The pellet morphology and diameter range (DR) of Ganoderma lucidum were observed in a repeated-batch fermentation (RBF) for the trio total production of biomass, exopolysaccharide (EPS) and endopolysaccharide (ENS). Two factors were involved in RBF; broth replacement ratio (BRR: 60%, 75% and 90%) and broth replacement time point (BRTP: log, transition and stationary phase) in days. In RBF, 34.31 g/L of biomass favoured small-compact pellets with DR of 20.67 µm< d < 24.00 µm (75% BRR, day 11 of BRTP). EPS production of 4.34 g/L was prone to ovoid-starburst pellets with DR of 34.33 µm< d <35.67 µm (75% BRR, day 13 of BRTP). Meanwhile, the highest 2.43 g/L of ENS production favoured large-hollow pellets with DR of 34.00 µm< d < 38.67 µm (90% BRR, day 13 of BRTP). In addition, RBF successfully shortened the biomass-EPS-ENS fermentation period (31, 33 and 35 days) from batch to 5 days, in seven consecutive cycles of RBF. In a FTIR detection, β-glucan (BG) from EPS and ENS extracts were associated with β-glycosidic linkages (2925 cm-1, 1635 cm-1, 1077 cm-1, 920 cm-1 and 800 cm-1 wavelengths) with similar 1H NMR spectral behaviour (4.58, 3.87 and 3.81 ppm). Meanwhile, 4 mg/L of BG gave negative cytotoxic effects on normal gingival cell line (hGF) but induced antiproliferation (IC50 = 0.23 mg/mL) against cancerous oral Asian cellosaurus cell line (ORL-48). Together, this study proved that G. lucidum mycelial pellets could withstand seven cycles of long fermentation condition and possessed anti-oral cancer beta-glucan, which suits large-scale natural drug fermentation.
Introduction and Objective: Tobacco use is a significant risk factor for oral diseases. Periodontal disease has been known to be associated with tobacco use for over twenty years. Despite that, dentists and particularly periodontist does not include tobacco use cessation as part of their initial treatment in treating periodontal disease or placing implants in patients who use tobacco. The increase in prevalence and severity of periodontitis among smokers
cannot be explained by differences in the amount of plaque between smokers and nonsmokers. A possible explanation is that smoking may alter the quality of the flora. Dental professionals also have a crucial role to play in tobacco cessation counseling, particularly for patients with chronic periodontitis. More patients will be affected by periodontitis than will ever be affected by oral cancer. Methods and Results: Reviews of literatures were
done on a clearly formulated question on the need of smoking cessation intervention to increase positive outcome of treatment on periodontal disease. Conclusion: Various epidemiological studies strongly suggest that tobacco use cessation is beneficial to patients following periodontal treatments for a better outcome.
We investigated the population burden of betel quid abuse and its related impact on oral premalignant disorders (OPDs) in South, Southeast, and East Asia.
Spindle-cell lipoma (SCL) of the oral cavity is very rare. There are only four such reported cases in the literature. A concise literature review of SCL and a case report of a SCL affecting the cheek and lip of a 23-year-old man is presented.
The diagnosis of oral cancer have been variously reported as being due to delay by clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer on more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
Odontogenic carcinomas of the jaws are subclassified into malignant ameloblastoma, ameloblastic carcinoma and primary intraosseous carcinoma arising from within the bone. These may arise from residual islands of epithelium derived from dental lamina or epithelial lining of dental cysts. Ameloblastic carcinoma is extremely rare. An aggressive case of ameloblastic carcinoma occumng in a 59-year-old Malay man is presented. Wide excision of the primary lesion with radical neck dissection was carried out. He developed lung metastasis 4 months post-operatively. Despite chemotherapy upon discovery of lung metastasis, he expired 7 months following the initial diagnosis.
This study aims to identify the relationship between dietary intakes of β-carotene with risk of oral cancer.
Methods: A hospital-based, case-control study was conducted on 306 Malaysians who seek treatment at participating centres/hospitals. Subjects selected from the Malaysian Oral Cancer Data and Tissue Banking System (MOCDTBS) consisted of 153 cases and 153 controls that were matched for gender, age (±5 years) and ethnicity. Food consumption was measured using Food Frequency Questionnaire (FFQ). NutrieMart Version 2.0.0 software was used to estimate daily nutrient of each subject from the FFQ. Logistic Regression analysis was conducted to compute the odds ratio (OR) for intakes of β-carotene and oral cancer risk.
Results: Intake of β-carotene was found to be not associated with risk of oral cancer (OR 0.83, 95%CI: 0.42-1.66, p>0.05).
Conclusion: No significant association was found between dietary intakes of β-carotene with oral cancer risk in this study population.
Oral cancer is the sixth most common malignancy in the world. Despite recent advances in cancer diagnoses and therapies, the five-year survival rate of oral cancer patients has remained at a dismal 50% in the last few decades. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits namely betel quid chewing, smoking and alcohol consumption. This paper provides a brief overview on the various aetiological agents and risk factors implicated in the development of oral cancer.
Background: MDM2 and p53 are involved in a negative feedback loop where p53 regulates MDM2 at the transcriptional level. MDM2, in turn, downregulates p53. This co-ordinated interaction between these proteins is set to play an important role in the regulation of cell cycle progression following DNA damage to cells. The over-expression of both p53 and MDM2 has been reported in various cancers. However there are only few studies discussing the co-expression of MDM2 with p53 in oral squamous cell carcinoma Aim: The purpose of this study was to determine the correlation of co-expression of p53, MDM2, and Ki-67 proteins with clinico-pathological factors in oral squamous cell carcinoma (OSCC) and to conduct a systematic review of the co-expression of p53/MDM2.
Method: This is a retrospective descriptive study and a systematic review. Formalin-fixed paraffinembedded tissues from 45 OSCC cases were stained by immunohistochemistry (IHC) for p53, MDM2, and Ki-67 proteins.
Results: Immuno-reactivity for p53, MDM2, and Ki-67 was seen in 75.6%, 97.8%, and 62.2% cases of OSCC respectively. The co-expression of p53 and MDM2 (p53/MDM2) was detected in 97.1%, however there was no significant correlation between p53 and MDM2 expression. Notably, p53/MDM2 coexpression was significantly associated with tumour differentiation (p-value = 0.045). The Ki-67LI was not significantly associated with neither MDM2 nor p53/MDM2 co-expression (p-value = 0.268, 0.916 respectively).
Conclusion: The expression of MDM2 was not signif icantly associated with p53 expression suggesting that MDM2 expression is mediated by p53-independent pathways or mutated p53 could not induce the expression of MDM2 in this set of OSCCs. The only clinico-pathological parameter that correlates significantly with co-expression of p53/MDM2 is tumour differentiation where it is suggestive that the co-expression of these 2 proteins is indicative of aggressive tumour behavior.
Tobacco use is linked with many serious illnesses, such as cancer, cardiopulmonary diseases, as well as with many health problems. Every year, the use of tobacco products causes a heavy toll of deaths and severe human disease worldwide. One of the many health problems linked to tobacco use is its detrimental impact on oral health. Tobacco causes a whole series of oral health problems, ranging from life-threatening (precancerous changes leading to oral cancer) and serious (periodontal disease, teeth decay) to social (bad breath). Tobacco is consumed through the mouth in a variety of forms, varied from smoked tobacco to smokeless tobacco chewing on itself or combined with areca nut. All these forms of tobacco have damaging effects on the oral health. The most significant preventive measure to prevent the oral health problems caused by tobacco use is to stop using tobacco products. The risk of developing oral cancer drops rapidly when a smoker ceases tobacco use. After ten years of not using tobacco, an ex-smoker/user's risk of oral cancers is about the same as that for someone who has never smoked. To stop using tobacco products is not an easy task. Fortunately, there are a number of therapies available to assist in quitting of tobacco. It is important to remember that, while it will be difficult, ceasing to use tobacco has immediate health benefits, including increased life expectancy and reduced risk of tobacco related diseases and conditions.
A study was carried out to investigate whether smoking had any effect on the Langerhans cells in the oral mucosa, which might throw light onto the mechanism of malignant transformation of some keratotic lesions in the oral cavity. Thirty-two cases of keratotic lesions from biopsy specimens of smokers and non-smokers were studied. Langerhans cells were identified by immuno cytochemical staining for 5100 proteins and their densities quantified. Smokers were associated with a significant reduction in the Langerhans cell population compared to non-smokers. The mean values of Langellans cell density in light smokers and heavy smokers were 2 2 2 28.64/mm and 33.421mm respectively compared to 66.51/mm in non- smokers. There was a dose-response relation between the number of cigarettes smoked daily and the effect on cell counts. These findings of a local immunological effect of smoking on oral epithelium may explain the means by which cigarette smoking contributes to the development of oral cancer.
The controversy on malignant transformation of oral lichen planus has always intrigued researchers. We present a case of lichenoid lesion and squamous cell carcinoma of the tongue, occurring in a middle aged Indian lady. The diagnosis and timing of these lesions is discussed.
The habit of chewing betel quid has been practised since ancient times. Although the world has gone through modernization, a significant proportion of people still practices this habit. Substantial evidence has shown that betel quid chewing is associated with the occurrence of oral cancer and precancerous lesions, which has a tremendous psychosocial impact on an individual's life. Thus it becomes significantly important to dentistry to look into this matter. Since betel quid chewing is one of the causes of oral cancer, effort in cha~ging this habit is essential. This article addresses this issue.
This paper attempts to review epidemiological studies of oral cancer and precancer in Malaysia. The defmitions of prevalence, incidence, risk habits and oral cancer and precancers were discussed to better understand' the different types of studies conducted, which would be important in making comparisons between studies. Currently, epidemiological data on oral cancer in Malaysia are sketchy. The only incidence data for oral cancer in Malaysia was reported by Hirayama in 1966, 35 years ago. He estimated that 3.1 new cases per 100,000 population were diagnosed for the year 1963. A number of histopathological data of oral and maxillofacial biopsies were reported. Oral cancer accounted for one-fifth of all oral biopsies. A national study on oral mucosal lesions in Malaysia carried out in 1993/4 reported that there was a variation seen in the occurrence of oral premalignancy among the ethnic groups. The Indians and the indigenous people of Sabah and Sarawak were identified as high risk groups for oral cancer and precancer. It was also observed that both of the ethnic groups chewed betel quid. In conclusion, the epidemiological studies have provided useful data, which may be used in planning for future oral health programmes and research towards enhancing Malaysia's on-going effort in preventing the occurrence of these diseases.
Oral cancer remains as a worldwide health issue. In Malaysia, oral neoplasm contributed about 10.6% death at the government hospitals. The significant consequences of delaying referral and poor prognosis of oral cancer was mainly due to the lack of knowledge among public. This study aims to determine the level of awareness and knowledge on oral cancer among students with non-medical background in Kepala Batas, Pulau Pinang, Malaysia. A cross sectional study using questionnaires were conducted among systematically randomly selected 275 non-medical background students aged 18 years old and above. The association of smoking habit with oral cancer awareness and knowledge was evaluated using chi-square test. Factors associated with the knowledge were determined at both univariable and multivariable levels using simple logistic and multiple logistic regression analyses respectively. Oral cancer awareness level was high among the students (85%) even though knowledge on early signs of oral cancer was low (19 years old has 1.96 time the odds compared to students aged ≤19 to have poor knowledge while Malay has 4.28 time the odds compared to Indian to have poor knowledge. Although smoking was observed as the most recognisable risk factor of oral cancer (82%), the smoking prevalence was relatively high (46.9%). The smokers in this study had low awareness and knowledge on oral cancer compared to the non-smoker. Hence, preventive measures adopting knowledge transfer should be proposed to enhance individual awareness and knowledge on oral cancer with Smoking cessation programme to help the smoker to quit smoking
Xeroderma pigmentosum-D (XPD) is one of the genes that play a role in the Nucleotide-Excision Repair (NER). Polymorphisms in XPD gene have been identified and reported to be associated with many types of cancer with two common single nucleotide polymorphisms (SNPs), namely, XPD312 and XPD751. The XPD312 polymorphism is at exon 10 codon 312 Asp to Asn (A→G) and the association of this polymorphism with oral cancer is very little known, especially, in Malaysia. The aim of this study was to screen for XPD312 gene polymorphisms in human oral cancer patients attending Hospital Universiti Sains Malaysia (HUSM), Malaysia. Blood samples were collected from 10 oral cancer and 10 normal healthy subjects with their consent. DNA was extracted using commercial DNA extraction kit and Polymerase Chain Reaction (PCR) was performed to amplify the XPD312 gene. The PCR products were digested using restriction enzyme, Sty I and analyzed on a 3% agarose gel for the detection of polymorphisms. This was followed by DNA sequencing to confirm the findings. In the current study, only homozygous wild type polymorphisms in the XPD312 gene was noticed in the oral cancer tissues as revealed by the restriction enzyme and DNA sequencing analyses.
Oral cancer is one of the common cancer cases identified in the developing countries. Genetic mutation and overexpression of certain genes and proteins have been associated in the development of this cancer. Notch signalling pathway is normally involved in controlling the development process of vertebrates and invertebrates; however, deregulation of this pathway was found to be responsible in the formation of certain cancers including oral cancers. Activation of this pathway requires binding of the ligands to its receptors. Four NOTCH receptors (NOTCH 1, 2, 3 and 4) have been identified in mammals. Disruptions within these molecules might interfere with the normal functions of Notch signalling pathway. Hence, this study was conducted to detect mutations of NOTCH1 and NOTCH2 receptor genes which might be occurring in the oral cancer cases obtained from the local population. DNA extracted from fresh-frozen tissue biopsy of the tongue and buccal mucosa from 10 confirmed cases of oral cancer were subjected for polymerase chain reaction (PCR) amplification using the specific sets of primers. The PCR products were sent for sequencing before final results were analysed.
Due to time and cost limitation, only two out of four NOTCH receptor genes; NOTCH1 and NOTCH2, were used in this analysis. The results revealed absence of nucleotide changes for both NOTCH receptor genes amplified from these oral cancer samples. More samples and further analysis looking into other regions in these genes are required to conclude the involvement of NOTCH receptor genes mutation in causing oral cancer.
The objective of this survey was to evaluate the knowledge of final year dental and medical students of Universiti Sains Malaysia concerning epidemiology, aetiology, clinical aspects, prevention, early detection and treatment of oral cancer and oral potentially malignant disorders (OPMD). A pre-tested, self-administered questionnaire with 36 questions was used. Forty five dental students and 147 medical students participated in the study. Dental students were relatively better informed than their medical colleagues concerning most issues addressed in the questionnaire. Yet, in some areas of knowledge, the dental students did not differ significantly from their medical colleagues. Only a small proportion of both groups of students expressed confidence in their knowledge and skills in oral cancer prevention and detection. This study revealed areas of deficiency in the awareness of these students concerning oral cancer and OPMD. It points to a necessity to strengthen these aspects of medical and dental undergraduate curricula.
Goniothalamin is a natural occurring styryl-lactone compound isolated from Goniothalamus macrophyllus. It had been demonstrated to process promising anticancer activity on various cancer cell lines. However, little study has been carried out on oral cancer. The aim of this study was to determine the cytotoxic effects of goniothalamin against H400 oral cancer cells and its underlying molecular pathways. Results from MTT assay demonstrated that goniothalamin exhibited selective cytotoxicity as well as inhibited cells growth of H400 in dose and time-dependent manner. This was achieved primarily via apoptosis where apoptotic bodies and membrane blebbing were observed using AO/PI and DAPI/Annexin V-FITC fluorescence double staining. In order to understand the apoptosis mechanisms induced by goniothalamin, apoptosis assessment based on mitochondrial membrane potential assay and cytochrome c enzyme-linked immunosorbent assay were carried out. Results demonstrated that the depolarization of mitochondrial transmembrane potential facilitated the release of mitochondrial cytochrome c into cytosol. Caspases assays revealed the activation of initiator caspase-9 and executioner caspase-3/7 in dose-dependent manners. This form of apoptosis was closely associated with the regulation on Bcl-2 family proteins, cell cycle arrest at S phase and inhibition of NF-κβ translocation from cytoplasm to nucleus. Conclusion, goniothalamin has the potential to act as an anticancer agent against human oral squamous cell carcinoma (H400 cells).