Breaking bad news: use of cancer survivors in role-playing exercises.

Purpose: To teach medical students how to deliver a diagnosis of cancer using role-play with a cancer survivor volunteer.

Method: Medical students participated in a curricular module on "breaking bad news." Its novel aspect was the inclusion of role-playing exercises during which the student communicated the initial diagnosis of cancer to a cancer survivor volunteer.

Comparative in vitro and in vivo studies on long-wavelength photosensitizers derived from bacteriopurpurinimide and Bacteriochlorin p6: fused imide ring enhances the in vivo PDT efficacy.

In situ conversion of bacteriochlorophyll-a, present in Rhodobacter sphaeroides (Rb. sphaeroides) gave bacteriopurpurin-18 in modest yield, which in a sequence of reactions was converted into two series of bacteriochlorins: bacteriopurpurinimide and bacteriopurpurin p6 with and without a fused imide ring system, respectively. To determine the effect of overall lipophilicity in photosensitizing efficacy, these bacteriochlorins were independently reacted with HBr gas and subsequently treated with various alkyl alcohols to afford the corresponding alkyl ether derivatives as diastereomeric mixtures (the R- and S-isomers were obtained in almost equal ratios).

A beam-splitting device for use with fiber-coupled laser light sources for photodynamic therapy.

A device that divides light into eight, four or two beams of equivalent power with only minor total power loss was designed, built and tested. The apparatus accepts light from a 200 microm diameter, 0.16 numerical aperture, silica-silica multimode optical fiber connected to one of several laser light sources for photodynamic therapy (PDT) of cancer.

A first comparative study of purpurinimide-based fluorinated vs. nonfluorinated photosensitizers for photodynamic therapy.

A first report on the synthesis and comparative in vitro-in vivo photosensitizing efficacy of various fluorinated and the corresponding nonfluorinated, purpurinimide-based photosensitizers is discussed. In preliminary in vivo screening, compared with the nonfluorinated analogs, purpurinimides bearing trifluoromethyl substituents showed enhanced photosensitizing efficacy. Among compounds (isomers) with similar lipophilicity, the position of the substituents was found to play a decisive role in biological efficacy.