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  1. Zahari Sham SY, C Thambiah S, Samsudin IN, Lim SM
    Malays J Pathol, 2017 Dec;39(3):311-315.
    PMID: 29279596 MyJurnal
    Multiple myeloma is a type of plasma cell dyscrasia, characterised by presence of paraprotein or monoclonal (M)-protein in serum or urine. The M-protein may consist of an intact immunoglobulin, the heavy chain only or the light chain only. The latter, designated as light chain multiple myeloma (LCMM) makes up almost 20% of myelomas. Clinical manifestation is often heralded by hypercalcaemia, renal impairment, normocytic normochromic anaemia and bone lesions, reflecting end-organ damage, collectively known as the acronym CRAB. In particular, free light chain nephrotoxicity accounts for the high prevalence of renal impairment seen in LCMM. This case illustrates a typical presentation of LCMM with focal discussion on its initial and diagnostic, as well as prognostic biochemical investigations.
    Matched MeSH terms: Bone and Bones/pathology; Multiple Myeloma/pathology
  2. Shaghayegh G, Alabsi AM, Ali-Saeed R, Ali AM, Vincent-Chong VK, Ismail NH, et al.
    Asian Pac J Cancer Prev, 2017 Dec 29;18(12):3333-3341.
    PMID: 29286228
    Cancer is one of the most common causes of death in the developed world, with one-third of people diagnosed with
    cancer during their lifetime. Oral cancer commonly occurs involving the buccal mucosa (cheeks), tongue, floor of the
    mouth and lip. It is one of the most devastating and disfiguring of malignancies. Morinda citrifolia L., commonly known
    as ‘noni’, belongs to the Rubiaceae family. It is native to the Pacific islands, Hawaii, Caribbean, Asia and Australia.
    The plant displays broad curative effects in pharmacological studies. Damnacanthal (DAM) and Nordamnacanthal
    (NDAM), anthraquinone compounds isolated from the roots of Morinda citrifolia L., has been used for the treatment
    of several chronic diseases including cancer. The objectives of this study were to evaluate cytotoxicity, morphological
    changes, cell death mode (apoptosis/necrosis), and cell migration induced by DAM and NDAM on the most common
    type of oral cancer, oral squamous cell carcinoma (OSCC)cells. Anti-proliferative effects of these compounds against
    OSCC cell lines were determined by MTT assay. The mode of cell death was analysed by phase contrast and fluorescent
    microscopy as well as flow cytometry. In addition, cell migration was assessed. The results showed that DAM and
    NDAM exerted cytotoxicity against OSCC cells with IC50 values of 1.9 to >30 μg/ml after 72 h treatment. Maximum
    growth inhibition among the tested cell lines for both compounds was observed in H400 cells, and thus it was selected
    for further study. The study demonstrated inhibition of H400 OSCC cell proliferation, marked apoptotic morphological
    changes, induction of early apoptosis, and inhibition of cell migration by DAM and NDAM. Therefore, this information
    suggests that these compounds from noni have potential for used as anti tumor agents for oral cancer therapy.
    Matched MeSH terms: Carcinoma, Squamous Cell/pathology*; Mouth Neoplasms/pathology*
  3. Mohamad N, Loh EYX, Fauzi MB, Ng MH, Mohd Amin MCI
    Drug Deliv Transl Res, 2019 04;9(2):444-452.
    PMID: 29302918 DOI: 10.1007/s13346-017-0475-3
    The healing of wounds, including those from burns, currently exerts a burden on healthcare systems worldwide. Hydrogels are widely used as wound dressings and in the field of tissue engineering. The popularity of bacterial cellulose-based hydrogels has increased owing to their biocompatibility. Previous study demonstrated that bacterial cellulose/acrylic acid (BC/AA) hydrogel increased the healing rate of burn wound. This in vivo study using athymic mice has extended the use of BC/AA hydrogel by the addition of human epidermal keratinocytes and human dermal fibroblasts. The results showed that hydrogel loaded with cells produces the greatest acceleration on burn wound healing, followed by treatment with hydrogel alone, compared with the untreated group. The percentage wound reduction on day 13 in the mice treated with hydrogel loaded with cells (77.34 ± 6.21%) was significantly higher than that in the control-treated mice (64.79 ± 6.84%). Histological analysis, the expression of collagen type I via immunohistochemistry, and transmission electron microscopy indicated a greater deposition of collagen in the mice treated with hydrogel loaded with cells than in the mice administered other treatments. Therefore, the BC/AA hydrogel has promising application as a wound dressing and a cell carrier.
    Matched MeSH terms: Burns/pathology; Skin/pathology
  4. Bashir ES, Kwan AK, Chan CY, Mun Keong K
    J Orthop Surg (Hong Kong), 2016 12;24(3):421-423.
    PMID: 28031519
    Gefitinib inhibits the epidermal growth factor receptor tyrosine kinase and improves survival in patients with non-small-cell lung cancer. We report 2 patients with extensive lytic bony metastasis in the spine and pelvis secondary to advanced pulmonary adenocarcinoma who were treated with gefitinib and had remarkable bone formation in the lytic bone lesions in the spine and pelvis. Surgery for stabilisation was avoided.
    Matched MeSH terms: Pelvic Bones/pathology; Spine/pathology
  5. Hu Y, Ran J, Zheng Z, Jin Z, Chen X, Yin Z, et al.
    Acta Biomater, 2018 04 15;71:168-183.
    PMID: 29524675 DOI: 10.1016/j.actbio.2018.02.019
    Anterior cruciate ligament (ACL) is one of the most difficult tissues to heal once injured. Ligament regeneration and tendon-bone junction healing are two major goals of ACL reconstruction. This study aimed to investigate the synergistic therapeutic effects of Stromal cell-derived factor 1 (SDF-1)-releasing collagen-silk (CSF) scaffold combined with intra-articular injection of ligament-derived stem/progenitor cells (LSPCs) for ACL regeneration and the amelioration in the long-term complication of osteoarthritis (OA). The stem cell recruitment ability of CSF scaffold and the multipotency, particularly the tendon forming ability of LSPCs from rabbits were characterized in vitro, while the synergistic effect of the CSF scaffold and LSPCs for ACL regeneration and OA amelioration were investigated in vivo at 1, 3, and 6 months with a rabbit ACL reconstruction model. The CSF scaffold was used as a substitute for the ACL, and LSPCs were injected into the joint cavity after 7 days of the ACL reconstruction. CSF scaffold displayed a controlled release pattern for the encapsulated protein for up to 7 days with an increased stiffness in the mechanical property. LSPCs, which exhibited highly I Collagen and CXCR4 expression, were attracted by SDF-1 and successfully relocated into the CSF scaffold at 1 month in vivo. At 3 and 6 months post-treatment, the CSF scaffold combined with LSPCs (CSFL group) enhanced the regeneration of ACL tissue, and promoted bone tunnel healing. Furthermore, the OA progression was impeded efficiently. Our findings here provided a new strategy that using stem cell recruiting CSF scaffold with tissue-specific stem cells, could be a promising solution for ACL regeneration.

    STATEMENT OF SIGNIFICANCE: In this study, we developed a silk scaffold with increased stiffness and SDF-1 controlled release capacity for ligament repair. This advanced scaffold transplantation combined with intra-articular injection of LSPCs (which was isolated from rabbit ligament for the first time in this study) promoted the regeneration of both the tendinous and bone tunnel portion of ACL. This therapeutic strategy also ameliorated cartilage degeneration and reduced the severity of arthrofibrosis. Hence, combining LSPCs injection with SDF-1-releasing silk scaffold is demonstrated as a therapeutic strategy for ACL regeneration and OA treatment in the clinic.

    Matched MeSH terms: Anterior Cruciate Ligament/pathology; Osteoarthritis, Knee/pathology
  6. Kuppusamy UR, Indran M, Ahmad T, Wong SW, Tan SY, Mahmood AA
    Clin Chim Acta, 2005 Jan;351(1-2):197-201.
    PMID: 15563890 DOI: 10.1016/j.cccn.2004.09.014
    BACKGROUND: Comparisons of oxidative indices and total antioxidant status between end-stage renal disease (ESRD) patients with or without diabetes is scant, especially in the Asian population.
    METHOD: The assays were carried out according to known established protocols.
    RESULT: The present study showed that ESRD patients with or without non-insulin-dependent diabetes mellitus (NIDDM) did not have any significant differences in antioxidant enzyme activities, advanced glycated end products (AGE), advanced oxidized protein products (AOPP) and ferric reducing ability of plasma (FRAP), indicating that hyperglycemia does not exacerbate oxidative damage in ESRD. The regulation of catalase and glutathione peroxidase is also altered in ESRD. Elevated FRAP was observed in both ESRD groups (with and without NIDDM). The dialysis process did not alter the antioxidant enzyme activities but decreased AGEs and FRAP and increased AOPP levels.
    CONCLUSION: Oxidative stress is present in ESRD but this is not significantly exacerbated by hyperglycemia. The contribution of components in the pathology of renal failure towards oxidative stress exceeds that of hyperglycemia.
    Matched MeSH terms: Diabetes Mellitus, Type 2/pathology*; Kidney Failure, Chronic/pathology*
  7. Sathasivam HP, Kist R, Sloan P, Thomson P, Nugent M, Alexander J, et al.
    Br J Cancer, 2021 Aug;125(3):413-421.
    PMID: 33972745 DOI: 10.1038/s41416-021-01411-z
    BACKGROUND: This study was undertaken to develop and validate a gene expression signature that characterises oral potentially malignant disorders (OPMD) with a high risk of undergoing malignant transformation.

    METHODS: Patients with oral epithelial dysplasia at one hospital were selected as the 'training set' (n = 56) whilst those at another hospital were selected for the 'test set' (n = 66). RNA was extracted from formalin-fixed paraffin-embedded (FFPE) diagnostic biopsies and analysed using the NanoString nCounter platform. A targeted panel of 42 genes selected on their association with oral carcinogenesis was used to develop a prognostic gene signature. Following data normalisation, uni- and multivariable analysis, as well as prognostic modelling, were employed to develop and validate the gene signature.

    RESULTS: A prognostic classifier composed of 11 genes was developed using the training set. The multivariable prognostic model was used to predict patient risk scores in the test set. The prognostic gene signature was an independent predictor of malignant transformation when assessed in the test set, with the high-risk group showing worse prognosis [Hazard ratio = 12.65, p = 0.0003].

    CONCLUSIONS: This study demonstrates proof of principle that RNA extracted from FFPE diagnostic biopsies of OPMD, when analysed on the NanoString nCounter platform, can be used to generate a molecular classifier that stratifies the risk of malignant transformation with promising clinical utility.

    Matched MeSH terms: Cell Transformation, Neoplastic/pathology*; Mouth Neoplasms/pathology*
  8. Sapuan J, Yam KF, Noorman MF, De Cruz PK, Abdul Razab WN, Rozali ZI, et al.
    Singapore Med J, 2012 Oct;53(10):671-5.
    PMID: 23112019
    Carpal tunnel syndrome (CTS) is a common pregnancy complication. However, it is often overlooked by medical practitioners and patients alike. This study aimed to describe CTS in relation to pregnancy and assess how significant the disease was among pregnant women.
    Matched MeSH terms: Carpal Tunnel Syndrome/pathology; Pregnancy Complications/pathology
  9. Shamsudin N, Chang CC
    Singapore Med J, 2012 Sep;53(9):e198-200.
    PMID: 23023915
    We report a case of systemic diffuse large B-cell lymphoma presenting with extensive infiltration of the skin. A 56-year-old woman presented with a two-month history of pruritic erythematous plaques and nodules over the neck, trunk and upper limbs. She also had night sweats, weight loss, lethargy and reduced effort tolerance. Systemic examination revealed a pale, ill appearance with hepatosplenomegaly and lymphadenopathy. Blood investigations showed pancytopenia (haemoglobin 6.3 g/dL, total white cell count 3.0 × 10(9)/L, platelet count 138 × 10(9)/L) with a few suspicious mononuclear cells and a mildly elevated lactate dehydrogenase level (478 U/L). Skin biopsy demonstrated diffuse sheets and nodular infiltrates of CD20 and CD79a positive neoplastic cells in the dermis and subcutis. Computed tomography revealed multiple cervical, axillary, mediastinal, para-aortic and mesenteric lymph nodes. Bone marrow aspiration and trephine biopsy confirmed marrow involvement by non-Hodgkin's lymphoma. The patient was treated with chemotherapy, which resulted in resolution of the skin lesions.
    Matched MeSH terms: Skin Neoplasms/pathology; Lymphoma, Large B-Cell, Diffuse/pathology*
  10. Tan SL, Neoh CY, Tan HH
    Singapore Med J, 2012 Feb;53(2):e24-7.
    PMID: 22337196
    Rhinoscleroma is a chronic, slowly progressive, inflammatory disease of the upper respiratory tract. It is associated with Klebsiella rhinoscleromatis infection. We present the clinical and pathological features of four patients diagnosed with rhinoscleroma at the National Skin Centre, Singapore between 1997 and 2010. All four patients presented with only cutaneous involvement, and the diagnosis was clinched via histological examination. The patients were treated with a combination of antibiotics. Two patients who were on follow-up at the time of this writing responded positively to the antibiotic treatment, while two were lost to follow-up. Rhinoscleroma is a diagnostic challenge, as it is an uncommon disease in Singapore and Malaysia. We highlight this condition to raise awareness of the disease in order to aid in early diagnosis of patients. Without treatment, this condition can result in significant complications, including involvement of the lower airways. Early diagnosis and appropriate treatment help to reduce morbidity.
    Matched MeSH terms: Nose/pathology; Rhinoscleroma/pathology*
  11. Singh VA, Haseeb A, Alkubaisi AA
    Singapore Med J, 2014 Oct;55(10):539-46.
    PMID: 25631896
    INTRODUCTION: Morbidity and mortality from malignant diseases are usually the result of metastasis. The bone is the third most common site of metastasis.

    METHODS: This is a retrospective study of patients with metastatic bone disease who were referred to the Orthopaedic Department of University Malaya Medical Centre, Malaysia, between January 2004 and October 2009.

    RESULTS: A total of 151 patients (51.0% men, 49.0% women) had metastatic bone disease, with the highest incidence at the age range of 50-59 years. The commonest primary cancer was breast (23.3%), followed by lung (21.2%), prostate (9.3%), thyroid (7.3%) and renal cell carcinoma (5.3%); unknown primary cancer was 6.6%. There was long bone involvement in 52.7% of cases, axial bone in 44.5%, and both long and axial bones in 2.8%. The majority (90.1%) were symptomatic, with pain as the commonest symptom. 106 (70.2%) patients had pathological fractures. Neurological deficit was reported in 90.7% of patients, with 41.1% having extraskeletal metastases. 67.8% of the lesions were osteolytic, 24.3% were sclerotic, and 7.9%, mixed. Palliative and therapeutic interventions were undertaken for 62.0% of patients. The mean survival times were: breast 21.0; thyroid 20.7; prostate 20.3; lung 16.0; and unknown primary cancer 32.6 months.

    CONCLUSION: In our study, breast and lung cancers were the commonest primary cancers in metastatic bone disease. Most patients had more than one site of involvement, pain at presentation and pathological fractures. Surgery is beneficial to relieve pain and improve function and neurology. Duration of survival depends on the type of primary cancer and whether systemic metastasis is present.
    Matched MeSH terms: Breast Neoplasms/pathology; Lung Neoplasms/pathology
  12. Ling PK
    Singapore Med J, 2009 Oct;50(10):e350-2.
    PMID: 19907873
    We report a pulmonary artery (PA) aneurysm associated with severe aortic stenosis and an aortic root dilatation occurring in a 59-year-old woman who presented with dyspnoea and chest pain. PA aneurysms are rare, and there are no definitive guidelines on its management. There are contentious opinions on whether such aneurysms should be managed conservatively or surgically. Our patient had associated aortic stenosis and underwent a successful aortic valve replacement and PA aneurysm repair. This case illustrates that concomitant PA repair with other cardiothoracic surgery can be performed safely, even in patients with moderate surgical risks. We also discuss the natural history, prognosis and management of PA aneurysms.
    Matched MeSH terms: Aortic Valve/pathology; Pulmonary Artery/pathology*
  13. Chuah SY, Leong CK, Pang CW
    Singapore Med J, 2003 May;44(5):261-7.
    PMID: 13677363
    Opium addicts (OA) with no biliary symptoms have been shown to have dilated common bile duct (CBD). Endoscopic retrograde cholangio-pancreatography (ERCP) without biliary drainage in such asymptomatic OA is hazardous. Hence it is not indicated unless there are clear clinical and laboratory evidences of biliary stasis.
    Matched MeSH terms: Acquired Immunodeficiency Syndrome/pathology; Common Bile Duct/pathology*
  14. Lim EJ, Peh SC
    Singapore Med J, 2000 Jun;41(6):279-85.
    PMID: 11109344
    47 patients with non-Hodgkin's lymphoma (NHL) were studied retrospectively to determine their marrow and blood changes at diagnosis.
    Matched MeSH terms: Bone Marrow/pathology*; Lymphoma, Non-Hodgkin/pathology*
  15. Wong KT, Koh KB, Lee SH, Chee CP
    Singapore Med J, 1996 Aug;37(4):441-2.
    PMID: 8993152
    Primary germinomas of the central nervous system carry a good prognosis because of their radiosensitivity. Recurrences are rare and extraneural metastases are even more unusual. One of the possible routes of extraneural spread is via ventriculo-peritoneal shunts which may be required to reduce intracranial pressure. One such case of germinoma metastasizing via a ventriculo-peritoneal shunt is reported. Patients with intracranial germinomas and ventriculo-peritoneal shunts should have close surveillance of their abdomens and may require systemic chemotherapy.
    Matched MeSH terms: Brain Neoplasms/pathology*; Germinoma/pathology*
  16. Al-Joudi FS, Iskandar ZA, Hasnan J, Rusli J, Kamal Y, Imran AK, et al.
    Singapore Med J, 2007 Jul;48(7):607-14.
    PMID: 17609820
    INTRODUCTION: Survivin is a 16.5-kDa intracellular protein that inhibits apoptosis and regulates cell division, and belongs to the inhibitors of apoptosis gene family. It appears to have an important role in regulating apoptosis at the cell cycle checkpoints. Survivin has been found to have a differential distribution in cancer compared to normal tissue, as it is over-expressed in malignant tumours.
    METHODS: In addition to the demographical analysis of the disease, data from 382 women with invasive ductal carcinoma of the breast were collected from three hospitals in Northeast Malaysia, and analysed for survivin expression by immunohistochemistry.
    RESULTS: Invasive ductal carcinoma of the breast was found to be the most prevalent breast cancer type. Survivin was detected in 260 (68.1 percent) study cases. In addition, significant correlations have been shown between survivin expression on one hand, and tumour size and lymph node involvement on the other hand (p-value is less than 0.05). However, no significant correlations were found with other clinicopathological factors, such as tumour histological grade, tumour side, oestrogen and progesterone receptors. Nuclear expression of survivin was detected in 16.5 percent of the study cases, cytoplasmic expression was detected in 24.1 percent, and 27.5 percent of the cases expressed survivin in both nuclear and cytoplasmic locations simultaneously. The subcellular localisation of survivin was significantly correlated (p is less than 0.001) with the lymph node involvement indicating its value in predicting the aggressiveness of tumour cells, since it increases the resistance to apoptosis and promotes cell proliferation.
    CONCLUSION: This is the fi rst known report on survivin expression in cancer in West Malaysia and Southeast Asia. It emphasises the importance of the detection of survivin in breast cancer to aid in diagnosis, confirm malignancy, and to assess the disease progress and response to therapy.
    Matched MeSH terms: Breast Neoplasms/pathology; Carcinoma, Ductal, Breast/pathology
  17. Shuhaila A, Rohaizak M, Phang KS, Mahdy ZA
    Singapore Med J, 2008 Mar;49(3):e71-2.
    PMID: 18362990
    A 40-year-old woman, a grand multipara with uncertain gestation, presented with severe, prolonged diarrhoea. She was previously diagnosed to have melanoma. Examination revealed gross ascites with hepatosplenomegaly and uterus corresponding to 29 weeks gestation. An emergency caesarean section confirmed widespread metastases to the ovaries, mesentery and placenta. A viable male foetus was delivered with features of intrauterine growth restriction. The baby survived, but the mother died a week later. This case highlights the importance of thoroughly assessing placentas and babies of patients with melanoma for metastases.
    Matched MeSH terms: Placenta Diseases/pathology; Pregnancy Complications, Neoplastic/pathology
  18. Kasthoori JJ, Liam CK, Wastie ML
    Singapore Med J, 2008 Feb;49(2):e47-9.
    PMID: 18301826
    Non-tuberculous mycobacterial infection (NMI) occurs in elderly women with no pre-existing lung disease, and this has been termed the Lady Windermere syndrome. NMIs are increasing in prevalence and an increasing number of pulmonary mycobacterial infections is due to non-tuberculous mycobacteria. The diagnosis is often difficult because the organism is not readily isolated or cultured, and the condition may not be considered by the radiologist. We report NMI in a 64-year-old woman, based on clinical and radiological findings. Although termed the Lady Windermere syndrome, the name does not correspond to the character in Oscar Wilde's play; hence the eponym is not widely used.
    Matched MeSH terms: Mycobacterium Infections, Nontuberculous/pathology*; Tuberculosis, Pulmonary/pathology*
  19. Faisham WI, Zulmi W, Halim AS, Biswal BM, Mutum SS, Ezane AM
    Singapore Med J, 2006 Aug;47(8):679-83.
    PMID: 16865207
    The surgical treatment of Stage III or aggressive giant cell tumour of the bone, whether to perform intralesional or en-bloc resection, remains controversial. The aim of this study is to identify the effectiveness of en-bloc resection for local control and final oncological outcome of the disease.
    Matched MeSH terms: Bone Neoplasms/pathology; Carcinoma, Giant Cell/pathology
  20. Razak NA, Abu N, Ho WY, Zamberi NR, Tan SW, Alitheen NB, et al.
    Sci Rep, 2019 Feb 06;9(1):1514.
    PMID: 30728391 DOI: 10.1038/s41598-018-37796-w
    Eupatorin has been reported with in vitro cytotoxic effect on several human cancer cells. However, reports on the mode of action and detail mechanism of eupatorin in vitro in breast cancer disease are limited. Hence, eupatorin's effect on the human breast carcinoma cell line MCF-7 and MDA-MB-231 was investigated. MTT assay showed that eupatorin had cytotoxic effects on MCF-7 and MDA-MB-231 cells but was non-toxic to the normal cells of MCF-10a in a time-dose dependent manner. At 24 h, the eupatorin showed mild cytotoxicity on both MCF-7 and MDA-MB-231 cells with IC50 values higher than 20 μg/mL. After 48 h, eupatorin at 5 μg/mL inhibited the proliferation of MCF-7 and MDA-MB-231 cells by 50% while the IC50 of MCF-10a was significantly (p 
    Matched MeSH terms: Aorta/pathology; Breast Neoplasms/pathology*
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