Motor disorders in childhood include tic disorder, developmental coordination disorder, and stereotypic movement disorder. A tic is a sudden, rapid, repetitive and nonrhythmic movement (motor tics) or phonic production (phonic or vocal tics) that can occur at any part of the body. Developmental coordination disorder (DCD) is characterized by marked impairment in the acquisition and performance of motor skills. Stereotypic movement disorder is a common childhood disorder which repetitive, hard to control, aimless motor activity interrupts everyday life or causes self-infliction of a child. Despite increased attention and the growing scientific knowledge about motor disorders, there are limitations in our understanding and knowledge about the pathogenesis and the management of the disorders. Motor disorders can itself be the primary diagnosis, or can be secondarily diagnosed caused by other disorders, and accompany many neuropsychiatric disorders such as autism and attention deficit hyperactivity disorder (ADHD), which in turn impairs proper learning and socializing of the children with motor disorders. Therefore comprehensive medical history taking, continuous observation of the changes in symptoms, and systematic assessment considering the child's developmental stage and current adaptive capacity are needed. Behavioral therapy and pharmacological therapy are the two most often mentioned treatments of motor disorders.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Autistic Disorder ; Child ; Diagnosis ; Humans ; Learning ; Medical History Taking ; Motor Activity ; Motor Skills ; Motor Skills Disorders ; Stereotypic Movement Disorder ; Tic Disorders ; Tics* ; Tourette Syndrome*

We evaluated whether LIM-kinase 2 inhibitor (LIMK2i) could improve erectile function by suppressing corporal fibrosis through the normalization of the Rho-associated coiled-coil protein kinase 1 (ROCK1)/LIMK2/Cofilin pathway in a rat model of cavernous nerve crush injury (CNCI). Sixty 11-week-old male Sprague-Dawley rats were divided equally into five groups: sham surgery (S), CNCI (I), and CNCI treated with low-dose (L), medium-dose (M), and high-dose (H) LIMK2i. The L, M, and H groups were treated with a daily intraperitoneal injection of LIMK2i (2.5, 5.0, and 10.0 mg kg-1 body weight, respectively) for 1 week after surgery. The erectile response was assessed using electrostimulation at 1 week, postoperatively. Penile tissues were processed for Masson's trichrome staining, double immunofluorescence, and Western blot assay. Erectile responses in the H group improved compared with the I group, while the M group showed only partial improvement. A significantly decreased smooth muscle/collagen ratio and an increased content of fibroblasts positive for phospho-LIMK2 were noted in the I group. The M and H groups revealed significant improvements in histological alterations and the dysregulated LIMK2/Cofilin pathway, except for LIMK2 phosphorylation in the M group. The inhibition of LIMK2 did not affect the ROCK1 protein expression. The content of fibroblasts positive for phospho-LIMK2 in the H group returned to the level found in the S group, whereas it did not in the M group. However, the L group did not exhibit such improvements. Our data suggest that the inhibition of LIMK2, particularly with administration of 10.0 mg kg-1 body weight LIMK2i, can improve corporal fibrosis and erectile function by normalizing the LIMK2/Cofilin pathway.

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.
Anxiety Disorders ; Behavior Therapy ; Comorbidity ; Drug Therapy ; Humans ; Obsessive-Compulsive Disorder ; Tics ; Tourette Syndrome

A 70-yr-old man presented with painless gross hematuria. He underwent right nephrectomy for benign disease 9 yr ago. Computed tomography and cystoscopy showed a mass in the distal region of the right ureteral stump. He underwent right ureterectomy and bladder cuff resection. Pathological examination showed T1 and WHO grade 2 transitional cell carcinoma. At 6 months postoperatively, the patient is alive without any evidence of recurrence.
Aged ; Carcinoma, Transitional Cell/*diagnosis/pathology/surgery ; Cystoscopy ; Hematuria/urine ; Humans ; Kidney Diseases/*surgery ; Male ; Nephrectomy ; Tomography, X-Ray Computed ; Ureteral Neoplasms/*diagnosis/pathology/surgery

The present study is aimed to assess the effect of antimicrobial photodynamic therapy (aPDT) on Streptococcus mutans biofilm through teeth whitening light emitting diode (LED).
Planktonic and dynamic biofilm state cultures of S. mutans were used. Erythrosine 20 μM/L was used as the photosensitizer. Irradiation was performed by exposing cultures to clinic and homecare whitening LEDs for 15 minutes. The viability was measured through Colony Forming Unit counts and confocal laser scanning microscopy.
aPDT using whitening LEDs and erythrosine significantly decreased the CFU count of S. mutans compared to that in the control group. Dynamic biofilm group showed more resistant features to aPDT compared with planktonic state. Clinic and homecare whitening LED device showed similar antimicrobial effect.
The whitening LED, which could irradiate the entire oral arch, showed a significant photodynamic effect on cariogenic S. mutans biofilm. aPDT mediated by erythrosine and LEDs used for teeth whitening exhibited promising antimicrobial activity.

This study is aimed to evaluate and compare the surface roughness and microbial adhesion to alkasite restorative material (Cention N), resin-modified glass ionomer (RMGI), and composite resin. And to examine the correlation between bacterial adhesion and surface roughness by different finishing systems.
Specimens were fabricated in disk shapes and divided into four groups by finishing methods (control, carbide bur, fine grit diamond bur, and white stone bur). Surface roughness was tested by atomic force microscope and surface observation was performed by scanning electron microscope. Colony forming units were measured after incubating Streptococcus mutans biofilm on specimens using CDC biofilm reactor.
Cention N surface roughness was less than 0.2 μm after finishing procedure. Control specimens of resin and Cention N specimens were significantly (p = 0.01) rougher. Pearson correlation coefficient (PCC = 0.13) indicated a weak correlation between surface roughness and S. mutans adhesion to the specimens.
Compared with resin specimens, RMGI and Cention N showed lower microbial adhesion. Surface roughness and bacterial adhesion were not significantly different, regardless of the finishing systems.

PURPOSE: To assess outcomes from patients who underwent radical prostatectomy and had their indwelling urinary catheter removed on postoperative day (POD) 4 or 7. MATERIALS AND METHODS: The medical records of 107 consecutive patients receiving radical prostatectomy (RP), were retrospectively reviewed. Patients were categorized into two groups according to length of catheterization. Group 1 (n=40) had the urethral catheter removed on postoperative day (POD) 4, and group 2 (n=67) had the catheter removed on POD7. Group 1 had urethral catheter removal following no leakage on intraoperative leak testing and POD4 cystography, whilst group 2 exhibited leakage at POD4 and instead had routine POD7 urethral catheter removal if there was evidence of no leakage of POD7 cystography. Incontinence was checked according to the use of protective pad. RESULTS: The mean age of the study population was 67.0 years. acute urinary retension (AUR) following catheter removal occurred in 6 of the cohort (5.6%); 3 patients (7.5%) from group 1 and 3 (4.5%) from group 2 (p=0.669). The overall continence rate was 39.3%, 68.2%, 80.4%, and 91.6% at 1, 3, 6, and 12 months respectively. Importantly, the incontinence recovery pace of group 1 was notably higher than that of group 2 (p=0.001). Neither group exhibited bladder neck contracture. Intraoperative factors influencing the decision to remove catheter at POD4 following RP, are bladder neck reconstruction (OR=3.792, p=0.010) and nerve sparing (OR=6.646, p=0.008). CONCLUSIONS: Selective early urethral catheter removal may shorten the length of incontinence recovery, without increasing the risk of AUR and bladder neck contracture.
Catheterization ; Catheters ; Cohort Studies ; Contracture ; Humans ; Medical Records ; Neck ; Prostatectomy* ; Prostatic Neoplasms ; Retrospective Studies ; Urinary Bladder ; Urinary Catheters*

Retrograde intrarenal surgery (RIRS) has been accepted as the first-line option for surgical treatment of upper urinary tract pathologies including stones and tumors. With the development of surgical instruments with improved deflection mechanisms, visualization, and durability, RIRS has taken on an expanding role in treating urinary calculi located in the upper urinary tract, as it compensates for the shortcomings of shockwave lithotripsy and percutaneous nephrolithotomy. RIRS can also be considered a conservative treatment option for upper urinary tract urothelial cancer or as a means of intensive postoperative surveillance after radical treatment of urinary tract urothelial cancer. RIRS has a steep learning curve and various surgical techniques can be utilized during operations. The use of particular surgical instruments should take into consideration of the gain in surgical efficiency, decrease in complications, and cost-benefit tradeoff.
Carcinoma, Transitional Cell ; Learning Curve ; Lithotripsy ; Minimally Invasive Surgical Procedures* ; Nephrostomy, Percutaneous ; Pathology ; Surgical Equipment ; Surgical Instruments ; Ureteroscopy* ; Urinary Calculi ; Urinary Tract ; Urolithiasis

PURPOSE: Abdominal computed tomography (CT) is a widely recognized method to diagnose patients with acute abdominal pain in the emergency departments (EDs). We aimed to investigate the current state and interpretations of abdominal CT performed in the ED of a tertiary university hospital. METHODS: This was a retrospective study based on an abdominal CT database and medical records of patients over 15 years of age, who had visited our ED between January 1 and December 31, 2013. The data collected included CT types, final interpretations, characteristics of the patients, and location of pain at the time of CT. RESULTS: A total of 1,978 abdominal CTs were performed among 1,923 patients during the research period. The most frequent organs involved in the major diagnosis were those in the urinary system, followed by the appendix, liver, large intestine, and gallbladder. The most frequently interpreted diagnoses in these organs were in the order of urinary stone, appendicitis, liver cirrhosis, infectious colitis, and acute cholecystitis. The most frequent location of pain was the right lower quadrant (429 cases, 21.7%), and the most frequently performed CT types were contrast-enhanced abdominal and pelvic CT (1,260 cases, 63.7%). CONCLUSION: Various interpretations were derived based on the abdominal CTs, ranging from critical to mild diseases and from common to rare diseases. Based on this study, we have developed a preliminary interpretation checklist for abdominal CTs.
Abdominal Pain ; Appendicitis ; Appendix ; Checklist* ; Cholecystitis, Acute ; Colitis ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Gallbladder ; Humans ; Intestine, Large ; Liver ; Liver Cirrhosis ; Medical Records ; Methods ; Rare Diseases ; Retrospective Studies ; Tomography, X-Ray Computed ; Urinary Calculi

PURPOSE: To evaluate the impact of photoselective vaporization of the prostate (PVP) with a 120-W GreenLight high-performance system on erectile function in a 2-year follow-up study. MATERIALS AND METHODS: One hundred seventy-seven patients who underwent PVP during 2008 to 2012 were analyzed retrospectively. The patients were divided into 5 groups according to their preoperative 5-item International Index of Erectile Function (IIEF-5) scores: Group I (IIEF-5: 5~7, n=28), II (IIEF-5: 8~11, n=47), III (IIEF-5: 12~16, n=43), IV (IIEF-5: 17~21, n=34), and V (IIEF-5: 22~25, n=25). The patients were assessed before surgery and 6, 12, and 24 months after the PVP. Their International Prostate Symptom Score/quality of life, maximum urinary flow rate/post-void residual urine volume, and IIEF-5 scores were measured at each visit. RESULTS: The mean age and presence of hypertension were significantly different among the 5 groups. Perioperative parameters and postoperative complication rates showed no statistical differences. After PVP, voiding parameters were significantly improved in all the groups and sustained during the 2-year follow-up. The postoperative IIEF-5 scores fell slightly overall, while group V showed the largest significant deterioration. In multivariate analysis, body mass index (BMI) was the only independent predictor of decreased erectile function after PVP. CONCLUSIONS: Erectile function declined in all the groups after PVP, with the most extensive deterioration observed in patients with normal erectile function preoperatively. Preoperative BMI was the only independent risk factor for a meaningful decrease in erectile function after PVP.
Body Mass Index ; Erectile Dysfunction ; Follow-Up Studies* ; Humans ; Hypertension ; Laser Therapy ; Male ; Multivariate Analysis ; Postoperative Complications ; Prostate* ; Prostatic Hyperplasia ; Retrospective Studies ; Risk Factors ; Volatilization*