• 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

• 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.

• 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.

• Radiation Oncology Journal
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• v.23 no.1
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• pp.17-21
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• 2005

Purpose : To evaluate the voices of irradiated patients with early glottic carcinoma and to compare these with the voices of healthy volunteers. Materials and Methods : The voice samples (sustained vowel) of seventeen male patients who had been irradiated for T1a glottic squamous carcinoma at least 1 year prior to the study were analyzed with objective voice analyzer (acoustic voice analysis, aerodynamic test, and videostroboscopic analysis) and compared with those of a normal group of twenty age- and sex-matched volunteers. Average fundamental frequency, jitter, shimmer, and noise-to-harmonic ratio were obtained for acoustic voice analysis. Maximal phonation time, mean flow rate, intensity, subglottic pressure, glottal resistance, glottal efficiency, and glottal power were obtained for aerodynamic test. Results : The irradiated group presented higher values of shimmer in acoustic voice analysis. There was no significant difference between two groups in other parameters. Conclusion : In this study all the objective voice parameters except shimmer were no4 significantly different between the irradiated group and the control group. These results suggest that the voice quality is minimally affected by radiation therapy for 71 a glottic carcinoma.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.527-537
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• 2007

To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.

• Phonetics and Speech Sciences
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• v.12 no.3
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• pp.1-14
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• 2020

Previous studies have confirmed that /o/ and /u/ in Seoul Korean are undergoing a merger in the F1/F2 space, especially for female speakers. As a substitute parameter for formants, it is reported that female speakers use phonation (H1-H2) differences to distinguish /o/ from /u/. This study aimed to explore whether H1-H2 values are being used as perceptual cues for /o/-/u/. A perception test was conducted with 35 college students using /o/ and /u/ spoken by 41 females, which overlap considerably in the vowel space. An acoustic analysis of 182 stimuli was also conducted to see if there is any correspondence between production and perception. The identification rate was 89% on average, 86% for /o/, and 91% for /u/. The results confirmed that when /o/ and /u/ cannot be distinguished in the F1/F2 space because they are too close, H1-H2 differences contribute significantly to the separation of the two vowels. However, in perception, this was not the case. H1-H2 values were not significantly involved in the identification process, and the formants (especially F2) were still dominant cues. The study also showed that even though H1-H2 differences are apparent in females' production, males do not use H1-H2 in their production, and both females and males do not use H1-H2 in their perception. It is presumed that H1-H2 has not yet been developed as a perceptual cue for /o/ and /u/.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.3
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• pp.338-360
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• 1992

This study was performed to investigate the phonetic alterations with upper anterior teeth were missing. To compare the changes of the phonations, before and after insertion of the temporary prosthesis, six subjects who lost their upper anterior teeth were selected (2-male, 4-female). Tested sounds (/ga(가), na(나), da(다), ra(라), sa(사), ja(자), cha(차), ta(타), pa(파), ha(하), gi(기), ni(니), di(디), ri(리), si(시), jl(지), chi(치), ti(티), pi(피), hi(히), seu(스), se(세), so(소), su(수)/were programmed into an IBM AT with and without temporary prosthesis. These experiments were analyzed by formants, consonants durations, and energy level changes with an LSI speech work station program. During the pronunciation of the tested sounds (with and without temporary prosthesis), mandibular movements were recorded to a Mandibular Kinesiogram and analyzed . The findings led to the following conclusions: 1. Objective differences could not be found. However, in every informant, subjective improvement could be noticed. 2. There were no persistant correlations of the formant's changes. And in every informant, phonetic changes were variable. 3. There were various changes of the consonant durations in every informant. By and large, those of /si(시), jl(지), chi(치), Pi(피), hi(히)/ were longer than other tested sounds. After insertion of the prosthesis, durations were shorter. Consonants with /i(ㅣ)/ were longer than with /a(ㅏ)/, with or without prosthesis. 4. With and without temporary prosthesis, mandibular movements were various in the frontal view. Mandibular movements showed lateral deviations, and mandibular positions with /si(시), ji(지), ti(티), seu(스), hi(히)/ were nearer to the mandibular rest position. 5. The kinds of temporary prosthesis and conditions of the missing teeth influenced every informant variously, so there were no correlation between informants. 6. Energy levels increased in all tested sounds with a fixed temporary prosthesis. And, there were no differences between before and after insertion of a removable temporary prosthesis. However, sibilant sounds, and consonants with /i(ㅣ)/ showed a little increased energy level.

• 재활복지
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• v.18 no.4
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• pp.237-255
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• 2014

Idiopathic Parkinson disease(IPD) is an neurodegenerative disease caused by the loss of dopamine cells in the substantia nigra, a region of midbrain. Its major symptoms are muscular rigidity, bradykinesia, resting tremor, and postural instability. An estimated 70~90% of patients with IPD also have hypokinetic dysarthria. Subthalamic nucleus deep brain stimulation (STN-DBS) has been reported to be successful in relieving the core motor symptoms of IPD in the advanced stages of the disease. However, data on the effects of STN-DBS on speech performance are inconsistent. A medline literature search was done to retrieve articles published from 1987 to 2012. The results were narrowed down to focus on speech performance under STN-DBS based perceptual, acoustic, and/or aerodynamic analyses. Among the 32 publications which dealt with speech performance after STN-DBS indicated improvement(42%), deterioration(29%), mixed results(26%), or no change(3%). The most favorite method was found to be based upon acoustic analysis by using a vowel prolongation and Unified Parkinson's Disease Rating Scale(UPDRS). For the purpose of verifying the effect of the STN-DBS, speech evaluation should be undertaken on all speech components such as articulation, resonance, phonation, respiration, and prosody by using a contextual speech task.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.77-87
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• 2019

The study aimed to develop Speech Range Profile (SRP) and to examine and validate its clinical application. Forty-five participants without voice disorders aged 18-29 years were compared using SRP and Voice Range Profile (VRP). The authors developed the "Fire!" paragraph as a SRP task compromising 14 sentences including all Korean spoken phonemes and sentence types. To compare SRP and VRP results, the participants read the paragraph (reading) and counted from 21 to 30 (counting) as a part of SRP tasks, and produced a vowel /a/ from low to high frequencies (gliding) and a shortened form of the VRP as a part of VRP tasks. $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, $I_{min}$, and $I_{range}$ for each task were measured and compared, showing that $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, and $I_{range}$ were not different between reading and gliding. $I_{min}$, had the lowest value in counting. It is concluded that the newly developed SRP task, reading the "Fire" paragraph, can yield a maximum phonation range similar to that found by VRP. Therefore, it is expected that voice evaluation can be effectively performed in a relatively short time by applying SRP with the "Fire" paragraph, a functional utterance task, in place of VRP, which may be difficult to measure long term or in cases of severe voice disorders.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.15-23
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• 2021

Background and Objectives During speech, the vocal folds oscillate at frequencies ranging from 100-200 Hz with amplitudes of a few millimeters. Mechanical stimulation is an essential factor which affects metabolism of human vocal folds. The effect of mechanical vibration on the cellular response in the human vocal fold fibroblasts cells (hVFFs) was evaluated. Materials and Method We created a culture systemic device capable of generating vibratory stimulations at human phonation frequencies. To establish optimal cell culture condition, cellular proliferation and viability assay was examined. Quantitative real time polymerase chain reaction was used to assess extracellular matrix (ECM) related and growth factors expression on response to changes in vibratory frequency and amplitude. Western blot was used to investigate ECM and inflammation-related transcription factor activation and its related cellular signaling transduction pathway. Results The cell viability was stable with vibratory stimulation within 24 h. A statistically significant increase of ECM genes (collagen type I alpha 1 and collagen type I alpha 2) and growth factor [transforming growth factor β1 (TGF-β1) and fibroblast growth factor 1 (FGF-1)] observe under the experimental conditions. Vibratory stimulation induced transcriptional activation of NF-κB by phosphorylation of p65 subunit through cellular Mitogen-activated protein kinases activation by extracellular signal regulated kinase and p38 mitogen-activated protein kinases (MAPKs) phosphorylation on hVFFs. Conclusion This study confirmed enhancing synthesis of collagen, TGF-β1 and FGF was testified by vibratory stimulation on hVFFs. This mechanism is thought to be due to the activation of NF-κB and MAPKs. Taken together, these results demonstrate that vibratory bioreactor may be a suitable alternative to hVFFs for studying vocal folds cellular response to vibratory vocalization.