To evaluate the incidence of abnormal gastroesophageal reflux in patients with bronchial asthma and the influence of drug therapy on the gastroesophageal reflux, we investigated the gastroesophageal reflux patterns using an ambulatory 24-hour esophageal monitoring in 25 healthy volunteers and 58 asthmatics. All the patients were stable conditions at the time of the study. Bronchodilator therapy was continued, if necessary along with steroid inhalation and xanthines. Compared with healthy volunteers, the asthmatics had significantly greater esophageal acid exposure time, more frequent reflux episode, and longer single reflux time. About 70% of asthmatics had abnormal gastroesophageal reflux. Asthma medications were not associated with the incidence of abnormal gastroesophageal reflux. However, asthmatics receiving β2-stimulants therapy (n=27) had significantly greater esophageal reflux exposure time than those not receiving (n=31). Our study suggested that most asthmatics have abnormal gastroesophageal reflux unrelated to asthma attack or asthma medications and that β2-stimulants used in asthmatics may worsen gastroesophageal reflux.
We have evaluated the efficasy of partial splenic embolization (SE) in the treatment in 10 cirrhotic patients with marked hypersplenism. The mean infarction rate of the spleen was 84%. The change of spleen size, peripheral blood cell counts and liver function tests after SE were investigated during 3 years, and also 10 cirrhotic patients without SE were followed as control. The residual spleens after SE did not enlarged except 1 case with 65% infarction rate of the spleen. In these cases, the SE led not only to a sustained increase in both platelet and white blood cell counts but also to a significant improvement of hepatic function tests (hepaplastin test, total cholesterol and albumin) during observation period. On the other hand, these parameters tended to decrease in control patients without SE. This study suggests that SE performed with a high infarction rate of spleen is an useful therapy for hypersplenism in cirrhosis.