• Title/Summary/Keyword: 기능적 발성장애

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Correlations of Cerebellar Function with Psychotic Symptoms and Cognitive Function in Schizophrenic Patients (남자 정신분열병 환자의 소뇌기능과 정신증상 및 인지기능간의 연관성)

  • Kim, Seo Young;Jun, Yong Ho;Kwon, Young Joon;Jeong, Hee Yeon;Hwang, Bo Young;Shim, Se Hoon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.3
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    • pp.184-193
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    • 2007
  • Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

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소아의 음성장애 및 치료 : 사례연구

  • 정옥란
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.7 no.1
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    • pp.128-131
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    • 1996
  • 소아들의 음성장애의 대부분은 음성과 기능에 의한 성대의 오용 및 남용으로부터 기인한다. 그러나 음성장애에 대한 인식의 부족으로 인하여 소아의 음성장애 발견율은 극히 낮은 수준에 머므르고 있다. 치료에 있어서도 행동의 통제가 그다지 쉽지 않기 때문에 많은 어려움이 따른다. 본 연구는 소아의 음성장애의 발생경위와 문제의 설명과 차팅에 의한 남용의 감소에 초점을 둔 치료사례이다. 5세 아동의 심한 음성장애로 의뢰되어졌다. 음성증후는 목쉰소리, 기식화된 소리, 일시적인 발성일탈(phonation break) 등이 두드러졌다. 이비인후과 전문의의 스트로보스코프(stroboscope) 검진결과 초기 양측성 성대결절이 성대 앞쪽으로부터 1/3 지점에서 발견되었으며 비지피치(Visi-Pitch)로 측정된 퍼터베이션(perturbation 수치가 16.8이었다. 사례사 조사 과정에서 아동이 활동적이며 자주 고함을 지르고 자동차놀이를 주로하며 많은 시간을 보낸다는 것이 밝혀졌다. 중재 프로그램은 우선 문제를 설명하고 인식시키는 것과 고함을 지르거나 자동차놀이를 하면서 자동차 소음을 흉내내는 등의 음성남용 회수를 감소시키는 것에 초점을 두었다 17회의 치료로 성대결절이 감소되었고 퍼터베이션은 3.8로 저하되었으며 아동 스스로 음성남용을 통제할 수 있다는 임상적 판단하에 치료를 종결하였다. 1개월 후 추후 검사에서 남용적인 습관이 여전히 나타나지 않았으며 음성상태도 양호하였다. 소아 음성장애의 치료는 소아가 이해할 수 있는 용어로 문제의 인식을 확실히 시키고 행동을 체계적으로 통제할 수 있는 치료프로그램을 실행시키는 임상가의 자질이 대단히 중요하다. 그러나 그에 못지 않게, 많은 시간을 아동과 함께 보내는 부모나 교사의 협력이 치료의 성패를 좌우할 수 있다.조구와 처리구간에 차이가 없었다. 그러나 유지방 함량의 경우 대조구가 3.22%, 처리구가 3.37%로 처리구가 0.15% point 증가했으나 유의차는 없었다. Fan + sprinkler가 설치된 시설에서 사육된 젖소에서 생산된 우유내 체세포수는 대조구에 비해 26.63%가 감소되었으나 유의차는 발견할 수 없었다. 이상의 시험 결과에서 볼 때 fan + sprinkler를 이용한 방서 방법은 고온 stress를 완화시켜 유생산성의 증가에 기여할 수 있는 하나의 방법이라고 본다.을 알 수가 있었다.없다. 본 논문의 대상은 바로 이러한 합성 동사성명사의 논항구조와 동사성명사에 의해 하위범주화된 논항들의 문법적 실현양상이다..그 결과 심리적 특성과 사용자 수용 특성은 아바타 수용도에 부분적으로 영향을 미친다는 것 결과가 나타났다.웨어 프로세스 평가와 개선 모델의 개발을 위한 기초적인 자료를 제공할 것으로 예상된다 또한, 본 연구 결과는, 우리나라 소프트웨어 조직들이 실제로 무엇을 필요로 하는지를 밝힘으로써, 우리나라의 소프트웨어 산업을 육성하기 위한 실효성 있는 정책 입안을 위한 기초 자료를 제공할 것으로 예상된다.다.를 검증하려고 한다. 협력체계 확립, ${\circled}3$ 전문인력 확보 및 인력구성 조정, 그리고 ${\circled}4$ 방문보건사업의 강화 등이다., 대사(代謝)와 관계(關係)있음을 시사(示唆)해 주고 있다.ble nutrient (TDN) was highest in booting stage (59.7%); however no significant difference was found among other stages. The concentrations of Ca and P were not

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Thyroplasty for the Restoration of a Normal Voice (음성개선을 위한 갑상연골성형술)

  • 김기령;김광문;정명현;이원상;정승규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.1-10
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    • 1982
  • The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

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Voice Change Associated with Swallowing Disorder Caused by a Stroke After Neuromuscular Electrical Stimulation (뇌졸중으로 인한 삼킴장애 환자의 경부근육전기자극치료에 따른 음성 변화)

  • Byeon, Hae-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1665-1671
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    • 2012
  • The purpose of this study was to look into changes in voice using acoustic analysis during the process of neuromuscular electrical stimulation targeting dysphagia treatment. Fifteen man with dysphagia caused by stroke was treated neuromuscular electrical stimulation for two months and intensity of voice, $F_0$, Jitter, Shimmer, NNE were measured. The results of this study that improvement in functions of dysphagia and Jitter, Shimmer were stabilized. But there was not significantly changes of $F_0$. NNE was improved after the intervention, but still showed abnormal levels. This result suggests a possibility of effects that Neuromuscular electrical stimulation has on stabilization of Jitter, Shimmer and intensity of voice.

A Study on Improving Speech Recognition Rate (H/W, S/W) of Speech Impairment by Neurological Injury (신경학적 손상에 의한 언어장애인 음성 인식률 개선(H/W, S/W)에 관한 연구)

  • Lee, Hyung-keun;Kim, Soon-hub;Yang, Ki-Woong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.11
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    • pp.1397-1406
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    • 2019
  • In everyday mobile phone calls between the disabled and non-disabled people due to neurological impairment, the communication accuracy is often hindered by combining the accuracy of pronunciation due to the neurological impairment and the pronunciation features of the disabled. In order to improve this problem, the limiting method is MEMS (micro electro mechanical systems), which includes an induction line that artificially corrects difficult vocalization according to the oral characteristics of the language impaired by improving the word of out of vocabulary. mechanical System) Microphone device improvement. S/W improvement is decision tree with invert function, and improved matrix-vector rnn method is proposed considering continuous word characteristics. Considering the characteristics of H/W and S/W, a similar dictionary was created, contributing to the improvement of speech intelligibility for smooth communication.

Effects of Fractionated Stereotactic Radiotherapy for Primary Hepatocellular Carcinoma (원발성 간암의 분할 정위방사선치료 효과)

  • Choi Byeong Ock;Kang Ki Mun;Jang Hong Seok;Lee Snag-wook;Kang Young Nam;Chai Gyu Young;Choi Ihl Bhong
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.92-97
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    • 2005
  • Purpose : Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. in this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC. Materials and Methods : A retrospective analysis was peformed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was $2\~6.5$ cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was S or 10 Gy: each dose was prescribed based on the planning target volume and normalized to $85\~99\%$ isocenter dose. Patients were treated $3\~5$ times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was $\~55$ months (the median follow up period: 23 months). Results : The response rate was $50\%$ (12 patients), with 4 patients showing complete response ($20%$), 8 patients showing partial response ($40\%$), and 8 patients showing stable disease ($40\%$). The 1-year and 2-year survival rates were $70.0\%$ and $43.1\%$, respectively, and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were $65\%$ and $32.5\%$, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients ($60\%$), nausea/emesis in 8 patients ($40\%$), and transient liver function impairment in 6 patients ($30\%$). However, there was no treatment related death. Conclusion : The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC.

Effects of vocal aerobic treatment on voice improvement in patients with voice disorders (성대에어로빅치료법이 음성장애환자의 음성개선에 미치는 효과)

  • Park, Jun-Hee;Yoo, Jae-Yeon;Lee, Ha-Na
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.69-76
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    • 2019
  • This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.

Preliminary Result in Patients with Primary Hepatoma Treated by Stereotactic Radiotherapy (원발성 간암에 대한 정위방사선치료의 예비결과)

  • Kang Ki Mun;Choi Ihl Bohng;Kim In Ah;Choi Byung Ock;Kang Young Nam;Chai Gyu Young;Han Sung Tae;Chung Gyu Won
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.34-39
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    • 2001
  • Purpose : It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. Materials and Methods : From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of $ 44\~66$ year old (median : 59) and the tumor size of $10\~825\;cc$ (median : 185 cc). SRT was given to them $3\~5$ fractions a week (5 Gy/fraction, $90\%$ isodose line) for $2\~3$ weeks. Median dose of SRT was 50 Gy and the range was $30\~50\;Gy$. Results : Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression $(7.7\%)$, 7 partial regression $(53.8\%)$, 4 minimal regression $(30.8\%)$, 1 stable disease $(7.7\%)$. The positive responses more than partial remission were 8 patients $(61.5\%)$ after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been $92.3\%$ decreased. There was no severe complication except dyspepsia $84.6\%$, mild nausea $69.2\%$, transient decreased of hepatic function $15.4\%$ and fever $7.7\%$. Conclusion : SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

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Effects of Respiration and Oral Motor Training based on Musical Elements and Singing on Voice of Healthy Elderly (음악요소와 노래 부르기를 활용한 호흡 및 구강훈련이 정상노인의 음성에 미치는 영향)

  • Jun, Hee-Un;Kim, Soo-Ji
    • The Journal of the Korea Contents Association
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    • v.11 no.10
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    • pp.380-387
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    • 2011
  • This study was to investigate the effects of music-combined respiration and oral motor training on the voice of healthy elderly. 27 women attending a senior center in Seoul participated and were randomly assigned to the experimental (n = 16) and the control group (n = 11). Subjects attended music program(25 minutes per session) once a week for 4 weeks. For both groups, Fundamental Frequency (F0), Maximum Phonation Time (MPT) and Sequential Motion Rates (SMR) were measured using the Praat speech analysis program before and after the training. The results showed statistical significance in scores of intensity, F0, MPT, and SMR in the experimental group while only intensity was statistically significant in the control group. Considering that, the increasing life expectancy and growing number of older adults, their quality of life has been important. So this study suggests that the respiration and oral motor training would be effectively incorporated into training and services for this population.

Treatment of Primary Spontaneous Pneumothorax Using a Commercialized 8-French Catheter ($Pleuracan^{(R)}$) (상품화된 8 Fr 흉부 배액도관($Pleuracan^{(R)}$)을 이용한 원발성 자연기흉의 치료)

  • Park, Jung-Sik;Hwang, Yeo-Ju;Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.292-296
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    • 2007
  • Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter ($Pleuracan^{(R)}$) for the initial treatment of primary spontaneous pneumothorax. Material and Method: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P ($Pleuracan^{(R)}$ group). Result: Initially, the $Pleuracan^{(R)}$ catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%) : three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time ($T:\;2.1{\pm}1.5\;days,\;P:\;2.1{\pm}1.3\;days$), hospital stay ($T:\;6.4{\pm}5.4\;days,\;P:\;5.2{\pm}2.9\;days$) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy(T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage ($T:\;0.5{\pm}0.7\;days,\;P:\;0.5{\pm}1.2\;days$) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. Conclusion: Application of the $Pleuracan^{(R)}$ catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.