• 대한후두음성언어의학회지
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• 제30권2호
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• pp.101-106
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• 2019

Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.118-123
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• 2019

Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권1호
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• pp.48-58
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• 2001

After performing mandibular setback surgery, we found some changes in patterns and organs of speech. This investigation was undertaken to investigate the aspect and degree of speech patterns according to the amount of surgical setback in mandibular prognathic patients. Thirteen patients with skeletal Class III malocclusion were studied preoperative and postoperative over 6 months. They had undergone the mandible setback operation via bilateral sagittal split ramus osteotomy(BSSRO). We split the patients into two groups. Group 1 included patients whose degree of mandibular setback was 6mm or less, and Group 2 above 6mm. Control group was two adults wish normal speech patterns. A phonetician performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the patients and the acoustic characteristics of the plosives, fricatives, and flaps were analyzed with a phonetic computer program (Computerized Speech Lab(CSL) Model 4300B(USA)). The results are as follows: 1. Generally, Patients showed longer closure duration of plosives, shorter VOT(voice onset time) and higher ratio of closure duration against VOT. 2. Patients showed more frequent diffuse distribution than the control group in frication noise energy of fricatives. 3. In fricatives, frequency of compact from were higher in group 1 than in group 2. 4. Generally, a short duration of closure for /ㄹ/ was not realized in the patient's flaps. Instead, it was realized as fricatives, sonorant with a vowel-like formant structure, or trill type consonant. 5. Abnormality of the patient's articulation was reduced, but adaptation of their articulation after surgery was not perfect and the degree of adaptation was different according to the degree of surgical setback.

• 대한후두음성언어의학회지
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• 제27권2호
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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.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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• pp.103-105
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• 2003

After fifteen years of development, Magnetic Resonance (MR) technology for human imaging and spectroscopy is reaching a refined state with FDA approved 3T clinical products from Siemens, GE, and Philips. Broker has cleared CE approval with a 4T system. Varian supports a 4T system platform as well. Shielded magnets are standard at 3T from GE, Oxford, Magnex, and IGC. A shielded 4T whole body magnet is available from Oxford. Stronger switched gradients and dynamic shim coils, desired at any field, areespecially useful at higher static magnetic fields B0. In addition to the higher currents required for higher resolution slice or volume selection afforded by higher SNR, whole body gradient coils will be driven at increasing slew rates to meet the needs of new cardiac applications and other requirements. For example 3T and 4T systems are now being equipped with 2kV, 500A gradient coils and amplifiers capable of generating 4G/cm in 200msec, over a 67+/-cm bore diameter. High field EPI applications require oscillation rates at 1 kHz and higher. To achieve a benchmark 0.2 ppm shim over a 30cm sphere in a high field magnet, at least four stages of shimming need to be considered. 1) A good high field magnet will be built to a homogeneity spec. falling in the range of 100 to 150 ppm over this 30cm spherical "sweet spot" 2) Most modern high field magnets will also have superconducting shim coils capable of finding 1.5 ppm by their adjustment during system installation. 3) Passive ferro-magnetic shimming combined with 4) active, high order room temperature shim coils (as many as five orders are now being recommended) will accomplish 0.2 ppm over the 30cm sphere, and 0.1 ppm over a human brain in even the highest field magnets for human studies. Safety concerns for strong, fast gradients at any B0 field include acoustic noise and peripheral nerve stimulation. One or more of the mechanical decoupling methods may lead to quieter gradients. Patient positioning relative to asymmetric or short gradient coils may limit peripheral nerve stimulation at higher slew rates. Gradient designs combining a short coil for local speed and strength with a longer coil for coverage are being developed for 3T systems. Local gradients give another approach to maximizing performance over a limited region while keeping within the physiologically imposed dB0/dt performance limits.

• 한국콘텐츠학회논문지
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• 제10권5호
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• pp.285-295
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• 2010

소음에너지가 시작되는 주파수 즉, 선행 모음이 끝나는 지점을 절삭주파수라 한다. 본 연구는 구개파열아동과 정상 아동을 대상으로 마찰음과 파찰음의 절삭주파수 값, 후행모음에 따른 절삭주파수 값, 절삭주파수와 비음 치의 상관관계를 알아보고자 하였다. 연구의 대상은 서울 및 경기 지역에 거주하고 있는 아동으로 구개파열 진단을 받고, 생활연령이 6세 이상인 아동, 생활연령과 성별을 일치시킨 6세 이상 정상아동 각각 6명씩 총 12명이었다. 실험과제는 마찰음 및 파찰음의 무의미음절 환경과 문장 환경(50환경)으로 구성하였다. 구개파열 아동 집단은 정상 아동 집단에 비해 마찰음, 파찰음의 절삭주파수 값이 무의미음절 환경 및 문장 환경 모두에서 낮게 나타났다. 구개파열 아동과 정상 아동의 절삭주파수와 비음치 간 상관관계 연구 결과 정상 아동 집단에서는 무의미음절 환경과 문장 환경 모두에서 통계적으로 유의한 상관관계를 보이지 않았으나 구개파열 아동 집단에서는 문장 환경에서 통계적으로 유의한 상관관계를 보였다.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.118-122
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• 2017

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.122-126
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• 2015

Background and Objective : Laryngeal microscopic surgery (LMS) is popular method to treat for vocal polyp. There is not always the improvement of the voice after operation. Many methods have been developed for better outcome of the surgery. The purpose of this study is to investigate the effect of the triamcinolone injection at vocal cord during LMS. Materials and Methods : The medical records of 28 patients, received LMS under diagnosis of vocal polyp, were retrospectively reviewed. The patients were divided into two groups depending on whether triamcinolone injected or not (case group : Triamcinolone-injected group, control group : Triamcinolone-not injected group). The quality of voice was evaluated by GRBAS scale, fundamental frequency (Fo), jitter, shimmer and NHR (Noise to harmonic ratio) at previous operation, 4 weeks after operation, 8 weeks after operation. Each voice analysis factor was compared between case group and control group by Independent t-test. Results : The mean differences of each voice analysis factor. The mean difference of Jitter, Shimmer, NHR in case group were lower than in control group, and mean difference of GRBAS scale in case group were higher than in control group. These differences were not significant (p>0.05). Conclusion : Though there was a tendency of better voice outcome in patients of triamcinolone-injection, it may not be concluded that the triamcinolone injection is helpful for better voice outcome in surgery of vocal polyp due to statistical insignificance.

• 한국철도학회논문집
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• 제19권1호
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• pp.11-19
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• 2016

고속열차의 주위의 유통특성은 열차의 항력 및 소음 등 전반적인 특성에 영향을 주는 인자이다. 특히 고속열차의 유동 경계층은 유동 특성에 큰 영향을 미치는데, 기존의 연구는 주로 열차 주행 시 발생하는 측면 열차풍이나 열차의 하부 열차풍에 대한 연구가 주로 이루어져왔다. 열차 상부 경계층의 측정 및 분석도 매우 중요한데, 이는 열차 상부에 위치한 팬터그래프의 유동입력 조건에 상부 경계층이 가장 큰 영향을 미치기 때문이다. 본 연구에서는 차세대 고속열차의 1/20 축소모델을 이용하여 열차의 상부경계층 조건을 확인하였고, 그 결과를 풀 스케일 전산유체해석결과와 비교하여 그 타당성을 검증하였다. 이를 통하여 팬터그래프로 유입되는 유동속도는 열차 주행속도의 약 85% 수준임을 확인하였으며, 또한 열차 길이방향에 따른 유동 경계층의 성장특성을 분석하였다.

• 지구물리와물리탐사
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• 제13권4호
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• pp.336-348
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• 2010

한-중 해저터널 후보지로 선정된 대천-원산도 지역의 부지조사를 위해 버블펄서(Bubble pulser) 음원을 이용한 단일채널 탄성파 탐사와 시추조사가 2008년 및 2009년에 수행되었다. 본 연구는 이 단일채널 탐사자료를 정밀 처리하고 시추자료와 연계하여 후보지역의 해저터널 안정성 평가와 시공설계에 필요한 기반암 심도 및 특성을 분석하는데 목적이 있다. 이를 위해 일반적으로 다중채널 탄성파자료에 적용되던 자료처리 기법 중 주파수-파수영역 필터링(F-K filtering)을 적용하여 교류전원잡음 등을 제거하고, 중합후 심도구조보정(post-stack depth migration) 기법을 적용하여 심도단면을 제작하였다. 수행 결과 단일채널 탄성파자료로부터 향상된 심도영역단면을 제작할 수 있음을 확인하였고, 시추자료와 통합 해석을 통하여 조사지역의 개략적인 기반암 분포와 지질특성을 파악할 수 있었다. 단층, 파쇄대 등의 세밀한 구조 파악은 버블펄서 음원과 단일채널 자료의 특성상 어려웠으나, 좀 더 해상도가 높은 탄성파자료가 있을 시 가능할 것으로 보인다. 이에 향후 해저터널 탐사 시 고해상자료를 얻기 위한 추천사항을 수록하였다.