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내전형 연축성 발성장애 화자의 구강 및 후두 교호운동 특성
박희준(Hee June Park),김근효(Geun Hyo Kim),배인호(In Ho Bae),권순복(Soon Bok Kwon) 한국언어치료학회 2014 言語治療硏究 Vol.23 No.3
Purpose: This study investigates characteristics of adductor spasmodic dysphonia (ADSD) speakers' laryngeal diadochokinesis (DDK). ADSD is a voice disorder characterized by involuntary movements or spasms of one or more muscles of the larynx during speech. There is no accurate diagnosis for ADSD. The assessment of laryngeal DDK in ADSD requires understanding the factors that affect balanced vocal production. Methods: A specific task was performed to compare 24 ADSD female speakers with 24 normal speakers. To perform the laryngeal DDK task, both groups were asked to speak /pa, ta, ka, a/ as fast as possible and as regularly as possible. The voices were recorded by Motor Speech Profile 5141 (CSL 4500), and stable sections were analyzed for four seconds. To determine statistical similarity, an independent samples t-test was conducted. Results: There were no rate or regularity differences between the two groups when the participants spoke /pa, ta, ka/ as oral DDK. On the other hand, when they spoke /a/ as laryngeal DDK, differences arose. The ADSD speakers showed slower laryngeal DDK rate and less accuracy in comparison with the normal speakers. Conclusions: The result shows that laryngeal DDK is helpful in the diagnosis of ADSD.
박희준(Hee June Park),신범주(Bum Joo Shin) 한국언어치료학회 2021 言語治療硏究 Vol.30 No.1
Purpose : In this study, we introduced Aalto Aparat, a piece of open-source software that can automatically execute glottal inverse filtering (GIF) and analyze various parameter values. We also tried to determine the usefulness of various parameters through normal and pathological voice analysis. Methods : GIF analysis was performed on 20 normal adults and 20 with vocal nodules, and 20 with vocal cords palsy. Using Aalto Aparat, two steps required in the GIF study were inverse-filtered and converted into a glottal waveform, and the converted glottal waveform was analyzed in various ways. Analysis variables included open quotient (OQ), speed quotient (SQ), closing quotient (CLQ), amplitude quotient (AQ), and normalized amplitude quotient (NAQ), and quasi-open quotient (QOQ). Results : By converting a general voice waveform into an LPC spectrum for converting to a glottal waveform, a glottal airflow waveform is obtained, and this waveform is integrated again to confirm that the glottal inverse filter analysis waveform is automatically analyzed without users special manipulation. The OQ, SQ, CIQ, AQ, NAQ, and QOQ values of normal speech using GIF were analyzed to establish a reference value. In addition, it was found that the values of AQ, CLQ and OQ are useful for distinguishing between pathological voice, vocal cord paralysis, vocal cord cysts and vocal cord nodules. Conclusions : In this study, objective values of the glottal waveforms of normal adults were obtained, and these parameter values were applied to negative diseases to determine whether there was a difference from normal voices; it was found that the GIF value is useful for pathological voice diagnosis.
노화에 따른 발화 시 입술움직임의 변화: 이중모음을 중심으로
박희준(Hee-June Park) 한국음성학회 2021 말소리와 음성과학 Vol.13 No.1
본 연구에서는 노화에 따른 발화 시 입술 움직임의 변화를 알아보고자 하였다. 연구대상으로 평균 69세의 노인 여성 15명과 평균 22세의 젊은 여성 15명을 선정하였다. 입술 움직임을 측정하기 위해 이중모음 발화시 입술 움직임을 녹화하여 스틸 이미지로 저장한 다음 입술의 움직임이 최소인 부분과 최대한 길이를 영상분석 소프트웨어를 이용하여 pixel 단위로 수작업으로 분석하여 비교하였다. 임상적 활용성을 위해 자동화 알고리즘을 적용하여 소프트웨어를 제작했으며 수작업의 결과와 비교하였다. 연구결과 노년층의 경우 청년층에 비해 이중모음 과제에서 입술의 가로 및 세로의 길이 범위가 작은 것을 알 수 있었다. 수작업과 자동화 방법의 상관관계를 측정한 결과 강한 정적 상관관계가 나타나 두 방법 모두 입술 윤곽 추출 시 유용함을 알 수 있었다. 이상의 결과를 바탕으로 노화가 진행됨에 따라 발화 시 입술의 범위가 작아지는 것을 알 수 있었다. 따라서 노화가 진행되기 전 간단하게 입술의 움직임을 측정하여 본인의 상태를 모니터링하고 입술 범위를 유지할 수 있는 운동을 실시한다면 노화로 인한 발음 문제를 예방할 수 있을 것이다. This study investigated the change in lip movement during speech according to aging. For the study, 15 elderly women with an average of 69 years and 15 young women with an average of 22 years were selected. To measure the movement of the lips, the ratio between the minimum point and the maximum point of movement when pronouncing a double vowel was analyzed in pixel units using image analysis software. For clinical utility, the software was produced by applying an automated algorithm and compared with the results of handwork. This study found that the range of the width and length of lips in double vowel tasks was smaller for the elderly than that of the young. A strong positive correlation was found between manual and automated methods, indicating that both methods are useful for extracting lip contours. Based on the above results, it was found that the range of the lips decreased when ignited as aging progressed. Therefore, monitoring the condition of lip performance by simply measuring the movement of lips before aging progresses, and performing exercises to maintain lip range, will prevent pronunciation problems caused by aging.
보호자 교육과 경험학습 훈련이 실어증 환자의 의사소통 개선에 미치는 효과
박희준(Park Hee-June),장현진(Chang Hyun-Jin) 대한신경계작업치료학회 2019 재활치료과학 Vol.8 No.2
목적 : 경험학습모델에 따라 하나의 체계적 프로그램으로 결합하였는데 이 접근법의 목표는 환자와 보호자들의 이해를 돕고 필요한 것을 인지시키는 것에 초점을 두었다. 이러한 선행연구들의 결과를 근거로 본 연구자는 환자와 대화상대자 사이의 의사소통 개선을 위한 보호자 교육과 경험학습모델에근거한 그룹훈련의 장점을 알아보고자 하였다. 연구방법 : 이 연구에서는 부산광역시 소재에 있는 종합병원에 입원한 40~50세의 비유창성 실어증 환자 6명(구어 실행증 2명, 브로카실어증 3명, 명칭 실어증 1명)과 보호자들을 연구 대상으로 선정하였다. 명확한 정보교환 의사소통은 보호자가 촉진전략을 사용하여 환자의 메시지를 파악하였는지 알아보고 사회적 상호작용 의사소통은 보호자의 긍정적인 행동과 방해하는 행동의 빈도 변화를 파악하였다. 보호자의 행동 변화는 훈련 전의 부정적 행동들이 훈련 후 어떠한 행동으로 변화하였는지알아보고 설문지를 통해 환자와 보호자들의 만족도를 알아보았다. 결과 : 첫째, 보호자 교육과 경험학습에 근거한 그룹훈련이 명확한 정보교환 의사소통을 향상 시켰다. 둘째, 보호자 교육과 경험학습에 근거한 그룹훈련이 사회적 상호작용 의사소통을 향상 시켰다. 셋째, 보호자 교육과 경험학습에 근거한 그룹훈련이 보호자의 행동을 변화시켰다. 넷째, 보호자 교육과 경험학습에 근거한 그룹훈련이 환자와 보호자들의 만족도를 향상 시켰다. 결론 : 본 연구를 바탕으로 하여 국내에서는 그동안 거의 고려되지 않았던 실어증 환자의 보호자 교육에 대한 중요성을 깨닫고, 국외에서 이미 활용 중인 여러 유형의 프로그램을 표방하여 우리나라의문화와 재활 환경에 맞는 다양한 보호자 교육의 내용을 계획할 필요가 있다. Objective : Aphasia interferes with communication between the patient and conversation partner. Adequate communication is essential not only for the patient but also for caregiver education and training Method : This study examined the benefits of parental education and group training in terms of improving the communication of six aphasic patients and their caregivers(family members). Caregiver education provided caregivers with information on stroke and aphasia, and group training was conducted according to the experimental learning cycle. Result : As a result, communication increased in terms of sending and receiving messages or interactive communication. Furthermore, the questionnaire analysis showed that caregivers learned more about aphasia and had confidence in using facilitation strategies. Conclusion : Giving educational opportunities to patients and caregivers promotes caregiver’s knowledge and positively interacts.
박희준(Hee June Park),유재연(Jae Yeon Yoo) 한국언어치료학회 2013 言語治療硏究 Vol.22 No.3
It is very important to use computer software for voice (speech) assessment and therapy. Although there is various commercial software for voice assessment, this software is rarely used because it is expensive. The aim of this study is to examine open source software (Praat, WaveSurfer, Audio Masking System, and PreLingua) and to investigate the efficacy of this software for speech therapy. This freeware has wide applicability to speech therapy. 1) It is capable of measuring various acoustic parameters including F0, jitter, shimmer, NHR, voice range, and formant. 2) This freeware is effective in providing realtime visual feedback. 3) This freeware is useful to measure diadochokinetic rate and regularity of dysarthric speech. 4) The masking is useful in treating functional voice disorder and stuttering. 5) It is effective in increasing children's motivation and attention ability by using game software.
오픈 소스 소프트웨어를 이용한 마비말장애 화자의 일련운동속도 분석
박희준(Hee June Park) 한국언어치료학회 2020 言語治療硏究 Vol.29 No.3
Purpose : Diachochokinetic analysis is often used to evaluate the objective speech production capability of dysarthria speakers. NeuroSpeech enables the analysis of pathological speech signals considering different speech dimensions: phonation, articulation, prosody, and intelligibility. The primary goal of this study was to determine if the articulatory diadochokinese (sequential motion rate: SMR) using the NeuroSpeech open-source software module can diagnose dysarthria and determine its severity. Methods : For this purpose, a group of subjects with spastic dysarthria (n=26) and a control group of normal speakers (n=30) without neurological disease was established. From both groups, the SMR was collected by NeuroSpeech and analyzed with descriptive statistics. DDK rate, DDK standard deviation, DDK regularity (ms), Energy variability (dB), and average duration DDK (ms) protocol were analyzed. Results : The dysarthria group showed lower performance than the normal group in the rate of DDK and the regularity of DDK. Dysarthria can be seen at the average syllable length, with each syllable having a long production, slowing down the overall SMR rate. Conclusions : The results show that the software module NeuroSpeech in clinical practice is generally suitable for quickly recording the parameters DDK rate, DDK regularity and mean syllable length at the level of articulatory diadochokinese. With the characteristics described above, we consider that this open source software will help other researchers to contribute to the state-of-the-art in pathological speech assessment from different perspectives, e.g., from the clinical point of view for interpretation, and from the computer science point of view enabling the test of different measures and pattern recognition techniques.
An Automated Method for Quantification of Two Dimensional Videokymography and Its Usefulness
Hee June Park(박희준) 한국언어치료학회 2020 言語治療硏究 Vol.29 No.4
Purpose : Vibration of the vocal cords is an essential part of voice production. A method for quantifying vibration is essential for the detection, diagnosis, and treatment of various voice disorders. The present study offers an automatic quantitative method to describe vibration properties and analyzes its clinical usefulness in evaluating pathological vocal cords via two-dimensional videokymography (2D VKG). Methods : The proposed method is based on image processing, which combines an active contour model with a genetic algorithm to improve the accuracy of detection and processing speed. It can accurately extract the vibration wave in two-dimensional videokymograms. The extracted 2D VKG information can be automatically converted into objective values in terms of five parameters (fundamental frequency [F0], open quotient [OQ], closed quotient [CQ], phase symmetry index [PSI], and amplitude symmetry index [ASI]). We compared the recovery of the vocal cords in a 52-year-old male with acute laryngitis by performing 2D VKG at 1, 3, and 4 weeks. Results : F0 was not measurable at 1 week. After 4 weeks, it could be measured (117.24 Hz) after vocal cord vibration was observed. CQ, which reflects the degree of vocal cord contact, increased from 38% to 44%, while OQ decreased from 62% to 56%. PSI, which shows the regularity of the vocal cords, decreased from 0.148 to 0.72, while ASI decreased from 0.175 to 0.081. Conclusions : The method used in this study allows easy analysis of vibratory parameters and quantifies mucosal wave parameters of vocal cord vibrations. Presenting the state of vocal cord vibration as a numerical value may increase clinical utility, as it is possible to compare the recovery of the vocal cords objectively.