• 대한불안의학회지
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• 제5권1호
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• pp.29-35
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• 2009

Background : In spite of the worldwide relevance of obsessive-compulsive disorder Ed-highlight : Unclear. Perhaps consider changing word choice. (OCD), there are considerable differences in prevalence, sex ratio, comorbidity patterns, and sociodemographic correlates. Data on subclinical OCD have been sparse to date. Methods : Data stemmed from the Korea Epidemiologic Catchment Area (KECA) study which had been carried out from April to December 2001. Korean versions of DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 6275 persons aged 18-64 living in the community. DSM-IV based criteria for subclinical OCD were applied. Results : The lifetime prevalence rates for OCD and subclinical OCD were 0.8% and 6.6%, respectively. In both OCD and subclinical OCD, the rates for males and females were not statistically different. OCD was demonstrated to be associated with depressive disorder, bipolar disorder, social phobia, generalized anxiety disorder, and alcohol and nicotine dependence. Additionally, subclinical OCD was associated with posttraumatic stress and somatoform disorders. Comorbidity rates in subclinical OCD were lower than those in OCD. Conclusions : The lifetime prevalence rate for OCD was less than 1% in the Korean general population. Age distribution and comorbidity patterns suggest that subclinical OCD represents a broad and heterogeneous syndrome and not simply a milder form of OCD.

• 말소리와 음성과학
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• 제5권1호
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• pp.63-69
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• 2013

This study attempted to investigate the characteristics of Phonation Threshold Pressure and Phonation Threshold Airflow of Patients who have Functional voice disorder. 50 subjects participated in study (32 subjects were patients who had functional voice disorders and 20 subjects were normal adults). The PAS (Phonatory aerodynamic system, model 6600, KAY electronics, Inc.) was used to measure the data and to do the analysis. Data from the Phonation Threshold Pressure was measured using voicing efficiency of the PAS protocol. Data from the Phonation Threshold Airflow was measured using Maximum Sustained Phonation of the PAS protocol. Those were used because of the ease of phonation. The results of this study showed that the differences in Phonation Threshold Pressure and Phonation Threshold Airflow between patients who had functional voice disorder and normal adults could be significant index. Patients who had functional voice disorder showed more higher figures than normal adults. These results suggest that Phonation Threshold Pressure and Phonation Threshold Airflow are very useful in diagnosing the voice disorder. The measured data also provided useful information for diagnosing patients with vocal fold diseases.

• 말소리와 음성과학
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• 제3권2호
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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.

• 대한후두음성언어의학회지
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• 제13권2호
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• pp.164-172
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• 2002

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

• 말소리와 음성과학
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• 제8권2호
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• pp.57-63
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• 2016

Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased $f_0$ and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

• 말소리와 음성과학
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• 제8권2호
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• pp.73-80
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• 2016

The purpose of this study was to analyze perceptual and spectral/cepstral measurements in patients with adductor spasmodic dysphonia(ADSD). Sixty participants with gender and age matched individuals(30 ADSD and 30 controls) were recorded in reading a sentence and sustained the vowel /a/. Acoustic data were analyzed acoustically by measuring CPP, L/H ratio, mean CPP F0 and CSID, and auditory-perceptual ratings were measured using GRBAS. The main results can be summarized as below: (a) the CSID for the connected speech was significantly higher than for the sustained vowel (b) the G, R and S for the connected speech were significantly higher than for the sustained vowel (c) Spectral/cepstral parameters were significantly correlated with the perceptual parameters, and (d) the ROC analysis showed that the threshold of 13.491 for the CSID achieved a good classification for ADSD, with 86.7% sensitivity and 96.7% specificity. Spectral and cepstral analysis for the connected speech is especially meaningful on cases where perceptual analysis and clinical evaluation alone are insufficient.

• 말소리와 음성과학
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• 제1권1호
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• pp.93-98
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• 2009

The aim of this study was to investigate voice characteristics of adductive spasmodic dysphonia(ADSD) by measuring electroglottal and acoustic examination at the sentence level. The clinical records of 86 ADSD female patients (age group of $20{\sim}50$ years) and the control records of 86 normal females (age group of $20{\sim}40$ years) were recorded by speech studio(Laryngograph Ltd., UK). An independent t-test was used to compare ADSD and normal group. Results were as follows. (1) Fundamental frequency($F_0$) was significantly decreased in ADSD compared with normal group. (2) Irregularity of frequency and closed quotient(CQ) was significantly increased in ADSD compared with normal group. (3) Voiceless duration increased and voiced duration was significantly decreased in ADSD compared with normal group. (4) Fricative duration was increased in ADSD compared with normal group but it wasn't significant. In conclusion, strained, tight and choked voice shows an increase of CQ, tremor voice shows an increase of irregularity of frequency and less feminine voice shows decrease of $F_0$. Increase of voiceless duration and fricative duration and decrease of voiced duration related with diminution speech intelligibility.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1991년도 제25차 학술대회 연제순서 및 초록
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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.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1976년도 제10차 학술대회연제 순서 및 초록
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• pp.87.2-87
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• 1976

1932년 Clausen이 삽관에 의한 전신마취 후에 발생한 후두육아종을 외상성 후두육아종이라고 보고한 이래 Harrison은 삽관환자의 약 4%에서 후두 및 상기도에 손상을 초래하고 그중 약 1%정도가 후두육아종을 일으켜서 이로 인하여 발성장애나 심할 때는 호흡곤란까지도 일으킬 수 있다고 하였다. 기관내 삽관은 전신마취를 하기 위하여 사용되거나 또는 인위적으로 환자의 기도를 확보하기 위한 방법의 하나로써 널리 사용되고 있으며 삽관 후 상기와 같은 합병증으로 육아종이 발생된 예는 국내외에서 점차 그 보고된 수가 증가되고 있다. 저자도 1975년 3월부터 1976년 2월까지 1년 동안에 9례의 삽관 후 발생한 후두육아종 환자를 경험하였기에 문헌적 고찰을 가하여 보고하는 바이다

• 말소리와 음성과학
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• 제3권3호
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• pp.133-140
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• 2011

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (M:F=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.