| 1. |
- Birney, Ewan, et al.
(author)
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Identification and analysis of functional elements in 1% of the human genome by the ENCODE pilot project
- 2007
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 447:7146, s. 799-816
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Journal article (peer-reviewed)abstract
- We report the generation and analysis of functional data from multiple, diverse experiments performed on a targeted 1% of the human genome as part of the pilot phase of the ENCODE Project. These data have been further integrated and augmented by a number of evolutionary and computational analyses. Together, our results advance the collective knowledge about human genome function in several major areas. First, our studies provide convincing evidence that the genome is pervasively transcribed, such that the majority of its bases can be found in primary transcripts, including non-protein-coding transcripts, and those that extensively overlap one another. Second, systematic examination of transcriptional regulation has yielded new understanding about transcription start sites, including their relationship to specific regulatory sequences and features of chromatin accessibility and histone modification. Third, a more sophisticated view of chromatin structure has emerged, including its inter-relationship with DNA replication and transcriptional regulation. Finally, integration of these new sources of information, in particular with respect to mammalian evolution based on inter- and intra-species sequence comparisons, has yielded new mechanistic and evolutionary insights concerning the functional landscape of the human genome. Together, these studies are defining a path for pursuit of a more comprehensive characterization of human genome function.
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| 2. |
- Alimena, Juliette, et al.
(author)
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Searching for long-lived particles beyond the Standard Model at the Large Hadron Collider
- 2020
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In: Journal of Physics G. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 47:9
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Journal article (peer-reviewed)abstract
- Particles beyond the Standard Model (SM) can generically have lifetimes that are long compared to SM particles at the weak scale. When produced at experiments such as the Large Hadron Collider (LHC) at CERN, these long-lived particles (LLPs) can decay far from the interaction vertex of the primary proton-proton collision. Such LLP signatures are distinct from those of promptly decaying particles that are targeted by the majority of searches for new physics at the LHC, often requiring customized techniques to identify, for example, significantly displaced decay vertices, tracks with atypical properties, and short track segments. Given their non-standard nature, a comprehensive overview of LLP signatures at the LHC is beneficial to ensure that possible avenues of the discovery of new physics are not overlooked. Here we report on the joint work of a community of theorists and experimentalists with the ATLAS, CMS, and LHCb experiments-as well as those working on dedicated experiments such as MoEDAL, milliQan, MATHUSLA, CODEX-b, and FASER-to survey the current state of LLP searches at the LHC, and to chart a path for the development of LLP searches into the future, both in the upcoming Run 3 and at the high-luminosity LHC. The work is organized around the current and future potential capabilities of LHC experiments to generally discover new LLPs, and takes a signature-based approach to surveying classes of models that give rise to LLPs rather than emphasizing any particular theory motivation. We develop a set of simplified models; assess the coverage of current searches; document known, often unexpected backgrounds; explore the capabilities of proposed detector upgrades; provide recommendations for the presentation of search results; and look towards the newest frontiers, namely high-multiplicity 'dark showers', highlighting opportunities for expanding the LHC reach for these signals.
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| 3. |
- Engert, Andreas, et al.
(author)
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The European Hematology Association Roadmap for European Hematology Research : a consensus document
- 2016
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In: Haematologica. - Pavia, Italy : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 101:2, s. 115-208
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Journal article (peer-reviewed)abstract
- The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at (sic)23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients.
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| 4. |
- Rieke, Johanna Magdalena, et al.
(author)
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SLC20A1Is Involved in Urinary Tract and Urorectal Development
- 2020
-
In: Frontiers in Cell and Developmental Biology. - : FRONTIERS MEDIA SA. - 2296-634X. ; 8
-
Journal article (peer-reviewed)abstract
- Previous studies in developingXenopusand zebrafish reported that the phosphate transporterslc20a1ais expressed in pronephric kidneys. The recent identification ofSLC20A1as a monoallelic candidate gene for cloacal exstrophy further suggests its involvement in the urinary tract and urorectal development. However, little is known of the functional role ofSLC20A1in urinary tract development. Here, we investigated this using morpholino oligonucleotide knockdown of the zebrafish orthologslc20a1a. This caused kidney cysts and malformations of the cloaca. Moreover, in morphants we demonstrated dysfunctional voiding and hindgut opening defects mimicking imperforate anus in human cloacal exstrophy. Furthermore, we performed immunohistochemistry of an unaffected 6-week-old human embryo and detectedSLC20A1in the urinary tract and the abdominal midline, structures implicated in the pathogenesis of cloacal exstrophy. Additionally, we resequencedSLC20A1in 690 individuals with bladder exstrophy-epispadias complex (BEEC) including 84 individuals with cloacal exstrophy. We identified two additional monoallelicde novovariants. One was identified in a case-parent trio with classic bladder exstrophy, and one additional novelde novovariant was detected in an affected mother who transmitted this variant to her affected son. To study the potential cellular impact ofSLC20A1variants, we expressed them in HEK293 cells. Here, phosphate transport was not compromised, suggesting that it is not a disease mechanism. However, there was a tendency for lower levels of cleaved caspase-3, perhaps implicating apoptosis pathways in the disease. Our results suggestSLC20A1is involved in urinary tract and urorectal development and implicateSLC20A1as a disease-gene for BEEC.
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| 5. |
- Bengtsson, Ewert, 1948-, et al.
(author)
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Detection of Malignancy-Associated Changes Due to Precancerous and Oral Cancer Lesions: A Pilot Study Using Deep Learning
- 2018
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In: CYTO2018.
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Conference paper (peer-reviewed)abstract
- Background: The incidence of oral cancer is increasing and it is effecting younger individuals. PAP smear-based screening, visual, and automated, have been used for decades, to successfully decrease the incidence of cervical cancer. Can similar methods be used for oral cancer screening? We have carried out a pilot study using neural networks for classifying cells, both from cervical cancer and oral cancer patients. The results which were reported from a technical point of view at the 2017 IEEE International Conference on Computer Vision Workshop (ICCVW), were particularly interesting for the oral cancer cases, and we are currently collecting and analyzing samples from more patients. Methods: Samples were collected with a brush in the oral cavity and smeared on glass slides, stained, and prepared, according to standard PAP procedures. Images from the slides were digitized with a 0.35 micron pixel size, using focus stacks with 15 levels 0.4 micron apart. Between 245 and 2,123 cell nuclei were manually selected for analysis for each of 14 datasets, usually 2 datasets for each of the 6 cases, in total around 15,000 cells. A small region was cropped around each nucleus, and the best 2 adjacent focus layers in each direction were automatically found, thus creating images of 100x100x5 pixels. Nuclei were chosen with an aim to select well preserved free-lying cells, with no effort to specifically select diagnostic cells. We therefore had no ground truth on the cellular level, only on the patient level. Subsets of these images were used for training 2 sets of neural networks, created according to the ResNet and VGG architectures described in literature, to distinguish between cells from healthy persons, and those with precancerous lesions. The datasets were augmented through mirroring and 90 degrees rotations. The resulting networks were used to classify subsets of cells from different persons, than those in the training sets. This was repeated for a total of 5 folds. Results: The results were expressed as the percentage of cell nuclei that the neural networks indicated as positive. The percentage of positive cells from healthy persons was in the range 8% to 38%. The percentage of positive cells collected near the lesions was in the range 31% to 96%. The percentages from the healthy side of the oral cavity of patients with lesions ranged 37% to 89%. For each fold, it was possible to find a threshold for the number of positive cells that would correctly classify all patients as normal or positive, even for the samples taken from the healthy side of the oral cavity. The network based on the ResNet architecture showed slightly better performance than the VGG-based one. Conclusion: Our small pilot study indicates that malignancyassociated changes that can be detected by neural networks may exist among cells in the oral cavity of patients with precancerous lesions. We are currently collecting samples from more patients, and will present those results as well, with our poster at CYTO 2018.
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| 6. |
- Blomstrand, Lena, et al.
(author)
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Telemedicine : a complement to traditional referrals in oral medicine
- 2012
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In: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 18:7, s. 549-553
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Journal article (peer-reviewed)abstract
- Introduction:Introducing telemedicine into clinical practice has not been without difficulties. Within the framework of the European Union project "Health Optimum," telemedicine consultations with specialists at the Department of Oral & Maxillofacial Surgery at Uppsala University Hospital (Uppsala, Sweden) have been offered to dentists in the public dental health service. The aim is to streamline the consultation process, improve/develop the skills of the participating dentists and dental hygienists, and save time and money for patients, healthcare authorities, and society.Subjects and Methods:Patient records are collected in a database for demonstration and discussion, and the system is also available for referrals. Both medical and dental photographs and x-rays are digitized in the same system. These can be viewed during telemedicine rounds and by the consultants at the hospital prior to a consultation. Secure, interactive conferencing software is used, which provides a quick, easy, and effective way to share video and data over the Internet. Both parties can demonstrate different parts of an image using a pointer or a drawing system. Conference phones are presently used for verbal communication.Results:Ten patients were discussed during telemedicine rounds (3 males and 7 females), all of whom would normally have been referred to a specialist. As a result of the telemedicine round, 2 were referred to a specialist, whereas diagnoses were made for the other 8, and treatment was suggested. The dental health clinic could thus provide treatment without the need for referral to a consultant.Conclusions:The telemedicine system described here allows patient care to be provided rapidly and more economically. Future plans include "live" rounds using a videocamera, providing the possibility to relay real-time information about the intraoral situation. A camera is being developed and should preferably be permanently installed chair side.
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| 7. |
- Dérand, Per, et al.
(author)
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Virtual bending of mandibular reconstruction plates using a computer-aided design
- 2009
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In: Journal of oral and maxillofacial surgery (Print). - : Elsevier BV. - 0278-2391 .- 1531-5053. ; 67:8, s. 1640-1643
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Journal article (peer-reviewed)abstract
- PURPOSE: The purpose of this study was to investigate the possibility of virtually designing and manufacturing a template for reconstruction plate bending, to be used during treatment of congenital or acquired bony entities. The outcome was compared with plates bent by the freehand approach in a stereolithographic skull model. MATERIALS AND METHODS: From a computed tomography examination, a polygon skull was created and the corresponding stereolithographic model retrieved. A polygon mesh of a Compact UniLock 2.4-mm plate was obtained from Synthes (Bettlach, Switzerland). The polygon plate was bent virtually around the mandible and rendered in all 3 dimensions, and a template was created. Five 10-hole plates were bent using this template, and five 10-hole plates were bent using a stereolithographic model as the template. The 2 groups were compared using the Wilcoxon signed rank test. P values less than .001 was considered to be statistically significant. RESULTS: No statistical difference was seen between the 2 methods. The median discrepancy between the 2 groups was 0.1 mm. CONCLUSION: Within the constraints of this investigation, by use of a virtually produced template based on a virtually planned reconstruction, it is possible to bend a reconstruction plate with the same degree of accuracy as that of the traditional freehand approach.
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| 8. |
- Edman, Kristina, 1958-, et al.
(author)
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Dental hygienists and dentists as providers of brush biopsies for oral mucosa screening
- 2023
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In: International Journal of Dental Hygiene. - : John Wiley & Sons. - 1601-5029 .- 1601-5037. ; 21:3, s. 524-532
-
Journal article (peer-reviewed)abstract
- BackgroundOral cancer is a severe and potentially fatal disease usually starting in the squamous epithelium lining the oral cavity. Together with oropharyngeal carcinoma, it is the fifth to sixth most common malignancy worldwide. To limit the increase in the global oral cancer incidence over the past two decades, the World Health Assembly adopted a resolution urging member states to integrate preventive measures such as engagement and training of dental personnel in screening, early diagnosis, and treatment into their national cancer control programs.AimThe aim of this study was to investigate if dental hygienists (DHs) and dentists (Ds) in general dental practice care can be entrusted to perform brush sampling of oral potentially malignant disorders (OPMDs), and to evaluate their level of comfort in performing brush biopsies.MethodsParticipants were five DHs and five Ds who received one day of theoretical and clinical training in oral pathology to identify OPMDs (leukoplakia [LP], erythroplakia [EP], and oral lichen planus [OLP]), and perform brush sampling for PAP cytology and high-risk human papillomavirus (hrHPV) analysis.ResultsOut of 222 collected samples, 215 were adequate for morphological assessment and hrHPV analysis. All the participants agreed that sample collection can be incorporated in DHs and Ds routine clinical duties, and most of them reported that sample collection and processing was easy/quite easy.ConclusionDentists and DHs are capable of collecting satisfactory material for cytology and hrHPV analysis. All the participating DHs and Ds were of the opinion that brush sampling could be handled routinely by DHs and Ds in GDP.
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| 9. |
- Farzad, Payam, et al.
(author)
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Högteknologi revolutionerar kraniomaxillofacial kirurgi : Datornavigation ger bättre precision och färre komplikationer
- 2009
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:38, s. 2362-2365
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Journal article (peer-reviewed)abstract
- Inom kraniofacial kirurgi pågår en högteknologisk utveckling. Datorstödd och datornavigerad kirurgi är områden som i dag utvecklas snabbt. Nyttan med dessa teknologier är framför allt förbättrad precision och förutsägbarhet med minskad risk för komplikationer och totalt mindre morbiditet. Virtuell planering av rekonstruktioner kan nu göras i och med att datortomografin utvecklats från analog till digital teknik. En ideal simulering av det tilltänkta ingreppet görs sedan på en datorarbetsstation. Osteotomier, förflyttningar av bensegment eller inpassning av biomaterial kan simuleras oändligt antal gånger. Med hjälp av individuellt producerade guider i stereolitografi eller med en navigator överförs den virtuella planen till operationssituationen.
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| 10. |
- Haj-Hosseini, Neda, 1980-, et al.
(author)
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Early Detection of Oral Potentially Malignant Disorders: A Review on Prospective Screening Methods with Regard to Global Challenges
- 2024
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In: Journal of Maxillofacial & Oral Surgery. - New Delhi, India : Springer Science and Business Media LLC. - 0972-8279 .- 0974-942X. ; 23:1, s. 23-32
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Journal article (peer-reviewed)abstract
- Oral cancer is a cancer type that is widely prevalent in low-and middle-income countries with a high mortality rate, and poor quality of life for patients after treatment. Early treatment of cancer increases patient survival, improves quality of life and results in less morbidity and a better prognosis. To reach this goal, early detection of malignancies using technologies that can be used in remote and low resource areas is desirable. Such technologies should be affordable, accurate, and easy to use and interpret. This review surveys different technologies that have the potentials of implementation in primary health and general dental practice, considering global perspectives and with a focus on the population in India, where oral cancer is highly prevalent. The technologies reviewed include both sample-based methods, such as saliva and blood analysis and brush biopsy, and more direct screening of the oral cavity including fluorescence, Raman techniques, and optical coherence tomography. Digitalisation, followed by automated artificial intelligence based analysis, are key elements in facilitating wide access to these technologies, to non-specialist personnel and in rural areas, increasing quality and objectivity of the analysis while simultaneously reducing the labour and need for highly trained specialists.
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| 11. |
- Hillbertz, Nicolette Salmon, et al.
(author)
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Viral and Molecular Aspects of Oral Cancer
- 2012
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 32:10, s. 4201-4212
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Research review (peer-reviewed)abstract
- Squamous cell carcinoma (SCC) is the most common epithelial malignancy in the oral cavity. SCCs and their variants constitute over 90% of oral malignancies, and the disease is associated with poor prognosis. OSCC is a complex malignancy where environmental factors, virus infections, and genetic alterations most likely interact, and thus give rise to the malignant condition. Herein, we review the available literature regarding high-risk factors such as alcohol and tobacco usage; discuss the roles of human papillomaviruses (HPV), the Epstein-Barr virus, and the human herpes simplex virus (HSV); and evaluate several candidate genes associated with the condition: p53, p16(INK4) and p21(WAF1/CIP1) survivin, B-cell lymphoma-2 (BCL-2), keratins, Fibroblast growth factor 3 (FGF3), FGF4, FGF19, Oral cancer overexpressed gene 1 (ORAOV1), and Cyclin D1 (CCND1).
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| 12. |
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| 13. |
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| 14. |
- Hirsch, Jan-Michael, et al.
(author)
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Oral Cancer in Swedish Snuff Dippers
- 2012
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 32:8, s. 3327-3330
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Journal article (peer-reviewed)abstract
- Over recent decades there has been debate over whether or not Swedish snuff is carcinogenic in humans. Animal studies and molecular biological and experimental studies have shown the carcinogenic potential of Swedish snuff, but this has not been proved in prospective randomized studies. We present a case series of patients with oral squamous cell carcinomas diagnosed at the sites where the patients had used Swedish snuff for several years. Sixteen male patients were referred to and treated at Oral and Maxillofacial Surgery Departments and Ear, Nose and Throat clinics at seven different hospitals in Sweden. The mean age of the patients at the time of diagnosis was 72.9 years and the mean time of snuff use prior to cancer diagnosis was 42.9 years. This case series shows that Swedish snuff may not be a harmless alternative to smoking.
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| 15. |
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| 16. |
- Huo, Jinxing, et al.
(author)
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Failure location predictoin by finite element analysis for an additive manufactured mandible implant
- 2015
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In: Medical Engineering and Physics. - : Elsevier BV. - 1350-4533 .- 1873-4030. ; 37:9, s. 862-869
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Journal article (peer-reviewed)abstract
- In order to reconstruct a patient with a bone defect in the mandible, a porous scaffold attached to a plate, both in a titanium alloy, was designed and manufactured using additive manufacturing. Regrettably, the implant fractured in vivo several months after surgery. The aim of this study was to investigate the failure of the implant and show a way of predicting the mechanical properties of the implant before surgery. All computed tomography data of the patient were preprocessed to remove metallic artefacts with metal deletion technique before mandible geometry reconstruction. The three-dimensional geometry of the patient's mandible was also reconstructed, and the implant was fixed to the bone model with screws in Mimics medical imaging software. A finite element model was established from the assembly of the mandible and the implant to study stresses developed during mastication. The stress distribution in the load-bearing plate was computed, and the location of main stress concentration in the plate was determined. Comparison between the fracture region and the location of the stress concentration shows that finite element analysis could serve as a tool for optimizing the design of mandible implants.
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| 17. |
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| 18. |
- Huo, Jinxing, et al.
(author)
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Finite Element Investigation of the In - Vivo Failure of a Titanium Alloy HumanJaw Implant
- 2014
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Conference paper (peer-reviewed)abstract
- In order to reconstruct a patient with a bone defect in the right lower jaw, a scaffold attached to a reconstruction plate, both in a titanium alloy, was designed and manufactured using three-dimensional printing technique. Regrettably the implant fractured in situ several months after surgery. This paper is orientated to investigate the reason for the implant’s failure and provide a way of predicting the mechanical properties of the implant before surgery. Preoperative, postoperative and implant-break computed tomography data of the patient were provided by the responsible surgeon. Metallic artifacts introduced by previous dental implants were removed with metallic deletion technique software beforehand. Three-dimensional volume of the patient’s jaw was thereafter reconstructed with trabecular bone removed based on the cleaned computed tomography data. The implant, screws and jaw were assembled together and meshed with triangular elements in Mimics 16.0. The assembly was imported into in-house software with surface mesh converted to linear tetrahedral mesh. Simulations were implemented under simplified but suitable loading conditions with the assumption that jaw was a linear elastic and homogeneous material. The stress distribution on the implant plate was calculated and the location of stress concentration on the plate was determined and then verified by the clinical data of the patient. This validated model could serve in the future as a tool for optimizing the design of jaw implants.
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| 19. |
- Jalouli, Jamshid, 1959-
(author)
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Human Papilloma Virus, Epstein-Barr Virus, and Herpes Simplex Virus Type-1 in Oral Squamous Cell Carcinomas from Three Populations
- 2010
-
Doctoral thesis (other academic/artistic)abstract
- Most oral squamous cell carcinoma (OSCC) is believed to develop via a multistep process of cumulative gene damage in epithelial cells. Increasing incidence of OSCC and evidence that traditional risk factors may not be responsible directed us to investigate the prevalence of virus in pre- and malignant samples.The integration of the DNA from human papillomavirus (HPV), Epstein-Barr virus (EBV), and Herpes simplex (HSV) into the human genome is associated with the expression of oncogenes and the down-regulation of tumor-suppressor genes in OSCC carcinogenesis. This thesis compared samples from India and Sudan, two countries on two continents having a documented high incidence of oral cancer, with specimens from Sweden, with its known low incidence of oral cancer. Each region has, in addition to smoking, a unique non-smoked tobacco habits with documented carcinogenic effects. These countries also typify areas of low and high socioeconomic living conditions with their expected impact on disease development. The study populations were selected from tobacco users and nonusers with OSCC, oral sub-mucous fibrosis (India), oral lichen planus (Sweden), oral leukoplakia with and without dysplasia and snuff-induced lesions (Sweden and Sudan). An expedient method was developed for extracting DNA from old formalin-fixed and paraffin-embedded biopsies. The prevalence of HPV, EBV, and HSV was investigated using PCR/DNA sequencing and southern blot hybridization analysis. We found HPV and EBV to be most prevalent in samples of tissue characterized as normal, with decreasing prevalence in dysplastic and malignant lesions. This intriguing finding that prevalence decreases as neoplastic development proceeds warrants further investigation. Our data do not at first sight support the conclusion that viruses and tobacco use jointly interact with cell mechanisms in the development of oral cancer.
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| 20. |
- Jalouli, Miranda, et al.
(author)
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Comparison Between Single PCR and Nested PCR in Detection of Human Papilloma Viruses in Paraffin-embedded OSCC and Fresh Oral Mucosa
- 2015
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In: In Vivo. - 0258-851X .- 1791-7549. ; 29:1, s. 65-70
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Journal article (peer-reviewed)abstract
- Background: Infection with human papilloma virus (HPV) has been implicated as one of the risk factors for the development of oropharyngeal cancer. Many different HPV tests exist, and information regarding their specific technical, analytical, and clinical properties is increasing. Aim: This study aimed to compare the level of detection of HPV using two reliable polymerase chain reaction (PCR) methods, nested PCR (NPCR) and single PCR (SPCR), in archival paraffin-embedded oral squamous cell carcinoma (OSCC) samples and fresh oral mucosa specimens. Materials and Methods: The presence of HPV genome in two groups of tissue samples was analyzed: (i) 57 paraffin-embedded OSCC samples from Sudan and (ii) eight healthy fresh oral mucosal samples from Swedish volunteers. The specimens were tested by SPCR with primer pair MY9/MY11 and NPCR using GP5+/GP6+ primer sets. Results: Eighteen (32%) out of the 57 paraffin-embedded OSCC samples, and five (62%) out of the eight fresh clinically healthy samples were found to be HPV-positive with NPCR. With SPCR, four (7%) out of the paraffin-embedded OSCC samples were HPV-positive. A statistically significant difference between HPV-positive and -negative samples was found when comparing NPCR and SPCR in OSCC and fresh oral mucosa (p<0.0001). The comparative test between SPCR and NPCR showed 100% sensitivity and 69% specificity for OSCC. Conclusion: The use of the GP5+/GP6+ nested PCR increased the positivity rate, efficiency rate and sensitivity of HPV detection in oral samples significantly and should be considered as the method of choice.
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| 21. |
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| 22. |
- Kharazmi, Mohammad, et al.
(author)
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Surgical approach to snus-induced injury of the oral mucosa
- 2014
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In: Journal of Oral Science. - : Nihon University School of Dentistry. - 1343-4934 .- 1880-4926. ; 56:1, s. 91-94
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Journal article (peer-reviewed)abstract
- Snus (Swedish moist snuff) causes lesions in the oral mucosa at the location where pinches are regularly placed. In addition, some patients develop irreversible local gingival recession and sometimes ulcers with perforations to the roots. Such injuries lead to denuded roots that are at risk for caries and periodontal disease, with subsequent esthetic consequences. Therapy for irreversible local gingival recession is currently lacking. In the present report, we describe two cases of successful surgical treatment for irreversible lesions caused by snus.
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| 23. |
- Korytowska, M., et al.
(author)
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Patient-reported pain after surgical removal of leukoplakia - an observational 1-year follow-up study
- 2021
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In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 79:5, s. 383-9
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Journal article (peer-reviewed)abstract
- Objective: Oral leukoplakia (OL) presents as a white lesion of the oral mucosa and is not typically associated with the sensation of pain. OL should be surgically removed when possible because it is considered a potentially malignant oral disorder (PMOD). This study assessed the pain sensations experienced by patients in association with the occurrence and surgical treatment of OL. Methods: Inclusion criteria were: a clinical diagnosis of OL; biopsy excision; and observation for at least 12 months in the ORA-LEU-CAN study. At the first visit, all the patients were asked about the occurrence of symptoms within the lesion. Ninety-four subjects were assessed over a period of 1 year. All patients underwent complete removal of OL. The patient cohort was divided into three sub-groups: (i) no pain before excision and at the 1-year follow-up; (ii) pain before excision; and (iii) pain at the 1-year follow-up. Results: Overall, pain was reported by 21.3% of the patients at the study start whereas 13.8% of the patients reported pain 1 year after surgical treatment. Patient-reported pain from the lesion at study inclusion was significantly associated with lesions found on the lateral side of the tongue (p=.002). Pain reported by patients one year after surgery was significantly related to female gender (p=.038) and the presence of epithelial cell dysplasia (p=.022). Conclusion: We conclude that surgical removal of OL results in a low risk of long-term post-surgical pain. However, OL located on the lateral side of the tongue and in OL with dysplasia are more likely to be associated with pain.
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| 24. |
- Leiggener, Christoph S, et al.
(author)
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A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps
- 2015
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In: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 49:2, s. 95-101
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Journal article (peer-reviewed)abstract
- The free fibula osteoseptocutaneous flap is the standard for reconstruction of extensive mandibular defects. The procedure must be precise to achieve the required functional and aesthetic results. The aim of the present study was to calculate retrospectively the exact differences in surgical outcome based on preoperative and postoperative Computed Tomography data sets. Ten patients with unilateral reconstructions of the mandible with a fibula based on conventional planning were analyzed quantitatively, applying mirroring techniques with direct comparison of the theoretically optimum with the actual reconstruction. The results showed that there is a significant discrepancy between what is actually achieved and the theoretical optimum. The result of the present retrospective analysis shows that there is room for further improvement of the outcome in complex mandible reconstruction cases.
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| 25. |
- Lekerud, Ann-Kristin, et al.
(author)
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Treatment of sleep apnoea using a mandibular advancement splint : an open prospective study
- 2012
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In: In Vivo. - 0258-851X .- 1791-7549. ; 26:5, s. 841-845
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Journal article (peer-reviewed)abstract
- Obstructive sleep apnoea (OSA) may cause considerable disturbances, including the development of health problems. This study was performed in order to evaluate the results of treating OAS with a mandibular advancement splint (MAS), and to evaluate the effects of this treatment. This was a prospective open longitudinal study. Ninety patients were randomly selected and included in the study. All 90 patients received an MAS. Forty-eight patients concluded the study, whereas 27 dropped-out and 15 were excluded. The sleep pattern was monitored at home with portable equipment. There was a clear tendency towards a reduction in the apnoea/hypopnea index (AHI) and the oxygen desaturation index (ODI) between the two investigations. Furthermore, there was a tendency towards reduced sleep apnoea; ratings on the Epworth sleepiness scale were lower, indicating a reduction in daytime sleepiness. Treatment with MAS in our study reduced sleep apnoea and snoring, and lowered the values of the Epworth sleepiness scale, indicating a reduction in daytime sleepiness in the majority of the patients. Lifestyle factors are not believed to have affected the results.
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| 26. |
- Lu, Jiahao, et al.
(author)
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A Deep Learning based Pipeline for Efficient Oral Cancer Screening on Whole Slide Images
- 2019
-
Other publication (other academic/artistic)abstract
- Oral cancer incidence is rapidly increasing worldwide. The most important determinant factor in cancer survival is early diagnosis. To facilitate large scale screening, we propose a fully automated end-to-end pipeline for oral cancer screening on whole slide cytology images. The pipeline consists of regression based nucleus detection, followed by per cell focus selection, and CNN based classification. We demonstrate that the pipeline provides fast and efficient cancer classification of whole slide cytology images, improving over previous results. The complete source code is made available as open source (https://github.com/MIDA-group/OralScreen).
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| 27. |
- Lu, Jiahao, et al.
(author)
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A Deep Learning Based Pipeline for Efficient Oral Cancer Screening on Whole Slide Images
- 2020
-
In: Image Analysis and Recognition. - Cham : Springer International Publishing. - 9783030505158 - 9783030505165 ; , s. 249-261
-
Conference paper (peer-reviewed)abstract
- Oral cancer incidence is rapidly increasing worldwide. The most important determinant factor in cancer survival is early diagnosis. To facilitate large scale screening, we propose a fully automated pipeline for oral cancer detection on whole slide cytology images. The pipeline consists of fully convolutional regression-based nucleus detection, followed by per-cell focus selection, and CNN based classification. Our novel focus selection step provides fast per-cell focus decisions at human-level accuracy. We demonstrate that the pipeline provides efficient cancer classification of whole slide cytology images, improving over previous results both in terms of accuracy and feasibility. The complete source code is made available as open source (https://github.com/MIDA-group/OralScreen).
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| 28. |
- Messo, Elias, et al.
(author)
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Custom-Made Horizontal and Vertical Maxillary Augmentation with Smartbone® On Demand™ : A Seven-Year Follow-Up Case
- 2020
-
In: Applied Sciences. - : MDPI AG. - 2076-3417. ; 10:22
-
Journal article (peer-reviewed)abstract
- The presence of non-sufficient bone height and width requires an increase in the amount of bone available to insert an implant. Different materials are described in the literature, and the “custom-made bone graft approach” is a modern option which currently requires a preoperative stage of studying the bone defect and designing the implant. SmartBone® (SB®) mimics the characteristics of healthy human bone. Thanks to the strong performance, high workability, resistance and shape retention of SB®, it is possible to obtain SmartBone® on DemandTM, a bone graft uniquely shaped exactly to patient specifications, produced by following the data precisely and contoured to the bone defect site. The aim of this study was to determine the success over 7 years following a customized SmartBone® on DemandTM, a xeno-hybrid bone graft and installation of implants in a maxillary horizontal and vertical atrophy. This case study presents the diagnosis for a 60-year-old male patient requesting the rehabilitation of his edentulous maxilla with dental implants. Preoperative evaluation included the study of photographs, a radiological examination and 3D reconstruction to assess the missing bone, implant size, positioning of implants and anatomical landmarks. Rehabilitation included the insertion of a custom-made xeno-hybrid bone block into the maxilla in order to restore the anatomy prior to the implants’ placement. The newly developed bone substitute SB® is a safe and effective material, and its custom-made variant SmartBone® on DemandTM has been shown to be a valid alternative to traditional autologous bone grafting techniques in terms of accuracy, absence of infection/rejection and overall clinical outcome.
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| 29. |
- Meyer, Simon, et al.
(author)
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Fibula Graft Cutting Devices : Are 3D-Printed Cutting Guides More Precise than a Universal, Reusable Osteotomy Jig?
- 2020
-
In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 9:12
-
Journal article (peer-reviewed)abstract
- Individual cutting guides for the reconstruction of lower jaw defects with fibular grafts are often used. However, the application of these osteotomy tools is costly and time intensive. The aim of this study was to compare the precision of osteotomies using a 3D-printed guide with those using a universal, reusable, and more cost-efficient Multi-Use Cutting Jig (MUC-Jig). In this non-blinded experimental study, 10 cranio-maxillofacial surgeons performed four graft removals each in a randomized order using the same osteotomy angle, both proximally (sagittal cut) and distally (coronal cut), of a graft (45°, 30°, 15°, or 0°), first with the MUC-Jig then with the 3D-printed cutting guide. The 40 fibula transplants (Tx) of each method (n = 80) were then analyzed concerning their Tx length and osteotomy angles and compared to the original planning data. Furthermore, the surgeons' subjective perception and the duration of the two procedures were analyzed. The mean relative length and mean relative angle deviation between the MUC-Jig (-0.08 ± 1.12 mm; -0.69° ± 3.15°) and the template (0.22 ± 0.90 mm; 0.36° ± 2.56°) group differed significantly (p = 0.002; p = < 0.001), but the absolute deviations did not (p = 0.206; p = 0.980). Consequently, clinically comparable osteotomy results can be achieved with both methods, but from an economic point of view the MUC-Jig is a more cost-efficient solution.
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| 30. |
- Noort, Sanne, et al.
(author)
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Prognostic impact of t(16;21)(p11;q22) and t(16;21)(q24;q22) in pediatric AML: a retrospective study by the I-BFM Study Group.
- 2018
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In: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 132:15, s. 1584-1592
-
Journal article (peer-reviewed)abstract
- To study the prognostic relevance of rare genetic aberrations in acute myeloid leukemia (AML), such as t(16;21), international collaboration is required. Two different types of t(16;21) translocations can be distinguished: t(16;21)(p11;q22), resulting in the FUS-ERG fusion gene; and t(16;21)(q24;q22), resulting in RUNX1-core binding factor (CBFA2T3). We collected data on clinical and biological characteristics of 54 pediatric AML cases with t(16;21) rearrangements from 14 international collaborative study groups participating in the international Berlin-Frankfurt-Münster (I-BFM) AML study group. The AML-BFM cohort diagnosed between 1997 and 2013 was used as a reference cohort. RUNX1-CBFA2T3 (n = 23) had significantly lower median white blood cell count (12.5 × 109/L, P = .03) compared with the reference cohort. FUS-ERG rearranged AML (n = 31) had no predominant French-American-British (FAB) type, whereas 76% of RUNX1-CBFA2T3 had an M1/M2 FAB type (M1, M2), significantly different from the reference cohort (P = .004). Four-year event-free survival (EFS) of patients with FUS-ERG was 7% (standard error [SE] = 5%), significantly lower compared with the reference cohort (51%, SE = 1%, P < .001). Four-year EFS of RUNX1-CBFA2T3 was 77% (SE = 8%, P = .06), significantly higher compared with the reference cohort. Cumulative incidence of relapse was 74% (SE = 8%) in FUS-ERG, 0% (SE = 0%) in RUNX1-CBFA2T3, compared with 32% (SE = 1%) in the reference cohort (P < .001). Multivariate analysis identified both FUS-ERG and RUNX1-CBFA2T3 as independent risk factors with hazard ratios of 1.9 (P < .0001) and 0.3 (P = .025), respectively. These results describe 2 clinically relevant distinct subtypes of pediatric AML. Similarly to other core-binding factor AMLs, patients with RUNX1-CBFA2T3 rearranged AML may benefit from stratification in the standard risk treatment, whereas patients with FUS-ERG rearranged AML should be considered high-risk.
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| 31. |
- Nowinski, Daniel, et al.
(author)
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Computer-navigated contouring of craniofacial fibrous dysplasia involving the orbit
- 2011
-
In: The Journal of craniofacial surgery (Print). - 1049-2275 .- 1536-3732. ; 22:2, s. 469-472
-
Journal article (peer-reviewed)abstract
- Virtual surgical planning and computer-aided surgery were used to treat a mono-ostotic fibrous dysplasia of the right zygoma. Mirroring of the contralateral zygoma sets the target for the contouring of the affected zygomatic bone. An optical system for computer-guided surgery was used. Instruments were calibrated and visualized in real time on screen. Achievement of the virtually set target for the orbitozygomatic anatomy was assessed during surgery. Postoperative computed tomography and clinical follow-up confirmed an excellent result with regard to facial symmetry and eye bulb position. The volume of the orbit was increased from 24.2 to 26.0 mL compared with a contralateral orbital volume of 25.7 mL. Computer-guided surgery may be a useful tool in the surgical reduction of craniofacial fibrous dysplasia.
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| 32. |
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| 33. |
- Nyström, Ingela, et al.
(author)
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Virtual Cranio-Maxillofacial Surgery Planning with Stereo Graphics and Haptics
- 2016
-
In: Computer-Assisted Musculoskeletal Surgery. - Cham : Springer International Publishing. - 9783319129433 ; , s. 29-42
-
Book chapter (peer-reviewed)abstract
- Computer-Assisted Surgery (CAS) is a new tool for performing complex procedures in a predictable and safe way. This book is designed to serve as a comprehensive review of Computer-Assisted Surgery, covering the current status of both research and applications.CAS includes Virtual Preoperative Planning (VPP) and Intraoperative Virtual Navigation (IVN), which are a set of technologies used to measure oncological margins in 3-Dimensions (3D), to locate small intraosseous tumors and apply controlled resections preserving anatomical structures. During VPP, patient acquired multimodal images are processed and an interactive virtual scenario is created. This can then be used as a platform to measure oncological distances and preplan osteotomies in safe areas. IVN is a procedure which allows the execution of the VPP with a mean error of less than 3mm.For the student, medical doctors, research and development scientists or new researchers, the protocols are central to the performance of Computer-Assisted technologies.
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| 34. |
- Olsson, Pontus, et al.
(author)
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A haptics-assisted cranio-maxillofacial surgery planning system for restoring skeletal anatomy in complex trauma cases
- 2013
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In: International Journal of Computer Assisted Radiology and Surgery. - : Springer Science and Business Media LLC. - 1861-6410 .- 1861-6429. ; 8:6, s. 887-894
-
Journal article (peer-reviewed)abstract
- Cranio-maxillofacial (CMF) surgery to restore normal skeletal anatomy in patients with serious trauma to the face can be both complex and time-consuming. But it is generally accepted that careful pre-operative planning leads to a better outcome with a higher degree of function and reduced morbidity in addition to reduced time in the operating room. However, today's surgery planning systems are primitive, relying mostly on the user's ability to plan complex tasks with a two-dimensional graphical interface. A system for planning the restoration of skeletal anatomy in facial trauma patients using a virtual model derived from patient-specific CT data. The system combines stereo visualization with six degrees-of-freedom, high-fidelity haptic feedback that enables analysis, planning, and preoperative testing of alternative solutions for restoring bone fragments to their proper positions. The stereo display provides accurate visual spatial perception, and the haptics system provides intuitive haptic feedback when bone fragments are in contact as well as six degrees-of-freedom attraction forces for precise bone fragment alignment. A senior surgeon without prior experience of the system received 45 min of system training. Following the training session, he completed a virtual reconstruction in 22 min of a complex mandibular fracture with an adequately reduced result. Preliminary testing with one surgeon indicates that our surgery planning system, which combines stereo visualization with sophisticated haptics, has the potential to become a powerful tool for CMF surgery planning. With little training, it allows a surgeon to complete a complex plan in a short amount of time.
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| 35. |
- Olsson, Pontus, et al.
(author)
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Haptics-assisted Virtual Planning of Bone, Soft Tissue, and Vessels in Fibula Osteocutaneous Free Flaps
- 2015
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In: Plastic and Reconstructive Surgery - Global Open. - : Wolters Kluwer. - 2169-7574. ; 3:8
-
Journal article (peer-reviewed)abstract
- Background: Virtual surgery planning has proven useful for reconstructing head and neck defects by fibula osteocutaneous free flaps (FOFF). Benefits include improved healing, function, and aesthetics, as well as cost savings. But available virtual surgery planning systems incorporating fibula in craniomaxillofacial reconstruction simulate only bone reconstruction without considering vessels and soft tissue.Methods: The Haptics-Assisted Surgery Planning (HASP) system incorporates bone, vessels, and soft tissue of the FOFF in craniomaxillofacial defect reconstruction. Two surgeons tested HASP on 4 cases they had previously operated on: 3 with composite mandibular defects and 1 with a composite cervical spine defect. With the HASP stereographics and haptic feedback, using patient-specific computed tomography angiogram data, the surgeons planned the 4 cases, including bone resection, fibula design, recipient vessels selection, pedicle and perforator location selection, and skin paddle configuration.Results: Some problems encountered during the actual surgery could have been avoided as they became evident with HASP. In one case, the fibula reconstruction was incomplete because the fibula had to be reversed and thus did not reach the temporal fossa. In another case, the fibula had to be rotated 180 degrees to correct the plate and screw placement in relation to the perforator. In the spinal case, difficulty in finding the optimal fibula shape and position required extra ischemia time.Conclusions: The surgeons found HASP to be an efficient planning tool for FOFF reconstructions. The testing of alternative reconstructions to arrive at an optimal FOFF solution preoperatively potentially improves patient function and aesthetics and reduces operating room time.
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| 36. |
- Olsson, Pontus, 1980-, et al.
(author)
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Snap-to-fit, a Haptic 6 DOF Alignment Tool for Virtual Assembly
- 2013
-
In: Proc. World Haptics (WHC), 2013 IEEE. - 9781479900879 ; , s. 205-210
-
Conference paper (peer-reviewed)abstract
- Virtual assembly of complex objects has application in domains ranging from surgery planning to archaeology. In these domains the objective is to plan the restoration of skeletal anatomy or archaeological artifacts to achieve an optimal reconstruction without causing further damage. While graphical modeling plays a central role in virtual assembly, visual feedback alone is often insufficient since object contact and penetration is difficult to discern due to occlusion. Haptics can improve an assembly task by giving feedback when objects collide, but precise fitting of fractured objects guided by delicate haptic cues similar to those present in the physical world requires haptic display transparency beyond the performance of today’s systems. We propose a haptic alignment tool that combines a 6 Degrees of Freedom (DOF) attraction force with traditional 6 DOF contact forces to pull a virtual object towards a local stable fit with a fixed object. The object forces are integrated into a virtual coupling framework yielding a stable haptic tool. We demonstrate the use of our system on applications from both cranio-maxillofacial surgery and archaeology, and show that we can achieve haptic rates for fractured surfaces with over 5000 points.
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| 37. |
- Ramadhan, Anwar, et al.
(author)
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Anatomical Variation of Mental Foramen : A case report
- 2010
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In: Stomatologija, Baltic Dental and Maxillofacial Journal. - 1392-8589 .- 1822-301X. ; 12:3, s. 93-96
-
Journal article (peer-reviewed)abstract
- We have reported a case of triple mental foramina at the right side of the premolar region, which was discovered during reposition and ostheosynthesis of a mandible fracture. A review of the literature, was performed which disclosed no previous clinical cases reported but an incidence of 1.2% of triple foramina after investigating dry skulls or radiographics. The discussion stresses the importance of adequate preoperative radiological examination in the clinical situation especially when closed surgery is planned.
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| 38. |
- Runow Stark, Christina, et al.
(author)
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Brush Samples of Oral Lesions to FTA Elute Card for High-risk Human Papilloma Virus Diagnosis
- 2021
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In: Anticancer Research. - : Anticancer Research USA Inc.. - 0250-7005 .- 1791-7530. ; 41:1, s. 269-277
-
Journal article (peer-reviewed)abstract
- AIM: To investigate the level of agreement between three non-invasive methods for hrHPV diagnosis in oral and oropharyngeal squamous cell carcinoma (OSCC, OPSCC) and in oral mucosal lesions.MATERIALS AND METHODS: For hrHPV DNA FTA Elute card™ and Anyplex II HPV28™ were used and for hrHPV mRNA PreTect SEE™ in tumour patients (n=60), non-tumour lesions (n=51), immunosuppression or previous hrHPV-infection (n=32).RESULTS: The level of agreement between the DNA-methods was 82.2% (k=0.54, p=0.001). Pair-wise comparison for the FTA Elute card were close to the reference (AUC=0.83, 95% CI=0.73-0.90). hrHPV mRNA was diagnosed in 50% of the tumours, with an agreement level of 58.3%, compared to Anyplex II (k=0.17, p=0.04). The hrHPV positivity in oral lesions was 3.9% for immunosuppression and for previous HPV infection 9.4%.CONCLUSION: The FTA card is reliable for hrHPV DNA diagnosis while mRNA gives an insight into viral activity and correlates with severity of the lesion.
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| 39. |
- Röing, Marta, et al.
(author)
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Living in a state of suspension - a phenomenological approach to the spouse's experience of oral cancer
- 2008
-
In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:1, s. 40-47
-
Journal article (peer-reviewed)abstract
- The consequences of oral cancer may affect not only the patient, but also their spouses, as the mouth is vital for communication, social interaction and nutrition. Treatment is complex, lengthy and involves a large number of medical and dental professionals. During the treatment of oral cancer spouses are often present when the patients meet the treatment team. While nursing and medical staff have experience of meeting both patients and spouses, dental teams may not. The aim of this phenomenological study was to describe oral cancer and its treatment as experienced by the patient's spouses. A purposeful sample of seven spouses was interviewed. The existentials of lived relations, lived body and lived space and time were used as interpretive means in analysing the data to illuminate the spouses' everyday experiences during treatment. The findings reveal that the experience of lived relations changes from being spouse to supportive carer, the lived body is neglected and lived space and time becomes restricted. The essence of their lived experience can be described as living in a state of suspension. This knowledge may be useful in the education and organization of supportive communication for multiprofessional caregivers.
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| 40. |
- Röing, Marta, et al.
(author)
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Making New Meanings of Being in the World After Treatment for Oral Cancer
- 2009
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In: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 19:8, s. 1076-1086
-
Journal article (peer-reviewed)abstract
- When the mouth is affected by cancer, difficulties in satisfying basic human needs such as eating, tasting, swallowing, and speaking might arise, and the existential significance of the mouth might become obvious. How does it feel to live with these difficulties? What does it mean to be a human being living with the consequences of oral cancer? Five patients with oral cancer were interviewed a median time of 4 years after the beginning of treatment. A hermeneutic research approach was used to understand, explain, and interpret the transcribed interviews and showed how the consequences of oral cancer affected the being-in-the-world of the participants in three ways: existing as oneself, existing in the eyes of others, and existing with others. Against the background of the philosophy of Martin Heidegger, these findings illuminate how essential the mouth is to a human being's identity and existence.
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| 41. |
- Röing, Marta, et al.
(author)
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The uncanny mouth - a phenomenological approach to oral cancer
- 2007
-
In: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 67:3, s. 301-306
-
Journal article (peer-reviewed)abstract
- Objective: The aim of this retrospective qualitative study was to describe how patients with oral cancer experience their sickness and treatment. Methods: A purposeful sample of seven patients with oral cancer was interviewed. Data were analysed using a phenomenological approach outlined by van Manen. Results: The essence of the patients' experiences can be described as embodiment in a mouth that has become unreal, or 'uncanny'. At treatment start the body is invaded by cancer, during treatment there is no escape from a wounded mouth, at treatment end the mouth is disabled. Conclusions: The findings indicate that oral cancer patients' need for support may increase as treatment progresses and may be greatest at end of radiotherapy, as they return home with mouths that have not recovered after treatment and do not function normally. Practice implications: This suggests the importance of understanding the patients' situation during treatment and their desire for a return to normal living and normal mouth functions at treatment end. If possible, plans for oral rehabilitation should be considered in initial treatment planning. As the treatment of oral cancer is multiprofessional, this knowledge may be useful in guiding the organization of oral cancer care and multiprofessional collaboration.
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| 42. |
- Röing, Marta, 1944-
(author)
-
Understanding Oral Cancer - A Lifeworld Approach
- 2007
-
Doctoral thesis (other academic/artistic)abstract
- Dental involvement with oral cancer patients during their treatment and rehabilitation can be long and intense. How can dental personnel better understand their role in the treatment of these patients? How does treatment affect the patients and their spouses? In searching for answers, the theories of phenomenography, phenomenology and hermeneutics are used to describe and interpret the experiences of the hospital dental treatment teams, oral cancer patients, and their spouses. Study I reveals that hospital dental treatment teams perceive the encounter with head and neck cancer patients in three qualitatively different ways; as an act of caring, as a serious and responsible task, and as an overwhelming emotional situation, indicating that they are not always able to lean on education and professional training in dealing with situations with strong emotional impact. Study II gives insight into the lifeworld of oral cancer patients, and how the patient becomes embodied in a mouth that is increasingly `uncanny´, as it slowly ceases to function normally. Study III shows that oral cancer puts a hold on the lifeworld of the patients’ spouses which can be described as `living in a state of suspension´. These findings suggest that the support needs of patients and spouses appear to be greatest at treatment end, when, upon returning home, they are faced with the accumulated impact of the patients’ sickness and treatment. Study IV gives insight into what it may mean to live with the consequences of oral cancer, revealing a silent physical, emotional and existential struggle to adjust to a changed way of living. This thesis raises the question if todays’ organisation of oral cancer care can meet the varying emotional and existential needs of treatment teams, patients and spouses that were brought to light.
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| 43. |
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| 44. |
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| 45. |
- Sand, Lars, et al.
(author)
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Smokeless tobacco, viruses and oral cancer
- 2014
-
In: Oral health and dental management. - 2247-2452. ; 13:2, s. 372-378
-
Journal article (peer-reviewed)abstract
- Oral Squamous Cell Carcinoma (OSCC) is the most common epithelial malignancy in the oral cavity. OSCCs and their variants constitute over 90% of oral malignancies, and the disease is associated with poor prognosis. OSCC is a complex malignancy where environmental factors, viral infections, and genetic alterations most likely interact, and thus give rise to the malignant condition. The International Agency for Research on Cancer (IARC) in 2007 concluded: "there is sufficient evidence in humans to establish smokeless tobacco as carcinogenic, i.e. smokeless tobacco causes cancer of the oral cavity and pancreas". ST products contain a large array of carcinogens, although the number found is actually smaller than in cigarette smoke. Worldwide, ST products have many different names depending on the region where it is produced. However, there are two main types of ST, chewing tobacco and snuff. It is estimated that approximately 150 million people in the world use ST. Herein, we review available literature regarding smokeless tobacco and oral Carcinogenesis. We also discuss the role of viral infections in combination with ST in OSCC development.
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| 46. |
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| 47. |
- Sullivan, Richard, et al.
(author)
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Delivering affordable cancer care in high-income countries
- 2011
-
In: The Lancet Oncology. - London : Lancet Oncology. - 1470-2045 .- 1474-5488. ; 12:10, s. 933-980
-
Journal article (peer-reviewed)abstract
- The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.
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| 48. |
- Sundberg, Jonas, et al.
(author)
-
Combined Testing of p16 Tumour-suppressor Protein and Human Papillomavirus in Patients With Oral Leukoplakia and Oral Squamous Cell Carcinoma.
- 2019
-
In: Anticancer research. - : Anticancer Research USA Inc.. - 1791-7530 .- 0250-7005. ; 39:3, s. 1293-1300
-
Journal article (peer-reviewed)abstract
- Oral leukoplakia (OL) is a potentially malignant oral mucosal disorder. A casual association between OL, oral squamous cell carcinoma (OSCC) and human papillomavirus (HPV) infection has been suggested, but no conclusive evidence has been presented. p16, a tumour-suppressor protein, is used as a surrogate marker for HPV infection. The aim of this study was to investigate how overexpression of p16 correlates with HPV infection in OL and in OSCC.Seventy-four patients with OL and 13 with OSCC with p16 overexpressed, were analyzed by immunohistochemistry visualizing p16 and a real-time polymerase chain reaction (PCR) assay targeting HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 52, 56, 58 and 59.Overexpression of p16 was observed in 18% of patients with OL. None of the HPV subtypes were detected by PCR analysis in patients with OL. In the p16-positive OSCC specimens, 38% were also HPV16-positive.Overexpression of p16 was not found to be a reliable biomarker for HPV infection in patients with OL and OSCC.
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| 49. |
- Sundberg, Jonas, et al.
(author)
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Recurrence rates after surgical removal of oral leukoplakia-A prospective longitudinal multi-centre study.
- 2019
-
In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:12
-
Journal article (peer-reviewed)abstract
- Oral leukoplakia (OL) is a potentially malignant oral disorder. The Gold Standard treatment is to remove surgically the OL. Despite optimal surgery, the recurrence rates are estimated to be 30%. The reason for this is unknown. The aim of this study was to investigate the clinical factors that correlate with recurrence after surgical removal of OL. In a prospective study data were collected from 226 patients with OL. Forty-six patients were excluded due to incomplete records or concomitant presence of other oral mucosal diseases. Overall, 180 patients proceeded to analysis (94 women and 86 men; mean age, 62 years; age range, 28-92 years). Clinical data, such as gender, diagnosis (homogeneous/non-homogeneous leukoplakia), location, size, tobacco and alcohol use, verified histopathological diagnosis, and clinical photograph, were obtained. In patients who were eligible for surgery, the OL was surgically removed with a margin. To establish recurrence, a healthy mucosa between the surgery and recurrence had to be confirmed in the records or clinical photographs. Statistical analysis was performed with the level of significance set at P<0.05. Of the 180 patients diagnosed with OL, 57% (N = 103) underwent surgical removal in toto. Recurrence was observed in 43 OL. The cumulative incidence of recurrence of OL was 45% after 4 years and 49% after 5 years. Fifty-six percent (N = 23) of the non-homogeneous type recurred. Among snuff-users 73% (N = 8) cases of OL recurred. A non-homogeneous type of OL and the use of snuff were significantly associated with recurrence after surgical excision (P = 0.021 and P = 0.003, respectively). Recurrence was also significantly associated with cancer transformation (P<0.001). No significant differences were found between recurrence and any of the following: dysplasia, site of lesion, size, multiple vs. solitary OL, gender, age, use of alcohol or smoking. In conclusion, clinical factors that predict recurrence of OL are non-homogeneous type and use of snuff.
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| 50. |
- Thor, Andreas, et al.
(author)
-
Bone formation at the maxillary sinus floor following simultaneous elevation of the mucosal lining and implant installation without graft material : an evaluation of 20 patients treated with 44 Astra Tech implants
- 2007
-
In: Journal of oral and maxillofacial surgery (Print). - : Elsevier BV. - 0278-2391 .- 1531-5053. ; 65:7, s. 64-72
-
Journal article (peer-reviewed)abstract
- PURPOSE: Restoration of lost dentition in the severely artrophic posterior maxilla has for the last 2 decades been successfully treated with various sinus augmentation techniques and installation of dental implants. The use of graft material is anticipated to be necessary; however, recent studies have demonstrated that the mere lifting of the sinus mucosal lining and simultaneous placement of implants result in bone formation. This study was conducted in order to evaluate simultaneous sinus mucosal lining elevation and installation of dental implants without any graft material. PATIENTS AND METHODS: Twenty patients were consecutively included from November 2001 to June 2004. Forty-four Astra ST dental implants (Astra Tech AB, Mölndal, Sweden) with a diameter of 4.5 mm or 5 mm were installed in 27 sinuses. A sinus lift was performed where a cortical window was removed from the maxillary anterior sinus wall. The sinus mucosal lining was elevated and implants installed in the residual subantral bone. The cortical window was thereafter replaced and the incision closed. The remaining bone height was recorded during surgery as well as perforations of the sinus mucosal lining. After 6 months of healing, abutments were connected (the series included 5 1-stage procedures). Clinical and radiological follow-up after loading was performed up to 4 years after implant installation. RESULTS: Patients tolerated the procedure well as few complications were observed. Firm primary stability was achieved for all implants at installation with bone levels in residual bone of 2 to 9 mm. Perforations of the maxillary sinus mucosal lining occurred in 11 of the 27 operated sinuses (41%). One implant was lost during a mean follow-up of 27.5 months (range, 14 to 45 months) giving an implant survival rate of 97.7%. The average gain of bone at the sinus floor was 6.51 mm (SD = 2.49, 44 implants) including all measured implants after a minimum of 1 year follow-up. Marked bone formation was observed around long implants and also when the residual bone below the sinus was diminutive. CONCLUSIONS: The present study including 20 patients showed consistent bone formation at the maxillary sinus floor following simultaneous mucosal lining elevation and installation of implants. It is suggested that the use of this technique can reduce the risk for morbidity related to harvesting of bone grafts and eliminate costs for grafting materials.
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