• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.102-107
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• 2016

Background and Objectives : Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. Methods : We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. Results : When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ${\leq}3mm$), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). Conclusion : All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.

• Speech Sciences
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• v.10 no.3
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• pp.7-27
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• 2003

Esophageal Speech uses the esophageal air during phonation. Fluent esophageal speakers frequently intake air in oral communication, but unskilled esophageal speakers are difficult with swallowing lots of air. The purpose of this study was to investigate the difference of acoustic characteristics of vowel and consonants production according to the speech proficiency level in esophageal speech. 13 normal male speakers and 13 male esophageal speakers (5 unskilled esophageal speakers, 8 skilled esophageal speakers) with age ranging from 50 to 70 years old. The stimuli were sustained /a/ vowel and 36 meaningless two syllable words. Used vowel is /a/ and consonants were 18 : /k, n, t, m, p, s, c, $C^{h},\;k^{h},\;t^{h},\;p^{h}$, h, I, k', t', p', s', c'/. Fundermental frequency (Fx), Jitter, shimmer, HNR, MPT were measured with by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). 36 meaningless words produced by esophageal speakers were presented to 3 speech-language pathologists who phonetically transcribed their responses. Fx, Jitter, HNR parameters is significant different between skilled esophageal speakers and unskilled esophageal speakers (P<.05). Considering manner of articulation, ANOVA showed that differences in two esophageal speech groups on speech proficiency were significant; Glide had the highest number of confusion with the other phoneme class, affricates are the most intelligible in the unskilled esophageal speech group, whereas in the skilled esophageal speech group fricatives resulted highest number of confusions, nasals are the most intelligible. In the place of articulation, glottal /h/ is the highest confusion consonant in both groups. Bilabials are the most intelligible in the skilled esophageal speech, velars are the most intelligible in the unskilled esophageal speech. In the structure of syllable, 'CV+V' is more confusion in the skilled esophageal group, unskilled esophageal speech group has similar confusion in both structures. In unskilled esophageal speech, significantly different Fx, Jitter, HNR acoustic parameters of vowel and the highest confusions of Liquid, Nasals consonants could be attributed to unstable, improper contact of neoglottis as vibratory source and insufficiency in the phonatory air supply, and higher motoric demand of remaining articulation due to morphological characteristics of vocal tract after laryngectomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.48-51
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• 2012

Background and Objectives : Vocal fold cyst is generally treated by surgical resection, it has a difference with vocal fold polyp, treated by conservative management first. Decrease in mucosal waves is known as main diagnostic criteria of vocal fold cyst. Sometimes there is a difficulty for diffrential diagnosis between cyst and polyp only by endoscopic examination. The purpose of the study is to identify the objective features of vocal cyst and polyp on the basis of voice analysis for the proper differential diagnosis, especially at high pitched phonation. Materials and Method : The voice analysis was done in 15 focal fold cyst patients and 42 vocal fold polyp. Parameters of perceptual assessment, acoustic and aerodynamic measure, and voice range profile were compared between two groups. Results : Vocal fold cyst patients showed significantly reduced MPT by acoustic and aerodynamic analysis, narrowed frequency-range and low maximun frequency by voice range profile analysis compared with vocal fold polyp patient. Maximun frequency 381 Hz is established for cut off value, differential diagnosis between cyst and polyp (ROC analysis, sensitivity 60%, specificity 68%). Conclusion : Voice analysis is helpful for differential diagnosis between vocal fold cyst and polyp, especially there is a difficulty for distinguish cyst from polyp at clinical situation by endoscopic examination. The result of decreased maximum frequncy at vocal fold cyst supports incomplete high-pitched phonation and falsetto regester at vocal fold cyst patients due to decreased mucosal wave, compared with vocal fold polyp patients.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.40 no.3
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• pp.382-390
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• 1995

To compare the rice yield and grain quality characteristics between mature(MPF) and reclaimed paddy field(RPF), grain yield and its components, some physicochemical properties of rice grain and palatability of cooked rice were investigated for Dongjinbyeo grown at three different locations of mature and reclaimed paddy field, respectively, in south western part of Korea. Variation of culm length in mature paddy area was larger than that in reclaimed saline area. Panicle number per m$^2$ in RPF was more then that in MPF but grain number per m$^2$, filled grain ratio and 1, 000-grain weight in RPF were lower than those in MPT. Average yield of milled rice in RPF was 12% lower than that in MPF (5.l1t /ha). Daejeon showed the highest yielding among MPF and Yeongam reveald the highest grain production among RPF. RPF rices had slightly higher carbohydrate content and alkali digestibility but lower protein, fat and amylose content compared with MPF rices. RPF rices also exhibited higher mineral contents, Mg/K ratio, peak and hot viscosity compared with MPF rices. RPF rice showed slightly poor apparent grain quality but a little better eating quality of cooked rice compared with MPF rice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.40-46
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• 2011

Background and Objectives : Vocal fold bowing is an organic voice disorder that is associated with an abnormal structure of the vocal folds whereas vocal fold polyp is a functional voice disorder caused by an abnormal use of the vocal folds. Both types of vocal folds share a common property in that they make one's voice breathy or strained. The purpose of this study is to compare voice from two types of vocal folds and to offer information of clinical importance. Materials and Method: Vocal fold bowing and vocal fold polyp groups consisted of 7 male subjects, respectively. All subjects recorded /a/ in the state of measuring MPT (maximum phonation time), repeating 3 times, by a voice recorder (48 kHz sampling rate; 24 bit quantization). They answered the questions of K-VHI. Time domain parameters (such as perturbation parameters including HNR, Jitter, etc.) were calculated for the whole duration of /a/ and those of the frequency domain were measured in initial 40 ms and stable 40 ms of /a/, respectively. Mann-Whitney V-test was used for the time domain parameters and K-VHI survey, and Wilcoxon signed rank test was applied to the frequency domain parameters (H1, H2, H1-H2). Results: For K-VHI survey and the time domain analysis, there was no significant difference between bowing and polyp group. For frequency domain analysis, H1 and H2 showed a significantly different result between two groups. Vocal fold bowing group has longer duration and lower intensity than that of vocal fold polyp group in the 'aspirated interval', which could be observable prior to ordinary vowel oscillation. Conclusion: Both groups seem to show breathy voice. This could be referred on the basis of the value of H1-H2. The K-VHI survey says that subjects with vocal fold bowing feel more uncomfortable than subjects with vocal fold polyp.

• Phonetics and Speech Sciences
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• v.2 no.4
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• pp.245-252
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• 2010

Korea does not have a certain criteria on the respiratory ability and phonation of the normal aged, and also has no clear standard to examine the boundaries of geriatric diseases. This study analyzed the characteristics in respiration and phonation of the aged in normal healthy elderly from diverse angles with different variables. Thirty-three participants in total, seven males and eight females in the age group 55-64 participated in the study. Seven males and eleven females in the age group 65-74 were selected for the respiration and phonation experiments, and 10 different variables such as FVC, $FEV_1$, $FEV_1$/FVC, MPT, MFR, Psub, f0, jitter, shimmer and NHR were comparatively analyzed for each group of different age and gender. To see the difference in respiration and phonation by age and gender, the study conducted a two-way ANOVA. First, from the result of the analysis on respiratory ability, FVC of male appeared to be significantly greater than female. In both age groups of 55-64 and 65-74, male displayed greater FVC than female did. Second, as for $FEV_1$, $FEV_1$/FVC, the age group of 55-64 showed greater values than the values measured in the age group of 65-74. Third, MFR showed a significant difference by gender. In both age groups, male showed significantly higher MFR than female. Fourth, for different gender, a significant difference in MFR was observed. In both age groups of 55-64 and 65-74, male exhibited higher MFR than female. This study has a clinical implication in that it analyzed the criteria on respiration and phonation in normal healthy elderly according to gender and age. The normal aged showed a difference in their respiratory and phonatory functions by age and gender, it was closely related to the decline of pulmonary function due to the physical aging and the weak respiration coming from weakness of respiratory muscles. Also, the physical differences in height, weight, and the muscles in laryngeal and respiratory system between males and females had an influence on the performance. These results from this study might be a helpful guideline for the clinical criterion in the future.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.39-43
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• 2007

Background and Objectives: There are few studies reported that specifically examine the phonetic characteristics and voice handicap index (VHI) in patients with Allergic Rhinitis. This study was designed to examine phonetic characteristics and VHI in adult patients with allergic rhinitis. Materials and Methods: Forty-two male patients diagnosed as allergic rhinitis were given skin-prick test and others, aged from 20 to 56 years, and were compared with a 16 male control group with no pathology and in the same age group. The VHI was used to measure the changes of patient's perception. Acoustic and aerodynamic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. Acoustic rhionometry (AR) was performed to evaluate nasal volume and nasal crosssectional area. Statistical analysis was done using independent sample t-test. Results: VHI showed significantly different score in the studied group, higher than that of control group. AR graph showed that there was no significant differences of nasal volume and nasal cross-sectional area. The Shimmer and SFF value in the group of allergic patients were higher than in the control group. MPT value in the group of allergic patients was lower than in the control group. Nasalance in allergic patients showed hypernasality all passage. Conclusion: We suggest that patients with allergic rhinitis have considerable voice problems. Most of them have hypernasality, which may be a compensatory mechanism by nasal obstruction.

• 재활복지
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• v.22 no.1
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• pp.169-194
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• 2018

The aim of this study is to examine changes in swallowing function and quality of life with therapeutic singing-based music therapy for patients with dysphagia. The music therapy program was based on the previous study (Kim, 2010), and designed to improve breathing, phonation, and swallowing functions focusing on laryngeal elevation. Three patients with dysphagia participated in this study and each participant received a total of 11 or 12 individual music therapy sessions and each session was conducted for 30 minutes. In this study, three kinds of measurements were used. First, the measures of maximum phonation time (MPT), fundamental frequency, average intensity, jitter, shimmer, noise to harmonics ratio (NHR) by Praat test, second, laryngeal-diadochokinesis (L-DDK) to investigate laryngeal elevation, and last, the Swallowing-Quality of Life (SWAL-QOL) was measured. These cases have shown improved breathing, phonation, swallowing function, and the scores of SWAL-QOL in all of the patients. It suggests that this music therapy intervention was effective on laryngeal elevation, and the music intervention with therapeutic singing can be effectively implemented in further research for patients with dysphagia.

• Journal of Korean Medical Ki-Gong Academy
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• v.23 no.1
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• pp.10-29
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• 2024

Objective : The purpose of this study is to determine whether An's breathing meditation qigong therapy (ABMQT) delivers bioenergy to the frontal lobe, prefrontal lobe, the olfactory tract in the mesolimbic pathway, olfactory bulb, CV22, CV21, olfactory area and vocal-related areas in Parkinson's disease (PD) patients to help improve olfactory disorders (anosmia) and vocal functions. Methods : The subjects of this study were 4 patients with idiopathic PD (3 males/1 female, 65.0±NA/68.7±10.2 years old). ABMQT was applied once a week, 120 minutes per session for 12 weeks in a non-invasive and noncontact manner, and the test before and after ABMQT application included olfactory impairment test the Korean version of Sniffin' stick test (KVSS), voice acoustic test, aerodynamic test, vocal handicap index (VHI-30), and auditory perception scale test tools. The results before and after the experiment were analyzed assuming a normal distribution, and a chi-square test was performed using a continuity correction, and the significance level was set to p<0.05. And the medical diagnosis and findings of the examiner (doctor in charge) before and after the experiment were described. Results : KVSS was significant as 0.2±0.5 and 9.0±0.0 before and after the experiment. There was no significant difference between the voice acoustic test FO and Jitter, the vocal aerodynamic test MPT, SP, AE, the vocal disorder index test, and the auditory perception test. However, the medical diagnosis findings of four study subjects showed that olfactory disorders, voice disorders, and laryngeal function were improved before and after the application of ABMQT. Conclusions : The breathing meditation qigong program showed significant effects on improving the olfactory disorders (anosmia) and speech function of each study subject. However, to produce meaningful results, it is thought that experiments involving a larger number of research participants are necessary, and additional blood and FMRI tests are conducted to verify metabolic activities and the olfactory neuron signal transmission system.