben. Vor allem die in dem vorwiegend älteren Patientenkollektiv deutlich erhöhte Prävalenz an metabolischen oder kardiopulmonalen Komorbiditäten fordert moderne Therapiekonzepte, die eine risikoarme, jedoch effektive Eradifizierung des bakteriell-entzündlichen Fokus mit schneller Wiederherstellung der prämorbiden Mobilität ermöglichen. Ausgehend von zwei grundlagenwissenschaftlichen Studien, wurden in der vorliegenden Habilitationsschrift zunächst die komplexen Zusammenhänge von lokaler Gewebsveränderungen und systemischer Entzündung erörtert. Hierbei zeigten die Analysen humaner degenerativer und traumatischer Bandscheibenzellen, dass die Apoptose, insbesondere die Herabregulation anti-apoptotischer Schlüsselkomponenten wie das Bcl-2, als mögliche Schnittstelle im katabolen Stoffwechsel der extrazellulären Bandscheibenmatrix diskutiert werden kann. In der generalisierten bakteriellen Entzündung (Sepsis), ließ sich durch die gentherapeutisch gewebsständige Überexpression von antiapoptotischen und antiinflammatorischen Interleukin-10 (IL-10), auch im IL-10-defzienten Organismus, eine deutliche Reduktion der systemischen proinflammatorischen Immunantwort mit verbesserter Überlebensrate septischer Tiere erzielen. Jedoch birgt der substantielle Gewebeschaden bei pyogener Spondylodiszitis nicht selten die Gefahr der konsekutiven Instabilität mit neurologischen Komplikationen und stellt damit eine besondere chirurgische Herausforderung dar. Daher wurden in drei weiteren klinischen Studien unsere, in den letzten 10 Jahren etablierten, lösungsorientierten Strategien erläutert. Zur Überbrückung größerer knöcherner Defekte gelang mit der Implantation expandierbarer Titancages eine sichere knöcherne Durchbauung mit vollständiger Ausheilung des Infektes. Im Beobachtungszeitraum von mehr als 3 Jahren war bei keinem der Patienten ein Infektrezidiv zu verzeichnen. In komplexen Fällen von monosegmentaler Spondylodiszitis der LWS mit multisegmentaler epiduraler Abszedierung, führte die epidurale Katheterspülung über den dorsalen Zugang für die Spondylodese zu einer folgenlosen Ausheilung. Damit konnte ein zusätzliches, iatrogenes Trauma mit multisegmentalen Lamintomien über die Distanz des epiduralen Abszesses vermieden werden. In einer weiteren Studie mit einem Beobachtungszeitraum von bis zu 5 Jahren, erzielte die Implantation von Poly-Ether-Ether-Keton (PEEK) Cages zur dorsalen intersomatischen Fusion bei pyogener Spondylodiszitis eine sehr gute, stabile knöcherne Durchbauung des infizierten Segmentes, ebenfalls ohne Infektrezidiv. Diese Abweichung vom herkömmlichen Standard mit Titanimplantaten erwies sich somit als sichere Alternative mit den für PEEK charakteristischen, verbesserten Eigenschaften. Im Vergleich zu herkömmlichen Operationsverfahren, verspricht die Integration dieser Ergebnisse in die Weiterentwicklung minimal-invasiver Techniken, insbesondere im multimorbiden Patientenklientel, mindestens gleichwertig gute Ergebnisse bei deutlich reduziertem Operationstrauma.:1. EINFÜHRUNG IN DIE THEMATIK 1 1.1 Die pyogene Spondylodiszitis 1 1.1.1 Epidemiologie, Ätiologie und Pathophysiologie 2 1.1.2 Diagnostik und Therapie 6 1.1.2.1 Konservative Therapie 11 1.1.2.2 Operative Therapie 12 1.2 Biomechanische Aspekte 14 1.3 Wissenschaftliche Fragestellung 15 2. ORIGINALARBEITEN 20 2.1 Apoptosis of human intervertebral discs after trauma compares to degenerated discs involving both receptor-mediated and mitochondrial-dependent pathways 20 2.2 Endogenous IL-10 regulates sepsis-induced thymic apoptosis and improves survival in septic IL-10 null mice 30 2.3 Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages 39 2.4 Single-stage epidural catheter lavage with posterior spondylodesis in lumbar pyogenic spondylodiscitis with multilevel abscess formation 45 2.5 Single-stage debridement and spinal fusion using PEEK-cages through a posterior approach for eradication of lumbar pyogenic spondylodiscitis: A safe treatment strategy for a detrimental condition 52 3. ZUSAMMENFASSUNG UND AUSBLICK 62 4. LITERATURVERZEICHNIS 78 5. APPENDIX 98 5.1 Tabellen und Abbildungen 98 Tabelle 1 & 2 98 Tabelle 3 & 4 99 Abbildung 1 100 Abbildung 2 101 Abbildung 3 102 Abbildung 4 103 Abbildung 5 104 5.2 Selbständigkeitserklärung 105 5.3 Danksagung 106 5.4 Curriculum Vitae 108

5 Summary So far, no commercially used device, capable of evaluating the condition of the deep stabilizing spine system (DSSS), has appeared on the market. Therefore, a so called muscle dynamometer (SD01, SD02), has been constructed that enables to reveal a possible dysfunction of the DSSS. During a six-week-rehabilitation-course, aimed at correcting the body posture and strengthening the DSSS muscles, a statistically significant change (p<0.001) between the values of input and output measurements of the chosen group tested has been obtained. Correctness of the approach to objectify the initial state of the patient and his progress during the treatment was shown by the completed measurements. The effectiveness of therapeutical training was confirmed. Based on positive experience from SD01, a new version of muscle dynamometer, SD02, was constructed. Measurements by SD02 were to establish the condition of DSSS (frontal spine stabilization) by a lay-sit test repeatedly from the test battery UNIFITTEST 6-60 and by the diaphragm test. Measurements were conducted on 45 samples. Basic somatic measurements were performed and then measurements with the SD02 were conducted during the diaphragm test and UNIFITTEST. For comparison of the values the pairing t-test was used (normal data distribution was verified by the...

1 Abstract Title: Exploitation of regular exercise based on the elements of developmental kinesiology for people suffering with back pain. Objectives: The aim of my diploma thesis was observing the effect of a group motional program based on tenets of developmental kinesiology for function of the motional system of clients suffering from back pain. Methods: The theoretical part of my diploma thesis was done with a method of literary recherché using technical literature, articles and studies. Experiment was chosen for the practical part, quasi in particular, which was complemented by method of qualitative research, personal case study in particular. There are two clinical casuistries paced in my thesis. There were two following methods for collecting data during my research: kinesiology analysis focused on anamnesis, check-up by sight, check-up by touch and functional probing (dynamic check-up of spine, diagnostically testing of deep stabilizing muscles.) Another methods used in my diploma thesis were assessments of pain with a usage of visual analogy scale and semi-structured interview. Pre-tests and post-test were identical. 10 people suffering from chronic back pain in an area of cervical spine or lumbar spine (5 clients suffering from chronic back pain in an area of lumbar spine and 5 clients suffering...

This project is a response to the author's passion for sport and his curiosity about the architectural process that is necessary to understand and facilitate the inter-relation of body, mind and soul. The potential influence of physical exercise; its correlation with the metaphysical aspects of the individual and how its influence spills over into the larger context of society is investigated. This dissertation attempts to form an architectural response that is indigenous to the local population, the climate and the existing urban condition and ranges from a thorough understanding of the community to the effective contribution that architecture can offer, based on the concept of ‘Sport for Development’ programmes in South Africa. The primary objective of the architectural response is to amplify the potential of sport as a means to peace building and self-actualization within a society that suffers from the effects of crime and violence. Although popular culture believes in the positive potential of sport, Ramon Spaaij identifies factors and conditions that must be met if the positive value of sport is to be enjoyed. The dissertation incorporates these factors and conditions into a multipurpose 'Sport for Development' community complex. This complex aims to augment the existing sport for development programmes in South Africa and serve as a prototype for future sport for development centres that ultimately includes everyone in the process of reconciliation. / Dissertation (MArch(Prof))--University of Pretoria, 2012. / Architecture / unrestricted