Strange attractor can be constructed from time series data such as heart sound. In the areas of the recognition and diagnosis of abnormal heart sounds, signal presentation method is very useful because good features can be detected from good presentation. This paper examines efficiency in diagnosing abnormal heart sounds of the two different methods for constructing attractor. Nine different heart sounds from typical clinical conditions were used for this study. The first method was constructing attractors using original heart sounds, and the second was modifying the original sounds by autocorrelation and they were then applied to the orignal sounds as to cross correlation checks. Attractors could be constructed using signals generated by these methods, and values of fractal dimensions would then be calculated which has been a well known method to measure characteristics of attractors. The results showed that the second method appeared to provide more efficient way to correctly classify abnormal heart sounds.
Diagnosis ; Fractals* ; Heart Sounds* ; Heart*

Strange attractor can be constructed from time series data such as heart sound. In the area of the recognition and diagnosis problem, signal presentation method is very important because good features can be detected from good presentation. This paper discusses a way to extract a cycle from strange attractor and introduce new attractor construction method using autocorrelation value of the heart rate. The result shows well-formed attractor and good ability for extraction features. Largest Lyapunov Exponent is used to check whether the attractors provide distinguish abilities among different types of heart rate. The result shows good points that can be applied to some areas of human signal processing.
Diagnosis ; Heart Rate* ; Heart Sounds ; Heart* ; Humans

OBJECTIVES: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. METHODS: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. RESULTS: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. CONCLUSIONS: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.
Angioplasty, Balloon, Coronary ; Arteries ; Cesarean Section ; Delivery of Health Care ; Female ; Hip ; Hysterectomy ; Korea ; Magnetic Resonance Imaging ; National Health Programs ; Population Density ; Pregnancy ; Small-Area Analysis ; Transplants

Tension pneumocephalus is a rare complication of endoscopic sinus surgery (ESS) that may lead to rapid neurologic deterioration. Symptoms typically develop within the first postoperative week after enough air has entered the intracranial cavity to create pressure on the dura. Furthermore, there may be a rapid onset of symptoms after a positive pressure event. However, there may be a more insidious onset of symptoms in the absence of a positive pressure event. We report a rare case of delayed tension pneumocephalus following an intraoperative cerebrospinal fluid leak repair. We discuss here the mechanisms of this complication and the diagnosis and treatment strategies of tension pneumocephalus after an ESS.

Abstract: Portable blood glucose meters (PBGMs) are widely used because of their practicality. However, the accuracy of PBGMs has frequently been questioned. The objectives of this study were to evaluate factors that might interfere with measurements made using PBGMs, and to assess the clinical utility of 6 PBGMs. The glucose concentrations measured using the PBGMs were compared with those obtained using a reference method. The agreement between the measured values was assessed using Spearman correlation analysis, Passing-Bablok regression analysis, Bland-Altman plots, and consensus error grid analysis. Mann-Whitney and KruskalWallis tests were performed to identify the parameters affecting glucose measurement. The results indicated that all of the PBGMs tested perform adequately for use in veterinary practice. In most cases, measurements made using PBGM corresponded well with the blood glucose values obtained using the reference method. Error grid analysis revealed that most of the PBGM values fell within zones A and B. However, some measurements of blood glucose concentrations < 80 mg/dL fell into zone C. PCV, and triglyceride and total protein concentration, significantly affected the output of some of the PBGMs. Therefore, clinicians should be aware of the characteristics of the PBGM that they use.

Primary ciliary dyskinesia (PCD) results in several characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Concerning the rhinologic aspect, medical therapy mainly involving a combination of long-term antimicrobial agents and intranasal steroid sprays can control sinusitis in the majority of cases. But, there are no definite treatment guidelines for recalcitrant chronic sinusitis with PCD. Recently, we examined a 28-year-old male with serous otitis effusion, chronic sinusitis, and bronchiectasis, and a 4-year-old female with chronic sinusitis and serous otitis effusion. We confirmed PCD by electron microscopy and endoscopic maxillary mega-antrostomy was performed in both cases for the treatment of chronic sinusitis that was refractory to conservative management.

Background: Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians’ understanding of mandibular split fractures and offer insights for future research. Methods: This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients’ medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. Results: The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. Conclusion This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.