Scandinavian journal of urology and nephrology. Supplementum最新文献

Historically, the urinary bladder urothelium has been viewed as a passive barrier; however, recent evidence has demonstrated that the urothelium is a responsive structure, which exhibits both "sensor" (i.e. ability to respond to thermal, mechanical and chemical stimuli) and "transducer" (i.e. ability to release chemicals) functions. Studies have also revealed that afferent nerves and urothelial cells in the bladder exhibit a number of common properties, including the expression of certain receptors and ion channels (i.e. vanilloid receptor-1). In addition, localization of afferent nerves adjacent to the urothelium suggests that these cells may be targets for transmitter release from bladder nerves or that chemicals released by urothelial cells may alter afferent excitability. Taken together, these and other findings suggest that alterations in afferents or epithelial cells in pelvic viscera may contribute to the sensory abnormalities in a number of pelvic disorders.

In 1981 the Scandinavian Association of Urology initiated the Scandinavian Prostate Cancer Group (SPCG) as one of eight collaborative groups representing different fields of urology. The task of the SPCG was to promote research, education and information concerning prostate cancer. In particular it became a forum for conducting clinical multicenter studies within the Nordic countries. This paper summarizes some aspects of the history of the SPCG and reviews the clinical trials initiated by the group on the occasion of its 20th anniversary.

In 1998, 28.5% of diagnosed prostate cancer patients in Norway were aged < 71 years and had organ-localized disease and 74.5% of prostate cancer patients aged < 71 years had organ-localized disease. This study compares the number of prostate cancer patients aged < 71 years with organ-localized disease in the five health regions of Norway with the number of patients who were treated with radical intent. In 1998, only 52% of these patients were treated with radical intent; in 1999 this proportion had increased to 73% but large regional differences existed.

Knowledge and understanding of the pathophysiology of prostate cancer remain rudimentary. However, insight into epigenetic events and cellular interactions between cancer cells and the surrounding milieu has recently opened up a broader concept of cancer development. Throughout the entire process of prostate cancer aetiology, progression and metastasis, the microenvironment of the local host tissue is an active participant, and the selective pressure exercised on the malignant cells changes with the tumour-host setting. Thus primary cancers and metastases may respond differently to biomolecules and treatment modalities. Indeed, treatment itself changes the selective pressure, and new cellular capabilities may evolve. In prostate cancer, neuroendocrine differentiation is believed to occur in response to androgen ablation, and neuroendocrine paracrine factors have been shown to stimulate growth of androgen-independent cancer cells. Review of the accumulated knowledge in this field suggests that we need to improve our understanding of neuroendocrine cells and their regulatory products and their influence in the prostate gland. Recent research shows promise however, and no doubt new protocols will soon emerge in the treatment of prostate cancer, based on neuroendocrine hormones and their intracellular pathways.