Reduced cerebellar vermis activation during urinary storage and micturition in multiple system atrophy: 99mTc-labelled ECD SPECT study.

Single-photon emission computed tomography brain imaging with special reference of bladder function was performed in eight multiple system atrophy (MSA) patients (two men, six women; mean age, 61 years) and age-matched five normal control subjects (three men, two women; 62 years). In both groups imagings were obtained in three conditions; empty bladder, storage, and micturition. [99mTc]-labelled ECD (555 MBq) was intravenously injected, which was immediately trapped and stabilized within the brain.

Correlation between lower urinary tract symptoms and urethral function in benign prostatic hyperplasia.

Aim: To examine the potential correlation between urethral function and lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH).

Methods: Thirty-one patients with clinical BPH, who were confirmed to have benign prostatic enlargement (BPE) of 20 ml or more, were enrolled into the study. A mark-sheet questionnaire was used for obtaining the LUTS history.

Colonic transit time, sphincter EMG, and rectoanal videomanometry in multiple system atrophy.

Both constipation and fecal incontinence are prominent lower gastrointestinal tract (LGIT) dysfunctions that occur frequently in multiple system atrophy (MSA). We investigated the mechanism of constipation and fecal incontinence in MSA. Colonic transit time (CTT), sphincter electromyography (EMG), and rectoanal videomanometry were performed in 15 patients with MSA (10 men, 5 women; mean age, 63.

Overexpression of RhoA, Rac1, and Cdc42 GTPases is associated with progression in testicular cancer.

The Rho family of GTPases are involved in actin cytoskeleton organization and associated with carcinogenesis and progression of human cancers. We investigated the roles of Rho family GTPases, prototypes RhoA, Rac1, and Cdc42, and the major downstream targets of RhoA, ROCK-I, and ROCK-II in testicular cancer. We quantified protein expression in paired tumor and nontumor samples from surgical specimens from 57 consecutive patients with testicular germ cell tumors using Western blotting.

Single-blind, randomized controlled study of the clinical and urodynamic effects of an alpha-blocker (naftopidil) and phytotherapy (eviprostat) in the treatment of benign prostatic hyperplasia.

Aim: The aim of our study was to examine the efficacy of naftopidil in terms of the international prostate symptom score (IPSS) and urodynamic parameters in the treatment of benign prostatic hyperplasia (BPH). Eviprostat was used as a control to study the efficacy of naftopidil.

Methods: Forty-nine patients with BPH (mean age 67.

A pilot study evaluating a new questionnaire for prostatic symptom scoring, the SPSS, and its sensitivity as constructed to objective measures of outflow obstruction.

Aim: To evaluate the extent to which our newly developed questionnaire, the Saitama Prostate Symptom Score (SPSS), for prostatic symptom scoring reflects objective findings in benign prostatic hyperplasia (clinical BPH) and to compare it with the International Prostate Symptom Score (IPSS) with regard to diagnostic sensitivity in clinical BPH.

Methods: In this study, both the SPSS and the IPSS were self-administered by patients. Free uroflowmetry, a pressure-flow study and the measurement of prostatic volume were carried out.

[Lockjaw caused by induction of anesthesia in a volunteer bone marrow donor].

A 43-year-old healthy female volunteer donor was scheduled for bone marrow harvesting. In the operating room her mouth opening was ascertained to be 5 cm. Anesthesia was induced with thiamylal 250 mg, fentanyl 0.

Urinary function in patients with corticobasal degeneration; comparison with normal subjects.

Aims: Corticobasal degeneration (CBD) is a rare neurodegenerative disorder affecting cerebral cortex and basal ganglia, both of which are crucial for regulating the lower urinary tract function. However, urinary function of this disorder has not been fully delineated. We investigated urinary function in patients with CBD.

Lower urinary tract dysfunction in Machado-Joseph disease: a study of 11 clinical-urodynamic observations.

Objectives: Machado-Joseph disease (MJD), or hereditary spinocerebellar ataxia type 3, is the most common dominantly inherited ataxia. However, lower urinary tract (LUT) dysfunction in MJD has not been fully delineated. We investigated LUT dysfunction in MJD by clinical-urodynamic observations.

Micturition disturbance in acute idiopathic autonomic neuropathy.

Objective: To define the nature of micturition disturbance in patients with acute idiopathic autonomic neuropathy (AIAN).

Methods: Micturitional symptoms were observed during hospital admissions and the in outpatient clinics in six patients with clinically definite AIAN (typical form in four, cholinergic variant in one, autonomic-sensory variant in one). Urodynamic studies included medium-fill water cystometry, external sphincter electromyography, and a bethanechol test.

Combination of a cholinergic drug and an alpha-blocker is more effective than monotherapy for the treatment of voiding difficulty in patients with underactive detrusor.

Aim: The aim of the present study was to compare the effectiveness of a cholinergic drug, an alpha-blocker and combinations of the two for the treatment of underactive detrusor.

Methods: One hundred and nineteen patients with underactive bladder were assigned to three groups: the cholinergic group, consisting of 40 patients taking bethanechol chloride (60 mg/day) or distigmine bromide (15 mg/day); the alpha-blocker group, consisting of 38 patients taking urapidil (60 mg/day); and the combination group, consisting of 41 patients taking both a cholinergic drug and an alpha-blocker. The effectiveness of each therapy was assessed 4 weeks after initialization of the therapy.

Lower urinary tract dysfunctions in patients with spinal cord tumors.

Aims: The objective of this study was to elucidate the incidence and pathophysiology of lower urinary tract dysfunctions (LUTS) in patients with spinal cord tumors.

Methods: Urinary questionnaire and urodynamic studies were done in 76 patients with spinal cord tumors.

Results: The patients included 56 with cervical-thoracic (C1 to T11) and 20 with lumbosacral tumors.

The functional role of beta-adrenoceptor subtypes in mediating relaxation of pig urethral smooth muscle.

Purpose: The predominant beta-adrenoceptor subtype present in the bladder and urethra is beta3-adrenoceptors. We investigated the role of beta-adrenoceptors in mediating relaxation of the in vitro female pig urethra.

Materials And Methods: Circular strips of urethral tissues were pre-contracted with KCl.

Urodynamic evaluation of surgical outcome in patients with urinary retention due to central lumbar disc prolapse.

Aims: To investigate whether acute urinary retention due to central lumbar disc prolapse is reversible after emergency spinal surgery.

Methods: Eight patients (two males, six females) with a mean age of 31.5 years (range, 18-42 years) with urinary retention due to lumbar disc prolapse were studied.

Oral-motor patterns of rhythmic trigeminal activity generated in fetal rat brainstem in vitro.

Development of neural circuits generating fetal oral-motor activity was characterized in an in vitro isolated brainstem block preparation. Rhythmical trigeminal activity (RTA) at E20-E21 resembled either the pattern or rhythm of neonatal RTA. Conversely, at E18-E19, RTA displayed a different pattern of discharge from neonatal RTA, and output was not regular but intermittent with another slow rhythm.

Micturitional disturbance in a patient with a spinal cavernous angioma.

A 58-year-old woman had a 3-year history of numbness in the right leg, which developed into thoracic transverse myelopathy and urinary retention. After referral to our department, MRI scans revealed a lesion with a target appearance at the T10-11 spinal cord with multiple silent cerebral lesions, which confirmed the diagnosis of cavernous angioma. Gamma-knife surgery was not indicated, considering the risk of adverse effects.

Urinary dysfunction in patients with systemic lupus erythematosis.

Aims: Nervous system involvement occurs in about half of patients with systemic lupus erythematosis (SLE). Seizures and psychiatric disorders are the most common manifestations; spinal cord lesions are uncommon. We had eight such patients who presented with urinary dysfunction.

Effects of subthalamic nucleus stimulation on the micturation reflex in cats.

High frequency stimulation (HFS) of the subthalamic nucleus (STN) has been performed to reverse motor dysfunction in severe parkinsonian patients. Recent studies suggested that neural circuitry in the basal ganglia might regulate micturition function as well. In 15 adult male cats under ketamine anesthesia, in which spontaneous isovolumetric micturition reflex had been generated, we performed electrical stimulation and extracellular single unit recording in the STN.

Role of beta-adrenoceptor subtypes in mediating relaxation of the pig bladder trigonal muscle in vitro.

Aims: To investigate the role of beta-adrenoceptor subtypes in mediating relaxation of the pig bladder trigonal muscle in vitro.

Materials And Methods: Longitudinal strips of trigonal muscle were isolated, and the mucosa and serosa removed. Tissues were precontracted with KCl, and beta-adrenoceptor agonists (isoprenaline or salbutamol) were added cumulatively, and concentration-relaxation curves (CRCs) were obtained.

Uroneurological assessment of spina bifida cystica and occulta.

Aims: Spina bifida is a rare but well-documented congenital spinal anomaly comprising a cystic form, which appears in infancy, and an occult form, which appears in late childhood and in adulthood. Herein, we report the results of uroneurological assessment in patients with spina bifida cystica and occulta, with respect to diagnosis and management of the disorders.

Methods: We performed a neurological examination, urinary questionnaire, and urodynamic studies in 28 consecutive patients with urinary symptoms, including 16 with the cystic form (nine male and seven female patients, ages 2 to 25 years), all of whom underwent neonatal surgical management, and 12 with occult form (six men and six women, ages 7 to 32 years) diagnosed by myelography and spinal magnetic resonance imaging who did not undergo surgery.

Short-term effect of a single levodopa dose on micturition disturbance in Parkinson's disease patients with the wearing-off phenomenon.

We investigated the short-term effects of a single dose of levodopa (L-dopa) on micturition function in PD patients with wearing-off phenomenon. Eighteen PD patients who had median Hoehn and Yahr scores of 5 during the off phase and 3 during the on phase were recruited. We carried out urodynamic studies before and about 1 hour after the patients had taken 100 mg of L-dopa with dopa-decarboxylase inhibitor (DCI).

The effect of intranasal desmopressin on nocturnal waking in urination in multiple system atrophy patients with nocturnal polyuria.

Nocturnal waking in urination (nocturia) is a common feature in patients with multiple system atrophy (MSA). Degeneration of arginine vasopressin (AVP) neurons in the suprachiasmatic nucleus in this disorder may lead to nocturnal polyuria, which has been treated with intramuscular desmopressin. We also prescribed 5 microg of intranasal desmopressin once a night in 3 MSA patients, who had nocturnal polyuria with abnormal circadian rhythm of the plasma AVP.

Amezinium metilsulfate, a sympathomimetic agent, may increase the risk of urinary retention in multiple system atrophy.

In 5 patients with multiple system atrophy, administration of 15 mg/day of amezinium metilsulfate, an adrenergic agent, during 6 months for the treatment of postural hypotension exacerbated post-micturition residuals as compared to that before treatment (178 ml versus 113 ml for a change of 37 %, p < 0.05). Amezinium metilsulfate most probably stimulates both alpha1B-receptors in the vascular wall and alpha1A/D-receptors in the proximal urethra.

Clinical application of the Harmonic Scalpel to allergic rhinitis.

Objective: The Harmonic Scalpel (HS) (Johnson & Johnson K.K.) is a surgical tool that allows cutting and coagulation using ultrasonic mechanical vibrations.