Introdução: A degeneração da articulação patelofemoral é uma patologia relativamente comum, ocorrendo em 5% a 9% dos pacientes com artrose isolada do joelho. Avanço progressivo do processo degenerativo acompanhado de dor, rigidez articular e considerável limitação funcional são achados comumente presentes, tornando-se, muitas vezes, necessária a adoção de intervenções cirúrgicas. O tratamento cirúrgico para pacientes jovens, apresentando estágio avançado de artrose isolada da articulação patelofemoral, permanece controverso. Diversas técnicas cirúrgicas, incluindo liberação do retináculo lateral, avanço da tuberosidade tibial, implante autólogo de condrócitos, patelectomia, artroplastia patelofemoral e artroplastia total do joelho têm sido empregadas, apresentando ampla variação nos índices de sucesso. Além disso, a rotina pós-operatória e a necessidade de imobilização e proteção do reparo, após alguns procedimentos, tendem a repercutir nos resultados funcionais finais e no retorno às atividades de vida diária. Não há solução perfeita para o tratamento cirúrgico da artrose patelofemoral isolada. As opções terapêuticas disponíveis até proporcionam resultados funcionais aceitáveis, mas os problemas inerentes a cada uma delas não podem ser considerados desprezíveis. Algumas das cirurgias sem implantes artificiais costumam comprometer, significativamente, a morfologia articular, com resultados estéticos bastante desconfortáveis, principalmente para pacientes do sexo feminino. As cirurgias com implantes, por outro lado, agregam um custo adicional significativamente alto, na forma do valor intrínseco desses implantes, já que os demais custos hospitalares são equivalentes aos procedimentos convencionais. Dessa forma, o desenvolvimento de um procedimento cirúrgico alternativo, capaz de promover alívio das queixas álgicas, melhora funcional, reabilitação precoce e resultado estético aceitável traria não somente grandes benefícios para os pacientes com artrose patelofemoral em estágios avançados de comprometimento articular, como também certo alívio para os gestores das secretarias municipais de saúde no que se refere ao alto custo dos implantes. Objetivo: Avaliar os resultados funcionais de pacientes com artrose patelofemoral submetidos a uma nova técnica cirúrgica, artroplastia de interposição retinacular. Material e Métodos: O estudo descreve uma série de 11 casos de pacientes com diagnóstico de artrose patelofemoral isolada, submetidos à artroplastia de interposição retinacular no Serviço de Ortopedia e Traumatologia do Hospital de Clínicas de Porto Alegre, que foram avaliados quanto à função e movimento articular do joelho durante o pré e o pós-operatório. O tempo de seguimento pós-operatório foi de, no mínimo, 2 anos. A avaliação da função foi realizada utilizando-se a Escala de Atividades de Vida Diária para Análise do Joelho. As amplitudes de movimento de flexão e extensão do joelho foram mensuradas por meio de um goniômetro universal. Foram comparados os resultados obtidos durante o pré e pós-operatório. Resultados: Após um período médio de seguimento de 25,9 meses (entre 24 e 29 meses), 10 dos 11 pacientes apresentaram melhora nos resultados funcionais. A média de escores da Escala de Atividades de Vida Diária para Análise do Joelho foi 34,0 ± 12,4 (IC 95%=25,7- 42,3) antes da cirurgia e 55,8 ± 11,2 (IC95%=48,3-63,4) após a cirurgia, apresentando uma melhora estatisticamente significativa (p<0,001). O paciente que não evidenciou melhora funcional pós-operatória apresentou progressão da artrose tibiofemoral e, após 2 anos de pós-operatório, foi submetido à artroplastia total do joelho. Não foi observado aumento estatisticamente significativo na amplitude de movimento de flexão e extensão do joelho após a cirurgia. Conclusão: A artroplastia de interposição retinacular proporcionou bons resultados funcionais em pacientes com artrose da articulação patelofemoral, podendo ser uma alternativa cirúrgica para pacientes jovens e de meia idade com processo degenerativo articular em estágio avançado. / Introduction: The degeneration of the patellofemoral joint is a relatively common patology. Patellofemoral artrhosis occurs in between 5% and 9% of patients with knee arthrosis. The frequent clinical findings observed in the presence of progressive degenerative process are pain, joint stiffness, and considerable functional impairment, which many a time requires surgical intervention. Yet, in the case of young patients in an advanced stage of isolated patellofemoral arthrosis, surgical approaches to treatment are surrounded by controversy. Several surgical techniques have been employed to varying degrees of success, including lateral reticular release, advancement of tibial tuberosity, autologous chondrocyte implantation, patellectomy, patellofemoral arthroplasty and total knee arthroplasty. Besides, the different postoperative routines adopted, at times followed by periods of immobilization and protection of the surgical repair performed, tend to lead to different functional outcomes and to influence the resumption of daily living activities. There is no ideal solution to the surgical treatment of isolated patellofemoral arthrosis. The therapeutic alternatives available do indeed manage to produce acceptable outcomes, but the issues inherent to each choice cannot be ignored. Some surgical procedures that do not use artificial implantations usually compromise significantly the joint morphology, and follow-up involves undesired esthetic results, specially for female patients. Conversely, surgeries that use implantations impose rising additional costs expressed by the intrinsic values of the implantation, as the other hospital expenditures are equivalent to conventional medical procedures. Therefore, the development of an alternative surgical procedure that promotes pain relief, functional improvements, with an early rehabilitation and an acceptable esthetic result, would bring not only substantial benefits to patients who suffer from patellofemoral arthrosis with advanced commitment of the joint, but also a certain relief to health authorities as regards high implantation costs. Aim: To evaluate the functional outcomes of patients with patellofemoral arthrosis who underwent a new surgical technique, retinacular interposition arthroplasty. Materials and methods: The present study is a case series. Eleven patients with positive diagnosis for isolated patellofemoral arthrosis who underwent to retinacular interposition arthroplasty were evaluated in the Orthopedics and Traumatology Service of Hospital de Clínicas de Porto Alegre for function and articular range of motion of the knee during the preand postoperative period. Follow-up was at least 2 years. The evaluation of function was carried out using the Knee Outcome Survey Activities of Daily Living Scale. The range of flexion and extension motion were measured by means of a goniometer. Pre- and postoperative results were compared. Results: After an average follow-up period of 25.9 months (between 24 and 29 months), 10 of the 11 patients showed improved functional outcomes. Average scores obtained by the Knee Outcome Survey Activities of Daily Living Scale was 34.0 ± 12.4 (CI 95% = 25.7 – 42.3) before surgery and 55.8 ± 11.2 (CI 95% = 48.3 – 63.4) after surgery, with a statistically significant improvement (P < 0.001). One patient did not present any functional improvement, and presented a progression of the femorotibial arthrosis. Two years after the end of the postoperative period, the patient underwent total knee arthroplasty. No statistically significant increase was observed in motion of knee flexion and extension after the surgery. Conclusion: Retinacular interposition arthroplasty afforded good functional results in patients with isolated arthrosis of the patellofemoral joint. The technique may be a surgical alternative for young and middle-aged patients who suffer from articular degenerative process at advanced stage.

Introdução: A degeneração da articulação patelofemoral é uma patologia relativamente comum, ocorrendo em 5% a 9% dos pacientes com artrose isolada do joelho. Avanço progressivo do processo degenerativo acompanhado de dor, rigidez articular e considerável limitação funcional são achados comumente presentes, tornando-se, muitas vezes, necessária a adoção de intervenções cirúrgicas. O tratamento cirúrgico para pacientes jovens, apresentando estágio avançado de artrose isolada da articulação patelofemoral, permanece controverso. Diversas técnicas cirúrgicas, incluindo liberação do retináculo lateral, avanço da tuberosidade tibial, implante autólogo de condrócitos, patelectomia, artroplastia patelofemoral e artroplastia total do joelho têm sido empregadas, apresentando ampla variação nos índices de sucesso. Além disso, a rotina pós-operatória e a necessidade de imobilização e proteção do reparo, após alguns procedimentos, tendem a repercutir nos resultados funcionais finais e no retorno às atividades de vida diária. Não há solução perfeita para o tratamento cirúrgico da artrose patelofemoral isolada. As opções terapêuticas disponíveis até proporcionam resultados funcionais aceitáveis, mas os problemas inerentes a cada uma delas não podem ser considerados desprezíveis. Algumas das cirurgias sem implantes artificiais costumam comprometer, significativamente, a morfologia articular, com resultados estéticos bastante desconfortáveis, principalmente para pacientes do sexo feminino. As cirurgias com implantes, por outro lado, agregam um custo adicional significativamente alto, na forma do valor intrínseco desses implantes, já que os demais custos hospitalares são equivalentes aos procedimentos convencionais. Dessa forma, o desenvolvimento de um procedimento cirúrgico alternativo, capaz de promover alívio das queixas álgicas, melhora funcional, reabilitação precoce e resultado estético aceitável traria não somente grandes benefícios para os pacientes com artrose patelofemoral em estágios avançados de comprometimento articular, como também certo alívio para os gestores das secretarias municipais de saúde no que se refere ao alto custo dos implantes. Objetivo: Avaliar os resultados funcionais de pacientes com artrose patelofemoral submetidos a uma nova técnica cirúrgica, artroplastia de interposição retinacular. Material e Métodos: O estudo descreve uma série de 11 casos de pacientes com diagnóstico de artrose patelofemoral isolada, submetidos à artroplastia de interposição retinacular no Serviço de Ortopedia e Traumatologia do Hospital de Clínicas de Porto Alegre, que foram avaliados quanto à função e movimento articular do joelho durante o pré e o pós-operatório. O tempo de seguimento pós-operatório foi de, no mínimo, 2 anos. A avaliação da função foi realizada utilizando-se a Escala de Atividades de Vida Diária para Análise do Joelho. As amplitudes de movimento de flexão e extensão do joelho foram mensuradas por meio de um goniômetro universal. Foram comparados os resultados obtidos durante o pré e pós-operatório. Resultados: Após um período médio de seguimento de 25,9 meses (entre 24 e 29 meses), 10 dos 11 pacientes apresentaram melhora nos resultados funcionais. A média de escores da Escala de Atividades de Vida Diária para Análise do Joelho foi 34,0 ± 12,4 (IC 95%=25,7- 42,3) antes da cirurgia e 55,8 ± 11,2 (IC95%=48,3-63,4) após a cirurgia, apresentando uma melhora estatisticamente significativa (p<0,001). O paciente que não evidenciou melhora funcional pós-operatória apresentou progressão da artrose tibiofemoral e, após 2 anos de pós-operatório, foi submetido à artroplastia total do joelho. Não foi observado aumento estatisticamente significativo na amplitude de movimento de flexão e extensão do joelho após a cirurgia. Conclusão: A artroplastia de interposição retinacular proporcionou bons resultados funcionais em pacientes com artrose da articulação patelofemoral, podendo ser uma alternativa cirúrgica para pacientes jovens e de meia idade com processo degenerativo articular em estágio avançado. / Introduction: The degeneration of the patellofemoral joint is a relatively common patology. Patellofemoral artrhosis occurs in between 5% and 9% of patients with knee arthrosis. The frequent clinical findings observed in the presence of progressive degenerative process are pain, joint stiffness, and considerable functional impairment, which many a time requires surgical intervention. Yet, in the case of young patients in an advanced stage of isolated patellofemoral arthrosis, surgical approaches to treatment are surrounded by controversy. Several surgical techniques have been employed to varying degrees of success, including lateral reticular release, advancement of tibial tuberosity, autologous chondrocyte implantation, patellectomy, patellofemoral arthroplasty and total knee arthroplasty. Besides, the different postoperative routines adopted, at times followed by periods of immobilization and protection of the surgical repair performed, tend to lead to different functional outcomes and to influence the resumption of daily living activities. There is no ideal solution to the surgical treatment of isolated patellofemoral arthrosis. The therapeutic alternatives available do indeed manage to produce acceptable outcomes, but the issues inherent to each choice cannot be ignored. Some surgical procedures that do not use artificial implantations usually compromise significantly the joint morphology, and follow-up involves undesired esthetic results, specially for female patients. Conversely, surgeries that use implantations impose rising additional costs expressed by the intrinsic values of the implantation, as the other hospital expenditures are equivalent to conventional medical procedures. Therefore, the development of an alternative surgical procedure that promotes pain relief, functional improvements, with an early rehabilitation and an acceptable esthetic result, would bring not only substantial benefits to patients who suffer from patellofemoral arthrosis with advanced commitment of the joint, but also a certain relief to health authorities as regards high implantation costs. Aim: To evaluate the functional outcomes of patients with patellofemoral arthrosis who underwent a new surgical technique, retinacular interposition arthroplasty. Materials and methods: The present study is a case series. Eleven patients with positive diagnosis for isolated patellofemoral arthrosis who underwent to retinacular interposition arthroplasty were evaluated in the Orthopedics and Traumatology Service of Hospital de Clínicas de Porto Alegre for function and articular range of motion of the knee during the preand postoperative period. Follow-up was at least 2 years. The evaluation of function was carried out using the Knee Outcome Survey Activities of Daily Living Scale. The range of flexion and extension motion were measured by means of a goniometer. Pre- and postoperative results were compared. Results: After an average follow-up period of 25.9 months (between 24 and 29 months), 10 of the 11 patients showed improved functional outcomes. Average scores obtained by the Knee Outcome Survey Activities of Daily Living Scale was 34.0 ± 12.4 (CI 95% = 25.7 – 42.3) before surgery and 55.8 ± 11.2 (CI 95% = 48.3 – 63.4) after surgery, with a statistically significant improvement (P < 0.001). One patient did not present any functional improvement, and presented a progression of the femorotibial arthrosis. Two years after the end of the postoperative period, the patient underwent total knee arthroplasty. No statistically significant increase was observed in motion of knee flexion and extension after the surgery. Conclusion: Retinacular interposition arthroplasty afforded good functional results in patients with isolated arthrosis of the patellofemoral joint. The technique may be a surgical alternative for young and middle-aged patients who suffer from articular degenerative process at advanced stage.

Introdução: A degeneração da articulação patelofemoral é uma patologia relativamente comum, ocorrendo em 5% a 9% dos pacientes com artrose isolada do joelho. Avanço progressivo do processo degenerativo acompanhado de dor, rigidez articular e considerável limitação funcional são achados comumente presentes, tornando-se, muitas vezes, necessária a adoção de intervenções cirúrgicas. O tratamento cirúrgico para pacientes jovens, apresentando estágio avançado de artrose isolada da articulação patelofemoral, permanece controverso. Diversas técnicas cirúrgicas, incluindo liberação do retináculo lateral, avanço da tuberosidade tibial, implante autólogo de condrócitos, patelectomia, artroplastia patelofemoral e artroplastia total do joelho têm sido empregadas, apresentando ampla variação nos índices de sucesso. Além disso, a rotina pós-operatória e a necessidade de imobilização e proteção do reparo, após alguns procedimentos, tendem a repercutir nos resultados funcionais finais e no retorno às atividades de vida diária. Não há solução perfeita para o tratamento cirúrgico da artrose patelofemoral isolada. As opções terapêuticas disponíveis até proporcionam resultados funcionais aceitáveis, mas os problemas inerentes a cada uma delas não podem ser considerados desprezíveis. Algumas das cirurgias sem implantes artificiais costumam comprometer, significativamente, a morfologia articular, com resultados estéticos bastante desconfortáveis, principalmente para pacientes do sexo feminino. As cirurgias com implantes, por outro lado, agregam um custo adicional significativamente alto, na forma do valor intrínseco desses implantes, já que os demais custos hospitalares são equivalentes aos procedimentos convencionais. Dessa forma, o desenvolvimento de um procedimento cirúrgico alternativo, capaz de promover alívio das queixas álgicas, melhora funcional, reabilitação precoce e resultado estético aceitável traria não somente grandes benefícios para os pacientes com artrose patelofemoral em estágios avançados de comprometimento articular, como também certo alívio para os gestores das secretarias municipais de saúde no que se refere ao alto custo dos implantes. Objetivo: Avaliar os resultados funcionais de pacientes com artrose patelofemoral submetidos a uma nova técnica cirúrgica, artroplastia de interposição retinacular. Material e Métodos: O estudo descreve uma série de 11 casos de pacientes com diagnóstico de artrose patelofemoral isolada, submetidos à artroplastia de interposição retinacular no Serviço de Ortopedia e Traumatologia do Hospital de Clínicas de Porto Alegre, que foram avaliados quanto à função e movimento articular do joelho durante o pré e o pós-operatório. O tempo de seguimento pós-operatório foi de, no mínimo, 2 anos. A avaliação da função foi realizada utilizando-se a Escala de Atividades de Vida Diária para Análise do Joelho. As amplitudes de movimento de flexão e extensão do joelho foram mensuradas por meio de um goniômetro universal. Foram comparados os resultados obtidos durante o pré e pós-operatório. Resultados: Após um período médio de seguimento de 25,9 meses (entre 24 e 29 meses), 10 dos 11 pacientes apresentaram melhora nos resultados funcionais. A média de escores da Escala de Atividades de Vida Diária para Análise do Joelho foi 34,0 ± 12,4 (IC 95%=25,7- 42,3) antes da cirurgia e 55,8 ± 11,2 (IC95%=48,3-63,4) após a cirurgia, apresentando uma melhora estatisticamente significativa (p<0,001). O paciente que não evidenciou melhora funcional pós-operatória apresentou progressão da artrose tibiofemoral e, após 2 anos de pós-operatório, foi submetido à artroplastia total do joelho. Não foi observado aumento estatisticamente significativo na amplitude de movimento de flexão e extensão do joelho após a cirurgia. Conclusão: A artroplastia de interposição retinacular proporcionou bons resultados funcionais em pacientes com artrose da articulação patelofemoral, podendo ser uma alternativa cirúrgica para pacientes jovens e de meia idade com processo degenerativo articular em estágio avançado. / Introduction: The degeneration of the patellofemoral joint is a relatively common patology. Patellofemoral artrhosis occurs in between 5% and 9% of patients with knee arthrosis. The frequent clinical findings observed in the presence of progressive degenerative process are pain, joint stiffness, and considerable functional impairment, which many a time requires surgical intervention. Yet, in the case of young patients in an advanced stage of isolated patellofemoral arthrosis, surgical approaches to treatment are surrounded by controversy. Several surgical techniques have been employed to varying degrees of success, including lateral reticular release, advancement of tibial tuberosity, autologous chondrocyte implantation, patellectomy, patellofemoral arthroplasty and total knee arthroplasty. Besides, the different postoperative routines adopted, at times followed by periods of immobilization and protection of the surgical repair performed, tend to lead to different functional outcomes and to influence the resumption of daily living activities. There is no ideal solution to the surgical treatment of isolated patellofemoral arthrosis. The therapeutic alternatives available do indeed manage to produce acceptable outcomes, but the issues inherent to each choice cannot be ignored. Some surgical procedures that do not use artificial implantations usually compromise significantly the joint morphology, and follow-up involves undesired esthetic results, specially for female patients. Conversely, surgeries that use implantations impose rising additional costs expressed by the intrinsic values of the implantation, as the other hospital expenditures are equivalent to conventional medical procedures. Therefore, the development of an alternative surgical procedure that promotes pain relief, functional improvements, with an early rehabilitation and an acceptable esthetic result, would bring not only substantial benefits to patients who suffer from patellofemoral arthrosis with advanced commitment of the joint, but also a certain relief to health authorities as regards high implantation costs. Aim: To evaluate the functional outcomes of patients with patellofemoral arthrosis who underwent a new surgical technique, retinacular interposition arthroplasty. Materials and methods: The present study is a case series. Eleven patients with positive diagnosis for isolated patellofemoral arthrosis who underwent to retinacular interposition arthroplasty were evaluated in the Orthopedics and Traumatology Service of Hospital de Clínicas de Porto Alegre for function and articular range of motion of the knee during the preand postoperative period. Follow-up was at least 2 years. The evaluation of function was carried out using the Knee Outcome Survey Activities of Daily Living Scale. The range of flexion and extension motion were measured by means of a goniometer. Pre- and postoperative results were compared. Results: After an average follow-up period of 25.9 months (between 24 and 29 months), 10 of the 11 patients showed improved functional outcomes. Average scores obtained by the Knee Outcome Survey Activities of Daily Living Scale was 34.0 ± 12.4 (CI 95% = 25.7 – 42.3) before surgery and 55.8 ± 11.2 (CI 95% = 48.3 – 63.4) after surgery, with a statistically significant improvement (P < 0.001). One patient did not present any functional improvement, and presented a progression of the femorotibial arthrosis. Two years after the end of the postoperative period, the patient underwent total knee arthroplasty. No statistically significant increase was observed in motion of knee flexion and extension after the surgery. Conclusion: Retinacular interposition arthroplasty afforded good functional results in patients with isolated arthrosis of the patellofemoral joint. The technique may be a surgical alternative for young and middle-aged patients who suffer from articular degenerative process at advanced stage.

The Constitution of the United State has never been a document with a fixed and determinable meaning and demanded continual reinterpretation. During the early republic, legal and political battles over constitutional meaning were commonplace, leading to claims of disloyalty as well as threats of violence. Challenges to actions of the federal government often were done in the name of the Virginia and Kentucky Resolutions and the “Principles of ‘98.” Reflecting a strand of mainstream political thought, the Virginia and Kentucky Resolutions were employed by Pennsylvanians, who militarily resisted federal efforts to enforce a Supreme Court decision, by New Englanders, who effectively nullified certain federal laws during the War of 1812, and by South Carolinians, who attempted to nullify a federal tariff. Authored by James Madison and Thomas Jefferson, respectively, in 1798, the Resolutions offered differing visions of the nation’s founding. Jefferson interpreted the Constitution as a contract between state governments, akin to a treaty between independent nations. Thus, unconstitutional actions by the federal government were a breach of the compact, and each state had a right to nullify the offending action. For Madison, the thirteen peoples of the several states, acting in their highest sovereign capacity, were the parties to the compact. Madison did not interpret the Constitution as a contract or treaty and did not deem every breach of the compact as justifying nullification by the people. Only a majority of the people could nullify actions of the federal government.

Obesity and Diabetes, the major cause for morbidity and mortality in United States raises a general curiosity regarding health care expenses when talked about treating them. Every year approximately 300,000 US adults die of reasons associated to obesity and diabetes, becoming the sixth leading cause of death. The prevalence of those diagnosed with diabetes witnessed an exponential curve in the last decade and for the year 2011 about 8.3% of the population in the US has been diagnosed with diabetes and it is predicted that in the year 2030 the prevalence of diabetes is to reach 4.4% globally. Type 2 diabetes is a condition, which develops when the body no longer makes enough insulin or when the insulin so produced does not work effectively. In reaction to the increase in obesity, treatments for obesity became more common especially the pharmacological treatments. Since this treatment also required one to change their lifestyle and food habits, bariatric surgeries were considered as an option to treat obesity and diabetes. A range of surgical procedures have been used to stimulate weight loss for obese patients. These procedures resulted in weight loss by restricting the size of the stomach (Gastric Banding) or bypassing a portion of the intestine (Gastric Bypass). Roux-en-Y Gastric Bypass (RYGB) accomplishes weight loss during a combination of gastric restriction and malabsorption. Reduction of the stomach to a small gastric pouch results in feelings of satiety. The RYGB procedure has been performed regularly since the early 1980s; it was first performed laparoscopically in the early 1990s. Ileal interposition (IT) is a surgical procedure where a section of ileum is snipped and moved closer to the jejunum. It is said that the food takes just ten minutes to reach the ileum instead of an hour after this procedure. The ileum produces Glucagon like Peptide-1 (GLP-1) which helps in insulin secretion. Glucose is a key stimulator for mammals and is derived from the diet consumed, transferred from the circulation into the target cells. Glucose penetrates the eukaryotic cells through membrane associated carrier proteins, the Na+ coupled glucose transporter (SGLT-1) and the glucose transporter (GLUT). These transporters are structurally and functionally distinct. The main research question was "are the receptors involved in glucose transport across the membrane (GLUT2 and SGLT1) important for Ileal Interposition"? With experiments like real time PCR (qPCR) and immunohistochemistry (IHC), we have observed the differences in the expression of these receptors with respect to the location and organ. Ileal interposition showed a significant difference (p<0.01) compared to sham-operated rats in the expression of GLUT2 in the gluconeogenic organs. The increased GLUT2 levels in ileal interposition may explain glucose sensitivity and these data emphasize the need for GLUT2 to maintain a positive glucose homeostasis and further study on SGLT1/GLUT2 influence on gluconeogenesis.

Antinomique semble être l’expression la plus adaptée pour traduire les relations qu’entretiennent les notions de tiers et de contrat. Toutefois, cette approche doit être dépassée puisque le droit objectif offre aux tiers diverses techniques juridiques leur permettant d’intégrer le contrat. La thématique de l’entremise des tiers dans le contrat trouve sa traduction la plus aboutie dans la figure du changement de contractant. Néanmoins, elle est dépendante de diverses opérations juridiques à trois personnes. En effet, chacune de ces techniques prétend constituer le nœud juridique de la figure du changement de contractant. Toutefois, il ne s’agit pas de rechercher l’existence d’un mécanisme original de remplacement de contractant à la formation du contrat et/ou à l’exécution de celui-ci. En effet, cette contribution vise à proposer un nouveau fondement à ces opérations. Or, la notion d’interposition possède en elle la capacité de subsumer l’ensemble de ces techniques. Puisant ses sources au sein du droit financier, elle traduit juridiquement le phénomène d’intégration des tiers dans la relation contractuelle et plus précisément la figure du changement de contractant. Cette contribution a donc pour vocation de faire accéder la notion d’interposition au rang de qualification autonome. Pour cela, il est nécessaire d’en dégager les contours ainsi que les caractéristiques pour se pencher ensuite sur son régime juridique. / Antinomic seems to be the most appropriate expression for translating the relations between the notions of third parties and contracts. However, this approach must be overcome since the objective right offers third parties various legal techniques enabling them to integrate the contract. The subject of third party intervention in the contract finds its most successful translation in the figure of the change of contracting party. However, it is dependent on various legal operations to three people. Each of these techniques claims to constitute the legal node of the figure of the change of contracting party. However, it is not a question of seeking the existence of an original mechanism for replacing the contractor in the formation of the contract and / or in the execution of the contract. This contribution aims to propose a new basis for these operations. Now, the notion of interposition has the capacity to subsume all these techniques. Drawing its sources from financial law, it legally translates the phenomenon of integration of third parties into the contractual relationship and more precisely the figure of change of contracting party. This contribution is therefore intended to make the notion of interposition accessible to the rank of autonomous qualification. To do this, it is necessary to identify the contours and the characteristics of the system and then examine its legal regime.

Durant cette thèse, nous nous sommes intéressés à la problématique de la captation de mouvement sans marqueurs. Une approche classique est basée sur l'utilisation d'un modèle prédéfini du sujet, et est divisée en deux phases : celle d'initialisation, où la pose initiale du sujet est estimée, et celle de suivi, où la pose actuelle du sujet est estimée à partir des précédentes. Souvent, la phase d'initialisation est faite manuellement, rendant impossible l'utilisation en direct, ou nécessite des actions spécifiques du sujet. Nous proposons une phase d'initialisation automatique et temps-réel, utilisant l'information topologique extraite par squelettisation d'une reconstruction 3D du sujet. Cette information est représentée sous forme d'arbre (arbre de données), qui est mis en correspondance avec un arbre utilisé comme modèle, afin d'identifier les différentes parties du sujet. Pour obtenir une telle méthode, nous apportons des contributions dans les domaines de la topologie discrète et de la théorie des graphes. Comme notre méthode requiert le temps réel, nous nous intéressons d'abord à l'optimisation du temps de calcul des méthodes de squelettisation, ainsi qu'à l'élaboration de nouveaux algorithmes rapides fournissant de bons résultats. Nous nous intéressons ensuite à la définition d'une mise en correspondance efficace entre l'arbre de données et celui décrivant le modèle. Enfin, nous améliorons la robustesse de notre méthode en ajoutant des contraintes novatrices au modèle. Nous terminons par l'application de notre méthode sur différents jeux de données, démontrantses propriétés : rapidité robustesse et adaptabilité à différents types de sujet / This manuscript deals with the problem of markerless motion capture. An approach to thisproblem is model-based and is divided into two steps : an initialization step in which the initialpose is estimated, and a tracking which computes the current pose of the subject using infor-mation of previous ones. Classically, the initialization step is done manually, for bidding the possibility to be used online, or requires constraining actions of the subject. We propose an automatic real-time markerless initialization step, that relies on topological information provided by skeletonization of a 3D reconstruction of the subject. This topological information is then represented as a tree, which is matched with another tree used as modeldescription, in order to identify the different parts of the subject. In order to provide such a method, we propose some contributions in both digital topology and graph theory researchfields. As our method requires real-time computation, we first focus on the speed optimization of skeletonization methods, and on the design of new fast skeletonization schemes providing good results. In order to efficiently match the tree representing the topological information with the tree describing the model, we propose new matching definitions and associated algorithms. Finally, we study how to improve the robustness of our method by the use of innovative con-straints in the model. This manuscript ends by a study of the application of our method on several data sets, demon-strating its interesting properties : fast computation, robustness, and adaptability to any kindof subjects

Considerando que à na linguagem e por meio dela que o indivÃduo se constitui como sujeito, desenvolvemos esta pesquisa, centrada na interrelaÃÃo que podemos estabelecer entre o processo da argumentaÃÃo, a problematizaÃÃo sobre discurso e sobre gÃnero textual e a subjetividade. Buscamos investigar, em fÃbulas bastante peculiares, como se dà a construÃÃo da argumentaÃÃo baseada no modelo dialogal da Teoria da ArgumentaÃÃo de Christian Plantin (1996; 2008) e partimos da hipÃtese de que a argumentaÃÃo na fÃbula em estudo se constrÃi especialmente por meio de estratÃgias usadas pelo narrador, instanciado por um sujeito/autor, as quais lhe permitem assumir papÃis argumentativos diferentes de acordo com seu nÃvel de envolvimento na argumentaÃÃo. Ainda acreditamos que, conforme a teoria plantiniana, o narrador assume tais papÃis a fim de fazer avaliaÃÃes do mundo narrado como recurso argumentativo, num movimento em direÃÃo ao leitor; que a inserÃÃo dessas avaliaÃÃes confere à fÃbula analisada um modo particular de organizaÃÃo; que a subjetividade se instaura sobremodo por meio do recurso da interposiÃÃo â forma privilegiada da intervenÃÃo do sujeito na construÃÃo do seu dizer. A projeÃÃo do narrador nas fÃbulas analisadas constitui formas de interaÃÃo e comunicaÃÃo entre este e o interlocutor, o que conduziu nossa pesquisa a uma anÃlise que busca uma semiÃtica da interaÃÃo textual, a partir da qual se pode depreender que o sentido construÃdo em um texto, por um dado discurso, nÃo deriva do sistema, mas das atividades do uso desse sistema, das suas possibilidades à elaboraÃÃo de sentidos, compartilhados dialÃgica e socialmente pelos interlocutores. O corpus da pesquisa à constituÃdo de cem fÃbulas de MillÃr Fernandes, formas atualizadas do gÃnero fÃbula, as quais foram analisadas qualitativamente, a partir do instrumental oferecido pela Teoria da Avaliatividade, de Martin & White (2005), mais especificamente pelo subsistema do engajamento, em busca de uma abordagem pragmÃtico-discursiva. Acreditamos que o processo argumentativo de que tratamos nas fÃbulas millorianas â que deixam entrever um discurso e um contradiscurso â de fato se dà a partir do recurso da interposiÃÃo usado pelo narrador, para se projetar no texto, e isso lhe permite assumir papÃis argumentativos diferentes, de acordo com seu engajamento no jogo argumentativo. Esse engajamento se estabelece num continuum, num contexto de menor ou maior expansÃo dialÃgica, sobremodo porque identificamos inÃmeras ocorrÃncias em que esses papÃis se sobrepÃem ou se imbricam. / Considering that in language and through it the individual is constituted as subject, we developed this research, focusing on the interrelation we can establish between the process of argumentation, questioning about discourse, text genre and subjectivity. We sought to investigate in very peculiar fables, how the construction of arguments based on the dialogic model of the Argumentation Theory of Christian Plantin (1996, 2008) takes place, and set out from the hypothesis that the arguments in the fable studied builds itself especially through strategies used by the narrator, instantiated by a subject/author, which allow it to take different argumentative roles according to its level of involvement in the argument. We also believe that, according to the Plantinian theory, the narrator assumes such roles in order to assess the narrated world as an argumentative resource, in a movement toward the reader, that the inclusion of these reviews give the fable considered a particular form of organization, that the subjectivity is established greatly through the use of interposition - privileged form of the intervention of the subject in the construction of its sayings. The projection of the narrator in the analyzed fables constitutes forms of interaction and communication between him/her and the interlocutor, which led our research to an analysis that searches for the semiotics of textual interaction, from which one can infer that the meaning constructed in a text, for a single discourse, does not derive from the system, but from the activities of the use of this system, and from its possibilities of elaboration of meanings, dialogically and socially shared by the interlocutors. The research corpus is composed of one hundred of Millor Fernandes fables, current forms of the fable gender, which were qualitatively analyzed, from the instrumentals provided by the Theory of Assessment of Martin & White (2005), more specifically the engagement subsystem in search of a pragmatic-discursive approach. We believe that the argumentative process we are dealing with in the Millorian fables - that display a speech and a counter speech- actually happens when the resource of interposition is used by the narrator to project himself in the text, and it allows him to take different argumentative roles, according to his engagement in argumentative game. This engagement happens in a continuum, in a context of greater or lesser dialogic expansion, greatly because we identified numerous instances in which these roles overlap or intertwine.

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La simulation est un mensonge. Cette notion prend des caractéristiques particulières lorsqu’il s’agit de simuler un contrat. La simulation de contrat est une des plus fascinantes institutions du micro univers des contrats. Elle consiste en une convention par laquelle les co-contractants dissimulent soit une partie soit l’intégralité de leur vrai accord. Ni le législateur français ni le législateur vénézuélien ne se sont préoccupés de définir ce qu’on doit comprendre par simulation de contrat en droit civil. Ce vide n’a été rempli ni par la doctrine, ni par la jurisprudence. Chaque auteur, et presque chaque décision, a sa propre notion de simulation de contrat. Cette situation n’apporte aucune sécurité lorsqu’on veut identifier une opération de cette nature. Dans ce travail, nous nous sommes fixés la tâche d’identifier les éléments qui confortent l’opération de simulation de contrat, tant en droit civil français qu’en droit civil vénézuélien. / Simulation is a lie. This notion takes on special characteristics when it comes to simulating a contract. The simulation of contract is one of the most fascinating institutions of the micro-world of contracts. A contract is a simulation when, by mutual agreement of the parties, it does not express their true intent. It is an agreement to hide all or part of the true agreement. Neither French law nor Venezuelan legislators have taken the trouble to define what we should understand by simulation of contract in civil law. This loophole has been filled either by doctrine or case law. Every author and almost all decisions have their own notion of contract simulation. This obviously provides no sure footing when seeking to identify a transaction of this nature. In this work, we have set ourselves the task of identifying the fundamental elements behind simulation of contracts, both in French and Venezuelan civil law.