Pectus Excavatum postsurgical outcome based on preoperative soft body dynamics simulation

Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which an abnormal formation of the rib cage gives the chest a caved-in or sunken appearance. Today, the surgical correction of this deformity is carried out in children and adults through Nuss technic, which consists in the placement of a prosthetic bar under the sternum and over the ribs. Although this technique has been shown to be safe and reliable, not all patients have achieved adequate cosmetic outcome. This often leads to psychological problems and social stress, before and after the surgical correction. This paper targets this particular problem by presenting a method to predict the patient surgical outcome based on pre-surgical imagiologic information and chest skin dynamic modulation. The proposed approach uses the patient pre-surgical thoracic CT scan and anatomical-surgical references to perform a 3D segmentation of the left ribs, right ribs, sternum and skin. The technique encompasses three steps: a) approximation of the cartilages, between the ribs and the sternum, trough b-spline interpolation; b) a volumetric mass spring model that connects two layers - inner skin layer based on the outer pleura contour and the outer surface skin; and c) displacement of the sternum according to the prosthetic bar position. A dynamic model of the skin around the chest wall region was generated, capable of simulating the effect of the movement of the prosthetic bar along the sternum. The results were compared and validated with patient postsurgical skin surface acquired with Polhemus FastSCAN system

Variations of the soft tissue thicknesses external to the ribs in Pectus Excavatum patients

Background: Surgical repair of pectus excavatum (PE) has become more popular due to improvements in the minimally invasive Nuss procedure. The pre-surgical assessment of PE patients requires Computerized Tomography (CT), as the malformation characteristics vary from patient to patient. Objective: This work aims to characterize soft tissue thickness (STT) external to the ribs among PE patients. It also presents a comparative analysis between the anterior chest wall surface before and after surgical correction. Methods: Through surrounding tissue segmentation in CT data, STT values were calculated at different lines along the thoracic wall, with a reference point in the intersection of coronal and median planes. The comparative analysis between the two 3D anterior chest surfaces sets a surgical correction influence area (SCIA) and a volume of interest (VOI) based on image processing algorithms, 3D surface algorithms, and registration methods. Results: There are always variations between left and right side STTs (2.54±2.05 mm and 2.95±2.97 mm for female and male patients, respectively). STTs are dependent on age, sex, and body mass index of each patient. On female patients, breast tissue induces additional errors in bar manual

Lições de Direito e Processo Penal, 2013/2014

§ Parte I A: DIREITO PENAL: CAPÍTULO I – CONCEITO DE DIREITO PENAL, COM ESPECIAL RELEVO DA DIFERENCIAÇÃO ENTRE DIREITO PENAL CLÁSSICO, DIREITO PENAL ECONÓMICO E SOCIAL E DIREITO DAS CONTRA-ORDENAÇÕES; CAPÍTULO II – O PROBLEMA DOS FINS DAS PENAS; CAPÍTULO III – BREVE ABORDAGEM DA EVOLUÇÃO HISTÓRICA DO DIREITO PENAL; CAPÍTULO IV – TEORIA GERAL DA LEI CRIMINAL; CAPÍTULO V – TEORIA GERAL DA INFRACÇÃO CRIMINAL: A) ELEMENTOS; B) CONSTRUÇÕES; C) ANÁLISE: 1) ACÇÃO; 2) TIPICIDADE; 3) ILICITUDE; 4) CULPA; 5) PUNIBILIDADE; CAPÍTULO VI – FORMAS DO CRIME: A) TENTATIVA; B) AUTORIA E COMPARTICIPAÇÃO; C) CONCURSO DE CRIMES § Parte I B: DIREITO PROCESSUAL PENAL; CAPÍTULO I – A DELIMITAÇÃO DO DIREITO PROCESSUAL PENAL; CAPÍTULO II – OS PRINCÍPIOS FUNDAMENTAIS DO PROCESSO PENAL; CAPÍTULO III - A LEI PROCESSUAL PENAL E A SUA APLICAÇÃO; Parte II: CAPÍTULO I - OS SUJEITOS DO PROCESSO; CAPÍTULO II - O OBJECTO DO PROCESSO; CAPÍTULO III - AS MEDIDAS DE COACÇÃO E DE GARANTIA PATRIMONIAL; CAPÍTULO IV - TRAMITAÇÃO PROCESSUAL PENAL. § § Part I: CRIMINAL LAW: CHAPTER I - CONCEPT OF CRIMINAL LAW, WITH SPECIAL RELIEF OF THE DIFFERENTIATION BETWEEN CLASSIC CRIMINAL LAW, ECONOMIC AND SOCIAL CRIMINAL LAW AND THE “AGAINST ORDINANCES” LAW ("LAW OFFENSES"); CHAPTER II - THE PROBLEM OF THE ENDS OF THE PENALTIES; CHAPTER III - BRIEF OVERVIEW OF THE EVOLUTION HISTORY OF CRIMINAL LAW; CHAPTER IV - GENERAL THEORY OF THE CRIMINAL LAW; CHAPTER V - GENERAL THEORY OF THE CRIMINAL INFRACTION: A) ELEMENTS; B) CONSTRUCTIONS; C) ANALYSIS: 1) ACTION; 2) VAGUENESS DOCTRINE; 3) ILLEGALITY; 4) GUILT (FAULT); 5) PUNISHMENT; CHAPTER VI - FORMS OF THE CRIME: A) ATTEMPT; B) AUTHORSHIP AND "CO-PARTICIPATION"; C) CUMULATION OF OFFENCES. § Part I - B: CRIMINAL PROCEDURAL LAW: CHAPTER I - THE DELIMITATION OF THE CRIMINAL PROCEDURAL LAW; CHAPTER II - THE BASIC PRINCIPLES OF THE CRIMINAL PROCEDURE; CHAPTER III - THE CRIMINAL PROCEDURE LAW AND ITS APPLICATION; Part II: CHAPTER I - THE FIGURES OF THE PROCESS; CHAPTER II - THE OBJECT OF THE PROCESS; CHAPTER III - THE MEASURES OF COERCION AND PATRIMONIAL GUARANTEE (WARRANTY); CHAPTER IV -CRIMINAL PROCEDURE.

Variations of the soft tissue thicknesses external to the ribs in pectus excavatum patients

Background: Surgical repair of pectus excavatum (PE) has become more popular due to improvements in the minimally invasive Nuss procedure. The pre-surgical assessment of PE patients requires Computerized Tomography (CT), as the malformation characteristics vary from patient to patient. Objective: This work aims to characterize soft tissue thickness (STT) external to the ribs among PE patients. It also presents a comparative analysis between the anterior chest wall surface before and after surgical correction. Methods: Through surrounding tissue segmentation in CT data, STT values were calculated at different lines along the thoracic wall, with a reference point in the intersection of coronal and median planes. The comparative analysis between the two 3D anterior chest surfaces sets a surgical correction influence area (SCIA) and a volume of interest (VOI) based on image processing algorithms, 3D surface algorithms, and registration methods. Results: There are always variations between left and right side STTs (2.54±2.05 mm and 2.95±2.97 mm for female and male patients, respectively). STTs are dependent on age, sex, and body mass index of each patient. On female patients, breast tissue induces additional errors in bar manual