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Objectifs : Ce travail a pour but de développer un larynx artificiel composé de 2 structures : 1) une structure inamovible en titane poreux prolongeant la trachée; 2) une double valve remplissant la fonction de sphincter. Matériels et Méthodes : L'intégration de la prothèse en remplacement trachéal a été testée in vitro et in vivo sur les modèles animaux rats, lapins et brebis. Suite à l'ensemble de ces résultats, nous avons réalisé la première application clinique du larynx artificiel. Résultats : 1) L'ajout d'un tube de silicone endoprothétique améliore la survie chez le gros animal; 2) l'intégration tissulaire de la prothèse de trachée associée à un matériel polymérique biodégradable était supérieure à celle des prothèses en titane poreux nu; 3) la vitesse de colonisation des prothèses en titane poreux était accélérée lorsque l'on diminuait la taille des billes. Un premier patient a été implanté avec une prothèse de larynx artificiel avec des résultats satisfaisants à 9 mois. Conclusions : Nos études concernant l'intégration de prothèses de trachées in vitro et in vivo ont permis de contribuer à l'aboutissement de la première application clinique de larynx artificiel.

In all of the developed countries, malignant neoplasms are, along with cardiovascular diseases, among the most frequent causes of death. This tendency persists in the European Union countries for many years. The goal of this diploma thesis is to analyze the development of mortality caused by selected malignant neoplasms in the European Union countries from the year 1996 until 2010. The analysis is divided into 4 sections. Aside from standard demographic methods of evaluating the mortality rates by means of age-adjusted death rates calculation, statistical methods are used in this thesis as well. Primary methods used are Joinpoint regression, analysis of the course of specific death rates according to age groups and cluster analysis. In the observed period of time, mortality caused by stomach, cervical, and within the male population also respiratory tract malignant neoplasms declines. On the contrary, within the female population, the death rate caused by respiratory tract malignant neoplasms increases. Malignant skin melanoma represent a great future danger concerning the male population, and malignant pancreatic neoplasms concerning both genders. Over the observed time period, malignant skin melanoma death rate almost doubled in some of the countries. Within the European Union, the variations...

Este trabalho descreve um modelo matemático para simulação da laringe humana durante a fonação. O objetivo foi produzir uma técnica computacional de grande escala de processamento para capturar os fenômenos fisiológicos que ocorrem na laringe durante a vocalização e servir de base para estudos mais aprofundados sobre esta importante estrutura do corpo humano. Usando o método dos elementos finitos como base para discretizar as equações dos tecidos musculares da laringe e das equações de Navier-Stokes, e um modelo de descrição da colisão entre as pregas vocais, o sinal glotal foi obtido a partir de diferentes geometrias de laringes com diferentes propriedades viscoelásticas. Os resultados confirmaram a teoria mioelástica-aerodinâmica que descreve a dinâmica da fonação, reproduzindo inclusive fenômenos fisiológicos que os modelos existentes são incapazes de simular. Estudos adicionais foram feitos para verificar a viabilidade do modelo para simular algumas doenças que danificam a laringe. / This work describes a mathematical model to simulate the human larynx during a phonation. The objective was to produce a large-scale computational technique to capture several physiological phenomena that take place on the larynx during the vocalization and to assist further studies about this important structure of the human body. Using the finite element methods as the way to discretize the muscle tissue equations of the larynx and the Navier-Stokes equations and a model to describe the collision between both vocal folds, the glottal signal for different larynx geometries with different viscoelastic properties was obtained. The results confirmed the myoelastic-aerodynamic theory which describes the dynamic of the phonation, also reproducing physiologic phenomena that current models are unable to simulate. Additional studies were conducted to confirm the feasibility of the model to simulate some diseases that affect the larynx.

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Made available in DSpace on 2014-06-11T19:32:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-07-24Bitstream added on 2014-06-13T20:43:03Z : No. of bitstreams: 1 colombo_j_dr_sjrp.pdf: 949474 bytes, checksum: 856a4b47ea1a9aa6adebae3e2e97b6a0 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Os tumores de cabeça e pescoço ocupam, mundialmente, a quinta posição na lista das neoplasias mais freqüentes. O tipo histológico predominante é o carcinoma de células escamosas, que acomete a cavidade oral, a orofaringe, a hipofaringe e a laringe. O tumor de laringe é um dos tipos mais comuns, correspondendo a 25% dos casos, com alto índice de mortalidade e prognóstico reservado. O principal fator etiológico para o seu desenvolvimento é o consumo combinado de álcool e fumo. O desenvolvimento do câncer de cabeça e pescoço é um processo multipasso acompanhado por mudanças genéticas e epigenéticas. Recentemente, estudos envolvendo a tecnologia microarray têm identificado genes específicos, cuja expressão está alterada em câncer de cabeça e pescoço quando comparado ao tecido normal. No entanto, a maioria dos estudos são realizados usando tumores de diferentes sítios. Neste estudo, foi analisado somente amostras de carcinoma de laringe para minimizar as diferenças genéticas. Dessa forma, os objetivos do presente projeto foram identificar e validar possíveis biomarcadores moleculares envolvidos na carcinogênese de laringe. Para tanto, foi construído um cDNA microarray com 340 genes previamente identificados pelo Head and Neck Annotation Consortium. A expressão desses genes foi analisada em 8 amostras de tecido tumoral e em 4 amostras de tecido histologicamente normal de laringe pela técnica de microarray. Foram identificados 35 genes diferencialmente expressos (SNR ½1.0½, p-value 0.001), os quais estão envolvidos em diversos processos celulares como adesão celular, apoptose, ciclo celular, inibição de proteases, metabolismo, proteólise, reparo de DNA, regulação da transcrição e transdução de sinal. A robustez da assinatura dos 35 genes diferencialmente expressos foi confirmada em um conjunto adicional de 5 amostras tumorais e 6 amostras... / Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer world-wide. More than 90% of this cancer type has a squamous origin and common sites include oral cavity, oropharynx, hypopharynx and larynx Laryngeal squamous cell carcinoma is very common in head and neck cancer, corresponding to 25% of cases, with high mortality rates and poor prognosis. Tobacco use and/or alcohol consumption are the two principal risk factors involved in development of HNSCC. The development of head and neck cancer is a multistep process accompanied by genetic and epigenetic changes. In recent years, studies involving microarrays have identified specific genes whose expression has changed in head and neck cancer compared with normal tissue. However, most microarray studies are performed using tumors from different sites in head and neck. In our study, we analyzed only larynx carcinoma samples to minimize the genetic differences. Thus, the purpose of this work was to identify and to validater molecular biomarkers involved in larynx carcinogenesis. Therefore, we constructed a cDNA microarray containing 340 genes previously identified by Head and Neck Annotation Consortium. Expression analysis was applied to 8 larynx tumor samples and 4 larynx normal samples. We identified 35 differentially expressed genes between tumor and non-tumor adjacent tissue of larynx (SNR ½1.0½, p-value 0.001). Genes detected were involved in processes as apoptosis, cell adhesion, cell cycle, DNA repair, metabolism, protease inhibition, proteolysis, signal transduction and transcription regulation. The robustness of the 35-gene signature was confirmed using data from an additional set of 5 larynx tumor samples and 6 adjacent non-tumor larynx tissues. For real time RT-PCR validation we selected fourteen genes, of which 10 (ADCY6, AES, AL2SCR3, CRR9, CSTB, DUSP1, MAP3K5, PLAT, UBL1 and ZNF706) were validated... (Complete abstract click electronic access below)

Este trabalho descreve um modelo matemático para simulação da laringe humana durante a fonação. O objetivo foi produzir uma técnica computacional de grande escala de processamento para capturar os fenômenos fisiológicos que ocorrem na laringe durante a vocalização e servir de base para estudos mais aprofundados sobre esta importante estrutura do corpo humano. Usando o método dos elementos finitos como base para discretizar as equações dos tecidos musculares da laringe e das equações de Navier-Stokes, e um modelo de descrição da colisão entre as pregas vocais, o sinal glotal foi obtido a partir de diferentes geometrias de laringes com diferentes propriedades viscoelásticas. Os resultados confirmaram a teoria mioelástica-aerodinâmica que descreve a dinâmica da fonação, reproduzindo inclusive fenômenos fisiológicos que os modelos existentes são incapazes de simular. Estudos adicionais foram feitos para verificar a viabilidade do modelo para simular algumas doenças que danificam a laringe. / This work describes a mathematical model to simulate the human larynx during a phonation. The objective was to produce a large-scale computational technique to capture several physiological phenomena that take place on the larynx during the vocalization and to assist further studies about this important structure of the human body. Using the finite element methods as the way to discretize the muscle tissue equations of the larynx and the Navier-Stokes equations and a model to describe the collision between both vocal folds, the glottal signal for different larynx geometries with different viscoelastic properties was obtained. The results confirmed the myoelastic-aerodynamic theory which describes the dynamic of the phonation, also reproducing physiologic phenomena that current models are unable to simulate. Additional studies were conducted to confirm the feasibility of the model to simulate some diseases that affect the larynx.

The professional voice has been studied in literature in various aspects and levels. However, no reference related to the professional voice of the barker has been found. Objective: describing the laryngeal alterations in sellers at public fairs in Aracaju-SE. Casuistic and methods: a descriptive study of transversal cut was done with quantitative approach. An interview was done along with a nasolaryngoscopy in 49 barkers. A descriptive analysis of data was applied. Results: there was a predominance of the feminine gender. The predominant age average was between 30 and 39 years old. The predominant symptomatology status was related to laryngeal-pharyngeal reflux disease. Laryngeal alterations were identified in all anatomic regions: subglottis, glottis and supraglottis. Conclusion: the laryngeal alterations were predominant in the subglottic region. These detected changes shows the need for further studies along with phonotrauma and other laryngeal diseases. / A voz profissional tem sido estudada na literatura sobre vários aspectos e em vários níveis, no entanto não foi encontrada nenhuma referência relacionada ao profissional da voz feirante.Objetivo: Descrever as alterações laríngeas em vendedores de feira livre do Município de Aracaju-Sergipe. Casuística e métodos: Realizou-se um estudo descritivo, de corte transversal e abordagem quantitativa .Foi realizada entrevista e exame de videonasolaringoscopia em 49 feirantes.Foi realizada análise descritiva dos dados. Resultados: Houve predominância do gênero feminino. A faixa etária predominante foi entre 30 e 39 anos. O quadro sintomatológico predominante esteve relacionado à doença do refluxo laringofaringeo. Foram identificadas alterações laríngeas em todas as regiões anatômicas. Em ordem decrescente as lesões predominaram em subglote,glote e supraglote.Conclusão: As alterações laríngeas encontradas predominaram na região subglótica. Estas alterações detectadas orienta para necessidade de futuros estudos conjugados ao fonotrauma e outras doenças laríngeas.

The traditional way of estimating the formant frequencies from articulatory data presupposes knowledge of how the vocal tract cross-sectional area varies for a given articulatory shape (Fant 1960/1970). Accordingly, in order to derive the formant pattern of a given articulation, the three-dimensional shape of the vocal tract (VT) needs to be known. In the past cross-sectional areas have typically been derived by means of ‘d-to-A rules’ that use the mid-sagittal cross-distance d at each point along the VT to produce a corresponding cross-sectional area A. X-ray and MRI data have been used to calibrate such rules (Heinz & Stevens 1964, Sundberg et al. 1987, Ericsdotter 2005). Although this procedure has produced many useful results it is time consuming and laborious. It is speaker-specific. It presupposes access to information on the three-dimensional shape of the VT, which is not experimentally readily accessible. Such observations raise the question whether sufficiently accurate alternative approaches can be developed. Is it possible to go straight from articulatory data to formant frequencies without having to construct a cross-sectional area function? If such methods could be developed it would have many uses both in phonetics and practical applications. This paper reports an attempt to map the time variations of selected articulatory parameters from X-ray profiles directly on the formant tracks using multiple regression analysis. Preliminary results for F1 indicate that multiple regression analysis can indeed be useful for making such predictions. The prospects of extending the present analyses to other formants are discussed.