Automatic Prediction of Atrial Fibrillation Based on Convolutional Neural Network Using a Short-term Normal Electrocardiogram Signal.

BACKGROUND: In this study, we propose a method for automatically predicting atrial fibrillation (AF) based on convolutional neural network (CNN) using a short-term normal electrocardiogram (ECG) signal. METHODS: We designed a CNN model and optimized it by dropout and normalization. One-dimensional convolution, max-pooling, and fully-connected multiple perceptron were used to analyze the short-term normal ECG. The ECG signal was preprocessed and segmented to train and evaluate the proposed CNN model. The training and test sets consisted of the two AF and one normal dataset from the MIT-BIH database. RESULTS: The proposed CNN model for the automatic prediction of AF achieved a high performance with a sensitivity of 98.6%, a specificity of 98.7%, and an accuracy of 98.7%. CONCLUSION: The results show the possibility of automatically predicting AF based on the CNN model using a short-term normal ECG signal. The proposed CNN model for the automatic prediction of AF can be a helpful tool for the early diagnosis of AF in healthcare fields.

Expression of Peroxisome Proliferator Activated Receptor gamma in Prostatic Adenocarcinoma.

Peroxisome proliferator-activated receptor gamma (PPAR-γ), a ligand-activated transcription factor has been investigated as the target for cancer treatment as well as metabolic disorders. Recent studies have demonstrated that PPAR-γ ligands are anti-tumorigenic in prostate cancer due to anti-proliferative and pro-differentiation effects. The aim of this study was to validate PPAR-γ expression in malignant and benign prostate tissues by immunohistochemistry and quantitative real-time polymerase chain reaction (PCR). A total of 730 prostatic adenocarcinomas (PCAs) including 63 whole sections from radical prostatectomy specimens and tissue microarrays containing 667 PCAs were subject to immunostaining for two PPAR-γ antibodies. Twenty-five benign prostate tissues and PCAs were selected for investigating mRNA expression by quantitative real-time PCR. 10.7% of PCAs (78/730) showed cytoplasmic immunoreactivity of PPAR-γ and no nuclear immunoreactivity was noted in PCAs. Most benign prostatic glands showed negative immunoreactivity of PPAR-γ except for variable weak cytoplasmic staining in some glands. Nuclear immunoreactivity of PPAR-γ was noted some central zone and verumontanum mucosal epithelium. The constitutive PPAR-γ mRNA showed significantly lower level in PCAs compared to that in the benign tissues. There was no difference of PPAR-γ mRNA expression between low (≤7) and high (>7) Gleason score groups. There was no association of PPAR-γ mRNA level or cytoplasmic immunostaining with Gleason grade or pathologic stage. Our study supported the evidence of extra-nuclear localization and nongenomic actions of PPAR-γ. Further studies are needed to assess the functional role of PPAR-γ and to validate its therapeutic implication in prostate cancer.

Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency.

PURPOSE: To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. METHODS: A total of 136 women who underwent TVT procedures with minimum follow-up duration of 3 years were included in the study. Patients were divided into two groups (non-ISD and ISD groups) based on preoperative urodynamic studies. Patient outcomes were assessed from retrospective chart review and telephone research. Cure was defined as the subjective resolution of SUI in any circumstances. Improvement was defined as the subjective improvement of SUI without complete resolution. Failure was defined as the subjective lack of improvement of SUI. Patients in ISD group were subdivided into two subgroups (cure and non-cure groups) and were compared to identify influencing factors for TVT procedure failure. RESULTS: Eighty-nine patients were in non-ISD group, and 47 in ISD group. The mean follow-up durations were 50.3±9.2 and 49.7±9.7 months, respectively. Subjective cure rate was 75.3% for non-ISD group, and 76.7% for ISD group (P>0.05). Improvement rate was 6.7% for non-ISD group, and 2.1% for ISD group (P>0.05). Satisfaction scores was 3.8±1.2 points in the non-ISD group, and 3.5±1.2 points in ISD group (P>0.05). In ISD subgroups, VLPP was 41.9±12.0 cmH(2)O for non-cure group, and 50.5±8.6 cmH(2)O for cure group, and was the only factor that showed significant statistical difference between the two subgroups (P=0.011). CONCLUSIONS: With our long-term results, TVT is an effective treatment even in women with ISD. However, ISD patients with low VLPP should be counseled carefully about TVT outcome.

Initial experience with concomitant prolift™ system and tension-free vaginal tape procedures in patients with stress urinary incontinence and cystocele.

PURPOSE: The objective of this study is to report our initial experience about the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift™) and concomitant tension-free vaginal tape (TVT) as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI). MATERIALS AND METHODS: We reviewed the charts of patients who underwent Prolift™ and TVT between April 2009 and March 2010. All patients had a physical examination and staging of cystocele. According to the International Continence Society system 2, 5 and 3 women had stage grade II, III and IV respectively. All the patients underwent pelvic examination 1, 3, 6 month and 1 year after operation and anatomical and functional outcomes were recorded. An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher on the last physical examination. RESULTS: The mean follow-up was 7.1 (1-11) months. Overall success rate of cystocele repair was 90%. The anatomical cure rate of cystocele was 50%. The cystocele repair improved 4 patients, but failed in 1. SUI was cured in all patients. No significant complications including bladder or vessel injury and mesh related erosion occurred. The postoperative complication was transient voiding difficulty (2 cases). CONCLUSIONS: These preliminary results suggest that Prolift™ and TVT offer a safe and effective treatment for female anterior vaginal wall prolapse and SUI. However, a long-term follow up is necessary in order to support the good result maintenance.

Risk factors for female urinary incontinence among middle-aged Korean women.

OBJECTIVE: The aim of this study was to investigate risk factors for urinary incontinence (UI) in middle-aged (35-64 years) Korean women. METHODS: This was a cross-sectional, case-control study using a structured self-administered questionnaire. To identify the unadjusted associations of each potential risk factor with prevalence of UI, univariate logistic regression analyses were used. A multiple logistic regression model was then constructed with only those variables that were significantly associated with the UI (p < 0.05) in the univariate analyses. Multivariate logistic regression analysis was used to determine adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Of 608 community-dwelling women included in the analyses, 259 (42.6%) met the definition of UI (at least once a month or the amount of more than a few drops lost during the past 12 months). A multivariate regression model was constructed that included the eight variables of age, body mass index (BMI), number of vaginal deliveries, menstrual status, hysterectomy, present hormone use, hypertension, and diabetes mellitus (DM). Obesity (BMI > 25 kg/m(2)), being postmenopausal, having two or more vaginal deliveries, having a history of hysterectomy, and being a current user of hormones increased the odds of having UI. CONCLUSIONS: Obesity as defined using Asian-Pacific criteria was a strong risk factor for middle-aged Korean women's UI. More than one vaginal birth caused increased odds of having stress or mixed UI. Hysterectomy, menopause, and hormone replacement were also significant risk factors.