• 대한후두음성언어의학회지
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• 제7권1호
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• pp.56-60
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• 1996

The vocal efficiency(VE) can be calculated as the ratio of acoustic power to aerodynamic power. It relates to the vocal intensity, air Sow rate and subglottic pressure. In this study, we treated 20 cases of vocal polyps and 10 cases of vocal nodules by way of laryngo-microsurgery or laser laryngo-microsurgery. The VE was measured preoperatively and postoperatively in all cases. The results showed that there was a significant improvement of VE postoperatively than that of preoperative measurement(p＜0.01) in vocal Polyp group. However, there was no significant difference(p＞0.05) in vocal nodule group. Through comparing the results, we obtained the conclusion : The laryngo-microsurgery is the reliable method of management for the vocal polyps, but f3r the vocal nodules, the laryngo-microsurgery should be selected after other more conservative approaches fail to produce the desired results.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.98-103
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• 2000

Background and Objectives : The etiology and pathophysiology of spasmodic dysphonia is yet unknown. This study was performed to determine if any laryngeal aerodynamic parameter distinguish the voice of patient diagnosed as having adductor spasmodic dysphonia from individuals with normal voice production and to investigate the pathophysiology of spasmodic dysphonia. Materials and Methods : fifteen women diagnosed as having adductor spasmodic dysphonia and fifteen normal control women participitated in this study Maximum phonation time, mean air flow rate, subglottic pressure, vocal efficiency, Vfo, NHR, VTI, FTRI, ATRI, Jitter percent, Shimmer percent were obtained from the participants using 'MDVP(multi-dimensional voice program)' of CSL(Computerized Speech lab, Kay Elemetrics, Co., Model No. 4300), and 'maximum sustained phonation' and 'IPIPI test' of AP II(Aerophone II, Kay Elemetrics, Co., Model 6800). Results : T-test statistical analysis revealed statistically different values for vocal efficiency, Vfo, NHR, MPT, litter percent, Shimmer percent between the spasmodic dysphonia group and the control group. Conclusions : Spasmodic dysphonia affects the ability of the laryngeal mechanism to function effectively. Results from our study demonstrate that certain aerodynamic and acoustic parameters distinguish adductor spasmodic dysphonia from normal voice.

• 중환자간호학회지
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• 제2권2호
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• pp.42-55
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• 2009

Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.70-70
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• 1993

발성시 기본주파수의 조절은 윤상갑상근과 갑상피열근의 적절한 수축 작용에 의한다는 사실은 잘 알려져 있다. 윤상갑상근의 기능은 자세히 알려져 있는데 반하여, 갑상피열근의 기능은 현재까지 생체 발성 모형이 개발되지 않아 자세한 내용을 알 수 없었기에, 저자들은 갑상피열근 기능 검사를 위한 생체 발성 모형을 고안하였다. 개의 갑상연골에 창문을 만들어서, 반회신경의 마지막 분지인 갑상피열 분지를 확인, 절단하고 전극으로 자극하도록 하였다. 유발된 음성에 대한 갑상피열근 수축의 효과는 성역의 결정에 중요한 결정 요소로 작용되며, 가성 (falsetto) 영역에서 갑상피열근의 수축은 기본주파수 하강을 초래하고, 지성 (modal) 영역에서는 반대로 기본주파수가 상승되었다. 한편, 갑상피열근의 자극에 따라 성문하압은 증가되고 성문개대율 (OQ) 은 감소되었다.

• 말소리와 음성과학
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• 제7권4호
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• pp.93-99
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• 2015

In case of PAS test, the air is sometimes leaked although the mask is tightly attached to the face, which is not reliable on the measured values. Therefore, this study aimed to assist the clinical practice suggesting the test method of PAS without air leakage. In the healthy subjects with 12 males and 12 females over 19 years old, three types of tests were performed on the voicing efficiency among the protocol of PAS Model 6600. They are; first, to attach the mask tightly to the face holding the handle of PAS with the subject's two hands (Method 1); second, to attach the mask tightly to the face holding the handle of PAS with the subject's one hand and pushing the body of PAS strongly with the other hand (Method 2); and third, to attach the mask tightly to the face pushing the upper part of the mask by the tester when the subject attached the mask to his or her face holding the handle of PAS with two hands (Method 3). Upon the study analyses, the mean negative pressure, the mean phonogram, subglottic air pressure, and voicing efficiency were shown to be statistically significantly different during PAS test in males depending on the methods. (p<.05) In case of females, only the target airflow rate showed significant difference depending on the methods during PAS test. (p<.001) In conclusion, Method 2 enhanced the noise level and strength while Method 1 was likely to leak the air more compared to the other two methods in males. In case of females, Method 1 showed significant leakage of the air flow. Not to allow the air flow leakage without affecting the outcome of PAS test, it will be the most useful for the tester to push the mask to the subject's face tightly (Method 3).

• 음성과학
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• 제5권1호
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• pp.121-139
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• 1999

Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.5-11
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• 1999

최근 음성장애에 관한 관심이 높아지면서 성대질환 내지는 후두질환의 정확한 진단을 위한 발성기능의 측정이 더욱 중요시되기에 이르렀다 이에 본 연구에서는 정상 한국인 남자 81명, 여자 76명과 성대용종 환자 남자 78명, 여자 65명을 대상으로 공기역학적 검사 중 컴퓨터화된 측정기구와 기류저지법으로 최대발성지속시간, 발성기류량, 평균호기류율, 및 성문하압을 연령별 및 성별에 따라 평균치를 측정, 이를 비교 분석하였다. 최대발성지속시간은 정상인 남자가 20.6${\pm}$6.34초, 여자가 17.2${\pm}$4.20초였고, 성대용종 환자에서 남자가 13.1${\pm}$4.26초, 여자가 11.6${\pm}$4.43초였다. 평균호기류율은 정상인 남자가 170.0${\pm}$67.00ml/sec, 여자가 131.1${\pm}$49.03ml/sec였고, 성대용종 환자에서 남자가 255.7${\pm}$216.52ml/sec, 여자가 183.24${\pm}$107.16ml/sec였다. 발성기류량은 정상인 남자가 3179.0${\pm}$648.94ml. 여자가 2144.1${\pm}$650.81ml였고, 성대용종 환자에서 남자가 2905.8${\pm}$1295.35ml, 여자가 1904.4${\pm}$1068.59ml였다 성문하압은 정상인 남자가 4.0${\pm}$1.88cm$H_2O$, 여자가 3.5${\pm}$4.20cm$H_2O$였고, 성대용종 환자에서 남자가 4.2$\pm$1.48cm$H_2O$, 여자가 3.9${\pm}$1.12cm$H_2O$였다. 성대용종 환자에서 통계학적으로 유의성있게 최대발성지속시간은 감소하고, 평균호기류율은 증가하였으며, 발성기류량과 성문하압은 여자환자에서만 의미 있게 각각 감소하거나 증가하였다. 이상의 결과는 정상인과 성대용종 환자에 있어서 객관적인 공기역학적 검사결과를 보여주며 이는 성대용종 환자의 음성이상에 대한 상태판정이나 치료 후 효과 판정에 기본자료로 이용할 수 있을 것으로 생각된다.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.141-144
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• 2004

Background and Objectives : To compare acoustic, aerodynamic analysis of voice and intelligibility score in patients with near-total laryngectomy and implantation of Provox prothesis. Material and Methods : In order to evaluate the voice characteristics, acoustic, aerodynamic parameter and speech intelligibility were measured in 5 patients after near-total laryngectomy, 5 patients after implantation of Provox prosthesis with total bility were measured in 5 patients after near-total laryngectomy, 5 patients after implantation of Provox prosthesis with total laryngectomy and 10 adults normal speaker. Acoustic analysis was carried out using CSL and aerodynamic analysis was carried out using Aerophon II. Speech sample was recorded and 10 listener was scored for speech intelligibility using a percentage of words correctly identified. Results. Fundamental frequency($F_0$), intensity, jitter, shimmer, maximal phonation time(MPT), subglottic air pressure were used for parameters for voice analysis. There were no significant difference between two group except on fundamental frequency and shimmer. The fundamental frequency was higher in patients with near-total laryngectomy and shimmer was higher in patients after implantation of Provox prosthesis with total laryngectomy. In addition, speech intelligibility was no significant difference between two groups. Conclusion : This results confirm that near-total laryngectomy and implantation of Provox prosthesis provides good voice rehabilitation.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.38-42
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• 2008

Background and Objectives : This study was performed to investigate the perceptual and aerodynamic characteristics and the relation between vocal efficiency and the severity of strained voice. of adductor spasmodic dysphonia. Materials and Methods : 13 female patients with adductor spasmodic dysphonia were examined and compared with 10 normal female control group. MPT, MFR, Psub, Sound Intensity, VE(vocal efficiency) were obtained using PAS(Phonatory Aerodynamic System). GRBA(S) scale was used for Perceptual evaluation. Results : Psub(subglottic pressure) of SD was significantly higher than normal group. MPT, MFR, Sound Intensity, VE were not significantly different between two groups. Correlation between VE and 'S'(strained) was not significant. Conclusion : The results of this study show that certain aerodynamic parameters(Psub) distinguish adductor spasmodic dysphonia from normal voice.

• 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.