1
|
Tan CC, Lim D, Mohd Hisham NQ, Elias NA, Azli AS, Goh YC. Clinicopathological correlation of oral candidiasis - Our experience in a tertiary centre over two decades. Malays J Pathol 2023; 45:237-246. [PMID: 37658533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
INTRODUCTION Oral candidiasis is one of the most common fungal infections that has been widely reported around the world. In Malaysia, the available studies for this infection are scarce. MATERIALS AND METHODS This is a 20-year retrospective study aimed to investigate the prevalence, demographic characteristics, clinical presentations, and the association of oral candidiasis with clinical parameters in oral candidiasis cases reported in the Faculty of Dentistry, Universiti Malaya from 1999 until 2019. A total of 12,964 histopathological records from the Oral Pathology Diagnostic and Research Laboratory (OPDRL) between 1999 to 2019 were retrieved. Oral candidiasis cases were selected according to the inclusion and exclusion criteria. Information of interest was obtained and analysed. RESULTS From the total records retrieved, 378 oral candidiasis cases were recorded and 82.8% were diagnosed from smear test. This study showed that oral candidiasis was predominantly reported in female (64.2%) and Indian population (64.2%). The peak incidence was in the sixth decades of life (27.0%). The most commonly affected site was tongue and coated tongue was the most common clinical presentation. More than 50% of the cases had comorbidity and 10.6% were associated with dentures. Ethnicity and site of occurrence were significantly associated (p<0.05) with oral candidiasis. CONCLUSION This is the first large-scale study of oral candidiasis cases in Malaysia. The findings of this study are useful for clinical assessment of patients suspected of oral candidiasis.
Collapse
Affiliation(s)
- C C Tan
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, 50603 Kuala Lumpur, Malaysia
| | - D Lim
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, 50603 Kuala Lumpur, Malaysia
| | - N Q Mohd Hisham
- Universiti Malaya, Faculty of Dentistry, 50603 Kuala Lumpur, Malaysia
| | - N A Elias
- Universiti Malaya, Faculty of Dentistry, 50603 Kuala Lumpur, Malaysia
| | - A S Azli
- Universiti Malaya, Faculty of Dentistry, 50603 Kuala Lumpur, Malaysia
| | - Y C Goh
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, 50603 Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Haron N, Rajendran S, Kallarakkal TG, Zain RB, Ramanathan A, Abraham MT, Lau SH, Cheng LC, Chong SMY, Mohamed Azahar FA, Mohamad Zaini Z, Chan SW, Goh YC, Lim D, Khairi J, Abidin MZ, Abdul Rahman ZA, Liew CS, Fong SC, Yang YH, Ismail SM, Cheong SC. High referral accuracy for oral cancers and oral potentially malignant disorders using telemedicine. Oral Dis 2023; 29:380-389. [PMID: 33914993 DOI: 10.1111/odi.13892] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/02/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the accuracy of MeMoSA®, a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral. SUBJECTS AND METHODS A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA®. The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions. RESULTS Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892, respectively. Sensitivity and specificity for referral decision were 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3%, respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA®. CONCLUSION Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.
Collapse
Affiliation(s)
| | | | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rosnah Binti Zain
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Dentistry, Saujana Putra Campus, MAHSA University, Selangor, Malaysia
| | - Anand Ramanathan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Mannil Thomas Abraham
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Shin Hin Lau
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Lai Choo Cheng
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Sherrie Mei Yee Chong
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Farah Aliya Mohamed Azahar
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Wui Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Juliana Khairi
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Marzuki Zainal Abidin
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zainal Ariff Abdul Rahman
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia.,Data Intensive Computing Centre, Research Management & Innovation Complex, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Data Science, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Sok Ching Cheong
- Cancer Research Malaysia, Selangor, Malaysia.,Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
3
|
Ngeow WC, Tan CC, Goh YC, Deliberador TM, Cheah CW. A Narrative Review on Means to Promote Oxygenation and Angiogenesis in Oral Wound Healing. Bioengineering (Basel) 2022; 9:636. [PMID: 36354548 PMCID: PMC9688034 DOI: 10.3390/bioengineering9110636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/19/2022] [Accepted: 10/29/2022] [Indexed: 08/22/2023] Open
Abstract
Oral mucosa serves as the primary barrier against pathogen invasions, mechanical stresses, and physical trauma. Although it is generally composed of keratinocytes and held in place by desmosomes, it shows variation in tissue elasticity and surface keratinization at different sites of the oral cavity. Wound healing undergoes four stages of tissue change sequences, namely haemostasis, inflammation, proliferation, and remodelling. The wound healing of oral hard tissue and soft tissue is largely dependent on the inflammatory response and vascular response, which are the targets of many research. Because of a less-robust inflammatory response, favourable saliva properties, a unique oral environment, and the presence of mesenchymal stem cells, oral wounds are reported to demonstrate rapid healing, less scar formation, and fewer inflammatory reactions. However, delayed oral wound healing is a major concern in certain populations with autoimmune disorders or underlying medical issues, or those subjected to surgically inflicted injuries. Various means of approach have been adopted to improve wound tissue proliferation without causing excessive scarring. This narrative review reappraises the current literature on the use of light, sound, mechanical, biological, and chemical means to enhance oxygen delivery to wounds. The current literature includes the use of hyperbaric oxygen and topical oxygen therapy, ultrasounds, lasers, platelet-rich plasma (PRP)/platelet-rich fibrin (PRF), and various chemical agents such as hyaluronic acid, astaxanthin, and Centella asiatica to promote angiogenesis in oral wound healing during the proliferation process. The arrival of a proprietary oral gel that is reported to improve oxygenation is highlighted.
Collapse
Affiliation(s)
- Wei Cheong Ngeow
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Chuey Chuan Tan
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Yet Ching Goh
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | | | - Chia Wei Cheah
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
4
|
Kallarakkal TG, Ismail SM, Goh YC. Zymogen-poor acinic cell carcinoma of the soft palate with high-grade transformation. Malays J Pathol 2022; 44:121-127. [PMID: 35484895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Acinic cell carcinoma is an uncommon malignant salivary gland tumour accounting for approximately 6-7% of all salivary gland neoplasms. The key diagnostic feature of acinic cell carcinoma is the presence of acinar cell differentiation characterised by cytoplasmic zymogen secretory granules. This tumour shows a variety of growth patterns, including solid, microcystic, follicular and papillary cystic patterns. Acinic cell carcinoma is typically a cytologically low-grade malignancy. Acinic cell carcinomas with high-grade transformation (HGT) are exceedingly rare and are reported to have a more aggressive clinical course than conventional acinic cell carcinoma. This is a case report of this uncommon entity with high-grade transformation arising on the soft palate in a 64-year-old woman.
Collapse
Affiliation(s)
- T G Kallarakkal
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, Kuala Lumpur, Malaysia
| | - S M Ismail
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, Kuala Lumpur, Malaysia
| | - Y C Goh
- Universiti Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, Kuala Lumpur, Malaysia.
| |
Collapse
|
5
|
Rajendran S, Mohamad Zaini Z, Lim YZ, Kallarakkal TG, Ramanathan A, Chan SW, Goh YC, Tan CC, Lim D, Hassan MK, Kanapathy J, Pathmanathan D, Chan CS, Liew CS, Ismail SM, Cheong SC. Accelerated implementation of teleconsultation services for the monitoring of oral potentially malignant disorders as a result of the COVID-19 pandemic. Oral Oncol 2022; 126:105730. [PMID: 35176655 PMCID: PMC8842584 DOI: 10.1016/j.oraloncology.2022.105730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Senthilmani Rajendran
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ying Zhi Lim
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Anand Ramanathan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Siew Wui Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chuey Chuan Tan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Kamil Hassan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jananezwary Kanapathy
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Chee Seng Chan
- Centre of Image and Signal Processing, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Centre for Data Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Sok Ching Cheong
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| |
Collapse
|
6
|
Goh YC, Siriwardena BSMS, Tilakaratne WM. Association of clinicopathological factors and treatment modalities in the recurrence of ameloblastoma: Analysis of 624 cases. J Oral Pathol Med 2021; 50:927-936. [PMID: 34358362 DOI: 10.1111/jop.13228] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high recurrence rate after treatment. Conventional ameloblastoma is reportedly been more aggressive showing infiltrative growth patterns and a tendency for recurrence. This is a retrospective study performed to analyse the relationship between clinicopathological characteristics and treatment modalities in the recurrence of ameloblastoma. METHODS 624 cases of ameloblastoma comprising of 519 non-recurrent ameloblastoma and 105 recurrent ameloblastoma from two main diagnostic centres in Malaysia and Sri Lanka were included. The demographic data, clinical characteristics, histopathological data, treatment modality and episodes of recurrence were extracted and analysed. RESULTS The mean age for recurrent ameloblastoma was 37.23 with a peak occurrence in the third decade of life. Recurrent ameloblastoma was marginally female predominant with male to female ratio of 1:1.3. Mandible was the commonest site for the recurrence with a predilection for more than two segments of left mandible followed by left posterior mandible. Follicular (58.1%) histopathological variant was the most reported type to recur followed by plexiform (17.1%). 49.5% of recurrent cases were treated with conservative approach. 65.7% of recurrent cases demonstrated a single episode of recurrence. Mixed (follicular and plexiform) histopathological variants showed the longest average years (11.5 years) for the single episode of recurrence. Plexiform ameloblastoma treated with conservative approach recurred in the shortest follow-up period. The recurrence of ameloblastoma was significantly associated with age group, sub-site of occurrence and histopathological variants (p<0.05). CONCLUSION This study showed that age, sub-site of occurrence and histopathological variants are significant factors responsible for the recurrence of ameloblastoma.
Collapse
Affiliation(s)
- Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | | | - Wanninayake Mudiyanselage Tilakaratne
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka
| |
Collapse
|
7
|
Lim D, Tan CC, Tilakaratne WM, Goh YC. Sclerosing odontogenic carcinoma - review of all published cases: is it a justifiable addition as a malignancy? Braz J Otorhinolaryngol 2021; 88:118-129. [PMID: 33715971 PMCID: PMC9422715 DOI: 10.1016/j.bjorl.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/08/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Sclerosing odontogenic carcinoma was a new addition to the list of head and neck tumors by World Health Organization in 2017. This lesion has scarcely been reported and a lack of pathognomonic markers for diagnosis exists. OBJECTIVE The aim of the study was to summarize findings from the available literature to provide up-to-date information on sclerosing odontogenic carcinoma and to analyse clinical, radiological, and histopathological features to obtain information for and against as an odontogenic malignancy. METHODS We conducted a comprehensive review of literature by searching Pubmed, EBSCO and Web of Science databases, according to PRISMA guidelines. All the cases reported as sclerosing odontogenic carcinoma in English were included. Data retrieved from the articles were gender, age, clinical features, site, relevant medical history, radiographical findings, histopathological findings, immunohistochemical findings, treatments provided and prognosis. RESULTS Mean age at diagnosis of sclerosing odontogenic carcinoma was 54.4 years with a very slight female predilection. Sclerosing odontogenic carcinoma was commonly reported in the mandible as an expansile swelling which can be asymptomatic or associated with pain or paraesthesia. They appeared radiolucent with cortical resorption in radiograph evaluation. Histologically, sclerosing odontogenic carcinoma was composed of epithelioid cells in dense, fibrous, or sclerotic stroma with equivocal perineural invasion. Mild cellular atypia and inconspicuous mitotic activity were observed. There is no specific immunohistochemical marker for sclerosing odontogenic carcinoma. AE1/AE3, CK 5/6, CK 14, CK19, p63 and E-cadherin were the widely expressed markers for sclerosing odontogenic carcinoma. Surgical resection was the main treatment provided with no recurrence in most cases. No cases of metastasis were reported. CONCLUSION From the literature available, sclerosing odontogenic carcinoma is justifiable as a malignant tumor with no or unknown metastatic potential which can be adequately treated with surgical resection. However, there is insufficient evidence for histological grading or degree of malignancy of this tumor.
Collapse
Affiliation(s)
- Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Malaysia
| | - Chuey Chuan Tan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Malaysia
| | | | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Malaysia.
| |
Collapse
|
8
|
Goh YC, Tan CC, Lim D. Coronoid hyperplasia: A review. J Stomatol Oral Maxillofac Surg 2020; 121:397-403. [PMID: 31904534 DOI: 10.1016/j.jormas.2019.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 01/29/2023]
Abstract
Coronoid hyperplasia is one of the rare causes of progressive limitation of mouth opening due to impingement of the enlarged coronoid process of the mandible on the zygomatic bone. A review was performed on all cases reports and case series on coronoid hyperplasia. Gender, age at treatment, age of onset, types of hyperplasia (unilateral/bilateral), associated history, treatment, surgical approach, preoperative mouth opening, intraoperative mouth opening, mouth opening at follow up and follow up period were recorded and analyzed. A total of 82 articles which reported 115 cases were included. Coronoid hyperplasia was commonly reported at mean age of 22.64 years old with male preponderance. Most of the cases were diagnosed and treated between the age of 11-20 years old. This condition commonly involved bilateral coronoid process of mandible. The mean width of preoperative mouth opening was 16.5mm and was improved to a mean mouth opening of 36.3mm intraoperatively. Mean mouth opening was 34.8mm at an average follow up of 19 months. While the etiopathogenesis of coronoid hyperplasia is still not conclusive, treatment with either coronoidectomy or coronoidotomy produced good improvement in mouth opening.
Collapse
Affiliation(s)
- Y C Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - C C Tan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - D Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| |
Collapse
|
9
|
Goh YC, Chan SW, Siar CH. Parenchyma-stromal interleukin-1 alpha and interleukin-6 overexpressions in ameloblastoma correlate with the aggressive phenotype. Malays J Pathol 2019; 41:303-311. [PMID: 31901915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Ameloblastoma is a benign but locally invasive odontogenic epithelial neoplasm with a high recurrence rate after treatment. The two main subsets encountered clinically are unicystic (UA) and solid/multicystic ameloblastoma (SMA). Currently neoplastic progression of many tumour types are believed to be related to parenchyma-stromal cell-cell interactions mediated by cytokines notably interleukins (IL). However their roles in ameloblastoma remain ill-understood. MATERIALS AND METHODS Thirty-nine formalin-fixed paraffin-embedded ameloblastoma cases comprising unicystic ameloblastoma (n=19) and solid/multicystic ameloblastoma (n=20) were subjected to IHC staining for IL-1α, IL-1β, IL-6 and IL-8. A semi-quantitative method was used to evaluate the expression levels of these cytokines according to cell types in the tumoural parenchyma and stroma. RESULTS Major findings were upregulations of IL-1α and IL-6 in SMA compared to UA. Both cytokines were heterogeneously detected in the tumoural parenchyma and stroma. Within the neoplastic epithelial compartment, IL-1α expression was more frequently detected in PA-like cells in UA whereas it was more frequently encountered in SR-like cells in SMA. IL-6 demonstrated higher expression levels in the stromal compartment of SMA. IL-1β and IL-8 were markedly underexpressed in both tumour subsets. CONCLUSIONS Overexpression of IL-1α in SMA suggests that this growth factor might play a role in promoting bone resorption and local invasiveness in this subtype. The expression levels of IL-1α and IL-6 in three cellular localizations indicate that parenchymal-stromal components of ameloblastoma interact reciprocally via IL-1α and IL-6 to create a microenvironment conducive for tumour progression.
Collapse
Affiliation(s)
- Y C Goh
- University of Malaya, Faculty of Dentistry, Department of Oral and Maxillofacial Clinical Sciences, Kuala Lumpur, Malaysia.
| | | | | |
Collapse
|
10
|
Eng A, Chan WH, Goh YC, Ong HS, Wong WK, Cingolani P, D'Angelo L, Chwat C, Iudica F, Terrés M, Marchionatti S, Lemme G. Topic: Incisional Hernia - Prophylactic Mesh. Hernia 2015; 19 Suppl 1:S248. [PMID: 26518814 DOI: 10.1007/bf03355363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- A Eng
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - W H Chan
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - Y C Goh
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - H S Ong
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - W K Wong
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - P Cingolani
- Department of General Surgery, Hospital Universitario Austral, Pilar, Argentina
| | | | | | | | | | | | | |
Collapse
|
11
|
Chan WH, Khin LW, Chung YFA, Goh YC, Ong HS, Wong WK. Randomized controlled trial of standard versus high-dose intravenous omeprazole after endoscopic therapy in high-risk patients with acute peptic ulcer bleeding. Br J Surg 2011; 98:640-4. [DOI: 10.1002/bjs.7420] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2010] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Rebleeding from peptic ulcers is a major contributor to death. This study compared standard (40-mg intravenous infusion of omeprazole once daily for 3 days) and high-dose (80-mg bolus of omeprazole followed by 8-mg/h infusion for 72 h) in reducing the rebleeding rate (primary endpoint), need for surgery, duration of hospital stay and mortality in patients with peptic ulcer bleeding after successful endoscopic therapy.
Methods
This was a single-institution prospective randomized controlled study based on a postulated therapeutic equivalence of the two treatments. All patients who had successful endoscopic haemostasis of a bleeding peptic ulcer (Forrest classification Ia, Ib, IIa or IIb) were recruited. Informed consent was obtained and patients were randomized to receive standard- or high-dose infusions of intravenous omeprazole.
Results
Two (3 per cent) of 61 patients in the high-dose group and ten (16 per cent) of 61 in the standard-dose group exhibited rebleeding, a difference of − 13 (95 per cent confidence interval − 25 to − 2) per cent. The upper limit of the one-sided confidence interval exceeded a predefined equivalence absolute difference of 16 per cent. Equivalence of standard- and high-dose omeprazole in preventing rebleeding was not demonstrated.
Conclusion
Intravenous standard-dose omeprazole was inferior to high-dose omeprazole in preventing rebleeding after endoscopic haemostasis for peptic ulcer bleeding. Registration number: NCT00519519 (http://www.clinicaltrials.gov).
Collapse
Affiliation(s)
- W H Chan
- Department of Surgery, Singapore General Hospital, National Heart Centre Singapore, Singapore, Republic of Singapore
| | - L W Khin
- Clinical Trial Unit, Department of Cardiology, National Heart Centre Singapore, Singapore, Republic of Singapore
| | - Y F A Chung
- Department of Surgery, Singapore General Hospital, National Heart Centre Singapore, Singapore, Republic of Singapore
| | - Y C Goh
- Department of Surgery, Singapore General Hospital, National Heart Centre Singapore, Singapore, Republic of Singapore
| | - H S Ong
- Department of Surgery, Singapore General Hospital, National Heart Centre Singapore, Singapore, Republic of Singapore
| | - W K Wong
- Department of Surgery, Singapore General Hospital, National Heart Centre Singapore, Singapore, Republic of Singapore
| |
Collapse
|
12
|
Ooi LL, Goh YC, Chew SP, Tay KH, Foo E, Low CH, Ch'ng HC, Chan ST, Soo KC. Bile duct injuries during laparoscopic cholecystectomy: a collective experience of four teaching hospitals and results of repair. Aust N Z J Surg 1999; 69:844-6. [PMID: 10613280 DOI: 10.1046/j.1440-1622.1999.01714.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Laparoscopic cholecystectomy has been performed in Singapore since 1990 and, up until the end of 1997, a total of 4445 procedures had been performed in the four major teaching hospitals. Although bile duct injuries were thought to have increased following the introduction of laparoscopic cholecystectomy, there have been no reviews done on the incidence of these injuries in the Singapore context. METHODS The present retrospective review aimed to audit the rate of bile duct injuries in the four major teaching hospitals in Singapore and to document the results of management of these injuries. RESULTS Of the 4445 procedures performed, there were 19 (0.43%) cases of bile duct injuries. These involved the common hepatic duct (n = 8), common bile duct (n = 10), and the right hepatic duct (n = 1). The underlying gall bladder pathology included non-inflamed gall bladders (n = 10), acute cholecystitis (n = 4), Mirrizzi's syndrome (n = 3) and mucocele of the gall bladder (n = 2). Transection of the duct accounted for the majority of the injuries. Eleven bile duct injuries were identified at the time of operation. These were primarily repaired over a T tube (n = 4) or by a bilio-enteric bypass (n = 7). The remainder were diagnosed at a median of 7 days (range: 1-556 days) after surgery with a presentation of jaundice or pain. These were repaired by bilio-enteric anastomosis (n = 7) and closure over a T tube (n = 1). Three patients developed strictures subsequently, two following bilio-enteric repair after delayed diagnosis and one following immediate primary repair over a T tube. One patient developed intrahepatic stones and required a left lateral segmentectomy. CONCLUSIONS The experience of a 0.43% bile duct injury rate is comparable to the best results from most large series in the West. Inflammation at Calot's triangle is an important associated factor for injury. Early recognition and prompt repair affords good results, and hepaticojejunostomy is recommended as the repair of choice.
Collapse
Affiliation(s)
- L L Ooi
- Department of Surgery, Singapore General Hospital, Singapore.
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
PURPOSE This study was undertaken to compare postoperatively laparoscopic (LAR) with open (OAR) anterior resection in patients with rectosigmoid cancers. METHODS Forty consecutive patients were divided into two groups: 20 patients (9 males) were allocated to LAR and 20 patients (6 males) to OAR. RESULTS Median age in the LAR group was 62 (range, 39-77) years, and in the OAR group, it was 61 (range, 43-84) years (P = 0.9). Median lengths of the distal margin of clearance beyond the tumor were 4 (range, 2-8) cm and 4.5 (range, 3-7.5) cm in the LAR and OAR groups, respectively (P = 0.35). Median numbers of lymph nodes harvested were 20 (range, 7-49) and 19 (range, 7-97) for the LAR and OAR groups, respectively (P = 0.44). Median operating times were 90 (range, 55-185) minutes and 73 (range, 40-140) minutes in the LAR and OAR groups, respectively (P = 0.08). Blood losses were 50 (range, 50-800) ml and 50 (range, 50-1,500) ml in the LAR and OAR groups, respectively. There was no intraoperative complication in either group, and no laparoscopic patient was converted to an open procedure. Median length of extraction site incision in the LAR group was 5.5 (4-13) cm, and length of incision in the OAR group was 18 (8-25) cm (P < 0.002). CONCLUSION There were no significant differences between the two groups with regard to duration of parenteral analgesia, starting of fluid and solid diet after surgery, or time to first bowel movement and time to discharge from the hospital.
Collapse
Affiliation(s)
- Y C Goh
- Department of Colorectal Surgery, Singapore General Hospital, Singapore
| | | | | |
Collapse
|