• 대한후두음성언어의학회지
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• 제27권1호
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• pp.45-50
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• 2016

Background and Objectives : This study aims to conduct post-voice therapy to patients with unilateral vocal fold paralysis for vocal improvement, motility recovery and analyze the results. Materials and Methods : Voice therapy was conducted to 13 patients who had shown response to voice therapy amongst 98 patients diagnosed with unilateral vocal fold paralysis. In order to be able compare before and after perceptual, acoustic and aerodynamic evaluations were conducted after voice therapy. Also, by using dysphagia checklist, we have verified whether if the patient had dysphagia prior to voice therapy. The therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic. Results : All 13 patients who underwent voice therapy had shown improvements that are statistically significant from 4 scales excluding the S scale from auditory perception evaluation (p<0.05), with enhanced glottal contact. In acoustic evaluation, Jitter, Shimmer and NHR had shown significant improvement after voice therapy. MPT was also notably improved among aerodynamical evaluation (p<0.001). All 11 patients had with dysphagia prior to voice therapy reported to have improved swallowing functions. Conclusion : Application of adequate voice therapy to patients with unilateral vocal fold paralysis, is an effective method that might be employed in the initial phase. Especially, the voice therapy proposed in this study is expected to be useful for patients in hypertension status due to secondary compensation after initial paralysis, since it focuses on improving vocal symptoms in a calm state with the supraglottis sufficiently relaxed. Also, the therapy is expected to be effective for improving swallowing functions.

• 대한후두음성언어의학회지
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• 제13권2호
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• pp.139-144
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• 2002

Background and objectives : The various voice-conserving treatments are used for Tla staged glottic cancer. Especially, Tla staged glottic cancer has been shown excellent treatment result after laser cordectomy or radiotherapy. To evaluate which treatment results better voice after treatment made it valuable to define the exact indication and recommending treatment modality on the Tla staged glottic cancer patients. Method : The medical records of 75 patients with glottic TlaN0 cancer diagnosed at Asan medical center, University of Ulsan college of medicine form May, 1989 to July,2001 were retrospectively reviewed on the point of voice quality and oncology including 5-year survival rate and local control rate. Results : Laser cordectomy and radiotherapy showed 100% and 94.0% 5-year survival rate, respectively. And laser cordectomy had 94.3% local control rate while radiotherapy got 87.6% local control rate. Voice analysis of pretreatment and posttreatment were used to compare each result. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum confortable phonation time(MPT) and vocal efficiency(VE) were used for parameters for voice analysis. Only in shimmer and MPT, we could find significant posttreatment difference between two therapies. In addition, we reviewed the total expenses for each therapy. Conclusion : On the basis of the oncologic result, both the laser cordectomy and radiotherapy had the similar results. Laser cordectomy showed the relatively acceptable voice as radiotherapy did. Laser cordectomy cost less than radiotherapy did. Laser cordectomy can be used for treatment about Tla staged glottic cancer.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.134-137
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• 2007

Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

• 대한후두음성언어의학회지
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• 제29권1호
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.21-26
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• 2004

Vocal Register Transition(Passaggio) is one of the most important vocal technique for classically trined male singers(tenor). Passaggio is that it bridges the chest register to head register without a noticeable voice break. Vocalist gest the feeling that voice is not locked a particular register. The purpose of this study was to clarify the difference between easy($B_3$) tone and non passaggio(F#_4$) & passaggio(F#_4$). We selected 6 trained singers(tenor), who had more than 12.6 years of experience and were well trained in passaggio technique. Simulataneous measurement was performed frequency(F0), mean flow rate(MFR), intensity(I), and subglottal pressure(Psub) using a phonatory function analyzer(Nagashima) and Closed Quotient(CQ), Jitter, Shimmer, NHR a Electro-glottography(EGG) of Lx. Speech Studio(Laryngogrph Lt, London, UK) and vocal efficiency was calculated by Carroll's method. For the tenor, target tone/a/was measured in three conditions : 1) easy phonation : $B_3$, 2) high tone without passaggio : F#_4$, 3) high tone with passaggio : F#_4$). The results revealed that F0 of the target tones between non-passaggio group and passaggio group were not significantly different though higher is F0, higher is subglottal pressure. And also CQ, MFR, Psub were increased in passagio than nonpssagio but these values were not statistically different. This study concluded that passaggio is the vocal technique to make the same quality of tone between chest register and head register in tenor.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.37-42
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• 2004

Electrolarynx(EL), battery operated vibrators which are held against the neck by on-off button, has been widely used as a verbal communication method among post-laryngectomized patients. EL speech can produce easily without need of any additional surgery or special training and be used with any other methods. This institute developed a neck-typed EL named "Blueton" in commperation with EL Company Linkus, which consists of 3 parts : Vibrator part, Control part, Battery part. In this study we evaluated the acoustic characteristics of the produced voices by Blueton compared with Servox-inton using MDVP. Three EL users (2 full time users, 1 part time user) were participated. The results revelaed that NHR higher in Servox than Blueton and intensity is higher in Blueton than Servox. The spectra for vowels produced by EL speakers are mixed signals combined with talkers' vocal output and electrolarynx noise. The spectra pattern is similar with two ELs. High, SPI index and vowel spectra from MDVP demonstrated characteristics of both electrolarynxes related to noise signal. This finding suggests that Blueton helps to provide one of useful rehabilitation options in the post laryngectomy patients.

• 대한후두음성언어의학회지
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• 제24권2호
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• pp.112-117
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• 2013

Background and Objectives : This study aimed to determine the clinical effect of $Artecoll^{(R)}$ injection laryngoplasty for patients with vocal atrophy and mild sulcus vocalis. Materials and Method : Forty-one patients with vocal atrophy and/or mild sulcus vocalis received transcutaneous $Artecoll^{(R)}$ injection into the vocal folds under local anesthesia. Subjective evaluations including voice handicap index (VHI) and perceptual grading with Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scales and objective evaluations including jitter, shimmer, noise-to-harmonic ratio (NHR), speaking fundamental frequency (SFF) and maximum phonation time (MPT) were evaluated before and 3 months after the injection. Results : VHI and Grade, Breathiness and Strain scales in GRBAS showed significant improvement 3 months after injection. SFF and MPT also significantly improved after the injection ; MPT increased and SFF in male patients decreased. Conclusion : Injection laryngoplasty with $Artecoll^{(R)}$ is an effective method for correcting the glottal insufficiency and improving voice quality in patients with vocal atrophy and/or mild sulcus.

• 말소리와 음성과학
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• 제9권3호
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• pp.85-91
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• 2017

The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.66-70
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• 1998

Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

• Applied Biological Chemistry
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• 제49권4호
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• pp.339-342
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• 2006

칸나의 뿌리를 80% MeOH용액으로 추출하고, 얻어진 추출물을 EtOAc, n-BuOH 및 물로 용매 분획 하였다. 이 중 EtOAc 분획과 n-BuOH 분획으로부터 silica gel과 octadecyl silica gel(ODS) column chromatography로 정제하여 4종의 화합물을 분리하였다. 각 화합물의 화학구조는 NHR, MS 및 IR 등의 스펙트럼 데이터를 해석하여, $\beta$-sitosterol(1), linoleic aicd methyl ester(2), monoglycosyldiglyceride(3), daucosterol(4)으로 동정하였다. 이 화합물들은 칸나에서 처음으로 분리되었다.