Pathophysiologic Correlation of Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux - An Electron Microscopic Study
- 주제(키워드) gastroesophageal reflux disease , laryngopharyngeal reflux , transmission electron microscopy
- 발행기관 고려대학교 대학원
- 지도교수 전훈재
- 발행년도 2010
- 학위수여년월 2010. 2
- 학위구분 박사
- 학과 일반대학원 의학과
- 원문페이지 30 p
- 실제URI http://www.dcollection.net/handler/korea/000000021007
- 본문언어 영어
- 제출원본 000045579507
초록/요약
BACKGROUND/AIMS: Laryngopharyngeal reflux (LPR) is a consequence of backward regurgitation of gastric contents, seemingly identical to mechanism of gastroesophageal reflux disease (GERD). Some researchers postulated implication between LPR and GERD studying with gastrointestinal endoscopy and laryngoscopic examination. Meanwhile recent reports assert LPR as an independent disease from GERD. The present study examined symptoms of GERD from LPR patients, and also performed a gastrointestinal endoscopy and transmission electron microscopy (TEM) to evaluate GERD findings from these patients. METHOD: Control group was assembled with subjects without symptoms or signs of LPR / GERD. LPR was diagnosed with Reflux Symptom Index (RSI) greater than 13 and Reflux Finding Score (RFS) greater than 7. These patients were questioned for GERD-related symptoms and also examined with gastrointestinal endoscopy, then allocated into either LPR without GERD group or LPR with GERD group. During endoscopic examination, tissues were obtained from esophageal epithelium 5 cm above of squamo-columnar junction; specimen were managed for TEM and intercellular space was measured to find dilatation of intercellular space (IS), a characteristic finding observed on GERD patients. RESULTS: About 30 % (8/26) of LPR patients revealed to concomitantly accompany GERD-related symptoms, comprising the LPR with GERD group. Most of the LPR patients showed grossly normal endoscopic findings. On electron microscopic photographs, IS of control group (n=15) was measured as 0.35 ± 0.27 um, while LPR without GERD group (n=18) and LPR with GERD group (n=8) revealed a dilated IS of 0.61 ± 0.47 um and 0.95 ± 0.44 um, respectively. This difference was statistically significant compared to control group (P < 0.05). CONCLUSION: Mean IS value of LPR also increased significantly, suggesting a possibility that LPR may share mechanism of pathogenesis with GERD.
more목차
I. Abstract 1
II. Introduction /Backgrounds 3
III. Materials and Methods 5
IV. Results 11
V. Discussion 17
VI. References 22
