Standardization Voice Training Method for Professional Voice User Based on Traditional

Opera singers train their vocal organ to have a good timbre of voice. They train and train again to have a strong resonance, large range of voice, homogenous color of voice, a voice goes far and to avoid vocal disorder, etc. This article is analyzing from scientific and medical perspective. It could approach the secret of the great art of 400 years history - . Furthermore standardizing voice training method based on will facilitate to train, therapy and care the voice professional user and voice disorders.

Comparison of Vocal Cord Motion and Voice Characteristics of Applied Music Singing Students before and after Singing Voice Therapy

BACKGROUND AND OBJECTIVES: Many students major in applied music singing have various difficulties in phonation when they sing or perform. But the studies about this cause are lack. The purpose of this study is whether singing voice therapy based on vocal music is effective or not to applied music singing students that have difficulties in phonation. MATERIALS AND METHODS: Singing voice therapy program had been done to 8 students major in applied music singing during 7 weeks. We did laryngeal stroboscope, perceptual, acoustic and aerodynamic examination before and after singing voice therapy to this students. And we studied post examination results have differences or improvements compared to pre examination results. RESULTS: Four male students don't have effective improvement after singing voice therapy but they shows slight improvement in aerodynamic examination values compared to pre examination values. Four female students shows improvement in aerodynamic examination values and pitch range increasing. Above all, one student's vocal nodules disappeared after singing voice therapy. CONCLUSIONS: Singing voice therapy based on music singing is very effective to the students major in applied music singing. Above all, their curriculum in applied music singing should include phonation training based on music singing before training perform and technic practices.

Dysphagia in Traumatic Brain Injured Patients

OBJECTIVE: To investigate the frequency and nature of dysphagia of traumatic brain injured (TBI) patients, and to examine the relationship of clinical parameters with the dysphagia. METHOD: Forty-two TBI patients were included in this study. We examined clinical parameters such as Glasgow coma scale (GCS), duration of coma, and posttraumatic amnesia (PTA), hospital stay, rehabilitation stay, functional independence measure (FIM) gain, and efficiency as functional outcomes. We classified the brain lesions into two categories: focal and nonfocal lesion according to the findings of the brain CT imaging. We performed videofluoroscopic swallowing study (VSS) for patients with dysphagia. RESULTS: Eighteen (42.8%) out of total 42 TBI patients had dysphagia. The presence of dysphagia had significant relationship with GCS, duration of PTA, hospital and rehabilitation stay, and FIM gain. Duration of dysphagia was positively correlated with duration of coma, and hospital and rehabilitation stay, but negatively correlated with FIM gain and efficiency. Duration of dysphagia was longer in patients with nonfocal brain lesion than those with focal brain lesion. On VSS findings, common problems were impairment of tongue control and prolonged pharyngeal transit time. Majority of patients had combined problems in oral and pharyngeal phases. CONCLUSION: Dysphagia was common problem in TBI patients, and occurrence and duration were correlated with several clinical parameters and with prognosis of TBI patients.

The Incidence of Secondary Poststroke Complications in Stroke Patients in Korea as Compared with Those in Western Countries

OBJECTIVE: It has been well known that many of patients with stroke have developed secondary poststroke complications which encompassed pneumonia, urinary tract infection, depression, fall and/or fracture, deep vein thrombosis, decubitus ulcer, and others. Our experience with Korean stroke patients indicated that the incidences of such complications were not as high as reported on the western literatures. This study was aimed to obtain the precise data in terms of occurrence of poststroke complications in Korea as compared with those in western countries. METHOD: Nine-hundred-eighty-four (984) charts of Stroke patients who were hospitalized at Asan Medical Center during the periods of 3 years from 1994 through 1997 were reviewed. The data from the review were compared with the data excerpted from the literatures. RESULTS: The review of charts disclosed that there was a great disparity of the incidences of complications in stroke patients between Korea and Western (U.S.A.) countries. The incidences of all stroke complications were uniformly much lower in Korea than Western countries. CONCLUSION: Compared with western countries, stroke patients in Korea presented significantly lower incidences of poststroke complications: 5.8% pneumonia; 3.7% urinary tract infection; 3.0% fall; 2.7% decubitus ulcer; and 2.4% deep vein thrombosis. Although there were a many factors accounting for lower incidences of complication, an extensive nursing service around the clock seemed to be a major attributing factor. However, the nursing services such as position change, massage, joint motion exercise etc. have been rendered not by registered nurse but by a caregiver hired by patient's family or a member of patient's family. Since patient's family or caregiver had not formally received an education of health care, their service may be liable for incidences against patient's quality care. Therefore, the strengthening of the manpower of registered nurse is essential to meet a standard of nursing service.

Changes of Oxygen Saturation in Stroke Patients with Dysphagia and Aspiration

OBJECTIVE: Our study was designed to evaluate the clinical value of pulse oximetry for the detection of aspiration in a stroke patient with dysphagia at bedside. METHODS: Thirty two acute stroke patients with dysphagia were devided into two groups according to the presence or absence of aspiration. And controls was selected among the inpatients without a neurological disease and an evidence of dysphagia. We assessed the dysphagia by a neurological examination, fiberoptic examination of vocal cord and videofluoroscopic swallowing study(VFSS). And the oxygen saturation of tissue blood flow(SpO2) was measured, while VFSS was performed by swallowing the barium sulfate fluid for three times. RESULTS: The clinical findings of dysphagia were not exactly correlated with the VFSS. There was no significant difference of the resting SpO2 among three groups, but the mean SpO2 fell more in the patients with aspirations( 2.73%) than in the controls( 0.11%) or the patients without aspirations( 0.33%). Mean SpO2 fell more in the patients with aspiration of larger amount, but the change of SpO2 was not statistically significant. CONCLUSIONS: We conclude that the pulse oximetric measurement of SpO2 is useful as a screening test for the assessment of aspiration and the efficacy of swallowing training.

Comparison of Percutaneous Endoscopic Gastrostomy and Nasogastric Tube Feeding in Dysphagic Stroke

This study was designed to compare the percutaneous endoscopic gastrostomy(PEG) tube feeding with the nasogastric(NG) tube feeding for the patients with dysphagia after the stroke, and to find out the most optimal timing for the PEG tube feeding. We monitored the nutritional parameters, the frequency and the timing of complications, and other risk factors in 54 stroke patients with dysphagia. In the group of patients with the nasogastric(NG) tube feeding, a reduction in nutritional parameters was greater than in the group of patients with PEG tube feeding. Especially the reduction in serum hemoglobin and albumin level was statistically significant. Thirteen cases of aspiration pneumonia who had frequent self removal of feeding tubes developed in the group with NG tube feeding. Most cases of aspiration pneumonia in the NG tube feeding group developed within the first 2 weeks. Complications from the PEG tube feeding group were three cases of upper gastrointestinal bleeding and three cases of local infection. There were no correlations between the duration of dysphagia and the location of brain lesions, the history of tracheostomy, the age, the initial mental status, or the artificial ventilation. But, there was a significant prolongation of duration of dysphagia in the group of patients who had a vocal cord palsy, an absence of gag reflex, a paralytic dysarthria and a prolonged intensive medical care. We conclude that the PEG tube feeding is a safer and the more effective method to provide a long term enteral nutrition to patients with neurological dysphagia than the NG tube feeding. Since the most complications developed in the first 2 weeks, the PEG tube feeding should be applied within the initial 2nd to 3rd week for the stroke patients with dysphagia and aspiration risks. Further prospective study will be needed to decide an ideal timing of PEG tube feeding after an acute stroke.

Effect on body weight control through behavior, diet, exercise therapy in obese patients

No abstract available.