• Biomolecules & Therapeutics
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• v.22 no.5
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• pp.420-425
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• 2014

Esophageal reflux of gastric contents causes esophageal mucosal damage and inflammation. Recent studies show that oxygen-derived free radicals mediate mucosal damage in reflux esophagitis (RE). Chlorogenic acid (CGA), an ester of caffeic acid and quinic acid, is one of the most abundant polyphenols in the human diet and possesses anti-inflammatory, antibacterial and anti-oxidant activities. In this context, we investigated the effects of CGA against experimental RE in rats. RE was produced by ligating the transitional region between the forestomach and the glandular portion and covering the duodenum near the pylorus ring with a small piece of catheter. CGA (10, 30 and 100 mg/kg) and omeprazole (positive control, 10 mg/kg) were administered orally 48 h after the RE operation for 12 days. CGA reduced the severity of esophageal lesions, and this beneficial effect was confirmed by histopathological observations. CGA reduced esophageal lipid peroxidation and increased the reduced glutathione/oxidized glutathione ratio. CGA attenuated increases in the serum level of tumor necrosis factor-${\alpha}$, and expressions of inducible nitric oxide synthase and cyclooxygenase-2 protein. CGA alleviates RE-induced mucosal injury, and this protection is associated with reduced oxidative stress and the anti-inflammatory properties of CGA.

• Journal of Acupuncture Research
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• v.32 no.3
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• pp.83-93
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• 2015

Objectives : The purpose of this study was to evaluate whether acupuncture at $SP_6$ attenuates esophageal inflammation on refluxed-induced esophagitis. Methods : Acupuncture at $SP_6$ was stimulated by acupuncture torsion technique for 30 seconds four times every hour after an operation induced reflux esophagitis(RE), and its effects were assessed in comparison with RE rats without acupuncture, and normal rats. Results : $SP_6$ acupuncture stimulation markedly ameliorated mucosal damage in the histological evaluation. Reflux-induced esophagitis rats exhibited the down-regulation of antioxidant-related protein expression levels such as heme oxygenase-1(HO-1) in the esophagitis; however, the associated levels with $SP_6$ acupuncture stimulation were significantly higher than those in RE rats without acupuncture stimulation. Moreover, $SP_6$ acupuncture stimulation significantly reduced the expression of inflammatory proteins through mitogen-activated protein kinase(MAPK)-related signaling pathways. The increased protein expressions of inflammatory mediators, cyclooxygenase-2(COX-2) and inducible nitric oxide synthase(iNOS), by nuclear factor-kappa B(NF-kB) activation were significantly suppressed through $SP_6$ acupuncture stimulation. Conclusions : Our findings support the therapeutic evidence for $SP_6$ acupuncture stimulation alleviating the development of esophagitis via regulating inflammation through the activation of the antioxidant pathway.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.669-677
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• 2016

Reflux esophagitis is a common disease in developed nations. We describe the case of a female patient with endoscopic reflux esophagitis complicated by gastric dysmotility. Both electrogastrography and enterotachography were performed to detect gastric myoelectrical activity and pyloric sphincter function and evaluate gastric motility. The patient was treated only with herbal medications and general acupuncture, with electrical stimulation of the ST.36 (Zusanli) point, in addition to moxibustion therapy. After each primary and secondary treatment, the therapeutic effect was immediately evaluated. At the final follow-up 5 mon after the end of the secondary treatment, the patient’s general condition was assessed, in addition to the mucosa of the esophagus. At follow up, all the patients’ symptoms had disappeared, and the mucosa of the esophagus had returned to normal. We attributed these therapeutic effects to improved gastric dysmotility. To confirm the usefulness of this treatment method, studies of larger numbers of patients with reflux esophagitis treated with Korean traditional medicine are needed.

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

• Nuclear Engineering and Technology
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• v.17 no.1
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• pp.45-52
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• 1985

A two inverted U-tubes condenser was constructed from transparent materials to study the heat removal capability of steam generators under filmwise reflux condensation mode. Essentially, two sets of experiments were performed: (1) the first dealt with the reflux condensation length, and (2) the second dealt with the flooding points with and without the presence of a noncondensible gas in the steam flow, and the effect of the flooding time. In addition, experimental results are compared with the predictions of analytical models.

• Biomedical Science Letters
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• v.27 no.2
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• pp.77-87
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• 2021

Reflux esophagitis (RE) is a disease that stomach contents, stomach acid, and pepsin continually refluxing and is curently increasing worldwide. This study was conducted to find natural materials that can reduce side effects and effectively treat RE. Animal experiments were conducted with a 1:1 (EA1), 1:5 (EA5) ratio of Evodiae Fructus and Arecae Semen known to be effective against reflux esophagitis. As a result of confirming the total lesion of the esophageal mucosa after EA1 or EA5 treatment in reflux esophagitis animals, it showed superior improvement compared to the RE-control rats. In addition, by regulating the expression of MPO and NADPH oxidase, the activation of NF-κB was inhibited, and the expression of COX-1 and COX-2 was regulated. Moreover, its improved esophageal barrier function through regulating protein expressions of tight junction protein and MMPs/TIMPs. Taken together, a mixture of Evodiae Fructus and Arecae Semen can attenuate the damage to the esophageal mucosa that not only inactivationed the NF-κB through oxidative stress control, but also by regulating tight junctions and MMPs/TIMPs. This effect was more excellent in the 1:1 mixture (EA1) than in the Evodiae Fructus and Arecae Semen 1:5 mixture (EA5).

• Journal of Acupuncture Research
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• v.40 no.3
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• pp.188-200
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• 2023

Laryngopharyngeal reflux (LPR) disease is a condition in which the stomach contents return to the larynx and pharynx via the esophagus, causing mucosal injury. While conventional treatments, such as proton pump inhibitors, have limitations, acupuncture has been shown to reduce LPR symptoms. However, its effectiveness has not been systematically assessed. This study aimed to systematically evaluate the effectiveness of acupuncture in treating LPR. We review 10 electronic databases with a consistent search strategy, and 2 independent reviewers screened the articles based on the inclusion and exclusion criteria. This study selected and analyzed 7 randomized controlled trials after the screening to assess primary outcomes, including reflux symptom index and reflux finding score, and secondary outcomes, including upper and lower esophageal sphincter pressure. The results revealed the statistically significant effectiveness of acupuncture in combination with conventional treatment in reducing LPR symptoms compared with conventional treatment alone. The most commonly used acupuncture points were CV22, ST36, and LR3. However, the meta-analysis demonstrated low reliability, as assessed using the GRADE Tool. Further research is needed to improve the evidence and draw clear conclusions regarding the clinical use of acupuncture for treating LPR.

• Clinical Endoscopy
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• v.56 no.6
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• pp.681-692
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• 2023

In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett's esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

• Journal of Magnetics
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• v.19 no.1
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• pp.5-9
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• 2014

The amine functionalized $CoFe_2O_4$ nanoparticles were prepared by thermal decomposition method at reflux temperatures $160^{\circ}C$ and $172^{\circ}C$. The obtained $CoFe_2O_4$ nanoparticles at $160^{\circ}C$ reflux temperature show aggregation free poly-dispersed nanoparticles in 4-15 nm range. In an elevated reflux temperature of $172^{\circ}C$, $CoFe_2O_4$ show aggregated poly-dispersed nanoparticles in the size range of 20-46 nm. The saturation magnetization value at 300 K exhibited 51 emu/g at reflux temperature of $160^{\circ}C$. However, the sample synthesized at an elevated temperature of $172^{\circ}C$ has shown a coercive field value of 560 Oe with saturation magnetization of 68 emu/g.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.55-71
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• 2008

Gastroesophageal reflux (GER) defined as passage of gastric contents into the esophagus without symptoms is a common physiologic gastrointestinal problem in infants, children and even in adults. But gastroesophageal reflux disease (GERD) defined as symptoms or complications of GER is a disease entity to find out the reason and treat. After the era of 1970 we have been studying about GERD with the development of diagnostic and therapeutic methods. I already introduced the nature and the fundamental knowledge of GERD in the opening symposium of KSPGHAN in 1998. Now, I will introduce the guidelines for evaluation and treatment of GERD which was recommended by the North American Society for Pediatric Gastroenterology and Nutrition and American Pediatric Association which was published in 2001. And I will introduce progressing subjects and the forecoming issues to be solved in near future. Those are as followings. Does GERD cause otolaryngologic symptoms such as chronic sinusitis and chronic otitis? Is GERD inherited? Can we find out the child who will become GERD in adult life and the way to reduce the incidence of Barrett's esophagus and esophageal cancer? Is long term PPI therapy safe in children?