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Cancer is one of the most common diseases this century, with breast cancer being the most common form. Pathological examination is used to detect and quantify Tumour-infiltrating lymphocytes (TILs) in breast cancer Whole Slide Images (WSIs), which can be done manually or automatically. Analysing these Whole Slide Images manually takes a lot of time and requires a lot of concentration from the pathologists. Automating this process takes significantly less time, is more efficient and less errorprone than the manual process. This study aims to provide an object detection model to localise and detect plasma and lymphocyte cells in breast cancer tissue. This research is conducted using the Design Science research strategy. First, data exploration of the TIGER data set took place. The data was pre-processed and split into a training, validation, and test set. Afterwards, the pre-trained YOLOv5 was used to train the object detection model. In the next step, the model is fine-tuned on the validation dataset. Finally, the model was tested and evaluated. The findings from this study show that training the YOLOv5m model without performing augmentation has the best performance. The results of this research are promising: the precision is 0.668, and the recall is 0.621. In conclusion, training an image analysis Deep Learning model to detect and localise tumour-infiltrating lymphocytes on Haematoxylin and Eosin (H&E) breast cancer tissue WSIs is feasible.

Background - Breast cancer is one of the most common cancer diseases among women worldwide. It causes many emotions to the affected woman but also for their relatives. It is important that nurses have knowledge and understanding of relatives' experiences to provide optimal support and be able to meet the needs of the relatives. Aim - This study aimed to illuminate experiences of being a relative to a person with breast cancer. Method - Friberg's (2017) designed method to contribute to evidence-based care based on analysis of qualitative research were used. Eleven scientific studies were analyzed, and it resulted in three themes and eight subthemes. Results - Three themes were found, it was: a storm of emotions, life turns upside down and support during a fragile journey. Relatives experienced many emotions when the woman was affected with breast cancer, which led to life changes. The relatives needed knowledge and support from the healthcare system, friends, and family but also from religion and God. Conclusion - The affected woman should always be in center of the healthcare but the importance of seeing relatives in the situation and caring for them is equally important. The disease often results in many negative thoughts and feelings. When the nurse sees, listens, and gives information and support to the relatives can contribute with knowledge and understanding which can facilitate their coping strategies and give a positive experience of the disease progression. / Examensarbetet behandlar erfarenheter av att vara anhörig till en person med bröstcancer från beskedet av diagnos till friskförklaring. Bröstcancer är den vanligaste cancerformen bland kvinnor och årligen insjuknar många kvinnor världen över. Sjukdomen väcker många tankar och känslor och det är inte enbart kvinnan som drabbas utan även anhöriga. Anhöriga genomgår en förändrad livssituation som resulterade i ökat ansvar för familjen, nya roller inom familjen, oro över ekonomin och påverkan på familjemässiga och sociala relationer. Anhöriga hade en bristande kunskap om sjukdomen och dess omständigheter vilket skapade ett behov av information. Under den svåra tiden var det viktigt med stöd från familj, vänner, omgivning och religion då det underlättade förmågan att hantera sjukdomen. Det blir tydligt att anhöriga drabbas hårt av sjukdomen. Inom vården är det lätt att anhörigas behov av involvering, information och kommunikation blir bristande, vilket kan resultera i att anhöriga upplever sig bortglömda. Den drabbade kvinnan ska alltid stå i centrum av vårdandet men vikten av att se anhöriga i situationen är lika viktigt. Sjukdomen resulterar ofta i många negativa känslor och tankar. Genom att sjuksköterskan ser, lyssnar, ger information och stöd till anhöriga kan det bidra till kunskap och förståelse som kan underlätta hanteringsprocessen och ge en positivare upplevelse av sjukdomstiden. En metod för att bidra till evidensbaserad omvårdnad med grund i analys av kvalitativ forskning valdes och elva vetenskapliga studier hittades via sökningar i databaser. De vetenskapliga studierna analyserades och sammanställdes till en ny helhet under tre teman och åtta underteman. Sjuksköterskans roll diskuterades, där vikten av att sjuksköterskan arbetar familjecentrerat, involverar anhöriga, bidrar med optimalt stöd, ger information och kunskap anpassat utifrån individuella behov och resurser lyftes. Genom att sjuksköterskan arbetar på följande sätt bidrar det till minskat lidande och ökat välbefinnande för anhöriga.

Bakgrund: Bröstcancer är den vanligaste cancerdiagnosen hos kvinnor över hela världen och i Sverige. En av de vanligaste behandlingsformerna är kirurgi. Mastektomi innebär att hela eller delar av bröstet operareas bort. Kroppsuppfattning är en individuell uppfattning och påverkar alla på olika sätt. Sjuksköterskor ska arbeta personcentrerat och respektera patientens livsvärld, för att kunna främja deras hälsa och livskvalité. Syfte: Syftet var att beskriva kvinnors upplevelser efter mastektomi vid bröstcancer.  Metod: En allmän litteraturöversikt baserat på tio kvalitativa artiklar. Artiklarna hämtades från databaserna PudMed och Cinahl Complete. Alla artiklar analyserades enligt Fribergs (2022) metod. Artiklarnas resultat granskades och kategoriserades utifrån olikheter och likheter.     Resultat: Innehållet i artiklarna resulterade i två stycken huvudkategorier. Det förändrade jaget med underteman psykisk påverkan efter mastektomi, fysisk påverkan efter mastektomi och förändring på relationer efter mastektomi. Som tyder på att mastektomin gav kvinnorna en förändrad kroppsbild som påverkade dem fysiskt och psykiskt. Mastektomin ledde till att relationen med deras partners påverkades. Flera uppgav också att dem ångrar mastektomin. Vägen till det nya jaget med underteman vägen till att finna acceptans efter mastektomi och behov av stöd från omgivningen efter mastektomi belyser olika metoder som kvinnorna använde sig av för att hantera den nya situationen, där bland med sin tro. Acceptansen var en central del i kvinnornas liv efter mastektomin. Omgivningen var viktigt för kvinnornas acceptans.   Slutsats: Efter mastektomin påverkas kvinnornas kroppsbild negativt och drabbar både deras psykiskt, fysiskt och sociala välmående. Kvinnor får även en förändrad identitet och självbild. Att ha ett bra stöd kring sig ansågs viktigt för kvinnorna för att kunna hitta en acceptans i den förändrade kroppen. Som sjuksköterska är det viktigt att ha kunskap om hur kvinnor upplever mastektomi i mötet med dem. / Background: Breast cancer is the most common form of cancer that affect women worldwide and in Sweden. One of the most common forms of treatment is surgery. Mastectomy means that the entire breast is surgically removed. Body image is an individual perception and affects everyone in different ways. Nurses should work in a person-centered way and respect the patient's life world, to promote their health and quality of life.  Aim: The aim was to describe women ́s experiences after undergoing a mastectomy for breast cancer. Method: A literature review based on ten qualitative articles. The articles were taken from PudMed and Cinahl Complete. The articles were analysed according to Fribergs (2022) method. The results were reviewed and categorized based on differences and similarities. Results: The content of the articles resulted in two main categories. The changing identity with sub-themes of psychological impact after mastectomy, physical impact after mastectomy and changes on relationships after mastectomy. Which suggests that mastectomy gave women an altered body image that affected them psychologically and physically. The mastectomy led to an impact on their relationships with their partners. Several also reported that they regret the mastectomy. The path to the new self with its sub-themes of the way to find acceptance after mastectomy and need of support from the surroundings after mastectomy, highlights the different ways in which women coped with the new situation, including their faith. Acceptance was a central part of women's lives after mastectomy. Getting support from the surroundings was important for the women's acceptance.   Conclusions: After mastectomy, women's body image is negatively affected, affecting their mental, physical and social well-being. Women also experience changes in their identity and self-image. Having good support around them was considered important for the women to be able to find acceptance in the changed body. As a nurse, it is important to have knowledge of how women experience mastectomy in their encounter with them.

Bakgrund: Bröstcancer är den vanligaste cancerformen för kvinnor globalt, cirka 20 kvinnor utvecklar bröstcancer varje dag och förutom strålbehandling är kirurgi den vanligaste behandlingen av bröstcancer. Den vanligaste operationsformen är mastektomi, som innebär att man tar bort hela bröstet. Ingreppet innebär kroppsliga förändringar som påverkar kvinnans liv på olika sätt. Syfte: Syftet var att belysa kvinnors upplevelse efter en mastektomi. Metod: En litteraturöversikt baserad på 11 kvalitativa artiklar hämtade från databaserna PubMed och Cinahl Complete. Artiklarna analyserades enligt Fribergs (2021) metod. Resultatet granskades och kategoriserades utifrån likheter och olikheter. Resultat: Innehållet ifrån artiklarna resulterade i tre huvudkategorier; En förändrad kropp som innebar en påverkan på kvinnans identitet, mående och sexualitet. Stöd ifrån omgivningen kan påverka hur kvinnan ser på sin kropp och livet i stort. Vägen till acceptans här beskrivs det hur kvinnorna genom olika strategier fann en väg till acceptans över den nya kroppen. Sammanfattning: Kroppsbilden förändras för många kvinnor efter att ha genomgått mastektomi och medför fysiska, psykologiska och sociala utmaningar. Det påverkar även kvinnornas syn på identitet och femininitet Partners och anhörigstöd var en förutsättning för att kvinnorna skulle acceptera sin nya kropp. Stödet från sjukvårdspersonalen upplevdes som viktigt för kvinnorna. Sjuksköterskans kunskap och attityd har en viktig roll i processen att hantera den nya situationen kopplat till den förändrade kroppsuppfattningen. / Background: Breast cancer is the most common form of cancer for women globally, about 20 women develop breast cancer every day and apart from radiotherapy is surgery the most common treatment for breast cancer. The most common form of surgery is mastectomy, which involves removing the entire breast. The procedure entails bodily changes that affect the woman's life in different ways. Aim: The aim of this literature review was to highlight women's experiences after a mastectomy Method: A literature review based on 11 qualitative articles taken from the databases PubMed and Cinahl Complete. The articles were analyzed according to Friberg's (2021) method. The results were reviewed and categorized based on similarities and differences. Results: The content from the articles resulted in three main categories; A changed body which meant an impact on the woman's identity, mood and sexuality. Support from the environment can affect how the woman views her body and life in general. The path to acceptance Here it is described how the women found a path to acceptance over the new body through different strategies. Summary: Body image changes for many women after undergone mastectomy and entails physical, psychological, and social challenges. It also affected the women's view of identity and femininity. Partners and relatives support was prerequisite for the women to accept their new bodies. The support of medical staff was perceived as important for the women. The nurse's knowledge and attitude have an important role in the process of handling the new situation linked to the changed body image

Objetivos: Este trabalho objetivou avaliar e comparar a incidência de linfedema, dor, restrição na amplitude de movimento e déficit sensorial 1 dia, 15 dias, 3 meses, 6 meses e 18 meses no membro superior homolateral, após linfadenectomia axilar total (LAT) e biópsia de linfonodo sentinela (BLS) para tratamento do câncer de mama. MÉTODOS: Neste estudo incluiu-se pacientes que realizaram ressecção segmentar de mama e LAT ou BLS. As pacientes foram avaliadas entre Dezembro de 2003 e Dezembro de 2004 e foram constituídos por dois grupos, o grupo A (n=100) foi formado por casos submetidos à LAT e o Grupo B, por casos submetidos à BLS (n=50). As pacientes foram analisadas através de questionário com respostas afirmativas e negativas, onde foram incluídas questões avaliando os sintomas de linfedema, dor, restrição da amplitude de movimento e déficit sensorial 1 dia (n=30), 15 dias (n=30), 6 meses (n=30) e 18 meses (n=30), após o procedimento cirúrgico. Além disto efetuou-se avaliação fisioterapêutica na qual foi realizada perimetria de membros superiores, mensuração da amplitude de movimento através da goniometria, os testes de sensibilidade cutânea através dos monofilamentos de Semmes-Weinstein e teste eletrodiagnóstico, utilizando-se gerador universal de correntes. RESULTADOS: No grupo A houve diferenças significantes (p < 0,05) em todos os sintomas subjetivamente avaliados, existindo maior queixa de edema (31%), dor (58%), restrição do movimento (52%) e dormência (57%). No grupo B houve menor prevalência da sensação de edema (2%), dor (26%), restrição do movimento (24%) e dormência (20%), em todos os tempos estudados. No exame clínico, o exame sensorial com monofilamentos apresentou 82% de diminuição da sensibilidade tátil na região axilar e 73% na região braquial proximal no grupo de mulheres submetidas à LAT e no grupo de mulheres submetidas à BLS houve diminuição da sensibilidade tátil nas duas regiões avaliadas em 40% (p<0.05). Nas provas cronaximétricas, a sensibilidade estava diminuída no grupo de mulheres submetidas à LAT em 56% na região axilar e 48% na região braquial proximal medial e no grupo BLS a sensibilidade estava diminuída em 39% e 14% respectivamente. CONCLUSÕES: A morbidade é maior a e funcionalidade do braço é menor em mulheres submetidas à LAT, quando comparadas à BLS, em mulheres operadas por câncer de mama / OBJECTIVES: The aim of this study was to evaluate and compare occurrence of lymphedema, pain, motion restriction and sensory deficit in the upper homolateral limb at 1 day, 15 days, 3 months, 6 months and 18 months after axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) after breast cancer surgery. METHODS: A controlled study was designed to include patients who underwent breast conservative surgery and ALND or SLNB. Patients were evaluated between December 2003 and December 2004, and they were divided into two groups, group A (n=100) consisted who had ALND and group B, with patients after only SLNB (n=50). All of them subjectively answer a \"yes\" or \"no\" questionnaire in which were included questions about incidence of lymphedema, pain, motion restriction and arm numbness at 1day (n=30), 15 days (n=30), 3 months (n=30), 6 months (n=30) and 18 months (n=30) after surgery. Besides this a physiotherapy examination was performed measuring circunference, shoulder adbuction range by a goniometer, sensibility tests by pressure Semmes-Weinsten monofilaments and by eletrodiagnostic tests using an universal stimulator. RESULTS: In the group A significant differences (p < 0,05) were seen in subjectively sensations, with significantly higher incidence of subjective swelling (31%), pain (58%), motion restriction (52%), arm numbness (57%). In group B there were less symptoms of subjective swelling (2%), pain (58%), motion restriction (24%), arm numbness (20%). In clinical examination sensory deficit using monofilaments the occurrence of numbness was 82% on axillary fold and 73% on medial part of upper arm after ALND and in 40% on axillary fold and medial part of upper arm after SLNB, with significantly different between the groups (p < 0.05). At cronaximetric proofs the sensibility was decreased in 56% in the axillary fold and 48% in the medial part of upper arm for ALND and 39% in the axillary fold and 14% at medial part of upper arm on patients who underwent SLNB. CONCLUSIONS: Arm morbidity is higher and function is lower after ALND compared to SLNB, in women submitted to breast cancer surgery

Objetivos: Este trabalho objetivou avaliar e comparar a incidência de linfedema, dor, restrição na amplitude de movimento e déficit sensorial 1 dia, 15 dias, 3 meses, 6 meses e 18 meses no membro superior homolateral, após linfadenectomia axilar total (LAT) e biópsia de linfonodo sentinela (BLS) para tratamento do câncer de mama. MÉTODOS: Neste estudo incluiu-se pacientes que realizaram ressecção segmentar de mama e LAT ou BLS. As pacientes foram avaliadas entre Dezembro de 2003 e Dezembro de 2004 e foram constituídos por dois grupos, o grupo A (n=100) foi formado por casos submetidos à LAT e o Grupo B, por casos submetidos à BLS (n=50). As pacientes foram analisadas através de questionário com respostas afirmativas e negativas, onde foram incluídas questões avaliando os sintomas de linfedema, dor, restrição da amplitude de movimento e déficit sensorial 1 dia (n=30), 15 dias (n=30), 6 meses (n=30) e 18 meses (n=30), após o procedimento cirúrgico. Além disto efetuou-se avaliação fisioterapêutica na qual foi realizada perimetria de membros superiores, mensuração da amplitude de movimento através da goniometria, os testes de sensibilidade cutânea através dos monofilamentos de Semmes-Weinstein e teste eletrodiagnóstico, utilizando-se gerador universal de correntes. RESULTADOS: No grupo A houve diferenças significantes (p < 0,05) em todos os sintomas subjetivamente avaliados, existindo maior queixa de edema (31%), dor (58%), restrição do movimento (52%) e dormência (57%). No grupo B houve menor prevalência da sensação de edema (2%), dor (26%), restrição do movimento (24%) e dormência (20%), em todos os tempos estudados. No exame clínico, o exame sensorial com monofilamentos apresentou 82% de diminuição da sensibilidade tátil na região axilar e 73% na região braquial proximal no grupo de mulheres submetidas à LAT e no grupo de mulheres submetidas à BLS houve diminuição da sensibilidade tátil nas duas regiões avaliadas em 40% (p<0.05). Nas provas cronaximétricas, a sensibilidade estava diminuída no grupo de mulheres submetidas à LAT em 56% na região axilar e 48% na região braquial proximal medial e no grupo BLS a sensibilidade estava diminuída em 39% e 14% respectivamente. CONCLUSÕES: A morbidade é maior a e funcionalidade do braço é menor em mulheres submetidas à LAT, quando comparadas à BLS, em mulheres operadas por câncer de mama / OBJECTIVES: The aim of this study was to evaluate and compare occurrence of lymphedema, pain, motion restriction and sensory deficit in the upper homolateral limb at 1 day, 15 days, 3 months, 6 months and 18 months after axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) after breast cancer surgery. METHODS: A controlled study was designed to include patients who underwent breast conservative surgery and ALND or SLNB. Patients were evaluated between December 2003 and December 2004, and they were divided into two groups, group A (n=100) consisted who had ALND and group B, with patients after only SLNB (n=50). All of them subjectively answer a \"yes\" or \"no\" questionnaire in which were included questions about incidence of lymphedema, pain, motion restriction and arm numbness at 1day (n=30), 15 days (n=30), 3 months (n=30), 6 months (n=30) and 18 months (n=30) after surgery. Besides this a physiotherapy examination was performed measuring circunference, shoulder adbuction range by a goniometer, sensibility tests by pressure Semmes-Weinsten monofilaments and by eletrodiagnostic tests using an universal stimulator. RESULTS: In the group A significant differences (p < 0,05) were seen in subjectively sensations, with significantly higher incidence of subjective swelling (31%), pain (58%), motion restriction (52%), arm numbness (57%). In group B there were less symptoms of subjective swelling (2%), pain (58%), motion restriction (24%), arm numbness (20%). In clinical examination sensory deficit using monofilaments the occurrence of numbness was 82% on axillary fold and 73% on medial part of upper arm after ALND and in 40% on axillary fold and medial part of upper arm after SLNB, with significantly different between the groups (p < 0.05). At cronaximetric proofs the sensibility was decreased in 56% in the axillary fold and 48% in the medial part of upper arm for ALND and 39% in the axillary fold and 14% at medial part of upper arm on patients who underwent SLNB. CONCLUSIONS: Arm morbidity is higher and function is lower after ALND compared to SLNB, in women submitted to breast cancer surgery

Introdução: Os cânceres de mama subtipos Luminal A e B (HER2 negativo) podem apresentar prognóstico variável, a depender do índice de proliferação, avaliado pelo Ki67. As células malignas e as células estromais adjacentes (fibroblastos e células de resposta imune ) podem interagir tanto pelo contato célula a célula como por fatores secretados por elas, ambas influenciando no comportamento tumoral. Já foi demonstrado que as células estromais podem aumentar a proliferação das células do câncer da mama. Objetivo: Nosso objetivo foi avaliar o perfil de expressão gênica de células do estroma em câncer de mama luminal A e luminal B e analisar se este se correlaciona com o prognóstico da doença. Pacientes e Métodos/ Resultados: Amostras de tumores de 11 pacientes na pós menopausa foram analisadas, todas elas HER2 negativas. A expressão de Ki67 foi <= 10 % em 5 pacientes (luminal A) e >= 30 % em outras 6 amostras(Luminal B ). Células estromais foram microdissecadas para a extração de RNA, que posteriormente foi hibridizado na plataforma de microarray Agilent G485 -1A GE 8x60K. Após a normalização, 50 % dos genes com a maior variância foram selecionados para análise por SAM duas classes desemparelhado (software TMEV ) e aceitando FDR 14.1%, 35 sequências foram identificadas como diferencialmente expressas, incluindo 16 genes conhecidos, entre as células estromais das amostras de Luminal A versos Luminal B, todos mais expressos nas amostras B. Dentre as funções biológicas enriquecidas em genes diferencialmente expressos encontram-se regulação positiva do sistema imune, incluindo genes como ZAP70 (proteína quinase 70kDa associada a cadeia zeta (TCR)), CD38 (molécula CD38); UBASH3A (ubiquitina associada e SH3 domínio que contém A); PLA2G7 (fosfolipase A2, grupo VII (fator acetil ativador de plaquetas no plasma)); NCR3 (citotoxicidade natural, provocando receptor 3). Nosso próximo passo foi avaliar se a expressão de alguns genes selecionados estava associada com prognóstico de tumores luminais. Para tal selecionamos amostras de outro grupo de 89 pacientes com seguimento de pelo menos 5 anos, cujos tumores eram ER(+), HER2(-), para análise de expressão proteica em Tissue microarray. Caracterizamos os fibroblastos destas amostras com 3 marcadores de fibroblastos: actina de músculo liso (AML), S100A4 e caveolina-1 (CAV1) e analisamos a marcação da proteína ZAP70. Correlacionamos a expressão proteica de todos os marcadores com as características anatomopatológicas da amostra. Observamos que fibroblastos de todas as amostras de tumor de mama expressam AML, S100A4 e CAV1, em diferentes proporções, entretanto não detectamos diferença entre os tumores luminais A e B. Também não obsevamos diferença de expressão de AML, S100A4 e CAV1 em relação a grau histológico, comprometimento linfonodal e estadiamento clínico. Nestas amostras não detectamos expressão proteica de ZAP70 em fibroblastos tumorais. Conclusão: Houve expressão diferencial de 16 genes relacionados a processos imunes, todos eles mais expressos em células estromais de tumores Luminal B em relação a luminal A / Introduction: Luminal breast cancer subtypes A and B (HER2 negative) may present a variable prognosis, depending on tumor proliferation index, evaluated by Ki67 expression. Malignant cells and adjacent stromal cells (fibroblasts and immune response cells) may interact by both cell contact and secreted factors and influence tumor behavior. It was shown that stromal cells may enhance breast cancer cells proliferation. Objective: Our aim was to evaluate stromal cells gene expression profile in luminal A and luminal B tumors and to evaluate whether selected transcripts expressed in stromal cells may be associated with prognosis in breast cancer. Material/ Methods and Results: Hormone receptor positive tumor samples from 11 post menopausal patients were analyzed, all of them Her2 negative. Ki67 expression <= 10% (luminal A) was observed in five and Ki67 >= 30% (luminal B) in six samples. Stromal cells were microdissected for RNA extraction, which was hybridized in Agilent G485-1A GE 8x60K microarray platform. After normalization, 50% of the genes with the highest variance were selected for further analysis by two class unpaired SAM (TMEV software) and accepting FDR 14,1%, 35 sequences, including 16 known genes, were found differentially expressed between stromal cells from luminal A vs luminal B breast cancer samples, all of them more expressed in luminal B. Among biological functions enriched in genes found differentially expressed were positive regulation of immune system process, including genes as: ZAP70 (zeta-chain (TCR) associated protein kinase 70kDa); CD38 (CD38 molecule); UBASH3A (ubiquitin associated and SH3 domain containing A); PLA2G7 (phospholipase A2, group VII (platelet-activating factor acetylhydrolase, plasma); NCR3 (natural cytotoxicity triggering receptor 3). Our next step was evaluate whether expression of selected genes was associated with prognosis in another group of patients. Tumor samples from 89 patients with at least 5 years of follow up, all of them estrogen receptor positive and HER2 negative, were selected. Tissue microarray was prepared with stromal tumor compartment from paraffin embedded tumor samples. Fibroblasts were characterized for the expression of 3 fibroblasts markers (alfa-SMA, alpha smooth muscel actin; S100A4 and CAV1, caveolin 1), and ZAP70. Correlation of expression of these markers with prognostic variables was determined. Expression of alfa-SMA, S100A4 and CAV1 was detected in fibroblasts from all tumor samples in different proportions, however no differential expression was observed between luminal A and B tumors. Neither difference was detected on the expression of these proteins in relation with histological grade, lymph node involvement and clinical stage. Conclusion: A differential expression of 16 genes involved in immune process was found, all of them more expressed in fibroblasts from luminal B as compared with luminal A tumors

Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.