• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.2
• /
• pp.136-141
• /
• 2008

Background and Objectives: Laryngopharyngeal reflux (LPR) is a very common disease among outpatients of department of otorhinolaryngology. Although there are several diagnostic tools for LPR disease and ambulatory 24-hour double-probe pH monitoring is gold standard method, empirical diagnosis by reflux symptom index and reflux finding score (RFS) are mainly used. So we analyzed the relationship between ambulatory 24-hour double-probe pH monitoring and RFS in patients with LPR. Subjective and Method: Fifty patients with LPR symptoms and abnormal RFS and ambulatory 24-hour double probe monitoring were enrolled. Each items and sum of laryngeal reflux score were compared the results of ambulatory 24-hour double-probe pH monitoring in upper (UES) and lower (LES) esophageal sphincter. Results: There were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES (pH<4 and pH<5) and each item and sum of RFS. However, supine time and reflux number of UES (pH<5) were showed the partial correlations with diffuse laryngeal edema and thick endolaryngeal mucus (p=0.03, p=0.01). Although there were no relationship between the results of ambulatory 24-hour double-probe pH monitoring in LES and sum of RFS, the significant correlations presented between granuloma and total time (p=0.008), upright time (p=0.008, reflux number (p=0.049) of LES. Conclusion: Although granuloma among items of RFS showed significantly correlation with the results of ambulatory 24-hour double-probe pH monitoring in LES, there were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES and LES and items and sum of RFS.

• Korean Journal of Bronchoesophagology
• /
• v.3 no.1
• /
• pp.79-83
• /
• 1997

The term laryngopharyngeal reflux (LPR) refers to the backflow of food or stomach acid back up into the larynx (the voice box) or the pharynx (the throat). Esophagopharyngeal reflux is suggested as an etiologic factor in laryngeal disease. To examine a possible esophageal basis for laryngopharyngeal symptoms, we studied 48 patients with persistent laryngopharyngeal symptoms, and 12 relative control subjects. Patients were evaluated for cervical symptoms by questionnaire and underwent gastrofiberoscopy, fiberoptic laryngoscopy, esophageal manometry and 24-hour ambulatory double-probe pH monitoring. We found LPR in fourteen out of 48 patients with cervical symptoms (29%). The LPR group consisted of nine men and five women. The symptoms that LPR patients complained were throat lump sensation, hoareness, sore throat, throat clearing, chronic coughing and dysphagia in order of frequency, and they were not different significantly from non-LPR patients. The laryngoscopic findings in LPR patients were posterior erythema, laryngeal edema and diffuse erythema, and there was also no significant difference between LPR group and non-LPR group. There was statistically significant correlation between LPR and gastroesophageal reflux (GER). We concluded that there is no pathognomonic symptoms or laryngoscopic findings in diagnosis of LPR, and 24-hour ambulatory double-probe pH monitoring is an essential diagnostic tool in LPR.

• Journal of agricultural medicine and community health
• /
• v.36 no.3
• /
• pp.157-166
• /
• 2011

Objectives: Anxiety and depression are known to be associated with hypertension, and blood pressure can vary spontaneously throughout the day. The aim of this study was to evaluate anxiety, depression and 24-hour ambulatory blood pressure (24-h ambulatory BP) in employees at their worksite. Methods: A total of 107 volunteers among 136 employees at a hotel in Gyeongju, Korea were enrolled in this study between December 2009 and March 2010. The Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to assess anxiety and depression, respectively. Blood pressure was measured using a 24-h ambulatory BP monitoring system. Results: No significant differences in either BAI or BDI scores were found when hypertensive individuals were compared to normotensive individuals. The frequency of diastolic non-dipper was significantly higher in individuals with depressive symptoms compared to those without (p<0.05). Depression was significantly associated with diastolic non-dipper (OR: 6.85, 95% CI: 1.50-30.01). Conclusions: The results of this study indicate that depression should be considered when deciding upon blood pressure control regimens, and appropriate additive psychotherapy may be beneficial in the treatment of hypertensive patients.

• Journal of Gastric Cancer
• /
• v.24 no.2
• /
• pp.137-144
• /
• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.18 no.2
• /
• pp.102-107
• /
• 2007

Laryngopharyngeal reflux disease (LPRD) is the result of retrograde flow of gastric contents to the laryngopharynx. Laryngoscopic findings and special questionnaires are first step of diagnosis of LPRD. Empiric trials of Proton pump inhibitor' test (PPI test) is recommended as treatment and diagnosis. However confirmation of reflux is then recommended primarily in patients with persistent symptoms despite acid-suppressive therapy. The 24 hour ambulatory double pH monitoring has been a gold standard method in diagnosis of LPRD even though it has some limitation. The combined multichannel intraluminal impedance and pH monitoring is a new-rising test tool. It can detect acid/non-acid, liquid/gaseous reflux and clearance of refluxate. The water siphon test is also used for diagnosis of LPRD.

• Journal of Gastric Cancer
• /
• v.4 no.4
• /
• pp.225-229
• /
• 2004

Purpose: Some patients develop gastroesophageal reflux disease (GERD) after a gastrectomy for stomach cancer. Therefore, we conducted this research to gain an understanding of esophageal acidity and motility change. Materials and Methods: From July 2002 to March 2004, the cases of 15 randomized patients with stomach cancer who underwent a radical subtotal gastrectomy (RSG) with Billroth I(B-I) reconstruction (n=12) or a radical total gastrectomy (RTG) with Roux-en-Y (R-Y) gastroenterostomy (n=3) were analyzed. We investigated the clinical values of the ambulatory 24-hour pH monitoring and esophageal manometry in these patients, just before discharge from the hospital after an operation. Results: GERD was present in three patients ($20\%$). Compared with two reconstructive procedures, 3 of the 12 patients in the RSG with B-I group had GERD; however, none of RTG with R-Y group had GERD. Compared with pathologic stage, 2 of 9 patients in stage I, 1 of 2 patients in stage II, none of 3 patients in stage III, and none of 1 patient in stage IV had GERD. Esophageal manometry was performed in 10 patients. Nonspecific esophageal motility disorder (NEMD) was present in 7 patients. Conclusion: Some patients had GERD as a complication following a gastrectomy for stomach cancer. We suspect that the postoperative esophageal symptom is due to not only bile reflux but also gastroesophageal acid reflux. Therefore, careful observation is recommended for the detection of GERD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.15 no.2
• /
• pp.81-86
• /
• 2004

Background and Objectives : In general, ambulatory 24-hour pH monitoring is considered the current gold standard for larynogopharyngeal reflux(LPR). There is no validated instrument whose purpose is to document the physical finding and severity of laryngopharyngeal reflux. The purposes of this study are to revaluate the validity and reliability of the reflux finding score(RFS) and to quantify laryngoscopic findings using reflux finding score. Material and Methods : Thirty-three LPR patients confirmed by dual-probe pH monitoring and thirty patients of control were selected. The RFS was documented for each patient with telescopic laryngoscopy before treatment. For test-retest intraobserver reliability assessment, a blinded laryngologists determined the RFS on two separate occasions. To evaluate interobserver reliability assessment, the RFS was determined by t재 different blinded laryngologists. Results : The mean age of the cohort with pH-documented LPR was 45.8 years and the mean RFS was 11.4. The mean age of cotrol subjects was 52 years and the mean RFS was 5.4. The mean RFS for laryngologist no. 1 was 10.8 at the initial screening and 10.9 at the repeat evaluation. The mean FRS for laryngologist no.2 was 11.1 at the intial test and 10.9 at the repeat evaluation. The correlation coefficient for interobserver variability was 0.93 and intraobserver variability was 0.94. Conclusion : The RFS demonstrates excellent inter-and introaobserver reproducibility and is helpful for quantifying laryngeal finding in LPR. We can be 95% certain that an individual with a RFS greater than 7 has LPR.

• Safety and Health at Work
• /
• v.6 no.3
• /
• pp.192-199
• /
• 2015

Background: Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong. Methods: Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. Results: Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. Conclusion: Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

• Anxiety and mood
• /
• v.2 no.1
• /
• pp.28-32
• /
• 2006

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.4 no.1
• /
• pp.92-98
• /
• 2001

The dumping syndrome has been a known complication of gastric surgery in adults, but it is recognized as a very rare disease in the pediatric population, especially in Korea. We report a case of dumping syndrome in a 10-month-old infant, who underwent Nissen fundoplication for the treatment of gastroesophageal reflux(GER). He was admitted because of aspiration pneumonia, and diagnosed as GER by 24-hour ambulatory esophageal pH monitoring test. For the treatment of GER, Nissen fundoplication was performed. After the operation, symptoms occurred within 30 minutes of meals, such as diaphoresis, palpitation, weakness, abdominal fullness, nausea, and diarrhea. The gastric emptying scan showed very rapid gastric emptying. His oral glucose tolerance tests revealed early-onset hyperglycema followed by delayed-onset hypoglycemia, which was the characteristic finding of the dumping syndrome. We introduced uncooked cornstarch to resolve symptoms and maintain the serum glucose level. After the feeding of uncooked cornstarch, his symptoms subsided and normal oral glucose test was restored. After the six months of treatment, his weight and height were increased dramatically from below 3 percentiles up to the normal range. The dumping syndrome should be considered when an infant suffers from the feeding difficulties after the gastric surgery like Nissen fundoplication, and the diet therapy including uncooked cornstarch could be applied as an effective measure.