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1.
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. 相似文献
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Herman Neufeld 《今日电子》2008,(9)
第一代NV SRAM模块问世近20年来,NVSRAM技术不断更新,以保持与各种应用同步发展,同时满足新的封装技术不断增长的需求。 相似文献
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The consumer health plan value survey: round two 总被引:2,自引:0,他引:2
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Lichen sclerosus is a chronic skin condition with a predilection for the genital area. In the present study, 35 male patients with lichen sclerosus were interviewed and examined. Blood screens were performed and histology was requested if not already performed. The findings indicate that lichen sclerosus in males exists as a spectrum of disease, ranging from a mild form with white plaques and few symptoms to a severe form with inflammation, atrophy and scarring with possible urological consequences. In many areas it differs from the condition in females; the association with autoimmune disease is weaker and there is less perianal and extragenital involvement. The association with malignancy in males is of lesser significance than initially believed. 相似文献
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Calcified and fibrotic coronary artery lesions cannot always be dilated with conventional balloon angioplasty even at high pressures. This study examines the success of excimer laser facilitated angioplasty in 38 lesions in 37 patients with lesions that failed balloon angioplasty alone. 相似文献
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Cerebral lateralization in visual perception was investigated in 9 severe stuttering, 11 mild stuttering and 48 fluent speakers. The subjects were asked to identify words presented in the left or right visual field for 20 ms. Children responded by pointing to the exposed test word on a response card which contained four different words. Errors committed in the left and right visual fields were analyzed. The data showed a left hemisphere superiority in the processing of words in both the mild stutterers and the fluent speakers, but a right hemisphere advantage in the severe stutterers. The results suggest a close relationship between the severity of stuttering and functional brain organization. 相似文献
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