12 resultados para Dalai Lama

em Université de Montréal, Canada


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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

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Les cytokines jouent un rôle fondamental dans la régulation des processus biologiques via la cascade de signalisation JAK-STAT. Les « Suppressors of Cytokine Signalling » (SOCS), protéines intracellulaires, inhibent la voie JAK-STAT. Plusieurs études supportent leur implication dans des maladies immunitaires, mais peu d’informations sont disponibles sur leur expression par les lymphocytes T humains. Nous postulons que les cytokines Interféron-β(IFN-β) et Interleukine-27 (IL-27), dotées d’un potentiel immuno-régulateur, ont des rôles bénéfiques via l’induction des SOCS. L’impact de l’IFN-β et l’IL-27 sur l’expression des SOCS-1 et SOCS-3 par des cellules T CD8 et CD4 humaines a été étudié en utilisant des cellules sanguines de donneurs sains. L’expression de ces régulateurs a été évaluée aux niveaux de l’ARNm par qRT-PCR et protéique par immunocytochimie. Les SOCS-1 et SOCS-3 ont été rapidement induits en ARNm dans les deux types cellulaires en réponse à l’IFN-β ou l’IL-27 et une augmentation de l’expression a été confirmée au niveau protéique. Afin de mimer les thérapies à base d’IFN-β, les cellules T ont été exposées chroniquement à l’IFN-β. Après chaque ajout de cytokine les cellules T ont augmenté l’expression du SOCS-1, sans moduler le SOCS-3. L’IL-27 a induit les SOCS-1 et SOCS-3 préférentiellement dans les cellules T CD8 ; ceci corrèle avec des résultats du laboratoire démontrant une plus petite expression des récepteurs à l’IL-27 par les lymphocytes T CD4 que les CD8. Notre projet a permis d’élucider l’expression des SOCS dans deux populations de cellules T et de clarifier les mécanismes d’actions de l’IFN-β et l’IL-27.

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Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

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Cette étude vise à comprendre quelle était la place des camélidés chez les Moche du centre urbain de Guadalupito de la vallée de Santa au Pérou. Les données ostéologiques analysées ont été obtenues grâce aux travaux effectués par le projet archéologique PSUM (Proyecto Santa de la Universidad de Montreal) de l’Université de Montréal. Dans ce document, une synthèse concernant les Moche de la côte nord du Pérou est d’abord présentée. Puis, il sera question de décrire le site archéologique Guadalupito et d’effectuer des observations concernant les camélidés d’Amérique du sud. Ce sont surtout les données zooarchéologiques qui ont été considérées pour répondre aux questions de recherche de ce travail. La céramique, les fibres de camélidés et les données ethnohistoriques ainsi qu’ethnographiques concernant les camélidés ont également été sujets à quelques observations afin de pouvoir répondre aux questions de recherche de manière holistique. Les résultats ont dévoilé qu’une grande quantité des camélidés du centre urbain de Guadalupito ont été exploités pour leur viande. Les camélidés constituaient une denrée alimentaire de base pour les gens qui fréquentaient les secteurs associés à l’élite. Plusieurs autres camélidés ont été utilisés comme animal de charge, car ils sont morts à un âge plus avancé. Aussi, il y avait des échanges entre la côte et la sierra, car de la laine tissé selon un style de la sierra a été trouvée. Certains camélidés étaient également utilisés lors de rituel et/ou pour leur cuir. Les lamas offraient une source stable de protéines, car ces animaux étaient sous le contrôle des Moche. Enfin, le camélidé a été le mammifère le plus polyvalent avant l’arrivée des animaux en provenance de l’Europe et il a représenté un moyen de transport et une source de nourriture fiable et significative chez les Moche.

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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

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Study Design. Reliability study. Objectives. To assess between-acquisition reliability of new multilevel trunk cross sections measurements, in order to define what is a real change when comparing 2 trunk surface acquisitions of a same patient, before and after surgery or throughout the clinical monitoring. Summary of Background Data. Several cross-sectional surface measurements have been proposed in the literature for noninvasive assessment of trunk deformity in patients with adolescent idiopathic scoliosis (AIS). However, only the maximum values along the trunk are evaluated and used for monitoring progression and assessing treatment outcome. Methods. Back surface rotation (BSR), trunk rotation (TR), and coronal and sagittal trunk deviation are computed on 300 cross sections of the trunk. Each set of 300 measures is represented as a single functional data, using a set of basis functions. To evaluate between-acquisition variability at all trunk levels, a test-retest reliability study is conducted on 35 patients with AIS. A functional correlation analysis is also carried out to evaluate any redundancy between the measurements. Results. Each set of 300 measures was successfully described using only 10 basis functions. The test-retest reliability of the functional measurements is good to very good all over the trunk, except above the shoulders level. The typical errors of measurement are between 1.20° and 2.2° for the rotational measures and between 2 and 6 mm for deviation measures. There is a very strong correlation between BSR and TR all over the trunk, a moderate correlation between coronal trunk deviation and both BSR and TR, and no correlation between sagittal trunk deviation and any other measurement. Conclusion. This novel representation of trunk surface measurements allows for a global assessment of trunk surface deformity. Multilevel trunk measurements provide a broader perspective of the trunk deformity and allow a reliable multilevel monitoring during clinical follow-up of patients with AIS and a reliable assessment of the esthetic outcome after surgery.

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In this paper, a new methodology for the prediction of scoliosis curve types from non invasive acquisitions of the back surface of the trunk is proposed. One hundred and fifty-nine scoliosis patients had their back surface acquired in 3D using an optical digitizer. Each surface is then characterized by 45 local measurements of the back surface rotation. Using a semi-supervised algorithm, the classifier is trained with only 32 labeled and 58 unlabeled data. Tested on 69 new samples, the classifier succeeded in classifying correctly 87.0% of the data. After reducing the number of labeled training samples to 12, the behavior of the resulting classifier tends to be similar to the reference case where the classifier is trained only with the maximum number of available labeled data. Moreover, the addition of unlabeled data guided the classifier towards more generalizable boundaries between the classes. Those results provide a proof of feasibility for using a semi-supervised learning algorithm to train a classifier for the prediction of a scoliosis curve type, when only a few training data are labeled. This constitutes a promising clinical finding since it will allow the diagnosis and the follow-up of scoliotic deformities without exposing the patient to X-ray radiations.

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Besides the spinal deformity, scoliosis modifies notably the general appearance of the trunk resulting in trunk rotation, imbalance, and asymmetries that constitutes patients' major concern. Existing classifications of scoliosis, based on the type of spinal curve as depicted on radiographs, are currently used to guide treatment strategies. Unfortunately, even though a perfect correction of the spinal curve is achieved, some trunk deformities remain, making patients dissatisfied with the treatment received. The purpose of this study is to identify possible shape patterns of trunk surface deformity associated with scoliosis. First, trunk surface is represented by a multivariate functional trunk shape descriptor based on 3-D clinical measurements computed on cross sections of the trunk. Then, the classical formulation of hierarchical clustering is adapted to the case of multivariate functional data and applied to a set of 236 trunk surface 3-D reconstructions. The highest internal validity is obtained when considering 11 clusters that explain up to 65% of the variance in our dataset. Our clustering result shows a concordance with the radiographic classification of spinal curves in 68% of the cases. As opposed to radiographic evaluation, the trunk descriptor is 3-D and its functional nature offers a compact and elegant description of not only the type, but also the severity and extent of the trunk surface deformity along the trunk length. In future work, new management strategies based on the resulting trunk shape patterns could be thought of in order to improve the esthetic outcome after treatment, and thus patients satisfaction.

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Study Design Retrospective study of surgical outcome. Objectives To evaluate quantitatively the changes in trunk surface deformities after scoliosis spinal surgery in Lenke 1A adolescent idiopathic scoliosis (AIS) patients and to compare it with changes in spinal measurements. Summary of Background Data Most studies documenting scoliosis surgical outcome used either radiographs to evaluate changes in the spinal curve or questionnaires to assess patients health-related quality of life. Because improving trunk appearance is a major reason for patients and their parents to seek treatment, this study focuses on postoperative changes in trunk surface deformities. Recently, a novel approach to quantify trunk deformities in a reliable, automatic, and noninvasive way has been proposed. Methods Forty-nine adolescents with Lenke 1A idiopathic scoliosis treated surgically were included. The back surface rotation and trunk lateral shift were computed on trunk surface acquisitions before and at least 6 months after surgery. We analyzed the effect of age, height, weight, curve severity, and flexibility before surgery, length of follow-up, and the surgical technique. For 25 patients with available three-dimensional (3D) spinal reconstructions, we compared changes in trunk deformities with changes in two-dimensional (2D) and 3D spinal measurements. Results The mean correction rates for the back surface rotation and the trunk lateral shift are 18% and 50%, respectively. Only the surgical technique had a significant effect on the correction rate of the back surface rotation. Direct vertebral derotation and reduction by spine translation provide a better correction of the rib hump (22% and 31% respectively) than the classic rod rotation technique (8%). The reductions of the lumbar Cobb angle and the apical vertebrae transverse rotation explain, respectively, up to 17% and 16% the reduction of the back surface rotation. Conclusions Current surgical techniques perform well in realigning the trunk; however, the correction of the deformity in the transverse plane proves to be more challenging. More analysis on the positive effect of vertebral derotation on the rib hump correction is needed. Level of evidence III.

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Among the external manifestations of scoliosis, the rib hump, which is associated with the ribs' deformities and rotations, constitutes the most disturbing aspect of the scoliotic deformity for patients. A personalized 3-D model of the rib cage is important for a better evaluation of the deformity, and hence, a better treatment planning. A novel method for the 3-D reconstruction of the rib cage, based only on two standard radiographs, is proposed in this paper. For each rib, two points are extrapolated from the reconstructed spine, and three points are reconstructed by stereo radiography. The reconstruction is then refined using a surface approximation. The method was evaluated using clinical data of 13 patients with scoliosis. A comparison was conducted between the reconstructions obtained with the proposed method and those obtained by using a previous reconstruction method based on two frontal radiographs. A first comparison criterion was the distances between the reconstructed ribs and the surface topography of the trunk, considered as the reference modality. The correlation between ribs axial rotation and back surface rotation was also evaluated. The proposed method successfully reconstructed the ribs of the 6th-12th thoracic levels. The evaluation results showed that the 3-D configuration of the new rib reconstructions is more consistent with the surface topography and provides more accurate measurements of ribs axial rotation.

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Scoliosis treatment strategy is generally chosen according to the severity and type of the spinal curve. Currently, the curve type is determined from X-rays whose acquisition can be harmful for the patient. We propose in this paper a system that can predict the scoliosis curve type based on the analysis of the surface of the trunk. The latter is acquired and reconstructed in 3D using a non invasive multi-head digitizing system. The deformity is described by the back surface rotation, measured on several cross-sections of the trunk. A classifier composed of three support vector machines was trained and tested using the data of 97 patients with scoliosis. A prediction rate of 72.2% was obtained, showing that the use of the trunk surface for a high-level scoliosis classification is feasible and promising.

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Improving the appearance of the trunk is an important goal of scoliosis surgical treatment, mainly in patients' eyes. Unfortunately, existing methods for assessing postoperative trunk appearance are rather subjective as they rely on a qualitative evaluation of the trunk shape. In this paper, an objective method is proposed to quantify the changes in trunk shape after surgery. Using a non-invasive optical system, the whole trunk surface is acquired and reconstructed in 3D. Trunk shape is described by two functional measurements spanning the trunk length: the lateral deviation and the axial rotation. To measure the pre and postoperative differences, a correction rate is computed for both measurements. On a cohort of 36 scoliosis patients with the same spinal curve type who underwent the same surgical approach, surgery achieved a very good correction of the lateral trunk deviation (median correction of 76%) and a poor to moderate correction of the back axial rotation (median correction of 19%). These results demonstrate that after surgery, patients are still confronted with residual trunk deformity, mainly a persisting hump on the back. That can be explained by the fact that current scoliosis assessment and treatment planning are based solely on radiographic measures of the spinal deformity and do not take trunk deformity into consideration. It is believed that with our novel quantitative trunk shape descriptor, clinicians and surgeons can now objectively assess trunk deformity and postoperative shape and propose new treatment strategies that could better address patients' concern about their appearance. © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.