Safety and Effectiveness of Reza Band in Management of Laryngopharyngeal Reflux Disease: A Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The main treatment of laryngopharyngeal reflux disease (LPRD) includes life style modification and proton pump inhibitor (PPI) medication. However, LPRD is sometimes refractory to PPI medication. The Reza band has been developed to exert external pressure on the upper esophageal sphincter thus preventing gastric acid reflux to the larynx and pharynx. The aim of this study was to evaluate safety and efficacy of using the Reza band in patients with LPRD. SUBJECTS AND METHOD: We prospectively enrolled 16 LPRD patients who were refractory to PPI medication and who had agreed to wear the Reza band. Patients were treated with the Reza band and PPI medication simultaneously or only the Reza band. We studied complications related to the Reza band, analyzed Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) before and after the application of the band up to 12 weeks. RESULTS: The Reza band was endured by 15 patients except one patient. One patient (6.25%) ceased wearing the band due to pain and discomfort in the neck. No major complications occurred, except one patient who reported mild neck discomfort when the band was applied. The mean value of RSI before the application of the Reza band was 12.31±6.43, which significantly improved at 8 weeks and 12 weeks (9.17±5.08, p=0.005 and 8.20±5.59, p=0.007, respectively) post-treatment. The mean value of RFS before the application of the Reza band was 13.50±2.97, which significantly improved at 2, 4, 8, and 12 weeks (p < 0.05) post-treatment. CONCLUSION: We conclude that the Reza band is safe and effective for the treatment of LPRD in properly selected patients.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma in Nasopharynx and Thyroid Gland / 대한이비인후과학회지

Mucosa associated lymphoid tissue (MALT) lymphoma refers to a type of marginal zone lymphomas, which represent a group of non-Hodgkin lymphomas originated from B lymphocytes of marginal zone. They are classified as extranodal MALT type (MALT lymphoma), splenic marginal zone B-cell lymphoma and nodal marginal zone B-cell lymphoma according to clinical and therapeutic implications of the tumor. MALT lymphoma is the most common type of marginal zone lymphoma, and about 5–8% of all B-cell lymphomas are diagnosed as MALT lymphoma. MALT lymphomas are usually found in the gastrointestinal tract, mostly in the stomach associated with H pylori infection; the non-gastric MALT lymphoma can also be found in the salivary gland, lung, head and neck, ocular adnexa, skin, thyroid, or breast. However, the involvement of nasal cavity and nasopharynx is rare. Based on our recent experience and a review of related literature, we report a case of MALT lymphoma that occurred in the nasopharynx and thyroid gland, which were treated with localized radiotherapy.

Characteristics of elderly patients with Diabetic Ketoacidosis

BACKGROUND: Diabetic ketoacidosis (DKA) is usually thought of as a condition of young, insulin-requiring diabetic patients. The clinical characteristics of older adults with DKA have not been well characterized. To characterize the elderly patients with DKA, we described how DKA in the elderly differs from that in the young adults. METHODS: We analyzed the clinical data of 112 patients who were diagnosed DKA for the first time from July, 1987 to June, 1997 at Hallym Univ. Sacred Heart Hospitals. We divided our patients into 3 groups according to the age at the first DKA and compared the clinical characteristics of DKA patients aged 65 or over with those of under 30 of age. RESULTS: Forty-four patients were under 30 of age and 8 patients were 65 or over of age. The duration of DM prior to DKA was 11.9+/-3.0 years in the elderly gouty and 1.6+/-0.4 years in the young group, and the debut DKA's were 12.5% and 47.7%, respectively. The elderly patients were less likely to have been using insulin before DKA (12.5% vs. 74%). The most frequent precipitating factor of DKA was 'infection' in the elderly group (50%) and 'unidentifiable' in the young group (46%). The elderly group showed the higher arterial pH (7.22+/-0.03 vs. 7.09+/-0.02), bicarbonate (10.9+/-1.5 vs. 5.1+/-0.7 mEq/L), and serum fasting C-peptide (0.37+/-0.08 vs. 0.19+/-0.04 nmol/L) levels, and the higher mortality rate (25% vs. 2.3%) compared with the young group. CONCLUSION: The elderly patients with DKA showed the longer duration of DM and less debut DKA's, the less previous history of insulin-treatment, the higher proportion of infection as precipitating (actors, the higher arterial pH, bicarbonate, and serum fasting C-peptide levels, and the higher mortality rate compared with the young patients with DKA.