Seroprevalence of IgG Anti-HAV in Hospital Employees below 40 Years Old / 대한소화기학회지

BACKGROUND/AIMS: Hepatitis A is an acute infectious disease transmitted by fecal-oral route. As the incidence of hepatitis A has been increased in Gwangju and Chonnam province of Korea recently, the number of hepatitis A patients in hospital employees has also increased. Thus, we investigated the seroprevalence of IgG anti-HAV in hospital employees below 40 years old. METHODS: We analysed the seroprevalence of anti-HAV IgG from 1,002 Chonnam national university hospital empolyees (men: 190, women: 812) who were below 40 years old. The age group was divided by 5 years; 21-25 years old 199 (19.9%), 26-30 years old 426 (42.5%), 31-35 years old 215 (21.5%), 36-40 years old 162 (16.1%). RESULTS: Overall seropositive rate of IgG anti-HAV was 32.8% (329/1,002). The seropositive rate of men was 40.5% (77/190) and that of women was 31.0% (252/812). The seropositive rates of each age group were 1.5% (3/199) in 21-25 years old, 21.6% (92/426) in 26-30 years old, 48.4% (104/215) in 31-35 years old, and 80.2% (130/162) in 36-40 years old. The seropositivity rate of the high risk group (doctors, nurses, technicians) was 28.9% (234/809). CONCLUSIONS: The seropositive rate of IgG anti-HAV was the lowest in early twenties of hospital employees and below 50% in early thirties. Therefore, hepatitis A vaccination may be warranted in the hospital empolyees below the early thirties.

Gastric Wall Abscess Caused by a Fish Bone and Treated with Endoscopic Management / 대한소화기내시경학회지

Intramural gastric abscess is a rare condition representing a localized form of suppurative gastritis. According to the extent of the disorder, suppurative gastritis is classified into diffuse and localized types. The diffuse or phlegmonous type is more common and involves the entire stomach with inflammation spreading to all layers from the submucosa. The localized form referred to as "intramural gastric abscess" accounts for 5% to 15% of cases. The pathogenic mechanism includes direct invasion by microorganisms and hematogenous spread from a distant source. Cases are usually diagnosed with a combination of imaging modalities such as ultrasound, computed tomography, endoscopic ultrasound, and esophagogastroduodenoscopy. Herein we report a case of intramural gastric abscess that developed following ingestion of a fish bone. It was successfully treated with endoscopic incision and drainage of pus.

A Case of Incidentally Found Primary Esophageal Bezoar in a Patient with Situs Inversus Totalis / 대한소화기내시경학회지

Situs inversus totalis (SIT) is very rare autosomal recessive condition, and patients with SIT have complete mirror image reversal of the thoracic and abdominal viscera. There have been no case reports of esophageal bezoar in a patient with situs inversus totalis. Bezoars are retained concretions of indigestible foreign material, including food material, vegetable material and hair, and they are usually founded in the stomach, small intestine and rectum. Esophageal bezoars are very rare, but they are known to occur in patients with anatomical defects or esophageal motility disorders. The treatment of esophageal bezoar is usually based on endoscopic fragmentation and extraction, dissolution with papain, cellulose, pancreatic enzyme and/or Coca cola. We report here on a case of an endoscopically treated primary esophageal bezoar in a patient with situs inversus totalis, and the patient experienced no complications from the treatment.

A Case of Acute Pancreatitis Caused by the Migration of a Feeding Gastrostomy Tube / 대한소화기내시경학회지

A feeding gastrostomy tube is used to provide chronic nutritional support for patients who have a swallowing disability. Serious complications associated with feeding gastrostomy are rare. However, dislocation of the gastrostomy tube into the duodenum can lead to serious complications. There have been 7 reports in which the gastrostomy tube used for enteral feeding was associated with acute pancreatitis. But there have been no reports of pancreatitis associated with feeding gastrostomy in Korea. Further, all the reported cases were associated with both pancreatitis and cholangitis secondary to the compression of the major papilla by the percutaneous endoscopic gastrostomy tube. To the best our knowledge, this is the first report of acute pancreatitis, without cholangitis, that was induced by the compression of migrating surgical gastrostomy tube. Herein, we report on a case of a 68-year-old Korean male diagnosed with acute pancreatitis, and this was induced by the migration of a surgical gastrostomy tube.

Occupational asthma induced by tobacco leaf / 천식및알레르기

We experienced a cose of occupational asthma induced by the tobacco leaf in 49-year old man. He has worked at the Korean Tobacco and Ginseng company for 23 years but suffered from the intermittent mild wheezing and dyspnea since 6 years ago. He has not involved in the process making the tobacco directly, but just managed it at the storage barn. He showed a whole negative reaction to 55 inhalant allergens(Bencard, UK) and the allergen extracted from the yellow Korean tobacco leaf, but showed the dual asthmatic respose to the allergen bronchial provocation test with it. His basal PC is 6.35 mg/ml with methacholine inhalation challenge. Now he changed the workplace far away from the barn at the same company and is treated with bronchodilator and anti-asthmatic inhaler.