• Title/Summary/Keyword: 과가능 음성장애

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Tube phonation in water for patients with hyperfunctional voice disorders: The effect of tube diameter and water immersion depth on bubble height and maximum phonation time (과기능적 음성장애 환자의 물저항발성: 튜브 직경과 물 깊이가 물거품 높이 및 최대발성지속시간에 미치는 영향)

  • Min Gyeong Kim;Seong Hee Choi;Jong-In Youn
    • Phonetics and Speech Sciences
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    • v.15 no.2
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    • pp.31-40
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    • 2023
  • Tube phonation in water has been widely used for voice training among semi-occluded vocal tract (SOVT) exercises in which the patient bubbles with phonation keeping the tube submerged in water. This study aims to investigate the effect of tube diameter and water depth on bubble height and maximum phonation time (MPT) for patients with hyperfunctional voice disorders. Seventeen patients with hyperfunctional voice disorders were asked to bubble with sustained /u/ at the different inner diameters of tube (5, 7, and 10 mm), water depth (4, 7, and 10 cm). A water resistance phonation biofeedback system using a water height sensor was used for recording bubble height and MPT. The bubble height was significantly changed by the tube diameter while MPT was significantly changed with the tube diameter and water depth. Although the wider tube presented significantly lower bubble height for a given depth, relatively consistent bubble height was maintained. Depending on the water depth, the bubble height did not significantly differ for a given tube diameter. In addtion, MPT significantly decreased with water depth and a wider tube led significantly shorter MPT. A water level-driven water resistance biofeedback system provided useful information on bubble characteristics and vocal fold vibration depending on tube diameter and water depth. It can be useful to monitor the breath support during water resistance phonation for patients with hyperfunctional voice disorders.

RESULT OF MANAGEMENT FOR VELOPHARYNGEAL INSUFFICIENCY (구개범인두부전증의 치료성적)

  • 진성민;최종욱;정광윤;유홍균
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.22-22
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    • 1991
  • 구개열 및 구개근의 기능부전 등에 의한 인두문(velopharyngeal valve)의 폐쇄부전으로 인하여 발생하는 구개범인두부전증(velopharyngeal insufficiency)은 흔히 과비성으로 알려진 구음장애를 나타내는 병적현상으로 Von Langenbeck(1861)이 구개 외측 점막성 골막편을, Smith(1895) 와 Ganzer(1920)는 각각 구개 4-판 및 3-판 점막성 골막편을 이용한 수술적 치료법을 통하여 구음장애를 해결하여 주려하였고, 그외 인두후벽의 증대 및 언어보조기 등을 이용한 방법으로 구음장애를 해결하여 주려는 연구가 최근까지 활발하게 이루어지고 있으나 만족할 만한 성적을 거두지 못하고 있는 실정에 있다. 이에 저자들은 구개범인두부전증에 대한 수술적 치료후 증상의 호전정도를 관찰하고, 술후에도 증상의 호전을 보이지 않는 환자의 음성재활에 대한 향후 방향제시에 도움을 주고자 1987년 1월부터 1991년 1월까지 과비성을 주소로 본원 이비인후과에 내원하여 구개성형술을 시행받고 3개월 이상 추적 관찰이 가능하였던 14례의 환자를 분석한 결과 구개범인두부전에 대하여 1차 수술을 시행받은 14례중 5례(36%)에서 정상적인 구음이 가능하였으며 실패한 9례중 5례에 대하여는 재 수술을 시행하였으나 만족할 만한 음성회복을 거두지 못하여 그 원인과 저자들의 술식을 분석 검토함으로써 구개범인두부전증의 치료에 대한 보다 효율적인 방법을 모색하고자 문헌고찰과 함께 보고하는 바이다.

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A Study on Improvement of Kid Authoring System for Developmental Disability Students (발달장애 학생을 위한 어린이용 저작시스템의 개선에 대한 연구)

  • Hong, Su-Jin;Roh, Jin-Lee;Lee, Jeong-Joong;Baik, Sung-Wook
    • Proceedings of the Korean Information Science Society Conference
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    • 2012.06a
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    • pp.134-136
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    • 2012
  • 본 연구에서는 일반 어린이들이 쉽게 활용할 수 있는 콘텐츠 저작시스템(COSMOS KID)을 발달장애 학생들에게도 활용가능한 저작시스템으로 개선하기 위하여 발달장애 학생들에게 기존 시스템을 직접 활용하게 해봄으로써 시스템 기능 이해 및 숙련도를 파악 및 분석하여 이에 대한 보완점 및 대안을 모색하여 다음과 같이 시스템 개선에 대한 연구 결과를 제안하고자 한다. (1) 실험 대상자들의 학습능력 부족으로 인해 최종 프로그램 숙련도가 매우 낮은 것으로 나타났으며, 이를 보완하기 위해 발달장애 아동의 특성을 고려한 인터페이스 개선이 우선적으로 필요할 것으로 파악되었다. (2) 발달장애 학생들의 음성표현능력이 매우 낮아서 저작하는 콘텐츠의 스토리를 적절히 표현하지 못하여 이를 보완하기 위한 방안으로 자막처리가 가능한 기능 등의 원활한 인터랙션이 지원될 수 있는 시스템 환경이 구축이 필요하다고 판단되었다.

Advanced Service Model of Mobile Broadcasting Communication System (모바일 방송 통신 시스템 서비스 품질 개선 모델)

  • Jeong, Hyeon-Jun;Yoo, Young-Hwan
    • Proceedings of the Korean Information Science Society Conference
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    • 2012.06d
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    • pp.10-12
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    • 2012
  • 본 논문은 모바일 방송 통신 시스템에서 나타나는 사용자들의 불편사항을 해소하기 위한 서비스 품질 개선 모델을 제안하였다. 사용자들의 불편사항인 일시적인 통신장애와 채널 변경 지연시간을 해결하기 위해 ATSC M/H 표준의 NRT서비스를 이용, 해당 영상보다 수 분 빠른 영상을 전송 받는 모델을 제시하였다. 또한, GPS 모듈을 통해 사용자의 현재 위치를 구한 뒤 이를 이용, 통과 예상되는 지역중 통신 장애 발생 가능 구간을 확인하여 해당 영상을 미리 전송 받을 수 있는 모델을 제시하였고 Key 프레임과 음성데이터 만의 조합으로 영상의 용량을 줄여 이를 이용하는 모델을 제시하였다. 마지막으로 사용자의 채널 선택 패턴을 조사한 정보를 바탕으로 채널 변경이 예상되는 시간 전에 미리 컨텐츠를 받는 모델도 제시하였다. 제안한 모델의 우수성을 알아보기 위해 PSNR(Peak Signal-to-Noise Ratio) 값을 사용자가 느끼는 만족감의 척도로 활용하고 제안모델은 통신장애 시 에러율 80% 에 비해 4.8배 높은 평균값을 결과로 얻었다.

A RESULT OF VOICE PRESERVATION FOLLOWING TREATMENT OF LARYNGEAL CANCER (후두암 치료후 음성보존의 성적)

  • 김형태;김형주;김민식;조승호;서병도
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.29-29
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    • 1991
  • 후두암의 치료는 병변의 위치, 크기 등에 따라 치료방법이 다양하고 그 예후 또한 상이하다. 일반적으로 초기 후두암에서는 수술이나 방사선 요법이 비슷한 치료결과를 보이고, 진행된 후두암에서는 수술적 치료가 더 좋은 예후를 나타내는 것으로 알려져 있으나 발성장애를 초래하는 경우가 대부분이다. 저자들은 1986년부터 1990년까지 5년간 강남성모병원에서 후두암치료를 받았던 환자 81명을 대상으로 치료방법에 따른 음성보존 성적을 분석하였다. 1. T1 성대암 환자 18명중 16명 (88.9%)에서 방사선치료 또는 수술로써 음성을 보존할 수 있었다. 2. T2 후두암 환자 11명중 6명은 수술후 음성보존이 가능하였다. 3. 진행암환자 (T3, T4) 50명중 33명에 대해 수술을 시행하였고 이중 16명(48.5%)은 후두부분 또는 근전적출술 및 기관-식도 누공술에 의해 음성기능을 보존할 수 있었다. 4. 진행암환자에서 유도화학요법과 방사선치료의 병용요법만을 받은 17명 모두 6개월 이내에 재발하였고, 수술 혹은 수술과 방사선 치료를 병용한 33명중 27명이 최소한 6개월 이상 평균 2년 이상의 무병상태였다. 5. 후두부분 또는 근전적출술은 총 81명중 28명에서 시행되었고 그중 5명 (17.9%)에서 재발하였다.

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FOLLOWF-UP STUDY OF THE TIC DISORDERS (틱 장애 환자의 추적 조사)

  • Shin, Zong-Hun;Jung, Chul-Ho;Kim, Hee-Cheol
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.68-76
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    • 1996
  • 30 DSM-III or DSM-III-R tic patients were assessed by hospital records and Yale Global Tic Severity Scale to study the common characteristics, clinical course and longterm outcome of tic disorders after 3.1-18.1 years, 73.3% of the patients(treated or untreated) have recovered or partially improved. Identifical precipitating factors were found in 9 patients. Associated disorders were ADHD, sleep disorder, and so on. The outcome according to age of onset, duration of follow-up and diagnoses have no statistically significance. Increased age at follow up was influenced improvement of tic symptoms, though statistically not significant(p=0.327). These results suggest that the outcome of tic disorder is not ominous and they are relatively good social adjustment inspite of carrying the tic symptoms. But this study has some limitations such as retrospective study and sample size. Studies designed prospectively with large sample would be needed to generalize theses results.

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The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic (ASQ :소아과외래에서의 발달지연 선별검사)

  • Kim, Eun Young;Sung, In Kyung
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1061-1066
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    • 2007
  • Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

Clinical Study on Laryngo - Microscopic Surgery For Vocal Nodules and Polyps (후두결절 및 폴립의 후두미세 수술에 관한 임상연구)

  • 문영일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.11.2-11
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    • 1983
  • Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.

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Ototoxic Evaluation of Cis-platinum (Cis-Platinum의 이중독증에 관한 임상적 고찰)

  • 홍원표;정명현;오혜경;이경재
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.17.1-17
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    • 1982
  • In 1965, Rosenberg reported that platinum compounds not only inhibit growth and cell division of E. coli but also has anti-tumor activity. Since then, through animal and clinical experiments by Welsch(1971), Speer(1972), Rossof(1972), Hill(1974), and Wittes(1975), it was proved that Cis-platinum has excellent supressive effects on malignant tumor, especially on head and neck cancer. Accordingly, Cis-platinum is now widely used, sometimes without any other durg, or sometimes with Bleomycin and Methotrexate etc. Inspite of the strong anticancer effect, the use of Cis-platinum is quite often discouraged because of the reports that Cis-platinum causes auditory impairment at high frequencies above the speech range due to inner ear damage and irreversible change in the renal tubules. Since Kohonen et al(1965), Standnicki et al(1974) reported that Cisplatinum has toxic effects at the basal turn of the cochlea using guinea pig, many studies on ototoxicity after infusion of Cis-platinum have been carried out using animals. But the studies on ototoxicity in human beings can hardly be found except in reports by Piel et al(1974) and Hong et al (1979). So the authors did a study which tried to clarify the ototoxic effect by comparing the hearing level after infusion of Cis-plastinum with the hearing level before infusion of Cis-plastinum in 30 patients who was treated with Cis-platinum and admitted to the dept. of otolaryngology of Yonsei University Hospital during 2 years and a half from July. 1979 to March. 1982 and the following results were obtained. 1) The results of auditory evaluation, using the pure tone average, hearing loss of 4kHz and 8kHz, Speech Reception Threshold, PB score, SISI showed that the difference of dosage does not change the hearing level after infusion of Cis-platinum and before infusion of Cis-platinum. 2) Cis-platinum had no effect on the hearing level of patients with conductive hearing loss, or with sensorineural hearing loss, as well as with normal hearing level. 3) The infusion of Cis-platinum did not cause any change in creatinine clearance, creatinine, uric acid, but only one case showed that Cis-platinum caused severe nephrotoxicity. 4) The infusion of Cis-plastinum did not cause any change in hemoglobin, leukocyte count, platelet count and there was no correlation with the amount of infusion. 5) To see the side effect of hydration practiced with the infusion of Cis-platinum, the electrolytes, particularly the K level in the serum was measured. But the results did not show any change. 6) Judging from the results of this study mentioned above, ototoxicity caused by infusion of Cis-platinum can be prevented by sufficient hydration. Also the results might say that the appropriate method of infusion of Cis-platinum might be effective in the patients with head and neck cancer who had sensorineural hearing loss for whom the infusion of Cis-platinum has been absolutely cotraindicated.

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The Phoniatric Evaluation of the Effect of the Laryngomicrosurgery for the Laryngeal Polyps and the Nodules (성대폴립및 결절의 치료 효과에 대한 음성의학적 고찰)

  • 김기령;홍원표;김광문;이경재;정태영;이명호
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.8.2-9
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    • 1983
  • Recently, the laryngomicrosurgery has been done for the removal of benign laryngeal mass and for the improvement of voice. For the evaluation of the effect of the treatment, there must be any objective method such as aerodynamic study, vocal fold vibration study, acoustic analysis, psycho-acoustic evaluation and the neuro-muscular study. The authors evaluated the phoniatric effect of the laryngomicrosurgery for the patients of 15 laryngeal polyps and 9 laryngeal nodules, who received pre-op. and post-op. vocal function study from Jun. 1981 to Mar. 1983. The results obtained were as follows ; 1) The post-op. mean value of the maximum phonation time was increased 40 % in the unilateral polyps, 62 % in the bilateral nodules and 18 % in the unilateral nodules. 2) The post-op. mean value of the phonation quotient was decreased 25 % in comparison with pre-op. value in the case of the bilateral polyps, 26 % in the unilateral polyps, 55 % in the bilateral nodules and 12 % in the unilateral nodules. 3) The post-op. mean value of the mean air flow rate was decreased 27 % in comparison with the pre-op. value in the case of the bilateral polyps, 25 % in the unilateral polyps, 65 % in the bilateral nodules, 25 % in the unilateral nodules. 4) The glottic chink of the 10 cases of polyps among the 11 cases were disappeared, and the glottic chink of the 5 cases of nodules among 7 cases were also disappeared after surgery. 5) The pre-op. hoarseness of the 10 cases of polyps among the pre-op. hoarseness of the 11 cases of polyps were changed to clear and the 3 cases of nodules were also changed to clear.

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