• 말소리와 음성과학
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• 제11권3호
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• pp.69-76
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• 2019

본 연구는 성대에어로빅치료법(vocal aerobic treatment, VAT)이 음성장애 환자의 음성 개선에 미치는 효과에 대해 알아보았다. 연구대상은 후두스트로보스코피, 음성검사 상 음성장애로 진단된 20명(남 13명, 여 7명)이었다. 음향학적 평가는 CSL(computerized speech lab)의 MDVP(Multi-Dimensional Voice Program)와 VRP(Voice Range Profile)를 통해 평가하였다. 공기역학적 평가는 PAS(Phonatory Aerodynamic System)를 통해 평가하였다. MDVP를 통해 치료 전 후 기본주파수(Fo), 주파수변동률(Jitter), 진폭변동률(Shimmer), 소음대배음비(NHR)의 변화를 측정하였고, VRP에서는 치료 전 후 주파수 범위(Fo range), 강도범위(Energy range)를 측정하였다. PAS에서는 치료 전 후 폐활량(FVC), 최대연장발성시간(PHOT), 평균호기류율(MEAF), 성문하압(MPAP), 음성효율성(AEFF)의 변화를 알아보았다. 후두스트로보스코피에서는 치료 전 후 양측 성대의 규칙성, 대칭성, 점막파동, 진폭 변화 소견을 알아보았다. 음성치료는 총체적 음성치료 접근법 중 하나인 VAT 프로그램을 환자별로 주 1회 실시하였다. 환자별 평균 치료 회기는 6.5회였다. 연구결과, MDVP에서는 Jitter, Shimmer, NHR이 통계적으로 유의하게 감소하였다(p<.001, p<.01, p<.05). VRP 결과, 주파수 범위에서 Hz와 Semitones이 치료 후 유의미하게 향상하였다(p<.01, p<.05). PAS 결과, FVC, PHOT에서 유의미한 향상이 나타났다(p<.01, p<.001). 후두스트로보스코피 결과 치료 후 기능적 음성장애, 인후두역류질환, 양성성대점막질환군에서 성대소견이 정상범주에 해당하였다. 따라서 VAT 프로그램은 음성장애환자의 음향학적 공기역학적 후두스트로보스코피 측면에서의 음성 개선에 효과적인 것으로 나타났다. 차후 연구에서는 동일 집단의 음성장애 환자에게 VAT 적용 연구가 필요하다고 생각된다. 또한 객관적인 음성 개선뿐만 아니라 주관적 음성 개선을 알아볼 필요가 있다. 나아가 직업적 음성사용자를 대상으로 VAT 효과에 대한 적용연구가 필요가 있다.

• 대한한방소아과학회지
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• 제29권4호
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• pp.108-118
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• 2015

Objectives The purpose of this study is to look into the methods of acupuncture for spastic cerebral palsy. Methods 27 cases of the clinical literature were selected from 43 studies about cerebral palsy and spastics. Theses literature were published between the January 2010 to September 2015 by using the China Academic Journal (CAJ) of China National Knoweldge Infrastructure (CNKI). Results Most studies mentioned the effect of acupuncture (scalp, general) or acupoint-injection, derma needle, warm acupoint. It was more effective with other herbal complex rehabilitation therapy such as acupuncture, physical therapy occupational therapy, rehabilitation, and the complex speech therapy than just the herbal therapy alone. Acupuncture of acupoint-injection has overall 86~96% of rehabilitation rate. The acupuncture was often used with the general acupuncture and scalp acupuncture. Commonly used major acupuncture points were sishencong (四神總), bohui (百會), yundongqu (運動區), and pinghengqu (平衡區), Li11, Li04, Gb39, St41. The main acupoint-injection points were fengchi (Gb21) and jiexi (St41). For the injection, brain actiator, astragalus injection, cerebroprotein hydrolysate, Vit B1, Vit B2 were commonly used. Conclusion Acupuncture and acupoint-injection have been shown as an effective treatment on spastic cerebral palsy. The acupuncture was used often with the general acupuncture and scalp acupuncture all together.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제15권2호
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• pp.132-142
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• 2004

반응성 애착 장애에 관한 미국과 영국으로부터의 대부분 논문들은 국외에서 입양한 탈억제형(Disinhibited Type) 반응성 애착장애를 보고하였다. 터키와 한국에서만 반응성 애착장애의 억제형(Inhibited Type) 아동들에 대한 보고를 하고 있는데 대부분 친부모에 의해 양육되고 있으며 그들의 증세는 자폐장애와 매우 유사하다. 반응성 애착장애의 치료, 특히 억제형의 치료에 대한 논문은 매우 드문 상태이기 때문에 저자는 1987년부터 한국의 반응성 애착장애 아동들을 치료해 온 경험을 이 논문에 자세히 기술하였다. 반응성 애착장애 환자와 그 부모들을 치료하기 위해서는 세가지 중요한 영역이 반드시 포함되어야 한다：1) 반응성 애착장애 아동에게 치료적인 환경을 조성해 주어야 한다. 2)개별 놀이치료, 엄마 놀이치료, 형제 놀이치료, 또래 놀이치료, 집단 놀이치료를 통해 반응성 애착장애 아동과 그 엄마와의 사이에 애착을 형성시켜 주어야 한다. 3) 언어치료, 인지치료, 치료교육등을 통하여 뒤진 발달을 촉진시켜 주어야 한다. 이 치료방법은 미국이나 영국을 포함한 서구에서의 다른 치료 방법보다 우리나라 환자들에게 좀더 쉽게 좀더 효과적으로 적용될 수 있을 것이다.

• 대한구순구개열학회지
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• 제6권1호
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• pp.35-42
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• 2003

PAP (Palatal Augmentation Prosthesis) may be given to the patients with dysphagia; especially, who cannot achieve tongue-palate contact. PAP fills hard palate area where the tongue cannot make contact and then the distance of tongue elevation is shortened. 1bat may be expected to improve swallowing and to prevent from aspiration. The purpose of this report is to show the effects of PAP in patients with dysphagia through the videofluoroscopic study. Oral-pharyngeal swallowing post PAP is analyzed in 2 cases; one is a person who had subarachnoid hemorrhage due to aneurysmal rupture, right hemiparesis, hydrocephalus and aphamia. And the other is a person who had squamous cell carcinoma on mouth floor and he had radical neck dissection and marginal mandibulectomy. In this report, the rate of aspiration, the transit time and length measurements of anatomical structure are examined in the each frame of videofluoroscopy. The results are as follows; 1) PAP decreased the aspiration in both cases. 2) In the cases of patients with PAP, the pharyngeal transit time was decreased.

• 말소리와 음성과학
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• 제9권4호
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• pp.107-114
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• 2017

The purpose of the current study was to compare selected acoustic and electroglottographic measures (closed quotient, pitch, and loudness) among vowel phonation, traditional voiced lip trill ($VLT_T$), modified voiced lip trill methods ($VLT_M$). A total of 21 participants without voice complaints produced 4-second long samples using each phonation method. Results indicated that mean closed quotient of $VLT_M$ was higher than that of vowel phonation and $VLT_T$, while its range and standard deviation measures were higher than those of vowel phonation. Mean, range, standard deviation, maximum of pitch measures of $VLT_M$ were higher than those of vowel phonation. Lastly, mean and maximum loudness of the $VLT_M$ were higher than $VLT_T$. In conclusion, the current data indicate the possibility to use the $VLT_M$ as a training method for singing or a strategy to facilitate generalization effect of voice therapy. Current results also reflect the necessity for further study pertaining to the long-term effect of the $VLT_M$ training method. Clinical implications are discussed.

• 대한한의학원전학회지
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• 제19권2호통권33호
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• pp.97-107
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• 2006

From the study on the relation of voice and O-jang(五臟廳), the conclusion is as follows. The function of breathing out in larynx is involved with lung and kidney. Lung press out the air, at the same time, kidney supports that to maintenance the density of air constantly. So the person who has short breathing can not make strong voice, and also if having a weak kidney in upper Cho[下蕉], their voice will be changed so very softly to cannot make hard type of voice and lingering sounds. Opening and Closing of vocal cords are controled by liver and spleen. when vocal cords are contracted, liver makes tension, whereas spleen does in slackness. So liver is likely to make high-piched sounds in tension of vocal cords, and spleen is the same to do smoothy and husky sounds through relaxing the vocal cords. In the rising condition of liver function, the temp of speech become fast, and more the pronunciation is clearer, it means that the function of thinking by spleen is operated well. Otherwise, indistinct pronunciation means that in the body seup-sa(濕邪) spreads. Also depression of emotion in speech often makes Gi(氣) of heart weaker, whereas it means regular condition of heart including Simpo(心包) that expression of emotion looks happy.

• 말소리와 음성과학
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• 제7권2호
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• pp.47-54
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• 2015

The objectives of this study are to research the frequency of depression symptom in patients with voice disorders and to investigate parameters associated with depression from voice evaluation. A hundred ninety six patients(106 males and 90 females) who had been diagnosed with voice disorders first in their lifetime were selected. All the patients were examined by laryngeal stroboscopy. For depression and voice study, personal interview, acoustic and aerodynamic analysis, voice handicap index(VHI), reflux symptom index(RSI), and beck depression index(BDI) were done respectively. Mild to severe BDI were seen in 26.2%(52 patients) of the whole patients. A BDI mean score of female patients was $8.8{\pm}7.5$ which was higher than that of male patients($5.6{\pm}6.6$), the difference observed being statistically significant(p<0.001). In the acoustic analysis, the score of sent_duration parameter was increasing in the patients with depression, which was significantly higher than the score of the patients without depression(p<0.05). In the addition, the scores of VHI and RSI were higher in the patients with depression(p<0.001). Our findings suggest that the prevalence of depression in patients with voice disorders is related to female, speaking velocity, and self-questionnaire. This result can be used for psychologically based approach to therapy.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.49-55
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• 2020

Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

• 재활복지공학회논문지
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• 제11권1호
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• pp.9-14
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• 2017

학령 전기 아동은 옹알이 단계부터 8세까지 모국어의 음운 체계를 습득하고 정상적으로 산출한다. 이 시기 청력손실은 외부 소리 자극을 수용하는데 어려움이 따른다. 청각적 수용의 문제는 언어 습득 및 발달을 지체시키고, 의사소통 장애를 일으킬 수 있다. 이외에도 학습, 사회성, 정서 발달 등에도 영향을 준다. 청력 손실은 조기 선별과 진단 및 중재가 중요하다. 그러나 그 정도가 낮거나 특정 음역에 국한된 경우 발견이 어려울 수 있고, 발견하더라도 재활 중재로 연결되기 어려운 경우가 많다. 이 연구는 학령 전기 아동에서 나타난 경도 및 중등고도 대칭성 고음급추형 감각신경성 난청의 사례를 청각학적 평가 결과 해석과 함께 의사소통 관련 문제를 분석하고, 청각 언어병리학적 재활 방향 등을 고찰하고자 한다.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.129-133
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• 2007

Background and Objectives: Nasometry is an easy, noninvasive method to obtain objective data regarding the function of velopharynx. However, because articulation errors may affect the results of nasometry, the examiner should interpret the nasalance score based on appropriate speech stimuli. The purpose of this study is to examine the difference of nasalance score between glottal and oral articulations in patients with velopharyngeal insufficiency (VPI). Materials and Method: Nineteen children between 3.4 and 12.1 years of age (mean age 5.7 years) with a confirmed VPl showing hypernasality and articulation errors (glottal stops) were included. Nasalance scores were obtained for two speech patterns of glottal and oral stops. In addition, the velopharyngeal functions were analyzed in four subjects using video nasopharyngoscopy. Results: The $mean{\pm}S.D$ nasalance scores of the glottal stops and oral stops were $42.54{\pm}16.26%$ and $25.47{\pm}16.51%$ respectively (p=.000). Six of 19 patients achieved normal nasalance scores when glottal stops changed to oral stops by the trial speech therapy. Video nasopharyngoscope confirmed that large velopharyngeal gaps can be decreased into tiny gaps or complete closure when compensatory articulations were corrected for some cases. Conclusion: Compensatory articulation errors must be corrected for the reliable interpretation of the nasalance scores that are obtained in children with velopharyngeal insufficiency, which would facilitate to make a better decision for further management of these patients.