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The theory of self-adjoint extensions of first- and second-order elliptic differential operators on manifolds with boundary is studied via its most representative instances: Dirac and Laplace operators. The theory is developed by exploiting the geometrical structures attached to them and, by using an adapted Cayley transform on each case, the space M of such extensions is shown to have a canonical group composition law structure. The obtained results are compared with von Neumann's theorem characterizing the self-adjoint extensions of densely defined symmetric operators on Hilbert spaces. The 1D case is thoroughly investigated. The geometry of the submanifold of elliptic self-adjoint extensions M-ellip is studied and it is shown that it is a Lagrangian submanifold of the universal Grassmannian Gr. The topology of M-ellip is also explored and it is shown that there is a canonical cycle whose dual is the Maslov class of the manifold. Such cycle, called the Cayley surface, plays a relevant role in the study of the phenomena of topology change. Self-adjoint extensions of Laplace operators are discussed in the path integral formalism, identifying a class of them for which both treatments leads to the same results. A theory of dissipative quantum systems is proposed based on this theory and a unitarization theorem for such class of dissipative systems is proved. The theory of self-adjoint extensions with symmetry of Dirac operators is also discussed and a reduction theorem for the self-adjoint elliptic Grassmannian is obtained. Finally, an interpretation of spontaneous symmetry breaking is offered from the point of view of the theory of self-adjoint extensions.