The application progress on diagnostic scales of laryngopharyngeal reflux disease / 临床耳鼻咽喉头颈外科杂志

At present, objective methods for diagnosing laryngopharyngeal reflux disease(LPRD) are not minimally invasive, effective, and economical. Diagnostic scales are widely used worldwide due to the advantages of inexpensive, noninvasive, and easy to operate. The reflux symptom index(RSI) and the reflux finding score(RFS) are preferred to use in clinical diagnosis. However, many controversies have appeared in the application of RSI and RFS in recent years, causing many troubles to clinical diagnosis. Therefore, this review briefly discusses the problems of RSI and RFS in clinical applications to provide reference for diagnosing LPRD accurately.

The influence of age on the score of reflux symptom index scale and reflux finding score scale in the diagnosis of pharyngeal and laryngeal reflux / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. @*Method@#From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, n=86）, group B （40-<60 years, n=107） and group C （≥60 years, n=65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. @*Result@#Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （P>0.05）, RSI score was significantly different （P<0.05）, RSI score of group A and group B was higher than that of group C （P<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. @*Conclusion@#The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

The influence of age on the score of reflux symptom index scale and reflux finding score scale in the diagnosis of pharyngeal and laryngeal reflux / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

Treating laryngopharyngeal reflux with proton-pump inhibitors - An observational study

Background: Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the throat, that is, into the hypopharynx. LPR is different from classical gastroesophageal reflux disease. Majority of such patients present with globus pharyngeus, cough, foreign body sensation in throat, and hoarseness. Objectives: Conflicting results appear in literature for the role of proton-pump inhibitors (PPIs) in LPR. Our aim in this study is to evaluate the role of PPI based on their effect on reflux finding score (RFS) and reflux symptom index (RSI). Materials and Methods: This prospective observational study was conducted in the Department of ENT and HNS of Government Medical College, Srinagar, for 3 years from 2015 to 2018. The materials for the present study were 70 patients of different age groups attending the ENT Outpatient Department (OPD) having different symptoms of LPR diagnosed on the basis of RFS >7 and RSI >13. Of them, 20 lost to follow up, and finally, 50 patients were followed as per the protocol. Patients were divided into different age groups. Results: A total number of patients included in the study were 50; 35 (70%) cases were females and 15 (30%) were males. A maximum number of patients were in the age group 31–40 years forming about 40% of the study group. Mean RSI of all patients was 24.4 before treatment with PPIs. Significant change in RSI occurred after the first 8 weeks of therapy, and no further significant change occurred in the next 16 weeks. Mean RFS of the patients was 13.2 before treatment with PPIs. There was a slight response after 8 weeks of therapy in physical findings and significant response after 16 weeks of therapy. Conclusion: PPIs are treatment of choice in patients with LPR and treatment should be continued for at least 4 months.

Effects of Proton Pump Inhibitor for Laryngopharyngeal Reflux and Comorbid Chronic Rhinosinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngopharyngeal reflux (LPR) is a prevalent condition with an increasing incidence, and several recent studies have reported the association of LPR with chronic rhinosinusitis (CRS). In this study, we studied the effect of proton-pump inhibitors (PPIs) on symptom improvement for LPR and comorbid CRS. SUBJECTS AND METHOD: Enrolled in the study from January 2017 to December 2017 were 164 patients (54 male, 110 female, mean age 48.8 years) who were diagnosed as LPR by reflux symptom index (RSI) or reflux finding scores (RFS) and comorbid CRS. Sino-Nasal Outcome Test (SNOT)-20 and Lund-Kennedy endoscopic scores were evaluated for CRS severity. The study group was divided into PPI treatment group (Ilaprazole 20 mg, once a day for 8 weeks) and non-treatment group. The RSI, RFS, SNOT-20, and Lund-Kennedy endoscopic scores were repeated at the end of treatment. RESULTS: Ninety-two patients were prescribed PPI and 72 patients were not. Initial RSI, RFS, SNOT-20, and Lund-Kennedy score did not differ between the two groups. RSI and RFS decreased significantly after eight weeks of PPI medication (p=0.002 and p<0.001, respectively). In the non-treatment group, only RFS showed statistically significant decrease. SNOT-20 and Lund-Kennedy endoscopic scores decreased significantly in the treatment group (p=0.005 and p<0.001, respectively) compared to the non-treatment group. CONCLUSION: The results of our study suggest that PPI treatment for 8 weeks was effective in reducing signs and symptoms of both LPR and CRS.

Efficacy and safety of Ningmitai Capsule in treatment towards type III prostatitis: A randomized, double-blind, placebo-control clinical trial / 中草药

Objective: To evaluate the efficacy and safety of Ningmitai Capsule in the treatment towards type III prostatitis. Methods A randomized, double-blind, placebo-control clinical trial was conducted. A total of 50 patients diagnosed as type III prostatitis were divided into two groups with the ratio of 1:1. Patients of the trial group were treated with Ningmitai Capsule at the dose of four grain tid for 4 weeks, and patients of the control group were given placebo in the same way. The efficacy was evaluated by the NIH chronic prostatitis symptom index (NIH-CPSI) while safety-evaluation was evaluated by adverse events, results of urine routine examinations and hepatorenal-function tests. Results:After 4-week treatment, NIH-CPSI total scores were 23.96 ± 1.30 before treatment, and reduced to 16.04 ± 1.66 (P < 0.001). To the contrary, for all these scores, no significant statistical differences exist in placebo-control group. Pain-symptom scores, micturition-symptom scores and QOL scores were all statistically reduced in the trial group. No significant adverse events occurred in all patients who completed the study. Conclusion:Ningmitai Capsule is effective and safe in the treatment of type III prostatitis.

Analysis of mental state in patients with laryngopharyngeal reflux disease / 中国耳鼻咽喉头颈外科

OBJECTIVE To identify the mental state of laryngopharyngeal reflux disease (LPRD) patients by analyzing anxiety scale and depression scale. METHODS The LPRD patients who received treatment in Fuzhou General Hospital were studied. The healthy volunteers were recruited as control group. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to get the individual scores. Mental states of LPRD patients were finally studied through statistical analysis. RESULTS The scores of anxiety and depression in patients with LPRD were significantly higher than those in control group (anxiety score 50.59±7.24 vs 38.76±7.70, depression score 52.90±7.14 vs 40.63±8.17). The incidence of anxiety and depression in patients with LPRD were significantly higher than that in control group (anxiety rate 56.68％ vs 9.80％, depression rate 50.98％ vs 11.76％). Significant association was detected between ref lux symptom index score and anxiety or depression score in patients with LPRD(r =0.786, r =0.736, P ＜0.05). Significant association between LPRD and anxiety and depression were concluded. CONCLUSION The results showed that the patients with LPRD are more prone to be anxiety and depression mental state than healthy control group, and the severity of LPRD symptoms is significantly correlated with the anxiety and depression. This suggests that the patient's mental state should also be emphasized as well as antacids treatment.

Efficacy and safety of № I Empirical Prescription for Chronic Prostatitis in the treatment of type Ⅲ refractory chronic prostatitis / 中华男科学杂志

<p><b>Objective</b>To evaluate the efficiency and safety of № I Empirical Prescription for Chronic Prostatitis (№ I EPCP) in the treatment of type Ⅲ refractory chronic prostatitis.</p><p><b>METHODS</b>We randomly assigned 53 cases of type Ⅲ refractory chronic prostatitis with damp-heat and blood stasis to an experimental and a control group to receive № I EPCP at 1 dose per day and saw palmetto extract at 160 mg bid), respectively, all for 8 weeks. Before and after 4 and 8 weeks of treatment, we obtained The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores, Traditional Chinese Medicine Syndrome Scores (TCMSS), maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Depression Rating Scale (HAMD) scores and Hamilton Anxiety Rating Scale (HAMA) scores, and compared them between the two groups of patients.</p><p><b>RESULTS</b>Totally 48 of the patients completed the medication and follow-up, 25 in the experimental and 23 in the control group. Compared with the baseline, the NIH-CPSI scores after 8 weeks of treatment were significantly decreased in the experimental (27.82 ± 7.25 vs 15.46 ± 4.77, P <0.05) and the control group (25.98 ± 6.47 vs 21.06 ± 5.74, P <0.05), and so were the TCMSSs (24.64 ± 9.82 vs 16.42 ± 6.33 and 9.15 ± 3.74, P <0.05, and 23.67 ± 8.73 vs 18.55 ± 5.92 and 13.48 ± 4.45, P <0.05); the Qmax at 8 weeks were dramatically increased in the experimental group (［18.45 ± 7.81］ vs ［23.44 ± 8.73］ ml/s, P <0.05) and the control (［17.58 ± 6.92］ vs ［21.26 ± 8.32］ ml/s, P <0.05), and so was the Qavg (［11.27 ± 5.33］ vs ［16.51 ± 7.36］ ml/s, P <0.05 and ［10.66 ± 5.82］ vs ［13.44 ± 6.16］ ml/s, P <0.05); the HAMD scores were remarkably reduced in the experimental group (22.74 ± 6.37 vs 17.62 ± 5.71 and 12.54 ± 5.22, P <0.05) and the control (23.55 ± 7.14 vs 22.34 ± 6.88 and 21.62 ± 5.63, P <0.05), and so were the HAMA scores (21.37 ± 7.15 vs 18.42 ± 6.35 and 14.63 ± 7.11, P <0.05 and 20.54 ± 6.77 vs 19.87 ± 6.24 and 19.42 ± 7.04, P <0.05). No obvious adverse reactions were observed in either of the two groups during the medication.</p><p><b>CONCLUSIONS</b>№ I EPCP deserves promotion and clinical application for its definite effectiveness and safety in the treatment of type Ⅲ refractory chronic prostatitis with damp-heat and blood stasis.</p>

Correlation between Laryngopharyngeal Reflux and Secretory Otitis Media in Adults / 听力学及言语疾病杂志

Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.

Changes of CD64 expression in succus in patients with chronic bacterial prostatitis / 中华内分泌外科杂志

Objective To observe the levels of neutrophil CD64 expression in prostatic fluid of patients with chronic prostatitis and different degrees of infection,to evaluate the value of CD64 in diagnosis and treatment of chronic bacterial prostatitis.Methods 100 subjects were divided into two groups according to chronic prostatitis symptom index (CPSI) established by the National Institutes of Health (NIH):CPSI high score group and CPSI low group,bacterial infection group,and 30 healthy controls.CD64 expression of neutrophils in prostatic fluid was detected by flow cytometry and prostate fluid routine microscopy inspection.Results The expression of CD64 in severe group (high score) was (4857.25±278.45) molecules / cell,which was significantly higher than that in the mild group (P＜0.05).There was significant difference between the mild group and the nonbacterial infection group or the healthy control group (P＜0.01).There was no significant difference between nonbacterial infection group and healthy control group.The expression of CD64 was positively correlated with some white blood cells in the bacterial infection group,but not the whole.ROC curve was drawn according to the data of the subjects.When CD64 was 2135.2 molecules/cell,the sensitivity was 92.9％ and the specificity was 91.7％.Conclusion Quantitative detection of CD64 in prostatic fluid can be used as a sensitive index for diagnosis of chronic bacterial prostatitis and has clinical value.

Bushen Daozhuo Granules for type Ⅲ prostatitis: A multicenter randomized controlled clinical trial / 中华男科学杂志

Objective@#To study the safety and efficacy of Bushen Daozhuo Granules (BDG) in the treatment of type Ⅲ prostatitis.@*METHODS@#This multicenter randomized controlled clinical trial included 478 patients with type Ⅲ prostatitis, 290 in the trial group and 188 as controls, the former treated with BDG at 200 ml bid and the latter with tamsulosin hydrochloride sustainedrelease capsules at 0.2 mg qd, both for 4 weeks. Before treatment, after 4 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the NIH Chronic Prostatitis Symptom Index (NIHCPSI) scores and compared the safety and effectiveness rate between the two groups of patients.@*RESULTS@#Compared with the baseline, the NIHCPSI score was markedly decreased in the control group after 4 weeks of medication (21.42 ± 4.02 vs 15.67 ± 3.65, P 0.05), while the NIHCPSI score in the trial group was remarkably lower than the baseline both after 4 weeks of medication and at 4 weeks after drug withdrawal (10.92 ± 2.06 and 12.91 ± 2.64 vs 21.58 ± 3.67, P < 0.05). The trial group exhibited both a higher rate of total effectiveness and safety than the control (P < 0.05).@*CONCLUSIONS@#BDG is safe and effective for the treatment of type Ⅲ prostatitis.

Traditional Chinese medicine fumigation combined with Levofloxacin for type ⅢA prostatitis with the symptoms of damp heat and blood stasis / 中华男科学杂志

Objective@#To investigate the clinical effects of traditional Chinese medicine (TCM) fumigation on type ⅢA prostatitis with the symptoms of damp heat and blood stasis.@*METHODS@#We randomly divided 72 cases of type ⅢA prostatitis with the symptoms of damp heat and blood stasis into an experimental and a control group of equal number, the former treated with TCM fumigation plus oral Levofloxacin while the latter with oral Levofloxacin only. After 4 weeks of treatment, we compared the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI) score, TCM symptoms score, maxinum flow rate (Qmax), and average urinary flow rate (Qave) between the two groups of patients.@*RESULTS@#The total effectiveness rate was significantly higher in the experimental than in the control group (91.7% vs 61.1%, P0.05) or in Qave (［10.9 ± 2.4］ vs ［11.1 ± 2.9］ ml/s, P>0.05).@*CONCLUSIONS@#TCM fumigation combined with Levofloxacin is an effective therapy for type ⅢA prostatitis with the symptoms of damp heat and blood stasis, which can significantly improve the symptoms, reduce the NIHCPSI score, and increase the Qmax and Qave of the patient.

Analysis the risk factors and the prevalence of Laryngopharyngeal reflux disease in Fuzhou area / 中国耳鼻咽喉头颈外科

OBJECTIVE To assess the prevalence and analyze the influence factors of laryngopharyngeal reflux disease(LPRD) in the Fuzhou region, in order to provide a theoretical basis for the development of prevention and control measures for LPRD. METHODS A questionnaire survey in residents in Fuzhou by a random cluster sampling was carried out. Individual information, reflux symptom index(RSI) of Belafsky and risk factors were included. Patients more than 13 scores of RSI were defined as LPRD. Data were statistically analyzed. RESULTS A total of 4100 residents were investigated, 4063 of them were available. The prevalence of LPRD was 5.00%. Often eating too much, often drinking strong tea, menolipsis, rhinitis, tonsillitis were closely related to LPRD. CONCLUSION The prevalence of LPRD in Fuzhou region were closely related to many factors.

Evaluation of the association between pollen count and the outbreak of allergic disease

PURPOSE: This study focused on the evaluation of the relation between pollen concentration and the outbreak of allergic disease (symptom index), and this outcome would be necessary to upgrade risk grade for the pollen forecasting system. METHODS: Airborne particles carrying allergens, such as pollen, were collected daily at the Seoul and Guri area by using 7-day Burkard samplers for 6 years. A total of 596 Subjects were recruited from Hanyang University Seoul Hospital (n=144 for spring, n=139 for autumn), and Hanyang University Guri Hospital (n=157 for spring, n=156 for autumn). Symptom index was evaluated and recorded by phone calling to study subjects daily or asking questionnaire when they visit outpatient clinic every week. Statistical analysis of data was performed by using correlation coefficients and regression models with time series graph. RESULTS: Two peak seasons of pollen concentration were May and September in Korea. In skin prick tests, the sensitization rate to ragweed pollen was gradually increased in children. In the same period, sensitization rates to airborne pollen, especially oak, birch for spring, and Japanese hop for autumn were increased annually. There was a significantly relationship between symptom index of allergic patients and allergic pollen concentrations in this study. Especially symptom index was significantly correlated to the concentration of oak pollen of day 1 in spring and to the concentration of Japanese hop pollen of day 0 in autumn. CONCLUSION: Sensitization rates to pollens increased annually. There is a significant relationship between allergy symptom index and pollen concentration. There remains to confirm the Korean own risk grade of pollen allergy.

Voice characteristics and changes before and after treatment of laryngopharyngeal reflux patients diagnosed by two diagnostic methods / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo diagnose laryngopharyngeal reflux (LPR) by using two methods: 24h pH monitoring and RSI combined with RFS scales. To research the voice characteristics of patients with LPR and changes of voice parameters before and after PPIs therapy, and to use voice parameters to help diagnosing and evaluating treatment effect of LPR.METHODSThe patients visited department of Otolaryngology head & neck surgery of Peking University Third Hospital from August 2012 to August 2013 were included in this study. There were 26 LPR patients diagnosed by 24 hr pH-MII monitoring (pH group) and 26 LPR patients diagnosed by RSI combined with RFS (questionnaire group). Another 52 subjects without laryngeal or pharyngeal symptoms were as control group. All subjects underwent MDVP examination. The patients from pH group and questionnaire group took esomeprazole 20 mg bid for one month, afterwards MDVP was examined again. The voice related parameters were compared before and after medication therapy.RESULTSComparing data between LPR patients and normal subjects, Jitter, Shimmer, NHR had significant difference (P0.05) before treatment. After PPIs therapy there was no significant difference between each group (P>0.05).CONCLUSIONAbnormal voice parameters were existed in LPR patients. After PPIs treatment, voice related parameters improved apparently.

Laryngopharyngeal reflux disease treated by combination of Chinese and western medicine / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo assess the clinical effects of proton pump inhibitor(PPI) combined with traditional Chinese medicine for laryngopharyngeal reflux disease(LPRD).METHODSA total of 74 LPRD patients with laryngopharyngeal signs and symptoms confirmed by reflux symptom index(RSI) and reflux finding score(RFS) were enrolled. All patients received PPI combined with traditional Chinese medicine therapy. Effect evaluation was conducted at 2, 6, 12, and 18 months after the beginning of therapy.RESULTSThe relief rate was 74.3%, 90.5%, 87.8%, and 86.5% at the 2, 6, 12, and 18 months after the beginning of treatment respectively.CONCLUSIONPPI combined with traditional Chinese medicine therapy is safe and effective for LPRD and worthy of wide application.

The diagnostic value of symptom index in gastroesophageal reflux-induced chronic cough / 中华内科杂志

Objective To explore the diagnostic value and optimal cut-off point of symptom index (SI) in gastroesophageal reflux-induced chronic cough (GERC).Methods The recordings of multichannel intraluminal esophageal impedance and pH monitoring were retrospectively analyzed in 118 patients with suspicious GERC.SI for all the refluxes,acid reflux and non-acid reflux was calculated respectively by analyzing the temporal association between detected reflux and cough recorded on diary card.Based on the favorable response to the anti-reflux therapy,the diagnostic value for GERC of SI was evaluated and compared with that of the symptom association probability (SAP).Results GERC was definitely determined in 100 patients (84.7％).When SI for all the refluxes was used for the diagnosis of GERC,the cut-off point of ≥45％ had the highest diagnostic efficacy,with the sensitivity of 56.0％,the specificity of 83.3％and Youden index of 0.393.SI for acid or non-acid reflux had the same optimal cut-off point of ≥30％ and presented with the similar efficacy in the diagnosis of acid or non-acid GERC.Compared with SAP of ≥75％,SIforall the refluxes of ≥45％ had a lower sensitivity (56.0％ vs 75.0％,x2 =7.988,P=0.005),a higher specificity (83.3％ vs 44.4％,x2 =5.900,P =0.015) and the comparable positive or negative predictive value in the diagnosis of GERC.The diagnostic accuracy for GERC was further improved when combining SI for all the refluxes with SAP.Conclusion SI for all the refluxes has a diagnostic value similar to SAP and its optimal cut-off point for GERC may be ≥45％.

Correlation of Laryngopharyngeal Reflux and Voice Disorders / 听力学及言语疾病杂志

Objective To study the correlation between laryngopharyngeal reflux (LPR) and voice disorders . Methods One hundred and three patients with reflux -related symptoms were recruited .The patients were evalu-ated with reflux symptom index (RSI) ,reflux finding score (RFS) evaluation and 24-hour dural-probe pH moni-toring .Eighty -nine cases with voice disorders were divided into 5 groups :vocal process granuloma (n=18) chron-ic pharyngolaryngitis (n=19) ,vocal polyps (n=15) ,vocal fold leukoplakia (n=21) and Reinke's edema (n=16) . The other 14 patients without voice disorders were the control subjects .Results According 24-hour dural -probe pH monitoring assessments ,48 .3% of the patients with voice disorders showed LPR positive .The positive rate in the vocal fold leukoplakia group (71 .4% ) and Reinke's edema group (75 .0% ) were significantly higher than the control group (35 .7% ) .RSI and RFS of the patients with Reinke's edema were both significantly higher than the control group(P=0 .020 ,P=0 .009) .RSI of the patients with chronic pharyngolaryngitis were significantly higher than the control group (P=0 .019) .The acid reflux episodes ,acid reflux time which except in the supine position of the vocal fold leukoplakia group were significantly higher than the control group .The acid reflux episodes ,acid ex-posure and acid reflux time which all except in the supine position of the Reinke's edema group were significantly higher than the control group .Conclusion The correlations between Reinke's edema ,vocal fold leukoplakia and LPR were stronger .In these two groups ,the acid reflux episodes were higher and acid reflux times were longer .

Optimal Regimen and Period for the Treatment of Patients with Laryngopharyngeal Reflux Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various drugs can be used for treatment of laryngopharyngeal reflux disease (LPRD). However, the optimal medical treatment regimen is still controversial. This study was performed to determine the optimal medical treatment regimen and duration for LPRD. SUBJECTS AND METHOD: We studied 172 patients who were diagnosed as LPRD by reflux symptom index (RSI) or reflux finding scores (RFS). The study group was divided into 4 groups according to the medication regimen: proton pump inhibitor (PPI), PPI and prokinetics, PPI and H2 blocker, and double dose PPI groups. All patients took medicines for 3 months or more. Clinical remission was defined as 70% improvement of initial RSI scores. RESULTS: 36 (20.9%) patients were prescribed PPI only, 65 (37.8%) patients PPI with prokinetics, 51 (29.6%) patients PPI with H2 blocker, 20 (11.6%) patients double dose PPI. Pretreatment with RSI and RFS did not differ among the four groups. RSI was improved after one month of medication in all of the groups. RSI and RFS tended to decrease during the treatment in all groups (p for trend <0.001). The mean clinical remission time was 2.3 months in patients receiving PPI alone, 2.6 months in PPI and prokinetics group, 2.5 months in the PPI and H2 blocker group and 1.8 months in the double dose PPI group. About 70% of patients reached clinical remission within 3 months. CONCLUSION: PPI with or without prokinetics or H2 blocker is effective treatment for LPRD, and the appropriate duration of medication seems to be about 3 months. Double dose PPI can be used for those whom normal dose PPI is ineffective.

Evaluation of the Relationship between Pollen Count and the Outbreak of Allergic Diseases / 소아알레르기및호흡기학회지

PURPOSE: The distribution of pollens in the air is mainly related to the weather conditions, especially temperature and humidity. This study focused on the evaluation of the relationship between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea in order to determine Korean own allergy risk grade for the pollen forecasting system. METHODS: Airborne particles carrying allergens were collected daily in nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju Busan, Kangneung, and Jeju) by using 7 day- Burkard sampler in South Korea for 8 months (March 1, 2008-October 31, 2008). They were counted and recorded along with weather factors. Symptom index was calculated and recorded by phone calling to allergic patients 3 times a week. RESULTS: Airborne pollens have 2 peak seasons (May and September) in Korea. In the skin prick test, ragweed was the highest sensitization rate (5.9%), followed by mugwort (5.8 %), alder (4.9%), birch (4.8%) and oak grasses among the pollen extracts in Korean school-aged children. There are significant relationship between symptom index of allergic patients and allergic pollen concentrations. Korean own risk grade of pollen allergy was made by using the data from this study. CONCLUSION: Risk grade of pollens for allergy pollen forecast among each allergic plant was established. Further studies are needed to confirm it our result.