Source: Masters Abstracts International, Volume: 45-04, page: 1935. Adviser: Erich M. Sturgis. Includes bibliographical references.

Thèse d'exercice : Médecine. Rhumatologie : Nantes : 2008. / Bibliogr.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (M.Sc.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Speech-Language Pathology, Department of Speech Pathology and Audiology. Title from pdf file main screen (viewed on July 25, 2010). Includes bibliographical references.

Orientador: Frederico Andrade e Silva / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T02:02:50Z (GMT). No. of bitstreams: 1 Alves_MarcelaRodrigues_D.pdf: 3962410 bytes, checksum: f9ab6a09265ef5789e38c0c28c3e6e4e (MD5) Previous issue date: 2009 / Resumo: O objetivo desta pesquisa foi avaliar a relação entre a morfologia crânio-facial, o espaço aéreo faríngeo, a posição do osso hioide e a postura crânio-cervical. Foram realizadas radiografias cefalométricas de perfil de 52 voluntários em posição natural, na faixa etária entre 18 e 28 anos, de ambos os gêneros, selecionados aleatoriamente, que não apresentassem histórico de tratamento ortodôntico, ausências de dentes (exceto os terceiros molares), presença de anomalias de crescimento ou desenvolvimento do esqueleto craniofacial (exceto prognatismo e retrognatismo), uso de qualquer tipo de aparelho oclusal e voluntários com amaurose (perda visual total) ou fonoaudiológicas graves. Foram obtidas medidas lineares e angulares da morfologia crânio-facial, do espaço aéreo faríngeo, da posição do osso hioide e da postura crânio-cervical. Os dados coletados foram agrupados e as variáveis relacionadas pela Correlação Linear de Pearson (a=0,05). A posição anteroposterior do osso hioide apresentou maior relação com o comprimento do corpo mandibular (r=0,50) e comprimento (r=0,62) e área intermaxilar (r=0,57), todos com p<0,01, porém foi detectada fraca relação com a inclinação da coluna cervical (r=-0,28; p<0,05). Sua posição superoinferior estava relacionada (p<0,01) com a altura facial anterior (r=0,79) e a altura do terço inferior da face (r=0,63). A inclinação do osso hióide apresentou relação com o eixo de crescimento (r=0,39; p<0,01), porém essa variável apresentou relação mais forte com a postura crânio-vertical (r=0,58; p<0,01) e crâniocervical (r=0,57; p<0,01). A distância do osso hioide à sínfise mandibular apresentou relação significativa (p<0,01) com a postura crânio-cervical (r=0,52) e cervical (r=-0,44). As posturas crânio-vertical e crânio-cervical apresentaram considerável relação (p<0,01) com o ângulo SNB, inclinação mandibular e com o eixo de crescimento. Não foi observada nenhuma relação entre a postura crânio-cervical e o espaço aéreo faríngeo. O diâmetro oro e hipofaríngeo apresentaram considerável relação (p<0,01) com o comprimento (r=0,67) e área intermaxilar (r=0,42) e com o eixo de crescimento (r=-0,50). Esses espaços apresentaram também relação significativa com a posição anteroposterior do osso hioide e com a distância deste a sínfise mandibular, sendo mais forte ainda, a relação com o espaço aéreo hipofaríngeo (r=0,59 e r=0,52, respectivamente; p<0,01). Pode-se observar que existe uma grande interação morfofuncional entre as estruturas da cabeça e pescoço. O conhecimento destas relações é importante, quando se pretende realizar alguma intervenção capaz de alterar o equilíbrio entre elas ou ainda que se proponha a corrigir a ausência deste. / Abstract: The aim of this research was to evaluate the relation between the craniofacial morphology, pharyngeal airway space, the hyoid bone position and the craniocervical posture. Lateral cephalometric radiographs were obtained from 52 volunteers in natural head posture, among 18 and 28 years old, of both genders, randomly selected, that had not historical of orthodontic treatment, tooth absences (except the third molar ones), presence of growth or development anomalies of the craniofacial skeleton (except prognathism and retrognathism), use of any type of occlusal appliance and volunteers with amaurosis (visual loss) or serious phonoaudiological deficiencies. Linear and angular measurements referring to the craniofacial morphology, pharyngeal airway space, hyoid bone position and craniocervical posture had been taken. The collected data were grouped and the variables had been related by means of Pearson Linear Correlation (a=0.05). The hyoid bone anteroposterior position showed greater relation with the mandibular body length (r=0.50) and intermaxilary length (r=0.62) and area (r=0.57), both with p<0.01, besides it showed a weak relation with cervical column inclination (r=-0.28; p<0.05). The hyoid bone superoinferior position was strongly related (p<0.01) with the total anterior facial height (r=0.79) and facial lower third height (r=0.63). The hyoid bone inclination presented relation with the growth axis (r=0.39; p<0.01), however this variable presented strongest relation with the cranio-vertical (r=0.58; p<0.01) and cranio-cervical (r=0.57; p<0.01) postures. The hyoid bone to mandibular synphysis distance presented significant relation (p<0.01) with the cranio-cervical (r=0.52) and cervical (r=-0.44) posture. The craniovertical and cranio-cervical postures presented considerable relation (p<0.01) with prognathism, mandibular inclination and with the growth axis. It was not seen any relation between cranio-cervical posture and pharyngeal airway space. The oropharynx and lower pharyngeal diameter presented considerable relation (p<0.01) with the intermaxilary length (r=0.67) and area (r=0.42) and with the growth axis (r=-0.50). These spaces still presented significant relation with the hyoid bone anteroposterior position and with the hyoid bone to mandibular synphysis distance, being strongest to the lower pharyngeal space (r=0.59 and r=0.52, respectively; p<0.01). It could be observed that a great morphofunctional interaction exists between the head and neck structures. The knowlegd of these relations is important, when it is intend to do some intervention that is able of modify this balance or when the intention is correct an unbalance. / Doutorado / Protese Dental / Doutor em Clínica Odontológica

Orientadores: Mario Mantovani, Abrão Rapoport / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T01:14:15Z (GMT). No. of bitstreams: 1 Camargo_JoseGonzagaTeixeirade_D.pdf: 1421018 bytes, checksum: 7277108ea7a68080fcab48a0e55c77c4 (MD5) Previous issue date: 2004 / Resumo: Com o objetivo de analisar as complicações do tubo gástrico isoperistáltico na reconstrução de faringe os autores analisaram retrospectivamente 16 pacientes submetidos a faringolaringectomia total (FL) no período de julho de 1997 a dezembro de 2000. Todos os pacientes eram dos sexo masculino, idades entre os 38-74 anos (média 54), sendo nove eutróficos e sete desnutridos. Onze pacientes apresentavam lesão primária no seio piriforme, dois na área retrocricóideia, um na epiglote e duas recidivas (base da língua e faringe). Todos eram estadio IV. Quatro pacientes apresentavam tratamento prévio, três com cirurgia e um com radioterapia. Em dez pacientes foram realizadas faringolaringectomia total + esofagectomia cervical com esvaziamento linfonodal bilateral, em três faringolaringectomia total + esofagectomia cervical + esvaziamento cervical unilateral; em um faringectomia total e esofagectomia cervical; glossectomia total com faringectomia total + esofagectomia cervical em um paciente e a rotação do tubo gástrico em um paciente. O tempo cirúrgico variou de duas horas e trinta minutos a oito horas (média cinco horas). Somente um paciente não apresentou complicações. A complicação cirúrgica mais freqüente foi a fístula em doze pacientes (75%), seguida da deiscência em cinco (31,2%). As complicações clínicas ocorreram em 37,5% dos pacientes, sendo a mais freqüente a broncopneumonia em quatro casos (25%). O tempo de internação variou de cinco a 20 dias com média de oito dias. Dois pacientes faleceram, um de sepsis abdominal e outro por acidente vascular cerebral. Os dados foram submetidos a análise estatística. Concluímos que o tempo cirúrgico é um fator determinante de complicações, existe uma tendência dos pacientes com idades acima de 74 anos de apresentar complicações. As demais variáveis estudadas: idade, estado nutricional, confecção de retalhos, esplenectomias e tratamento prévio (radioterapia) não implicam necessariamente em complicações. Assim, não constituem fatores limitantes para utilização do tubo gástrico isoperistáltico com vistas à reconstrução da faringe e esôfago cervical / Abstract: The purpose of this study was to analyze complications when the isoperistaltic gastric tube is used in pharyngeal reconstruction. Therefore, the authors retrospectively analyzed 16 patients who had undergone total pharyngolaryngectomy during the period, July 1997 to December 2000. The study population consisted of male patients, whose ages ranged from 38 years to 74 years (mean 54 years). There were nine healthy patients and seven malnourished patients, who presented: primary lesions in the piriform sinus ¿11 patients, lesions in the retrocricoid area ¿ 02 patients, lesions in the epiglottis ¿01 patient and 2 recurrences (base of tongue and pharynx) . All were stage IV lesions and four patients had previously undergone treatment - three surgical and one radiotherapeutic. Ten patients underwent total pharyngolaryngectomy and cervical esophagectomy with bilateral lymphonodal emptying; three patients - total pharyngolaryngectomy and cervical esophagectomy with unilateral cervical emptying; one patient underwent total pharyngectomy and cervical esophagectomy; one patient underwent total glossectomy with total pharyngectomy and cervical esophagectomy; gastric tube rotation was performed in one patient. The duration of the surgery varied between two and a half hours and eight hours (mean 05 hours). Only one patient did not present complications. The most common complication was a fistula in twelve patients (75%), followed by dehiscence in five patients (31.2%). Clinical complications occurred in 37.5% of the patients, the most common was bronchopneumonia in 4 cases (25%). The hospitalization period varied between 05 days and 20 days (mean 08 days). Two patients died, one with abdominal sepsis and the other due to cerebrovascular accident. The data were statistically analyzed. We concluded that the duration of surgery was a determining factor for complications and patients above the age of 74 demonstrated a tendency to present complications. The other variables in this study such as age, nutritional status, creation of flaps, splenectomies as well as previous radiotherapy do not necessarily imply complications and, therefore, are not limiting factors when the isoperistaltic gastric tube is used in pharyngeal and cervical esophageal reconstruction / Doutorado / Cirurgia / Doutor em Cirurgia

Orientador: Francisco Haiter Neto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T19:01:13Z (GMT). No. of bitstreams: 1 Brasil_DanieliMoura_M.pdf: 14824425 bytes, checksum: 3057ff676ccce0f70d5ed273ef3ffed8 (MD5) Previous issue date: 2015 / Resumo: O objetivo deste estudo foi avaliar a influência da morfologia craniofacial em volumes e áreas transversais das vias aéreas superiores. Para isso, foram utilizadas 74 imagens por Tomografia Computadorizada de Feixe Cônico (TCFC) e 74 fotografias faciais em perfil lateral, que pertenciam aos mesmos pacientes, sendo 38 do sexo masculino e 36 do sexo feminino, com idades entre 18 e 56 anos (32,8 ± 1,8). As imagens foram selecionadas a partir de um arquivo de exames de pacientes atendidos em uma Clínica de Radiologia. Um radiologista experiente classificou a amostra em tipos esqueléticos ântero-posteriores (classe II e classe III) empregando a análise cefalométrica de Steiner e a medida AO-BO de Jacobson; e em padrões verticais (braquifacial, mesofacial e dolicofacial) utilizando a análise cefalométrica de Ricketts. A análise facial de perfil foi realizada para cada paciente. Medidas de volume total, de nasofaringe e de orofaringe e ainda de cinco áreas transversais ao longo das vias aéreas superiores foram realizadas, utilizando o software Insight ITK-SNAP 2.4.0®. Os resultados foram submetidos à análise estatística, em que o teste Mann-Whitney foi utilizado para analisar a influência do sexo e dos tipos esqueléticos ântero-posteriores nas variáveis do estudo, o teste Kruskal-Wallis foi aplicado para verificar a existência de relação entre os padrões verticais e as variáveis; o teste de Correlação de Spearman foi utilizado para analisar a possível correlação entre as medidas dentro dos padrões esqueléticos ântero-posteriores, dentro dos padrões verticais e dentro das variáveis da análise facial e as demais medidas propostas pelo estudo. Os resultados mostraram que o tipo esquelético ântero-posterior e o padrão vertical da face não influenciaram no volume das vias aéreas superiores; a área transversal na região de palato mole (PM) mostrou-se significativamente maior para classe III; o terço superior da face apresentou correlação negativa com as medidas da faringe e o terço médio da face mostrou correlação positiva com a área transversal PM. Concluiu-se que os padrões faciais não influenciaram no volume da faringe e que a observação fotográfica do perfil facial foi capaz de mostrar tendências de correlações entre terços da face e vias aéreas superiores / Abstract: The aim of this study was to evaluate the influence of craniofacial morphology in volumes and cross-sectional areas of the upper airway. For this 74 Cone Beam Computed Tomography (CBCT) images and 74 facial photographs in side profile were used, which belonged to the same patients, 38 males and 36 females, aged between 18 and 56 years (32.8 ± 1.8). The images were selected from a file examination of patients seen in a Radiology Clinic. An experienced radiologist classified the sample into anteroposterior skeletal types (class II e class III) using Steiner¿s analysis and the AO-BO measure Jacobson; and into vertical groups (brachyfacial, mesofacial and dolichofacial) using Ricketts¿ analysis. The facial profile analysis was performed for each patient. Measurement of volume and of five cross-sectional areas of upper airway were performed using Insight ITK-SNAP 2.4.0®. The data was subjected to statistical analysis, the Kruskal-Wallis test was used to verify the existence of a relationship between the vertical groups and other variables analyzed in the study. The Mann-Whitney test was used to analyze the influence of gender and anteroposterior skeletal types in the variables. Spearman Correlation test was used to analyze the possible correlation between measurements within vertical groups; within the anteroposterior skeletal types; and within variables of facial analysis, and other measures proposed by the study. Results showed that the anteroposterior skeletal type and the vertical pattern did not influence the volume of the upper airway; soft palate (SP) cross-sectional area was significantly greater in type class III; the upper facial third was negatively correlated with measures of the pharynx, and the middle facial third had positive correlation with the SP cross-sectional area. It was concluded that facial patterns do not influence the pharynx volumes. The photographic observation of the facial profiles is able to show trends of correlations between thirds of the face and upper airway / Mestrado / Radiologia Odontologica / Mestra em Radiologia Odontológica

Contexte : L’amiante est maintenant une cause avérée de cancer du larynx, mais le rôle des expositions professionnelles dans la survenue des cancers des voies aéro-digestives supérieures (VADS) reste largement méconnu. Bien que plusieurs études aient rapporté des associations entre les expositions professionnelles et ces cancers, il est difficile de synthétiser les résultats et d’en tirer des conclusions définitives. Objectifs : (1) Le premier objectif est de synthétiser les données épidémiologiques disponibles sur les associations entre les cancers de la cavité buccale, du pharynx et du larynx (les cancers des VADS les plus fréquents) et les expositions professionnelles ; (2) le second objectif est, à partir des données d’une large étude cas-témoins, l'étude Icare, d'identifier les professions ou industries présentant des risques élevés de cancer des VADS, puis d'étudier le rôle de certaines expositions professionnelles suspectées (amiante, laines minérales (LM), poussières de ciment, silice). Matériel et méthodes : (1) Une recherche bibliographique et des séries de méta-analyses ont été réalisées pour certaines expositions professionnelles suspectées. (2) L'étude Icare est une étude cas-témoins en population générale française incluant 2415 cas de cancer des VADS et 3555 témoins. L'historique professionnel complet des sujets a été recueilli, avec une description détaillée de chaque emploi exercé. L'évaluation des expositions à l'amiante, aux LM, aux poussières de ciment et à la silice sur l’ensemble de la vie professionnelle a été réalisée à l'aide des matrices emplois-expositions développées dans le cadre du programme Matgéné (Institut de Veille Sanitaire). Résultats : Des méta-risques relatifs (méta-RR) significativement augmentés ont été observés pour le cancer du larynx et les expositions aux hydrocarbures aromatiques polycycliques (HAP), aux gaz d'échappement de moteurs, au travail dans l'industrie textile et dans l'industrie du caoutchouc, et pour le cancer de la cavité buccale et du pharynx et les expositions à l'amiante, aux HAP et aux gaz d'échappement de moteurs. Des augmentations de risque significatives ont été observées pour plusieurs professions et secteurs d'activité exposant notamment aux nuisances présentant des méta-RR augmentés. Les résultats des analyses par nuisance confirment l'association entre l'amiante et le cancer du larynx et suggèrent également une association avec les cancers de la cavité buccale et du pharynx. Une association avec les poussières de ciment est également suggérée. Les résultats ne sont pas en faveur d’un rôle de l’exposition aux LM et à la silice.Conclusion : Ce travail renforce l’hypothèse d’un rôle des expositions professionnelles dans la survenue des cancers des VADS. Dans l’ensemble, nos résultats suggèrent des associations entre le risque de cancer des VADS et les expositions à l'amiante, aux HAP, aux poussières de ciment, et le travail dans l'industrie du caoutchouc. / Background: There is sufficient evidence that asbestos causes laryngeal cancer, but overall the role of occupational exposures in the etiology of head and neck cancer (HNC) remains largely unknown. Although several studies have reported associations between occupational exposures and HNC, it is difficult to draw firm conclusions. Objectives: (1) To summarize available epidemiologic data on occupational exposures and cancers of the oral cavity (OC), pharynx and larynx (the most frequent HNC); (2) using data from a large case-control study, to identify occupations and industries with an increased risk of HNC, then to investigate the role of some suspected occupational exposures (asbestos, mineral wools (MW), cement dust, silica). Methods: (1) A literature research and a series of meta-analyses were performed. (2) The Icare study is a French population-based case-control study including 2415 HNC cases and 3555 controls. Complete and detailed occupational histories were collected. Analyses by job title were conducted. Job exposure matrices, developed by the Occupational Health Department of the French Institute for Public Health Surveillance (InVS), were used to assess lifetime occupational exposure to asbestos, MW, cement dust and silica. Results: Significantly increased meta-relative risks (meta-RR) were obtained considering laryngeal cancer and exposures to polycyclic aromatic hydrocarbons (PAH), engine exhausts, working in the textile industry and the rubber industry, and for cancer of the OC and pharynx and exposures to asbestos, PAH and engine exhausts. Significantly increased risks were found for several jobs and industries, some of them entailing exposures to agents for which meta-RR were increased. Analyses for specific occupational exposures confirmed the association between asbestos and laryngeal cancer and showed an association with the risk of oral cavity and pharyngeal cancer. An association with exposure to cement dust was also suggested. The results did not support an association between HNC risk and exposure to MW or silica. Conclusion: This work emphasizes the role of occupational exposures in HNC. Overall, our results suggest associations between HNC and exposure to asbestos, PAH, cement dust, and work in the rubber industry.

Contexte : Le rôle de l’exposition professionnelle aux solvants dans la survenue de cancers des voies aéro-digestives supérieures (VADS), suggéré dans quelques études, n’a été que peu examiné, malgré leur utilisation très répandue en milieu de travail. Objectif : L’objectif de cette thèse état d’évaluer les associations entre les expositions professionnelles aux solvants et le risque de cancer des VADS. Méthodes : Ce travail est basé sur les données de l’étude Icare, une large étude cas-témoins en population générale conduite en France entre 2001-2007. L’analyse a été restreinte aux hommes et a porté sur 1857 cas de carcinome épidermoïde de la cavité buccale, du pharynx et du larynx, et 2780 témoins. L’histoire professionnelle détaillée ainsi que les consommations de tabac et d’alcool ont été recueillies par questionnaire. Les expositions aux solvants ont été évaluées à l’aide de matrices emplois-expositions et incluaient cinq solvants chlorés (perchloroéthylène, trichloroéthylène, chlorure de méthylène, chloroforme, tétrachlorure de carbone), cinq solvants pétroliers (benzène ; essences carburant ; gazole, fiouls et kérosène ; essences spéciales ; white spirits) et cinq solvants oxygénés (cétones et esters ; alcools ; éther éthylique ; éthylène glycol ; tétrahydrofurane). Les odds-ratios ajustés sur les consommations de tabac et d’alcool et d’autres facteurs de confusion potentiels, et les intervalles de confiances à 95% ont été estimés par régression logistique. Résultats : Aucune association significative n’a été mise en évidence entre exposition professionnelle aux solvants chlorés, pétroliers et oxygénés étudiés et le risque de cancer de l’ensemble des VADS. Dans l’analyse par localisation, le risque de cancer du larynx augmentait significativement avec l’exposition cumulée au perchloroéthylène. Des risques élevés de cancer de l’hypopharynx, bien que non significatifs, étaient observés pour les hommes exposés à des niveaux élevés de chlorure de méthylène, de white spirits et de tétrahydrofurane. Une association entre exposition au tétrahydrofurane et cancer de la cavité buccale était également suggérée. Aucune association claire n’était observée pour les autres solvants, quelle que soit la localisation de cancer. Conclusion : Des associations positives ont été observées avec plusieurs solvants spécifiques. Toutefois, dans l’ensemble, nos résultats ne sont pas en faveur d’un rôle majeur de l’exposition aux solvants dans la survenue de cancer des VADS. / Background : The role of occupational exposure to solvents in the risk of head and neck cancer has been suggested in some studies but has been few investigated, despite their widespread use in the workplace. Objective: The objective of this thesis was to examine the associations between occupational exposure to solvents and the risk of head and neck cancer. Methods: This work is based on data from the ICARE study, a large population-based case-control study conducted in France between 2001 and 2007. The analysis was restricted to men and included 1,857 cases of squamous cell carcinoma of the oral cavity, pharynx and larynx and 2,780 controls. Detailed occupational lifetime as well as alcohol and tobacco consumptions were collected by questionnaires. Exposure to solvents was assessed by job exposure matrices and included five chlorinated solvents (perchloroethylene, trichloroethylene, methylene chloride, chloroform, carbon tetrachloride), five petroleum-based solvents (benzene; gasoline; diesel, fuels and kerosene; special petroleum products; white spirits) and five oxygenated solvents (ketones and esters; alcohols; diethyl ether; ethylene glycol; tetrahydrofuran). Odds-ratios adjusted for smoking, alcohol drinking and other potential confounders and 95% confidence intervals were estimated with logistic models. Results: No significant association was found between occupational exposure to chlorinated, petroleum-based and oxygenated solvents and the risk of head and neck cancer overall. In subsite analysis, the risk of laryngeal cancer increased with cumulative exposure to perchloroethylene. Non-significantly elevated risks of hypopharyngeal cancer were found in men exposed to high cumulative levels of methylene chloride, white spirits and tetrahydrofuran. An association between exposure to tetrahydrofuran and oral cavity cancer was also suggested. No other clear association was found for the other solvents under study, for any cancer site. Conclusion: Although positive associations were observed for several solvents, overall the results do not suggest a substantial role of exposure to solvents in head and neck cancer risk.

Caenorhabditis elegans is a powerful tool to study cellular migration and morphogenesis during organ development. During pharynx development, the dorsal gland cell, g1p, is born in the anterior aspect of the pharyngeal primordium and undergoes a form of morphogenesis called retrograde extension. egl-15, the single Fibroblast Growth Factor Receptor (FGFR) in C. elegans and ina-1, one of two α-integrin receptors, are both required for the proper extension or migration of g1p cell. Mutations in either egl-15 or ina-1 show similar gland cell over-migration defects where the gland cell body migrates past the terminal bulb and is located in proximity of the intestine. The kinase domain of EGL-15 was found to be required for migration and transgenic rescue strategies were used to determine the tissue of EGL-15 function. RNA interference was used to determine if egl-15 and ina-1 are functioning in the same pathway to regulate gland cell migration. / February 2015