• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.115-126
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• 2006

Background and Objectives : Training of breath support and laryngeal muscles control are important components in the development of the singing voice. The purpose of this study is to compare characteristics of respiratory and phonatory control on pitch, loudness, register change with untrained males and trained male singers. Materials and Methods : The 11 untrained males and 11 trained male singers participated. Closed Quotient(CQ), fundamental frequency (fo) and relative volume contribution of the rib cage (in percentage rib cage, % RC) and relative volume contribution of abdomen (in percentage abdomen, % AB) were measured during various pitch, loudness, register tasks using /a/ vowel phonation : Legato, staccato with C3-D3-E3-F3-G3 notes and crescendo and decrescendo with C3 note as well as modal register with C3 and falsetto register with C4 note using an integrated analysis system of Respiration, EGG and Voice. Results : (1) When pitch increased with legato task, loudness also increased in untrained male group but maintained in trained male singers. CQ was also increased both untrained and trained male singers but it was not significantly different ($p>.05$). The abdomen contribution to lung volume were significantly predominant both in inhalation and exhalation in trained males singers ($p<.05$). (2) When pitch increased with staccato task, CQ was not significantly different in untrained but significantly different in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$) (3) When loudness increased with crescendo, fo was significantly increased with increasing CQ in untrained males but fo was relatively consistent with increasing CQ in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). (4) Most male singers were able to change register from modal to falsetto register, but untrained males were not. Thus, CQ was significantly different between modal and falsetto register in trained male singers ($p<.05$). The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). Conclusion : Male singers were superior to untrained males in coordination of respiratory and phonatory control on pitch, loudness, register change. Implication are offered regarding how the results might be applied to the voice therapy as well as singing training.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.212-222
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• 2018

Background and Objectives : The purpose of this study was to compare the measured values of acoustic and auditory perceptual assessments between normal and functional dysphonia (FD) groups. Materials and Methods : 102 subjects with FD and 59 normal voice groups were participated in this study. Mid-vowel portion of the sustained vowel /a/ and two sentences of 'Sanchaek' were edited, concatenated, and analyzed by Praat script. And then auditory-perceptual (AP) rating was completed by three listeners. Results : The FD group showed higher acoustic voice quality index version 2.02 and version 3.01 (AVQIv2 and AVQIv3), slope, Hammarberg index (HAM), grade (G) and overall severity (OS), values than normal group. Additionally, smoothed cepstral peak prominence in Praat (PraatCPPS), tilt, low-to high spectral band energies (L/H ratio), long-term average spectrum (LTAS) in FD group were lower than normal voice group. And the correlation among measured values ranged from -0.250 to 0.960. In ROC curve analysis, cutoff values of AVQIv2, AVQIv3, PraatCPPS, slope, tilt, L/H ratio, HAM, and LTAS were 3.270, 2.013, 13.838, -22.286, -9.754, 369.043, 27.912, and 34.523, respectively, and the AUC of each analysis was over .890 in AVQIv2, AVQIv3, and PraatCPPS, over 0.731 in HAM, tilt, and slope, over 0.605 in LTAS and L/H ratio. Conclusions : In conclusion, AVQI and CPPS showed the highest predictive power for distinguishing between normal and FD groups. Acoustic analyses and AP rating as noninvasive examination can reinforce the screening capability of FD and help to establish efficient diagnosis and treatment process plan for FD.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.26-31
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• 1996

Radiation therapy in T1 glottic cancer offers an excellent cure rate with preservation of voice. From 1983 to 1992 eighty nine patients with TNM staged T1N0M0 invasive squamous cell carcinoma of the glottis were treated at the Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 84 men and 5 women with median age of 59 years. All patients were treated either with Co-60 teletherapy unit or 4MV linear accelerator with an median dose of 6400 cGy(6000-7000 cGy), 200 cGy per day, 5 days in a week. Fourteen local failures have been observed and the median time to local recurrence was 17 months. There were no nodal failure without local recurrence or distant metastases. The 5 year local control rate was 84.3%. The 5 year actuarial surivival rate and the 5 year disease free survival rate were 89.2%, 87.5%, respectively. The 5 year actuarial survival rate and the 5 year disease free survival rate of the nineteen patients with anterior commissure involvement were 77.8% and 74.5% which were lower than those of seventy patients without anterior commissure involvement(91.6%, 90.6%)(p < 0.05). Among the several influencing factors, anterior commissure involvement was the significant prognostic foctor. Final local control rate, taking into account the salvage surgery, was 89.9% at 5 years.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.2
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• pp.156-162
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• 2014

A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.

• Journal of East-West Nursing Research
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• v.6 no.1
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• pp.37-45
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• 2001

The purpose of this study was to identify the effect of hand acupuncture for reduction of dysmenorrhea. 71 female middle school and high school students were selected as subjects from April to May 2001, among which 38 students consisted of the experimental group while 22 students were the control group by convenient assignment. The experimental group participated in hand acupuncture treatment. The experimental treatment was to puncture corresponding points(A4, A5, J1, J3, J23, H2, F7) on both the palm and back of a hand with disposable acupuncture needles and to remove needles after 20-30 minutes' recess during which the subjects reposed themselves on bed. The collected data were processed using the SPSS PC Program and analyzed using $X^2test$ and The results of this study were as follows 1. The symptoms of premenstrual syndrome have decreased, but no significant differences were statistically observed between hand-acupunctured group and non-hand acupunctured group. 2. Subjective pain degree has decreased after hand acupuncture. 3. As for objective pain degree, a significant reduction in voice change was observed between two groups. Facial expressional changes and perspiration degree reduced but showed no significant statistically changes between two groups. 4. Comfort has increased after hand acupuncture. These results suggest that the hand acupuncture therapy works effectively on easing menstrual pain and symptoms as well as partially on reducing discomfort. It is particularly efficacious for a reduction in subjective pain and facial expressional changes in positive respect. Therefore the hand acupuncture therapy can be considered as an independent nursing intervention for dysmenorrhea reduction.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.121-129
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• 2019

PURPOSE: This study was conducted to measure the effects of cervical stabilization exercises on neck pain, forward head posture, and the acoustic characteristics frequency and amplitude modulation of patients with chronic neck pain caused by forward head posture using pressure biofeedback. METHODS: 20 patients with chronic neck pain and voice disorders presenting at the S Exercise Center in Daegu, Korea, were included in the study. A cervical stabilization exercise program of 50 minutes per session was performed three times a week for eight weeks. Pressure biofeedback was utilized to determine the impact of the exercises on neck pain, forward head posture, and the acoustic characteristics of the patients. The measurements were taken prior to and after the intervention to determine any changes. RESULTS: A significant improvement in neck pain, craniovertebral angle and the acoustic characteristics frequency and amplitude modulation of the patients was demonstrated after the intervention (p<.05). CONCLUSION: Cervical stabilization exercises were demonstrated to have a significantly positive effect on neck pain, forward head posture, and vocalization stability in patients with chronic neck pain in the current study based on measurements taken using a pressure biofeedback system. This indicates that an improvement in forward head posture positively impacts postural stability and vocalization. Future studies investigating a greater range of interventions designed to improve neck pain and acoustical effects in patients with chronic neck pain and forward head posture patients are warranted.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.5
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• pp.2203-2208
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• 2011

This study was to examine the change of vowel acoustic characteristics of the temporomandibular joint disorder patients by maintaining normal vocalization pattern of the temporomandibular joint through increasing the range of motion, that was, the oral cavity sonorant cavity of the temporomandibular joint, related to vowel articulation through temporomandibular training using the physical therapy. The subjects of this study were 3 male adults in 20-30s that were diagnosed with temporomandibular joint disorder. As a result of conducting temporomandibular training program using the physical therapy, the $1^{st}$ Formant Frequency(F1), $2^{nd}$ Formant Frequency(F2), and Fundamental Frequency(F0) of the temporomandibular joint disorder patients were increased compared to before and this showed the change of the $1^{st}$ Formant Frequency(F1) related to the open mouth grade of a vowel, as well as the $2^{nd}$ Formant Frequency(F2), and Fundamental Frequency(F0) related to the front-back of a vowel which shows the relationship between the temporomandibular joint, vowels and voice calculation.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.132-138
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• 2005

Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

• Therapeutic Science for Rehabilitation
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• v.12 no.4
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• pp.135-151
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• 2023

Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

• Speech Sciences
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• v.9 no.3
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• pp.87-97
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• 2002

The purpose of this study is to analyze the speech duration in Korean-speaking aphasics. Five patients with nonfluent aphasia (2 with traumatic brain injury and 3 with strokes) and five normal adults participated in this experiment. The mean age in patients with nonfluent aphasia was $45.8\pm2.3$ years and $47.4\pm2.3$ years for the normal adults. The Computerized Speech Lab was used to evaluate the acoustic characteristics of the subjects. Voice onset time, vowel duration, total duration, hold and consonant duration were evaluated for the monosyllabic and the polysyllabic words. The patients with nonfluent aphasia did not show the voicing bar on hold area, however, it was seen in the normal persons in the intervocalic position. Explosion duration of glottalized stops in the intervocalic position was significantly prolonged in nonfluent aphasics in comparison with the normal persons. This suggestes that the laryngeal adjustment is disturbed in these patients. Consonant duration, vowel duration, and total duration of the polysyllabic words were significantly longer in the patients with nonfluent aphasia than those of the normal persons. These results demonstrate the disturbances in controlling articulatory muscles during sound production in patients with nonfluent aphasia. The objective and quantitative analysis based on the acoustic characteristics of nonfluent aphasics, will be very useful in therapeutic planning and on the the effects of speech therapy.