모음과 연결발화에서 캡스트럼 음향 지표의 정상 및 음성장애 예측

유미옥(Miok Yu),최성희(Seong Hee Choi),최철희(Chul-Hee Choi),최병흔(Byeongheun Choi) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.4

배경 및 목적: 본 연구에서는 모음연장발성과 연결발화에서 음성장애 진단을 위한 기준값을 정희하고, 두 음성표본 중 음성장애를 분석하기 위한 민감한 표본이 무엇인지 알아보았다. 방법: 74명의 정상화자와 214명의 음성장애 환자를 대상으로 모음연장발성과 연결발 화의 캡스트럼 및 스펙트럼 변수를 측정하였다. 음성장애 유무와 음성표본에 따라 각 측정치를 비교하고, 각 과제의 캡스트럼 및 스펙 트럼 측정치의 진단 기준값을 정의하였다. 결과: CPP와 L/H ratio는 두 음성표본 모두에서 음성장애 유무 집단 간 유의미한 차이를 보였다. CPP 값은 음성표본에 관계없이 높은 정확도로 정상음성과 병리적 음성을 변별할 수 있었고 특히 모음연장발성 과제에 비해 연결 발화 과제에서 CPP는 더욱 높은 변별 정확도를 나타내었다. 논의 및 결론: 캡스트럼 및 스펙트럼 측정치는 정상음성과 병리적인 음성을 구분하는 높은 감별 정확도를 보였다. 따라서, 본 연구는 장애음성을 평가할 때 진단적 예측으로서 캡스트럼 측정치를 포함시켜야할 것을 제안한다. Objectives: In recent years, the use of cepstral measures for acoustic evaluation of voice has increased. The objective of this study is to evaluate the diagnostic value of spectral/ cepstral measures to differentiate dysphonia from normal voice and to determine what type of voice sample (sustained vowel /a/ or connected speech) is the most sensitive in differentiating normal and pathological voice. Methods: Two hundred and eighty-eight individuals (99 men, 189 women) from 214 dysphonia patients and 74 normal speakers recorded connected speech and a sustained vowel /a/. One laryngologist and two speechlanguage pathologists performed visual and auditory-perceptual rating of voice samples in terms of the degree of dysphonia/normality. Recorded voices were analyzed with two spectral/cepstral measures. The cutoff value for positivity that has the highest specificity for discriminating between normal and dysphonia voices was determined based on receiver operating characteristic (ROC) analyses. Results: Measures of cepstral peak prominence (CPP) and ratio of low- to high-frequency spectral energies (L/H ratio) were significantly different between groups in both speech conditions. ROC analysis demonstrated CPP had high sensitivity and specificity for the classification of dysphonia versus controls in the both speech conditions (area under curve [AUC] = .815 in vowel, AUC = .91 in connected speech); and CPP, in particular, showed higher discrimination accuracy. Conclusion: CPP is a good predictable acoustic measure to detect dysphonic speakers in both vowel prolongation and connected speech from normal voice. Therefore, this study suggested cepstralbased acoustic measures should be included for clinical evaluation of dysphonia.

후두암에 동반펀 SIADH

윤석근(Seok Keun Yoon),최병흔(Byung Heun Choi),박헌웅(Hun Woong Park) 대한두경부종양학회 1987 대한두경부 종양학회지 Vol.3 No.1

The syndrome of inappropriate ADH secretion (SIADH) is a clinical disorder in which there is continual release of antidiuretic hormone (ADH) unrelated to plasma osmolality. ltmay occur usually in association with malignant tumors below the clavicle and other pulmonary disorders which are capable of synthesizing, storing and releasing ADH into the circulation but rarely with the head and neck tumors yet. We experienced a patient with unexplained hyponatremia associated with laryngeal carcinoma. The clinical and laboratory diagnostic studies suggested that patient's sodium deficiercy was secondary to the SIADH. Subsequent resection of the neoplasm, total laryngectomy led to resolution of hyponatremia, suggesting that a tumor associated humoral factor, such as vasopressin or vasopressin like substance, was responsible for the electrolyte disturbance.

후두 내시경(Fiber-Optic Nasolaryngoscope)을 이용한 말더듬인의 후두양상에 관한 연구

정훈(Hun Jung),안종복(Jong-Bok Ahn),최병흔(Byung-Heun Choi),권도하(Do-Ha Kwon) 한국음성학회 2008 음성과학 Vol.15 No.3

The purpose of this study was to use fiber-optic nasolaryngoscope to find outdifferences in laryngeal behavior between persons who stutter(PS) and those who do not stutter(NS) upon their utterance. To meet the goal above, this study took 5 NS and 5 PS respectively as a part of sampling, so that they were all asked to join an experiment hereof. As a result, this study came to the following findings: First, there was not any significant difference in laryngeal behavior of uttering spoken languages between stuttering group and control. Second, there were some differences in laryngeal behavior of repetition and prolongation, which were a sort of disfluency revealed in the utterance of nonfluent spoken languages between stuttering group and control. Third, as reported by prior studies, it was found that there were differences in laryngeal abehavior of stutterer group's nonfluent spoken languages depending upon stuttering types. In this study, a variety of laryngeal behavior unreported in prior studies could be found. In addition, it was notable that stutterers showed different laryngeal behavior depending on their personal stuttering types. On block condition, Subject 1 showed laryngeal behavior of fAB, INT and fAD; Subject 2 showed laryngeal behavior of fAB, fAD and rAD; Subject 3 showed laryngeal behavior of fAD and rAD; Subject 4 showed only laryngeal behavior of fAD; and Subejct 5 showed laryngeal behavior of fAB, fAD and rAD. Summing up, these findings imply that when stutterers utter nonfluent words, they may reveal a variety of laryngeal behavior depending on their personal stuttering types. Moreover, it is found that there are more or less differences in the utterance of nonfluent spoken languages between NS and stuttering ones. In particular, it is interesting that one common trait of nonfluent spoken languages uttered by PS is evidently excessive laryngeal stress, no matter which type of stuttering they reveal.

내전형연축성 발성장애 음성에 대한 켑스트럼과 스펙트럼 분석

심희정(Shim, Hee Jeong),정훈(Jung, Hun),Lee, Sue Ann,최병흔(Choi, Byung Heun),허정화(Heo, Jeong Hwa),고도흥(Ko, Do-Heung) 한국음성학회 2016 말소리와 음성과학 Vol.8 No.2

The purpose of this study was to analyze perceptual and spectral/cepstral measurements in patients with adductor spasmodic dysphonia(ADSD). Sixty participants with gender and age matched individuals(30 ADSD and 30 controls) were recorded in reading a sentence and sustained the vowel /a/. Acoustic data were analyzed acoustically by measuring CPP, L/H ratio, mean CPP F0 and CSID, and auditory-perceptual ratings were measured using GRBAS. The main results can be summarized as below: (a) the CSID for the connected speech was significantly higher than for the sustained vowel (b) the G, R and S for the connected speech were significantly higher than for the sustained vowel (c) Spectral/cepstral parameters were significantly correlated with the perceptual parameters, and (d) the ROC analysis showed that the threshold of 13.491 for the CSID achieved a good classification for ADSD, with 86.7% sensitivity and 96.7% specificity. Spectral and cepstral analysis for the connected speech is especially meaningful on cases where perceptual analysis and clinical evaluation alone are insufficient.

초고속 성대촬영기(High-Speed Digital Imaging)를 이용한 말더듬인과 근 긴장성 발성장애인의 /이/모음 발성 시 성대 진동 양상에 관한 비교 연구

정훈(Jung Hun),안종복(Ahn Jong-Bok),박진향(Park Jin-Hyaung),최병흔(Choi Byung-Heun),권도하(Kwon Do-Ha) 한국음성학회 2009 말소리와 음성과학 Vol.1 No.4

초인지 학습능력 발달을 촉진하는 국어과 교수-학습 전략

최병흔 청람어문교육학회 2003 청람어문교육 Vol.26 No.-

교수-학습을 재선해야 하는 국어과 교사의 시대적 과제가 작지 않다. 교과의 특성상 범교과교육의 역할을 담당해야 할 책무도 있다. 오늘날 인지심리학의 발달로 학습의 전이와 파지의 효과를 극대화할 다양한 학습전략이 개발되었다. 이 가운데 초인지 전략은 인지에 관한 지식과 인지과장 및 지석에 관한 통제라 할 수 있는데 학습의 주도성을 획득 하여 평생학습자로 성장하는데 중요한 역할을 담당한다. 반성과 자기 성찰, 또는 자기 자각의 지속적 반복은 모든 학습활동과 과정에 두루 적용되어야 한다. 읽기 교육에서 초인지 활동을 강화하고 적용할 맥락 의 조성이 우선 필요하다. 그것은 구성주의적 관점, 생태학적 학습환경, 상호작용적인 협력학습 모델, 학습의 전이력, 능동적인 학습촉진을 위 한 과정 지도를 포함한다. 지금까지의 대다수 국어수업은 읽기후 활동에 초점이 맞추어져 온 것이 사실이다. 실생활과 짧은 학습환경을 만들어 배경지식을 활성화하고 학습의 천 과정을 계획하고 점검하고 평가하는 읽기전, 읽기중, 읽기후 전략 및 활동을 구안하여 국어과 교수-학습을 실천한다면 학습의 동계를 강화하고 유능한 독자, 혹은 학습자롤 길러낼 수 있다. 앞으로 체계적이고 과학적인 실험을 통해 초인지가 갖는 교육적 의의와 가능성을 검증하는 일도 아울러 필요하다. The teachers of Korean who should improve the way of instruction-learning have some assignments which are demanded in this time. They should also play a role of the pan-subject education due to the characteristics of Korean subject. Today the various learning strategies to maximize the effect of learning transition by the development of cognitive psychology have been developed. The meta-cognitive strategy of them is a kind of knowledge about the cognition itself , the cognition process and control about some knowledge. It is also very important fact for acquisition of the initiative learning as life long learners. Some reconsideration, self-reflection or the continuous repetition of self-consciousness should be applied to all learning activities and processes. Above all, it is necessary to strengthen and apply the meta-cognitive activity in reading instruction. It includes the point of view of constructivism, ecological learning environment, interactive cooperation learning model, learning transition and guiding of the process for active learning promotion. It is true that most of the Korean classes have been focus on the activity after reading. If we make the learning environment which is very similar to a real life, activate the prior knowledge and practice the idea of strategy or activity for before-reading, during-reading and after-reading which make a plan, check and evaluate for the whole processes about learning, we can strengthen the learning motive and bring up the capable readers or learners. It is also necessary for us to demonstrate the educational meaning and possibility of meta-cognition through the systematical and scientifical experiment in the future.

長期間 高鹽 攝取한 쥐에서 calcium 이 angiotensin Ⅱ 와 vasopressin 에 대한 昇壓反應에 미치는 影響

崔秉欣,黃駿河,朴載植,李元晶 慶北大學校 醫科大學 1987 慶北醫大誌 Vol.28 No.2

고염 섭취한 쥐에서 Ca^++주입 전후의 Ang Ⅱ와 AVP에 대한 승압반응을 비교하였다. 젖 떨어진 생후 5주의 Wistar 숫쥐에게 Na^+이 0.5mM/100g(저염) 또는 25mM/100g(고염)이 포함된 사료를 먹였다. 실험 식이를 12주 섭취시킨 후에는 쥐를 ether로 마취시킨 다음, 대퇴동맥과 정맥에 catheter를 삽입하였다. 수술 후 마취가 깨고 두시간정도 기다려 혈압이 안정된 다음 Ang Ⅱ와 AVP5-250ng/㎏를 정맥 주사하여 용량에 대한 승압반응을 기록하였다. 그 후 CaCl_2 용액을 한시간동안 주입(750㎍ Ca^++/100g/hr)한 다음, Ca^++을 계속 주입하는 상태에서 앞의 방법으로 Ang Ⅱ와 AVP를 주사하여 각각의 용량에 따른 승압반응을 실험하였다. 고염 섭취한 쥐에서는 Ang Ⅱ에 대한 승압반응이 저염군보다 유의하게 높았다. 그러나 AVP에 대한 승압반응은 두 군 사이에 차이가 없었다. Ca^++주입하는 동안 혈장의 Ca^++농도나 안정시 혈압에는 유의한 변화가 없었으나, 심박수는 감소하였다. Ca^++주입하는 동안의 Ang Ⅱ와 AVP에 대한 승압 반응은 1.5배 정도 현저하게 증가하였다. 이 때에도 역시, Ang Ⅱ에 대한 승압반응은 고염군이 저염군 보다 높았는데, 두 군 사이의 차이는 Ca^++주입 전보다 월등히 많았다. Ca^++주입시 AVP에 대한 승압반응은 두군 사이에 차이가 없었다. 이상의 결과로 소금 섭취량에 따라 Ang Ⅱ에 대한 순환계의 반응이 변화함을 알 수 있었다. 혈장 Ca^++농도가 소량 변화할 때 심근이 혈관근육보다 더 예민하게 영향을 받으며, Ca^++은 Ang Ⅱ나 AVP의 승압반응을 증가시켰다. Pressor responses to Ang Ⅱ and AVP berfore and after Ca^++ infusion were compared in male Wistar rats fed low (0.5mM Na^+/100g diet) or high salt (25mM/100g) diet. Experimental diets were fed for 12 weeks from 5 week old. Then catheters were inserted in femoral artery and vein under ether anesthesia. After arterial pressure had stabilized for 2 hr, the pressor responses to graded i.v. injection of Ang Ⅱ and AVP were determined in each rats. The dose-response curves were examined during Ca^++ infusion (750㎍/100g/hr). Rats fed high salt diet showed significantly greater pressor response to Ang Ⅱ than the low salt group. However, there was no difference in pressor responses to AVP between sodium loaded and restricted rats. Ca^++ infusion produced no significant change in plasma Ca^++ level or arterial pressure, but significant decrease in heart rate. Pressor responses to Ang Ⅱ and AVP during Ca^++ infusion were increased about 1.5-fold. Pressor response to Ang Ⅱ during Ca^++ infusion was also greater in rats fed high salt diet, and the difference between the two groups was much greater than that before Ca^++ infusion. Pressor response to AVP during Ca^++ infusion was similar in the two groups. These results indicate that sodium balance influences the action of Ang Ⅱ on vascular systems. Cardiac muscle responded to Ca^++ more sensitively than blood vessels, and Ca^++ increased the vascular responses to Ang Ⅱ and AVP.

Plummer-Vinson Syndrome 2례 : Report of Two Cases

윤석근,서장수,최병흔,한태희,이형철 대한이비인후과학회 1986 대한이비인후과학회지 두경부외과학 Vol.29 No.6