No abstract available.
Esophageal pH Monitoring* ; Gastroesophageal Reflux*

The purpose of this study was to determine aluminium (Al) concentrations in groundwater used for drinking and cooking and its related health risk among population of 28th Mile Orang Asli village in Jenderam Hilir, Selangor, Malaysia. A total of 100 respondents were recruited, comprising 51 (51.0 %) male and 49 (49.0 %) female residents. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine Al concentration, while the LAMOTTE TRACER ORP PockeTester was used to measure pH levels. Statistical Package for Social Science (SPSS) was used to analyze the data. Results showed that Al concentration ranged from 0.041 - 0.136 mg/L with a mean of 0.136 + SD 0.041 mg/L, hence the values obtained were below the standard value (0.2 mg/L). pH levels ranged from 3.82 to 5.84, with a mean of 4.163 + SD 0.411, which is acidic and below the range permitted by the health authorities. The acidic nature may have an impact on the Al concentration in the water. The Hazard Index (HI) was found to be less than 1, thus there was no health risk of Al exposure in drinking water for the respondents involved. The study area was considered safe from having health risk associated with Al exposure.
Aluminium ; Ph ; drinking water ; groundwater ; Hazard Index

BACKGROUND/AIMS: Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux. METHODS: Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy were analyzed. Characteristics of nocturnal supine reflux, time distribution and esophageal activity seen on impedance at 2 minute intervals preceding and following reflux were described. RESULTS: Patients had more nocturnal reflux events than healthy subjects (8 [4-12] vs 2 [1-5], P = 0.002), with lower proportion of weakly acidic reflux (57% [35-78] vs 80% [60-100], P = 0.044). Nocturnal reflux was mainly liquid (80%) and reached the proximal esophagus more often in patients (6% vs 0%, P = 0.047). Acid reflux predominated in the first 2 hours (66%) and weakly acidic reflux in the last 3 hours (70%) of the night. Most nocturnal reflux was preceded by aboral flows and cleared by short lasting volume clearance. In patients, prolonged chemical clearance was associated with less esophageal activity. CONCLUSIONS: Nocturnal weakly acidic reflux is as common as acid reflux in patients with gastroesophageal reflux disease, and predominates later in the night. Impedance-pH can predict prolonged chemical clearance after nocturnal acid reflux.
Electric Impedance ; Esophageal pH Monitoring ; Esophagus ; Gastroesophageal Reflux ; Humans

PURPOSE: The aim of this study was to evaluate the clinical significance of 24 hour pH monitoring in the pediatric patients with recurrent vomiting or regurgitation. METHODS: We performed 24 hour pH monitoring on 87 pediatric patients with recurrent vomiting or regurgitation using GastrograpH with glass electrode. The pathologic GER was determined by the reflux index (RI). RIs>10% were considered positive in patients <1 year of age, whereas RIs of <5% were positive in other age groups. We evaluated the mean and standard deviation of the reflux parameters between physiologic and pathologic GER groups, and also compared the reflux indices of each group with respect to time zones of the day. RESULTS: Pathologic GER was found in 32 of 87 patients (36.8%), and the age incidence included 32.5% in infants <6 months old, 13.3% in infants aged 6 months-1 year old, 61.5% in children aged 1~2 years old, 14.3% in children aged 2~3 years old and 66.7% in children >3 years old. In physiologic GER patients, the RI was 3.7+/-2.9% for the patients <1 year old (group A), and 1.8+/-1.5% for those > or =1 year old (group B) which was statistically significant between the 2 age groups (p=0.02). The number of long refluxes more than 5 minutes was significantly increased (p=0.03) in group A (1.7+/-1.9) than in group B (0.8+/-1.0). The duration of the longest reflux was significantly longer (p=0.007) in group A (604+/-551 sec) than in group B (275+/-296 sec). In pathologic GER patients, the RI was 17.7+/-11.6% for the patients <1 year old and 7.8+/-2.9 for those > or =1 year old. The number of long refluxes of more than 5 minutes were 8.9+/-4.6 and 3.2+/-1.8, and the duration of the longest reflux were 1955+/-2190 sec and 1093+/-706 sec for each age group. In both physiologic and pathologic GER patients, there was no significant difference of RI among the time zones of the day. CONCLUSION: Pathologic GER was found in 36.8% of patients. There was significant difference of RI between those <1 year old and those > or =1 year old in physiologic GER patients. There was no significant difference of RI among the time zones of the day in both pathologic and physiologic groups. In our study, the frequency of pathplogic GER was too much higher in age group of 1~2 years old (61.5%) than in group of 6 months-1 year old (13.3%), which means that further study is needed to determine the pathologic criteria of RI (Vandenplas criteria is >5%) in the age group of 1~2 years old.
Child* ; Electrodes ; Esophageal pH Monitoring* ; Gastroesophageal Reflux ; Glass ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant ; Vomiting*

Introduction: The need for gama \u2013 globulin, especially gama - globulin - anti \u2013 HBs, is huge in Vietnam. A number of patients cannot to afford use them due to the high price as they are imported. Meanwhile, Vietnam has high quality input sources for producing gama \u2013 globulin. \r\n', u'Objectives: To study the production process of gama - Globulin from Human Plasma and Standard gama - Globulin with Rich of Anti \u2013 HBs. \r\n', u'Subjects and method: 168 samples of human plasma from voluntary blood donors, which had been screened with for transfusion transmittable infections (TTLs), were chosen as plasma with rich of anti - HBs. The plasma with anti - HBsAg was precipitated with ethanol 25%, pH 6,9 to gain gama - globulin with rich anti - HBs, which was dried by Dutch Ly - 3 - TTE machine. Activation of anti - HBs gama - globulin was identified by a standard method of the degree of antibody specific for anti - HBsAg kit of BIORAD, \r\n', u'Results: The purity of the gama - globulin achieved was 93%, which was almost equal with the results of some foreign researchers (7.8), the activation of anti - HBs was 1:128 dilution degree. The productivity of gama - globulin gaining from 1 litter plasma was 6.0 gram. This new issue was first demonstrated in Vietnam. \r\n', u'Conclusion: We can domestically produce anti-Bs gama - globulin with high degree of activeness (1:128) from human plasma by the precipitating method with ethanol, pH and low temperature. \r\n', u'
Human plasma ; gama - globulin - anti - HBs ; Precipitation of ethanol ; pH and low temperature

BACKGROUND: The prevalence of Gastro-esophageal reflux(GER) in patients with asthma is estimated to be 50~60% and treatment of GER has been shown to improve asthma symptoms in Western. But GER has been known to be less common in Eastern and GER prevalence rates in asthmatics are not available in Korea. METHOD: We compared the prevalence rate of GER in 42 patients with asthma to that in 20 healthy normal controls and examed the efficacy of new prokinetic drug, cisapride(40mg/day, 8weeks) in patients with GER and asthma. For acid GER to be considered pathological, 24 hour esophageal pH monitoring should reveal values exceeding upper limit of 95 percentile for at least one of 6 parameter of DeMesseter's table. RESULT: The results showed GER was more common in patients with asthma(11/42, 26.2%) than normal controls(3/20, 15%) and asthmatics group showed a significant longer supine time pH<4(%) and total time pH<4(%), and more reflux episodes as compared with normal control group. After 4 asthmatics with GER were treated with cisapride, their asthma symtom scores, FEV1 and composite scores of pH monitoring were improved. CONCLUSION: GER is more common in asthmatics than in normal controls in Korea and prepulsid reduces asthma symptoms in patients with GER and asthma.
Asthma ; Cisapride ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Korea ; Prevalence

Fundoplication is a common surgical procedure for gastroesophageal reflux disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to review our 11 years experience with fundoplication in infants and children. From October 1994 to December 2005, 59 fundoplications in 55 patients were performed at Sungkyunkwan University Samsung Medical Center. Medical records and laboratory results of these children were retrospectively reviewed for sex, age, symptoms and signs, coexisting disease, diagnostic methods, treatment modalities and length of operative time. Open fundoplication was performed in 41 cases and laparoscopic fundoplication in 18 cases. Simultaneous gastrostomy was done in 27 cases. Recurrent GERD symptom occurred in four patients (7.2 %) within 2 years after first fundoplication and all 4 patients had re-do fundoplication. There were no intra- and immediate post-operative complications. Gastrointesitnal symptoms were the most common indication for fundoplication in neurologically normal patients. The most frequent diagnostic studies were upper gastrointestinal series (76.3 %) and 24 hour esophageal pH monitoring (78.2 %). Fundoplication had been increased since 2004 and mostly done laparoscopically. In conclusion, our 11 years' practice of open and laparoscopic fundoplication indicates that both approaches are safe and effective in the treatment of GERD for infants and children.
Child ; Esophageal pH Monitoring ; Fundoplication ; Gastroesophageal Reflux ; Gastrostomy ; Humans ; Infant ; Medical Records ; Operative Time ; Retrospective Studies

BACKGROUND/AIMS: Several specific foods are known to precipitate gastroesophageal reflux disease (GERD) symptoms and GERD patients are usually advised to avoid such foods. However, foods consumed daily are quite variable according to regions, cultures, etc. This study was done to elucidate the food items which induce typical GERD symptoms in Korean patients. METHODS: One hundred and twenty-six Korean patients with weekly typical GERD symptoms were asked to mark all food items that induced typical GERD symptoms from a list containing 152 typical foods consumed daily in Korea. All patients underwent upper gastrointestinal endoscopy followed by 24-hour ambulatory esophageal pH monitoring. The definition of “GERD” was if either of the 2 studies revealed evidence of GERD, and “possible GERD” if both studies were negative. RESULTS: One hundred and twenty-six cases (51 GERD and 75 possible GERD) were enrolled. In 19 (37.3%) of 51 GERD cases and in 17 (22.7%) of 75 possible GERD cases, foods inducing typical GERD symptoms were identified. In the GERD group (n = 19), frequent symptom-inducers were hot spicy stews, rice cakes, ramen noodles, fried foods, and topokki. In the possible GERD group (n = 17), frequent symptom-inducers were hot spicy stews, fried foods, doughnuts, breads, ramen noodles, coffee, pizza, topokki, rice cakes, champon noodles, and hotdogs. CONCLUSIONS: In one-third of GERD patients, foods inducing typical symptoms were identified. Hot spicy stews, rice cakes, ramen noodles, fried foods, and topokki were the foods frequently inducing typical symptoms in Korea. The list of foods frequently inducing typical GERD symptoms needs to be modified based on their own local experiences.
Bread ; Coffee ; Endoscopy, Gastrointestinal ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Korea* ; Symptom Assessment

BACKGROUND/AIMS: Twenty-four-hour ambulatory esophageal pH monitoring is considered the gold standard for diagnosing gastroesophageal reflux disease. The aim of this study was to quantify normal distal esophageal acid parameters in healthy Koreans. METHODS: Thirty healthy adults who were not on medication and were free from gastrointestinal symptoms were analyzed. Ambulatory esophageal acid (pH <4) exposure parameters were recorded at 5 cm above the lower esophageal sphincter. RESULTS: The 95th percentiles for reflux parameters assessed in the distal esophagus were as follows: percentage of total time with pH <4, 5.10%; percentage of upright time with pH <4, 7.88%; percentage of supine time with pH <4, 4.00%; number of reflux episodes, 62.7; number of reflux episodes with pH <4 for >5 minutes, 5.3; and the longest single acid-exposure episode, 21.3 minutes. CONCLUSIONS: Physiological gastroesophageal reflux occurs frequently in healthy Koreans. These data provide a reference range that could be utilized in studies involving Korean subjects.
Adult ; Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagus ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Reference Values

Gastroesophageal reflux disease (GERD) is a disease predominantly seen in the West but there is a rising trend in Asia. Ambulatory 24-hour catheter-based pH monitoring has been the de facto gold standard test for GERD that correlates symptoms with acid reflux episodes. However, drawbacks such as patients' discomfort, and catheter displacement render the test as cumbersome and error-prone. The Bravo pH wireless system is designed to be user-friendly and has an added advantage of prolonged pH monitoring. The system is comparable to the catheter-based pH monitoring system in terms of diagnostic yield and symptom-reflux association. Indications include evaluation of patients with refractory GERD symptoms and prior to anti-reflux surgery. Bravo utilizes a wireless pH-sensing capsule with a complete prepackaged system, and a data processing software. The capsule may be positioned indirectly using endoscopic or manometric landmarks or under direct endoscopic guidance. Optimal threshold cut-off values are yet to be standardized but based on available studies, for the Asian population, it may be recommended for total % time pH < 4 of 5.8 over 48 hours. Cost is a limitation but capsule placement is relatively safe although technical failures may be seen in small percentage of cases.
Asia ; Asian Continental Ancestry Group ; Catheters ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration*