Mitsuhiro Mizunaga

Clinical Applicability of a New Tactile Sensor for Evaluating Rigidity of the Penis: A Comparative Study with Rigiscan

Background: A new tactile sensor was developed for detecting hardness of living tissue by Omata et al. in 1992. This paper reports applicability of the sensor for evaluation of penile rigidity.

Cerebral control of bladder storage in patients with detrusor overactivity

ObjectiveTo identify the brain areas that control bladder storage by technetium-99m hexamethylpropyleneamine oxime single-photon emission computed tomography (SPECT) with the Neurological Statistical Image Analysis software (NEUROSTAT) in patients with detrusor overactivity (DO). MethodsSPECT scans were performed on 19 patients with DO. Eight patients with normal detrusor function, who had some storage symptoms of the lower urinary tract as the patients with DO, also had a SPECT scan, as controls. All the patients were male and right handed, and were scanned twice under two conditions: resting state and urine withholding state. NEUROSTAT was adopted to analyze the difference in brain--blood perfusion between groups and states. The results were displayed on Z score images at a significance threshold of P value of less than 0.05 with correction for multiple comparisons. ResultsNo region reached the significant threshold in comparison with patients with DO and normal detrusor function in resting state. Significant increases in tracer activity in the right inferior frontal gyrus and the right middle temporal gyrus during urine withholding state as compared with resting state in patients with normal detrusor function were observed. Among the regions, the right inferior frontal gyrus was distinctly prominent at both Z score and the extent. The regions that were significantly activated in patients with normal detrusor function did not reach a significant threshold during urine withholding in patients with DO. ConclusionThe study indicated that the right inferior frontal gyrus and the right middle temporal gyrus, especially the right inferior frontal gyrus, played a role in the cerebral control of bladder storage, inhibiting the contraction of detrusor in urine storage.

NEUROPATHIC BLADDER DYSFUNCTION IN PATIENTS WITH OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT

Background: Ossification of the posterior longitudinal ligament (OPLL) may cause neuropathic bladder dysfunction due to spinal cord involvement. OPLL, unlike a traumatic spinal cord lesion, progresses insidiously and sometimes affects longer cord segments. As the manifestation of bladder dysfunction may depend on the development of OPLL, we studied the relationship between bladder function and roentgenographic changes in the spinal canals of OPLL patients.

Automatic Analysis of Urethral Electromyography for Accurate Diagnosis of Voiding Dysfunction

An electromyogram contains much more information than observed in the gross pattern of an electromyogram simultaneously recorded with a cystometrogram. Being able to pick up some of the information would be helpful in the accurate diagnosis of ambiguous patients showing a discrepancy between clinical symptoms and laboratory data. This study analyzed electromyograms of the urethral and anal sphincter during the filling phase of the cystometrogram by means of automatic turns-amplitude analysis with a computer-assisted analyzer. In normal subjects, turns and amplitudes of an urethral electromyogram had increased frequency and size as the subjects felt a greater sensation of fullness. In patients with abnormal vesical function, the characteristics of the urethral electromyogram varied. Some of the patients with normal vesical activity and coordinated urethral sphincter, though their clinical symptoms strongly suggested neuropathic vesical dysfunction, showed a low frequency and low amplitude pattern of the urethral sphincter electromyogram. Anal sphincter electromyogram did not always show the same patterns as the urethral sphincter even in the normal subjects. The turns-amplitude analysis of urethral sphincter electromyogram will be of use for accurate diagnosis of vesical dysfunction.