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  1. Computerised image analysis of vitiligo lesion: evaluation using manually defined lesion areas
    Nugroho H, Ahmad Fadzil MH, Shamsudin N, Hussein SH
    Skin Res Technol, 2013 Feb;19(1):e72-7.
    PMID: 22233154 DOI: 10.1111/j.1600-0846.2011.00610.x
    Vitiligo is a cutaneous pigmentary disorder characterized by depigmented macules and patches that result from loss of epidermal melanocytes. Physician evaluates the efficacy of treatment by comparing the extent of vitiligo lesions before and after treatment based on the overall visual impression of the treatment response. This method is called the physician's global assessment (PGA) which is subjective. In this article, we present an innovative digital image processing method to determine vitiligo lesion area in an objective manner.
    Matched MeSH terms: Epidermis/pathology*; Melanocytes/pathology; Vitiligo/pathology*
  2. Fulltext Mucosal malignant melanoma of the maxillary sinus
    Norhafizah M, Mustafa WM, Sabariah AR, Shiran MS, Pathmanathan R
    Med J Malaysia, 2010 Sep;65(3):218-20.
    PMID: 21939172
    Mucosal malignant melanoma (MMM) is an aggressive tumour occurring in the upper respiratory tract. It is rare compared to malignant melanoma of the skin. We report a case of a 53-year-old man with left paranasal swelling. A biopsy showed high-grade spindle cell tumour. Subsequently a subtotal maxillectomy was performed. Histopathological examination revealed a hypercellular tumour composed of mixed spindle and epitheloid cells with very occasional intracytoplasmic melanin pigment. The malignant cells were immunopositive for vimentin, S-100 protein and HMB-45. It was diagnosed as mucosal malignant melanoma (MMM). This article illustrates a rare case of MMM where the diagnosis may be missed or delayed without proper histopathological examination that include meticulous search for melanin pigment and appropriate immunohistochemical stains to confirm the diagnosis. Malignant melanoma can mimic many other types of high-grade malignancy and should be considered as a differential diagnosis in many of these instances.
    Matched MeSH terms: Maxillary Sinus Neoplasms/pathology*; Melanoma/pathology*; Neoplasm Recurrence, Local/pathology*
  3. Fulltext Nosocomial nasal myiasis in an intensive care unit
    Nazni WA, Jeffery J, Lee HL, Lailatul AM, Chew WK, Heo CC, et al.
    Malays J Pathol, 2011 Jun;33(1):53-6.
    PMID: 21874753 MyJurnal
    A 73-year-old Chinese man was admitted to the Accident and Emergency Premorbid Ward of a local hospital in Malaysia. The patient complained of shortness of breath with cough and was in a semi-conscious state. He was later admitted to an intensive care unit (ICU) of the hospital. Six days after admission 5-6 maggots were recoverd from the nasal cavity. The maggots were identified as the third-instar larvae of Lucilia cuprina Wiedmann (Diptera: Calliphoridae) based on the morphological characteristics. This patient was classified as having nosocomial myiasis. The presence of the third instar larvae indicated that the infestation was not more than three to four days. An adult sarcophagid identified as Parasarcophaga ruficornis (Fabricius) caught in the ICU where the patient was warded provided further evidence of the potential for the nosocomial infestation.
    Matched MeSH terms: Cross Infection/pathology; Myiasis/pathology; Nose Diseases/pathology
  4. Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization
    Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T
    Malays J Pathol, 2011 Jun;33(1):47-51.
    PMID: 21874752 MyJurnal
    Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.
    Matched MeSH terms: Urinary Bladder Neoplasms/pathology*; Skin Neoplasms/pathology; Sarcoma, Myeloid/pathology*
  5. Anti-leukemic activity of Newcastle disease virus strains AF2240 and V4-UPM in murine myelomonocytic leukemia in vivo
    Alabsi AM, Ali R, Ideris A, Omar AR, Bejo MH, Yusoff K, et al.
    Leuk. Res., 2012 May;36(5):634-45.
    PMID: 22133641 DOI: 10.1016/j.leukres.2011.11.001
    Newcastle disease virus (NDV) is a member of the Paramyxoviridae that has caused severe economic losses in poultry industry worldwide. Several strains of NDV were reported to induce cytolysis to cancerous cell lines. It has prompted much interest as anticancer agent because it can replicate up to 10,000 times better in human cancer cells than in most normal cells. In this study, two NDV strains, viserotropic-velogenic strain AF2240 and lentogenic strain V4-UPM, showed cytolytic activity and apoptosis induction against Mouse myelomoncytic leukemia (WEHI 3B). The cytolytic effects of NDV strains were determined using microtetrazolium (MTT) assay. The cytolytic dose - fifty percent (CD(50)) were 2 and 8HAU for AF2240 and V4-UPM strains, respectively. Cells treated with NDV strains showed apoptotic features compared to the untreated cells under fluorescence microscope. NDV induced activation of caspase-3 and DNA laddering in agarose gel electrophoresis which confirmed the apoptosis. The anti-leukemic activity of both strains was evaluated on myelomoncytic leukemia BALB/c mice. The results indicated that both NDV strains significantly decreased liver and spleen weights. It also decreased blasts cell percentage in blood, bone marrow and spleen smears of treated mice (p<0.05). Histopathological studies for spleen and liver confirmed the hematological results of blood and bone marrow. From the results obtained, the exposure to both NDV stains AF2240 and V4-UPM showed similar results for Ara-c. In conclusion NDV strains AF2240 and V4-UPM can affect WEHI 3B leukemia cells in vitro and in vivo.
    Matched MeSH terms: Liver/pathology; Spleen/pathology; Leukemia, Myelomonocytic, Chronic/pathology
  6. Clusterin as a potential marker in distinguishing cervical neoplasia
    Lokamani I, Looi ML, Ali SA, Dali AZ, Jamal R
    Anal. Quant. Cytol. Histol., 2011 Aug;33(4):223-8.
    PMID: 21980627
    To assess the immunoexpression of clusterin (CLU) in the progression of cervical neoplasia.
    Matched MeSH terms: Adenocarcinoma/pathology; Uterine Cervical Neoplasms/pathology*; Epithelium/pathology
  7. Dementia, stroke, and vascular risk factors; a review
    Sahathevan R, Brodtmann A, Donnan GA
    Int J Stroke, 2012 Jan;7(1):61-73.
    PMID: 22188853 DOI: 10.1111/j.1747-4949.2011.00731.x
    Interest in dementia has increased over the past few decades. Stroke is an important cause of cognitive problems. The term vascular cognitive impairment is now used to describe dementia attributed to stroke or deep white matter lesions detected on imaging. Although vascular cognitive impairment is increasingly diagnosed, Alzheimer's disease remains the most common dementia worldwide. The relationship between Alzheimer's disease and vascular cognitive impairment is unclear, although there exists significant overlap, which prompts physicians to consider them opposite ends of a disease spectrum, rather than separate entities. There is also substantial evidence that stroke risk factors such as hypertension, diabetes; lipid disorders, etc. are independently associated with an increased risk of Alzheimer's disease and vascular cognitive impairment. Evidence suggests that these risk factors have a cumulative effect on Alzheimer's disease development but not on vascular cognitive impairment. This is more marked in Alzheimer's disease patients in the presence of the ε4 allelic variant of apolipoprotein E. How these risk factors increase the risk of dementia is largely unknown. Physicians must be aware that stroke causes dementia; that vascular risk factors appear to be independent risk factors in developing dementia, and that poststroke care must include cognitive assessment.
    Matched MeSH terms: Cerebrovascular Disorders/pathology; Dementia, Vascular/pathology; Stroke/pathology
  8. Risk of the contralateral mucosa in patients with oral potentially malignant disorders
    Siar CH, Mah MC, Gill PP
    Asian Pac J Cancer Prev, 2011;12(3):631-5.
    PMID: 21627356
    BACKGROUND: It is known that abnormal changes may occur in any part of the oral mucous membrane exposed to a carcinogen. Therefore patients with oral potentially malignant disorders (PMDs) are at risk of developing similar lesions at multiple sites.

    OBJECTIVES: To determine the risk of the contralateral mucosa in patients presenting with oral PMDs.

    MATERIALS AND METHODS: Sixty individuals with PMDs were selected for this study. These comprised 32 (53.3%) Indians, 23 (38.3%) Chinese, four (6.7%) Malays and one (1.7%) Nepalese. All selected cases had histopathological confirmation of their primary existing lesion as inclusion criteria. Cases that subsequently presented with a lesion in the corresponding anatomical site also underwent scalpel incisional biopsy on this second lesion to verify its diagnosis. The remaining cases that presented with unilateral PMDs at the time of study were subjected to a cytobrush biopsy on the normal looking contralateral mucosa.

    RESULTS: A total of 70 primary PMDs were detected in 60 patients. The most common PMD found was oral lichen planus (n=40, 57.1%). Of the 60 patients studied, 28 (46.6%) exhibited bilateral lesions either synchronously (n=21, 35.0%) or metachronously (n=7, 11.6%). The remaining cases that had undergone cytobrush biopsy on the corresponding anatomical site yielded normal cytological results.

    CONCLUSIONS: Present findings demonstrated that patients presenting with PMDs in the upper aerodigestive tract are at a greater risk of developing a second lesion most probably in the contralateral anatomical site.

    Matched MeSH terms: Mouth Mucosa/pathology*; Mouth Neoplasms/pathology*; Precancerous Conditions/pathology*
  9. Picture of the month. Subcutaneous fat necrosis of the newborn
    Yuen NS, Ibrahim SB
    Arch Pediatr Adolesc Med, 2011 Jun;165(6):563-4.
    PMID: 21646590 DOI: 10.1001/archpediatrics.2011.80-a
    Matched MeSH terms: Adipose Tissue/pathology*; Fat Necrosis/pathology*; Skin Diseases/pathology*
  10. A rare case of diplopodia and syndactyly: anatomical and surgical considerations
    Kadir KH, Abdul Rashid AH, Das S, Ibrahim S
    J Foot Ankle Surg, 2011 Mar-Apr;50(2):252-6.
    PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017
    Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
    Matched MeSH terms: Foot Deformities, Congenital/pathology; Hand Deformities, Congenital/pathology; Syndactyly/pathology
  11. Fulltext Nasal septal haemangioma in pregnancy
    Noorizan Y, Salina H
    Med J Malaysia, 2010 Mar;65(1):70-1.
    PMID: 21265255 MyJurnal
    A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for two months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under local anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis. Due to the rapidity of growth, presentation with epistaxis and its macroscopic appearance which often mimics malignancy; histologic confirmation is crucial.
    Matched MeSH terms: Hemangioma/pathology*; Nose Neoplasms/pathology*; Pregnancy Complications, Neoplastic/pathology*
  12. Locally advanced anourological verrucous carcinoma: a multidisciplinary approach
    Koh PS, Roslani AC, Leow M, Ng CL, Lee GE
    Tech Coloproctol, 2009 Mar;13(1):101.
    PMID: 19288239 DOI: 10.1007/s10151-009-0464-8
    Matched MeSH terms: Anus Neoplasms/pathology; Genital Neoplasms, Male/pathology; Carcinoma, Verrucous/pathology
  13. The anomalous origin and branches of the obturator artery with its clinical implications
    Jusoh AR, Abd Rahman N, Abd Latiff A, Othman F, Das S, Abd Ghafar N, et al.
    Rom J Morphol Embryol, 2010;51(1):163-6.
    PMID: 20191138
    The obturator artery (OA) originates from the internal iliac artery. Variation in the origin of the OA may be asymptomatic in individuals and occasionally be detected during routine cadaveric dissections or autopsies. In the present study, we observed the origin and the branching pattern of the OA on 34 lower limbs (17 right sides and 17 left sides) irrespective of sex. The bifurcation of the common iliac artery into internal and external iliac from the sacral ala varied between 4.3-5.3 cm. The distance of the origin of the anterior division of internal iliac artery from the bifurcation of common iliac artery varied between 1-6 cm. The distance of the origin of the posterior division of the internal iliac artery from the point of bifurcation of the common iliac artery varied between 0-6 cm. Out of 34 lower limbs studied, two specimens (5.8%) showed anomalous origin of the OA originating from the posterior division of the internal iliac artery. Of these two, one limb belonged to the right side while the other was from the left side. The anomalous OA gave off an inferior vesical branch to the prostate in both the specimens. No other associated anomalies regarding the origin or branching pattern of the OA were observed. Prior knowledge of the anatomical variations may be beneficial for vascular surgeons ligating the internal iliac artery or its branches and the radiologists interpreting angiograms of the pelvic region.
    Matched MeSH terms: Iliac Artery/pathology*; Iliac Artery/physiopathology*; Peripheral Vascular Diseases/pathology; Lower Extremity/pathology
  14. Securing the airway in a child with extensive post-burn contracture of the neck: a novel strategy
    Wong TE, Lim LH, Tan WJ, Khoo TH
    Burns, 2010 Aug;36(5):e78-81.
    PMID: 20036061 DOI: 10.1016/j.burns.2009.10.016
    Matched MeSH terms: Cicatrix/pathology; Contracture/pathology; Trachea/pathology
  15. Objective assessment of psoriasis erythema for PASI scoring
    Ahmad Fadzil MH, Ihtatho D, Mohd Affandi A, Hussein SH
    J Med Eng Technol, 2009;33(7):516-24.
    PMID: 19639508 DOI: 10.1080/07434610902744074
    Skin colour is vital information in dermatological diagnosis as it reflects the pathological condition beneath the skin. It is commonly used to indicate the extent of diseases such as psoriasis, which is indicated by the appearance of red plaques. Although there is no cure for psoriasis, there are many treatment modalities to help control the disease. To evaluate treatment efficacy, the current gold standard method, PASI (Psoriasis Area and Severity Index), is used to determine severity of psoriasis lesion. Erythema (redness) is one parameter in PASI and this condition is assessed visually, thus leading to subjective and inconsistent results. Current methods or instruments that assess erythema have limitations, such as being able to measure erythema well for low pigmented skin (fair skin) but not for highly pigmented skin (dark skin) or vice versa. In this work, we proposed an objective assessment of psoriasis erythema for PASI scoring for different (low to highly pigmented) skin types. The colour of psoriasis lesions are initially obtained by using a chromameter giving the values L*, a*, and b* of CIELAB colour space. The L* value is used to classify skin into three categories: low, medium and highly pigmented skin. The lightness difference (DeltaL*), hue difference (Deltah(ab)), chroma (DeltaC*(ab)) between lesions and the surrounding normal skin are calculated and analysed. It is found that the erythema score of a lesion can be distinguished by their Deltah(ab) value within a particular skin type group. References of lesion with different scores are obtained from the selected lesions by two dermatologists. Results based on 38 lesions from 22 patients with various level of skin pigmentation show that PASI erythema score for different skin types i.e. low (fair skin) to highly pigmented (dark skin) skin types can be determined objectively and consistent with dermatology scoring.
    Matched MeSH terms: Erythema/pathology*; Psoriasis/pathology*; Skin/pathology
  16. Primary plasma cell leukemia presented as progressive paraplegia: a case report
    Hasmoni MH, Wahid FA, Keng CS
    South. Med. J., 2009 Jan;102(1):101-3.
    PMID: 19077786 DOI: 10.1097/SMJ.0b013e31818018c1
    Plasma cell leukemia (PCL) is a rare plasma cell disorder. It is the leukemic variant of multiple myeloma. A 52-year-old man with an atypical presentation of primary plasma cell leukemia is reported. The patient presented with paraparesis which progressively worsened to paraplegia. MRI of the spine showed an extradural mass causing cord compression and multiple bony erosions from soft tissue masses. Peripheral blood film examination and bone marrow aspiration showed numerous plasmablasts. Atypical cells expressed surface and cytoplasmic lambda light chain on immunochemical studies, surface CD45 and CD38. To our knowledge, primary PCL presenting with progressive paraplegia has not been reported in the literature.
    Matched MeSH terms: Leukemia, Plasma Cell/pathology; Paraplegia/pathology; Spinal Cord Compression/pathology
  17. Metachronous inflammatory myofibroblastic tumour in the temporal bone: case report
    Goh BS, Tan SP, Husain S, Rose IM, Saim L
    J Laryngol Otol, 2009 Oct;123(10):1184-7.
    PMID: 19192318 DOI: 10.1017/S0022215109004642
    We report an extremely rare case of metachronous inflammatory myofibroblastic tumour in the temporal bone.
    Matched MeSH terms: Neoplasms, Muscle Tissue/pathology; Skull Neoplasms/pathology; Temporal Bone/pathology
  18. The floppy vocal polyp
    Rahmat O, Prepageran N
    Ear Nose Throat J, 2008 Dec;87(12):668-9.
    PMID: 19105136
    Matched MeSH terms: Laryngeal Neoplasms/pathology*; Polyps/pathology*; Vocal Cords/pathology*
  19. Primary corneal myxoma
    Soong T, Soong V, Salvi SM, Raynor M, Mudhar H, Goel S, et al.
    Cornea, 2008 Dec;27(10):1186-8.
    PMID: 19034139 DOI: 10.1097/ICO.0b013e31817a5d0b
    Primary corneal myxoma is extremely rare. It has only been reported on 2 previous occasions. Secondary corneal myxomas are more common, arising from corneal diseases such as infective keratitis, keratoconus, and bullous keratopathy. Myxomas occur commonly in other soft tissues such as the heart, paranasal sinuses, and muscles but can rarely present in periocular structures including the conjunctiva, orbit, and eyelid. Ours is only the third case of primary corneal myxoma reported in the literature and illustrates several unusual features. These include an inferonasal location between the corneal epithelium and Bowman layer and with no relationship to the corneal stroma, rapid tumor growth over a 3-month period, and no previous ocular trauma or conjunctival pathology. The histology of this lesion has an important part to play in the management of this condition as it determines the cellular origin, establishes a benign or malignant state, and helps with treatment and prognosis. One reported case of primary corneal myxoma recurred within 2 months after local resection. This was treated with bandage soft contact lens, and no recurrence had been reported since. Our case is now 12 months post op and has had no recurrence.
    Matched MeSH terms: Corneal Diseases/pathology*; Eye Neoplasms/pathology*; Myxoma/pathology*
  20. Fulltext Bilateral epidural extension of thoracic capillary vertebral (intraosseous) hemangioma mimicking spinal meningioma
    Kan CH, Saw CB, Rozaini R, Fauziah K, Ng CM, Saffari MH
    Med J Malaysia, 2008 Jun;63(2):154-6.
    PMID: 18942307 MyJurnal
    We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead the neurosurgeon to the more common diagnosis of spinal meningioma. Epidural extension of vertebral hemangiomas causing cord compression is rarely reported. Review of literatures reveal that cases that have been reported are of unilateral extension into epidural space and of cavernous type. This is the first case report of capillary vertebral (intraossous) hemangioma with bilateral extension through both intervetebral foramen into the epidural space causing myelopathy.
    Matched MeSH terms: Epidural Space/pathology*; Hemangioma/pathology*; Spinal Neoplasms/pathology*
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