• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.47-51
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• 2011

Background and Objectives: Vocal polyps arc one of the most frequent benign laryngeal diseases. They arc usually found at the midpoint of the vocal fold. They are mainly caused by vocal overuse. Vocal polyps arc usually removed surgically. Generally, age-related changes to speech are attributed to change in anatomy and physiology of the speech mechanism. These changes result in increased variability in the acoustic properties of speech with age. Still, not 'all studies of age-related changes in speech have taken differences between the young group and adult group after laryngeal microsurgery into account. The aim of this investigation was to compare improvement of acoustic analysis in young patients and elderly patients with vocal polyps, before and after the laryngeal microsurgery. Materials and Method: One hundred and twenty-eight patients who underwent laryngeal microsurgery for vocal polyps from 2008 through 2011 were reviewed retrospectively. 105 of the 128 patients under age 60 were classified as adult group (AG), and remaining 23 patients as elderly group (EG). The speech of AG and EG were evaluated before and after surgery for identification of differences for age group across measures of fundamental frequency (F0), Jitter, Shimmer and Maximum phonation time (MPT). Results: There were not significant differences between two groups for improvement of F0, Jitter, Shimmer, NHR, and MPT before and after surgery. The findings suggest that elderly group compares quite well with adult group in effectiveness of surgery. However, comparison between elderly group and young group (Age under 40) there was significant difference of improvement in Jitter and Shimmer. Conclusion: In general, the results of the present research showed significant improvement in vocal quality after phonosurgery of vocal polyp in both elderly and adult group. However, comparison of improvement between elderly group and young group, there were significant differences of improvement in jitter and shimmer. Therefore, in treatment planning of elderly group, we should consider age related changes of vocal cord.

• Archives of Pharmacal Research
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• v.24 no.2
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• pp.126-135
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• 2001

Quinacrine (QU), a phospholipase-A2 (PLA-2) inhibitor has been used clinically as a chemotherapeutic adjuvant. To understand the mechanisms leading to its chemotherapeutic effect, we have investigated QU-induced apoptotic signaling pathways in human cervical squamous carcinoma HeLa cells. In this study, we found that QU induced cytochrome c-dependent apoptotic signaling. The release of pro-apoptotic cytochrome c was QU concentration- and time-dependent, and preceded activation of caspase-9 and -3. Flow cytometric FACScan analysis using fluorescence intensities of $DiOC_6$/ demonstrated that QU-induced cytochrome c release was independent of mitochondrial permeability transition (MPT), since the concentrations of QU that induced cytochrome c release did not alter mitochondrial membrane potential (${\blacktriangle}{\Psi}_m$). Moreover, kinetic analysis of caspase activities showed that cytochrome c release led to the activation of caspase-9 and downstream death effector caspase-3, Caspase-3 inhibitor (Ac-DEVD-CHO) partially blocked QU-induced apoptosis, suggesting the importance of caspase-3 in this apoptotic signaling mechanism. Supplementation with arachidonic acid (AA) sustained caspase-3 activation induced by QU. Using inhibitors against cellular arachidonate metabolism of lipooxygenase (Nordihydroxyguaiaretic Acid, NDGA) and cyclooxygenase (5,8,11,14-Eicosatetraynoic Acid, ETYA) demonstrated that QU-induced apoptotic signaling may be dependent on its role as a PLA-2 inhibitor. Interestingly, NDCA attenuated QU-induced cytochrome c release, caspase activity as well as apoptotic cell death. The blockade of cytochrome c release by NDCA was much more effective than that attained with cyclosporin A (CsA), a MPT inhibitor. ETYA was not effective in blocking cytochrome c release, except under very high concentrations. Caspase inhibitor z-VAD blocked the release of cytochrome c suggesting that this signaling event is caspase dependent, and caspase-8 activation may be upstream of the mitochondrial events. In summary, we report that QU induced cytochrome c-dependent apoptotic signaling cascade, which may be dependent on its role as a PLA-2 inhibitor. This apoptotic mechanism induced by QU may contribute to its known chemotherapeutic effects.

• The Journal of the Korea Contents Association
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• v.18 no.11
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• pp.634-642
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• 2018

People with spinocerebellar ataxia, a hereditary and progressive neurogenic disorder, suffer from ataxic dysarthria due to cerebellar dystrophy. This study was designed to examine if intensive motor speech treatment yields improvement in progressive ataxic dysarthria and if then, to investigate magnitude of therapeutic effect. SPEAK $OUT!^{(R)}$ was provided to a 55-year old female diagnosed with SCA for improving motor speech functions. Magnitude of therapeutic effect was large in changes of MPT and vocal intensity across speech tasks. Small effect size was found in changes of fundamental frequency, however, large therapeutic effect was observed in changes of frequency range. In addition, improvement of vocal quality based on jitter, shimmer, and HNR was observed with large therapeutic effect size and vowel space was expanded, particularly, due to F1. Lastly, VHI scores were decreased. Intensive motor speech treatment, called as SPEAK $OUT!^{(R)}$ was effective enough to observe improvement in vocal intensity, frequency range, and vocal quality, expanding vowel space and lowering VHI scores. Based on the results of this case study, further efficacy evaluation of SPEAK $OUT!^{(R)}$ for improving progressive ataxic dysarthria in people with SCA is required.

• International Journal of Oral Biology
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• v.37 no.1
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• pp.17-23
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• 2012

Recent studies indicate that reactive oxygen species (ROS) are critically involved in persistent pain primarily through spinal mechanisms, and that mitochondria are the main source of ROS in the spinal dorsal horn. To investigate whether mitochondrial ROS can induce changes in membrane excitability on spinal substantia gelatonosa (SG) neurons, we examined the effects of mitochondrial electron transport complex (ETC) substrates and inhibitors on the membrane potential of SG neurons in spinal slices. Application of ETC inhibitors, rotenone or antimycin A, resulted in a slowly developing and slight membrane depolarization in SG neurons. Also, application of both malate, a complex I substrate, and succinate, a complex II substrate, caused reversible membrane depolarization and enhanced firing activity. Changes in membrane potential after malate exposure were more prominent than succinate exposure. When slices were pretreated with ROS scavengers such as phenyl-N-tert-buthylnitrone (PBN), catalase and 4- hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPOL), malate-induced depolarization was significantly decreased. Intracellular calcium above $100{\mu}M$ increased malateinduced depolarization, witch was suppressed by cyclosporin A, a mitochondrial permeability transition (MPT) inhibitor. These results suggest that enhanced production of spinal mitochondrial ROS can induce nociception through central sensitization.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.121-125
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• 2001

Singing requires exquisite coordination between the respiratory and phonatory system to efficiently control glottal airflow. Respiratory function and vocal aerodynamics were investigated in six female professional sopranos and in six female subjects without vocal training. All sopranos had more than 15 years of formal classic vocal training. Pulmonary function test data on simple pulmonary function, flow volume curve, static lung volumes, maximum inspiratory pressure(MIP), and maximum expiratory pressure(MEP) were obtained from all subjects. Vocal aerodynamic studies of maximum phonation time(MPT), phonation quotient, and mean glottal flow rates (MFR) were also measured in all subjects. Simple pulmonary function in professional sopranos was generally the same as that of other female subjects without vocal training. However, MIP and MEP showing respiratory muscle forces were significantly elevated in professional sopranos, compared to those of other female subjects without vocal training. Maximum phonation times and phonation quotient in sopranos are longer than those of other female subjects even though there were no differences in simple pulmonary function. High-pitched tones were made with significantly higher mean glottal flow rates(GFR) in normal subjects than low-pitched tones, whereas no changes in GFR were found in sopranos. The result indicated that sopranos demonstrated significant improvements in aerodynamic measures of GFR, maximum phonation time, suggesting an increase in glottal efficiency.

• Phonetics and Speech Sciences
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• v.3 no.2
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.31-37
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• 2013

Background: The purpose of this study was to identify the effects of cervical manipulation for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Methods: Twenty-four subjects on asymmetric vertebral artery with right side have less blood flow than left side participated in this study for apply to non-specific cervical manipulation on lower portion. Measurement method were using duplex ultrasound with colour doppler imaging for blood velocity and flow on left and right vertebral artery. Results: Compared changes of blood velocity and flow on unilateral after the cervical manipulation, the left blood velocity decreased significantly (p<.01) and the right blood velocity increased significantly (p<.01). The left blood flow no significant changes and the right blood flow increased significantly (p<.01). Compared changes of blood velocity and flow on bilateral, the left and right blood velocity and flow made significantly difference on pre-manipulation (p<.01). However, both side no significantly difference on post-manipulation. Conclusions: These findings suggest that the non-specific cervical manipulation took effect for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Therefore, therapeutic approaches for improve to asymmetric vertebral artery should be consider non-specific cervical manipulation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.134-141
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• 1998

Mutational falsetto is a kind of voice disorders due to the failure to acquire proper low-pitched voice during the puberty. The patients with mutational falsetto can produce the normal low-pitched voice by the surgical treatment, like the type III-thyroplasty, or the voice therapy. The present study is, focusing on the latter treatment, to consider the efficiency of voice therapy for the mutational falsetto. The 7 patients who were diagnosed as mutational falsetto by the laryngologists, and treated by the voice therapist were selected as subjects. Their voices of pretherapy and posttherapy were analyzed on the aspects of acoustics and aerodynamics. Acoustic analysis was done by the MDVP(Multidimensional Voice Program) of CSL(Computerized Speech Lab, Kay Elemetrics, Co.), and aerodynamic analysis, by the Maximum Sustained Phonation of Aerophone II(Kay Elemetrics, Co.). By these measurements, we could find that fundamental frequency(F0) was significantly lowered, on the average, 65Hz. Maximum phonation time(MPT) was increased 4.57 second, and shimmer was decreased 1.644%, respectively, and each changes was statistically significant, too. On the average, jitter was decreased 0.499%, mean flow rate(MFR) was decreased 27.71ml/sec, and NHR was increased 0.023 which was the only parameter not showing improvement. But the changes of jitter, MFR and NHR were not statistically significant.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.64-68
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• 2000

Background and Objectives : To assess the role of altered vocal function in transient voice change after short-term endotracheal intubation, we evaluated acoustic parameters, aerodynamic parameters, and laryngoscopic characteristics preoperatively and postoperatively. Materials and Methods : Vocal function of 10 patients undergoing tympanoplasty and mastoidectomy using general anesthesia and endotracheal intubation were studied preoperatively, at 1day and 7 days after extubation. Acoustic analysis, aerodynamic study, and telescopic examination were used to assess vocal function. Results : In acoustic parameters, there was no significant difference between preoperative and postoperative measures. However, in subglottic pressure, ere was a significant decrease at 1 day after extubation and this change was return to preoperative value at 7 days after extubation. MPT(Maximal Phonation Time), MER(Mean flow Ratio), and VC(Vital Capacity) were decreased 1 day after extubation but did not show statistically significant change. Three of 10 patients manifested a vocal fold edema and injection 1 day after extubation. Conclusions : Subglottic pressure revealed a significant decrease at 1 day after extubation. And this change was correlated with laryngeal morphologic change and decrement in pulmonary function.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.98-103
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• 2000

Background and Objectives : The etiology and pathophysiology of spasmodic dysphonia is yet unknown. This study was performed to determine if any laryngeal aerodynamic parameter distinguish the voice of patient diagnosed as having adductor spasmodic dysphonia from individuals with normal voice production and to investigate the pathophysiology of spasmodic dysphonia. Materials and Methods : fifteen women diagnosed as having adductor spasmodic dysphonia and fifteen normal control women participitated in this study Maximum phonation time, mean air flow rate, subglottic pressure, vocal efficiency, Vfo, NHR, VTI, FTRI, ATRI, Jitter percent, Shimmer percent were obtained from the participants using 'MDVP(multi-dimensional voice program)' of CSL(Computerized Speech lab, Kay Elemetrics, Co., Model No. 4300), and 'maximum sustained phonation' and 'IPIPI test' of AP II(Aerophone II, Kay Elemetrics, Co., Model 6800). Results : T-test statistical analysis revealed statistically different values for vocal efficiency, Vfo, NHR, MPT, litter percent, Shimmer percent between the spasmodic dysphonia group and the control group. Conclusions : Spasmodic dysphonia affects the ability of the laryngeal mechanism to function effectively. Results from our study demonstrate that certain aerodynamic and acoustic parameters distinguish adductor spasmodic dysphonia from normal voice.