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Sleep exerts modulatory effects on the cerebral cortex. Whether sleep modulates local connectivity in the cortex or only individual neural activity, however, is poorly understood. Here we investigated functional connectivity, that is, covarying activity between neurons, during spontaneous sleep–wake states and during and after sleep deprivation using calcium imaging of identified excitatory/inhibitory neurons in the motor cortex. Functional connectivity was estimated with a statistical learning approach glasso and quantified by “the probability of establishing connectivity (sparse/dense)” and “the strength of the established connectivity (weak/strong).” Local cortical connectivity was sparse in non-rapid eye movement (NREM) sleep and dense in REM sleep, which was similar in both excitatory and inhibitory neurons. The overall mean strength of the connectivity did not differ largely across spontaneous sleep–wake states. Sleep deprivation induced strong excitatory/inhibitory and dense inhibitory, but not excitatory, connectivity. Subsequent NREM sleep after sleep deprivation exhibited weak excitatory/inhibitory, sparse excitatory, and dense inhibitory connectivity. These findings indicate that sleep–wake states modulate local cortical connectivity, and the modulation is large and compensatory for stability of local circuits during the homeostatic control of sleep, which contributes to plastic changes in neural information flow.

Objectives. To assess the value of magnetic resonance imaging (MRI) for predicting the alpha-blocker response in men with symptomatic benign prostatic hyperplasia (BPH) and to examine the relationship between MRI and the area density of smooth muscle cells in BPH. Methods. Twenty-eight men were consecutively enrolled in this study and received tamsulosin 0.2 mg once daily for 4 to 6 weeks. The efficacy of tamsulosin was determined by measuring improvements in the maximum urinary flow rate (Qmax) and International Prostate Symptom Score (IPSS). The patients underwent T2-weighted MRI and were separated into a high (H) or iso-low (IL) group according to the signal intensity of the inner gland of the prostate compared with that of bone marrow of the proximal femur head. The area density of smooth muscle cells was determined using immunostaining with antiactin antibody in 16 prostate specimens. Results. IPSS significantly decreased after the administration of tamsulosin from 16 ± 1 to 8 ± 1 (n = 28, P

A 45-year-old man with spinal injury and diabetes mellitus who complained high fever and progressive enlargement of left intrascrotal mass visited to our hospital. Preoperative ultrasonography demonstrated epididymitis and abscess formation. Left high orchiectomy was performed because testicular tumor could not be denied. Epididymis was replaces by bright yellow mass associated with abscess and adhered to testis strongly. Histopathologically, the mass diagnosed xanthogranulomatous epididymitis consisted of foamy macrophages and chronic inflammatory cells. This is the first case in Japanese medical literature.

A rare case of bilateral spermatocele developed 17 years after vasectomy was presented. A forty-seven year old man visited to our hospital with a chief complaint of swelling of bilateral intrascrotal contents. Sonographic findings demonstrated multilocular lesions of the bilateral intrascrotal contents. Operative procedure revealed bilateral cysts originating from the caput of the epididymis. Bilateral epididymectomy were performed. It was diagnosed as spermatocele because of demonstration of spermatozoa in the cystic fluid. We concluded that bilateral spermatocele has been induced by prolonged increased pressure of the intraepididymal duct following vasectomy 17 years ago.A rare case of bilateral spermatocele, which developed 17 years after vasectomy, is presented. A 47-year-old man visited the hospital with a complaint of swelling of the bilateral intrascrotal contents. Sonographic findings demonstrated multilocular lesions of the bilateral intrascrotal contents. A surgical procedure revealed bilateral cysts originating from the caput of the epididymis. Bilateral epididymectomy was performed. This case was diagnosed as spermatocele because of the demonstration of spermatozoa in the cystic fluid. It was concluded that the bilateral spermatocele was induced by prolonged increased pressure in the intraepididymal duct due to increased sexual activity over a long period of time following vasectomy.

Vesicourethral anastomosis during radical retropubic prostatectomy is often difficult. We present a new simple technique using a Nélaton catheter to aid in accurate suture placement for vesicourethral anastomosis.

The Biopty-gun is a useful tool in conducting percutaneous renal biopsies, but bleeding is still a significant complication. To reduce the rate of severe bleeding complications, we attempted a new method of renal needle biopsy using a retrograde access technique. Retrograde puncture of the renal calyx was performed using the Lawson nephrostomy kit. The 18-gauge needle of the Biopty-gun was inserted along the puncture wire and fired. A 7-french pigtail catheter was retained in the renal pelvis for a few days following the procedure. This biopsy is a promising and safe technique.

Malignant neurofibroma of the urinary bladder is a very rare entity and usually associated with von Recklinghausen’s disease. We present the first case of sporadic malignant neurofibroma of the urinary bladder and a review of the literature.