• ETRI Journal
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• v.37 no.4
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• pp.824-832
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• 2015

Heart sounds are the main obstacle in lung sound analysis. To tackle this obstacle, we propose a diagnosis algorithm that uses singular spectrum analysis (SSA) and frequency features of heart and lung sounds. In particular, we introduce a frequency coefficient that shows the frequency difference between heart and lung sounds. The proposed algorithm is applied to a synthetic mixture of heart and lung sounds. The results show that heart sounds can be extracted successfully and localizations for the first and second heart sounds are remarkably performed. An error analysis of the localization results shows that the proposed algorithm has fewer errors compared to the SSA method, which is one of the most powerful methods in the localization of heart sounds. The presented algorithm is also applied in the cases of recorded respiratory sounds from the chest walls of five healthy subjects. The efficiency of the algorithm in extracting heart sounds from the recorded breathing sounds is verified with power spectral density evaluations and listening. Most studies have used only normal respiratory sounds, whereas we additionally use abnormal breathing sounds to validate the strength of our achievements.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.51 no.3
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• pp.122-128
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• 2002

In this paper, a robust pattern classification of breath sounds for the diagnosis of pulmonary dysfunction in noise environment is proposed. The feature parameter extraction method by highpass lifter algorithm and PM(projection measure) algorithm are used. 17 different groups of breath sounds are experimentally classified and investigated. The classification has been performed by 6 different types of combinations with proposed methods to evaluate the performances, such as ARC with EDM and LCC with EDM, WLCC with EDM, ARC with PM, LCC with PM, WLCC with PM. Furthermore, all feature parameters are extracted to 80th orders by 5th orders step, and all experiments are evaluated in increasing noise environments by degrees SNR 24dB to 0dB. As a results, WLCC which is derived from highpass lifter algorithm, is selected for the feature parameter extraction method. Pm is more robust than EDM in noisy environments to test and compare experimental results. WLCC with PM method(WLCC/PM) has a better performance in an increasing noise environment for diagnosis of pulmonary dysfunction.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.62 no.10
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• pp.1444-1450
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• 2013

Esophageal stethoscope is used for monitoring the heart sounds and breath sounds of patients during surgery under a general anesthesia. Recently, an electronic esophageal stethoscope (EES)[1] has been developed for the purpose of real-time monitoring these information visually. This system uses only a microphone as the sound sensor. A drawback of the EES system is that it may be difficult to distinguish the first sound ($S_1$) and the second sound ($S_2$) of heart, because their periods are irregular depending on patients. In this paper, we propose an improved EES system in which the infrasound is measured by adding a pressure sensor as well as a sound sensor. We investigate some correlations between the infrasound and characteristics of the heart sound. The proposed system has been tested on 15 patients. The results show that the new system is capable of detecting the first sound more reliably and easily determining the heart rate and breathing period.

• Annals of Clinical Neurophysiology
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• v.6 no.1
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• pp.43-47
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• 2004

We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.154-157
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• 1980

A twenty three year old, Primigravida and 32 week pregnant woman who has been complained dyspnea, chest pain, nausea and vomiting was admitted to this chest surgical department on Feb. 19, 1979. Physical findings were those of acutely ill appearance, decreased thoracic excursion and absence of breath sounds in the left hemithorax. Roentgen examination of the chest revealed reticular cystic densities in the left, particularly in lower lung field with collapse of the left lung. Correction of the diaphragmatic hernia was carried out with reduction and repair of the hernia through transperitoneal approach. On exploration, the defect of the diaphragm was 12 x 12 cm in size and was located posterolateral area of left diaphragm. Hernia contents were stomach, spleen, omentum and splenic flexure of large bowel. The baby was normal full term spontaneous delivered at 36th POD. Diaphragmatic hernia complicated by pregnancy is a rarity and mortality is extremely high. Therefore, the literatures have reviewed and the case is reported.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.271-275
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• 2018

The purpose of this study was to report and discuss the diagnosis and treatment of obstructive atelectasis secondary to pus obstruction in a patient who had developed a maxillofacial abscess, and to review the literature on similar cases. Persistently discharging pus within the oral cavity can act as an aspirate, and may lead to obstructive atelectasis. Additionally, maxillofacial surgery patients should be carefully assessed for the presence of risk factors of obstructive atelectasis, such as, epistaxis after nasotracheal intubation, oral bleeding, and mucus secretion. Furthermore, patients with these risk factors should be continuously followed up by monitoring $SPO_2$, breath sounds, and chest x-ray.

• Journal of People, Plants, and Environment
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• v.22 no.5
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• pp.489-503
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• 2019

This study aimed to analyze the preference of subfertile women for forest therapy programs depending on their emotional characteristics, and to provide basic data for the development of forest therapy programs in order to promote the mental health of subfertile women. Among the surveyed emotional characteristics of subfertile women, the level of emotions including pressure to become pregnant, impatience and frustration were high, while that of emotions including anxiety and fear; depression, hopelessness, helplessness, loneliness and sadness tended to be medium. The level of emotions including shame and guilt tended to be low. The top six forest therapy programs preferred by subfertile women include a deep breath of air /phytoncide, forest bathing/wind bathing/sun bathing, self-esteem recovery program, eating organic foods, low body bathing/foot bathing/hot spring bathing, and breathing/breathing exercises. Subfertile women highly pressured to become pregnant showed significant differences in the preference of the self-esteem recovery program, Domar 's relaxation therapy, NLP therapy, and sleeping in the woods, while women with anxiety and fear showed significant differences in the preference of walking barefoot in forests, mountain walking in silence, listening to water sounds/ hand and foot soak, self-esteem recovery program, NLP therapy, cognitive behavior therapy, aroma therapy, integrated art therapy in forests, forest bathing/wind bathing/sunbathing, a deep breath of air/phytoncide, and observing stars. Women with depression, hopelessness, helplessness, loneliness, and sadness showed significant differences in eating organic foods, self-esteem recovery program, counseling/coaching, and cognitive behavior therapy. The significance of this study was to analyze the preference of subfertile women, as subjects, for forest therapy program. The results of this study are expected to be used as basis data for developing forest therapy programs for subfertile women.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.250-255
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• 2015

Purpose: To compare audio-only biofeedback to conventional audiovisual biofeedback for regulating patients' respiration during four-dimensional radiotherapy, limiting damage to healthy surrounding tissues caused by organ movement. Materials and Methods: Six healthy volunteers were assisted by audiovisual or audio-only biofeedback systems to regulate their respirations. Volunteers breathed through a mask developed for this study by following computer-generated guiding curves displayed on a screen, combined with instructional sounds. They then performed breathing following instructional sounds only. The guiding signals and the volunteers' respiratory signals were logged at 20 samples per second. Results: The standard deviations between the guiding and respiratory curves for the audiovisual and audio-only biofeedback systems were 21.55% and 23.19%, respectively; the average correlation coefficients were 0.9778 and 0.9756, respectively. The regularities between audiovisual and audio-only biofeedback for six volunteers' respirations were same statistically from the paired t-test. Conclusion: The difference between the audiovisual and audio-only biofeedback methods was not significant. Audio-only biofeedback has many advantages, as patients do not require a mask and can quickly adapt to this method in the clinic.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.839-846
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• 1987

The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.