Displaying publications 1 - 20 of 91 in total

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  1. Al-Namnam NM, Kutty MG, Chai WL, Ha KO, Kim KH, Siar CH, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 Mar 01;72:332-340.
    PMID: 28024594 DOI: 10.1016/j.msec.2016.11.086
    Recently, a modified form of a three-dimension (3D) porous poly(caprolactone-trifumarate) (PCLTF) scaffold has been produced using a fabrication technique that involves gelatin microparticles porogen leaching. This poly(caprolactone trifumarate-gelatin microparticles) (PCLTF-GMPs) scaffold has been shown to be biocompatible, more flowable clinically, and has a shorter degradation time as compared to its existing predecessors. In this report, a detailed characterization of this new scaffold was performed by testing its cytocompatibility, analyzing the surface topography, and understanding its thermal, physical and mechanical properties. The result showed that the PCLTF-GMPs has no critical cytotoxic effect. To confirm improvement, the surface properties were compared against the older version of PCLTF fabricated using salt porogen leaching. This PCLTF-GMPs scaffold showed no significant difference (unpaired t-test; p>0.05) in mechanical properties before and after gelatin leaching. However, it is mechanically weaker when compared to its predecessors. It has a high biodegradability rate of 16weeks. The pore size produced ranges from 40 to 300μm, and the RMS roughness is 613.7±236.9nm. These characteristics are condusive for osteoblast in-growth, as observed by the extension of filopodia across the macropores. Overall, this newly produced material has good thermal, physical and mechanical properties that complements its biocompatibility and ease of use.
  2. Alblazi KM, Siar CH
    Asian Pac J Cancer Prev, 2015;16(6):2187-91.
    PMID: 25824735
    BACKGROUND: Protrusive structures formed by migrating and invading cells are termed lamellipodia, filopodia, invadopodia and podosomes. Lamellipodia and filopodia appear on the leading edges of migrating cells and function to command the direction of the migrating cells. Invadopodia and podosomes are special F-actin-rich matrix-degrading structures that arise on the ventral surface of the cell membrane. Invadopodia are found in a variety of carcinomatous cells including squamous cell carcinoma of head and neck region whereas podosomes are found in normal highly motile cells of mesenchymal and myelomonocytic lineage. Invadopodia-associated protein markers consisted of 129 proteins belonging to different functional classes including WASP, NWASP, cortactin, Src kinase, Arp 2/3 complex, MT1-MMP and F-actin. To date, our current understanding on the role(s) of these regulators of actin dynamics in tumors of the orofacial region indicates that upregulation of these proteins promotes invasion and metastasis in oral squamous cell carcinoma, is associated with poor/worst prognostic outcome in laryngeal cancers, contributes to the persistent growth and metastasis characteristics of salivary gland adenoid cystic carcinoma, is a significant predictor of increased cancer risk in oral mucosal premalignant lesions and enhances local invasiveness in jawbone ameloblastomas.
  3. Barakat SM, Siar CH
    J Appl Oral Sci, 2015 Jan-Feb;23(1):79-86.
    PMID: 25760270 DOI: 10.1590/1678-775720140245
    The identification of stem cells (SC) remains challenging. In the human oral mucosal epithelium, these cells are believed to be in the basal layer (stem cell niche), but their exact location is unclear. The aim of this study was to examine the dysplastic oral epithelium for these SC-like proteins in order to assess their diagnostic value as biomarkers complementing the histological grading of dysplasia.
  4. Cheah CW, Vaithilingam RD, Siar CH, Swaminathan D, Hornbuckle GC
    Implant Dent, 2014 Oct;23(5):593-601.
    PMID: 25192162 DOI: 10.1097/ID.0000000000000148
    To assess dimensional changes and histologic/histomorphometric aspects of grafted sockets using either calcium sulfate-platelet-rich plasma (CS-PRP) or CS alone in socket preservation procedure.
  5. Foo GC, Siar CH, Ling KC, Chin CT
    Med J Malaysia, 1983 Dec;38(4):334-8.
    PMID: 6599995
    Features of the typical ameloblastoma of the mandible are outlined. Three cases managed by conservative surgical treatment maintaining the continuity of the mandible are described. The factors taken into consideration when instituting this method of treatment are discussed. Results obtained are encouraging.
  6. Goh YC, Chan SW, Siar CH
    Malays J Pathol, 2019 Dec;41(3):303-311.
    PMID: 31901915
    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.

  7. Kawai H, Tsujigiwa H, Siar CH, Nakano K, Takabatake K, Fujii M, et al.
    Int J Med Sci, 2018;15(12):1406-1414.
    PMID: 30275769 DOI: 10.7150/ijms.24370
    Background: The tumor microenvironment and its stromal cells play an important role in cancer development and metastasis. Bone marrow-derived cells (BMDCs), a rich source of hematopoietic and mesenchymal stem cells, putatively contribute to this tumoral stroma. However their characteristics and roles within the tumor microenvironment are unclear. In the present study, BMDCs in the tumor microenvironment were traced using the green fluorescent protein (GFP) bone marrow transplantation model. Methods: C57BL/6 mice were irradiated and rescued by bone marrow transplantation from GFP-transgenic mice. Lewis lung cancer cells were inoculated into the mice to generate subcutaneous allograft tumors or lung metastases. Confocal microscopy, immunohistochemistry for GFP, α-SMA, CD11b, CD31, CD34 and CD105, and double-fluorescent immunohistochemistry for GFP-CD11b, GFP-CD105 and GFP-CD31 were performed. Results: Round and dendritic-shaped GFP-positive mononuclear cells constituted a significant stromal subpopulation in primary tumor peripheral area (PA) and metastatic tumor area (MA) microenvironment, thus implicating an invasive and metastatic role for these cells. CD11b co-expression in GFP-positive cells suggests that round/dendritic cell subpopulations are possibly BM-derived macrophages. Identification of GFP-positive mononuclear infiltrates co-expressing CD31 suggests that these cells might be BM-derived angioblasts, whereas their non-reactivity for CD34, CD105 and α-SMA implies an altered vascular phenotype distinct from endothelial cells. Significant upregulation of GFP-positive, CD31-positive and GFP/CD31 double-positive cell densities positively correlated with PA and MA (P<0.05). Conclusion: Taken together, in vivo evidence of traceable GFP-positive BMDCs in primary and metastatic tumor microenvironment suggests that recruited BMDCs might partake in cancer invasion and metastasis, possess multilineage potency and promote angiogenesis.
  8. Kechik KA, Siar CH
    Ann Diagn Pathol, 2018 Feb;32:17-22.
    PMID: 29414392 DOI: 10.1016/j.anndiagpath.2017.08.002
    BACKGROUND AND AIMS: The odontogenic keratocyst (OKC) remains the most challenging jaw cyst to treat because of its locally-aggressive behaviour and high recurrence potential. Emerging evidence suggests that osteopontin, its receptors CD44v6 and integrin αv, and podoplanin, have a role in the local invasiveness of this cyst. However the spatial distribution characteristics of these pro-invasive markers in the lining epithelium of OKC, and their association with the clinicopathologic parameters of OKC are largely unexplored. This study sought to address these issues in comparison with dentigerous cysts (DCs) and radicular cysts (RCs) and to evaluate their biological relevance.

    METHODS: A sample consisting of 20 OKC cases, 10 DCs and 10 RCs was subjected to immunohistochemical staining for osteopontin, CD44v6 and integrin αv, and podoplanin, and semiquantitative analysis was performed.

    RESULTS: All factors (except integrin αv) were detected heterogeneously in the constitutive layers of the lining epithelium in all three cyst types. Key observations were significant upregulation of CD44v6 and podoplanin in OKC compared to DCs and RCs, suggesting that these protein molecules may play crucial roles in promoting local invasiveness in OKC (P<0.05). Osteopontin underexpression and distribution patterns were indistinctive among all three cysts indicating its limited role as pro-invasive factor. Clinical parameters showed no significant correlations with all protein factors investigated.

    CONCLUSIONS: Present findings suggest that an osteopontinlow CD44v6high and podoplaninhigh immunoprofile most probably represent epithelial signatures of OKC and are markers of local invasiveness in this cyst.

  9. Koay CL, Lim JA, Siar CH
    Oral Dis, 2011 Mar;17(2):210-6.
    PMID: 20796228 DOI: 10.1111/j.1601-0825.2010.01724.x
    OBJECTIVES: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.
    SUBJECTS AND METHODS: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents.
    RESULTS: One hundred eighty-one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P 
  10. Lim JS, Tang SP, Siar CH
    Asian Pac J Cancer Prev, 2009;10(6):1071-4.
    PMID: 20192586
    BACKGROUND: Conventional methods for writing case notes detailing the progress of oral lichen planus (OLP), a precancerous condition that requires long-term surveillance, is both time-consuming and tedious for the busy clinician.

    OBJECTIVES: To design and perform a simple surveillance on OLP patients based on colour-coded topography mouth maps (TMM).

    MATERIALS AND METHODS: Three colour-coded TMM were employed: red for OLP in high risk oral mucosal sites, yellow for cases showing improvement and green for asymptomatic lesions at each recall visit. In this preliminary study, these were applied on 30 histologically confirmed OLP individuals attending the Oral Medicine Clinic at the Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya. The sites and extent of OLP lesions were charted on either red, yellow or green TMM based on defined criteria. This surveillance evaluated OLP in relation to patientandapos;s age, race, gender, underlying systemic conditions, oral habits, initial onset of OLP, oral manifestations and presence/absence of clinically suspicious areas.

    RESULTS: Study sample comprised 4 (13.3%) Malays, 9 (30.0%) Chinese and 17 (56.7%) Indians. Most OLP patients belong to the green TMM (n= 14, 46.6%) group followed by red (n= 11, 36.7%) and yellow (n= 5, 16.7%) groups. Of the 11 cases with red TMM, rebiopsy was performed on 4 cases but no dysplasia was detected. Any local confounding factors namely periodontal disease or faulty dental restorations were managed accordingly.

    CONCLUSIONS: TMM is simple to use and aided the clinicians in terms of time saving and patient management. Hence, follow-up of OLP patients can be carried out more efficiently and appropriately. TMM can be used for surveillance of other oral precancerous lesions and conditions.

  11. Majid ZA, Siar CH, Ling KC
    Med J Malaysia, 1986 Jun;41(2):179-82.
    PMID: 3821617
    An unusual case of fibrous epulis in a newborn is presented. The clinical appearance, histological features and method of treatment are described. A short review of the literature is also included.
  12. Ng KH, Siar CH
    PMID: 12738952
    Although rare, hard tissue deposits, namely dystrophic calcifications and cartilage, have been reported to occur in the connective tissue wall of the odontogenic keratocyst. However, dentinoid formation has not been previously documented. A case involving the left mandibular premolar-molar region in a 37-year-old Malay male is described here along with a brief review on the reported prevalence of hard tissue deposits in the odontogenic keratocyst. Differential diagnosis of this case from other dentinoid-forming odontogenic cysts and tumors-notably calcifying odontogenic cyst, odontoma, ameloblastic fibro-odontoma, central odontogenic fibroma and adenomatoid odontogenic tumor that may present with dentin/dentinoid formation-is discussed.
  13. Ng KH, Siar CH, Ganesapillai T
    PMID: 9247945
    We report two cases of body piercing as a religious practice that subsequently led to the development of granulomatous nodules at previously punctured sites of the skin and oral mucosa. These lesions were diagnosed as sarcoid-like foreign body reaction after other possible causes including sarcoidosis, tuberculosis, tuberculoid leprosy, fungal infections, viral infections, and Crohn's disease were excluded.
  14. Ng KH, Siar CH
    J Nihon Univ Sch Dent, 1995 Sep;37(3):156-62.
    PMID: 7490609
    Calcifying odontogenic cysts (COCs) represent a group of lesions that may be broadly classified into two main entities: cysts and neoplasms. In the present study 30 non-neoplastic cystic COCs were examined by a quantitative histological method in an attempt to calibrate the relative distribution of the type of epithelial lining, intensity of ghost cell formation and the amount of dentinoid present. The results showed that there are two main types of cystic COC: an odontoma-producing type and a non-odontoma-producing variant. Morphologically, tooth-like structures were a valid distinguishing feature, while morphometrically the odontoma-producing variant showed a greater amount of luminal and mural dentinoid as well as luminal ghost cells. Demographic analysis also revealed that the odontoma-producing COC occurred in younger patients and showed an even sex distribution, whereas the non-odontoma-producing type was seen in older patients and showed a predilection for females. Both subtypes were more prevalent in the Chinese population and occurred preferentially in the maxilla.
  15. Ng KH, Siar CH
    PMID: 8653464
    We reviewed biopsy records for 37 cases of oral histoplasmosis for patient characteristics, clinical features, and histopathologic findings. These represented cases diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur between July 1967 and October 1994. All were male patients who ranged in age from 11 to 79 years (mean age, 56.7 years). There were 40.6% Malays, 37.8% Chinese, 18.9% Indians, and 2.7% other races. Five patients with mouth lesions as the initial presenting lesions were proven to be cases of disseminated histoplasmosis. In the remaining cases apart from the biopsy-proven oral histoplasmosis lesions, the extent of the disease elsewhere was unknown. The majority of these lesions involved the gingiva, tongue, and palate in decreasing order of frequency. The most frequent presenting symptom was oral mucosal ulceration. Squamous cell carcinoma and tuberculosis were the two most common clinical differential diagnoses. Our present findings compare favorably with published reports from other regions.
  16. Ng KH, Siar CH
    Br J Oral Maxillofac Surg, 1993 Oct;31(5):299-303.
    PMID: 8218083
    Seventeen cases are reported of desmoplastic variant of ameloblastoma of the jaws observed during the years 1967-1991. There were 12 females and 5 males, and these consisted of 7 Chinese, 6 Malays, 2 Indians, 1 Sikh and 1 Kadazan. Their ages at diagnosis ranged from 21-60 years with a mean of 36.6 years. There were 10 mandibular and 7 maxillary tumours. Of these, 14 cases involved the anterior segment with extension to the premolar region in 5 cases. 60% of cases were radiologically suggestive of fibro-osseous lesions. The main mode of treatment was resection and 1 case presented with recurrence. The findings of this study were compared with those of previous reports.
  17. Ng KH, Siar CH, Abdul Latif H
    Ann Dent, 1992;51(1):29-31.
    PMID: 1632624
    Leiomyomas are benign neoplasms of smooth muscle origin. They represent rare entities in the oral cavity. A case arising from the incisive papilla region of a 3-month-old infant is described and the histogenesis as well as the biologic potential of this tumor are discussed.
  18. Ng KH, Siar CH
    J Nihon Univ Sch Dent, 1997 Dec;39(4):171-5.
    PMID: 9476429
    This report reviews the clinicopathologic characteristics of 104 cases of odontomas diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period (1967-1995). The results showed no real predilection in terms of sex (M:F ratio, 1:1), race (45.2% Malays, 40.4% Chinese, 10.6% Indians and 3.8% other races) or site (maxilla:mandible ratio, 1: 1.04) distribution. The mean age at presentation was 24.8 years and the age range was 3-74 years. There were 102 intraosseous and 2 extraosseous odontomas. Swelling was the most common presenting complaint. The majority of cases (81.9%) were clinically diagnosed as odontomas. The treatment of choice was surgical enucleation. Compound (43.3%) and complex (35.5%) odontomas were the two most common histological types encountered. The present findings correlate favorably with reported studies from other geographic areas.
  19. Ng KH, Siar CH
    J Laryngol Otol, 1996 Aug;110(8):757-62.
    PMID: 8869610
    We reviewed the clinicopathological characteristics of 13 cases of calcifying epithelial odontogenic tumour (CEOT) (Pindborg tumour) diagnosed in the Division on Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period. There were eight female and five male patients. These consisted of eight (61.5 per cent) Malays, three (23.1 per cent) Chinese, one (7.7 per cent) Indian and one (7.7 per cent) Melanau. Their ages at presentation ranged from 19-61 years (mean age, 31.8 years). There were 12 central and one peripheral CEOT. Of these, 76.9 per cent of cases were located in the maxilla, the remaining in the mandible. The commonest clinical diagnosis was a dentigerous cyst (66.7 per cent). Enucleation was the main mode of treatment. Histologically, sheets and strands of polyhedral epithelial cells containing eosinophilic, homogeneous globules with Liesegang rings were observed. One case also showed extensive calcification and clear cell differentiation. Immunohistochemistry revealed a variable keratin staining of the CEOT epithelium, confirming its heterogeneity.
  20. Ng KH, Siar CH, Loh HT
    Ann Dent, 1991;50(2):26-7.
    PMID: 1785910
    The clinical and histologic features of Kimura's disease are briefly outlined. A case presenting as a subcutaneous nodule in the region of the angle of the right mandible of a 20-year-old male is presented. The relationship of this disease to angiolymphoid hyperplasia with eosinophilia is discussed.
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