Smooth muscle of the bladder in the normal and the diseased state: pathophysiology, diagnosis and treatment

The smooth muscle of the normal bladder wall must have some specific properties. It must be very compliant and able to reorganise itself during filling and emptying to accommodate the change in volume without generating any intravesical pressure, but whilst maintaining the normal shape of the bladder. It must be capable of synchronous activation to generate intravesical pressure at any length to allow voiding. The cells achieve this through spontaneous electrical activity combined with poor electrical coupling between cells, and a dense excitatory innervation. In the diseased state, alterations of the smooth muscle may lead to failure to store or failure to empty properly. The diseased states discussed are bladder instability and diabetic neuropathy. Bladder instability is characterised urodynamically by uninhibitable rises in pressure during filling, and is seen idiopathically and in association with bladder outflow obstruction and neuropathy. In diabetic neuropathy, many of the smooth muscle changes are a consequence of diuresis, but there is evidence for alterations in the sensory arm of the micturition reflex. In the unstable bladder, additional alterations of the smooth muscle are seen, which are probably caused by the patchy denervation that occurs. The causes of this denervation are not fully established. Nonsurgical treatment of instability is not yet satisfactory; neuromodulation has some promise, but is expensive, and the mechanisms poorly understood. Pharmacological treatment is largely through muscarinic receptor blockade. Drugs to reduce the excitability of the smooth muscle are being sought, since they may represent a better pharmacological option.     

Chronic wounds

Skin ulcers are the most common chronic wounds. Current management principles and theories of causation of the most common ulcers--pressure, diabetic, and venous--are described. Issues related to occlusive dressings, compression dressings, topical antimicrobials, debridement, growth factors, grafting, and bioengineered tissue therapy are discussed. Special emphasis is placed on regulatory concerns.     

ENHANCING THE CREATIVITY OF REENGINEERING Techniques for Making IS More Creative

Industries in the US continue to lose ground in international competition. If IS is to help change that trend, it will have to become more creative. Creativity improvement programs are being introduced in other areas of the company— now is the time for IS organizations to follow suit.     

European diversity in science and technology

A clear understanding of the concept and consequences of diversity in science and technology is a key issue for Europe, when considering the current debate on cohesion Put forward within the Single European Act. According to Article 130B of the Single Act, all European policies, including technological policies must contribute to the achievement of a greater cohesion throughout the EC. The European market is generally presented as mainly a patchwork of national or even regional characteristics, with compartmentalized niches, and specific regulations. But does cohesion mean decreasing disparities between regions, which in such case signifies a passive policy of reallocation of resources within the EC, at the risk of generating uniformity? Or, does cohesion mean integration of all innovative and creative efforts, which implies a more complex policy of stimulation, under the condition to maintain a certain diversity? Must the governments systematically reduce diversity, or on the contrary must they enlarge diversity? How can they distinguish between negative and positive aspects of diversity? How do they operate a trade off between economies of scale and economies of diversity? To try to answer these political issues and to set up a coherent industrial policy at the EC level, a careful analysis of the sources of diversity, of the mechanisms that generate or reduce diversity, of the ways to valorize diversity are discussed in this paper     

Prevalence of multiple cardiovascular disease risk factors among women in the United States, 1992 and 1995: the Behavioral Risk Factor Surveillance System

We sought to examine the prevalence of self-reported multiple cardiovascular disease (CVD) risk factors (hypertension, high blood cholesterol, diabetes, overweight, and current smoking) among women in 1992 and 1995 in the United States using data from the Behavioral Risk Factor Surveillance System. In 1992, 37.5%, 34.4%, and 28.1% of women had zero, one, and two or more of the five risk factors, respectively. In 1995, the respective estimates were 35.5%, 34.3%, and 30%. In both years, the prevalence of two or more risk factors increased with age, decreased with educational level, was higher among black women (lowest among Hispanic women and women of other ethnic groups), and higher among women reporting cost as a barrier to healthcare. The percentage of women with two or more risk factors was higher in 1995 than in 1992 for 35 of 48 states, being statistically significant for 7 states. The percentage of women with at least two risk factors was not significantly lower in 1995 than in 1992 for any state. A higher percentage of women reported having multiple CVD risk factors in 1995 compared with 1992. A multifactorial approach to primary prevention and risk factor reduction should be encouraged to help reduce the prevalence and burden of CVD among women.     

Investigating the thermal-plasma processing of advanced materials

Due to several inherent advantages, plasma processing technology may become a very useful tool in the production of new materials. An increasing research effort based on experimental as well as theoretical investigations has been invested in this area for the synthesis of advanced materials. In describing the thermal-plasma processing technique, this article employs examples from research at the Plasma Processing Laboratory at the University of Idaho.     

Effect of humidity and temperature on the adhesive strength of pressure sensitive adhesives

This paper reports the effect of humidity and temperature on the adhesive strength of a pressure sensitive adhesive (Flexbond 150) used to bond Mylar films. It has been found that, ill general, the adhesive strength decreases significantly with an increase in temperature. The effect of humidity on the bonding strength, however, was found to be process dependent. The sample preparation conditions, e.g., press weight for the bonding and the press time, are important in determining the humidity effect. The water sorption isotherm A 24°C for the adhesive was also determined. The amount of water sorbed by the adhesive at 95 percent relative pressure was found to be less than one weight percent.     

Vom freiwilligen Seminar zur Q2-Pflichtveranstaltung

Definition of the problem: Ethical reasoning cannot be enforced. Voluntary understanding is a basic condition for the development of ethical competencies and attitudes. The aim of this survey was to investigate whether the presence of those students who attended our seminars compulsorily would have a negative effect upon the quality of the course. Methods and results: The participants of our small-group seminars in medical ethics were asked to complete a questionnaire on teaching aims, seminar atmosphere, moderation and importance of subjects. One hundred and ninety-two voluntary participants (2001/2) and 293 compulsory participants (2002/3) completed the questionnaire and were statistically compared. There was no significant difference between voluntary and compulsory participants in any of the important items. However, there were considerable differences in some items between male and female participants. Conclusion: We were surprised that there was no difference between the two groups. This leads us to hope that our concept of case-based small-group seminars will prove capable of realising our teaching aims for all students. The difference between male and female participants may have important didactic consequences and will be the subject of further studies.     

Resistance to Fracture of a Partially Stabilized Zirconia/β-Alumina Composite

Partially stabilized zirconia (PSZ) /β-alumina composites exhibit extensive non-elastic deformation during fracture. Repeated loading/stable fracture/unloading experiments were performed on chevron-notched four-point-bend specimens of the composite and pure PSZ. The energy consumption during the propagation of long cracks in the composite (∼500 J/m²) is 1 order of magnitude larger than for PSZ (∼50 J/m²). Breaking strengths of 127 MPa were obtained with a Weibull modulus of 43.