• 한국멀티미디어학회논문지
• /
• 제19권3호
• /
• pp.557-566
• /
• 2016

Heart sounds generated by the beating heart and blood flow reflect the turbulence created when the heart valves snap shut. Cardiac diagnosis is typically started by an auscultation using a stethoscope, from which a medical doctor, depending on his hearing capabilities and training, listens and interprets the acoustic signal. This method of diagnostic is uncertain, mostly due to the fact that human ear loses the acoustic frequency sensitivity through the years. Even though an auscultation has some weaknesses like uncertainty, it is considered as a primary tool due to its simplicity. In this paper, heart murmur detection algorithm is proposed using time and frequency characteristics of heart sound. The propose heart murmur detection method adapted conventional primary heart sound detection method in time domain and modified spectral flatness method in frequency domain for detecting heart murmurs. From experimental results, it is confirmed that the proposed algorithm detect the heart murmurs efficiently.

• 한국정보통신학회논문지
• /
• 제17권12호
• /
• pp.3001-3008
• /
• 2013

심음도(PCG, Phonocardiogram) 분석을 이용하여 심장의 판막과 관련된 질환을 진단하기 위해서는 먼저 심음 분할을 위해 심음의 주성분인 S1과 S2를 정확하게 찾아야 한다. 본 논문에서는 심음포락선의 모멘트 특성을 분석하고 이를 심음 분할에 적용하였다. 기존의 2차 모멘트를 이용한 심음 분할의 문제점을 분석하고, 심잡음이 있더라도 심음 주성분의 검출이 용이한 3차 모멘트에 기반한 방법을 제안하였다. 심음포락선은 심음 신호의 단구간 에너지를 이용하였으며, 3차 모멘트 궤적의 기울기 정보를 이용하여 심음 주성분을 검출하고 지속시간을 게이팅(gating) 하였다. 다양한 심잡음이 포함된 심음 신호에 대한 실험을 통해 제안한 방법이 기존의 2차 모멘트 기법보다 심잡음의 영향을 적게 받고 심음 주성분의 구간을 정확하게 검출 할 수 있음을 보였다.

• Journal of Chest Surgery
• /
• 제21권6호
• /
• pp.996-1002
• /
• 1988

A clinical analysis was performed on 115 cases of -patent ductus arteriosus treated surgically during the period of 11 years from Aug. 1977 to Jul. 1988. at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Among 115 cases, male was 38 and female was 77 and ages ranged 12 days to 27 years old with the average of 8 7/12 years. The major clinical symptoms on admission were frequent URI attack[77.4%], dyspnea on exertion[32.2%] and palpitation[13%]. On auscultation, continuous machinery murmurs were detected in 97 cases[84.3%] and loud systolic murmurs were detected in 18 cases[15.7%]. Preoperative electrocardiographic findings were as follows: LVH 59[51.3%], RVH 12[10.4%], BVH 16[13.9%] and WNL 28[24.3%]. Radiologically, there were increased pulmonary vascularity in 104[90.4%] and cardiomegaly 62[53.9%]. Cardiac catheterization were performed in 101 cases and mean systolic pulmonary arterial pressure was 49.84*29.7mmHg and mean Qp/Qs was 2.95k1.8. Methods of operation were multiple ligation in 96, division in 11 and transpulmonary arterial repair using cardiopulmonary bypass in 8. Complication were recannalization in 2, temporary hoarseness due to left recurrent laryngeal nerve paralysis in 3 and respiratory distress in 1 and overall mortality rate was 1.7%[2 cases].

• Journal of Chest Surgery
• /
• 제18권2호
• /
• pp.165-173
• /
• 1985

A clinical analysis was performed n 706 uses of patent ductus arteriosus experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 27 years period from 1958 to 1984. Of the 706 patients of PDA, 244 patients were male and 462 patients were female and ages ranged from 2 months to 53 years old with the average age of 8.5 years. The chief complaints on admission were dyspnea on exertion and frequent URI in 58.9%, non specific symptoms such as palpitation and easy fatigability in 9.7%, symptoms of CHF in 2.0% and no subjective symptoms in 29.4%. On auscultation of heart, continuous machinery murmurs were heard in 82% and only systolic murmurs were heard in 18% of patients. On simple chest PA of patients, cardiomegalies were detected in 78% and there were increased pulmonary vascularities in 93% of patients. EKG findings were as followed; LVH 56.9%, BVH 12.6%, RVH 2.9% and WNL 27.6%. Cardiac Catheterizations were performed in 512 patients and mean Qp/Qs was 2.56 and mean systolic pulmonary artery pressure was 45mmHg. Operation methods were as followed; in patients in whom operations were performed on PDA only, ligation 94.3%, division 3.7% and ligation [0.5%] or trans-pulmonary artery suture closure [1.5%] under cardiopulmonary bypass 2.0% and in patients in whom operations were performed with associated anomalies, ligation 17.6%, division 2.4%, and ligation [44.7%] or trans-pulmonary artery suture closure [35.3%] under cardiopulmonary bypass 80%. 52 postoperative complications [8.4%] were developed in 42 patients [6.8%] and its were as followed; permanent or transient hoarseness 16 [2.6%], intraoperative rupture of PDA 8 [1.3%], recannalization 6 [1.[%], operative death 5 [0.8%], late death 4 [0.6%] and other miscellaneous complications 13 [2.1%]. 140 associated cardiac anomalies [19.8%] were found in 105 patients [14.9%] and its were as followed; VSD 68 [9.6%], COA 15 [2.1%], Subaortic discrete membrane 7 [0.9%], ASD 6 [0.8%], TOF 5 [0.7%] and other miscellaneous and

• 대한전자공학회:학술대회논문집
• /
• 대한전자공학회 2000년도 ITC-CSCC -2
• /
• pp.1045-1048
• /
• 2000

This paper presents the application of the wavelet transform analysis and the neural network method to the phonocardiogram (PCG) signal. Heart sound is a acoustic signal generated by cardiac valves, myocardium and blood flow and is a very complex and nonstationary signal composed of many source. Heart sound can be discriminated normal heart sound and heart murmur. Murmurs have broader frequency bandwidth than the normal ones and can occur at random position of cardiac cycle. In this paper, we classified the group of heart sound as normal heart sound(NO), pre-systolic murmur(PS), early systolic murmur(ES), late systolic murmur(LS), early diastolic murmur(ED). And we used the wavelet transform to shorten artifacts and strengthen the low level signal. The ANN system was trained and tested with the back- propagation algorithm from a large data set of examples-normal and abnormal signals classified by expert. The best ANN configuration occurred with 15 hidden layer neurons. We can get the accuracy of 85.6% by using the proposed algorithm.

• Journal of Chest Surgery
• /
• 제20권3호
• /
• pp.528-535
• /
• 1987

A clinical study was performed on 164 cases of PDA experienced at the Dept. of Thoracic and Cardiovascular Surgery of Pusan National University Hospital during 6 years from Jan. 1981 to Dec. 1986. It was shown that the PDA was a female-dominant heart disease [male to female ratio, 1:2.8] and two most common symptoms were frequent URI [45.6%] and exertional dyspnea [36.7%]. Continuous machinery murmurs were detected in 143 cases [87.2%], increased pulmonary vascularities [89.0%] and cardiomegalies [63.4%] by chest X-ray. The signs of LVH [43.9%], RVH [3.7%] and BVH [4.9%] were noted on the EKG. Cardiac catheterizations were performed on 67 out of 164 patients and the mean systolic pulmonary artery pressure was 48mmHg [range: 18-131mmHg] and the mean Qp/Qs was 3.1 [range:1.2-8.5] and Rp/Rs below 0.25 was 83.6%. Associated cardiac anomalies were VSD [7.9%], ASD [3.0%], pulmonary valvular stenosis [2.4%] and left persistent SVC [2.4%]. Operative methods were as follows; ligations [145; 88.4%] and divisions [6;3.7%] were performed through the left posterolateral thoracotomies without mortality and the remained cases [13;8.0%] were managed under the cardiopulmonary bypass because of the associated cardiac anomalies. Atelectasis [4.9%] and pneumonia [4.3%] were most frequent postoperative complications and the overall mortality rate was 2.4% [4 out of 164 cases].

• 한국음향학회지
• /
• 제28권1호
• /
• pp.32-43
• /
• 2009

본 논문은 자동 분할과 extreme learning machine (ELM)을 이용하여 연속 심음신호에 의한 심장질환 분류의 성능을 개선한다. 자동 분할을 위한 전처리 단계에서 비정상적인 심음신호는 심잡음 (murmur)과 클릭음 (click)을 포함하고 있기 때문에 제1음 (S1)과 제2음 (S2) 시작점 검출 결과가 부정확하거나 누락되어 기존의 심장질환 분류 시스템의 정확도를 저하시키게된다. 이러한 분할 오류에 의한 성능 저하를 감소하기 위해 S1 및 S2의 위치를 찾고, S1 및 S2의 시간 차이를 이용하여 부정확한 시작점을 교정한 다음 한 주기 심음 신호를 추출한다. 특징벡터로는 단일 주기의 심음 신호로부터 추출된 멜척도 필터뱅크 로그 에너지 계수와 포락선을 사용한다. 심장질환을 분류하기 위하여 한 개의 은닉층을 가진 ELM 알고리듬을 사용한다. 9가지 심장질환 분류 실험을 수행한 결과, 제안 방법은 81.6%의 분류 정확도를 나타내며, multi-layer perceptron(MLP), support vector machine (SVM), hidden Markov model (HMM) 중에서 가장 높은 분류 정확도를 보여준다.

• 대한수의학회지
• /
• 제41권2호
• /
• pp.227-231
• /
• 2001

A 8-year-old, intact male Yorkshire Terrier Dog was presented with dark-black mass on the third digits of the left forelimb. Three months earlier, the dog had experienced an episode of digit amputation because of growing mass with ulcerated nodule of the same area. According to the owner, the recurrence of the mass appeared suddenly and was growing rapidly from the amputation site. The mass was more infiltrative than the first one and measured 1.5 cm in diameter. The clinical signs were anorexia, coughing, respiratory distress, exercise intolerance, cardiac murmurs, and cyanosis on the oral mucous membrane. Plain radiographic findings revealed multiple, various-sized(0.5 to 7 cm in diameter), slightly firm-nodules on the thoracic region but digital bone lysis was not seen. These lesions on the thoracic cavity were considered likely to be metastatic from the digit and the dog was naturally died after 3 weeks from the time. Histologically, the digital mass confirmed the diagnosis of metastatic malignant melanoma that was composed of round melanocytic neoplastic, anaplastic, and melanin-containing cells. This report records clinical information and gross and light microscopic features of metastatic malignant melanoma in a dog.

• Clinical and Experimental Pediatrics
• /
• 제46권10호
• /
• pp.996-1002
• /
• 2003

목 적 : Rett 증후군 환자에서는 일반인에서 보다 돌연사의 확률이 높은 것으로 알려져 있으며, 그 원인으로 자율신경계 기능 부전에 의한 치명적인 부정맥 같은 심장의 전기 생리적 불안정성이 가장 의심되고 있다. 본 연구는 Rett 증후군 환자에서 심박수 변이도와 교정 QT 간격을 측정하여 실제로 자율신경 활성도에 문제가 있는지의 여부를 확인하기 위하여 실시하였다. 방 법 : 분자유전학적 염색체검사나 임상적 진단기준에 의하여 진단된 Rett 증후군 환자 12례를 대상군으로, 나이가 비슷한 정상아 30례를 대조군으로 하여 이들에서의 자율신경 활성도인 심박수 변이도와 교정 QT 간격을 측정하여 비교하였다. 심박수 변이도는 24시간 보행 심전도를 기록한 후 디지털화 된 심전도를 자동적으로 분석하여 power spectrum을 만들고 그 중 주파수영역(고주파 성분, 저주파 성분, 극소저주파 성분, LF/HF 비율)과 시간 영역(평균 RR 간격, SDNN, rMSSD, pNN50), 교정 QT 간격을 측정하여 비교하였다. 비교는 세 그룹으로 나누어서 전체 Rett 증후군과 정상 대조군 사이, 전형적인 Rett 증후군과 정상 대조군 사이, 비전형적 Rett 증후군과 정상 대조군 사이에서 실시하였다. 결 과 : 1) Rett 증후군 환자에서는 대조군에서 보다 시간영역의 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율이 의미있게 높았으며(P<0.005), 교정 QT 간격도 의미있게 연장되어(P<0.005) 있었다. 2) 전형적인 Rett 증후군 환자에서도 대조군에서 보다 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율도 의미있게 높았으며(P<0.05), 교정 QT 간격도 의미있게 연장되어 있었다(P<0.001). 3) 비전형적 Rett 증후군에서도 마찬가지로 rMSSD이 통계적으로 의미있게 낮았고(P<0.05), LF/HF 비율도 의미있게 높았으며(P<0.001), 교정 QT간격도 의미있게 연장되어 있었다(P<0.05). 4) 이상의 결과에서 Rett 증후군에서는 전형적인 환자나 비전형적인 환자 모두 미주신경긴장의 변화와 호흡에 의해 민감한 영향을 받는 rMSSD의 저하가 있었고, 교감-부교감신경 균형성을 나타내는 LF/HF 비율의 증가가 있었으며, 자율신경계에 영향을 받는 교정 QT 간격이 연장되었던 것으로 보아, 교감-부교감신경의 균형성에 이상이 있는 것으로 사료된다. 결 론 : Rett 증후군 환자에서 자율신경 활성도의 지표인 심박수 변이도의 의미있는 저하와 교정 QT 간격의 의미있는 연장이 나타나는 것으로 미루어 보아, 이 질환에서 자주 동반되는 돌연사가 일어나는 원인 중의 하나로 이러한 교감-부교감신경의 불균형을 의심할 수 있겠다.

• 한국임상수의학회지
• /
• 제28권6호
• /
• pp.586-590
• /
• 2011

5 kg 미만의 소형견 3마리가 호흡곤란과 심잡음을 주증상으로 내원하였다. 한 마리 환자에서는 일차 심방중격결손과 함께 유미흉이 진단되었다. 나머지 두 마리 환자들에서는 이차 심방중격결손이 확인되었으며, 이 중 한 마리의 환자에서는 폐동맥 협착증이 병발되었다. 내과적 치료를 시도하였으나, 이차 심방중격 결손을 가진 두 마리의 환자들은 폐사하였으며 일차 심방중격 결손이 있는 환자는 약물치료로 성공적으로 유지되었다. 폐사한 두 마리의 환자에 서는 부검을 통하여 결손부를 확인하였다. 본 증례의 경우, 세 마리의 소형견에서 발생한 다양한 해부학적, 혈역학적, 병태생리학적 타입의 심방중격 결손의 임상증상, 진단학적 특징을 대형견에서의 특징과 비교 분석한 첫 증례보고이다.