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Current Situation of Substance Abuse and Treatment Strategies (우리나라 약물중독의 치료 실태와 대책)

  • Cho, Sung Nam
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.11-36
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    • 2013
  • Korea has been recognized as a safe country about the substance abuse, but now is not safe country because there are over 10 thousand drug related offenses in a year since 1999. Seventy percent of them are drug abusers, so Korea government must have stronger political strategies about the prevention and the treatment of the drug abuse. Till now Korea government has focused on the imprisonment rather than the treatment for the drug abusers. So the relapse rates are over 40% among the incarcerated drug abusers. Now we need more treatment strategies and development of treatment methods to decrease the relapse rates. Substance abuse is a brain disease with a chronic relapsing nature and has a bio-psycho-social etiology. So treatment process has three steps, motivation enhancement treatment for substance-free lifestyle, rehabilitation aimed at maximizing multiple aspects of life functioning, and relapse prevention. To improving the treatment strategies the Government must execute the national survey about the substance abuse, enforce a law to operate the drug court and to sentence a treatment order with a probation, and establish a national addiction institute for study and education about the substance abuse.

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Could A1 Aplasia or Hypoplasia Affect the Morphology and Rupture Risk of Anterior Communicating Artery Aneurysm?

  • Park, Sung Chan;Jung, Na Young;Park, Eun Suk;Kwon, Soon Chan
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.531-538
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    • 2022
  • Objective : Anterior communicating artery (Acom) aneurysm is one of the most common intracranial aneurysms, constituting approximately 30-35% of all aneurysm formation in the brain. Anatomically, the H-complex (the anatomic morphology of both A1 to A2 segments) is thought to affects the nature of the Acom aneurysm due to its close relationship with the hemodynamics of the vessel. Therefore, we investigated the relative risk factors of aneurysmal rupture, especially focusing on H-complex morphology of the Acom. Methods : From January 2016 to December 2020, a total of 209 patients who underwent surgery, including clipping and coiling for Acom aneurysm in our institution were reviewed. There were 102 cases of ruptured aneurysm and 107 cases of unruptured aneurysm. The baseline morphology of aneurysms was investigated and the relationship between the H-complex and the clinical characteristics of patients with Acom aneurysms was assessed. Results : Of the 209 patients, 109 patients (52.1%) had symmetrical A1, 79 patients (37.8%) had unilateral hypoplastic A1, and 21 patients (10.0%) had aplastic A1. The hypoplastic A1 group and the aplastic A1 group were grouped together as unilateral dominancy of A1, and were compared with the symmetrical A1 group. There was no significant difference in demographic characteristics and radiological findings of Acom aneurysms between two groups. However, when dichotomizing the patients into ruptured cases and unruptured cases, unilateral dominance of the A1 segment was associated with aneurysmal rupture with statistical significance (p=0.011). Conclusion : These results suggest that the unilateral dominance of the A1 segment does not have a significant effect on the morphology of Acom aneurysms, but contributes to aneurysmal rupture. Thus, we can better understand the effects of hemodynamics on Acom aneurysm.

Great Toe Pulp Graft for the Reconstruction of the Postburn Flexion Contracture in the Fingers (수지 화상 후 굴곡성 구축 치료 시 족질부 이식)

  • Seo, Je Won;Kwon, Ho;Yim, Young Min;Jung, Sung-No
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.587-592
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    • 2007
  • Purpose: In case of postburn flexion contracture of the fingers, skin graft, geometrical relaxation techniques, local flap, and free flap have been used. Among these procedures, full-thickness skin grafts from the inguinal area are widely used to reconstruct a postburn flexion contracture in the fingers. But there are many esthetic and functional problems in this procedure. Especially, hyperpigmentation of the skin-grafted fingers poses a troublesome problem, particularly in the patients who have dark colored skin. To solve the problem, we have used pulp graft which was harvested from the lateral aspect of great toe. In the present study, we report pulp graft, with which we have obtained a good result in the treatment of postburn flexion contracture of the fingers. Methods: Between September of 2004 and August of 2006, great toe pulp graft was performed to 20 sites of 15 patients. After release of the postburn flexion contracture using Z-plasty, the composite tissue (pulp) harvested from the lateral aspect of great toe was grafted on the raw surface. Moisture dressing with ointment and foam dressing material was performed. Stratum corneum of the graft got stripped off in two to four weeks after pulp graft. The color of the pulp graft was slightly reddish, then it became similar to the adjacent tissue. Results: There was complete take in all the patients who were treated with pulp graft. Great toe pulp graft provided similar color and texture to the adjacent skin, high rate of graft take, and left only a minimal scar at donor site. Conclusion: Thick keratin layer and inelastic nature of the pulp make this type of the graft much easier and simpler, and ensure a better take. Pulp graft is useful method for the reconstruction of the postburn flexion contracture in fingers.

Prevalence of antibody against 38 kDa outer membrane protein of Yersinia enterocolitica in swine (국내 사육돼지에서의 Yersinia enterocolitica 38 kDa outer membrane protein에 대한 항체가 분포)

  • Shin, Seong-jae;Park, Joo-youn;Choi, In-soo;Shin, Na-ri;Yoo, Han-sang
    • Korean Journal of Veterinary Research
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    • v.41 no.1
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    • pp.73-78
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    • 2001
  • Yersinia enterocolitica is an inhabitant in the lower intestinal tract of many domestic and wild animals as well as in the nature. Of the several forms of diseases caused by Y. enterocolitica, an acute enteritis, especially in young children, is the most common form. Infection of the bacteria usually occurs through fecal-oral route by contaminated foods or water, especially mountainspring water. Of the domestic animals, swine has been known as one of the most important carrier in the human infection. Based on the knowledge, prevalence of antibody against Y enterocolitica was investigated with swine sera collected from Korea for the survey of Y enterocolitica infection in swine. As the first step of this survey, we analyzed outer membrane protein (OMP) profiles of the representative strains of Y enterocolitica isolated from the feces of piglets and mountainspring water in Korea. Thirty-eight kDa OMP was identified as the common OMP regardless of origin, serotype, or biotype of Y enterocolitica isolates. Presence of antibody specific for 38 kDa OMP of Y enterocolitica in 1,076 swine sera collected from November 1999 to October 2000 was analysed with ELISA. Antibody titer in sows was significantly higher than that in piglets, growing pigs and finishing pigs (p<0.05). Also, there was seasonal difference in the prevalence of antibody against Y enterocolitica. These results would provide the basic knowledge for controlling the Y enterocolitica infection in human as well as swine.

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Assessment of respondents' knowledge, attitudes, and practices toward rabies and associated risk factors in Shone Town, Southern Ethiopia

  • Teketel Gizaw Beresa;Teshita Edaso Beriso;Tesfaye Bekele Kassa;Isayas Asefa Kebede
    • Journal of Veterinary Science
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    • v.25 no.3
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    • pp.46.1-46.11
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    • 2024
  • Importance: Rabies is a neglected tropical viral disease most often transmitted through the bite of an infected animal. Objective: This study assessed the level of knowledge, attitudes, and practices of the Shone Ttown community toward rabies. Methods: A survey-based cross-sectional study was conducted in Shone town, Ethiopia, from November 2022 to April 2023. Woreda was selected purposefully, while Kebeles and the study populations were selected by simple random sampling. Four hundred and sixteen respondents were interviewed using a semi-structured questionnaire. Results: All respondents had heard about rabies from different sources, with the majority hearing from informal sources (62%). Approximately 51.9%, 0.7%, and 47.4% of individuals were aware of saliva contact, rabid animal bites, and both as means of transmission, respectively. The survey showed that 64.4% of participants knew the 100% fatal nature of rabies once the clinical signs developed, and 35.6% did not. Approximately 51.4% of respondents agreed that killing stray dogs was an effective method for rabies prevention. In this study, 72.6% of the respondents had contact with pets, and 36.8% of the interviewees had vaccinated their dogs. Only the educational level (p = 0.03) was associated with knowledge of the transmission route. Age (p = 0.04) and educational level (p = 0.01) had a statistically significant association with knowledge of the risk of not vaccinating dogs. Conclusions and Relevance: A lack of formal education in the communities, low levels of education, and the majority of respondents acquiring their knowledge from unofficial sources are important contributors to the low levels of awareness.

Role of TGF-β1/SMADs signalling pathway in resveratrol-induced reduction of extracellular matrix deposition by dexamethasone-treated human trabecular meshwork cells

  • Amy Suzana Abu Bakar;Norhafiza Razali;Renu Agarwal;Igor Iezhitsa;Maxim A. Perfilev;Pavel M. Vassiliev
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.4
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    • pp.345-359
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    • 2024
  • Deposition of extracellular matrix (ECM) in the trabecular meshwork (TM) increases aqueous humour outflow resistance leading to elevation of intraocular pressure (IOP) in primary open-angle glaucoma, which remains the only modifiable risk factor. Resveratrol has been shown to counteract the steroid-induced increase in IOP and increase the TM expression of ECM proteolytic enzymes; however, its effects on the deposition of ECM components by TM and its associated pathways, such as TGF-β-SMAD signalling remain uncertain. This study, therefore, explored the effects of trans-resveratrol on the expression of ECM components, SMAD signalling molecules, plasminogen activator inhibitor-1 and tissue plasminogen activator in dexamethasone-treated human TM cells (HTMCs). We also studied the nature of molecular interaction of trans-resveratrol with SMAD4 domains using ensemble docking. Treatment of HTMCs with 12.5 µM trans-resveratrol downregulated the dexamethasone-induced increase in collagen, fibronectin and α-smooth muscle actin at gene and protein levels through downregulation of TGF-β1, SMAD4, and upregulation of SMAD7. Downregulation of TGF-β1 signalling by trans-resveratrol could be attributed to its effect on the transcriptional activity due to high affinity for the MH2 domain of SMAD4. These effects may contribute to resveratrol's IOP-lowering properties by reducing ECM deposition and enhancing aqueous humour outflow in the TM.

Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

  • Jeong, Hyung Hwa;Choi, Dong Hoon;Hong, Joon Pio;Suh, Hyun Suk
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.466-469
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    • 2018
  • The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of $1{\times}1{\times}0.5cm$ was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.

The conservative treatment of mandibular fracture in a child with circummandibular wiring: case report (환악 결찰술을 이용한 소아 하악 골절의 보존적 치료: 증례보고)

  • Kim, Hyung-Mo;Kim, Tae-Wan;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.145-148
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    • 2010
  • Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

EXPERIMENTAL STUDY ON THE EFFECTS OF VARIOUS DISINFECTANTS TO ORAL MICROFLORA (각종 소독제가 구강균총에 미치는 영향에 관한 실험적 연구)

  • Kim, Joon-Bae;Paik, Tae-Hyun;Choi, Tae-Kyung;Kim, Seong-Soo
    • The Journal of the Korean dental association
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    • v.22 no.9 s.184
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    • pp.793-801
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    • 1984
  • Though oral microgranisms were among the first to be observed by humans, the interest in oral microbiology lagged. When it became apparent that the oral microflora did influence systemic disease of the body, interest was aroused in the nature and kinds of the microgranisms. The risk of infection in dental procedures is due to the abundant flora of the mouth. This hazard can be reduced to some extent by the use of a local disinfectant. The present studies were undertaken to evaluate and compare the various disinfectants which are commonly used in clinics and hospitals. The results were as follows. 1. The bactericidal activity of the disinfectants mainly depends upon the kinds of the agents, not upon the kinds of the microorganisms. 2. In H₂O₂(3%), the bactericidal activity was greatly related to the contact time. So, at least 4 minitues of contract time was required to use it as an oral antiseptic. 3. In ethyl alcohol (70%), Pseudomonas aeruginosa and Streptococcus salivarius surived a little after 15 seconds of contact time, but, no other colony was discovered after more than 15 seconds of contact time in any kins of microorganisms. 4. Merthiolate (0.1%) showed low antibacterial activity, more in Gram-positive organisms and less in Gram-negative organisms. 5. Benzalkonium chloride (0.1%) and povidone-iodine (10%) showed the most excellent results, revealing no surviving organisms only after 14 seconds of contact time.

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Diagnostic Aspects of Fine Needle Aspiration for Lung Lesions: Series of 245 Cases

  • Kravtsov, Vladimir;Sukmanov, Inna;Yaffe, Dani;Shitrit, David;Gottfried, Maya;Cioca, Andreea;Kidron, Debora
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9865-9869
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    • 2014
  • Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissue diagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washing and brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy. The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests in diagnosing lung lesions. Materials and Methods: The population included all patients undergoing FNA for lung lesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology, patient records and files from the Department of Oncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for each test. Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases (78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, not otherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificity of FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%. Conclusions: FNA is the most sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsy increases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performance of all stages of test affect the ability to establish a diagnosis.