정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계

강영애,배수진,송치은,Kang, Young Ae,Bae, Su Jin,Song, Chie Eun 한국중환자간호학회 2016 중환자간호학회지 Vol.9 No.1

Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

궁형성대와 성대폴립 간의 음성 비교

강영애,윤여훈,윤규철,성철재,Kang, Young-Ae,Yoon, Yeo-Hoon,Yoon, Kyu-Chul,Seong, Cheol-Jae 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.1

Background and Objectives : Vocal fold bowing is an organic voice disorder that is associated with an abnormal structure of the vocal folds whereas vocal fold polyp is a functional voice disorder caused by an abnormal use of the vocal folds. Both types of vocal folds share a common property in that they make one's voice breathy or strained. The purpose of this study is to compare voice from two types of vocal folds and to offer information of clinical importance. Materials and Method: Vocal fold bowing and vocal fold polyp groups consisted of 7 male subjects, respectively. All subjects recorded /a/ in the state of measuring MPT (maximum phonation time), repeating 3 times, by a voice recorder (48 kHz sampling rate; 24 bit quantization). They answered the questions of K-VHI. Time domain parameters (such as perturbation parameters including HNR, Jitter, etc.) were calculated for the whole duration of /a/ and those of the frequency domain were measured in initial 40 ms and stable 40 ms of /a/, respectively. Mann-Whitney V-test was used for the time domain parameters and K-VHI survey, and Wilcoxon signed rank test was applied to the frequency domain parameters (H1, H2, H1-H2). Results: For K-VHI survey and the time domain analysis, there was no significant difference between bowing and polyp group. For frequency domain analysis, H1 and H2 showed a significantly different result between two groups. Vocal fold bowing group has longer duration and lower intensity than that of vocal fold polyp group in the 'aspirated interval', which could be observable prior to ordinary vowel oscillation. Conclusion: Both groups seem to show breathy voice. This could be referred on the basis of the value of H1-H2. The K-VHI survey says that subjects with vocal fold bowing feel more uncomfortable than subjects with vocal fold polyp.

사례 적용 Praat 기반 CSL 대체 자동화 음성분석 프로그램

강영애,장재원,구본석,Kang, Young Ae,Chang, Jae Won,Koo, Bon Seok 대한후두음성언어의학회 2021 대한후두음성언어의학회지 Vol.32 No.2

There are a number of voice analysis programs around the world. Domestic voice analysis is performed by relying heavily on specific commercial program. We intend to develop coding for voice analysis using Praat and apply it to clinical practice. This study consisted of Experiment 1 and Experiment 2. Experiment 1 was the development of automated voice analysis coding based on Praat. The coding was largely divided into a recording, an analysis, and a storage section. Experiment 2 was applied to the voice analysis of 2 male patients pre- and post-operation with this coding. The analysis parameters of this coding provided 26 parameters for vowel /a/, nine parameters for sentence analysis, and a total of 4 parameters for voice range profile analysis. In two male patients, the pitch and the intensity increased, the voice quality improved, and the sentence length decreased after surgery. The coding was well made, so the output was good in real time. The code is automated as much as possible to block manual errors and increases convenience and efficiency by generating the result sheet in real time.

뇌졸중 환자 대상 흡인 음성의 음향변수 변동

강영애(Kang, Young Ae),지성주(Jee, Sung Ju),구본석(Koo, Bon Seok),조철우(Jo, Cheolwoo) 한국음성학회 2017 말소리와 음성과학 Vol.9 No.3

The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

갑상선 수술범위에 따른 음성의 음향적 분석

강영애(Kang, Young Ae),구본석(Koo, Bon Seok) 한국음성학회 2015 말소리와 음성과학 Vol.7 No.4

Voice complication without the laryngeal nerve injury can occur after thyroidectomy. The purpose of this study is to investigate voice changes according to extent of thyroidectomy with acoustic analysis. Thirty-five female patients with papillary thyroid carcinoma took voice evaluation at before and 1 month, and 3 months after thyroidectomy. Acoustic analysis parameters were speaking fundamental frequency(SFF), min F0, max F0, dynamic range F0, jitter, shimmer, noise-to-harmonic ratio(NHR), and Cepstral prominence peak(CPP). Repeated-measured analysis of variance was applied. Time-related voice changes showed significant differences in all parameters except NHR. At 1 month after surgery, voice quality was worse and pitch was decreasing, but voice quality and pitch were improving at 3-month follow-up. Voice changes according to the extent of surgery were in SFF, max F0, and dynamic range F0. Time by surgery-related voice change existed only in min F0. The result showed that the severity of voice complication depended on the extend of thyroidectomy which had a negative impact on F0-related parameters. The deterioration of voice quality at 1 month after thyroidectomy may be affected by the loss of thyroid hormone in the blood. The descent of F0-related parameters may be impacted by laryngeal fixation of surgical site adhesion.

항산균 도말 검사, 세포진 검사가 음성이고, ADA와 CEA가 낮은 림프구성 흉막 삼출증의 임상 양상과 예후

강영애 ( Young Ae Kang ),윤영순 ( Young Soon Yoon ),이세원 ( Sei Won Lee ),최창민 ( Chang Min Choi ),김덕겸 ( Deog Kyeom Kim ),이희석 ( Hee Seok Lee ),고동석 ( Dong Seok Ko ),유철규 ( Chul Gyu Yoo ),김영환 ( Young Whan Kim ),한성 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.1

Background : A pleural effusion is a common medical problem. Despite several diagnostic tests, 15-20% of pleural effusions go undiagnosed. The aim of this study was to evaluate the clinical characteristics and prognosis of a lymphocyte dominant exudative

기식 등급에 따른 CPP (Cepstral Peak Prominence) 분석 비교

강영애(Kang, Youngae),구본석(Koo, Bonseok),조철우(Jo, Cheolwoo) 한국음성학회 2015 말소리와 음성과학 Vol.7 No.1

The aim of this study is to synthesize pathological breathy voice and to make a cepstral peak prominence (CPP) table following breathiness ranks by cepstral analysis to supplement reliability of the perceptual auditory judgment task. KlattGrid synthesizer included in Praat was used. Synthesis parameters consist of two groups, i.e., constants and variables. Constant parameters are pitch, amplitude, flutter, open phase, oral formant and bandwidth. Variable parameters are breathiness (BR), aspiration amplitude (AH), and spectral tilt (TL). Five hundred sixty samples of synthetic breathy vowel /a/ for male were created. Three raters participated in ranking of the breathiness. 217 were proved to be inadequate samples from perceptual judgment and cepstral analysis. Finally, 343 samples were selected. These CPP values and other related parameters from cepstral analysis are classified under four breathiness ranks (B0~B3). The mean and standard deviation of CPP is 16.10±1.15 dB(B0), 13.68±1.34 dB(B1), 10.97±1.41 dB(B2), and 3.03±4.07 dB(B3). The value of CPP decreases toward the severe group of breathiness because there is a lot of noise and a small quantity of harmonics.

음성장애환자에게서의 우울감 연구

강영애(Kang, Young Ae),구본석(Koo, Bon Seok) 한국음성학회 2015 말소리와 음성과학 Vol.7 No.2

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±7.5 which was higher than that of male patients(5.6±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.

β₂-촉진제 사용전후에 따른 만성폐쇄성폐질환/천식 환자의 음성 연구

강영애(Kang Youngae),김세훈(Kim Sehun),정성수(Jong Seongsu),이태용(Lee Taeyong),성철재(Seong Cheoljae) 한국음성학회 2010 말소리와 음성과학 Vol.2 No.2

An inhaled salbutamol and salmeterol for chronic obstructive pulmonary disease(COPD) and asthma have been used worldwidely. But there has been few study about the voice change evoked from the post-medicine effect. To evaluate the voice influenced of short-acting and long-acting β₂-agonists, two experiments were carried out: one was salbutamol experiment 1 with eight patients, the other was salmeterol experiment 2 with six patients. Experiment 1 was made of two stages: premedication & postmedication. Experiment 2 was four stages: stageI was premedication, stageⅡ was postmedication & pregaggling, stageⅢ was postmedication & postgaggling(100 ml with water), and stageⅣ was postmedication & 30 minutes later. Measured parameters were F0, F0_SD, Jitter_rap, Shimmer_apq11, HNR, BW(1, 2, 3), Intensity, and H1-H2. The mean data collected from 3 repetitions each was statistically analyzed by Wilcoxon signed rank test for experiment 1 and repeated measures ANOVA for experiment 2. In experiment 1, significant differences were found in the Jitter_rap(Z= -2.10, p=0.036). The findings indicated that the postmedicated voice was worse than premedicated voice. In experiment 2, there wasn't significant difference, but values of parameters related to voice quality(Jitter_rap, Shimmer_apq11, HNR, and H1-H2) showed changes toward stageⅣ, that is, the voice quality was worse under medication.

인두피판술 전ㆍ후의 공명파라미터의 비교 : 예비연구

강영애(Kang Youngae),강낙헌(Kang Nakheon),이태용(Lee Taeyong),성철재(Seong Cheoljae) 한국음성학회 2009 말소리와 음성과학 Vol.1 No.3