• Journal of Pharmacopuncture
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• v.17 no.3
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• pp.57-61
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• 2014

Objectives: When a person speaks, voice problems usually include pain or discomfort and/or difficulties in terms of the pitch, the loudness and the quality of the voice. When patients with voice problems induced by stroke, Parkinson's disease, and systemic diseases involving the voice are examined, generally, of the Four Diagnoses (四診), a Diagnosis of Hearing can be used in current Korean medicine. The effects of acupuncture and herb medicine on voice problems have been reported for over 20 years. However, when it comes to improvements, objective and subjective evaluation methods need to be explained. Methods: Subjective methods for evaluating voice were studied through a literature search of old medicinal books containing Korean medicine diagnostics, and an objective evaluation method using Praat software is presented. Results: Korean medicine doctors analyze the patient's voice in clinical settings unconsciously on a daily basis. However, most voice diagnoses depend on the doctor's subjective evaluation. Voice qualities can be evaluated by using the Eight Principles (八綱), including Yin-Yang; the Five Elements (Phases); the Grade, Roughness, Breathy, Asthenic, Strained (GRBAS) score, and the Visual Analogue Scale (VAS) as subjective methods, and an acoustic analysis using the Praat program can be used as an objective method. Conclusion: A more complete voice examination can be achieved by using subjective and objective methods at the same time. For an objective explanation and management of patient's voice problems or systemic disorders, an objective method should be used in Korean medicine, which already has many subjective diagnostic methods. More research needs to be conducted, and more clinical evidence needs to be collected in the future.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.99-102
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• 2009

Inflammatory pseudotumor is an uncommon lesion with unknown etiology characterized by sclerosing inflammation which clinically and radiographically mimics a neoplastic lesion. A 47-year-old man presented with sudden headache and dysarthria. Brain CT scan revealed a $2.6{\times}2.2\;cm$ sized, round, and hyperdense mass in the anterolateral wall of the left lateral ventricular trigone. On MR imaging studies, the mass showed low signal intensity in the wall of the trigone on T2-weighted image, central mixed (iso- and high-) signal intensity with peripheral low-signal intensity on T1-weighted image. Subtle staining of left choroid plexus with irregular shaped distal branch of anterior choroidal artery was found on the cerebral angiography. These findings suggested a small tumorous lesion originated from the left choroid plexus. During the hospital days, the mass manifested as repeated hemorrhages. The mass was successfully removed via left occipital transcortical approach. The histopathological report of the specimen was hemorrhage and fibrosis, with dense lymphoplasma cell infiltration, suggestive of an inflammatory pseudotumor.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

• Speech Sciences
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• v.8 no.2
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• pp.39-48
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• 2001

The purpose of this study was to examine changes in acoustic characteristics after drinking alcoholic beverages and singing in order to establish guidelines for vocal hygiene of both singers and non-singers. 21 university students (10 males and 11 females) vocalized /a/ before drinking, after drinking and after singing. Changes in vocal range and acoustic characteristics were analyzed by Dr. Speech 4.0 (Tigers Electronics). No significant difference was observed in vocal range following drinking. However, there was statistically significant changes in vocal range after singing. We may infer that appropriate amount of singing functioning as vocal warm-up, rather than drinking alone, resulted in improvement in their abilities to lengthen vocal folds. This is directly related to the ability to produce high-pitched sounds. Changes in jitter in female voices after singing was the only acoustic factor that was significant. Changes in Shimmer and NNE was not significant either after drinking nor singing. Subjects who were judged to perform better in singing were marked by minimum acoustic changes, which may due to their well-trained vocal fold function. The results of this study may address the necessity for vocal function exercises for the patients with neurogenic voice disorders including dysarthria. The need for more extensive research with a larger number of subjects including professional voice users is also addressed.

• Speech Sciences
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• v.12 no.2
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• pp.89-99
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• 2005

The purpose of the present study were (1) to assess differences in tongue performances and speech intelligibility between normal and dysarthric speakers; and (2) to analyze the possible interrelationships between tongue strength, range of motion, and speech intelligibility in dysarthric patients. In order to measure maximum strength of anterior and lateral tongue strength, a force transducer has been designed. And a ruler was used for guaging range of motion. 'Word intelligibility test' was administered to each group. The results were analyzed by a quantitative statistical method(t test, Pearson product- moment correlation, and one-way ANOVA). The results were as follows; (1) dysarthric speakers showed significantly poorer performance than the normal in the tongue strength, range of motion, and speech intelligibility tasks; (2) the correlation between speech intelligibility and instrumental tongue performance was high in the dysarthric group; and (3) instrumental assessment was coincide with perceptual judgement of dysarthric tongue performance. The present investigation demonstrated that tongue weakness is causally related to articulation deficits in dysarthric. The clinical use of the force transducer would help a speech pathologist to quantify the degree of tongue weakness.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.149-151
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• 2007

This study was designed to investigate fast ab/adduction rate of articulation valves in normal adults. The measurement of fast ab/aduction rate has traditionally been used for assessment, diagnosis and therapy in patients who suffered from dysarthria, functional articulation disorders or apraxia of speech. Fast ab/adduction rate shows the documented structural and physiological changes in the central nervous system and the peripheral components of oral and speech production mechanism. Fast ab/adduction rates were obtained from 20 normal subjects by producing the repetition of vocal function (/ihi/), tongue function (/t${\wedge}$/), velopharyngeal function (/m/), and labial function (/p${\wedge}$/). The Aerophone II was used for data recording. The results of finding as follows: average fast ab/adduction rates were vocal function(6.21cps), tongue function(7.42cps), velopharyngeal function(5.23cps), labial function (6.93cps). The results of this study are guidelines of normal diadochokinetic rates. In addition, they can indicate the severity of diseases and evaluation of treatment.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.741-749
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• 2016

Objective: To evaluate the effect of Sukjihwangbogan-tang-gagam (熟地黃補肝湯加減) in a patient with delayed vascular chorea. Methods: A vascular chorea patient was treated with acupuncture, moxibustion, and herbal medicine (Sukjihwangbogan-tang-gagam). Results: Improvements in the Unified Huntington’s Disease Rating Scale (UHDRS), UFMG Sydenham’s Chorea Rating Scale (USCRS) (especially the scale of Activity of Daily Living (ADL)) (dysarthria 2→0, tongue protrusion 3→1, chorea 3→1, handwriting 3→1), and a Visual Analogue Scale (VAS) (8→2) were observed after the Sukjihwangbogan-tang-gagam treatment. Conclusions: Sukjihwangbogan-tang-gagam may be an effective treatment for patients with delayed vascular chorea.

• Phonetics and Speech Sciences
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• v.9 no.3
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• pp.67-74
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• 2017

An increase in speech intelligibility has been found in Clear Speech compared to conversational speech. Clear Speech is defined by decreased articulation rates and increased frequency and length of pauses. The objective of the present study was to investigate improvement in immediate speech intelligibility in 10 patients with Parkinson's disease (age range: 46 to 75 years) using Clear Speech. This experiment has been performed using the Phonatory Aerodynamic System 6600 after the participants read the first sentence of a Sanchaek passage and the "List for Adults 1" in the Sentence Recognition Test (SRT) using casual speech and Clear Speech. Acoustic and aerodynamic parameters that affect speech intelligibility were measured, including mean F0, F0 range, intensity, speaking rate, mean airflow rate, and respiratory rate. In the Sanchaek passage, use of Clear Speech resulted in significant differences in mean F0, F0 range, speaking rate, and respiratory rate, compared with the use of casual speech. In the SRT list, significant differences were seen in mean F0, F0 range, and speaking rate. Based on these findings, it is claimed that speech intelligibility can be affected by adjusting breathing and tone in Clear Speech. Future studies should identify the benefits of Clear Speech through auditory-perceptual studies and evaluate programs that use Clear Speech to increase intelligibility.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.149-151
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• 2016

Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical symptoms associated with CM-I, including suboccipital headache, weakness in the upper extremities, facial numbness, loss of temperature sensation, ataxia, diplopia, dysarthria, dysphagia, vomiting, vertigo, nystagmus, and tinnitus. Syncope is one of the rarest presentations in patients with CM-I. There are many hypotheses regarding the causes of syncope in patients with CM-I; however, the mechanisms are not clearly understood. Although surgical decompression for CM-I in patients with syncope has yielded good clinical results in some studies, such cases are rarely reported. We report a case of orthostatic syncope in a patient with CM-I who was treated with surgical intervention.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1245-1249
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• 2001

Germinomas of the central nervous system are rare embryonal tumors(accounting for less than 1% of intracranial neoplasms) that may be located in the pineal region, in the floor of the third ventricle, or in the suprasellar area. We report a case of germinoma developed in periventricular deep white matter without pineal region tumors or suprasellar masses. The 19-year-old male patient presented with slowly progressing headache, dizziness, photophobia, and dysarthria. Initial brain MRI revealed a irregular and dense enhancement from lateral ventricles to 4th ventricle. The stereotactic biopsy of tumor and histologic examination revealed the germinoma. Craniospinal axis radiation therapy was performed. After radiation therapy patient was improved and no neurologic sequelae was seen at discharge. Periventricular germinomas without pineal or suprasellar lesion are very rare. The radiation therapy, as in our case, is beneficial as with other intracranial germinomas. Stereotactic biopsy of periventricular germinoma provides precise pathologic diagnosis and thus allows more specific management.