This study investigated the effect of leuprolide acetate treatment on sex offenders' sexual fantasies and behaviors, as well as on their criminogenic psychological character and the risk of second conviction. The study participants consisted of 22 sex offenders who were confined to the National Institute of Forensic Psychiatry. Among them, 9 patients were given off-label leuprolide acetate for three months to inhibit sexual impulses, whereas the others were not given any medication. All sex offenders underwent two psychological evaluations; the first evaluation was conducted before starting medication, and the second was conducted after medication. Wilson's Sex Fantasy Questionnaire (WSFQ), the Rape Myth Acceptance Scale (RMAS), and the Endorsement of Violence Scale (EVS) were used for evaluation. Leuprolide acetate-treated sex offenders showed a statistically significant decline in the total WSFQ score (p < 0.05). However, the RMAS and EVS scores did not differ after leuprolide acetate treatment, indicating that cognitive distortions like rape myth acceptance and endorsement of violence were unchanged after leuprolide medication. Leuprolide acetate may reduce deviant sexual impulses and fantasies, as suggested by previous research form Korea and other countries. However, it probably cannot alter cognitive distortion. On the basis of these findings, we recommend a combination of leuprolide medication and other therapies, like cognitive behavioral therapy, for the treatment of paraphilic sex offenders.
Cognitive Therapy ; Criminals ; Fantasy ; Forensic Psychiatry ; Humans ; Korea ; Leuprolide ; Paraphilic Disorders ; Rape ; Violence ; Surveys and Questionnaires

This study aimed to classify individuals who had perpetrated child sexual abuse according to the Federal Bureau of Investigation (FBI) typologies of child molesters and to assess the correlations between sociodemographic and criminal variables. We examined a total of 26 patients diagnosed with pedophilia (DSM-IV-TR criteria) who had been hospitalized in the National Forensic Hospital for Cure Custody. Data were obtained through self-administered questionnaires and reviews of patient records. Patients were classified into preferential offenders or situational offenders based on FBI typologies. Current and first offense ages of preferential offenders were younger than those of situational offenders. Preferential offenders were more likely to have been exposed to sexual abuse during childhood, and were more likely to watch child pornography than situational offenders (p < 0.05). Additionally, recidivists had lower IQs (intelligence quotient), lower levels of education, and longer illness durations than first-time offenders (p < 0.05). A multiple logistic regression analysis revealed that IQ and duration of illness might be risk factors of recidivism, although results were not statistically significant (p < 0.1). We found that classification of individuals who had sexually abused children into preferential or situational types, based on FBI typologies, provided on pedophile characteristics and probability of recidivism. We highly recommended that low IQ patients receive intensive treatment and education in order to reduce the possibility of future offenses.
Child Abuse, Sexual ; Child* ; Classification ; Criminals ; Education ; Erotica ; Humans ; Logistic Models ; Pedophilia* ; Risk Factors ; Sex Offenses ; Surveys and Questionnaires

Total gastrectomy has been a standard treatment for upper-third early gastric cancer for decades. Supplementation is essential after total gastrectomy due to vitamin B12 deficiency. Additionally, postoperative complications, such as reflux esophagitis, anastomotic stricture, leakage, and malnutrition, are the main issues. Proximal gastrectomy is considered an alternative treatment for upper-third early gastric cancer. As a function-preserving gastrectomy it is known that the incidence of vitamin B12 deficiency is low and due to its various reconstruction methods we can easily overcome major postoperative complications. Therefore, we aimed to review about proximal gastrectomy, how it is reconstructed, and complications after reconstruction.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a positive-sense singlestranded RNA (+ssRNA) that causes coronavirus disease 2019 (COVID-19). The viral genome encodes twelve genes for viral replication and infection. The third open reading frame is the spike (S) gene that encodes for the spike glycoprotein interacting with specific cell surface receptor – angiotensin converting enzyme 2 (ACE2) – on the host cell membrane. Most recent studies identified a single point mutation in S gene. A single point mutation in S gene leading to an amino acid substitution at codon 614 from an aspartic acid 614 into glycine (D614G) resulted in greater infectivity compared to the wild type SARS-CoV2. We were interested in investigating the mutation region of S gene of SARS-CoV2 from Korean COVID-19 patients. New mutation sites were found in the critical receptor binding domain (RBD) of S gene, which is adjacent to the aforementioned D614G mutation residue. This specific sequence data demonstrated the active progression of SARS-CoV2 by mutations in the RBD of S gene.The sequence information of new mutations is critical to the development of recombinant SARS-CoV2 spike antigens, which may be required to improve and advance the strategy against a wide range of possible SARS-CoV2 mutations.