Computational electrocardiogram (ECG) analysis is one of the most crucial topics in cardiovascular research domain especially in identifying abnormalities of heart condition through cardiac arrhythmia symptom. There a...Computational electrocardiogram (ECG) analysis is one of the most crucial topics in cardiovascular research domain especially in identifying abnormalities of heart condition through cardiac arrhythmia symptom. There are many existing works focusing on recognizing the abnormalities condition through arrhythmia symptom, however, the detection rate is still unsatisfied. Arrhythmia consists of more than 14 various types of symptoms. Therefore, most of the existing research found it difficult to classify the entire symptom and maintain the overall accuracy especially in long hour data. In this study, a new mechanism to overcome this issue is proposed: A combination between Autocorrelation methods with K-Nearest Neighbor (KNN) classifier method is introduced to accurately and robustly detect 14 types of Arrhythmia symptom regardless of the origin of the symptom in a long hour data. Moreover, variability analysis based on periodic autocorrelation result is proposed and used for classification procedure. 1 minute and 12 hours duration data was chosen to compare and signify the most suitable time duration to detect Arrhythmia symptom. In addition, an analytical result and discussion is done to provide justification behind each tendency of Arrhythmia and Normal Sinus symptom in autocorrelation result. As the result of proposed method performance evaluation, it was revealed that the accuracy of 95.5% in discriminating Arrhythmia from Normal Sinus data is achieved. Furthermore, it was confirmed that utilizing autocorrelation result in long hour data can help to generalize abnormalities characteristic of heart condition like Arrhythmia symptom. It is concluded that the proposed method can be useful to diagnose abnormalities of heart condition at any stage.展开更多
Objective To discuss the diagnosis and treatment of children sinus pericranii ( sp) Methods From Jan. 2000 to Dec. 2008,12 cases of SP were treated. The clinical data and CT results were studied. If SP had no com-
Chagas heart disease(CHD)affects approximately 30%of patients chronically infected with the protozoa Trypanosoma cruzi.CHD is classified into four stages of increasing severity according to electrocardiographic,echoca...Chagas heart disease(CHD)affects approximately 30%of patients chronically infected with the protozoa Trypanosoma cruzi.CHD is classified into four stages of increasing severity according to electrocardiographic,echocardiographic,and clinical criteria.CHD presents with a myriad of clinical manifestations,but its main complications are sudden cardiac death,heart failure,and stroke.Importantly,CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies,and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies.Among patients with CHD,approximately 90%of deaths can be attributed to complications of Chagas disease.Sudden cardiac death is the most common cause of death(55%–60%),followed by heart failure(25%–30%)and stroke(10%–15%).The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with.Therefore,the management of CHD is challenging,and in this review,we present the most updated available data to help clinicians and cardiologists in the care of these patients.We describe the clinical manifestations,diagnosis and classification criteria,risk stratification,and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.展开更多
AIM:To evaluate the referrals with suspected arrhythmogenic right ventricular cardiomyopathy(ARVC)and compare cardiac MR(cMR)findings against clinical diagnosis.METHODS:A retrospective analysis of 114(age range16 to 8...AIM:To evaluate the referrals with suspected arrhythmogenic right ventricular cardiomyopathy(ARVC)and compare cardiac MR(cMR)findings against clinical diagnosis.METHODS:A retrospective analysis of 114(age range16 to 83,males 55%and females 45%)patients referred for cMR with a suspected diagnosis of ARVC between May 2006 and February 2010 was performed after obtaining institutional approval for service evaluation.Reasons for referral including clinical symptoms and family history of sudden death,electrocardiogram and echo abnormalities,cMR findings,final clinical diagnosis and information about clinical management were obtained.The results of cMR were classified as major,minor,non-specific or negative depending on both functional and tissue characterisation and the cMR results were compared against the final clinical diagnosis.RESULTS:The most common reasons for referral included arrhythmias(30%)and a family history of sudden death(20%).Of the total cohort of 114 patients:4 patients(4%)had major cMR findings for ARVC,13patients(11%)had minor cMR findings,2 patients had non-specific cMR findings relating to the right ventricle and 95 patients had a negative cMR.Of the 4 patients who had major cMR findings,3(75%)had a positive clinical diagnosis.In contrast,of the 13 patients who had minor cMR findings,only 2(15%)had a positive clinical diagnosis.Out of the 95 negative patients,clinical details were available for 81 patients and none of them had ARVC.Excluding the 14 patients with no clinical data and final diagnosis,the sensitivity of the test was 100%,specificity 87%,positive predictive value29%and the negative predictive value 100%.CONCLUSION:CMR is a useful tool for ARVC evaluation because of the high negative predictive value as the outcome has a significant impact on the clinical decision-making.展开更多
BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal r...BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal rhinosinusitis is higher than that in other provinces. However, its physiological mechanism is not yet clear.Not every patient colonized by fungi develops a fungal infection. To a large extent, the immune status of the patient determines the nature of fungal disease in the nasal passages. The pathologic process of progression from harmless fungal colonization to fungal rhinosinusitis is unclear and has not been reported.CASE SUMMURY We report two patients, one who developed fungal rhinosinusitis 1.5 years after surgery performed to treat an inverted papilloma, and the other with a history of hypertension and cerebral infarction. Both patients recovered from their surgeries. An average time of 2.5 years elapsed from the development of maxillary sinus cysts to the development of fungal rhinosinusitis.CONCLUSION According to these case reports, we speculate that the progression of fungal rhinosinusitis from harmless colonization to disease onset requires approximately one to three years and that the length of the process may be related to underlying diseases, surgical treatment, deficient autoimmune status,and abuse of hormone antibiotics and hormones. Additional data are needed to conduct relevant studies to appropriately prevent and treat fungal rhinosinusitis.展开更多
BACKGROUND Sick sinus syndrome is a common disease in cardiology.Typical symptoms include palpitations,dizziness,shortness of breath,chest tightness,and amaurosis.However,to date,there are no known reports of sick sin...BACKGROUND Sick sinus syndrome is a common disease in cardiology.Typical symptoms include palpitations,dizziness,shortness of breath,chest tightness,and amaurosis.However,to date,there are no known reports of sick sinus syndrome presenting with headache.Whether there is a correlation between headache and sick sinus syndrome merits further research.In this report,we describe a case of headache induced by sick sinus syndrome.CASE SUMMARY A 73-year-old female patient presented to our department with the chief complaint of recurrent paroxysmal headache for more than 7 years.The patient described paroxysmal palpations,usually headache occurring after palpitation.Her blood pressure was normal when the most recent headache occurred.A magnetic resonance imaging study and magnetic resonance angiography of the head at another center were normal.A clinical neurological examination was negative.A 24-h Holter electrocardiogram monitoring study showed sick sinus syndrome.The patient received dual chamber pacing implantation and was administered drug therapy to control ventricular rate.The patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.CONCLUSION After dual-chamber pacing implantation and drug therapy administration to control the ventricular rate,the patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.We believe that the headaches were related to the patient’s sick sinus syndrome.展开更多
BACKGROUND Infective endocarditis is more common in hemodialysis patients than in the general population and is sometimes difficult to diagnose.Isolated coronary sinus(CS)vegetation is extremely rare and has a good pr...BACKGROUND Infective endocarditis is more common in hemodialysis patients than in the general population and is sometimes difficult to diagnose.Isolated coronary sinus(CS)vegetation is extremely rare and has a good prognosis,but complicated CS vegetation may have a poorer clinical course.We report a case of CS vegetation accidentally found via echocardiography in a hemodialysis patient with undifferentiated shock.The CS vegetation may have been caused by endocardial denudation due to tricuspid regurgitant jet and subsequent bacteremia.CASE SUMMARY A 91-year-old man with dyspnea and hypotension was transferred from a nursing hospital.He was on regular hemodialysis and had a history of severe grade of tricuspid regurgitation.There was no leukocytosis or fever upon admission.Repetitive and sequential blood cultures revealed absence of microorganism growth.Chest computed tomography showed lung consolidation and a large pleural effusion.A mobile band-like mass on the CS,suggestive of vegetation,was observed on echocardiography.We diagnosed him with infective endocarditis involving the CS,pneumonia,and septic shock based on echocardiographic,radiographic,and clinical findings.Infusion of broad-spectrum antibiotics,fluid resuscitation,inotropic support,and ventilator care were performed.However,the patient died from uncontrolled infection and septic shock.CONCLUSION CS vegetation can be fatal in hemodialysis patients with impaired immune systems,especially when it delays the diagnosis.展开更多
BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,...BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,and little is known about their biological behavior and operative management.CASE SUMMARY We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache.On clinical examination the mass was non-tender,fixed,sessile and non-pulsatile situating in the right maxillary sinus.Computed tomography scan showed a well-defined mass of 7 cm×6 cm×6 cm compressing the surrounding structures.Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging.Imaging studies revealed no evidence of intracranial extension and metastatic nests.Biopsy showed grade I primary extracranial with low mitotic activity.Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon.The biopsy reported fibrous meningioma based on the hematoxylin and eosin section.On immunohistochemistry the tumor cells were positive for vimentin,focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6.The mass was removed surgically with reconstruction,and the pathological studies confirmed the diagnosis to be an extracranial meningioma.The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.CONCLUSION To conclude,extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.展开更多
Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a ...Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a 6.5 cm×3.0 cm shadow of a soft-tissue tumor growing longitudinally in her supravaginal uterine area （Fig. 1）. The density of the shadow was uneven, in which there were irregular low-density loci, an indication of a compression of the colon and bladder and a diffuse boundary between the posterior wall of the urinary bladder and tumor. No abnormalities were found in either kidney or ovary, the liver or gall bladder. Also no obvious lesions were seen on the chest X-ray film, and routine blood and urine laboratory examinations were normal.展开更多
文摘Computational electrocardiogram (ECG) analysis is one of the most crucial topics in cardiovascular research domain especially in identifying abnormalities of heart condition through cardiac arrhythmia symptom. There are many existing works focusing on recognizing the abnormalities condition through arrhythmia symptom, however, the detection rate is still unsatisfied. Arrhythmia consists of more than 14 various types of symptoms. Therefore, most of the existing research found it difficult to classify the entire symptom and maintain the overall accuracy especially in long hour data. In this study, a new mechanism to overcome this issue is proposed: A combination between Autocorrelation methods with K-Nearest Neighbor (KNN) classifier method is introduced to accurately and robustly detect 14 types of Arrhythmia symptom regardless of the origin of the symptom in a long hour data. Moreover, variability analysis based on periodic autocorrelation result is proposed and used for classification procedure. 1 minute and 12 hours duration data was chosen to compare and signify the most suitable time duration to detect Arrhythmia symptom. In addition, an analytical result and discussion is done to provide justification behind each tendency of Arrhythmia and Normal Sinus symptom in autocorrelation result. As the result of proposed method performance evaluation, it was revealed that the accuracy of 95.5% in discriminating Arrhythmia from Normal Sinus data is achieved. Furthermore, it was confirmed that utilizing autocorrelation result in long hour data can help to generalize abnormalities characteristic of heart condition like Arrhythmia symptom. It is concluded that the proposed method can be useful to diagnose abnormalities of heart condition at any stage.
文摘Objective To discuss the diagnosis and treatment of children sinus pericranii ( sp) Methods From Jan. 2000 to Dec. 2008,12 cases of SP were treated. The clinical data and CT results were studied. If SP had no com-
文摘Chagas heart disease(CHD)affects approximately 30%of patients chronically infected with the protozoa Trypanosoma cruzi.CHD is classified into four stages of increasing severity according to electrocardiographic,echocardiographic,and clinical criteria.CHD presents with a myriad of clinical manifestations,but its main complications are sudden cardiac death,heart failure,and stroke.Importantly,CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies,and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies.Among patients with CHD,approximately 90%of deaths can be attributed to complications of Chagas disease.Sudden cardiac death is the most common cause of death(55%–60%),followed by heart failure(25%–30%)and stroke(10%–15%).The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with.Therefore,the management of CHD is challenging,and in this review,we present the most updated available data to help clinicians and cardiologists in the care of these patients.We describe the clinical manifestations,diagnosis and classification criteria,risk stratification,and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
文摘AIM:To evaluate the referrals with suspected arrhythmogenic right ventricular cardiomyopathy(ARVC)and compare cardiac MR(cMR)findings against clinical diagnosis.METHODS:A retrospective analysis of 114(age range16 to 83,males 55%and females 45%)patients referred for cMR with a suspected diagnosis of ARVC between May 2006 and February 2010 was performed after obtaining institutional approval for service evaluation.Reasons for referral including clinical symptoms and family history of sudden death,electrocardiogram and echo abnormalities,cMR findings,final clinical diagnosis and information about clinical management were obtained.The results of cMR were classified as major,minor,non-specific or negative depending on both functional and tissue characterisation and the cMR results were compared against the final clinical diagnosis.RESULTS:The most common reasons for referral included arrhythmias(30%)and a family history of sudden death(20%).Of the total cohort of 114 patients:4 patients(4%)had major cMR findings for ARVC,13patients(11%)had minor cMR findings,2 patients had non-specific cMR findings relating to the right ventricle and 95 patients had a negative cMR.Of the 4 patients who had major cMR findings,3(75%)had a positive clinical diagnosis.In contrast,of the 13 patients who had minor cMR findings,only 2(15%)had a positive clinical diagnosis.Out of the 95 negative patients,clinical details were available for 81 patients and none of them had ARVC.Excluding the 14 patients with no clinical data and final diagnosis,the sensitivity of the test was 100%,specificity 87%,positive predictive value29%and the negative predictive value 100%.CONCLUSION:CMR is a useful tool for ARVC evaluation because of the high negative predictive value as the outcome has a significant impact on the clinical decision-making.
文摘BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal rhinosinusitis is higher than that in other provinces. However, its physiological mechanism is not yet clear.Not every patient colonized by fungi develops a fungal infection. To a large extent, the immune status of the patient determines the nature of fungal disease in the nasal passages. The pathologic process of progression from harmless fungal colonization to fungal rhinosinusitis is unclear and has not been reported.CASE SUMMURY We report two patients, one who developed fungal rhinosinusitis 1.5 years after surgery performed to treat an inverted papilloma, and the other with a history of hypertension and cerebral infarction. Both patients recovered from their surgeries. An average time of 2.5 years elapsed from the development of maxillary sinus cysts to the development of fungal rhinosinusitis.CONCLUSION According to these case reports, we speculate that the progression of fungal rhinosinusitis from harmless colonization to disease onset requires approximately one to three years and that the length of the process may be related to underlying diseases, surgical treatment, deficient autoimmune status,and abuse of hormone antibiotics and hormones. Additional data are needed to conduct relevant studies to appropriately prevent and treat fungal rhinosinusitis.
基金Supported by the Sichuan Science and Technology Program,No.2020YJ0197the Chengdu Medical Research Project,No.2019115.
文摘BACKGROUND Sick sinus syndrome is a common disease in cardiology.Typical symptoms include palpitations,dizziness,shortness of breath,chest tightness,and amaurosis.However,to date,there are no known reports of sick sinus syndrome presenting with headache.Whether there is a correlation between headache and sick sinus syndrome merits further research.In this report,we describe a case of headache induced by sick sinus syndrome.CASE SUMMARY A 73-year-old female patient presented to our department with the chief complaint of recurrent paroxysmal headache for more than 7 years.The patient described paroxysmal palpations,usually headache occurring after palpitation.Her blood pressure was normal when the most recent headache occurred.A magnetic resonance imaging study and magnetic resonance angiography of the head at another center were normal.A clinical neurological examination was negative.A 24-h Holter electrocardiogram monitoring study showed sick sinus syndrome.The patient received dual chamber pacing implantation and was administered drug therapy to control ventricular rate.The patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.CONCLUSION After dual-chamber pacing implantation and drug therapy administration to control the ventricular rate,the patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.We believe that the headaches were related to the patient’s sick sinus syndrome.
文摘BACKGROUND Infective endocarditis is more common in hemodialysis patients than in the general population and is sometimes difficult to diagnose.Isolated coronary sinus(CS)vegetation is extremely rare and has a good prognosis,but complicated CS vegetation may have a poorer clinical course.We report a case of CS vegetation accidentally found via echocardiography in a hemodialysis patient with undifferentiated shock.The CS vegetation may have been caused by endocardial denudation due to tricuspid regurgitant jet and subsequent bacteremia.CASE SUMMARY A 91-year-old man with dyspnea and hypotension was transferred from a nursing hospital.He was on regular hemodialysis and had a history of severe grade of tricuspid regurgitation.There was no leukocytosis or fever upon admission.Repetitive and sequential blood cultures revealed absence of microorganism growth.Chest computed tomography showed lung consolidation and a large pleural effusion.A mobile band-like mass on the CS,suggestive of vegetation,was observed on echocardiography.We diagnosed him with infective endocarditis involving the CS,pneumonia,and septic shock based on echocardiographic,radiographic,and clinical findings.Infusion of broad-spectrum antibiotics,fluid resuscitation,inotropic support,and ventilator care were performed.However,the patient died from uncontrolled infection and septic shock.CONCLUSION CS vegetation can be fatal in hemodialysis patients with impaired immune systems,especially when it delays the diagnosis.
文摘BACKGROUND Meningiomas are benign tumors that originate from the meningothelial arachnoid cells,but they rarely develop extracranially.There is no specific surgical guideline for resecting them in the maxillary sinus,and little is known about their biological behavior and operative management.CASE SUMMARY We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache.On clinical examination the mass was non-tender,fixed,sessile and non-pulsatile situating in the right maxillary sinus.Computed tomography scan showed a well-defined mass of 7 cm×6 cm×6 cm compressing the surrounding structures.Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging.Imaging studies revealed no evidence of intracranial extension and metastatic nests.Biopsy showed grade I primary extracranial with low mitotic activity.Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon.The biopsy reported fibrous meningioma based on the hematoxylin and eosin section.On immunohistochemistry the tumor cells were positive for vimentin,focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6.The mass was removed surgically with reconstruction,and the pathological studies confirmed the diagnosis to be an extracranial meningioma.The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.CONCLUSION To conclude,extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.
文摘Case Report An female infant patient, aged 8 months old, suffered from irregular colporrhagia for a period of 1 month after which she was taken to our hospital on 30th April, 2003. A pelvic CT examination displayed a 6.5 cm×3.0 cm shadow of a soft-tissue tumor growing longitudinally in her supravaginal uterine area （Fig. 1）. The density of the shadow was uneven, in which there were irregular low-density loci, an indication of a compression of the colon and bladder and a diffuse boundary between the posterior wall of the urinary bladder and tumor. No abnormalities were found in either kidney or ovary, the liver or gall bladder. Also no obvious lesions were seen on the chest X-ray film, and routine blood and urine laboratory examinations were normal.
