Injection-related necrosis is a common pattern in the arterial injuries. But the acute embolization that led to extremity necrosis is very rare. Here we described a case of 43-year male patient with arm necrosis due to intra-arterial drug injection. The patient has addicted drug for 24 years and has injected opium for 18 years with dose of 2 ml self-prepared opium solution, 3-4 times daily. On April 2000, after second injection of a day, the patient felt burn and pain in his left hand. Then watery purples and necrotic papules appeared on the skin of left arm. He was treated by antibiotics, analgesics, and vasodilators, but the condition was not improved. The patients had to be amputated his left arm after 3 days of admission.
Substance Withdrawal Syndrome ; Alcohol Withdrawal Delirium ; diagnosis

Delirium tremens is a severe state of alcohol-related withdrawal syndrome, which is precipitated in the chronic alcoholic who are suddenly deprived of alcohol because of traumatic injury or other diseases. About 5 % of alcoholics show evidence of severe withdrawal symptoms. Symptoms begin within 1 to 3 days after stopping ethanol intake. These include a state of confusion sometimes accompanied by visual, tactile, or auditory hallucinations. The diagnosis is made when the course progresses beyond the usual symptoms of withdrawal to include confusion, severe agitation, and generalized seizures. The likelihood of developing severe withdrawal symptoms increases with concomitant infections or medical problems, a prior history of withdrawal seizures of DTs, and higher quantity and frequency of drinking. Most periods of severe withdrawal begin and end abruptly, rarely lasting longer than 3 to 5 days. The mortality risk for DTs is quite low but increases with preexisting medical illnesses or organ system failure. We experienced a case of DTs associated with fracture of mandible. The patient was a 36-years-old male who was admitted to our hospital via emergency room after suffering from a traffic accident. He developed DTs 3 days after admission and eventually expired. The report of a case and review of literatures are as follows.
Accidents, Traffic ; Alcohol Withdrawal Delirium* ; Alcoholics ; Delirium* ; Diagnosis ; Dihydroergotamine ; Drinking ; Emergency Service, Hospital ; Ethanol ; Hallucinations ; Humans ; Male ; Mandible* ; Mortality ; Seizures ; Substance Withdrawal Syndrome

40 patients with ages of 31-60 and alcohol withdrawal syndrome in hospital 103 during 1999-2001 participated to a study. The evaluation of the exogenous factors that influenced the alcoholism and clinical features of alcoholism withdrawal syndrome after 5-10 days of the treatment.
Substance Withdrawal Syndrome ; alcoholism

OBJECTIVES: The aim of this study was to explore clinical factors or high-risk factors associated with occurrence of delirium tremens (DT) during acute alcohol withdrawal in inpatients with alcohol dependence. METHODS: This study included 164 inpatients seeking treatment for acute alcohol withdrawal in the detoxification unit. All subjects were evaluated prospectively for known risk factors for DT and their occurrence of DT. Correlations were determined between risk factors obtained at admission and development of DT. RESULTS: Among all subjects, 42 patients (25.6%) suffered from delirium tremens within seven days after admission. DT patients had more severe alcohol withdrawal symptoms, the presence of past DT, and higher levels of aspartate aminotransferas, alanine aminotransferase, gamma-glutamyl-transpeptidase, and homocysteine, compared with patients who did not suffer DTs. According to results of a multiple regression, occurrence of DT showed correlation with the following factors at admission: tremor, a past history of DT, higher homocysteine level, and nausea and vomiting. CONCLUSION: Development of DT showed correlation with symptoms of severe alcohol withdrawal, past history of DT, and higher homocysteine level. Among these, a severity of alcohol withdrawal symptoms and a history of DT are factors that can be easily evaluated on the day of admission in order to predict the potential for occurrence of DT.
Alanine Transaminase ; Alcohol Withdrawal Delirium ; Alcoholism ; Aspartic Acid ; Delirium ; Homocysteine ; Humans ; Inpatients ; Nausea ; Prospective Studies ; Risk Factors ; Substance Withdrawal Syndrome ; Tremor

OBJECTIVE: This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. METHODS: This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. RESULTS: The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. CONCLUSION: Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.
Alcohol Drinking ; Alcohol Withdrawal Delirium* ; Alcoholism* ; Amylases ; Blood Urea Nitrogen ; C-Reactive Protein ; Creatinine ; Dihydroergotamine ; Drinking ; Hallucinations ; Humans ; Inpatients ; Logistic Models ; Risk Factors ; Substance Withdrawal Syndrome* ; Sweat ; Sweating

As for treatment in community: the alcohol addicts are giving up alcohol completely after treatment is 4/31 equals 12.90%. The times using alcohol daily are reduced from 7 days down to 5 days is 11/31 (35.48%). The treatment of alcohol addiction in the community: beside the use of different anti-anxieties must be combine together with psychotherapy as well as the support from family and community, particularly addict's determination.
Alcoholism ; therapy ; Substance Withdrawal Syndrome

The Central Mental Hospital combined with communes to establish 6 subdivisions of drug addiction withdrawal. The rate of drug addiction in communes was 0,31 and occurred mainly in Youth. After 10 days of treatment, almost of addicts had no addictive crisis and came their home. However, there were some difficulties for model of community based drug addiction withdrawal, including addict’s management, isolation, participation of social organizations, existance of addictive focuses, which lead the high relapsed addiction.
Substance-Related Disorders ; Substance Withdrawal Syndrome

OBJECTIVES: The aims of this study were to evaluate changes in plasma superoxide dismutase(SOD) activities in alcohol depedence, to fine out variables to influence on the SOD activities, and finally to identify the correlation of SOD activities with the alcohol-associated cognitive disorders. METHODS: For 24 male alcoholics and 21 healthy male controls, plasma SOD activities were measured by spectrophotometry on 1-2 wks after alcohol withdrawal. Structured interviews and laboratory tests were also performed. RESULTS: 1) Upon comparing SOD activities between controls and alcoholics, the SOD activities were significantly(p<0.01) lower in alcoholics(0.308+/-0.140 units/mL) than in healthy controls(0.313+/-0.086 units/mL). 2) Upon comparing SOD activities according to the presence of alcohol-related cognitive disorders, the SOD activities were significantly(p<0.05) lower in alcoholics with cognitive disorders(0.247+/-0.049 units/mL) than in alcoholics without cognitive disorders(0.317+/-0.148 units/mL). 3) Upon comparing SOD activities according to the presence of alcoholic polyneuropathy or alcohol withdrawal seizure, the SOD activities showed no significant differences between alcoholics with polyneuropathy or epilepsy and those without. 4) Upon analyzing variables influencing on the SOD activities in alcoholics, the SOD activities had the negative correlation with hemoglobin(gamma=-0.433) and severity of alcohol withdrawal symptoms(gamma=-0.375). 5) Upon comparing variables according to the presence of alcohol-related cognitive disorders, the occurrence of alcoholic polyneuropathy(p<0.05) and blood phosphorus concentrations(p<0.01) were significantly higher in alcoholics with cognitive disorders than those without. 6) Upon analyzing an association between SOD activities and variables in alcoholics with cognitive disorders, the SOD activities were positively correlated with the onset age(gamma=0.995), and negatively correlated with the severity of alcohol withdrawal symptoms(gamma=-0.996). CONCLUSIONS: Lower SOD activities in alcohol dependence suggested alcohol-associated cognitive disorders and alcohol withdrawal symptoms might be caused by oxidative stress.
Alcohol Withdrawal Seizures ; Alcoholic Neuropathy ; Alcoholics ; Alcoholism ; Epilepsy ; Humans ; Male ; Oxidative Stress ; Phosphorus ; Plasma ; Polyneuropathies ; Spectrophotometry ; Substance Withdrawal Syndrome ; Superoxide Dismutase* ; Superoxides*

The study was designed as perspective clinical trial, comparing before and after treatment with BSA 52 in 30 patients with drug withdrawal. BSA 52 supported the addicts to overcome the drug substinent symptoms and to recover promptly general health status. Effective time was between 2 to 3 days in average with a sucessful rate of 93.33% of all studies cases. No considerable side effects were observed during the trial
Pharmaceutical Preparations ; Therapeutics ; Substance Withdrawal Syndrome

There are many traditional medications for withdrawing drug addiction. They are various kinds, formulation and has been being tried clinically. The clinical trials should be considered under principles including only implementation of clinical trial after preclinical studies; the clinical trials in centers for withdrawal of drug addiction. It should have a unified guideline of treatment by MOH. It should clarify the clinical trials and retrospective study.
Medicine, Traditional ; Substance-Related Disorders ; Substance Withdrawal Syndrome