Free Tools and Strategies for the Generation of 3D Finite Element Meshes: Modeling of the Cardiac Structures.

The Finite Element Method is a well-known technique, being extensively applied in different areas. Studies using the Finite Element Method (FEM) are targeted to improve cardiac ablation procedures. For such simulations, the finite element meshes should consider the size and histological features of the target structures. However, it is possible to verify that some methods or tools used to generate meshes of human body structures are still limited, due to nondetailed models, nontrivial preprocessing, or mainly limitation in the use condition. In this paper, alternatives are demonstrated to solid modeling and automatic generation of highly refined tetrahedral meshes, with quality compatible with other studies focused on mesh generation. The innovations presented here are strategies to integrate Open Source Software (OSS). The chosen techniques and strategies are presented and discussed, considering cardiac structures as a first application context.

Lower-extremity amputation: a 6-year follow-up study in Brazil.

PURPOSE: To evaluate the 6-year mortality in 50 patients following lower-limb amputation. METHODS: The cumulative survival rate of 50 (28 men, 22 women) amputees aged 54 to 94 years (mean, 67.3; median, 73.5) was retrospectively studied from 1993 to 1998. Indications for above- or below-knee amputation were trauma (n = 2), vasculitis (n = 2), and critical ischaemia of the lower limbs (n = 46). Leg amputation was performed after anamnesis, physical examination, and angiography. All patients were followed up for 6 years by phone or domiciliary visit. A death certificate was verified when a patient was lost to follow-up. Statistical analysis was expressed by the actuarial survival curve. RESULTS: Of 50 amputees, 36 died in the 6 years following leg amputation: 22 in the first year, 3 in the second year, 5 in the third year, 2 in the fourth year, 2 in the fifth year, 2 in the sixth year; 14 remained alive after 6 years. CONCLUSION: Patients who underwent lower-limb amputation had a high 6-year mortality. Most deaths occurred in the first year.

Prevalence of anticardiolipin antibodies in peripheral arterial thrombosis.

The aim of this study was to assess prospectively the prevalence of anticardiolipin antibodies in patients with peripheral arterial thrombosis. Fifty-nine patients with arterial thrombosis (38 men, 21 women), ages ranging from 24 to 80 years, mean age, 45.5 years, were studied. The control group included 100 volunteer blood donors. After confirmation of the thrombotic event, anticardiolipin antibodies were dosed by the immunoassay enzyme method and by dilution. In Group I these antibodies were present in 62.7% of the patients, of which 33.9% were borderline and 28.8% were positive. In the control group 6% of the patients were borderline and 1% was positive. The statistical analysis showed that the prevalence found was statistically significant (p < 0.001), even when the borderline titers were not considered positive. Patients with peripheral arterial thrombosis have a high prevalence of anticardiolipin antibodies.

Lymphoscintigraphic evaluation in patients after erysipelas.

Erysipelas (cellulitis/lymphangitis) is a superficial cutaneous infection spread by the lymphatic system which may result in permanent injury to the lymphatic vessels. The study evaluated the lymphatic drainage in the lower limbs of 30 patients with at least two episodes of erysipelas by means of lymphoscintigraphy. Twenty-two (73%) were female and 8 (27%) were male with ages ranging from 26 to 77 years (mean 52 years). Lymphoscintigraphy was performed by intradermal administration of 500 microCi (20 Mbq) of 99mTc antimony sulfur-colloid in two interdigital spaces of the feet. Whole body scintigraphy was performed 45 minutes after the administration of the radiopharmaceutical using a computerized gamma camera. Significant lymphatic abnormalities were found in 23 (77%) of these patients. We conclude that most patients with repeated erysipelas have significant and even permanent abnormalities in regional lymphatic drainage. Recurrent erysipelas suggests underlying primary or secondary lymphedema.

[Left atrial myxoma and isquemic stroke in a child]. / Mixoma atrial esquerdo com acidente vascular cerebral isquêmico em criança.

The authors present a case of left atrial myxoma with stroke in an 8-year-old female child. The tumor was removed and two months after the surgery a left atrial septum mass was observed suggesting recurrence. The child was asymptomatic. Literature review emphasizes the rarity and clinically aggressive behavior of this tumor at this age group and demonstrates rare recurrence rates after surgery.