Effect of CORE Program on Cognitive, Social and Emotional Characteristics of Sex Offenders / 대한법의학회지

The purpose of this study was to develop the CORE Program for sex offenders and to determine its effectiveness. The CORE Program was designed with an aim to achieve cognitive restructuring, improve the ability to empathize in interpersonal relationships, and enhance self-esteem and intimacy. We conducted this program over 48 sessions for 28 sex offenders. The effectiveness of the program was evaluated using the Interpersonal Responsiveness Index (IRI), Self-esteem Questionnaire (SEQ), UCLA Loneliness Scale (UCLALS), Coping Using Sex Inventory (CUSI), Rape Myth Acceptance Scale (RMAS), and Wilson's Sex Fantasy Questionnaire (WSFQ). The data were analyzed using paired t-tests. Our results showed no significant changes in the SEQ, UCLALS, and IRI scores after the treatment program. However, the scores for the CUSI, RMAS, and WSFQ significantly improved after this program. In this paper, we demonstrate the effectiveness of the CORE Program for sex offenders. We also discuss the limitations of our study and provide suggestions for future research. Our findings indicate that this treatment program should be provided to sex offenders for preventing recidivism.

Osteoradionecrosis on mandible: A case report and literature review

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

A Clinical Case of the Extensive Tissue Necrosis Due to Radiofrequency Ablation Applied on Malignant Melanoma

Radiofrequency ablation is an effective alternative for the treatment of many benign and malignant lesions. The hyperthermia caused by radiofrequency can induce the coagulation necrosis of tumor mass that is more sensitive to heat than normal tissue. It is getting more attention of physicians because of its safety, convenience and various procedure routes. So it has been applied to more and more various fields, recently. It has some complications including erythema, blisters and full thickness skin losses, and these complication that had been reported caused not so severe problems. But there is a potential risk of an unpredictable, extensive, and progressive tissue necrosis in radiofrequency ablation because it is difficult to define the extent of thermal damage precisely. Authors has experienced a clinical case of progressive, wide and deep tissue necrosis due to radiofrequency ablation applied to metastatic malignant melanoma in the right groin region. We performed debridement carefully for the necrotic tissue just above femoral vessels and the sartorius muscle flap procedure to fill the defect. Radiofrequency ablation should be performed with extreme caution not to damage surrounding tissue, especially in the region close to skin and large vessels.

Scar Revision with Frostbite Using Dry Ice

Facial scar is one of the most common problems in plastic surgery department. Many various methods are attempted to improve facial scars, but there is no definite satisfactory method on scar revision. Authors have been interested in a tendency to show good results when traumatic lacerations were accompanied by abrasions. The improved appearance of the scars with this situation is the result that there were fewer elevations and depressions, and no break in continuity of the epidermal covering on both sides of the scar. But mechanical or other dermabrasive methods have a risk of hyperpigmentation. Authors suggest the scar revision with frostbite using dry ice. This method has little hyperpigmentation due to the sensitivity of melanocytes to cold injury. And the tissue destruction is progressed selectively because of the resistance of collagen against the cold injury and the preserved dermal fibrous network as the structural framework. These characteristics of cryotherapy improve the result of scar revision with fewer side effects rather than other dermabrasive methods. We performed this method to 349 patients from 1993 to 2003 and obtained high patients' satisfaction (85.9% more than fair). Moreover, this method is simple, cheap and handy. In conclusion, the scar revision with frostbite using dry ice is very useful method to improve facial scars.

Lidocaine and Verapamil Enhances Neuromuscular Block Induced by Rocuronium / 대한마취과학회지

BACKGROUND: Lidocaine or verapamil are used as an antiarrhythmic agent or agent blunting the cardiovascular changes induced by intubation or extubation during anesthesia. After recovery from general anesthesia with muscle relaxants, most patients remained in a residual paralytic state, hence it might develop easily recurarization by factors that affect neuromuscular transmission. Lidocaine and verapamil are well known as agents to potentiate the neuromuscular block. We investigated the effects of lidocaine or verapamil on neuromuscular transmission in vitro. METHODS: Square wave, 0.2 ms duration at a frequency of 0.1 Hz supramaximal or train of four stimuli was applied and the twitch height response was recorded mechanomyographically on rat phrenic nerve hemidiaphragm preparations. Dose responses of rocuronium, lidocaine, verapamil, rocuronium pretreated with lidocaine or verapamil, lidocaine pretreated with rocuronium, and verapamil pretreated with rocuronium were observed by cumulative method, and effective doses (Lag dose, ED50 and ED95) between a pretreated and nonpretreated agent were compared statistically. TOF ratios were observed at 80, 70, 40 and 30% of the control twitch height value during the observation of dose responses. RESULTS: Lag dose, ED50 and ED95 of rocuronium were reduced significantly after pretreatment of lidocaine, verapamil or their mixture, and the dose response of lidocaine, verapamil or their mixture were also reduced significantly by rocuronium pretreatment. TOF ratios at the point of each twitch height decreased significantly after pretreatment. CONCLUSIONS: Lidocaine or verapamil itself did not affect the neuromuscular transmission but might have potentiated the neuromuscular blocking effect induced by rocuronium. However, in excessive doses, these agents produced neuromuscular blockade. Consequently, in the residual neuromuscular block induced by rocuronium, lidocaine or verapamil may enhance recurarization.