Neste trabalho, definimos a obstrução local de Euler de um espaço analítico complexo singular (X, \'x IND.0\'), denotada por Eu(X, \'x IND.0\'), e a obstrução local de Euler de uma função holomorfa f definida neste espaço, com uma singularidade isolada em \'x IND. 0\', denotada por \'Eu IND. f\' (X, \'x IND.0\'); e apresentamos duas fórmulas para seus respectivos cálculos. Em seguida, através de uma abordagem geométrica, determinamos as relações entre \'Eu IND. f\' (X,\'x IND.0\') e algumas generalizações do número de Milnor para funções em espaços singulares / In this work we define the local Euler obstruction of a complex analytic singularity (X, \'x IND.0\'), denoted Eu(X, \'x IND.0\'), and the local Euler obstruction of a holomorphic function f defined on this space, with an isolated singularity at \'x IND. 0\', denoted \'Eu IND. f\' (X, \'x IND.0\'); and we present two formulas for their respective calculations. Next, using a geometric approach, we determine the relations between \'Eu IND.f\' (X, \'x IND.0\') and several generalizations of the Milnor number for functions on singular spaces

Neste trabalho determinamos relações entre a obstrução de Euler de uma função analítica com singularidade isolada f e o número de Milnor de f definido por Bruce e Roberts para funções definidas em espaços singulares. Apresentamos também uma generalização da obstrução de Euler de uma função analítica com singularidade isolada para o caso de uma aplicação \'f : (V, 0) seta (\'C POT. k\', 0) onde (V, 0) é o germe de uma variedade analítica complexa, equidimensional de dimensão \' n > OU = k\' , e uma fórmula para calcular a obstrução de Euler de k-referenciais, em termos da obstrução de Euler de f / In this work we determine relations between the local Euler obstruction of an analytic function singular at the origin to the case of a analytic map \'f : (V, 0) seta (\'C POT. k, 0\'), where (V, 0) is the germ of a complex analytic variety, equidimensional of dimension \' n > OU = k\', and a formula which computes the local Euler obstruction, defined for k-frames, in the local Euler obstruction of f

A obstrução intestinal mecânica representa uma condição de urgência, necessitando diagnóstico precoce e terapêutica adequada, em virtude do seu elevado grau de morbidade e de mortalidade. Desta forma, o objetivo deste estudo foi avaliar o efeito da N-acetilcisteína associada ao Ringer lactato ou à solução salina hipertônica na resposta inflamatória, histologia e translocação bacteriana em modelo experimental de obstrução e isquemia intestinal. Para tanto, Foram constituídos quatro grupos experimentais, com 10 ratos Wistar em cada, além do grupo de referência: OI - Submetidos a obstrução e isquemia intestinal e enterectomia com anastomose intestinal, sem reanimação volêmica; RL - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com Ringer lactato (32ml/kg, i.v., em 10 minutos) e enterectomia com anastomose intestinal; RLNAC - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com Ringer lactato associado a NAC (32ml/kg + 150 mg/kg i.v. em 10 minutos) e enterectomia com anastomose intestinal; SHNAC - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com solução salina hipertônica a 7,5% associado com NAC (4ml/kg + 150 mg/kg i.v., em 10 minutos) e enterectomia com anastomose intestinal. Grupo Referência (n=5): Animais anestesiados, submetidos a coleta de materiais para cultura e histologia e sacrificados por exsanguinação. Os animais receberam uma associação anestésica de cetamina e xilazina intramuscular em membro posterior direito, na dose de 60mg/kg e 10mg/kg, respectivamente. Decorridas 24 h do tratamento, a eutanásia foi realizada por exanguinação, sob anestesia, após a coleta dos tecidos / Mechanical intestinal obstruction represents a condition of urgency, necessary early diagnosis and appropriate therapy, due to their high degree of morbidity and mortality. In this way, the objective of this study was to evaluate the effect of N-acetylcysteine associated with lactated Ringer\'s or hypertonic saline solution in the inflammatory response, histology and translocation in an experimental model of intestinal obstruction and ischemia. For Four experimental groups were constituted with 10 Wistar rats each, in addition to the reference group: OI - submitted to obstruction and ischemia intestinal and enterectomy with intestinal anastomosis, without volume resuscitation; RL - Undergoing intestinal obstruction and ischemia, volume resuscitation with Ringer\'s lactate (32ml / kg, i.v., within 10 minutes) and anastomosis enterectomy intestinal; RLNAC - Undergoing obstruction and intestinal ischemia, resuscitation with lactated Ringer\'s lactating NAC (32 ml / kg + 150 mg / kg i.v. in 10 minutes) and enterectomy with intestinal anastomosis; SHNAC - Submitted to obstruction and intestinal ischemia, volume resuscitation with saline solution hypertension at 7.5% associated with CAP (4 ml / kg + 150 mg / kg i.v., in 10 minutes) and enterectomy with intestinal anastomosis. Reference Group (n = 5): Anesthetized animals, submitted to collection of materials for culture and histology and sacrificed by exsanguination. The animals received a anesthetic association of ketamine and intramuscular xylazine in limb posterior right, at the dose of 60mg / kg and 10mg / kg, respectively. After 24 h of treatment, euthanasia was performed by exsanguination, under anesthesia, after collection of tissues

Orientadores: Valfrido Antonio Pereira Filho, Márcio de Moraes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T01:23:09Z (GMT). No. of bitstreams: 1 Menegat_Fabiano_M.pdf: 1317919 bytes, checksum: 61ce561ad17c6220b258f90a146bda84 (MD5) Previous issue date: 2014 / Resumo: Este estudo avaliou prospectivamente os sintomas de obstrução nasal em pacientes submetidos à expansão rápida da maxila cirurgicamente assistida (ERMCA) usando a escala NOSE (Nasal Obstruction Symptom Evaluation). Foram estudados dezesseis pacientes (idade média 31 ± 7,7 anos), dez mulheres e seis homens, que necessitaram de ERMCA. Os pacientes receberam no pré-operatório, aparelhos do tipo Hyrax e os procedimentos de ERMCA foram executados pela técnica de Kraut (1984), sob anestesia geral. O questionário (NOSE) foi aplicado no pré-operatório e aos seis meses de pós-operatório e os resultados foram comparados. Os resultados para cada indicador foram obtidos em uma escala que variou de 0 a 4 e multiplicados por 5, gerando uma escala de 0 a 100. Os dados foram estratificados de acordo com os índices NOSE e a obstrução nasal foi categorizada como LEVE (0 a 25), MODERADA (26 a 50) e GRAVE (> 50). Os dados foram submetidos ao tratamento estatístico utilizando-se o pacote estatístico SAS®, e o teste de Wilcoxon foi utilizado para comparação entre os grupos, com nível de significância de 5%. Todos os pacientes mantiveram ou melhoraram dos sintomas de obstrução nasal seis meses após a ERMCA, quando avaliados por meio da escala NOSE. Concluiu-se que a avaliação por meio da escala NOSE demonstrou que a ERMCA pode melhorar a sintomatologia de obstrução nasal / Abstract: This study prospectively assessed nasal obstruction symptoms in patients submitted to surgically assisted rapid maxillary expansion (SARME) using the NOSE (Nasal Obstruction Symptom Evaluation) scale. Sixteen patients were included (mean age 31 ± 7,7 years), ten women and six men, who needed SARME. All patients received Hyrax type devices in the preoperative period and SARME was performed by the Kraut¿s technique (1984). The NOSE scale was used to prospectively assess nasal obstruction symptoms. Results were recorded for each score in a scale ranging from 0 to 4 and multiplied by 5, generating a scale from 0 to 100. Data were stratified according NOSE scores and nasal obstruction was categorized as MILD (0 to 25), MODERATE (26 to 50) and SEVERE (> 50). The questionnaire was applied in preoperative period and after six months and results compared. Records were statistically analyzed using SAS¿ statistical pack. The Wilcoxon test was employed for comparison between groups with a significance level of 5%. All patients maintained or improved of nasal obstruction symptoms six months after SARME when evaluated with NOSE scale. In conclusion, maxillary expansion may improve nasal obstruction symptoms / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13325号 / 論医博第2193号 / 新制||医||1043(附属図書館) / (主査)教授 黒田 知宏, 教授 藤渕 航, 教授 別所 和久 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

More spirometric analysis needs to be performed in order to discover lung diseases like chronic obstructive pulmonary disease (COPD). A mini spirometer can quickly and easily be used for screening. Today, a plethysmograph is used at the hospital in Helsingborg at the department of clinically physiology. However, they also have a mini spirometer, which is seldom used. By comparing the mini spirometer with the reference (the plethysmograph), results may indicate whether it could be possible to use the mini spirometer for screening or in other situations at the department when immediate and reliable information about lung function is needed. As a total of 45 patients participated in this study. All were examined with the mini spirometre after the conventional spirometry using a reversibility test. Of these there were 41 who were used in the study. After the conventional spirometry, they performed 4 - 7 forced expirations followed by inspirations. Theparameters investigated were FVC (forced vital capacity), FEV1 (forced expiratory vital capacity in 1 second), and FEV1/FVC. For the conventional spirometry slow VC was used, according to clinical routine. With 95 % CI the mean ・} SD was calculated to be for FVC between the 2 methods -0,19 ・} 0,30 litre. For FEV1 the results were 0,04 ・} 0,13 litre and for FEV1/FVC 0,05 ・} 0,05 litre. Paired t-test resulted for FVC in t = 4,1. FEV1 gave t= 1,79 and for FEV1/FVC was t= 6,28. The t-values were compared with t critical= 2,03 which were taken from a table. A lower t- value than t critical suggests that the methods are comparable. When comparing the difference between the both methods, FEV1 agreed well, while FVC and FEV1/FVC was too large. / Fler spirometrier behover genomforas for att upptacka lungsjukdomar som t.ex. kronisk obstruktiv lungsjukdom (KOL). En minispirometer kan snabbt och enkelt screena for detta. Pa Helsingborgs lasarett pa avdelningen for klinisk fysiologi anvands rutinmassigt enbart en plethysmograf-spirometer, trots att det dar aven finns en minispirometer. Genom att undersoka hur noggrann minispirometern ar jamfort med den vanligtvis anvanda spirometern, kan den lilla varianten i vissa fall anvandas vid t.ex. screening eller i samband med andra undersokningar dar information om lungfunktion behovs. Sammanlagt stallde 45 konsekutiva patienter upp pa analys via minispirometri efter genomford konventionell spirometri med reversibilitetstest. Av dessa anvandes 41 stycken i undersokningen. Efter den konventionella spirometrin fick de utfora 4 - 7 forcerade expirationer direkt foljt av inspirationer. De parametrar som anvandes var forcerad expiratorisk volym under den forsta sekunden (FEV1), forcerad vital kapacitet (FVC) och kvoten FEV1/FVC. For den konventionella spirometrin anvandes langsam VC enligt klinisk rutin. Med 95 % KI beraknades medelvardet och SD for skillnaden i FVC mellan de bada metoderna till -0,19 ・} 0,30 liter. For FEV1 var resultatet 0,04 ・} 0,13 liter och kvoten FEV1/FVC gav 0,05 ・} 0,05. Parat t-test gav for FVC t= 4,1. For FEV1 t= 1,79 och for kvoten FEV1/FVC t= 6,28. T- vardena jamfordes med t kritiskt = 2,03 som erholls ur en tabell. Ett lagre t- varde an tkritiskt antyder att metoderna ar tillrackligt lika. FEV1 stamde bra overens mellan de bada metoderna. Det fanns en signifikant skillnad for FVC och forkvoten FEV1/FVC.

Orientador: Priscylla Tatiana Chalfun Guimarães Okamoto / Resumo: A doença do trato urinário inferior de felinos (DTUIF) corresponde a uma série de afecções que podem acometer a bexiga e a uretra desses animais. A forma obstrutiva é a consequência mais prevalente e mais grave dentre outras DTUIF, podendo levar o animal a azotemia pós-renal, redução da taxa de filtração glomerular (TFG) e a lesão renal aguda (LRA), que caso não seja tratada de forma eficiente, pode evoluir para doença renal crônica (DRC), uma doença frequente na população geriátrica felina. A creatinina sérica (sCr) é o biomarcador de TFG mais utilizado na clínica veterinária, porém apresenta baixa sensibilidade e diversos fatores que podem afetar seus valores. A dimetilarginina simétrica (SDMA) é um biomarcador mais recente na medicina veterinária que vem apresentado maior precocidade na detecção da perda da função renal e menor interferência de fatores extrarrenais, porém poucos são os trabalhos que determinam valores de SDMA em lesão renal de gatos. Este trabalho visou avaliar os valores de SDMA e compará-los com a sCr, ureia, dados hemogasométricos, escore clínico e tempo de obstrução de gatos com DTUIF obstrutiva. Os animais foram alocados em dois grupos experimentais, sendo 17 animais do grupo obstruído (GO) e 13 animais sadios para grupo controle (GC). As amostras foram coletadas antes da desobstrução (M0) e durante o tratamento clínico, nos momentos 12, 24 e 48 horas (M12, M24 e M48). Resultados obtidos demonstraram que no M48 do GO, 50% dos gatos obstruídos apresent... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Feline lower urinary tract disease (FLUTD) is a series of conditions that can affect the bladder and urethra of these animals. The obstructive form is the most prevalent and most serious consequence among other FLUTD, which can lead to post-renal azotemia and reduced glomerular filtration rate (GFR) and acute kidney injury (AKI), which if not treated effectively, can progress to chronic kidney disease (CKD), a common disease in the feline geriatric population. Serum creatinine (sCr) is the biomarker of GFR most commonly used in veterinary pratice, but it has low sensitivity and there are several factors that may affect its values. Symmetrical dimethylarginine (SDMA) is a newer biomarker in veterinary medicine that has been shown to be more precocious in detecting loss of renal function and less interference of extrarenal factors, but there are few studies determining SDMA values in feline kidney injury. This work aimed to evaluate SDMA values and to correlate them with sCr, urea, hemogasometric data, clinical score and duration of obstruction of felines with obstructive DTUIF. The animals were allocated into two experimental groups, 17 animals from the obstructed group (GO) and 13 healthy animals for control group (GC). Samples were collected before clearance (M0) and during clinical treatment at 12, 24 and 48 hours (M12, M24 and M48). The results obtained were that in GO M48, 50% of obstructed cats had SDMA values above normal, while for sCr only 29.41% of cats were elevated... (Complete abstract click electronic access below) / Mestre

When a malfunction in the collection system occurs and a pipe overflows, the wastewater may be discharged in the natural environment. To avoid such pollution, nuisances to inhabitants living nearby and extra cost for the operator, there is an issue of detecting early enough the buildup of obstructions in sewerage pipes in order to react before the damage is done. The aim of this thesis was thus to develop a decision support tool to detect obstructions and to optimize cleaning operations. Some additional specifications were the file size for sending by email, the simplicity of setup and use, the visual attractiveness and a quick visualization of results. The tool consists of two Excel files coupled with a database which permits to send a daily email to the operator with the functioning state of each measurement point. However, the tool does not do everything, human analysis is necessary to have a critical eye on the results and to decide when to trigger a cleaning operation. The main perspective at the end of this thesis is the replacement of the preventive cleaning operations that were previously performed with a fixed frequency per year by conditional cleaning operations triggered by the tool and to observe the decrease of cleaning operations. Other perspectives are to spread the tool to other sites and to use the received feedbacks to adjust the different parameters and eventually to determine an automatic trigger condition of cleaning operations.

Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel (“neo left main”) that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve. Although valve-in-valve in a Mitroflow degenerated bioprosthesis is a relatively safe procedure, 2 or more stents may be necessary to scaffold a channel to the coronary arteries between Edwards Sapien 3 prosthesis and aorta in the event of a coronary obstruction.

Introduction: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is the commonest benign paediatric neoplasm. There is no curative treatment, but the condition is self-limiting. Current primary treatment is aimed at symptomatic relief, comprising of serial surgical debulking of obstructive papillomas along the respiratory tract, with voice preservation. Adjuvant therapy is indicated in severe cases. Objective: A review of children with JoRRP presenting to the ENT Department at Red Cross War Memorial Children’s Hospital (RCWMCH) over 2 years. Evaluation of the pattern of disease and factors that may contribute to disease severity were reviewed. Method: Retrospective folder review of children with histologically confirmed laryngeal papillomatosis over above the time period. Results: Twenty children were included. Nine were male, 11 were female. The median age at diagnosis was 2.4 years (11 - 109 months). Presentation at < 3 years was noted in 5/7 of the most severe cases. Nine of 20 were HPV serotyped; 5 were type 11, and 4 were type 6. Eighty percent (16/20) were HIV negative; 10% (2/20) HIV positive; and 10% (2/20) were unknown. A total of 90 surgical procedures were performed; the highest number of surgeries per child was 13. Inter-surgical time was 1 to 164 weeks (median 9 weeks). Four received Gardasil vaccination as adjuvant therapy, 3 of who showed a reduction in disease severity. Conclusion: JoRRP commonly presents around the first 3 years of life. Severe cases can be life-threatening, often with multiple hospital admissions for clearance of surgical papillomata. Severe cases presented before 3 years. Gardasil vaccination as adjuvant therapy has promise. No identifiable risk factors in our review were noted. HIV co-infection and HPV type were not risk factors for severity.