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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

Insights into atrial function using speckle tracking strain: report of a new, modified method

Borkowski, Philip 22 January 2016 (has links)
Speckle tracking echocardiography (STE) is a relatively new imaging modality that enables the direct measurement of active contractile myocardial tissue in an offline analysis. This is accomplished through a software algorithm that tracks collections of acoustic markers, known as 'speckles', that are unique to a given section of myocardium. By measuring the displacement of these 'speckles' as the heart contracts and relaxes, STE produces parameters of the strain, or percent change in length, exhibited by the myocardium. As multiple studies have shown, this strain data produced by tracking of the global left atrium has the ability to accurately assess the physiologic functions of the atrium as a reservoir, conduit and booster pump in the cardiac cycle. Despite these valuable correlations, there are noted problems with STE regarding acoustic cluttering and disappearance of 'speckles' that can occur as the selected region of interest moves out of the field of view or becomes obscured. These problems may be increased when tracking an extended region of myocardium. Therefore, this present study sought to test a new method of assessing left atrial function with STE strain analysis by focusing on a concise region of the atrium, specifically the interatrial septum. To test this, the echocardiograms of 37 patients were obtained and grouped according to the designation of their cardiac function as normal (n=11), abnormal (n=12), or exhibiting signs of cardiac amyloidosis (n=14). In all patients, STE strain analysis was performed on the both the global left atrium and the interatrial septum. Measurements of the mean peak strain observed in the resultant strain curves were recorded for both STE scans of each patient. The curves produced by the tracking the segments of the entire atrium (6 segments) and interatrial septum (3 segments) were compared based on the exhibited changes in strain seen in the relative shapes of the curves, as well as the spread of the segmental strain curves about the calculated mean strain curve. Additionally, the number of segments that were either unsuccessfully or incorrectly tracked was recorded as a measure of the accuracy of STE. As a final step, the interatrial strain curves of four selected patients in the various states of ventricular diastolic dysfunction were chosen and compared with data obtained from scans of mitral flow echocardiography and tissue Doppler imaging (TDI) in an attempt to correlate the exhibited changes in strain shown in the interatrial septum with the physiologic functions of the atrium during ventricular diastole. The results showed that the mean peak strain of the global atrial strain trace decreased from normal (41.32%±10.8) to abnormal (21.69%±13.8) to the amyloid group (10.41%±6.9). This trend was echoed in the mean peak strain measured in the interatrial septum, as measured in normal (64.2%±15.6), abnormal (28.37%±13.4) and amyloid groups (12.21%±12.1). When the strain curves of the entire atrium and interatrial septum were compared, they demonstrated similar patterns in the timing of changes in strain, however the strain curves of the individual interatrial septum segments showed a much more concise grouping about the mean strain curve and were less likely to exhibit discordant segmental strain curves that deviated from the pattern established by all other segments in the trace. Additionally, within the STE scans of the global atrium, the interatrial septum exhibited a higher percentage of successfully tracked segments than did the lateral atrial wall; this trend was universally exhibited in all three groups. Finally, the interatrial septum strain curves, mitral flow echocardiography and TDI scans all demonstrated similar indications of left atrial function in the four selected patients. Ultimately, STE strain analysis of the interatrial septum appears to be a more accurate method of tracking the atrial myocardium than STE tracing of the global left atrium. Furthermore, it shows viable potential as a method for assessing the global physiologic function of the left atrium, as indicated by the similarities between the trends exhibited by these STE scans and the data gathered from scans produced by mitral flow echocardiography and TDI.
42

Estudo comparativo em cadáveres do uso de enxertos cartilaginosos septais e costais para aumento da área seccional externa narinária / A comparative study on cadavers of the use of septal and rib cartilage grafts to increase nostril cross-sectional area

Marcelo Wulkan 12 December 2012 (has links)
INTRODUÇÃO: A área da seccção externa da narina é a parte inferior da válvula nasal externa que é o primeiro obstáculo ao fluxo de ar. Existem dúvidas e controvérsias em relação a eficácia de tratamentos cirúrgicos nessa região do nariz durante a rinoplastia. Neste estudo, compararam-se em cadáveres o uso do enxerto de reforço alar modificado de cartilagem septal e costal para analisar o aumento da área seccional externa narinária. MÉTODOS: Trinta narinas de cadáveres foram dissecados no Serviço de Verificação de Óbito da Capital- Universidade de São Paulo. A escolha dos cadáveres foi aleatória (9 mulheres e 6 homens) excluíndo-se os casos com lesão deformante nasal ou doença intra-nasal. Todos os enxertos septais e costais apresentavam as mesmas dimensões (30 x 5 x 1 mm) e foram inseridos acima do ramo lateral das cartilagens alares de maneira aleatória. A seguir, realizaram-se fotos padronizadas e mensurações das 90 áreas seccionais externas de narina com o programa Autocad®; 30 antes de qualquer procedimento; 60 após a inclusão de enxertos (30 usando cartilagem costal e 30 usando cartilagem septal). A análise estatística foi feita com um modelo de medidas repetidas e ANOVA (análise de variância) para a variável área. A comparação das médias foi feita pelo método de Tukey, sendo o coeficiente de confiança global de 95%. RESULTADOS: A área seccional externa da narina sem tratamento, com inclusão de enxerto de reforço alar modificado septal e costal é, respectivamente, 0,76 cm2, 0,85 cm2 (aumento de 11,8%) e 0,91 cm2 (aumento de 19,7%). CONCLUSÃO: O enxerto de reforço alar modificado de costela é estatisticamente mais efetivo que o enxerto de reforço alar modificado de septo para aumentar a área de secção externa da narina / INTRODUCTION: The nostril cross-sectional area (bottom of the external nasal valve) presents the first obstacle to airflow. There are doubts and controversies regarding the effectiveness of surgical treatments in this region of the nose during a rhinoplasty. In this study, we have tested two modified strategies for alar reinforcement, one using a cartilage graft from the nasal septum and the other using rib cartilage, to analyze and compare their effectiveness in augmenting nostril cross-sectional area. METHODS: Thirty corpses nostrils were dissected in the Division of Postmortem Inspection at the University of São Paulo. Corpses were chosen at random (9 women and 6 men) excluding those with deforming nasal injury or intra-nasal disease. All nasal septum and rib grafts had the same dimensions (30 x 5 x 1 mm) and were inserted randomly above the lateral crura of the alar cartilages. Then, a total of 90 standardized photographs were taken to measure nostril cross-sectional area using the Autocad® program; one per nostril on all 15 cadavers, at three separate intervals. Thirty photos were taken prior to any procedure being performed, and 60 after the insertion in each nostril, of the two different types of cartilage grafts. After one graft was tested, it was removed and replaced with the other type. The order of the procedures was randomized. Statistical analyses were conducted using a model for repeated measures and ANOVA for the variable area. The comparison of means was done with Tukeys method and a 95% confidence coefficient. RESULTS: The nostril cross-sectional area before treatment, after modified alar reinforcement using septum cartilage graft, and after modified alar reinforcement using rib graft were 0,76 cm2, 0,85 cm2 (increase of 11,8%) and 0,91 cm2 (increase 19.7%), respectively. CONCLUSION: The modified alar reinforcement using grafts of rib cartilage is statistically more effective than the modified alar reinforcement using grafts of nasal septum in increasing the nostril cross-sectional area
43

Avaliação de desvio do septo nasal em imagens panorâmicas e tomográficas volumétricas / Study on nasal septum deviation in panoramic and computerized tomography images

Marcelo Junior Zanda 28 August 2009 (has links)
Neste estudo avaliou-se a eficácia da radiografia panorâmica na detecção de desvio do septo nasal. Para tanto, utilizou-se como padrão ouro o exame clínico e imagens tomográficas da face. A amostra foi composta por imagens radiográficas panorâmicas e por imagens de tomografia computadorizada da face de 70 indivíduos. Dentre os indivíduos que compuseram o estudo, 30 eram pacientes que seriam submetidos a tratamento odontológico e possuíam radiografias panorâmicas nas quais foram observadas imagens compatíveis com desvio do septo nasal. Estes pacientes foram avaliados por um otorrinolaringologista e submetidos, segundo o critério da justificação, ao exame de tomografia computadorizada da face. Os outros 40 indivíduos foram selecionados a partir de imagens panorâmicas dos prontuários de pacientes disponíveis no arquivo da Clínica de Estomatologia da FOB-USP e que também haviam realizado tomografia computadorizada da face para elaboração de diagnóstico e plano de tratamento odontológico. Os resultados mostraram que a radiografia panorâmica, segundo a metodologia adotada, foi eficaz na detecção do desvio do septo nasal, com 100% de Especificidade. Além disso, este exame permite a confirmação da ausência deste desvio na maioria dos casos, com 86% de Sensibilidade. / OBJECTIVE: Discern the efficacy of panoramic radiography on nasal septum deviation. Gold standard computerized tomography along with clinical examination was used for comparison. MATERIAL AND METHODS: Sample was composed of 70 subjects from Stomatology files of FOB-USP. Nasal septum deviation was assessed using the panoramic radiographies. Then, computerized tomography was analyzed and the results confronted. RESULTS: Images of nasal septum deviation were observed and confirmed in both exams on 100% of the subjects. However, in those cases with no deviation observed with the panoramic radiographies, its presence was confirmed in 86% after computerized tomography. CONCLUSION: Panoramic radiography was trustable for confirmation of nasal septum presence, with 100% of Specificity. Further, this exam allows the confirmation of the absence of this deviation in the majority of cases, with 86% of Sensibility.
44

Functional Significance of Sympathetic Fiber Ingrowth in the Habenula

Howard, A. Jean (Ava Jean) 08 1900 (has links)
The physiological significance of noradrenergic sympathohabenular ingrowth following medial septal lesions was investigated. Following septal lesions, sympathetic fibers originating in the superior cervical ganglia are known to sprout into the medial habenular nuclei, and into the hippocampal formation. Previous work involving sympathohippocampal ingrowth showed that firing rates in septal animals with no ingrowth showed that firing rates in septal animals with no ingrowth were higher than rates of septal animals with ingrowth and controls. Those results suggested that sympathetic ingrowth in the hippocampus had some functional capability in a modulatory manner. The primary aim of the present study was to determine if the peripheral sympathetic ingrowth into the medial habenular nuclei following a septal lesion is functionally significant. The results showed that firing rates of neurons of the medial habenulae in animals receiving septal lesions were significantly higher than rates of control animals and septal lesioned + ganglionectomized animals.
45

Regulation of Septum Formation by Two Novel Proteins Art1 and Bga1 in Fission Yeast Cytokinesis

Davidson, Reshma 29 December 2016 (has links)
No description available.
46

TEMPOROMANDIBULAR JOINT DISORDERS AND NASAL SEPTUM DEVIATION IN DENTOFACIAL DEFORMITY PATIENTS

Rambo, Lindsay Ellen January 2015 (has links)
Introduction: The purpose of this study was to subclassify the types of facial asymmetries present in a pre-surgical dentofacial deformity patient population to determine the prevalence of each subcategory. Associations between the craniofacial characteristics of each asymmetry and pre-surgical Jaw Pain and Function Questionnaire (JPFQ) scores, diagnosis of temporomandibular disorders (TMD), and posterior facial asymmetry (PFA) as determined by nasal septum deviation were analyzed. In addition, the data will aid in the development of a phenomics database to allow for subsequent genotyping and gene expression evaluation from patient saliva and masseter muscle samples that were obtained at the time of corrective orthognathic surgery. Methods: Pre-surgical posterio-anterior (PA) cephalograms, submentovertex (SMV) and panoramic (PAN) radiographs from 92 pre-surgical dentofacial deformity patients at the Department of Oral and Maxillofacial Surgery, University of Lille, France were collected to evaluate facial asymmetry. PAs were traced and analyzed according to the Grummons Simplified Frontal analysis and Ramal Height analysis (Dolphin Imaging). SMVs were analyzed by the refined clinical system of the Ritucci and Burstone analysis proposed by Arnold et al along with original angular measurements for maxillary, mandibular, and nasal septum deviations (ImageJ). PFA was determined by a nasal septum deviation greater than 15 degrees. Lastly, PANs were evaluated visually for condylar pathologies. A comprehensive diagnostic decision tree for facial asymmetry was formulated based upon the current literature for normal variation of landmarks and the study design. Patient diagnosis via the decision tree was compared to visual examination of the appropriate x-rays to verify accuracy. Using this decision tree, patients were classified into subtypes and prevalence of each was calculated to form a phenomics database for future research on genotyping and gene expression. Associations between the subclassifications, mean pre-surgical JPFQ scores, temporomandibular joint (TMJ) clinical examination results (TMD+ or TMD-), and the diagnosis of posterior facial asymmetry (PFA+ or PFA-) were completed. Results: Sixty-two patients were able to fulfill all radiographic requirements to arrive at a diagnosis. Eighteen patients demonstrated facial asymmetry that fell within normal biological variation while the other 44 were diagnosed as having a form of facial asymmetry – Cranial Base Asymmetry: 11 female, 6 male; Non-Condylar Mandibular Asymmetry: 5 female, 3 male; Hemimandibular Elongation: 2 female, 3 male; Maxillary Asymmetry: 3 female, 1 male; Idiopathic Condylar Resorption: 3 female, 1 male; Atypical Asymmetry: 3 female, 1 male; Hemimandibular Hyperplasia: 1 female, 0 male; and Maxillary Base & Mandibular Body Asymmetry: 0 female, 1 male. JPFQ scores for symmetric patients ((x ) ̅= 5.33) and asymmetric patients (x ̅= 4.57) were non-significant overall, however, differences between gender were noted (female symmetric (x ) ̅= 6.13, male symmetric (x ) ̅= 1.33, female asymmetric (x ) ̅= 5.36, male asymmetric (x ) ̅= 3.19). TMD was diagnosed by pre-surgical TMJ examinations and MRIs. Four symmetric patients (3 female, 1 male) were positively diagnosed with TMD while 14 asymmetric patients (11 female, 1 male) also were diagnosed. PFA was diagnosed when nasal septum deviation was greater than 15 degrees – 25⁰ to ≤35⁰: 9 patients; >35⁰ to ≤45⁰: 3 patients; >45⁰: 1 patient. Twenty patients with a positive PFA were asymmetric while the other 8 symmetric. Twenty-one patients with PFA were female while the other 7 were male. Conclusion: A comprehensive diagnostic decision tree for facial asymmetry classification was formulated and validated. With it, it was found that: Females have increased JPFQ scores and clinical diagnosis of TMD versus males. Asymmetric females have decreased JPFQ scores, but increased prevalence of TMD. Presence of PFA does not appear to be a strong influence on development of facial asymmetry but is significantly linked to the presence of TMD. PFA is present in nearly half of all dentofacial deformity subjects. Mandibular asymmetry is most commonly associated with increased JPFQ scores and presence of TMD. However, Hemimandibular Hyperplasia, a particular and less common form of mandibular asymmetry, never associated with TMD. One form of mandibular and mid-facial asymmetry, Atypical Asymmetry, had a relatively high prevalence of TMD. Future directions for this research include continuation of genotypic description of IGF1 and Nodal biologic pathways to determine how gene expression levels in masseter muscle and patient genotypes differ in the eight subclassifications of craniofacial asymmetry compared to the symmetric population. / Oral Biology
47

Implication du noyau dorsomédian du lit de la strie terminale dans les circuits de l'homéostasie sodique

Arbour, Danielle 16 April 2018 (has links)
Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2010-2011 / Nous avons investigué le rôle exact du BSTdm dans la gestion des réponses physiologiques et comportementales qui surviennent en condition d'équilibre et lors d'un déficit en ions sodium. Nous avons aussi évalué l'influence qu'aurait le BSTdm au niveau de la circuiterie neuronale impliquée dans l'homéostasie hydrominérale. Nos résultats démontrent que les mesures de la consommation d'eau et de sel en condition de repletion sodique ont respectivement augmenté et diminué suite à la lésion du BSTdm. De plus, la partie coquille du noyau accumbens s'est révélée avoir un indice d'activation cellulaire deux fois plus élevé chez les rats ayant une lésion du BSTdm. Ainsi, nos résultats suggèrent que suite à l'intégration des messages en provenance des structures impliquées dans l'osmorégulation et la détection, le BSTdm désinhibe les structures impliquées dans le comportement motivé afin de favoriser la consommation de sel dans la période de repletion sodique.
48

Etude du comportement d'un implant BCP pour la réparation du septum nasal

Le Taillandier de Gabory, Ludovic 04 May 2010 (has links)
Le septum nasal joue un rôle prépondérant dans la croissance de l’étage moyen de la face et la physiologie ventilatoire. Sa solidité, sa rectitude et sa position sagittale sont déterminantes pour percevoir un confort respiratoire diurne et nocturne. Vulnérable aux traumatismes de part sa projection antérieure, la destruction ou l’inefficience de son squelette entraîne une demande de réparation fonctionnelle et esthétique. Dans les cas les plus sévères, le remplacement tissulaire fait appel à des volumineux greffons autologues pour lesquels la morbidité du site donneur et leurs imperfections propres restent un écueil. Pour les remplacer, certains biomatériaux ont été essayés de manière empirique sans donner de résultats fiables. Le premier objectif de notre travail été d’évaluer le comportement d’un implant phosphocalcique biphasique pour la reconstruction du septum nasal afin d’éviter ces greffons tout en répondant aux objectifs biofonctionnels locaux, au contact d’un milieu septique et susceptible d’être exposé aux particules aéroportées de l’environnement. Le deuxième objectif était d’évaluer la cytotoxicité des nanotubes de carbone à double paroi sur des cellules de l’arbre respiratoire, premier organe concerné par une exposition potentielle lors de leur fabrication. Par la suite, les résultats de ces deux sujets différents ont été utilisés de manière synergique pour répondre au troisième objectif qui était, d’évaluer l’influence des nanotubes de carbone sur la cicatrisation du septum nasal en présence ou non de l’implant phosphocalcique. / The nasal septum plays a paramount role in the growth of the face and respiratory physiology. Its solidity, its straightness and its sagittal position are determining to perceive a diurnal and night respiratory comfort. Vulnerable to the traumas, the destruction or the inefficiency of its skeleton involves request for a functional and aesthetic repair. In severe cases, the tissue replacement requires large autologous grafts for which the morbidity of the donor site and their own imperfections remain a problem. To replace them, certain biomaterials were tested in an empirical way without giving reliable results. The primary goal of our work was to evaluate the behaviour of a biphasic phosphocalcic implant to repair nasal septum in order to avoid these grafts with an adapted biofunctional implant, exposed to the septic nasal content and the airborne particles of the environment. The second objective was to evaluate the cytotoxicity of the double wall carbon nanotubes on epithelial respiratory cells, first organ concerned by a potential exposure during their manufacture. Thereafter, the results of these two different subjects were used in a synergistic way to answer the third objective which was, to evaluate the influence of the carbon nanotubes on the cicatrization of the nasal septum in presence or not of the phosphocalcic implant.
49

Primary sinonasal surgery and health-related quality of life in adults

Alakärppä, A. (Antti) 14 May 2019 (has links)
Abstract Surgery for ear, nose and throat (ENT) diseases most often aims to improve quality of life (QoL). The extent of having QoL as an outcome in papers included in evidence-based medicine databases is not known. In primary sinonasal surgery, the QoL outcomes and predictors and usability of various QoL instruments need more clarification. The aim was to: 1. Find out with a systematic literature review how the Cochrane database currently includes the QoL dimension. 2. Investigate the effect of primary sinonasal surgery on QoL, to identify predictors of QoL outcomes and to compare QoL instruments. In total 160 adults undergoing primary septoplasty (SP) or endoscopic sinus surgery (ESS) were recruited in 2010–2014 with 206 controls for a prospective matched cohort study. QoL was measured with a disease-specific Sino-Nasal Outcome Test–22 (SNOT–22) and generic RAND–36 before surgery and 12 months after surgery. Retrospective Glasgow Benefit Inventory (GBI) was also used. QoL was an outcome measure in 10% (3 out of 30) of trials included in Cochrane databases on most common ENT surgeries. The use of QoL since the year 2000 has increased. The total SNOT–22 score improved in both patient groups after surgery, almost to the level of the controls, In the SP group (N=64) from 34.9 to 19.1 and in ESS (N=70), from 35.1 to 19.3. The control cohort’s SNOT–22 was 17.7 at entry and after follow-up, 15.3 (N=165). RAND–36 and GBI also improved after surgery. The best predictor for a good QoL outcome in multivariate analysis after surgery was a high preoperative (≥20) SNOT–22 score in the SP and ESS groups (adjusted odds ratio 10; 95% confidence interval 1.6–64 and 12; 2.5–55, respectively). In receiver operating characteristic curve analysis, the highest preoperative SNOT–22 total score of 30 was the most sensitive (74%) and specific (70%). GBI seemed to be the most sensitive instrument to detect a change, but the three instruments in this study agreed in only about 10% of the patients who had the worst impact before surgery or best outcome. The results suggest that papers on the Cochrane databases on ENT surgeries have rarely addressed the QoL outcome. Septal deviation and recurrent acute or chronic rhinosinusitis lowered QoL. Primary surgery on these conditions improved QoL almost to the level of the control population, which was not symptom-free either. A high preoperative SNOT–22 total score was the best predictor of a beneficial outcome. The QoL instruments identified different patients experiencing the best improvement after surgery. / Tiivistelmä Korva-, nenä- ja kurkkutautien (KNK) kirurgia tähtää useimmiten elämänlaadun (EL) parantamiseen. EL:n huomioinnin yleisyys näyttöön perustuvien tietokantojen sisältämissä tutkimuksissa ei ole tiedossa. Primaareissa nenäleikkauksissa EL:n tulokset, ennustekijät ja eri mittareiden käytettävyys kaipaavat lisätietoja. Tarkoituksena oli 1: Tutkia systemaattisella kirjallisuuskatsauksella miten nykyiset Cochrane-suositukset huomioivat EL:n. 2: Tutkia primaarin nenäkirurgian vaikutus EL:uun, tunnistaa EL:n ennustekijöitä ja vertailla eri mittareita. Yhteensä 160 primaariin nenän väliseinäleikkaukseen (VL) tai sivuonteloiden tähystysleikkaukseen (ESS) tulevaa aikuista ja 206 ikä- ja sukupuolivakioitua verrokkia osallistui etenevään kaltaistettuun kohorttitutkimukseen vv. 2010-2014. EL mitattiin tautispesifillä Sino-Nasal Outcome Test -22:lla (SNOT–22) ja yleisellä RAND–36:lla ennen leikkausta ja 12 kk leikkauksen jälkeen. Kolmantena mittarina käytettiin taannehtivaa Glasgow Benefit Inventoryä (GBI). Cochrane-tietokannan yleisimpien KNK-leikkausten tutkimuksista 10 %:ssa (3 30:stä) sisälsi EL-tuloksia. Vuoden 2000 jälkeen EL:n käyttö on lisääntynyt. SNOT–22 kokonaispistemäärä parani VL- ja ESS-ryhmissä lähes kontrollien tasolle, VL-ryhmässä (N=64) 34.9:stä 19.1:een ja ESS-ryhmässä (N=70) 35.1:stä 19.3:een. Kontrollien SNOT–22 oli alussa 17.7 ja seurannan jälkeen 15.3. Myös RAND–36 ja GBI paranivat leikkauksen jälkeen. Monimuuttuja-analyysissä hyvän EL-tuloksen paras ennustetekijä oli korkea leikkausta edeltävä SNOT–22 sekä VL- että ESS-ryhmissä (vakioitu vetokertoimien suhde 10; 95 % luottamusväli 1.6–64 ja 12; 2.5–55, ryhmittäin). ROC (receiver operating characteristic) -käyräanalyysissä leikkausta edeltävä arvo 30 antoi parhaan herkkyyden (74 %) ja tarkkuuden (70 %). GBI vaikutti herkimmältä aistimaan muutoksen, mutta mittarit olivat samaa mieltä vain noin 10%:ssa niistä potilaista, joilla oli huonoin EL ennen leikkausta tai paras tulos leikkauksen jälkeen. Tulosten mukaan Cochrane-tietokannassa olevat KNK-tautien kirurgian tutkimukset ovat ottaneet harvoin elämänlaadun huomioon. Nenän väliseinän vinous ja toistuva äkillinen tai krooninen sivuontelotulehdus laskivat EL:ua. Näiden tautien primaarikirurgia paransi EL:n lähes samalle tasolle kuin kontrolliryhmällä. Korkea leikkausta edeltävä SNOT–22 –kokonaispistemäärä ennusti parhaiten hyvää tulosta. Eri EL-mittarit tunnistivat eri potilaat, jotka hyötyivät parhaiten leikkauksista.
50

Rinomanometria realizada por meio da fluidodinâmica computacional / Rhinomanometry using computational fluid dynamics

Cherobin, Giancarlo Bonotto 05 December 2017 (has links)
Introdução: A obstrução nasal é um sintoma presente em várias doenças nasais. Este projeto propõe desenvolver uma metodologia para o cálculo da resistência nasal ao fluxo aerífero por meio de fluidodinâmica computacional e comparar os resultados dessa técnica com os da rinomanometria. Métodos: a resistência nasal ao fluxo aerífero foi medida por rinomanometria, experimentalmente e por fluidodinâmica computacional. A influência da segmentação da tomografia computadorizada nas variáveis de fluidodinâmica computacional foi investigada. O modelo computacional de escoamento laminar foi comparado ao modelo de turbulência k-w padrão. Foram analisadas a acurácia, correlação e concordância entre a resistência nasal calculada por fluidodinâmica computacional com aquela obtida por experimento e rinomanometria. Resultados: A resistência nasal provida por fluidodinâmica computacional pode variar até 50% de acordo com os critérios de segmentação da tomografia computadorizada. O modelo de turbulência k-w padrão apresentou acurácia de 93,1%, demonstrando melhor desempenho que o modelo laminar para prever a resistência da cavidade nasal. A correlação entre a vazão em 75Pa obtida por rinomanometria e fluidodinâmica computacional foi alta para ambas as cavidades, Pearson r = 0,75 p < 0,001. Não houve concordância entre a resistência nasal fornecida pelos dois métodos. A resistência nasal por fluidodinâmica computacional é, em média, 65% da resistência por rinomanometria. Conclusão: os critérios para segmentação da cavidade nasal interferem na resistência calculada por fluidodinâmica computacional. A metodologia de fluidodinâmica computacional para calcular a resistência nasal foi validada experimentalmente. O modelo de escoamento turbulento é melhor que o modelo laminar para calcular a resistência nasal. A resistência nasal calculada por fluidodinâmica computacional apresentou alta correlação com a medida por rinomanometria anterior ativa, mas o nível de concordância entre os métodos não permite comparação direta entre os valores obtidos por cada um / Introduction: Nasal obstruction is a symptom present in various nasal diseases. This project proposes to develop a methodology for the calculation of nasal resistance to airflow through computational fluid dynamics and, to compare the results of this technique with those of rhinomanometry. Methods: nasal airflow resistance was measured by rhinomanometry, experimentally and computational fluid dynamics. We investigated the influence of computed tomography segmentation on the computational fluid dynamics variables. The computational model of laminar flow was compared to the kw turbulence model. The accuracy, correlation and agreement between the nasal resistance calculated by computational fluid dynamics was analyzed comparing it with nasal resistance obtained through experiment and rhinomanometry. Results: The nasal resistance provided by computational fluid dynamics can vary up to 50% according to the computed tomography segmentation criteria. The k-w turbulence model showed accuracy of 93.1%, presenting a better performance than the laminar model to predict nasal cavity resistance. The correlation between the flow in 75Pa obtained by rhinomanometry and computational fluid dynamics was high for both cavities, Pearson r >= 0.75 p < 0.001. There was no agreement between nasal resistance provided by the two methods. Nasal resistance due to computational fluid dynamics is, on average, 65% of rhinomanometric resistance. Conclusion: the criteria used for nasal cavity segmentation interfere with the resistance calculated by computational fluid dynamics. The methodology of computational fluid dynamics to calculate nasal resistance was validated experimentally. The turbulent flow model is better than the laminar model to calculate nasal resistance. The nasal resistance calculated by computational fluid dynamics showed a high correlation with the measurement by active rhinomanometry, but the level of agreement between the methods does not allow a direct comparison between the values obtained by each one

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