This article projects the social cost of carbon (SCC) and other related consequences of climate change by using Malaysia's intended nationally determined contribution (INDC) and climate vision 2040 (CV2040) by 2050. It compares the projections derived from the Dynamic Integrated Model of the Climate and Economy (DICME) based on the respective INDC and CV2040 scenario. The results reveal that industrial emissions would incur a substantial increase every 5 years under the scenario CV2040, while Malaysia would experience lower industrial emissions in the coming years under the scenario INDC. Emission intensity in Malaysia will be 0.61 and 0.59 tons/capita in 2030 for scenario CV2040 and scenario INDC respectively. Malaysia would face climate damage of MYR456 billion and MYR 49 billion by 2050 under CV2040 and INDC scenario respectively. However, climate damage could be much lower if the INDC regime were adopted, as this scenario would decrease climatic impacts over time. The estimated SSC per ton of CO2 varies between MYR74 and MYR97 for scenario CV2040 and MYR44 and MYR62 for scenario INDC in 2030 and 2050 respectively. Considering different aspects, including industrial emissions, damage cost, and social cost of carbon, INDC is the best policy compared to CV2040. Thus, Malaysia could achieve its emissions reduction target by implementing INDC by 2050.
Laryngeal leiomyosarcoma is a rare smooth muscle malignancy of the head and neck region. Diagnosis is based on immunohistochemistry. Here we present a case of laryngeal leiomyosarcoma that was diagnosed and treated in our center, focusing on the clinical features, histological diagnosis and management of this rare disease.
This study aimed to compare the 3D skull models reconstructed from computed tomography (CT) images using three different open-source software with a commercial software as a reference. The commercial Mimics v17.0 software was used to reconstruct the 3D skull models from 58 subjects. Next, two open-source software, MITK Workbench 2016.11, 3D Slicer 4.8.1 and InVesalius 3.1 were used to reconstruct the 3D skull models from the same subjects. All four software went through similar steps in 3D reconstruction process. The 3D skull models from the commercial and open-source software were exported in standard tessellation language (STL) format into CloudCompare v2.8 software and superimposed for geometric analyses. Hausdorff distance (HD) analysis demonstrated the average points distance of Mimics versus MITK was 0.25 mm. Meanwhile, for Mimics versus 3D Slicer and Mimics versus InVesalius, there was almost no differences between the two superimposed 3D skull models with average points distance of 0.01 mm. Based on Dice similarity coefficient (DSC) analysis, the similarity between Mimics versus MITK, Mimics versus 3D Slicer and Mimics versus InVesalius were 94.1, 98.8 and 98.3%, respectively. In conclusion, this study confirmed that the alternative open-source software, MITK, 3D Slicer and InVesalius gave comparable results in 3D reconstruction of skull models compared to the commercial gold standard Mimics software. This open-source software could possibly be used for pre-operative planning in cranio-maxillofacial cases and for patient management in the hospitals or institutions with limited budget.
Teratoma of the neck is a rare extra-gonadal teratoma. Although it can be seen in adult, most of the cases present in fetal life or early childhood. Grading and classification of teratoma is important for management and prognosis. Decision making between mature and immature teratoma is sometime challenging if it is not composed of extensive unusual neuroectodermal tissue component. We reported a rare case of huge congenital mature cystic teratoma composted of various neuroectodermal tissues in an 8-month-old boy; it was located at the lateral neck and mimicked congenital cystic hygroma. A literature review was done to grade and classify the tumour.
Matched MeSH terms: Head and Neck Neoplasms/congenital; Head and Neck Neoplasms/diagnosis*
The identification of new biomarkers for early detection of highly recurrent head and neck cancer is urgently needed. MicroRNAs (miRNAs) are small and non-coding RNAs that regulate cancer-related gene expression, such as tumor protein 53 (TP53) gene expression. This study was carried out to analyze TP53 gene expression using real-time PCR and to determine changes in intracellular p53 level by flow cytometry after downregulation of miRNA-181a miRNA inhibitor in the FaDu cell line. TP53 gene expression showed a 3-fold increment and the p53 protein level was also increased in the miRNA-181a-treated cells. In conclusion, miRNA-181a binds to the TP53 gene and inhibits its expression, decreasing the synthesis of p53.
Matched MeSH terms: Head and Neck Neoplasms/genetics*; Head and Neck Neoplasms/pathology
Extracranial schwannomas in the head and neck region are rare neoplasms. The tumours often present as asymptomatic, slowly enlarging lateral neck masses and determination of the nerve origin is not often made until the time of surgery. Preoperative diagnosis maybe aided by imaging studies such as magnetic resonance imaging or computed tomography, while open biopsy is no longer recommended. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We report four cases of cervical schwannomas that we encountered at our center during four years of period. The clinical features, diagnosis and origin, management and pathological findings of these benign tumors are discussed.
Matched MeSH terms: Head and Neck Neoplasms/diagnosis*; Head and Neck Neoplasms/surgery
Vagal nerve schwannoma is extremely rare. The majority of cases present with a slow growing neck swelling without neurological deficit. Magnetic resonance imaging is the gold standard investigation to establish a pre-operative diagnosis. We report a case of a 32-year-old man with an extensive right vagal nerve schwannoma involving the right jugular foramen and parapharyngeal space. The tumour was resected via a transcervical approach. Complete excision of the tumour is the key to prevent recurrence.
Matched MeSH terms: Head and Neck Neoplasms/diagnosis*; Head and Neck Neoplasms/surgery
Being a rapidly developing country, a study was needed to see how we faired in treating head and neck cancer patients compared with international standards. Although being a retrospective study, this research shows that there is still a lot to be done in our developing nation in educating the general public about head and neck cancers as most of them presented in the later stages to us. There also needs to be a proper review about the treatment modality offered to patient as our survival results are far behind in certain categories of cancers compared with the developed nations.
Matched MeSH terms: Head and Neck Neoplasms/mortality*; Head and Neck Neoplasms/therapy
A 21-year-old lady was admitted with a one year history of painless swelling in the neck. The clinical features and radiological findings suggested a thyroglossal duct cyst. Histology of the excised duct cyst showed papillary carcinoma. Ultrasound examination of the thyroid gland was normal. The patient is on regular follow-up and is well two years following surgery.
Matched MeSH terms: Head and Neck Neoplasms/pathology*; Head and Neck Neoplasms/surgery
Radiotherapy has been recognized as a valuable modality of treatment in the management of head and neck cancers. It can have a direct bactericidal effect on the normal flora of the oropharynx. The objective of this study is to determine the changes in the oropharyngeal flora after external beam radiation. This prospective non randomized control study was performed to aid in identification of organisms involved in sepsis, as well as aid in choosing appropriate antibiotics for surgical procedures in irradiated patient. Forty patients with various head and neck malignancy and thirty control patients were selected. Oropharyngeal swabs were taken prior to radiotherapy, at the end and one month after radiotherapy. A single swab was taken from the control group. A full bacteriological analysis was performed. There was a statistically significant decrease in Alpha Hemolytic Streptococci and Neisseria species post radiotherapy. B Proteus and Candida Albicans showed a statistical significant increase in patients with head and neck cancer post radiotherapy. These changes remained even one month after radiotherapy.
Matched MeSH terms: Head and Neck Neoplasms/microbiology*; Head and Neck Neoplasms/radiotherapy*
Motorcyclists make up the largest group of fatalities on Malaysian roads, majority succumbing to head injuries despite the compulsory safety helmet laws in the country. One possible reason for this high fatality is improper usage of safety helmets. This study examines the compliance of proper safety helmet use in motorcyclists in a typical Malaysian town. Five hundred motorcyclists were studied. Only 54.4% of motorcyclists used helmets properly, 21.4% used them improperly; and 24.2% did not wear helmets. Six variables were found to be significant in improper safety helmet use. They were age, gender, race, formal education level, prior accident experience and type of license held. Marital status and riding experience were not significant. Efforts promoting proper use of safety helmets should focus on the young, male, less formally educated, unlicensed rider, who has had a prior accident.
Matched MeSH terms: Head Protective Devices/utilization*; Head Protective Devices/statistics & numerical data
We report our experience with intralesional injection of bleomycin in the treatment of neck lymphangioma. From May 1995 to April 1998, 11 patients aged between 6 to 22 months were treated with intralesional bleomycin injection. Ultrasonography and computed tomography were used to assess and select the cases suitable for sclerotherapy. Patients with lesions encasing the internal jugular vein and the carotid artery were chosen. With the patient under sedation and using ultrasound guidance, the cysts were aspirated and bleomycin was injected at a dose of 0.5 mg/kg body weight. The number of procedures varied from 1 to 4 over a period of 8 months to 1 year. Patients were initially followed-up 3 monthly, then 6 monthly and subsequently yearly. In 4 patients, the neck mass was no longer visible (excellent response). In 5 patients, the neck mass had reduced to a size (more than 50% reduction) that was cosmetically acceptable (good response). There were 2 failures (poor response). There were no complications. Our results suggest that intralesional injection of bleomycin can be effectively used to treat selected cases of neck lymphangiomas.
Matched MeSH terms: Head and Neck Neoplasms/drug therapy*; Head and Neck Neoplasms/surgery
Oncocytic carcinoma of the salivary gland is an uncommon tumour in the head and neck region. Owing to its rarity, identifying the histopathological features of a malignant tumour can be difficult and challenging. We report a case of a 70-year-old man who presented with a left facial weakness for six months in a background history of left parotid swelling over the past 10 years. Clinical examination revealed a 3x3cm left parotid mass and grade 4 facial nerve palsy. Fine needle aspiration of the mass showed scattered cohesive, monolayered sheets of uniform oncocytic cells. Subsequently, a left total parotidectomy and selective neck dissection were performed. Histological examination showed sheets of small oncocytes with minimal nuclear atypia. Evidence of nerve entrapment, capsular invasion and perivascular permeation were identified in focal areas. Thus, a final diagnosis of oncocytic carcinoma was rendered.
Matched MeSH terms: Head and Neck Neoplasms/diagnosis; Head and Neck Neoplasms/pathology
Testicular cancer is an uncommon malignancy of the male reproductive organ, accounting for 1% of all cancers in men. Distant cervical metastasis from testicular cancer has been reported in 5% of patients. We present 2 cases of non-seminomatous testicular cancers that were diagnosed retrospectively in patients who presented with pure cervical lymph nodes. A comprehensive approach bearing in mind the possible differentials, pathogenesis and treatment options are discussed.
Matched MeSH terms: Head and Neck Neoplasms/secondary*; Head and Neck Neoplasms/therapy
INTRODUCTION: Hip arthroplasty is commonly performed worldwide. The objective of this study was to determine the diameter of the femoral head in the Malaysian population in relation to gender and race (i.e. among Malay, Chinese and Indian patients).
METHODS: This was a retrospective cross-sectional study performed between January 1995 and December 2006, evaluating the femoral head diameters of all patients aged 50 years and above who underwent hemiarthroplasty at two major hospitals in Malaysia.
RESULTS: A total of 945 femoral heads (663 women, 282 men) were evaluated. The mean age of the patients in our cohort was 75.2 ± 9.4 (range 50-101) years. The mean femoral head diameter (with intact articular cartilage) was 44.9 ± 3.2 (range 38-54) mm. In our study, men had a significantly larger mean femoral head diameter than women (47.7 ± 2.8 mm vs. 43.7 ± 2.4 mm; p < 0.05). Patients of Chinese ethnicity were also found to have significantly larger femoral head diameters, when compared among the three races studied (p < 0.05).
CONCLUSION: Malaysians have a mean femoral head diameter of 44.9 ± 3.2 mm. Among our patients, Chinese patients had a significantly larger femoral head size than Malay and Indian patients. We also found that, in our cohort, men had significantly larger femoral head diameters than women.
We report a 56-year-old Malay woman with a tumour that involved the skin and caused hyoid bone erosion. There was no clinical or radiological evidence of regional lymph node involvement. A modified radical neck dissection with preservation of the accessory nerve and internal jugular vein was performed, followed by an "extended" Sistrunk operation. The surgical defect was reconstructed with a pectoralis major myocutaneous flap. Our literature review showed that this is the first reported thyroglossal duct carcinoma which involved the skin and required a pedicle flap reconstruction.
Matched MeSH terms: Head and Neck Neoplasms/pathology*; Head and Neck Neoplasms/surgery
Metastasising pleomorphic adenoma is rare and may occur years after surgical excision of a pleomorphic adenoma (PA). We present a 61-year-old woman with a right infratemporal PA with metastases to the cervical lymph nodes after 30 years following a total parotidectomy. She was treated successfully with a resection of the tumour with combined neck and mandibulotomy approach along with postoperative radiotherapy given subsequently.
Matched MeSH terms: Head and Neck Neoplasms/diagnosis*; Head and Neck Neoplasms/etiology; Head and Neck Neoplasms/pathology; Head and Neck Neoplasms/therapy