• 말소리와 음성과학
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• 제6권3호
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• pp.3-12
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• 2014

Larynx plays an important role in phonation and protection of the respiratory tract during swallowing. The reduced anatomical and physiological function in elevation of larynx and glottis closure can cause problems in voice and swallowing. The present study investigated the Korean version of handicap index of dysphagia in elderly Koreans. Therefore, 60 normal elderly Koreans ranged from 65 to 95 and 20 normal Korean young adults aged from 20 to 25 were participated in this study to compare total (T), physical (P), functional (F), and emotional (E) index scores between two groups as well as among sub groups (60s, 70s, 80s) in elderly. For swallowing, total and sub dysphagia handicap index (DHI) scores, voice quality during /a/phonation following swallowing (saliva and water), intensity of coughing, and L-DDK were measured. The results showed that functional (P), physical (P), emotional (E) scores as well as total (T) score were significantly different between young adults and old adults in DHI(p<.05). Additionally, there was a negative correlation between total DHI score and intensity of coughing (r=-.51) as well as L-DDK (r=-.70). These findings suggest that a slow rate in vocal fold adduction and reduced intensity of coughing in the elderly affect swallowing function. Thus, recently translated Korean version of DHI may be useful as supplement in evaluating the swallowing problems in elderly people.

• Journal of Yeungnam Medical Science
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• 제23권2호
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• pp.227-231
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• 2006

기도가 닫힌 상태에서 강하게 숨을 뿜어내는 발살바법은 망막의 정맥압을 상승시키고 이에 따라 망막 출혈을 유발시킬 수 있다. 힘든 배변을 경험한 55세 남자가 우안의 중심시력 감소로 인해 본원을 방문하였다. 전신적인 질환으로 고혈압, 만성 변비를 앓고 있었고 동공을 산대하여 정밀 안저검사를 한 결과 유두 한 개 정도 크기의 망막전 출혈과 황반와주위로 작은 크기의 망막내 출혈이 관찰되었다. 특별한 치료없이 망막 출혈은 자연 흡수되어 시력은 정상으로 회복되었다. 배변으로 인해 급작스런 시력감퇴를 나타낸 발살바 망막증을 경험하였기에 보고하는 바이다.

• 한국전산유체공학회:학술대회논문집
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• 한국전산유체공학회 2008년도 춘계학술대회논문집
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• pp.21-24
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• 2008

The present study numerically investigates the glottal airflow characteristics as well as acoustic features of phonation fully coupled with dynamic behavior of vocal folds. The vocal folds are described by a low-dimensional body-covered model characterized by bio-mechanical parameters such as glottal width, vocal folds stiffness, and subglottal pressure. The flow in the vocal tract is modeled as an incompressible, axisymmetric form of the Navier-Stokes equations (INS), while the acoustic field is predicted by the linearized perturbed compressible equations (LPCE). The computed result shows that a two-mass model of vocal folds is sufficient to reproduce temporal variations in oral airflow and glottis motion produced by female speakers. It is also found that i) the glottal width has a significant effect on the amplitude of glottal flow, and thus on the amplitude of acoustic wave in the vocal tract, ii) the vocal fold tension is the main control parameter for the fundamental frequency of phonation, iii) the subglottal pressure plays an appreciable role on reproduction of the self-sustained oscillation of vocal folds, and iv) the strength of pulsating airflow and vortical structures are primarily affected by glottal width and subglottal pressure, and are closely related to pitch, loudness, and voice quality. Finally, more comprehensive explanation about the difference between one- and two-mass models is presented with discussion of effectiveness of vocal folds oscillation and voice quality.

• 음성과학
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• 제9권4호
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• pp.113-130
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• 2002

Measurements were made of pressure rise time (PoRT), voice cessation time, flattened peak intraoral air pressure (Po), pressure static time (PoST), pressure-fall time and the duration of oral closure as four English speakers uttered isolated nonsense $V_{1}CV_{2}$ words containing /b/ and /p/ ($V_{1}=V_{2}$ and the V was /$\alpha$/), with stress on either $V_{1}orV_{2}$ alternately. The hypothesis tested was: The tense stop consonant. will be characterized either by a higher Po or a longer PoST, and/or by both against lax. Findings: (1) PoRT was significantly greater in /b/ than /p/, (2) the voiceless stop /p/ produced generally greater mean Po, averaged across five tokens, than its voiced counterpart /b/, but statistically insignificant, and (3) altogether, across stress, tokens and subjects, the difference in the calculated pressure static time (PoSTc), i.e., PoST + PoRT, between /p/ and /b/ was highly significant (p $\leq$ 0.003). Although further investigations remain to be taken, the results strongly supported the linguistic hypothesis of tense-lax distinction, with /b/ being lax and /p/ tense. Airflow resistance at the glottis and supraglottal air volume are assumed to be responsible for much of difference in PoRT between /p/ and /b/. The PoSTc reflecting, although indirectly, the respiratory efforts during the oral closure of a stop, was a convincing phonetic parameter of the consonantal tenseness based on respiratory efforts. The effects of stress on Po and PoSTc were inconsistent, and the shorter PoRT than consonantal constriction interval was always accompanied by Po and PoST.

• 대한두경부종양학회지
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• 제15권1호
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.21-27
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• 1997

Total laryngectomy has become an usual treatment for any advanced carcinoma of the laynx, but most patients who have undergone total laryngectomy have shown permanant disability in voice production. I compared the first three formant frequencies estimated from MRI to those measured directly from speech data of the T-E patients and the normal. It was to estimate the accuracy of MRI and to compare the vocal tract shape of the normal to T-E patients. The obtained results were as follows : 1. The middle sagittle section of the MRI represents vocal tract well during pnonation. The vocal tract shape of the T-E shunt patients are lack of pharyngeal space and superior space of the glottis. 2. The length of the normal subject's vocal tract is 17 cm. For the T-E shunt patients, the length from lip to shunt opening is 17.5 cm in case 1, and 18.5 cm in case 2. That of the true resonante chamber is 13 cm and 13.5 cm for each case respectively. 3. T-E shunt patients phonated strained voice. The intensity of the higher formant frequency decreased especially in /o/, /u/. 4. The vocal tract is shortened during the phonation by T-E shunt patients. In case of /e/ and /i/, front cavities are constricted while back cavities are shortened. 5. The pseudoglottis of the T-E shunt patients is located at $14{\sim}15\;cm$ below from lips.

• The Korean Journal of Pain
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• 제8권1호
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• pp.131-134
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• 1995

Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

• 대한두경부종양학회지
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• 제29권2호
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• pp.58-61
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• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• 말소리와 음성과학
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• 제4권2호
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• pp.95-104
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• 2012

Thyroidectomy patients may have vocal paralysis or paresis, resulting in a breathy voice. The aim of this study was to investigate the aerodynamic and acoustic characteristics of a breathy voice in thyroidectomy patients. Thirty-five subjects who have vocal paralysis after thyroidectomy participated in this study. According to perceptual judgements by three speech pathologists and one phonetic scholar, subjects were divided into two groups: breathy voice group (n = 21) and non-breathy voice group (n = 14). Aerodynamic analysis was conducted by three tasks (Voicing Efficiency, Maximum Sustained Phonation, Vital Capacity) and acoustic analysis was measured during Maximum Sustained Phonation task. The breathy voice group had significantly higher subglottal pressure and more pathological voice characteristics than the non breathy voice group. Showing 94.1% classification accuracy in result logistic regression of aerodynamic analysis, the predictor parameters for breathiness were maximum sound pressure level, sound pressure level range, phonation time of Maximum Sustained Phonation task and Pitch range, peak air pressure, and mean peak air pressure of Voicing Efficiency task. Classification accuracy of acoustic logistic regression was 88.6%, and five frequency perturbation parameters were shown as predictors. Vocal paralysis creates air turbulence at the glottis. It fluctuates frequency-related parameters and increases aspiration in high frequency areas. These changes determine perceptual breathiness.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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• pp.475-476
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• 2007

Electroglottography (EGG) is a technique used to register laryngeal behavior indirectly by a measuring the change in electrical impedance across the throat during speaking. However, EGG waveform is affected by laryngeal muscles which fluctuate the vocal cords, and which result in baseline wander. It is required to reduce baseline wander in EGG waveform, because EGG waveform is used for input signal of nonlinear speech synthesizer in next chapter. In vocal cords, the abduction-adduction of glottis is mainly controlled by the posterior cricoarytenoid (abductor) and interarytenoid (adductor) muscles respectively. Empirical Mode Decomposition method was adopted in cancellation of EGG waveform baseline wandering, and showd better performance than that of high pass filter with 500 order.