Hidden Markov model (HMM) is known to be one of the most powerful methods in the acoustic modeling of heart sound signals. Conventionally, we usually use a fixed number of states for each HMM. However, due to the various types of the heart sound signals, it seems that more accurate acoustic modeling is possible by varying the number of states in the HMM depending on the signal types to be modeled. In this paper, we propose to assign different number of states to the HMM for better acoustic modeling and consequently, improving the classification performance of the heart sound signals. Compared with when fixing the number of states, the proposed approach has shown some performance improvement in the classification experiments on various types of heart sound signals.
Acoustics ; Heart ; Heart Sounds

No abstract available.
Diagnosis*

No abstract available.
Biopsy, Fine-Needle* ; Breast*

Mirizzi syndrome is an uncommon cause of obstructive jaundice. It consists of the following elements: (1) an anatomic arrangement of the cystic duct such that it lies almost parallel to the common hepatic duct, (2) impaction of a gallstone in the cystic duct or neck of the gall bladder, (3) partial mechanical obstruction of the common hepatic duct by the stone itself or the resulting inflammatory reaction, and (4) recurrent cholangitis or ultimately cholangitic cirrhosis due to the partial obstruction. (continue...)
Cholangitis ; Cystic Duct ; Fibrosis ; Gallstones ; Hepatic Duct, Common ; Jaundice, Obstructive ; Mirizzi Syndrome* ; Neck ; Urinary Bladder

In the field of urological surgery, robotic surgery continues to develop and increase. This paper is an overview of the present and future of robotic urological surgery.Current Concepts: Robot-assisted surgery has revolutionized minimally invasive surgery and advanced the technical limitations of laparoscopy. Urologists have always been eager to adopt new technological advances to benefit their patients, and they have also been pioneers in the field of robotic surgery.Discussion and Conclusion: Following the first approval by the Food and Drug Administration in 2000, the da Vinci System (Intuitive Surgical, USA) remained the leading robotic surgical system for over 20 years. In 2000, the first robot-assisted laparoscopic radical prostatectomy was performed in urology. Subsequently, applications of the da Vinci System in urology have grown exponentially, including the kidney, urinary bladder, and reconstructive and functional urological surgeries. To date, urology is driving robotic innovation. The first specialist-engineered system for single-site surgery, the da Vinci SP, was initially approved for use in urological surgery. Due to the advantages of robotic surgery, such as excellent visibility and operability, the demand for robotic surgery in the urology department is continuously increasing. Recently, in addition to the da Vinci System, other robot platforms are being developed and commercialized in many countries. In South Korea, robots such as Revo-I (Meere Company Inc., Korea) and Zamenix (Roen Surgical, Korea) are being released and commercialized. Urologists continue to lead the development of domestic robots and robotic surgery.

Dyschromatosis universalis hereditaria was reported in 1933 by Ichikawa and Hiraga in Japan. This disease is characterized by small pigmented and depigmented mottled macules on the trunk and extremities. We report two cases of dyschromatosis universalis. Case one is a 47-year-old man presented with hypoand hyperpigmented spots on the trunk and extrexities. At about 30 years of age, he started to show pigmentary changes on the back, which became progressively spread to the other parts of the trunk and extremities. Case two is a 27-year-old man with numerous mottled hypo-and hyperpigmented spots on the trunk and extremities. He started to show pigmentary changes on the back about 12 years ago. This pigmentary changes also became progressively spread to the other part of the trunk and extrimities. There were no family history of similar disease. On physical exminations, both patients had hrown rice-grain sized pigmented and depigmented macules without scales and atropy on the trunk and extremites. Fontana-Masson stains revealed decreased and increased melar in granules in the basal cell layers in the hypopigrnented and hyperpigmented lesions respectively.
Adult ; Coloring Agents ; Extremities ; Humans ; Japan ; Middle Aged ; Weights and Measures

Acute pulmonary edema associated with direct current shock is a rare complication. Pulmonary edema with an increase in heart size following direct current shock have been previously reported and confirmed. The cause of this complication is unknown. This is not due to a sudden increase in the cardiac output with the establishment of sinus rhythm. It has been most commonly noted in the presence of mitral or aortic valvular diseases or ventricular dysfunction. It is likely that acute alteration or disparities in atrial or ventricular mechanical function consequent to electrical discharge precipitate pulmonary congestion. This is a case report of acute pulmonary edema following cardioversion with direct current shock which caused ventricullar fibrillation during tonsillectomy. He was treated with oxygen, iuretics, digitalis, steroid, dopamine and PEEP (positive end expiratory pressure). The patient recovered uneventful ventilation.

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

BACKGROUND: Cerebral cortical dysplasia (CD) is one of the important causes of intractable epilepsies and characterized histologically by disorganized cortical lamination and cytomegalic dysplastic neurons. Although various cytoskeletal abnormalities have been found in dysplastic neurons of CD, the pathogenetic role of dysplastic neurons has rarely been investigated. METHODS: In this study, immunohistochemical analysis was performed using antibodies against non-phosphorylated high- or medium-molecular weight neurofilament protein and microtubule-associated protein 2 (MAP-2) in surgical specimens of CD. In order to know the possible relationship of dysplastic neurons with cytoskeletal abnormalities and various neurotrophin receptors, NGFR p75, trkA, trkB, and trkC immunoreactivities were also analyzed. RESULTS: Dysplastic neurons showed strong immunoreactivities for non-phosphorylated high- or medium-molecular weight neurofilament protein and MAP-2, which might reflect abnormal outgrowth and altered plasticity of the dysplastic neurons. TrkB and trkC were strongly expressed in dysplastic neurons and NGFR p75 was also strongly expressed in some dysplastic neurons. CONCLUSIONS: Since it has been known that brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) have effects on the differentiation of neuronal precursor cells from the cortex and on dendritic and axonal arborization, increased expression of trkB and trkC may play a role in cytoskeletal abnormalities and altered synaptic transmission in dysplastic neurons.
Antibodies ; Axons ; Brain-Derived Neurotrophic Factor ; Epilepsy ; Malformations of Cortical Development* ; Microtubule-Associated Proteins ; Neurons* ; Plastics ; Receptors, Nerve Growth Factor ; Synaptic Transmission

We report a case of idiopathic progressive atrophoderma of Pasini and Pierini in which the characteristics atrophic paches developed on the lumbar area and new lesions have a zosteriform distribution in lumbar area, scapular area and heels. This 32-year-old male patient who has had above lesions for 15 yeara, was first seen in September 1985. Histologic findings of this patient are atrophy in epidermis, tightly packed collagen bundles and moderatly decreased elastic fibers in the dermis. We observed this patient without treatment and 5 month later, lesions did not progress.
Adult ; Atrophy ; Collagen ; Dermis ; Elastic Tissue ; Epidermis ; Heel ; Humans ; Male