Bahn, Geon Ho;Hong, Min Ha;Lee, Yeon Jung;Han, Ju Hee;Oh, Soo Hyun
Korean Journal of Biological Psychiatry
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v.21
no.2
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pp.37-48
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2014
Besides from medical data, the patients who were previously called as attention disorder, mental instability, moral imbeciles, or moral defectives, can also be identified by exploring literatures and historical figures. In the past, as we can notice from the titles, they were recognized as a 'moral defect group'. And rather than treating them, separation from the society was the main solution. After the endemic encephalitis from 1917 to late 1920s, however, many survivors suffered from behavioral problems similar to those of the previous 'moral defect group' and studies on the relationship between brain damage and behavior problems were started henceforth. After being known as the 'minimal brain dysfunction', it was developed into the current attention-deficit/hyperactivity disorder. While the disease concept changed and developed over time, after numerous trials and errors, treatment medication starting from central nervous system stimulants such as amphetamine and methylphenidate is used for treatment in children and adult patients with ADHD, and most recently non-stimulants such as atomoxetine has become the one of the first line treatment options. Although we went through a thorough verification process of the safety and efficacy of the medication by contemplating the historical development process, we believe that adjustment is needed for remaining concerns on medication abuse and slight differences in disease paradigm and therapeutic philosophy depending on cultures.
Objectives : The BangPungTongSungSan(BPTSS) has been used as a therapeutic agent for cerebrovascular disease, cerebral hemorrhage, hypertension, diabetes and obesity in oriental medicine. The present study designed to investigate the effect of BPTSS on behavioral change and neuronal activation induced by acute methamphetamine(METH, 2 mg/kg, i.p.) in C57BL/6 mice. Methods : Mice received the oral administration of BPTTS(25, 50 and 100 mg/kg) 1 h prior to saline or METH administration. Locomotor activity was measured for 90 min using videotractking method and c-Fos expression, as marker of neuronal activation, was identified in a separate groups of mice by immunohistochemistry. Results and conclusions : Methamphetamine injection significantly increased locomotor activity and c-Fos expression in the nucleus accumbens and striatum. Interestingly, BPTTS(100 mg/kg) significantly suppressed locomotor activity and c-Fos expression in the nucleus accumbens and striatum by acute exposure to METH. These results suggest that BangPungTongSungSan may be effective in suppressing the reinforcing effect of methamphetamine by modulation neuronal activity.
Caudal, rostral and both areas of the nucleus accumbens septi (NAB) were lesioned each in separate animal group by applying DC of 3.0 mA for 15 sec. in order to examine if any regional differences in the NAB with regard to the manifestation of locomotor activity, The r-NAB and cr-NAB-lesioned rats were significantly increased in locomotor activity but not in the c-NAB-lesioned rats and the effect following the NAB lesion was immediately produced and returned to control levels in about 7 days postoperatively. On the other hand, the locomotor stimulation produced by methamphetamine was significantly attenuated in all NAB-lesioned rats but also stereotyped behavior was significantly elicited simultaneously. These results thus suggested that NAB may be attributed to the inhibitory role in the locomotor activity, of which intensity differs from rostral site and caudal site, and stereotyped behavior may be shown higher sensitivity of the denervated striatal dopamine function.
Ok, Young Bin;Kim, Jin Yong;Lee, Kyeong Ryong;Hong, Dae Young;Baek, Kwang Je;Park, Sang O;Kim, Jong Won;Kim, Sin Young
Journal of The Korean Society of Clinical Toxicology
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v.16
no.1
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pp.25-32
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2018
Purpose: Methamphetamine is an ongoing illegal drug problem worldwide, and its use in South Korea has spread over the last few years. In this study, a clinical review of patients who visited emergency medical centers with positive methamphetamine tests was conducted. Methods: Patients underwent methamphetamine screening based on physician suspicion over a period of 13 years. Their patient characteristics, clinical features, and drug administration properties were described. Results: A total of 297 patients were included, with 19 positive methamphetamine results. Patient age ranged from 21 to 84, with a mean of 37.52. Additionally, 13 were male and 6 were female. The mean BP, PR, RR were 131/82 mmHg, 94/min, 20/min. Saturation levels were all over 95%. Five patients had a psychiatric history. Patient showed varied symptoms ranging from mental changes to chest discomfort. In addition, seven showed abnormal electrocardiography findings and one showed elevated cardiac enzyme levels. Other laboratory results revealed no significantly abnormal results. Six patients also suffered from related trauma. The majority of patients consumed the methamphetamine orally, with unknown motivation at unknown locations. Most were transported by 119 and six patients co-ingested other drugs. Conclusion: Patients who showed positive results to a methamphetamine screening test in Korea visited the emergency medical center mostly by 119 and were unaware of or reluctant to reveal the fact that they had ingested methamphetamine. Emergency physicians should be more aware of the possibility that a patient may have consumed methamphetamine.
The aim of this review is to analyze the trend of using Virtual Reality (VR) in addiction treatment by categorizing the types of addictions and methods of Virtual Reality Therapy (VRT) for substance use disorders. VR has been utilized as a new paradigm for treating various mental and psychological problems. In recent years, a number of researches have been done to demonstrate the effectiveness of VRT for addiction treatment, specifically substance use disorders. In order to comprehend the tendency of these researches, the current study performed a systematic review of published book and journal articles using the following bibliographical databases: ScienceDirect, MEDLINE, ProQuest, and Embase. Forty-five (45) articles were retrieved; out of these researches, nicotine/smoking has garnered the highest number of studies (73%, n=33); alcohol (18%, n=8); cannabis/marijuana (2%, n=1); and other drugs such as heroin, cocaine and methamphetamine (7%, n=3). This paper analyzed the results of those studies, found some limitations as well as strengths, and made suggestions for further research on VRT for addiction treatment.
Kim, Eun-Mi;Lee, Ju-Seon;Choi, Hye-Young;Choi, Hwa-Kyung;Chung, Hee-Sun
YAKHAK HOEJI
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v.52
no.6
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pp.419-425
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2008
A qualitative and quantitative analytical method was developed for detection of methamphetamine (MA) and its main metabolite amphetamine (AM) in oral fluid. Oral fluids of eleven drug abusers were provided by Police, specimens were collected by stimulation with a cotton swab treated with 20 mg of citric acid ($Salivette^{(R)}$; Sarstedt, USA). As the preliminary test, oral fluid samples were screened for amphetamines by Fluorescence Polarization Immunoassay (TDxFLx, Abbott Co.). Extraction for MA was performed using solid-phase extraction (SPE) by $RapidTrace^{TM}$ (Zymark, USA) with mixed mode cation exchange cartridge, CLEAN $SCREEN^{(R)}$ (130 mg/3 ml, UCT) after dilution with phosphate buffer. Samples were evaporated and derivatized by pentafluoropropionic acid anhydride (PFPA). Quantitation of MA and AM was performed by gas chromatography-mass spectrometry (GC-MS) using selective ion monitoring (SIM), the quantitation ions were m/z 204 (MA), 208 (MA-$D_5$), 190 (AM) and 194 (AM-$D_5$). The selectivity, linearity of calibration, limit of detection (LOD) and quantification (LOQ) within- and between day precision, accuracy and recoveries were examined as parts of the method validation. All oral fluid samples gave positive results to immunoassay for MA (cut-off level, 50 ng/ml as d-amphetamine). Concentrations of MA and AM by GC-MS in eleven samples were ranged 104.2${\sim}$4603.3 ng/ml and 32.4${\sim}$268.6 ng/ml, respectively. Extracted calibration curves of MA and AM were linear over the two concentration range of 1${\sim}$100 and 50${\sim}$1000 ng/ml with correlation coefficient of above 0.999. LOQ of MA and AM was 1 and 3 ng/ml, respectively. The intraand inter-day run precisions (CV) for MA and AM were less than 10%, and the accuracies (bias) for MA and AM were also less than 10% at the two different concentrations 5 and 100 ng/ml at low calibration range, 50 and 1000 ng/ml at high calibration range. The absolute recoveries of MA and AM at low and high calibration ranges were more than 82% and 75%, respectively. In this study the qualitative and quantitative analytical method of MA in oral fluid was established. Oral fluid testing may detect drug use in past hours because of its shorter detection window than urine, and be useful in post-accident situations. So oral fluids will be most useful for testing drug abuse in the driving under the influence of drug (DUID) as the alternative specimens of urine.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.14
no.1
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pp.3-11
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2003
Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.
Cheong, Jae Chul;Kim, Jin Young;In, Moon Kyo;Cheong, Won Jo
Analytical Science and Technology
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v.21
no.1
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pp.41-47
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2008
Although liquid-liquid extraction (LLE) method has been used routinely for the analysis of amphetamine-like drugs (amphetamine; AP, methamphetamine; MA, 3,4-methylenedioxyamphetamine; MDA, 3,4-methylenedioxymethamphetamine; MDMA, 3,4-methylenedioxyethylamphetamine; MDEA), a solid-phase extraction (SPE) method, which can be automated, was applied for the simultaneous determination by GC/MS in human urine. Urine samples (3 mL) and 0.1 M phosphate buffer (1 mL, pH 7.0) were extracted by an automated SPE system. The eluent was evaporated, derivatized with trifluoroacetic anhydride (TFAA), and analyzed by GC/MS. The calibration curves was linear with correlation coefficient ($r^2$) above 0.994 in the ranges of 34.0 (AP), 28.0 (MDA)~1000.0 ng/mL for AP, MDA, and 50.0~2000.0 ng/mL for MA, MDMA, and MDEA. The limits of detection ranged from 4.0 to 10.0 ng/mL, and the limits of quantitation ranged from 12.0 to 34.0 ng/mL. The relative recoveries were 93.5~107.7 %. The precisions and accuracies were 1.9~14.8 % and -8.7~14.8 %, respectively. The present method was successfully applied to identify the MA or Ecstasy (MDMA) abusers in exact as well as rapid.
Herbal medicine (HM)-containing Ephedra Sinica (ES) has been associated with false-positive amphetamine immunoassay (FP IA) results. This study retrospectively evaluated the effects of dose, duration, and withdrawal instructions on FP IA and the safety of HM-containing ES at a clinic in Seoul from 2022 to 2023. The study included 6 patients in the FP IA group and 5 patients in the withdrawal instruction negative (Neg) group. The pre-test ephedrine alkaloids dose in the FP IA group was 95.17±31.90 mg, compared with 88.6±20.43 mg in the Neg group. The FP IA group had taken HM for 226.67±152.87 days before testing, and testing was performed while taking HM. In contrast, the Neg group had taken HM for 147.6±23.49 days and had 5.4±1.50 days of withdrawal period before the test following instructions of Korean medicine doctors. All adverse events (AEs) were moderate in severity, and the number of occurrences was similar: 5 in the FP IA group and 7 in the Neg group. AEs included constipation, insomnia (3 cases each), and palpitations (2 cases). The results of this study show that ES-induced FP IA can be resolved with withdrawal instructions and ES can be safely prescribed and administered by Korean medicine doctors. Further studies are needed to determine how to prevent FP IA after taking ES.
Cannabis (Marijuana) is one of the most widely used drugs in the world, and its distribution has been controlled in South Korea since 1976. Identification of 11-nor-Δ9-carboxy-tetrahydrocannabinol (THCCOOH) in urine can provide important proof of cannabis use, and it is considered scientific evidence in the forensic field. In this study, we describe a simultaneous quantitative method for identifying THCCOOH and THCCOOH-glucuronide in urine, using simple liquid-liquid extraction (LLE), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). THCCOOH-D3 and THCCOOH-glucuronide-D3 were used as internal standards. Validation results of the matrix effect, as well as recovery, linearity, precision, accuracy, process efficiency, and stability were all satisfactory. No carryover, endogenous or exogenous interferences were observed. The limit of detection (LOD) of THCCOOH and THCCOOH-glucuronide were 0.3 and 0.2 ng/mL, respectively. The developed method was applied to 28 authentic human urine samples that tested positive in immunoassay screening and gas chromatography/mass spectrometry (GC/MS) tests. The ranges of concentrations of THCCOOH and THCCOOH-glucuronide in the samples were less than LOQ~266.90 ng/mL and 6.43~2133.03 ng/mL, respectively. The concentrations of THCCOOH-glucuronide were higher than those of THCCOOH in all samples. This method can be effectively and successfully applied for the confirmation of cannabinoid use in human urine samples in the forensic field.
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