| 1. |
- Van Poppel, H., et al.
(author)
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Precancerous lesions in the kidney
- 2000
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In: Scandinavian Journal of Urology and Nephrology, Supplementum. - Oslo, Norway : Taylor & Francis. - 0300-8886 .- 1651-2537 .- 0000-0000 .- 0036-5599. ; :205, s. 136-165
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Research review (peer-reviewed)abstract
- Renal cell carcinoma (RCC), although occurring less frequently than prostate and bladder cancer, is actually the most malignant urologic disease, killing >35% of affected patients. Therefore, investigation of the nature of premalignant lesions of the kidney is a relevant issue. Following the most recent histological classification RCC can be subdivided into four categories: conventional RCC; papillary RCC; chromophobe RCC; and collecting duct carcinoma. In contrast to many genitourinary malignancies, premalignant alterations in the kidney are scarcely described. Intratubular epithelial dysplasia has been recognized as the most common precursor of RCC. In analogy to prostatic intraepithelial neoplasia (PIN), the premalignant lesions of the kidney are described as high or low-grade renal intratubular neoplasia. In contrast, precancerous lesions have been described as part of the von Hippel-Lindau syndrome (VHL) where the evolution from a simple cyst to an atypical cyst with epithelial hyperplasia to cystic or solid conventional-type RCC is well documented. Finally, in the genesis of papillary RCC an adenoma-carcinoma sequence has been recognized with specific genetic changes. There are no data on the epidemiology of premalignant lesions of the kidney, but research into the etiology of RCC has been extended substantially. Familial and genetic factors are well documented in VHL disease, in hereditary papillary RCC, in the tuberous sclerosis complex and in familial RCC. Cigarette smoking and obesity are established risk factors for RCC. Hypertension or its medication has also been associated with an increased risk. Among dietary factors an inverse relation between risk and consumption of vegetables and fruit has been found. Occupational exposure to substances such as asbestos and solvents has been linked to an increased risk of RCC. Specific RCC variants have distinctive chromosome alterations and several genes have been implicated in the development of RCC. Loss of material from the 3p chromosome characterizes conventional RCC and the deletion of the VHL suppressor gene plays an important role in the genesis of this RCC variant. In contrast, numerical changes with trisomy of chromosomes 7 and 17 and loss of the sex chromosome are typical changes in papillary tumors, whereas papillary RCC have additional trisomies. Chromophobe RCC is characterized by loss of chromosomes with a combination of monosomies. Less consistent genetic alterations are associated with collecting duct carcinoma. The traditional treatment of RCC is surgery by radical or partial nephrectomy. The latter approach carries a risk of tumor recurrence as a result of unrecognized satellite lesions or premalignant lesions that might have been present at the time of surgery. However, the reported recurrence rates after partial nephrectomy are <1% and therefore the possible presence of premalignant disease does not alter the actual treatment strategy advocated. Although multifocality and bilateral occurrence of RCC are much more likely in cases of papillary RCC, biopsy of the renal remnant or contralateral kidney is not justified even in patients with this tumor type. Conversely, patients with RIN in a partial or radical nephrectomy specimen or in a renal biopsy taken for whatever reason should be subjected to closer follow-up with regularly repeated ultrasound. When an effective chemopreventive regimen becomes available it might be useful for patients with an inherited risk of RCC as well as in those who are at risk of tumor recurrence after intervention. Mass screening with the purpose of detecting RCC at its earliest stage is not recommended at the present time, but screening focused on certain risk groups can be advocated. Further research is needed to identify avoidable risks, develop effective chemoprevention and recognize patients at risk.
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| 2. |
- Andersson, Lennart, et al.
(author)
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Chairmen's summary
- 2008
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In: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 1651-2537 .- 0036-5599 .- 1651-2065. ; :218, s. 7-11
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Journal article (peer-reviewed)
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| 3. |
- Montironi, Rodolfo, et al.
(author)
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Bladder cancer : pathogenesis.
- 2008
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In: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 1651-2537 .- 0036-5599 .- 1651-2065. ; :218, s. 93-4
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Journal article (peer-reviewed)
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| 4. |
- Dillner, J, et al.
(author)
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Epidemiology of human papillomavirus infection
- 2000
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0000-0000 .- 0036-5599. ; 34:205, s. 194-200
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Journal article (peer-reviewed)
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| 5. |
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| 6. |
- Andersson, Karl-Erik
(author)
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Overactive bladder--pharmacological aspects.
- 2002
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In: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; Suppl 210:Supp 210, s. 72-81
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Journal article (peer-reviewed)abstract
- The micturition reflex can be initiated by contraction or distension of detrusor smooth muscle cells, or by signals from the urothelium. It has been shown that bladder distension causes release of ATP from the urothelium and that ATP can activate P2X(3) receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably the activation of afferent fibres during bladder filling involves not only ATP, but a cascade of inhibitory and stimulatory transmitters/mediators. These mechanisms may be targets for future drugs. Both in the normal and functionally disturbed bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such as neurogenic bladders, outflow obstruction, idiopathic detrusor instability, interstitial cystitis, and also in the ageing bladder, a non-cholinergic activation via purinergic receptors may occur. If this component of activation is responsible not only for part of the bladder contractions, but also for the symptoms of the overactive bladder, it should be considered an important target for therapeutic interventions. Drugs blocking different P2X receptor subtypes, or counteracting bladder contraction via other mechanisms. e.g. beta(3)-adrenoceptor stimulation, may be developed for treatment of the overactive bladder.
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| 7. |
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| 8. |
- Bostwick, DG, et al.
(author)
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Epidemiology and statistical methods in prediction of patient outcome.
- 2005
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In: Scand J Urol Nephrol Suppl. - : Informa UK Limited. ; 39:216, s. 94-110
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Journal article (peer-reviewed)abstract
- Substantial gaps exist in the data of the assessment of risk and prognosis that limit our understanding of the complex mechanisms that contribute to the greatest cancer epidemic, prostate cancer, of our time. This report was prepared by an international multidisciplinary committee of the World Health Organization to address contemporary issues of epidemiology and statistical methods in prostate cancer, including a summary of current risk assessment methods and prognostic factors. Emphasis was placed on the relative merits of each of the statistical methods available. We concluded that: An international committee should be created to guide the assessment and validation of molecular biomarkers. The goal is to achieve more precise identification of those who would benefit from treatment. Prostate cancer is a predictable disease despite its biologic heterogeneity. However, the accuracy of predicting it must be improved. We expect that more precise statistical methods will supplant the current staging system. The simplicity and intuitive ease of using the current staging system must be balanced against the serious compromise in accuracy for the individual patient. The most useful new statistical approaches will integrate molecular biomarkers with existing prognostic factors to predict conditional life expectancy (i.e. the expected remaining years of a patient's life) and take into account all-cause mortality.
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| 9. |
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| 10. |
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| 11. |
- Dillner, J, et al.
(author)
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Etiology of squamous cell carcinoma of the penis
- 2000
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 34:205, s. 189-193
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Journal article (peer-reviewed)
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| 12. |
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| 13. |
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| 14. |
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| 15. |
- Hall, P
(author)
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Radiation-associated urinary bladder cancer
- 2008
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 42:218, s. 85-88
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Journal article (peer-reviewed)
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| 16. |
- Hedlund, H., et al.
(author)
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Pharmacotherapy in erectile dysfunction agents for self-injection programs and alternative application models
- 1996
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In: Scandinavian Journal of Urology and Nephrology, Supplementum. - 0300-8886 .- 1651-2537. ; 179, s. 129-38
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Research review (peer-reviewed)abstract
- Previously, men with erectile dysfunction (ED) were frequently treated with penile prosthesis implants or considered to have psychogenic impotence. Since the reports by Virag and Brindley in 1932 and 1983, pharmacotherapy, by self-injection programs has become a new therapeutic concept for impotent men. In clinical practice, this application model has been generally accepted as the "golden standard" in the treatment of ED. Papaverine was first used as monotherapy, but because of side-effects such as prolonged erection, priapism, and fibrosis of the corpus cavernosum, single use of the drug was abandoned. Instead, papaverine was introduced in mixtures, e.g. together with alpha adrenoceptor-blockers as phentolamine, and/or prostaglandin E1 (PGE1) in these "cocktails", the dose of papaverine is reduced to 10-15 mg compared to the high doses (80-120 mg) that were used initially. By having two or more drugs in the mixture, a facilitating cascade effect as probably obtained. PGE1 is the only drug that has been approved by the FDA and is today registered in more than 50 countries. Other combination therapies such as vasoactive intestinal polypeptide+ phentolamine, or calcitonin gene-related peptide+ PGE1, have been suggested as suitable alternatives for intracavernosal injection. Transdermal and intraurethral application models may be considered in selected patients. Recently, oral administration of a phosphodiesterase inhibitor (UK-92.480) was reported to improve penile erection in patients with psychogenic impotence. Further clinical results from controlled trials will probably explain if this new oral drug will compete with PGE1 or other agents in self-injection programs.
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| 17. |
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| 18. |
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| 19. |
- Nilsson, S, et al.
(author)
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Chemotherapy-induced bladder cancer
- 2008
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 42:218, s. 89-92
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Journal article (peer-reviewed)
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| 20. |
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| 21. |
- Sillén, Ulla, 1946
(author)
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Bladder function in infants.
- 2004
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; :215, s. 69-74
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Journal article (peer-reviewed)abstract
- The purpose with the present review was to describe what could be considered as normal urodynamic findings in neonates and infants. During the first months of life, urodynamics were characterised by small bladder capacity and high voiding pressure levels, the latter especially marked in male infants. Also dyscoordination at voiding was a common finding. However, detrusor overactivity (unstable contractions) during filling was uncommon in infants. Towards the end of infancy, findings became more in accordance with what is seen in older children. Concluding these findings concerning urodynamic pattern in early infancy high voiding pressure levels must be looked upon as normal and the same is true for intermittent increase in activity in the pelvic floor during voiding. However, instability during filling is rarely seen.
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| 22. |
- Sillén, Ulla, 1946, et al.
(author)
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Bladder function in preterm and full-term infants--free voidings during four-hour voiding observation.
- 2004
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In: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; :215, s. 63-8
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Journal article (peer-reviewed)abstract
- The purpose with the present review was to characterise bladder function in healthy preterm and full-term infants from findings in studies using the four-hour voiding observation. Characteristics of the free voiding pattern were very similar in preterm and full-term infants. The frequency of voidings was once an hour, bladder volume inducing voiding varied, infants often woke up before voiding and the bladder was not completely emptied at every voiding. Furthermore, interrupted voidings interpreted as a detrusor-sphincter dyscoordination, were seen and were clearly an immature phenomenon since the frequency was high in the preterm infants and then decreased. Concluding these findings the voiding pattern seems to be immature early in life and there is distinct evidence for a connection to the CNS already in the preterm infant.
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