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.

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.

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.

파킨슨병 환자와 정상 노인의 조음 특성 연구

강영애(Young-Ae Kang),박상희(Sang-Hee Park),성철재(Cheol-Jae Seong) 한국언어치료학회 2009 言語治療硏究 Vol.18 No.3

This study sought to characterize the articulatory rate and acoustic vowel space of people with dysarthric idiopathic Parkinson's disease before pharmacological intervention.Ten female patients with idiopathic Parkinson's disease and a healthy control group of 10 females were selected and every voice was recorded 3-4 times using praat (ver. 5022) with a headset microphone. Parameters of the articulatory rate were sequential motion rate (/pʌtʌkʌ/) and alternating motion rate (/pʌ/,/tʌ/,/kʌ/) in five second intervals. The acoustic space parameters for vowels were as follows: Euclidean distance between vowels (/a/_/i/, /i/_/o/, and /o/_/a/) and acoustic space area. All parameters were statistically analyzed by Mann-Whitney U-test and Pearson correlation analysis. The results were (1) The articulatory rate of the patient group was lower than that of the normal group. (2) The Euclidean distance and vowel space area were smaller for the patient group than the normal group. (3) There were positive correlations among three parameters of articulatory rate in the normal group. However there was a positive correlation only of [AMR/pʌ/ & AMR/tʌ/] in the patient group. In particular, only the patient group showed a positive correlation between SMR and I_O distance. These findings indicate that Parkinson's disease causes a decrease of mandible movement. This physical change has the characteristics of dysarthric articulation. Consequently, in speech therapy sessions for regressive dysarthria patients, drills for articulatory acoustic space extension are important.

지역주민의 장소애착과 환경인식이 생태관광 영향인식과 지지도에 미치는 영향

강영애(Young Ae Kang),유광민(Kwang Mun Yoo),김남조(Nam Jo Kim) 한양대학교 관광연구소 2012 觀光硏究論叢 Vol.24 No.4

지속가능한 관광의 한 형태로서 생태관광이 성공적으로 운영되기 위해서는 지역주민의 역할이 중요하다는데 의견이 모아지고 있다. 지역주민의 관광개발 지지도에 미치는 영향요인을 찾는 것은 관광분야의 중요한 이슈 중의 하나다. 본 연구에서는 지역주민의 장소애착, 환경인식, 생태관광 영향인식, 생태관광개발 지지도 간의 관계성을 살펴보고자 하였다. 연구결과 생태관광개발 지지도에 영향을 미치는 요인은 생태관광에 따른 사회문화적 환경적 영향인식, 장소애착도와 환경인식으로 나타났다. 이러한 결과는 지역주민이 관광개발이 지역사회에 초래할 변화의 수준을 판단함으로써 관광개 발에 대한 지지를 표현하고 있음을 보여주고 있다. 따라서 지역주민의 지지도를 이끌어내기 위해서는 관광개발이 지역사회에 미치는 영향 정도를 고려할 필요가 있다. It is agreed that the role of local residents is important to make ecotourism as a successful form of sustainable tourism. One of the most important issues is to find the influential factors of residents`` support for tourism development. This study is to find the relationships among place attachment, environmental perception, the cognitive effects, and residents`` support of ecotourism. The result is that the factors supporting ecotourism are place attachment, environmental perception, and social-cultural and environmental cognitive effects by ecotourism. This shows that the residents consider the level of community changes caused by the tourism development. Therefore, it needs to be considered how the community will be influenced by the tourism development in the tourism development process.

제주지역 아동양육시설 종사자의 직무특성 인식이 전문성에 미치는 영향 연구

강영애(Young Ae Kang) 제주학회 2016 濟州島硏究 Vol.45 No.-

본 연구는 제주지역 아동양육시설 종사자의 직무특성 인식이 전문성에 미치는 영향 및 전문성을 향상시킬 수 있는 개선방안을 파악하여 아동복지 전문인력으로서 역량을 강화하고, 전문성을 향상시킬 수 있는 실천적 방안을 모색하는데 목적이 있다. 이를 위해 연구방법은 설문조사 방법과 심층면접 방법을 활용하였다. 설문조사 대상은 제주지역에 설문조사 방법과 심층면접 방법을 활용하였다. 설문조사 대상은 제주지역에 소재한 아동양육시설 7곳의 종사자 100여명을 대상으로 실시하였다. 자료분석방법은 일반적 특성, 직무특성 인식, 전문성 간의 차이를 검증하기 위해 t-test, one way ANOVA 분석을 실시하였고, 직무특성 인식이 전문성에 미치는 영향을 알아보기 위해서 상관관계 분석과 회귀분석을 실시하였다. 심층면접 대상자는 제주지역에 소재한 아동양육시설 7곳 중 심층면접을 사절한 시설을 제외하고, 4곳의 시설에서 근무하고 있는 종사자들중에서 심층면접에 동의를 한 시설 종사자 10명을 심층면접 대상자로 선정하여 개별면접을 실시하였다. 이를 바탕으로 제주지역 아동양육시설 종사자의 전문성을 향상시키기 위한 실천적 방안으로 아동양육시설 종사자의 인성함양을 위한 인성교육 및 아동학등의 전문화된 교육을 개발하고 제공해야 하며, 시설 종사자의 사회적 지지와 전문직업인으로서의 안정을 위해 직원복지제도를 강화해야 할 것이다. 또한, 시설, 종사자, 시ㆍ도의 아동양육시설 담당공무원간의 연계ㆍ협력을 통한 네트워크를 구축하여야 하며, 아동복지 및 사회복지 전문인력을 양성하기 위해 사회복지 현장실습을 강화해야 한다고 제시하였다. The objective of this study is to seek for practical measures to improve competence and professionalism of professional manpower of child welfare, by understanding the influence of the cognition of job characteristics on professionalism targeting workers of childcare facilities in Jeju region and also the improvement measures to enhance their professionalism. For this, the survey and in-depth interview methods were used. The survey was conducted for total 100 workers if seven childcare facilities in Jeju region. In order to verify the differences between general characteristics, cognition of job characteristics, and professionalism, t-test and one way ANOVA were performed while correlation analysis and regression analysis were also conducted to examine the influence of the cognition of job characteristics on professionalism. Targeting ten workers agreeing with the in-depth interview from four childcare facilities after excluding facilities refusing to have it in Jeju region, the individual interview was conducted. Based on it, as practical measures to improve professionalism of workers of childcare facilities in Jeju region, the specialized education like pedology and also character education for childcare workers should be developed/provided. For the stability of professional workers and social support for them, the employee welfare system should be reinforced. Also, the networks through cooperations between facilities, workers, and municipal/provinicial government workers in charge of childcare facilities should be established while the social welfare field practice should be reinforced to foster professional manpower of child/social welfare.

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

연구 배경 : 흉수의 항산균 도말과 세포진 검사가 음성이며, 흉수의 ADA 가 40 IU/L 이하, CEA가 10ng/ml 이하인 림프구성 흉막 삼출증의 임상적 특징과 예후를 살펴보고자 한다. 연구 방법 : 2000년 1월 1일부터 2001년 8월 31일 사이에 서울대학교 병원을 방문한 림프구성 흉막 삼출증 환자들 중 흉수의 항산균 도말과 세포진 검사가 음성이며, 흉수의 ADA가 40 IU/L 이하, CEA가 10ng/ml 이하인 환자들의 의무 기록을 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

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.

성대용종 환자의 후두미세수술 전후 공기역학 변수 변화

강영애(Kang, Young Ae),장재원(Chang, Jae Won),구본석(Koo, Bon Seok) 한국음성학회 2016 말소리와 음성과학 Vol.8 No.3

The present study examined the change of aerodynamic features after laryngomicrosurgery in patients with vocal polyps. Aerodynamic evaluation was performed in thirty-nine patients (15 males and 24 females) one week before surgery and four weeks after surgery. Evaluation protocols of vital capacity, maximum sustained phonation(MXPH), and voicing efficiency(VOFT) were used to collect 29 phonatory aerodynamic measures, requiring voice with a comfortable pitch and loudness. Statistically significant changes were found for phonation time and airflow values in the MXPH protocol, while changes were also found for airflow values, subglottal pressure values and acoustic resistance values in the VOFT protocol. Although phonation time was increased in both male and female patients, gender-dependent changes were found in airflow measurements. Men’s phonation time increased with no difference in airflow rate, but women’s phonation time increased with decreased airflow rate and lower subglottal pressure. The changes of aerodynamic features may be affected by women"s self-perceived change for vocal attitude, which was reducing sense of vocal effort after surgery.

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.