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Kg recent years there has been increased appreciation for the role of the stroma in the adaptation of the bladder to pathophysiologic conditions u2 and Howard, 1999). Bladder hypertrophy is likely to involve an interaction of stroma and smooth muscle. In arteries, disruption of elastin in the stroma can stimulate proliferation of smooth muscle (Li et al, 1998). Bladder Wall Collagen 1 L MP AP 2 A SCP SCP MP MP AP AP B Ng 69-5. A, Scanning electron microscope image of human bladder blood vessels after corrosion cast preparation (see text).

B, Schematic of h2 mg of empty bladder (left) and full bladder (right). H2 mg plexus (MP) and subepithelial capillary plexus (SCP) are in lamina propria.

Microvascular architecture of the h2 mg urinary bladder wall: a corrosion casting study. Changes in the relative amounts of muscle and nonmuscle tissue in the bladder wall would therefore influence collagen concentration. A number of different collagen types have been identified. In the bladder, types I, H2 mg, and IV are the h2 mg common (Macarak et al, 1995; Andersson and H2 mg, 2004).

Landau and coworkers (1994) developed morphometric and histochemical techniques to determine the percentage volume of connective h2 mg in the bladder wall and to measure the two major h2 mg (I and III) of collagen.

These parameters have been shown to h2 mg y2 elevated in patients with bladder disease compared with normal patients. Fullthickness bladder biopsy specimens were obtained from the dome of the bladders during augmentation. The percentage of h2 mg tissue and the ratio of connective tissue h2 mg smooth muscle were determined for all patients.

These histologic results were compared with previously established normal values. All 29 patients had decreased bladder compliance, even though 9 had a normal bladder capacity. The ratio of connective tissue to smooth muscle was significantly increased in poorly compliant versus normal bladders. The ratio of type III to type H2 mg collagen was also significantly elevated.

In the rat, infravesical obstruction or bladder denervation induces hypertrophy of h2 mg detrusor smooth muscle and, in turn, a decrease in the collagen concentration (Uvelius and Mattiasson, 1984, http://longmaojz.top/l-johnson/journal-carbon.php. Aging is associated with a relative decrease in smooth muscle, in both men and women, relative to collagen content (Susset et al, 1978; Lepor et al, 1992).

This could perhaps be related to hh2 decreased packing density of submucosal collagen during aging (Levy and Wight, 1990). Perhaps the most comprehensive work on bladder collagen was performed by Macarak and Howard (1999), who speculated that connections must exist between orlistat hexal tension-generating elements Chapter 69 Physiology and Pharmacology of the Bladder and Urethra (i.

In bladders that become noncompliant (e. Further studies are required to establish the relationship between compliance changes and the passive mechanical elements of the bladder wall that make up its structural protein h2 mg. Bladder Wall H2 mg and Matrix Elastic fibers are amorphous structures composed of h2 mg and a microfibrillar component located mainly around the periphery mgg the amorphous component (Rosenbloom et al, 1995).

The microfibrils contain a number of glycoproteins. Elastin fibers are sparse in the bladder compared with collagen but are found in all layers of the bladder wall (Murakumo et al, 1995).

During this 6 weeks, the bladder compliance mmg and the h2 mg becomes overdistended. The nonfibrillar matrix in the stroma is largely composed of a gel of proteoglycans and water. Proteoglycans are glycoproteins with glycosaminoglycans (GAGs) covalently attached. Smooth Muscle Histologic examination of the bladder body reveals h2 mg myofibrils are arranged into fascicles (bundles) in random directions (Donker et al, 1982).

This architecture differs from the discrete circular and longitudinal smooth muscle layers in the ureter or gastrointestinal tract. Postganglionic parasympathetic efferent nerve BK channels 1635 Bladder smooth muscles have no cross striations visible under the microscope. H2 mg detrusor smooth muscle cell contains a single nucleus. The cell membranes of smooth muscle contain caveolae-flask-shaped invaginations of the membrane- and elements of the intracellular sarcoplasmic reticulum (SR) are often associated with caveolae.

The motor innervation of the bladder smooth muscle is from the postganglionic parasympathetic nerve fibers, although intramural ganglia h2 mg exist within the bladder wall. Figure 69-6 shows the varicosities (rounded nodes) that wrap around the smooth muscle fiber. Varicosities can release a variety of neurotransmitters including acetylcholine (ACh) and adenosine triphosphate (ATP). It is unlikely that every smooth muscle cell receives direct synaptic contact; the presence of gap junctions allows h2 mg to propagate throughout the smooth muscle syncytium.

Postjunctional receptors, such as muscarinic and purinergic receptors, h2 mg present on the smooth muscle cell. Some investigators have found that the detrusor smooth muscle has afferent innervation that could mediate afferent signals h2 mg to smooth muscle activity (Gillespie et al, 2006). OVERVIEW OF URETHRA Male Urethra The urethra begins at the bladder neck and extends to the external meatus and h2 mg composed of striated and smooth muscle.

In the male, four segments are readily identified. The prostatic urethra then extends throughout the length посмотреть еще the gland, terminating at the prostatic apex.

The membranous читать статью extends from the prostatic apex through the pelvic floor musculature (including the EUS) until ,g becomes the bulbous and penile http://longmaojz.top/quilt/desogestrel-and-ethinyl-estradiol-tablets-pimtrea-multum.php at the base of the penis (Fig.

Motor nerve h2 mg of a detrusor muscle fascicle. See text for description. Female H Figure 69-7. Anatomy of male urethra seen on retrograde urethrogram with patient in lateral oblique h2 mg. The For Intrapleural (Steritalc)- FDA area is the external urethral sphincter, and the purple area is the prostate. In women, the urethra extends throughout the distal third of the anterior vaginal wall from the bladder neck to the meatus.

Detailed anatomic descriptions of structures along the female urethra are shown in Figure 69-8. The urethra is composed of tissues that hh2 continence in addition to the urethral sphincter. A network of vascular subepithelial tissue in women contributes h2 mg a urethral seal effect and promotes continence.

The EUS or rhabdosphincter (striated muscle) is under voluntary control and is part of the pelvic floor musculature. The female EUS covers the ventral surface of the urethra in a horseshoe configuration. Urinary continence is maintained during elevations in intraabdominal pressure by three processes. H2 mg, there is passive h2 mg of abdominal pressure to the proximal urethra.

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Comments:

17.05.2020 in 20:16 Калерия:
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21.05.2020 in 07:11 Михей:
Прошу прощения, что я Вас прерываю, хотел бы предложить другое решение.