Comparação entre a técnica convencional e a minimamente invasiva vídeo-assistida nas tireoidectomias parciais

OBJETIVO: A tireoidectomia minimamente invasiva vídeo-assistida (TIMIVA) sem infusão de gás é considerada segura com vantagem estética em relação ao procedimento convencional. O objetivo deste trabalho é comparar a experiência preliminar brasileira com a TIMIVA e a técnica convencional nahemitireoidectomia. MÉTODO: Doze pacientes foram submetidos à hemitireoidectomia por doença nodular tireoidiana por TIMIVA (grupo I) e quatorze pela técnica convencional (grupo II). Analisamos gênero, idade, volume do bócio, medida do maior eixo do nódulo dominante, tempo de cirurgia, queixa de dor no pós-operatório, resultado estético e complicações (paralisia de prega vocal, infecção e hematoma). RESULTADOS: No grupo I, todos eram do gênero feminino, a mediana etária foi 34 anos, a mediana do volume do bócio foi 16,5 mL, a mediana do tamanho do nódulo dominante foi 2,3 cm, a mediana do tempo cirúrgico foi 55 minutos. Oito pacientes referiram dor discreta e quatro negaram dor. A mediana do tamanho da incisão foi 2 cm, todos consideraram os resultados estéticos excelentes e não houve complicações. No grupo II, o índice feminino/masculino foi 6:1, a mediana etária foi 35 anos, a mediana do volume foi de 18 mL, a mediana do tamanho do nódulo foi 2,5 cm, a mediana do tempo foi 55 minutos. Sete pacientes referiram discreta dor, cinco moderada e dois intensa. A mediana do tamanho da cicatriz foi 5 cm. Onze pacientes consideraram os resultados estéticos excelentes e três, bom. Não houve complicações. CONCLUSÕES: A TIMIVA proporciona bom resultado estético e dor pós-operatória mínima, sem aumento do tempo cirúrgico e das complicações.

Importance of flexible bronchoscopy in decannulation of tracheostomy patients

OBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheostomized patients aged between 19 and 87 years, with tracheal stent for a mean of 46 ± 28 days and with clinical criteria for decannulation. They were submitted to tracheostomy tube occlusion tolerance testfor 24 hours, and then to flexible bronchoscopy. We described and classified the diagnosed laryngotracheal changes. We compared the clinical criteria for decannulation indication with the bronchoscopy-diagnosed laryngotracheal injuries that contraindicated decannulation. We identified the factors that could interfere in decannulation and evaluated the importance of bronchoscopy as part of the process. RESULTS: Forty (80.4%) patients had laryngotracheal alterations. Of the 40 patients considered clinically fit to decannulation, eight (20%) (p = 0.0007) presented with laryngotracheal injuries at bronchoscopy that contraindicated the procedure. The most frequent laryngeal alteration was vocal cords lesion, in 15 (29%) individuals, and granuloma, the most prevalent tracheal lesion, in 14 (27.5%) patients. CONCLUSION: flexible bronchoscopy showed a large number of laryngotracheal injuries, the most frequent being the vocal cords injury in the larynx and the granuloma in the trachea, which contributed to increase the decannulation procedure safety.

Quantificação do líquido amniótico pela ultra-sonografia tridimensional e bidimensional no primeiro trimestre da gestação

OBJETIVO: quantificar os valores do líquido amniótico no primeiro trimestre da gestação, em fetos normais, por meio de ultra-sonografia tridimensional e bidimensional. MÉTODOS: foram avaliados 25 fetos normais, da 8ª à 11ª semana de gestação. O estudo foi do tipo prospectivo longitudinal. As medidas do volume de líquido amniótico foram obtidas por meio de ultra-sonografia endovaginal, modos tridimensional e bidimensional. O estudo bidimensional consistiu em determinar o volume por cálculo matemático com base na forma de um elipsóide (constante 0,52), obtendo-se o volume do saco amniótico e do embrião. No estudo tridimensional, o volume do líquido amniótico foi feito pela técnica VOCAL, utilizando os graus de rotação 6, 9, 15 e 30°. Foi considerado como resultado final o volume do líquido amniótico obtido pelo grau de rotação6. Em ambos, o volume de líquido amniótico foi obtido pela subtração do volume do saco amniótico pela medida volumétrica do embrião. Para análise estatística utilizamos análise de variância (ANOVA), correlação e análise de regressão. O nível de significância adotado foi p < 0,05. RESULTADOS: a evolução no volume de líquido amniótico pela ultra-sonografia bidimensional foi de 5,4 para 39,5 cm³ da 8ª para a 11ª semana (ANOVA - p < 0,05). Observamos correlação entre idade gestacional e volume de líquido amniótico (p < 0,001, r² = 88,3%). No estudo tridimensional o volume de líquido amniótico aumentou de 5,7 para 42,9 cm³ da 8ª para a 11ª semana (ANOVA - p < 0,05). Também observamos correlação entre idade gestacional e volume de líquido amniótico (p < 0,001, r² = 98,1%). CONCLUSÃO: há aumento no volume de líquido amniótico no primeiro trimestre da gestação, quando avaliado nos modos bidimensional e tridimensional. Além disso, demonstramos que, quanto maior a idade gestacional, maior é o volume de líquido amniótico.

Volume do embrião estimado pela ultra-sonografia tridimensional entre a sétima e a décima semana de gestação

OBJETIVO: avaliar a evolução do volume do embrião (VE) entre a sétima e a décima semana de gestação por meio da ultra-sonografia tridimensional. MÉTODOS: realizou-se um estudo de corte transversal com 63 gestantes normais entre a sétima e a décima semana. Os exames ultra-sonográficos foram realizados por meio de um transdutor endocavitário volumétrico. Para o cálculo do VE, utilizou-se o método VOCAL (Virtual Organ Computer-aided Analysis) com ângulo de rotação de 12º, com delimitação de 15 planos seqüenciais. Para o VE foram calculadas médias, medianas, desvios padrão e valores máximo e mínimo em todas as idades gestacionais. Para se avaliar a correlação entre o VE e o comprimento cabeça-nádega (CCN) foi criado gráfico de dispersão, sendo o ajuste realizado pelo coeficiente de determinação (R²). Para se determinarem intervalos de referência do VE em função do CCN, utilizou-se a seguinte fórmula: percentil =VE+K versus dp, com K=1,96. RESULTADOS: o CCN variou de 9,0 a 39,7 mm, com média de 23,9 mm (±7,9 mm), enquanto o VE variou de 0,1 a 7,6 cm³, com média de 2,7 cm³ (±3,2 cm³). O VE foi altamente correlacionado com o CCN, sendo que o melhor ajuste foi obtido com regressão quadrática (VE=0,165 - 0,055 x CCN + 0,005 x CCN²; R²=0,853). O VE médio variou de 0,1 (-0,3 a 0,5 cm³) a 6,7 cm³ (3,8 a 9,7 cm³) no intervalo de 9 a 40 mm do CCN. Neste intervalo o VE aumentou 67 vezes, enquanto o CCN aumentou apenas 4,4 vezes. CONCLUSÕES: o VE é um parâmetro mais sensível que o CCN para avaliar o crescimento embrionário entre a sétima e a décima semana de gestação.

Ultrasound call detection in capybara

The vocal repertoire of some animal species has been considered a non-invasive tool to predict distress reactivity. In rats ultrasound emissions were reported as distress indicator. Capybaras[ vocal repertoire was reported recently and seems to have ultrasound calls, but this has not yet been confirmed. Thus, in order to check if a poor state of welfare was linked to ultrasound calls in the capybara vocal repertoire, the aim of this study was to track the presence of ultrasound emissions in 11 animals under three conditions: 1) unrestrained; 2) intermediately restrained, and 3) highly restrained. The ultrasound track identified frequencies in the range of 31.8±3.5 kHz in adults and 33.2±8.5 kHz in juveniles. These ultrasound frequencies occurred only when animals were highly restrained, physically restrained or injured during handling. We concluded that these calls with ultrasound components are related to pain and restraint because they did not occur when animals were free of restraint. Thus we suggest that this vocalization may be used as an additional tool to assess capybaras[ welfare.

Yliopiston yrittäjämäisyyden sosiaalinen rakentuminen: case Aalto-yliopisto

Keskustelu yrittäjyyden sijoittumisesta yliopistojen tehtäväkenttään on muodostunut 2000-luvun aikana osaksi yhteiskunnallista ja maailmanlaajuista korkeakoulutuksen muutosta. Tämän tutkimuksen tarkoituksena on lisätä ymmärrystä yliopiston yrittäjämäisyyden sosiaalisesta rakentumisesta. Lähestyn yliopiston sisällä tuotettua moniäänistä yrittäjyyspuhetta yliopiston yrittäjämäisyyden todellisuuden representaationa, ja pyrin tekemään siitä selkoa kommunikaatioon kohdistuvan analyysin avulla. Ilmiön empiirinen tarkastelu pohjautuu Aalto-yliopistossa ja sitä edeltäneessä Teknillisessä korkeakoulussa vuosina 2006–2013 kerättyihin tekstiaineistoihin. Aineistojen tulkinta tuottaa monikerroksellista tietoa ilmiöstä niin yksilö- kuin organisaatiotasolla. Tarkastelen tutkimuksessani millaisia merkityksenantoja yrittäjyydelle ja yrittäjämäisyydelle annetaan yliopiston sisällä eri näkökulmista katsottuna, kun yliopisto käy läpi merkittävää organisaatiorakenteellista ja institutionaalista muutosta. Tutkimusasetelman neljä näkökulmaa perustuvat tekniikan alan jatko-opiskelijoiden puheeseen, TKK:n opetussuunnitelmatekstiin, Aalto-yliopiston opettajien puheeseen ja johdon tuottamaan strategiatekstiaineistoon. Tutkimuksen tulosten mukaan käynnissä on ollut akateemisten arvojen ja arvojärjestelmien laajentumisen aika ja tila, jossa yrittäjämäisyys astuu areenalle, mutta sen suppeat tulkinnat eivät tarjoa mahdollisuuksia ruohonjuuritason kiinnittymiseen akateemisesta kulttuurista käsin. Yrittäjyyden ja yrittäjämäisyyden saamat taloudelliskaupalliset merkitykset koetaan uhkaksi, eikä tilannetta helpota yleisesti uuvuttavaksi koettu rakenteellinen ja yhteiskunnallinen yliopiston muutosvaihe. Hallitsevat tarinalinjat kuten puhe kilpailukyvystä ja kilpailutilanteen kovenemisesta tuottavat odotusten viitekehyksen, joilla yliopiston toimintaa raamitetaan ulkoapäin. Yrittäjyyteen laajassa merkityksessä sisältyvät mahdollisuudet jäävät niin ikään hyödyntämättä, ja lukuisat edistämistoiminnot kilpistyvät sosiaalisesti rakentuviin esteisiin. Tässä tutkimuksessa rakentuva laajennettu yliopiston yrittäjämäisyyden viitekehys pyrkii palvelemaan moniäänistymisen tarkoitusta käsitteellisellä tasolla ja avaamaan uusia mahdollisuuksia yliopiston yrittäjämäisyyden edistämiselle.

Remembering the War and Aggression: A Discourse Analysis of Japan’s State Apologies and Commemoration Speeches on August 15th 1995-2015

Memories of historical injustices affect contemporary politics from local to global level. In East Asia, questions of commemoration and historical responsibility have turned into international and domestic controversies. The main focus has been and still is in apologies conducted by Japanese prime ministers in regards to the war, aggression and colonialism during the era of Imperial Japan. Although it is granted that state apologies are not a crucial part of reconciliation, they can be analysed as a linked but separate process within the context of memory and international relations. The purpose of this study is to examine the discourses of history in Japanese prime ministers’ commemoration speeches on Memorial Ceremony for the War Dead from 1995 to 2015 in order to analyse how the Japanese government is reflecting on its past. In particular, attention is paid on what is being commemorated and how, whether it is the war and its victims or Japan’s post-war era of peace. As an apology is a reciprocal activity, responses from Japan’s most vocal former victims, South Korea and China, were also examined. Discourse analysis was used to identify and examine the different representations of the past. In addition, the apology statements of Japanese prime ministers were analysed in the Many to Many apology framework developed by Tavuchis (1991). Primary material consisted of 21 prime ministers’ speeches from the annual Memorial Ceremony for the War Dead on August 15th and from three apology statements made in 1995, 2005 and 2015. Further international context was primarily collected from newspaper articles of The New York Times and The Times throughout the examined period. It can be concluded from the findings that in the official Japanese remembrance of the past war from 1985’s annexation of Taiwan to the atomic bombings in 1945, both discourses that reinforce apology and remorse over Japan’s past aggressions and discourses that consciously avoid doing so are used. The commemoration speeches and apology statements consistently assert that Japan has acknowledged its past and expresses regret over the acts of aggression. At the same time, the speeches and statements strengthen the narrative that Japan was a victim of circumstances as well as turn the focus on post-war peace-making or on Japan’s own victimhood.

The human rights dilemma : an east-west encounter : Germany and China in 1996 /

Conflicts over human rights in relations between East Asia and the West have increased since the end of the Cold War. Western governments express concern about human rights standards in East Asian countries. In the East, these expressions have been perceived as interference in internal affairs. Due to dramatic economic development, East Asian nations recently have gained in pride and self-confidence as global actors. Such development is observed with suspicion in the West. Concerned about the decline of global U.S. influence, some American scholars have re-invented the notion of "culture" to point at an alleged East Asian threat. Also East Asian statesmen use the cultural argument by claiming the existence of so-called 'Asian values', which they allege are the key to Eastern economic success. This thesis argues that issues of human rights in East-West relations are not only a consequence of well-intended concern by Western governments regarding the human rights and welfare of the citizens of East Asian nations, but are in fact dominated by and used as a pawn in interplay with more complicated questions of global power and economic relations between East and West. The thesis reviews the relevance of culture in East-West relations. In the West, particularly Samuel P. Huntington with his prediction of the Clash of Civilizations stands out. Singapore's Lee Kuan Yew has been very vocal on the Eastern side. Whereas the West tries to cope with its decrease of global influence, after hundreds of years under Western hegemonism, the East believes in an Asian way of development without interference form the West. Most of this dispute revolves around the issue of human rights. The West claims the universality of rights which in fact emphasizes political and civil rights. Western countries critizise poor human rights standards in East Asia. The East, in return, accuses the West of hypocritical policies that seek global dominance. East Asian governments assert that due to a different stage of development they have to stress first their rights to development in order to assure stability. In particular, China argues this way. The country's leadership, however, shows concern about human rights and has already improved its human rights record over the past years. This thesis analyses the dispute over human rights in a case study on Germany and China. Both countries have a mutual interest in trade relations which has conflicted with Germany's criticism of China's problematic human rights record. In 1996, the two countries clashed after the German parliament passed a resolution condemning China's treatment of Tibet. This caused a lot of damage to the Chinese-German relationship which in the course of the year went back to normality. In the light of these frictions a German human rights policy that focuses on unspectacular grass-roots support of China, for example in strengthening China's legal system, would be preferable. Such co-operation must be based on mutual respect.

The role of the GABAergic system in the production of ultrasonic vocalization in rats /

Ultrasonic vocalization plays an important role in intraspecies communication for rats. It has been well demonstrated that rats will emit 22kHz vocalization in stressfiil or threatening situations. Although the neural mechanism underlying vocahzation is not well understood, it is known that chohnergic input to the basal forebrain induces such alarm calls. A number of experiments have found that intracerebral injection of carbachol, a predominantly muscarinic agonist, into die anterior hypothalamic/preoptic area (AH/POA) rehably induces vocalization similar to naturally emitted ultrasonic calls. It has also been shown that carbachol has extensive inhibitory effects on neuronal firing in the same area. This result impUes that the inhibitory effects of carbachol in the AH/POA could trigger vocahzation, and that the GABAergic system could be involved. The purpose of this study is to investigate the effects ofGABA agonists and antagonists on flie production of carbachol induced 22kHz vocalization. The following hypotheses were examined: 1) apphcation ofGABA (a naturally occurring inhibitory neurotransmitter) will have a synergistic effect with carbachol, increasing vocalization; and 2) tiie apphcation ofGABA antagonists (picrotoxin or bicuculline) will reduce caibachol-induced vocalization. A total of sixty rats were implanted with stainless steel guide cannulae in the AH/POA area. After recovery, animals were locally pretreated with 1) GABA (l-40ng), 2) picrotoxin (1 .5^g) or bicuculhne (0.03ng), or 3) sahne; before injection with carbachol (1 .5^g). The resulting vocalization was measured and quantitated. The results indicate that pretreatment with GABA or GABA antagonists had no significant effect on vocalization. Local pretreatment with GABA did not potentiate the vocal response as measured by its duration, latraicy, and total number of calls. Similarly, pretreatment with picrotoxin or bicuculline had no effects on the same measures of vocalization. The results suggest tfiat chohnoceptive neurons involved in the production of alarm calls are not under direct GABAergic control.

The Role of Orexin-A in Anxiety and the Emission of Ultrasonic Vocalizations in Rats

Central administration of orexin-A has been shown to activate autonomic arousal in rats, reliably inducing anxiety-like behaviours in the open field. To date, there has yet to be a study investigating the role of orexin-A in the communication of such negative affective state. In the current study, forty-six adult male rats were chronically cannulated and administered orexin-A into the medial preoptic area/anterior hypothalamic area to determine the effect of this neuropeptide on anxiety-like behaviour and the production of 22 kHz aversive ultrasonic vocalizations. It was found that intracerebral administration of orexin-A increased autonomic arousal as measured by a significant increase in fecal boli output, however orexin-A did not significantly affect locomotor activity or induce 22 kHz calling. These data suggest that orexin-A is involved in the regulation of the autonomic aspect of anxiety-like behaviour but not in the vocal communication of such negative affect

Cognition sociale et traitement du contexte dans la schizophrénie : effets des stéréotypes

Un déficit de la cognition sociale incluant l’attribution d’états mentaux, la perception sociale et la perception des émotions est l’une des caractéristiques les plus handicapantes de la schizophrénie. Les résultats d’une étude par Hardy-Baylé et al. (2003) suggèrent que les difficultés des schizophrènes (SZ) à attribuer des intentions aux autres seraient dues à l’incapacité à utiliser l’information contextuelle. Certaines études (Ivanko & Pexman, 2003; Pexman & Olineck, 2002b) démontrent que des facteurs comme le degré d’incongruité entre le contexte et l’énoncé, l’intonation de la voix et les caractéristiques des personnages peuvent influencer la compréhension de l’intention ironique chez les sujets sains (CT). L’objectif de cette étude est de manipuler des informations contextuelles afin de déterminer si le type de métier du locuteur est un indice social facilitant la compréhension de l’intention du locuteur (théorie de l’esprit ; TdE) et de la perception sociale chez les patients SZ. Trente participants SZ appariés avec trente participants CT ont été recrutés. Ils ont été évalués sur la compréhension de l’ironie et sur la mémoire de travail. Les histoires étaient développées selon deux conditions de métier: un métier favorisant la compréhension de l’ironie (e.g. comédien) et un métier ne favorisant pas la compréhension de l’ironie (e.g. prêtre). Les résultats montrent que les patients SZ ont un trouble de TdE et ils ne semblent pas sensibles aux stéréotypes contrairement aux participants CT. Toutefois, les résultats indiquent que les participants SZ n’ont pas de déficit concernant la perception sociale.

Vers une scène commune : rapports croisés entre poésie et chanson chez Raoul Duguay (1966-1970)

Ce mémoire porte sur les deux premiers recueils de Raoul Duguay (ruts et or le cycle du sang dure donc). Il cherche à examiner les liens étroits qu’entretient la poésie de Duguay avec la production parallèle du poète, qui s’oriente dès la fin des années 1960 vers la chanson. Le mémoire s’attachera d’abord, dans le premier chapitre, à présenter l’histoire des liens entre les poètes et la chanson au Québec afin de relever les points de contact significatifs au cours des années 1960 et de poser le cadre théorique de la chanson comme objet d’étude. Dans un deuxième temps, l’analyse des deux premiers recueils de poèmes de Duguay nous mènera à une réflexion sur la présence de la métaphore du chant, puis de la parole poétique en poésie québécoise, qui annonce un changement de paradigme dans l’approche du lyrisme et du sujet lyrique. Enfin, le troisième chapitre se penchera sur le contexte contre-culturel québécois, pour examiner le discours et le contre-discours sur la poésie, pour expliquer le phénomène de décloisonnement des genres qui conduit Raoul Duguay à investir le champ de la culture populaire de sa poésie. Il y sera aussi question du sujet « dans le langage », de l’expérience de la langue et de la subjectivité de la voix.

Ontogénèse et spécificité de la voix humaine

La voix est un stimulus auditif omniprésent dans notre environnement sonore. Elle permet non seulement la parole, mais serait aussi l’équivalent d’un visage auditif transmettant notamment des informations identitaires et affectives importantes. Notre capacité à discriminer et reconnaître des voix est socialement et biologiquement importante et elle figure parmi les fonctions les plus importantes du système auditif humain. La présente thèse s’intéressait à l’ontogénèse et à la spécificité de la réponse corticale à la voix humaine et avait pour but trois objectifs : (1) mettre sur pied un protocole électrophysiologique permettant de mesurer objectivement le traitement de la familiarité de la voix chez le sujet adulte; (2) déterminer si ce même protocole pouvait aussi objectiver chez le nouveau-né de 24 heures un traitement préférentiel d’une voix familière, notamment la voix de la mère; et (3) mettre à l’épreuve la robustesse d’une mesure électrophysiologique, notamment la Fronto-Temporal Positivity to Voices, s’intéressant à la discrimination pré-attentionnelle entre des stimuli vocaux et non-vocaux. Les résultats découlant des trois études expérimentales qui composent cette thèse ont permis (1) d’identifier des composantes électrophysiologiques (Mismatch Negativity et P3a) sensibles au traitement de la familiarité d’une voix; (2) de mettre en lumière un patron d’activation corticale singulier à la voix de la mère chez le nouveau-né, fournissant le premier indice neurophysiologique de l’acquisition du langage, processus particulièrement lié à l’interaction mère-enfant; et (3) de confirmer l’aspect pré-attentionnel de la distinction entre une voix et un stimulus non-vocal tout en accentuant la sélectivité et la sensibilité de la réponse corticale réservée au traitement de la voix.

La musique traitée comme sujet dans le cinéma narratif, contemporain et occidental : réflexion et expérimentation autour d’une forme : la matérialisation de la musique

La création cinématographique de l’étudiante qui accompagne ce mémoire sous la forme d’un DVD est disponible à la Médiathèque de la Bibliothèque des lettres et sciences humaines sous le titre : A Capella.(http://atrium.umontreal.ca/notice/UM-ALEPH002343644)

Of tradition and conversion : a comparative study of two Phuo griottes

La version intégrale de ce mémoire est disponible uniquement pour consultation individuelle à la Bibliothèque de musique de l’Université de Montréal (www.bib.umontreal.ca/MU).