Therapeutic Effects of Leuprorelin (Leuprolide Acetate) in Sexual Offenders with Paraphilia

BACKGROUND: This study examined the clinical effects of leuprolide acetate in sexual offenders with paraphilic disorders evaluated by means of objective psychiatric assessment. METHODS: The subjects of this study were seven sexual offenders who were being treated by means of an injection for sexual impulse control by a court order. They had been diagnosed with paraphilia by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and had been put on probation by the Ministry of Justice between January 2016 and December 2016. RESULTS: After twelve months, we observed significant improvement in symptoms, as decrease of abnormal sexual interest and activity, sexual fantasy, Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Impulsivity (GCI-I). There were a mild feminization of the body shape, feelings of fatigue, and mild hot flushes. No other adverse effect was reported. CONCLUSION: These results suggested that the clinical effects of leuprolide acetate in sexual offenders might be an effective treatment and safety strategy.

Clinical aspects of Primary Epiploic Appendagitis / 대한내과학회지

BACKGROUND: Primary epiploic appendagitis is rarely diagnosed preoperatively and usually results from torsion with subsequent infarction epiploic appendage. Until recent years no diagnostic procedures or clinical symptoms were pathognomic for this disease and the most common preoperative diagnosis were acute diverticulitis and appendicitis. Rapid advance of imaging technique, especially ultrasound, makes it possible to get image of diseased epiploic appandage. Also primary epiploic appendagitis occurs more frequently than it has been suggested in the literature. Therefore authors analyzed and reviewed clinical features and radiological findings of 15 cases with primary epiploic appendagitis to give attention to the acute epiploic appendagitis as one of the ways for diagnosing the acute abdominal pain that has unclear diagnosis, thinking that the rapid diagnosis will helpful to escaping the unnecessary operations. METHODS: This study included twelve men and three women(aged 20-60years). Surgery was done in two patients, one misdiagnosed for acute appendicitis and another for acute diverticulitis with abscess. Follow up examinations were performed with US and CT(n=3), with US, CT and MRI(n=2) and with clinical course (n=13). RESULTS: All patients had localized abdominal pain and tenderness, mostly in the left lower quadrants (n=12). Duration of pain was 3.3 days (1-15days). Two patients had mild fever and two patients had nausea. Leukocytosis was found in four patients. In all cases US revealed a solid hyperechoic(n=13) or isoechoic(n=2) non-compressible ovoid mass with hypoechoic rim. The masses were located under the site of maximum tenderness. CT and MRI finding were compatible with US. CONCLUSION: Primary epiploic appendagitis can be diagnosed pre-operatively using recent imaging technique, and US finding is fairly characteristic. This disorder is not so rare entity as previously known and must be included in the differential diagnosis of acute unexplained abdominal pain in adults.