• Journal of Korea Multimedia Society
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• v.19 no.3
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• pp.557-566
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• 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.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.17 no.12
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• pp.3001-3008
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• 2013

To diagnose the cardiac valve abnormalities using analysis of phonocardiogram, first of all, accurate detection of S1, S2 components is needed for heart sound segmentation. In this paper, a new method that uses the third moment characteristics of an envelope of the PCG is proposed for accurate detection of S1 and S2 components of the heart sound with cardiac murmurs. The envelope of the PCG is obtained from the short-time energy profile, and its third moment profile with slope information is used for accurate time gating of the S1, S2 components. Experimental results have shown that the proposed method is superior to the conventional second moment method for detection of S1 and S2 regions from the heart sound signals with cardiac murmurs.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.996-1002
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• 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
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• v.18 no.2
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• pp.165-173
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• 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

• Proceedings of the IEEK Conference
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• 2000.07b
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• pp.1045-1048
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• 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
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• v.20 no.3
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• pp.528-535
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• 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].

• The Journal of the Acoustical Society of Korea
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• v.28 no.1
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• pp.32-43
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• 2009

In this paper, we improve the performance of cardiac disorder classification by continuous heart sound signals using automatic segmentation and extreme learning machine (ELM). The accuracy of the conventional cardiac disorder classification systems degrades because murmurs and click sounds contained in the abnormal heart sound signals cause incorrect or missing starting points of the first (S1) and the second heart pulses (S2) in the automatic segmentation stage, In order to reduce the performance degradation due to segmentation errors, we find the positions of the S1 and S2 pulses, modify them using the time difference of S1 or S2, and extract a single period of heart sound signals. We then obtain a feature vector consisting of the mel-scaled filter bank energy coefficients and the envelope of uniform-sized sub-segments from the single-period heart sound signals. To classify the heart disorders, we use ELM with a single hidden layer. In cardiac disorder classification experiments with 9 cardiac disorder categories, the proposed method shows the classification accuracy of 81.6% and achieves the highest classification accuracy among ELM, multi-layer perceptron (MLP), support vector machine (SVM), and hidden Markov model (HMM).

• Korean Journal of Veterinary Research
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• v.41 no.2
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• pp.227-231
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• 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
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• v.46 no.10
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• pp.996-1002
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• 2003

Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

• Journal of Veterinary Clinics
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• v.28 no.6
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• pp.586-590
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• 2011

Three small breed dogs weighing less 5 kg were admitted with dyspnea and cardiac murmurs. One dog had primum type ASD and chylothorax was concurrently noted. Two dogs had secundum type ASD with and without concomitant pulmonic stenosis. Although medical treatment was attempted, two dogs with secundum type ASD died and a dog with primum type ASD was successfully managed with medication. Defects were confirmed by the postmortem examination in two cases. We first describe the comparison of clinical and diagnostic features in different anatomic, hemodynamic, and pathophysiological types of ASD in small breed dogs and they show some differences with ASD in large breed dogs.