• Journal of Chest Surgery
• /
• 제51권5호
• /
• pp.338-343
• /
• 2018

Background: This study examined the role of superficial vein surgery in patients with combined superficial venous reflux and segmental popliteal vein reflux. Methods: We retrospectively reviewed 42 limbs in 38 patients with combined superficial venous reflux and segmental popliteal vein reflux who underwent saphenous vein ablation between January 2014 and February 2017. Patients underwent outpatient follow-up duplex ultrasonography at 3, 6, and 12 months postoperatively. Resolution of deep vein reflux was defined as reversed blood flow in a popliteal segment for less than 1.0 second and a decrease in the reflux time of more than 20% of the preoperative reflux time. Results: The mean follow-up period was 9 months (range, 3-23 months). Saphenous vein ablations were performed by stripping in 24 limbs and radiofrequency ablation in 18 limbs. Preoperative segmental popliteal vein reflux resolved in 21 of the 42 limbs (50%). Conclusion: This study demonstrated that superficial venous surgery corrected segmental popliteal vein reflux in 50% of limbs with combined superficial venous reflux and segmental popliteal vein reflux. Other prospective studies are necessary to elucidate the etiology of the non-reversible cases.

• 대한한방내과학회지
• /
• 제36권1호
• /
• pp.40-48
• /
• 2015

Objectives : This study is to report the effects of SokPyeonAnGel (SPAG) on patients with reflux esophagitis. Methods : Four patients with gastroesophageal reflux disease (GERD) symptoms, who had suffered from different symptoms, were diagnosed with reflux esophagitis by gastroscopy. SPAG was orally administered 30 minutes after each meal, 3 times a day. Analysis of the Gastroesophageal Reflux Disease Questionnaire (GerdQ) for GERD symptoms and quality of life was performed before and 1~3 weeks after SPAG treatment. Results and Conclusions : The rating scores decreased by 1~4 points after treatment. In particular, there was a 2-point decrease in “How often did you take additional medication for your heartburn and/or regurgitation?” except for one patient who hadn't taken additional medication. This suggests that SPAG could be used to treat symptoms of reflux esophagitis.

• Childhood Kidney Diseases
• /
• 제20권1호
• /
• pp.18-22
• /
• 2016

Purpose: The previous reports regarding VUR resolution were not precise due to early frequent surgical intervention. We evaluated the spontaneous resolution (SR) rate and the incidence of new renal scars in primary VUR, focusing on severe reflux. Methods: Medical records of 334 patients with primary VUR who were on medical prophylaxis without surgery for 1 to 9 years, were retrospectively reviewed. Medical prophylaxis was initiated with low-dose antibiotic prophylaxis or probiotics. Radioisotope cystourethrography was performed every 1 to 3 years until SR of reflux. New renal scar was evaluated with follow-up $^{99m}Tc$ DMSA renal scan. Results: The SR rates decreased as VUR grades were getting higher (P=0.00). The overall and annual SR were 58.4% and 14.9%/yr in grade IV reflux and 37.5% and 9.3%/yr in grade V reflux. The median times of SR were 38 months in grade IV reflux and 66 months in grade V reflux. The probable SR rates in grade IV and V reflux were 7.8% and 8.9% in the 1st year, 46.0% and 30.8% in the 3rd year and 74.4% and 64.4% in the 5th year. The incidences of new renal scars between low to moderate reflux and severe reflux showed no significant difference (P=0.32). Conclusion: The SR rates of severe primary VUR were higher than previously reported and most new renal scars were focal and mild.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제17권1호
• /
• pp.13-22
• /
• 2014

Esophageal pH monitoring is considered the gold standard for the diagnosis of gastroesophageal reflux disease because of the normal ranges across the pediatric age range. However, this method can only detect acid reflux. Multichannel intraluminal impedance-pH (MII-pH) monitoring has recently been used for the detection of bolus reflux in infants and children. This method allows for the detection of liquid, gas or mixed reflux in addition to acid, weakly acidic or weakly alkaline reflux. MII-pH monitoring can record the direction of flow and the height of reflux, which are useful parameters to identify an association between symptoms and reflux. However, the technique is limited by its high cost and the lack of normative data of MII-pH in the pediatric population. Despite certain limitations, MII-pH monitoring will become more common and gradually replace pH monitoring in the future, because pH monitoring is part of MII-pH.

• 대한후두음성언어의학회지
• /
• 제23권2호
• /
• pp.124-128
• /
• 2012

Background and Objectives : There are many diagnostic modalities to evaluate laryngopharyngeal reflux. However, ideal diagnostic methods have not been established yet. The purpose of this study is to evaluate the effectiveness of Water-Siphon test as a diagnostic test of laryngopharyngeal reflux. Subjects and Methods : From November 2006 to September 2007, we performed esophagography with Water-Siphon test and questionnaire, physical examination for 227 patients with laryngopharyngeal reflux symptoms. The results of Water-Siphon test were classified according to the degree of reflux, the number of reflux, the retention time and analyzed about the relationship with the reflux symptom index (RSI), reflux finding score (RFS). Results : The degree of reflux was related with pseudosulcus, thick endolaryngeal mucus. The number of reflux was related with thick endolaryngeal mucus. A positive predictive value of Water-Siphon test was 82.7% and sensitivity was 91.5%. Conclusion : Water-Siphon test is a reliable diagnostic test for laryngopharyngeal reflux.

• 대한후두음성언어의학회지
• /
• 제16권1호
• /
• pp.15-18
• /
• 2005

Background and Objectives : To determine the changes of reflux symptoms and laryngoscopic findings of patients with laryngopharyngeal reflux (LPR) on the duration of proton pump inhibitor medication. Materials and Methods : From Feb 2003 to Nov 2004, 58 patients who were diagnosed with LPR by 24-hour double-probe pH monitoring were enrolled. All patients were treated with proton pump inhibitor and followed up for 8 weeks at least. The response of symptoms and laryngoscopic findings of patients were assessed with reflux symptom index (RSI) and reflux finding score (RFS) before treatment and 2, 4, 8, 12, 16, 20 weeks after treatment. Results : The symptoms of patients with LPR were improved significantly at 2, 4, 8 weeks of treatment. The laryngoscopic findings of patients with LPR were improved significantly at 4 and 12 weeks of treatment. There was no correlation between improvement of reflux symptoms and laryngoscopic findings. Conclusions : The laryngoscopic findings of LPR patients were improved more slowly than reflux symptoms. Based on our results, anti-reflux therapy might be continued at least for 3 months until the improvement of laryngoscopic findings.

• 대한본초학회지
• /
• 제36권3호
• /
• pp.1-8
• /
• 2021

Objective : Reflux esophagitis (RE), one of gastroesophageal reflux disease (GERD), is a disease that causes inflammation due to reflux of stomach contents such as stomach acid and pepsin due to the unstable gastroesophageal sphincter, and is currently increasing worldwide. The currently used treatment for reflux esophagitis has various side effects. Therefore, in this study the effect of Toosendan Fructus extract on chronic acid reflux esophagitis in rats was evaluated in order to find a new treatment material for reflux treatment. Methods : After inducing reflux esophagitis through surgery, the group was separated and the drug was administered for 2 weeks; Normal rats (Normal, n=8), chronic acid reflux esophagitis rats (Control, n=8), Toosendan Fructus 200 mg/kg body weight/day-treated chronic acid reflux esophagitis rats (TF, n=8). After, we were taken esophageal tissue and esophageal mucosa damage was identified, and analyzed the expression of NADPH oxidase, AP-1/MAPK-related proteins, and tight junction proteins by western blot in esophageal tissue. Results : Toosendan Fructus administration significantly protected the esophageal mucosal damage of reflux esophagitis. Also, Toosendan Fructus significantly reduced the expression of NADPH oxidases (NOX2 and p22^phox) and AP-1/MAPK-related proteins (c-Fos, c-Jun, p-p38, p-ERK, and p-JNK). In addition, it significantly increased the expression of tight junction proteins (Occludin, Claudin-3, and Claudin-4). Conclusions : These results suggest that Toosendan Fructus reduced damage to the esophageal mucosa by protecting the esophageal mucosa by upregulating tight junctions proteins as well as inhibiting the AP-1/MAPK pathway through reducing NADPH oxidases expression.

• 대한핵의학회지
• /
• 제29권3호
• /
• pp.313-318
• /
• 1995

통상적인 Tc-99m DISIDA 스캔도중 우연하게 위장역류가 발견되는 경우가 있는데 이의 임상적 의의를 알아보고자 1991년 12월부터 1995년 6월까지 충남대학교병원에서 통상적인 Tc-99m DISIDA 스캔을 시행한 1,553명의 환자들중 우연하게 위장부위로 방사능역류를 보인 36명의 환자들을 대상으로 후향적으로 이러한 환자들의 검사당시 임상상을 알아보았다. 1) 연구기간동안 시행한 Tc-99m DISIDA 스캔상 위장 역류는 2.3%에서 발견되었다. 2) 위장역류를 보인 대상환자중 위장관 및 담도계에 수술을 받은 과거 병력이 있는 경우는 19% 이었으며 역류가 없었던 환자들에서보다 의미있게 많았다(p<0.01). 3) 역류가 발견되는 시점은 Tc-99m DISIDA 정맥주사 후 30분에서 60분 사이가 50%로 가장 많았으며 60분에서 90분 사이가 23% 이었다. 4) 위장 역류를 보인 환자중 87%에서 위내시경 검사상 위염, 위궤양, 십이지장궤양, 위암등의 병변을 보였다. 이상에서 저자들은 Tc-99m DISIDA 스캔상 위-십이지장 역류를 보이는 경우는 역류가 없는 경우보다 위장관이나 담도계에 수술을 받은 병력이 있는 경우가 의미있게 많았으며 이들 중 상당수가 위-십이지장에 질환을 가지고 있음을 알 수 있었다.

• 대한후두음성언어의학회지
• /
• 제14권1호
• /
• pp.26-29
• /
• 2003

Background and Objectives : Gastric acid reflux has been suggested to have an association with sleep apnea(SA). This study's aim is to evaluate the relationship between reflux laryngitis and SA through the fact that the treatment of reflux laryngitis may impact the snoring and SA related symptoms in selective individuals. Methods : Population consist of 24 males and 10 female aged 34 to 66 years(mean age 50 years) confirmed by Reflux Finding Score(RFS) of PC Belafsky. Thirty four patients with reflux laryngitis and associated symptoms of SA were treated with proton pump inhibitor(Rabeprazole sodium 10mg/day) for 60 days. The degree of snoring and apnea related symptoms were evaluated using questionnaires, and palatine tonsillar hypertropy(PTH) and RFS were compared preoperatively and postoperatively. Results : After antireflux treatment for 60 days, the snoring(p=0.039), daytime sleepiness(p=0.002), and concentration(p=0.011) were significantly improved(p<0.05) and RFS was significantly decreased(p=0.000), but morning headache(p=0.057) and sleep apnea(p=0.083) were not significantly improved(p>0.05) and PTH was not significantly decreased(p=0.328). Conclusion : Treatment of reflux laryngitis significantly impacted the snoring, daytime sleepiness, and concentration in selective individuals. These results suggest some close relationship between reflux laryngitis and SA, and the treatment of reflux laryngitis may be some effective in those with both disorders.

• Journal of Gastric Cancer
• /
• 제18권4호
• /
• pp.313-327
• /
• 2018

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.