Effects of Lax Vox Voice Therapy on Respiration and Phonation in Patients with Parkinson’s Disease

Hye-Rim Chae(채혜림),Seong Hee Choi(최성희),Chul-Hee Choi(최철희),Kyoungjae Lee(이경재) 한국언어청각임상학회 2019 Communication Sciences and Disorders Vol.24 No.3

배경 및 목적: 파킨슨병은 운동기능에 영향을 미치는 중추신경계의 퇴행성 질환으로 자신의 음성을 자가 모니터링을 하지 못하여 음성의 강도와 음도 조절에 어려움을 보이는 감각장애이다. 반폐쇄성도훈련 중 Lax Vox는 튜브를 물에 넣어 발성하는 것으로 호흡, 공명, 발성의 상호작용에 초점을 맞추어 bio-feedback을 제공하는 총체적인 기법이다. 본 연구는 Lax Vox 음성치료가 파킨슨병 환자의 호흡 및 발성에 미치는 영향을 알아보고자 한다. 방법: 파킨슨병 환자 10명(남자 4명, 여자 6명)을 대상으로 Lax Vox 음성치료를 주 1회 간격으로 6주간 총 6회 실시하였다. 치료효과를 살펴보기 위해 음성치료 전후 공기역학적, 음향학적, 청지각적 평가, 전기성문파형 검사 및 한국어판 음성장애지수-10을 실시하였다. 결과: 음성치료 후 공기역학적, 음향학적 및 청지각적 평가 측정치와 음성장애지수가 유의하게 개선되었다. 특히, 폐활량, 음성 강도, 최대발성지속시간이 증가하였으며, 성문하압이 유의미하게 감소하였다. CPP와 음성범위프로파일, 발화 시 평균 강도가 유의하게 증가하였으며, sPPQ, vF0, shimmer, APQ, sAPQ, vAm가 감소하고, 한국어판 음성장애지수-10의 총점이 낮아졌다. 논의 및 결론: Lax Vox 음성치료는 파킨슨병 환자의 호흡 및 발성 능력에 긍정적인 효과가 있음을 확인하였으며, LSVT와 더불어 Lax Vox 음성치료는 파킨슨병 환자의 효과적인 치료법이 될 수 있음을 시사하였다. Objectives: Parkinson’s disease (PD) is a degenerative disease of the central nervous system that mainly affects sensory and motor function. PD patients have difficulty in controlling their vocal pitch and loudness, and poor self-monitoring due to their sensory disorder. Among semi-occluded vocal tract exercises, Lax Vox is a holistic method that provides bio-feedback by focusing on the interaction of breathing, resonance, and phonation by tube phonation in water. The purpose of this study was to investigate the effect of Lax Vox voice therapy on respiration and phonation in patients with PD. Methods: Ten patients with PD (4 males and 6 females) underwent Lax Vox voice therapy six times a week for 6 weeks. To assess the effectiveness of Lax Vox voice therapy, aerodynamic, acoustic evaluation, GRBAS scale, electroglottography, and Korean Voice Handicap Index (KVHI)-10 were performed before and after voice therapy. Results: Significant improvement in aerodynamic, acoustic, auditory-perceptual rating measures, and KVHI-10 score was yielded following Lax Vox voice therapy. After treatment, significantly increased vital capacity (VC) and maximum phonation time (MPT); and reduced subglottal pressure (Psub) were observed. Cepstral peak prominence (CPP) was significantly increased and smoothed pitch perturbation quotient (sPPQ), vF0, shimmer, amplitude perturbation quotient (APQ), smoothed APQ (sAPQ), peak-amplitude variation (vAm) were significantly decreased after treatment. Moreover, Voice Range Profile (VRP) was extended and KVHI-10 scored significantly lower. Conclusion: Current outcomes confirmed that significantly positive effects were found in respiration and phonation change following Lax Vox voice therapy for patients with PD. Therefore, Lax Vox voice therapy, in addition to Lee Silverman Voice Treatment, can be useful for an effective treatment option in patients with PD.

일부 치위생학과 학생들의 스케일링 실습 과정에서의 근골격계 통증과 불편감

강채림(Chae-Rim Kang),강한솔(Han-Sol Kang),김예빈(Ye-Bim Kim),김지혜(Ji-Hye Kim),류수빈(Su-Bin Ryu),박지호(Ji-Ho Park),백예림(Ye-Rim Baek),이우정(Woo-Jeong Lee),이정민(Jeong-Min Lee),최은정(Eun-Jeong Choi),심선주(Seon-Ju Sim) 대한치과의료관리학회 2019 대한치과의료관리학회지 Vol.7 No.1

물저항 치료를 이용한 다계통위축증의 환자의 마비말장애 치료 효과

채혜림(Hye-Rim Chae),최성희(Seong Hee Choi),최철희(Chul-Hee Choi) 한국언어청각임상학회 2020 Communication Sciences and Disorders Vol.25 No.3

배경 및 목적: 다계통위축증은 비정형 파킨슨 증후군으로 실조형과 경직형 및 과소 운동형의 혼합형 마비말장애이며, 호흡, 발성, 공명 및 조음에 영향을 준다. 하지만, 아직까지 다계통위축증 말치료에 대한 중재법이 매우 제한적이며 연구마다 치료 효과가 상이하다. 본 연구의 목적은 총체적 음성치료기법인 물저항 치료를 사용하여 다계통위축증 환자의 마비말장애 치료의 효과를 살펴보고자 한다. 방법: 실조형 다계통위축증으로 진단받은 총 9명(남자 5명, 여자 4명)을 대상으로 물저항 치료를 주 1회 간격으로 6주간 총 6회 실시하였다. 치료 효과를 분석하기 위하여 치료 전후 공기역학적 및 음향학적, 청지각적 파라미터를 측정하였으며, 질병 진행 기간에 따른 치료 효과를 살펴보기 위하여 발병 후 4년 미만과 4년 이상 집단의 측정치를 비교하였다. 결과: 치료 후 공기역학적, 음향학적 및 청지각적 평가에서 유의하게 개선되었다. 공기역학적 평가 결과, 폐활량, 최대발성지속시간, 호기량이 증가하고 성문하압이 감소하였다. 음향학적 평가 결과, Jitt, PPQ, sPPQ, vF0, Shim, APQ, sAPQ, vAm, STD, NHR, σCPP, σL/H ratio가 감소하고 CPP, L/H ratio가 증가하였다. 청지각적 평가에서는 거친 음성과 긴장되 쥐어짜는 음성, 음도 변이, 음성진전, 음소 연장, 말명료도가 개선되었다. 또한, 발병 초기 그룹은 sAPQ, vAm, σCPP, 발병 후기 그룹은 APQ가 통계적으로 각각 유의한 차이가 있었다(p<.05). 논의 및 결론: 물저항 치료 후 다계통위축증 환자의 호흡, 발성, 공명 및 조음 개선에 유의하게 긍정적인 효과가 나타났다. 물저항 치료는 다계통위축증 환자의 효과적인 마비말장애 치료 방법으로 사용될 수 있을 것이다. Objectives: Multiple System Atrophy (MSA) is atypical parkinsonian syndrome (APS) affecting respiration, phonation, resonance, and articulation, which is characterized by a mixed type of dysarthria involving hypokinetic, ataxic and spastic. However, there are still very limited speech interventions for MSA, and these demonstrate contrasting effects. The purpose of this study was to investigate the efficacy of water resistance therapy (WRT) of dysarthria in patients with multiple system atrophy. Methods: A total of 9 patients with MSA-C (cerebellar type) (5 males and 4 females) underwent WRT once per week for 6 weeks. Aerodynamic, acoustic, and auditory-perceptual evaluation were performed before and after voice therapy to determine the efficacy of WRT. In addition, outcomes were compared based on disease duration (less than 4 years and more than 4 years), before and after therapy. Results: Significant improvement in aerodynamic, acoustic, and auditory - perceptual evaluation was found following WRT. After therapy, in aerodynamic analysis, increased VC, MPT and reduced Psub were observed. Significant improvements were also observed for CPP, L/H ratio and reduced Jitt, PPQ, sPPQ, vF0, Shim, APQ, sAPQ, vAm, STD, NHR, σCPP, and σL/H ratio. In addition, in auditory-perceptual analysis, harsh voice, strained-strangled voice, pitch fluctuations, vocal tremor, prolonged phonemes, and speech intelligibility were improved. Moreover, significantly reduced sAPQ, vAm & σCPP were seen in the less than 4-year group, while significant improvement in APQ was observed in the more than 4-year group. Conclusion: Accordingly, significantly positive effects were found in respiration, phonation, and articulation changes following WRT for patients with MSA. WRT may be useful speech therapy for improving dysarthria in patients with MSA.

중추신경계 병변에 대한 흡인 세포학의 적응-진단적 정확도에 대한 경험 -

박혜림,채양석,이갑노,백승룡,정흥섭,이기찬 대한병리학회 1989 Journal of Pathology and Translational Medicine Vol.23 No.3

악성 수막종 -임상 및 병리학적 특성을 중심으로 -

박혜림,채양석,이갑노,백승룡 대한병리학회 1988 Journal of Pathology and Translational Medicine Vol.22 No.3

P148 : A clinical study of skin diseases on vulvar

( Hye Rim Ko ),( So Min Kim ),( Chae Young Won ),( Hyung Jin Hahn ),( Young Bok Lee ),( Jin Wou Kim ),( Dong Soo Yu ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: Vulvar diseases are not rare in dermatology, however the clinical investigations of the vulvar lesions are insufficient. Objectives: The purpose of this study was to investigate the epidemiological aspects of the vulvar diseases, and to highlight the clinical features of dermatoses of the vulvar with the brief review of the common vulvar diseases. Methods: The retrospective clinical study was performed by reviewing charts, pathologic slide, and clinical photographs of 37 patients who had received skin biopsy for vulvar lesions at Uijeongbu St. Mary’s Hospital between February 2009 and September 2013. Results: The mean age was 47.3 years. The most frequent vulvar diseases were epidermal cyst, lichen sclerosus, lichen simplex chronicus, herpes simplex infection and condyloma accuminatum in the decreasing order of frequency. Except for the 11 asymptomatic patients, the rest of the patients complained of various symptoms such as a pain, prickling sensation, tenderness and pruritus. Of the 37 cases, 14 had patches or plaques, 11 had papules or nodules, 6 had erosions or ulcers and 6 had vulvar mass. Conclusion: We retrospectively studied 37 cases of vulvar diseases. The results of this study are similar to previousreports on the clinical features of vulvar diseases. This study suggests that various conditions can affect the vulvar. Further investigation with a larger group of patients is necessary to better understand the epidemiology of vulvar diseases.

Clinical Research Article : A comparison of sufentanil and fentanyl for patientcontrolled epidural analgesia in arthroplasty

( Hye Rim Jeon ),( Won Seok Chae ),( Se Jin Lee ),( Joon Ho Lee ),( Sung Hwan Cho ),( Sang Hyun Kim ),( Hee Cheol Jin ),( Jeong Seok Lee ),( Yong Ik Kim ) 대한마취과학회 2011 Korean Journal of Anesthesiology Vol.60 No.1

Background: The use of lipid soluble opioids such as fentanyl, alfentanil and sufentanil are recently on the increase for patient-controlled epidural analgesia (PCEA). In this study, the effects and adequate dose of sufentanil in arthroplasty were investigated. Methods: Eighty patients scheduled for arthroplasty were enrolled for the study. Seventy-one patients (ASA physical status I-III) were randomly allocated into four groups. All groups received 0.1% ropivacaine through PCEA and each group received either fentanyl (group F: fentanyl 4 μg/ml) or sufentanil (group S1: sufentanil 0.5 μg/ml, group S2: sufentanil 0.75 μg/ml, and group S3: sufentanil 1.0 μg/ml). Postoperative pain scores were evaluated using VAS (visual analog scale, 0-10) and side effects such as hypotension, nausea/vomiting, pruritus and the degree of satisfaction were evaluated at 1, 6, 12, 24, 48 hours after surgery. Results: Postoperative pain score (VAS) decreased gradually and the highest VAS score was recorded at 1 hour postoperative for all four groups. There were no differences in the degree of satisfaction and postoperative pain score between all groups. The incidence of pruritus was significantly lower in group S1 than in groups S2 and S3. Conclusions: The incidence of side effects were significantly lower in group S1 (0.1% ropivacaine plus sufentanil 0.5 μg/ml). Therefore, 0.5 μg/ml of sufentanil through PCEA is the recommended dose for postoperative pain control in arthroplasty. (Korean J Anesthesiol 2011; 60: 41-46)

Silicone tube 를 삽입한 난치성 녹내장안의 합병성 백내장 수술후의 안압 변화

조혜림(Hye Rim Cho),이찬주(Chan Ju Lee),조병채(Byung Chae Cho) 대한안과학회 1991 대한안과학회지 Vol.32 No.9

Integrated analysis of miRNA and mRNA expression profiles in diabetic mouse kidney treated to Korean Red Ginseng

Park Hye Rim,Lee Seung Eun,Yi Yoojung,Moon Sangji,Yoon Hyunkyung,Kang Chae Won,김재택,박용식 대한독성 유전단백체 학회 2022 Molecular & cellular toxicology Vol.18 No.4

Background Diabetes mellitus (DM) and its complications, including diabetic nephropathy, are rapidly increasing public health concerns. Korean Red Ginseng (KRG) is a popular herbal medicine that has many biological affects. The current literature demonstrates that KRG induced changes to the transcriptome in diabetic nephropathy mouse model are limited. Thus, we designed experiments to confirm whether changes of genes and miRNAs expression patterns in the renal cells of mice with DM, and then whether these changes are reversed by KRG. Objective This study aims to whether miRNAs and mRNAs expression and their relationships were contributed in the renal tissues of mice with streptozotocin (STZ)-induced diabetes. Results We determined that the expression levels of 46 miRNAs and 827 mRNAs expression were changed in KRG-treated DM renal cells compared to DM renal cells. In addition, we found that mRNAs expression shows anti-correlation with miRNAs expression and further validated their biological processes and signaling pathways by Gene Ontology (GO). Conclusion Our data suggest that KRG may regulate miRNA and gene expression in a way that relieves diabetic nephropathy in mice.

현대인의 독서문화 증진을 위한 공원형 파빌리온 제안 : 프로젝트 ‘Book-around’를 중심으로

공혜림 ( Hye-rim Kong ),김경희 ( Kyung-hee Kim ),이채린 ( Chae-rin Lee ),정다은 ( Da-eun Jeong ) 숙명여자대학교 디자인연구소 2020 숙명디자인학 연구 Vol.29 No.-

최근. 디지털 시대를 살아가는 현대인들은 복잡하고 바쁜 하루를 보내며, 여유를 찾지 못하고 있다. 특히 전자기기의 장시간 사용으로 디지털 피로와 같은 각종 문제들이 발생하여 현대인들의 여유를 되찾아줄 수 있는 새로운 공간을 제안할 필요가 있다. 따라서 능동적이며 스스로 상상하고 생각하게 하는 매체인 책을 통하여 나를 돌아보며 주변을 돌아보고, 더불어 진정한 휴식을 제공하는 공간을 만들고자 한다. 특히 한강공원이라는 일상적이며 자연적인 공간에 자리 잡아 편리한 접근성을 제공하고, 현대인들이 휴식의 개념으로 독서를 경험하며 능동적으로 공간에 참여함으로써 독서 문화 증진을 가능케 하고자 한다. 이에, 본 논문에서는 현대인의 독서문화 증진을 위해 공원형 파빌리온을 제안하며, 사용자에게 책을 읽을 수 있는 유연한 환경을 제공하고, 일상의 여유를 되찾기 위해 휴식의 기능을 중점적으로 접목하고자 하였다. Recently, modern people in the digital age have not been able to relax in their complex and busy daily lives. Since the long use of electronic devices has caused many problems such as digital fatigue, it is necessary to suggest a new space for modern people to regain their composure. Therefore, we want to create a space where we can look around and provide real rest through books, a medium that makes us think and imagine ourselves. In particular, we intend to provide convenient access by establishing it in the Han River Park, which is a common and natural space, and to make it possible to promote reading culture by actively participating in the space as well as experiencing reading as a concept of relaxation. Thus, this paper proposed a park-type pavilion to promote the reading culture of modern people, provided a flexible environment for reading books to users, and focused on combining the functions of comfortable rest to regain composure.