Background
Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem.
Methods
We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017.
Results
A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia (<150×109 /L). Twelve patients (12/159, 7.5%) showed low serum albumin level (<3.5 g/dL). Three patients (3/160, 1.9%) had chronic kidney disease stages 3–4 based on estimated glomerular filtration rate. Six patients (6/27, 22.2%) had high hemoglobin A1c (HbA1c) level (>7.0%). Positive rates of hepatitis B surface antigen and antiHBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively.
Conclusion
Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

Citations

• Efficiency of Flossing Technique Application among Dental Students at Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
  Rakan S Shaheen, Mohammed M Aldosari, Humod A Altuwaijri, Faris T Arnous, Abdullah A Alamro, Rayan A Almarshedi
  Journal of Oral Health and Community Dentistry.2019; 13(3): 63.     CrossRef

Citations

• Systematic review: chronic viral hepatitis and metabolic derangement
  Chia‐Chi Wang, Pin‐Nan Cheng, Jia‐Horng Kao
  Alimentary Pharmacology & Therapeutics.2020; 51(2): 216.     CrossRef
• Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome
  Edina Amponsah-Dacosta, Cynthia Tamandjou Tchuem, Motswedi Anderson
  World Journal of Virology.2020; 9(5): 54.     CrossRef
• Canonical Correlation Between Self-Care Agency and Health-Related Self-Efficacy with Chronic Viral Hepatitis Patients
  HooJeung Cho, Euna Park
  Osong Public Health and Research Perspectives.2019; 10(5): 281.     CrossRef
• Association between chronic hepatitis B infection and metabolic syndrome
  Xiaohui Zhao, Drishti Shah, Usha Sambamoorthi
  Journal of Diabetes & Metabolic Disorders.2018; 17(2): 223.     CrossRef
• Hepatitis‐Viral
  
  Journal of Gastroenterology and Hepatology.2017; 32(S2): 65.     CrossRef
• Unawareness of Hepatitis B Virus Infection confers on Higher Rate of Metabolic Syndrome: A Community-based Study
  Cheng-Hung Chien, Li-Wei Chen, Chih-Lang Lin, Su-Wie Chang, Yu-Chiau Shyu, Kuan-Fu Chen, Shuo-Wei Chen, Ching-Chih Hu, Chia-Ying Yu, Rong-Nan Chien
  Scientific Reports.2017;[Epub]     CrossRef
• Serum HBV surface antigen positivity is associated with low prevalence of metabolic syndrome: A meta-analysis
  Yuanyuan Li, Ying Zhao, Jianping Wu, Ferruccio Bonino
  PLOS ONE.2017; 12(5): e0177713.     CrossRef
• Hepatitis B virus prevents excessive viral production via reduction of cell death-inducing DFF45-like effectors
  Jun Yasumoto, Hirotake Kasai, Kentaro Yoshimura, Teruhime Otoguro, Koichi Watashi, Takaji Wakita, Atsuya Yamashita, Tomohisa Tanaka, Sen Takeda, Kohji Moriishi
  Journal of General Virology .2017; 98(7): 1762.     CrossRef
• Association of chronic hepatitis B infection with metabolic syndrome and its components: Meta-analysis of observational studies
  Bahman Razi, Shahab Alizadeh, Azadeh Omidkhoda, Danyal Imani, Ramazan Rezaei
  Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2017; 11: S939.     CrossRef
• Occult Hepatitis B Virus Infection in Hyperlipidemia Patients
  Liu Yang, Tingting Li, Wenmin Li, Xi Tang, Jinfeng Li, Ruiwen Long, Yongshui Fu, Jean-Pierre Allain, Chengyao Li
  The Tohoku Journal of Experimental Medicine.2017; 241(4): 255.     CrossRef
• Prevalence of metabolic syndrome among adults with liver function injury in rural area of Southwest China: A cross-sectional study
  Hui Zeng, Hui Lin, Wenyi Liu, Jia Wang, Lingqiao Wang, Chuanfen Zheng, Yao Tan, Yujing Huang, Lixiong He, Jiaohua Luo, Chaowen Pu, Renping Zhang, Xiaohong Yang, Yingqiao Tian, Zhiqun Qiu, Ji-an Chen, Yang Luo, Xiaobin Feng, Guosheng Xiao, Liping Wu, Weiqu
  Scientific Reports.2017;[Epub]     CrossRef
• Association between hepatitis B and metabolic syndrome: Current state of the art
  Peter Jarcuska
  World Journal of Gastroenterology.2016; 22(1): 155.     CrossRef
• Relationship between chronic hepatitis B and metabolic syndrome: A structural equation modeling approach
  Chiao‐Yu Huang, Chia‐Wen Lu, Yi‐Lien Liu, Chien‐Hsieh Chiang, Long‐Teng Lee, Kuo‐Chin Huang
  Obesity.2016; 24(2): 483.     CrossRef
• Chronic hepatitis B infection is not associated with increased risk of vascular mortality while having an association with metabolic syndrome
  Aezam Katoonizadeh, Shima Ghoroghi, Maryam Sharafkhah, Masoud Khoshnia, Samaneh Mirzaei, Amaneh Shayanrad, Hossein Poustchi, Reza Malekzadeh
  Journal of Medical Virology.2016; 88(7): 1230.     CrossRef
• Hepatitis B virus infection and metabolic syndrome: Fact or fiction?
  Chia‐Chi Wang, Tai‐Chung Tseng, Jia‐Horng Kao
  Journal of Gastroenterology and Hepatology.2015; 30(1): 14.     CrossRef

Background
: Heavy drinking may be a cause of serious health problems in hepatitis B virus carriers. The aim of this study was to reveal the degree of drinking problems in the Korean hepatitis B virus healthy carriers.

Methods : The subjects were 218 hepatitis B virus healthy carriers (124 males and 94 females) recruited from those who visited the Health Promotion Center of Chungnam National University Hospital for a general health check-up. Drinking problems of the subjects were evaluated by the AUDIT (Alcohol Use Disorders Identification Test) questionnaire.

Results : The AUDIT scores (mean±SD) of the male subjects (9.6±7.9) were significantly (P＜0.001) higher than those of the female subjects (2.7±5.2). The individuals with heavy drinking (more than 14 drinks in males and 7 drinks in females per week) are 24 (19.4%) in males and 5 (5.3%) in females. Alcohol use disorders were suspected in 36 (29.0%) males and 4 (4.3%) females.

Conclusion : It is suggested that, in Korea, clinical attention in primary health care should be focused on reducing the alcohol consumption among the hepatitis B virus carriers, considering a large proportion have drinking problems and the possible harmful effect on their health by heavy drinking.

Background
: Korea Academy of Family Medicine recommands HBsAb and HBsAb test in youth health promotion program. Adequate management are necessary for prevention of vertical transmission at perinatal period. especially girls' high school students as a future's conceivable woman. Health examination program for the first grade students of high school which was established by the Educational Ministry has been acted since 1998. So, throught the students health examination we'd like to find an adequate method of prevention and management in hepatitis B.

Methods : Our study examines HBs Ag/Ab about girl's high school students at two high schools in an city. According to the results of hepatitis B, active intervention in carrier group, passive intervention in candidate were done. And then a year later, hepatitis B management was investigated through the questionnaire.

Results : In active intervention group, regular check up of hepatitis B is 21.4%, hepatitis B blood test in family is 39.3% and in passive intervention group, hepatitis B vaccination rate after health examiantion is 9.1%.

Conclusion : More active intervention such as mass vaccination are required in health examination for the purpose of hepatitis B management at youth.

Background
: Hepatitis B is an important disease in South Korea because the prevalence is high. There are two officially-granted hepatitis B vaccination schedules; 0, 1, 2-month schedule (not, 0, 1, 2, 12-month schedule) and 0, 1, 6-month schedule. This study was performed to compare vaccination completion rate between the two schedules.

Methods : The study subjects were all subjects who came to the City Medical Center to receive their first hepatitis vaccination dose from March to September, 1998. On odd-numbered day, 0, 1, 2-month schedule was delivered and on even-numbered day 0, 1, 6-month schedule was deliv-ered. On the first visit, the data about general characteristics were collected via self-administered questionnaire. Whether three vaccination doses were all received or not was ascertained by vaccination registration book. The subjects whose vaccination completion could not be ascertained by the book were called by telephone. The data were analyzed by Excel and SPSS-PC.

Results : Total collected cases were 822. Among them, 99 cases were excluded from analysis due to reasonable incompletion (11), incorrect inclusion (9) and impossible confirmation (79), which left 723 cases. General characteristics between two groups were not different except the existence of intrafamilial hepatitis carrier. The hepatitis B vaccination completion rate was higher in 0, 1, 2 -month schedule (85.4%) than in 0, 1, 6-month schedule (76.1%) only in the cases without intrafamilial hepatitis B carrier member.

Conclusion : The completion rate of heatitis B vaccination was higher in 0, 1, 2-month schedule than 0, 1, 6-month schedule in the cases without intrafamilial hepatitis B carrier member.

Background
: Hepatitis B is a leading cause of chronic hepatitis, cirrhosis, and hepatocelluar carcinoma. It is a well-known fact that Korea is one of the hyperendemic areas of Hepatitis B virus among East Asian countries. Many pnst reports have shown that positive rate of HBsAg in Korea was about 6-14%. But precise data for Yongdong area of Kwangwon Province in Korea was lacking. Here authors report on the prevalence of viral markers of hepatitis B among adults in this area.

Methods : Sera were collected from 7469 residents in Yongdong area of Kwangwon Province who visited the Health Care Center, Asan Kangnung Hospital from September 11th to August 31th. HBsAg, AntiHBc-lgG, and AntiHBs were tested by radioimmunoassay.

Results : Positive rate of HSsAg of total study subjects was 8.5%, and significantly decreased as age increased, and higher in males(10.2%) than in females (6.6%). Positive rate for one or more markers among HBsAg, AntiHBc-lgG, and AntiHBs was 84%, and was significantly increased as age increased, and higher in males(86.2%) than in females(81.2%). All negative rate for HBsAg, AntiHBc-lgG, and AntiHBs was 16.0% and all positive rate was 0.5%. Positive rate of AntiHBc-lgG without HBsAg and AntiHBs was 15.7% Positive rate of AntiHBs without HBsAg and AntiHBc-lgG was 11.7%. Positive rate of AntihHBc-lgG and AntiHBs was 72.1% and 60.2%, respectively.

Conclusion : There was no significant difference in positive rate of HBsAg between this study for residents in Yongdong area of Kwangwon Province and past many reports. 84% of the total study subjects showed serological evidence of previous exposure to hepatitis B virus (HBV) naturally exposed or by vaccine immunization. 16% of the total study subjects was a proper candidate for hepatitis B vaccination.

Background
: It is well known that Korea is one of the endemic areas for viral hepatitis B and those who are positive for HBsAg has been reported to be about 5-10% in Korea. Since the 1980's, research and population education for prevention and vaccination for hepatitis B were implemented in Korea. Therefore, we predicted that the positive rates of HBsAg and Anti-HBs have changed since then. Young adults are considered to be the main candidates for hepatitis B vaccination, and the change in the rate of prevalence of HBsAg and Anti-HBs has been investigated in this study.

Methods : We surveyed 1760 freshmen who were positive for HBsAg and Anti-HBs who were in 1998. HBsAg and Anti-HBs was tested by RPHA/PHA.

Results : 3760 students included 2780 males and 980 females(mean age 19.44 years). Among them, 128(3.4%) was positive for HBsAg and 2488(66.2%) was positive for Anti-HBs. The positive rate of HBsAg was 105(3.8%) and that of Anti-HBs was 1797(64.7%) among 2780 male students. The positive rate of HBsAg was 23(2.3%) and that of Anti-HBs was 691(70.5%) among 980 female students.

Conclusion : As compared with previous prevalence studies of HBsAg and Anti-HBs, the positive rate of HBsAg was decreased and that of Anti-HBs was increased. The researchers hope that farther study is necessary using wider range of subjects.

Background
: Although adult immunization is as important as childhood immunization, is being inadequately performed. However, previous studies concerning adult immunization could not be sufficiently evaluated because studies were restricted to the residents in rural area or those who have visited a doctor.

Methods : We conducted a study by telephone interview which included 201 households(375 adult family members)selected by systematic sampling from the yellow pages of Kangnam-gu and Sungbuk-gu districts of Seoul. The types of immunization covered in this study were immunizations against hepatitis B, influenza, pneumococcus, and hemorrhagic fever with renal syndrome(HFRS). Immunization status of all adult household members, cognition of the need for immunization and of interviewees were surveyed. Sex, age, area of residency, education, medical history of study subjects were considered as factors related to the cognition of the need for immunization and immunization performance.

Results : The cognition rates of immunization were as follows : hepatitis B 85.1%, influenza 45.8%, pneumonia 38.3%, and HFRS 33.8%. In the people over 65 years old, the cognition rate against influenza and pneumococcus were 6.25%, 6.25% respectively and for those who have chronic disease. 80.0%, 20.0%, respectively. The cognition rates of immunization was significantly higher among those subjects who were young, well educated, and those residing in Kangnam-gu district.
The immunization performance rate of hepatitis B was 62.5%, influenza 5.6%, pneumonia 0.8%, and HFRS 1.1%. 75.8% of subjects vaccinated against hepatitis B had received at least three times. The immunization performance rate of influenza and pneumococcus by the immunization indication are as follows : 8.0%, 0.0%, respectively in the subjects over 65 years old, and 11.1%, 0.0% respectively in the people who have chronic diseases. The immunization performance rate of hepatitis B was higher among young, well educated subjects living in Kangnam-gu district. But age, education, area of residency played no apparent role in the case of other types of immunization.
The immunization performance rate of those who felt the need for immunization as significantly higher than that of those who did not. To assess the factors which relate to the correct cognition for immunization necessity, we used a multiple logistic regression test. For all types of immunization surveyed, sex(females) and age(young) seemed to be significantly related to the correct necessity cognition. Medical history of chronic disease was also related to the correct necessity cognition for immunization against hepatitis B and influenza.

Conclusion : This study reveals that among living in urban area the immunization performance rate and the correct cognition rate concerning the necessity for adult immunization was generally very low. Therefore, an active publicity and public education will be needed to increase the level of correct necessity cognition for immunization in which the disease status, sex, and age of vaccinee are considered. And more active effort to increase the cognition for immunization necessity performance is required.

Background
: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of health individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination.

Methods : From Feb. 1996 to Aug. 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBs negative and a normal LFT). All subjects were vaccinated with Hepavax-B® 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonresponders(anti-HBsTiter < 2mIU/ml) and the hyporesponders(2~10 mIU/ml). All 13 nonresponders were revaccinated with 2 ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later.

Results : The difference in age(p<0.01) and smoking amount(p<0.05) between the responders andhe hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 58.08 mIU/ml(1~132.4 mIU/ml).

Conclusion : Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.

Background
: Korea is one of the endemic areas of viral hepatitis B, and 6-8% of general population are hepatitis B virus carriers. Although there have been little reduction in morbidity and infectivity of viral hepatitis B owing to newer vaccines and the effects of immunizations, there are some differences among physicians in managing hepatitis B virus infection, and guidelines have not been established. Therefore in this study, we investigated general practitioners' concept and the practical management of viral hepatitis B in comparison with the hepatologists'.

Methods : Information was obtained through questionnaires sent to 67 hepatologists and 400 general practitioners(general internists, general surgeons, family physicians, general physicians, and public health center managers) in Pusan during the 5 months from April to August, 1997. Overall respondents were 142(116 General practitioners, 26 Hepatologists), and the response rate was 32.9%.

Results : In general practitioners, the most commonly used serologic test for viral hepatitis was HBsAg/HBsAb(71.0%). 51.9% of subjects underwent anti-HBs test 3-5 months later after vaccination. The most common revaccination method for healthy non-responders of initial vaccination was 3 series of immunizations with the same vaccine of equal dosage(36.9%). 65.7% of subjects were tested for LFT every 6 months for chronic carriers, and 41.5% of them were advised α-interferon treatment for chronic active hepatitis patients only if the patients requested it. In comparison with general practitioners, hepatologists had a tendency to add anti-HCV test for the serologic evaluation of hepatitis(56.6% vs 26.2%), to limit age for vaccination(82.6% vs 54.1%), and to delay prescribing hepatotonics until the AST and ALT levels increased up to 2 folds normal(53.8% vs 39.1%). 38.5% of hepatologists did not recommend giving booster injection of hepatitis.

Conclusion : Practical guideline is necessary to manage viral hepatitis B patients.