• Title, Summary, Keyword: reflux

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Spade-Shaped Anastomosis Following a Proximal Gastrectomy Using a Double Suture to Fix the Posterior Esophageal Wall to the Anterior Gastric Wall (SPADE Operation): Case-Control Study of Early Outcomes

  • Han, Won Ho;Eom, Bang Wool;Yoon, Hong Man;Ryu, Junsun;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.72-80
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    • 2020
  • Purpose: Proximal gastrectomy (PG) is a function-preserving surgery in cases of proximally located early-stage gastric cancer. Because gastroesophageal reflux is a major pitfall of this operation, we devised a modified esophagogastrostomy (EG) anastomosis to fix the distal part of the posterior esophageal wall to the proximal part of the anterior stomach wall to produce an anti-reflux mechanism; we named this the SPADE operation. This study aimed to show demonstrate the clinical outcomes of the SPADE operation and compare them to those of previous PG cases. Materials and Methods: Case details of 56 patients who underwent PG between January 2012 and March 2018 were retrospectively reviewed: 30 underwent conventional esophagogastrostomy (CEG) anastomosis using a circular stapler, while 26 underwent the SPADE operation. Early postoperative clinical outcome-related reflux symptoms, endoscopic findings, and postoperative complications were compared in this case-control study. Results: Follow-up endoscopy showed more frequent reflux esophagitis cases in the CEG group than in the SPADE group (30% vs. 15.3%, P=0.19). Similarly, bile reflux (26.7% vs. 7.7%, P=0.08) and residual food (P=0.01) cases occurred more frequently in the CEG group than in the SPADE group. In the CEG group, 13 patients (43.3%) had mild reflux symptoms, while 3 patients (10%) had severe reflux symptoms. In the SPADE group, 3 patients (11.5%) had mild reflux symptoms, while 1 had severe reflux symptoms (absolute difference, 31.8%; 95% confidence interval, 1.11-29.64; P=0.01). Conclusions: A novel modified EG, the SPADE operation, has the potential to decrease gastroesophageal reflux following a PG.

A Clinical Case Report of Non-erosive Reflux Disease Treated with Traditional Oriental Medicine (한방치료(韓方治療)로 호전된 비미란성 위식도 역류질환 1례)

  • Yoon, Seong-Woo;Park, Jae-Woo
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.991-998
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    • 2006
  • Gastroesophageal reflux disorder (GERD) refers to reflux of gastric contents into the esophagus leading to esophagitis, reflux symptoms (e.g. heartburn, regurgitation and non-cardiac chest pain) sufficient to impair quality of life, or long term complications. Non-erosive reflux disease (NERD), a subdivision of GERD, is diagnosed when there were some reflux symptoms without esophagitis and mucosal breaks at endoscopy. We report that severe NERD symptoms and lower quality of life which have not responded to more than 6 months' western medical therapy (acid suppression) were successfully improved with traditional oriental medicine.

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A Study on Optimal Reflux Ratio for Batch Distillation (회분식 증류공정의 환류비 최적에 관한 연구)

  • 이영상;이의수
    • Journal of Institute of Control, Robotics and Systems
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    • v.8 no.10
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    • pp.833-841
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    • 2002
  • We develope a model that can manipulate the reflux ratio of a batch distillation process in real time for optimal operations. Firstly, reflux ratio decision model for batch distillation unit was developed using the simple short-cut method. Secondly, more detailed rigorous method was applied to improve the accuracy of the model. Based on these models, operational strategies for the optimal reflux ratio was proposed. The results are illustrated with suitable examples and compared with the results using commercial simulator.

24 Hour Esophageal PH Monitoring in Preterm Infants (미숙아에서의 24시간 식도 PH 검사)

  • Park, Jeung-Hyun;Park, Beom-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.133-141
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    • 2001
  • Purpose: Gastroesophageal reflux (GER) has been found to be the causative factors of apnea, stridor, feeding intolerance, poor weight gain, and sudden infants death syndrome (SIDS) in infants. GER is a well-described in infants and children, but only scant mention of the premature infants with GER can be found in the literature. Methods: Esophageal pH was measured during 24 hour in 21 healthy preterm infants, using a silicone microelectrode with an external reference electrode connected to a portable recorder. The mean age of the patients was $29{\pm}8$ days, mean gestational age was $30^{+5}{\pm}2^{+0}$ weeks, mean birth weight was $1,468{\pm}329$ g, mean postconceptional age was $34^{+6}{\pm}1^{+4}$ weeks and mean weight was $1,750{\pm}329$ g. We evaluated the following reflux parameters; number of acid reflux, number of long acid reflux, longest acid reflux minutes, and reflux index. Results: Pathologic GER was detected in 12 (57%) subjects and most interesting parameters are reflux index and number of episodes with a pH<4 during 24 hour (high correlation with postprandial reflux index). Reflux was not correlated to gestational age, birth weight, age, postconceptional age, weight, sex and medication of the theophylline. Conclusion: Gastroesophageal reflux is common in preterm infants, but it is usually not apparent, even with severe reflux.

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Optimal control of batch distillation (회분식 증류장치의 최적 제어)

  • 이주엽;정상헌;이광순
    • 제어로봇시스템학회:학술대회논문집
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    • pp.941-946
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    • 1992
  • Three different reflux policies are compared for a batch distillation process in which a fixed recovery with a given average purity of the distillate is required ; the first, for the constant distillate purity ; the second, for the constant reflux ratio ; finally, for the optimal reflux policy which gives the minimum operation time. The optimal reflux policy was obtained using pontryagin's maximum principle. Througy the numerical simulations for the three different binary mixtures, it was found that the time advantage of the optimal reflux operation over the constant overhead composition operation varies form 10.0 to 22.4% and the advantage over the constant reflux operation varies from 1106 to 36.6% in the three cases considered.

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The use of Barium reflux study in patients with Gastroesophageal reflux disease and presentation of a new classification of gastroesophageal reflux (위 식도역류질환 환자에서 바륨조영역류검시의 유용성에 대한 고찰과 신 분류 안의 제시)

  • Jang Dong Hyuk;Kim Dae Jung;Seo Jung Whan;Park Young Soon
    • Journal of The Korean Radiological Technologist Association
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    • v.28 no.1
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    • pp.61-66
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    • 2002
  • Purpose : This study presents a new classification of gastroesophageal reflux to evaluate the patients with Gastroesophageal reflux disease after barium contrast reflux exam to help making the correct diagnosis and Treatment according to the symptoms and

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Update on Medical Treatment of GERD/LPR (위식도역류질환과 인후두역류질환의 약물 요법에 대한 최신지견)

  • Kim, Mi-Na;Kim, Joo-Sung
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.97-104
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    • 2010
  • Gastroesophageal reflux disease (GERD) is a common disorder caused by the reflux of gastric contents into the esophagus. According to the recent classification, GERD can elicit esophageal and extraesophageal syndromes. Laryngopharyngeal reflux (LPR) is defined as laryngeal symptoms with laryngeal inflammation caused by the acid reflux. The prevalence of GERD and LPR is increasing during the past decades in Korea and management of GERD and LPR is a challenging issue in clinical practice. Proton pump inhibitor is the most effective drug in the treatment of GERD. Most patients with LPR are given a 2-month trial of a proton pump inhibitor (PPI), however, there is still little evidence on the diagnosis or the treatment of LPR. During the last years concern have been raised regarding the risk of averse events related to long-term use of PPI. We review the recent update on medical treatment of GERD/LPR.

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The Inhibitory Effect of Quercetin-3-O-${\beta}$-D-Glucuronopyranoside on Gastritis and Reflux Esophagitis in Rats

  • Min, Young-Sil;Lee, Se-Eun;Hong, Seung-Tae;Kim, Hyun-Sik;Choi, Byung-Chul;Sim, Sang-Soo;Whang, Wan-Kyun;Sohn, Uy-Dong
    • The Korean Journal of Physiology and Pharmacology
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    • v.13 no.4
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    • pp.295-300
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    • 2009
  • It was evaluated the inhibitory action of quercetin-3-O-${\beta}$-D-glucuronopyranoside (QGC) on reflux esophagitis and gastritis in rats. QGC was isolated from the herba of Rumex Aquaticus. Reflux esophagitis or gastritis was induced surgically or by administering indomethacin, respectively. Oral QGC decreased ulcer index, injury area, gastric volume, and acid output and increased gastric pH as compared with quercetin. Furthermore, QGC significantly decreased gastric lesion sizes induced by exposing the gastric mucosa to indomethacin. Malondialdehyde levels were found to increase significantly after inducing reflux esophagitis, and were reduced by QGC, but not by quercetin or omeprazole. These results show that QGC can inhibit reflux esophagitis and gastritis in rats.

Upper Gastrointestinal Cancer and Reflux Disease

  • Kim, Jin-Jo
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.79-85
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    • 2013
  • There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.

Reflux Following Esophagectomy for Esophageal Cancer

  • Cho, Jong Ho
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.53 no.4
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    • pp.217-221
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    • 2020
  • Gastroesophageal reflux is a common problem after gastroesophageal resection and reconstruction, despite the routine prescription of proton pump inhibitors (PPIs). Resection of the lower esophageal sphincter and excision of the vagus nerve are generally thought to be the main factors that interfere with gastric motor function. However, physiological studies of reflux symptoms after esophagectomy are still lacking. Gastroesophageal reflux occurs frequently after esophagectomy, but there is no known effective method to prevent it. Therefore, in order to manage gastroesophageal reflux after esophagectomy, strict lifestyle modifications and gastric acid suppression treatment such as PPIs are needed, and further clinical studies are required.