| 1. |
- Munem, Marwa, et al.
(författare)
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Chemical imaging of aggressive basal cell carcinoma using time-of-flight secondary ion mass spectrometry.
- 2018
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Ingår i: Biointerphases. - : American Vacuum Society. - 1559-4106 .- 1934-8630. ; 13:3
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Tidskriftsartikel (refereegranskat)abstract
- A set of basal cell carcinoma samples, removed by Mohs micrographic surgery and pathologically identified as having an aggressive subtype, have been analyzed using time-of-flight secondary ion mass spectrometry (SIMS). The SIMS analysis employed a gas cluster ion beam (GCIB) to increase the sensitivity of the technique for the detection of intact lipid species. The GCIB also allowed these intact molecular signals to be maintained while surface contamination and delocalized chemicals were removed from the upper tissue surface. Distinct mass spectral signals were detected from different regions of the tissue (epidermis, dermis, hair follicles, sebaceous glands, scar tissue, and cancerous tissue) allowing mass spectral pathology to be performed. The cancerous regions of the tissue showed a particular increase in sphingomyelin signals that were detected in both positive and negative ion mode along with increased specific phosphatidylserine and phosphatidylinositol signals observed in negative ion mode. Samples containing mixed more and less aggressive tumor regions showed increased phosphatidylcholine lipid content in the less aggressive areas similar to a punch biopsy sample of a nonaggressive nodular lesion.
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| 2. |
- Zaar, Oscar, et al.
(författare)
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A prospective, randomized, within-subject study of ALA-PDT for actinic keratoses using different irradiation regimes
- 2018
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Ingår i: Photodermatology Photoimmunology & Photomedicine. - : Wiley. - 0905-4383. ; 34:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPhotodynamic therapy (PDT) can be used to treat large fields of actinic keratoses (AKs) with high clearance rates. A notable downside is the amount of pain that accompany the treatment. This study aimed to optimize the illumination protocol during conventional PDT in order to reduce pain without compromising treatment effectiveness. MethodsIn this prospective, randomized study with a split-face design, patients with, symmetrically distributed AKs were included. All patients were treated using a ALA 78mg/g gel. One side was illuminated with the Aktilite((R)) CL-128 lamp and the other side with the RhodoLED((R)) lamp in which the light intensity gradually increased to a maximum of 60%. Both sides received a total light dose of 37J/cm(2). Pain during the treatment was measured using a visual analogue scale. The clinical effectiveness of the 2 treated sides was assessed after 12weeks. ResultsTwenty-nine patients with 399 AKs were included. Illumination with the gradually increasing light intensity resulted in a decrease in the median visual analogue scale score by 1.1 points. Clearance rates were similar between the 2 lamps. ConclusionMinimizing the light intensity during the illumination phase of PDT reduces pain, while still preserving a high clearance rate of AKs.
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| 3. |
- Zaar, Oscar
(författare)
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Epidemiology, diagnostics and treatment of non-melanoma skin cancers
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Skin cancer, including malignant melanoma and non-melanoma skin cancer (NMSC), is a growing problem due to the increasing incidence in Sweden and in other Caucasian populations. NMSCs are diagnosed as often as all other cancers combined and include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), precursors to SCC such as Bowen’s disease (BD) and actinic keratosis (AK), as well as several rare skin cancers including Merkel cell carcinoma (MCC). The purpose of this thesis was to investigate novel aspects within the fields of epidemiology, diagnosis and treatment of NMSCs. In study I, the incidence and clinical characteristics of Swedish patients with MCC was explored. During the study period from 1993 to 2012, the age standardised incidence of MCC almost doubled with an increase of 73-85 % depending on the population used for age standardisation. The overall incidence for women and men per 100,000 persons, using the world population for age standardisation, rose from 0.11 to 0.19 between 1993 and 2012. In study II, the effectiveness of photodynamic therapy (PDT) for the treatment of BD was evaluated retrospectively for 423 lesions in 335 patients. The study showed that PDT was a relatively effective treatment with a complete clearance rate of 63.4 % after a median FU time of 11.2 months. BD lesions greater than 20 mm in size and a single session of PDT were factors associated with statistically worse outcome. In study III, a novel irradiation protocol in PDT for multiple AKs using a stepwise increase of light intensity, staying below 50 mW/cm2 during the whole treatment session, was compared to the conventional irradiation protocol to assess pain levels during treatment and effectiveness. Both protocols had the same total light dose of 37 J/cm2. The novel treatment protocol led to a small but statically significant decrease in pain ( 1.1 points on a visual analogue scale, p<0.01). However, the clearance rate with the new protocol was slightly but significantly lower than that of the conventional protocol (91.2 % vs 93.7 %, respectively) (p=0.04). In study IV, the chemical composition of lipids in BCCs was mapped using Time-of-Flight-Secondary-Ion-Mass-Spectrometry (ToF-SIMS). ToF-SIMS was able to identify different lipids in healthy and cancerous tissue. Furthermore, sphingomyelin lipids were found in aggressive BCCs whereas phosphatidylcholine lipids were observed in less aggressive tumours. In conclusion, the incidence of MCC has increased the last 20 years, PDT is a relatively effective treatment modality in BD, novel illumination protocols with lower light intensity can decrease pain in PDT and ToF-SIMS can be used to identify the lipid composition of BCCs.
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