Objective: The objective of this nationwide, long-term follow-up study was to explore the connection between congestive heart failure (CHF) and ossification of the posterior longitudinal ligament (OPLL) in Korea. Methods: Patient information was collected from the Health Screening cohort of the National Health Insurance Service. Individuals diagnosed with OPLL were identified using specific International Classification of Diseases, 10th revision codes (M48.8, M48.81, M48.82, and M48.83). A total of 1,289 OPLL patients and 6,445 controls were included in the study, selected through 1:5 age and sex matching. The data spanned from January 1, 2004 to July 31, 2015. To compute the incidence rate of CHF in each group, the Kaplan-Meier method was employed. Additionally, Cox proportional-hazards regression analysis was utilized to estimate the hazard ratio of CHF. Results: CHF was present in 19 patients (1.47%) in the OPLL group and 71 patients (1.10%) in the control group. After accounting for age and sex, the hazard ratio for CHF in the OPLL group was 3.164 (95% confidence interval [CI], 1.867-5.360). When additionally considering income and underlying diseases, the hazard ratio for CHF within the OPLL group was 3.355 (95% CI, 1.977-5.694). All subgroups of OPLL patients exhibited an increased risk ratio for CHF across parameters such as sex, age, diabetes, hypertension, and dyslipidemia. Conclusion According to this nationwide longitudinal study, an elevated incidence rate of CHF was associated with OPLL.

To date,measuring the neural activity of speech processing in adults and children after cochlear implantation has been a great challenge because conventional neuroimaging techniques are limited by the magnetic properties of cochlear implants.Functional near-infrared spectroscopy(fNIRS)is a non-invasive imaging technique for neuroimaging the brain compatible with implanted devices and unaffected by electrical artifacts.fNIRS is suitable for measuring the neural activity of speech processing in adult and pediatric cochlear implant recipients and can better identify and interpret cortical responses.The purpose of this paper is to summarize the use of fNIRS as a tool to measure the neural activation level of speech processing in cochlear implant recipients for different types of speech stimuli,and thus to provide a clinical and objective basis for the assessment of auditory speech rehabilitation and the development of rehabilitation programs for implant recipients.

Objective To investigate the vowel acoustic characteristics of patients with voice disorders and the reasonable way of administering vocal space area(VSA)and language in the Mandarin system.Methods A total of 40 subjects(20 males and 20 females)with voice disorder and normal healthy controls were recruited.The differ-ences in VSA between the disorder and healthy control groups were analyzed under different corpora and different vowel vertex numbers.Results The differences in VSA between the voice disorder and the control groups were highly significant in both the vowel and long sentence corpus.The differences in VSA between 4 vowels and 3 vow-els and 5 vowels were not significant,and 5 vowels were more suitable for VSA measurement in Mandarin.Conclu-sion The vowel articulation of patients with voice disorder is less clear than that of normal speakers.It is more ac-curate to use 5 vowels to measure VSA under the Mandarin system and it is better for measuring oral motility.Both single vowels and continuous speech are suitable for the measurement of VSA.

Objective To investigate the characteristics of oral and laryngeal diadochokinesis abilities and the developmental patterns of coordinated vocal fold movements in preschool children aged 3～6 years.Methods Sixty-one normal preschool children aged 3～6 years were selected to measure their maximum phonation time(MPT),as well as two types of acoustic parameters of oral and laryngeal diadochokinesis ability movements,including the as-sessment of one trisyllabic/pataka/diadochokinesis ability rate and four monosyllabic/?a/,/ha/,/?A/,/hA/la-ryngeal diadochokinesis ability rates.Results Diadochokinesis ability(DDK)and laryngeal diadochokinesis ability(LDDK)rates increased with age in preschool children aged 3～6 years,showing highly significant differences(P＜0.01).The growth rate of children's LDDK rates at age 4～5 years was the maximum within the 3～6 year age range.Children's MPT was highly significantly and positively correlated with DDK and LDDK(P＜0.01).The vo-cal fold adduction capacity in laryngeal diadochokinesis ability movements in children of all age groups was greater than vocal fold adduction ability/?a/LDDK＞/ha/LDDK(P＜0.01),/?A/LDDK＞/h∧/LDDK(P＜0.05).Con-clusion Age,MPT,and vocal fold adduction and abduction status had a significant effect on the oral and laryngeal diadochokinesis ability of preschool children aged 3～6 years old.The ages of 4～5 is a critical period for the devel-opment of children's oral and laryngeal diadochokinesis ability.

Objective: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions The risk rate of IS increased in patient with pyogenic spondylitis.

Objective: : The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson’s disease (PD). Methods: : Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. Results: : After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837–4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795–4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. Conclusion : Individuals with PD have a greater chance of AMI, according to this cross-national study.

Objective: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson’s disease (PD) associated with ischemic stroke in Korea. Methods: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD. Results: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group. Conclusions This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.

Objective: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson’s disease (PD) associated with ischemic stroke in Korea. Methods: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD. Results: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group. Conclusions This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.

Objective To analyze the acoustic features of patients with Parkinson's disease (PD),and to explore the correlation between the acoustic features and the severity and course of disease.Methods Fifty-two patients with PD from the Tongji Hospital Affiliated to Tongji Medical University and the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiaotong University from August to December 2015 were enrolled into this study.Thirty-two age-matched healthy people served as control group.PD patients were tested with Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr (H-Y) staging.And all the patients were tested with Mini-Mental State Examiantion (MMSE) and Voice Handicap Index (VHI).The voice samples of all subjects were collected and the frequency perturbation (jitter),amplitude perturbation (shimmer),and harmonic-to-noise ratio (NHR) were analyzed using a vocal assessment.Fundamental frequency (F0),standard deviation of fundamental frequency (SDF0) and formant ratio (F2i/F2u) were analyzed using a real-time speech measuring instrument.The acoustic parameters of the two groups were compared and the correlation between the parameters of the patients and the disease and course of disease was analyzed.Results Subjective assessment using VHI showed a total of 24 VHI abnormalities (46％) in the PD group,including 13 males (54％),11 females (46％).No VHI abnormalities were found in the control group.Among the parameters analyzed by objective acoustic method,compared with the control group (female/a/1.43(1.19,1.92),/i/3.39(1.49,9.85),/u/1.46(1.23,3.85);male/a/1.06(0.92,1.89),/u/1.30(1.07,1.64)),the SDF0 of the three vowels of the female patients in the PD group (/a/2.99(1.81,4.12),Z=5.429,P＜0.01;/i/10.89(5.47,22.20),Z=8.487,P＜0.01;/u/5.16(3.75,7.80),Z=7.138,P＜0.01) and /a/ and /u/ of the male patients in the PD group (/a/2.16(1.73,2.94),Z=4.858,P=0.002;/u/3.70(2.41,5.43),Z=7.664,P＜0.01) were significantly increased,and the F2i/F2u in the PD group (male 1.96±0.84,female 1.81± 1.14) was lower than that in the control group (male 3.48±0.70,female 4.14± 1.08),and the difference was statistically significant (t=-6.669,-6.844,P＜0.01).There were no statistically significant differences in frequency perturbation,amplitude perturbation,harmonic noise ratio and fundamental frequency.Only the fundamental frequency standard deviation of the sound parameters used in the study was correlated with the disease course of PD patients.After the severity of the disease was assessed by H-Y staging,the frequency perturbation (jitter),amplitude perturbation (shimmer) in the middle and late stage patients were higher than those in the early stage patients,and the difference of frequency perturbation in the three vowels was statistically significant,and the difference of amplitude perturbation in the vowels/i/and/u/was statistically significant.No correlation was found between the acoustic parameters and UPDRS score.Conclusions Consonance disorders are common in PD patients,and the changes in acoustic parameters are mainly manifested as the increase in the SDF0 and the decrease in the F2i/F2u.Acoustic parameters can be used as an effective indicator to evaluate the condition and course of PD patients,and further language tasks need to be added to clarify.

Objective To study the characteristics of the working memory in patients with Chinese aphasia in different ways of tasks and test materials .Methods Fifteen aphasia patients (aphasia group ,54~70 years old) and fifteen matched normal cases (control group) were requested to finish auditory retelling and auditory recognition tests of numerical materials ,content and function words .The maximum length of the string correctly completed was referred to as the working memory span .The working memory span was compared between the two groups .Results The working memory span of the aphasia group was significantly smaller than that of in the normal group (P<0 .01) .The working memory span of in patients with the aphasia group in the positive sequence retelling tasks were significantly greater than in reverse retelling ,positive recognition and reverse recognition (P<0 .01) .Reverse retell-ing was significantly greater than reverse recognition (P<0 .01) .The positive recognition was significantly greater than the reverse recognition(P<0 .01) .In retelling tasks ,the order of the working memory span was numbers , function words ,content words from high to low in the aphasia group ,but there was no significant difference be-tween them .In the positive recognition tasks ,the average working memory span for the numerical material was sig-nificantly greater than the content words(P< 0 .01) and the function words(P< 0 .01) .The content words were greater than the function words(P<0 .01) .In the reverse recognition tasks ,average working memory span for the numerical material was significantly greater than the function words (P<0 .01) .Conclusion The working memoryspan of in patients with aphasics significantly lags behind the normal people .Numbers are the easiest for aphasics . In different task modes ,the difficulties from high to low are as follow :positive retelling ,reverse retelling ,positive recognition and reverse recognition .