The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that... more The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that several anatomical variations of the lower limb vascular system exist, including peronea arteria magna (PAM). PAM is a rare congenital variation in which both anterior tibial artery and posterior tibial artery are either aplastic or hypoplastic, and as a result, PA will be the dominant blood supply to the foot. This variation was described as type III-C in Kim-Lippert's Classification of the Infra-Popliteal Arterial Branching Variations. The awareness of its existence is crucial as it often precludes FFF from being harvested due to the risk of significant limb ischemia and limb loss. Despite some literature reporting donor site complications and impending limb loss following FFF harvest in PAM, preoperative vascular mapping before FFF transfer remains controversial among the microsurgeons. We present a case with an incidental intraoperative finding of PAM that had a successful FFF h...
INTRODUCTION: Anterior border of the tibia is covered only by a thin layer of protective tissue. ... more INTRODUCTION: Anterior border of the tibia is covered only by a thin layer of protective tissue. Plating of the tibia often results in wound complication and infection if the injury to this area is not recognized. We review our results of managing infection following plating of the tibia using a protocol base on the status of bone healing and the presence of bone or soft-tissue defect. Methods: Eight cases of infection following plating of the tibia were managed according to stage procedures protocols and classification, which is based on the state of bony union and the defect following wound debridement. The soft-tissue defects were managed with local flaps, and the bone defects were managed with Illizarov bone transport. Results: Three patients had more than one bacterium isolated. Gram negative organisms were isolated from seven patients. Methicillineresistant Staphylococcus aureus was isolated in two patients. All patients achieved union with a mean union time of seven months. T...
Parry-Romberg syndrome (PRS) is a rare facial deformity characterised by slowly progressive hemif... more Parry-Romberg syndrome (PRS) is a rare facial deformity characterised by slowly progressive hemifacial atrophy. We present a new case of hemifacial atrophy in an 18-year-old lady. Rudimentary understanding of the pathogenesis poses a challenge in deciding optimal timing and surgical intervention. Current suggested management are reviewed and discussed.
Stem cells have been widely used for treating disease due to the various benefits they offer in t... more Stem cells have been widely used for treating disease due to the various benefits they offer in the curing process. Several treatments using stem cells have undergone clinical trials, such as cell-based therapies for heart disease, sickle cell disease, thalassemia, etc. Adipose-derived stem cells are some of the many mesenchymal stem cells that exist in our body that can be harvested from the abdomen, thighs, etc. Adipose tissue is easy to harvest, and its stem cells can be obtained in higher volumes compared to stem cells harvested from bone marrow, for which a more invasive technique is required with a smaller volume obtained. Many scientists have expressed interest in investigating the role of adipose-derived stem cells in treating disease since their use was first described. This is due to these stem cells’ ability to differentiate into multiple lineages and secrete a variety of growth factors and proteins. Previous studies have found that the hormones, cytokines, and growth fac...
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2020
Background. Replantation of an avulsed digit often poses a surgical challenge even to an experien... more Background. Replantation of an avulsed digit often poses a surgical challenge even to an experienced microsurgeon. Therefore, it is often difficult to choose the treatment path for traumatic amputation of digit following ring avulsion injury, be it completion amputation or replantation. We discuss the surgical challenges encountered and management strategies used in this case of an unfortunate child who sustained an amputation of his dominant thumb. Clinical case. We present the case of a 10-year-old boy who sustained a complete amputation of his right thumb following a ring avulsion injury which was reconstructed with multiple approaches and surgical techniques to address difficulties at different stages. We replanted the avulsed thumb, reconstructed the tendon, soft tissue coverage with the use of allograft skin and local flap, and improvised surgical tactic to overcome complications encountered intra- and post-operative states such as thrombosis of arterial anastomosis and venous...
A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical managem... more A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical management following a failed endovascular approach to relieve central venous occlusion. She had an obstructed left brachiocephalic vein with a history of numerous central vein catheter placements. Alternative routes for new arteriovenous fistula creation had been exhausted due to previous contralateral upper limb fistula rupture and ligation. To the best of our knowledge, no similar cases of airway obstruction in central venous occlusion occurring in hemodialysis patients with AV fistula have been reported. The importance of identifying the possible emergency red flags in hemodialysis patients with central venous occlusion is important to prevent unwanted consequences.
Ukrainian Journal of Nephrology and Dialysis, 2020
Illicit penile augmentation is thought to be a common practice in Southeast Asia. This article ai... more Illicit penile augmentation is thought to be a common practice in Southeast Asia. This article aimed to explore the demographics of the patient who had illicit penile augmentation, its complications, surgical methods employed for removal as well as the long-term outcome following treatment, specifically on sexual satisfaction. Method. Records of patients with a penile foreign body to the Reconstructive Science Unit were retrieved. Demographics, presenting symptoms, surgical methods and outcomes were recorded and analyzed. Results. A total of 14 patients was identified. The median age at implantation and duration is 36 years old and 48 months respectively. The penile subdermal injection was the sole method utilized with the use of liquid silicone in 7 patients. Constant pain, painful erection, and discomfort were common symptoms (42.8%). All patients underwent surgical excision followed with either native (penile skin) full-thickness skin graft (FTSG), distant donor FTSG or primary c...
Recent Clinical Techniques, Results, and Research in Wounds, 2018
In the field of tissue engineering and reconstruction, the development of efficient biomaterial i... more In the field of tissue engineering and reconstruction, the development of efficient biomaterial is in high demand to achieve uncomplicated wound healing. Chronic wounds and excessive scarring are the major complications of tissue repair, and, as this inadequate healing continues to increase, novel therapies and treatments for dysfunctional skin repair and reconstruction are important. Skin substitutes that aid in the closure of extensive wounds with no scarring is the ultimate goal in the field of tissue engineering. The ideal skin substitute is still on high demand to achieve effective and scar-free wound healing. This paper reviews the various aspects of the complications related to wound healing and widely used skin substitutes and focuses on chitosan because of its unique function in accelerating wound healing. The proliferation of keratinocytes is essential for wound closure, and adipose-derived stem cells (ASCs) play a significant role in wound healing. ASCs were used to treat deep burns, skin radiation injuries, and even nonhealing wounds like diabetic ulcers. The usage of cultured cells on skin substitutes exactly mimics the skin which promotes the release of growth factors, cytokines, and chemokines. Thus, chitosan in combination with keratinocytes and adipose-derived stem cells may act as a vehicle for delivering cells, which would increase the proliferation of keratinocytes and help complete recovery from injuries.
Introduction: The modified Meek micrografting technique has been used in the treatment of severel... more Introduction: The modified Meek micrografting technique has been used in the treatment of severely burned patients and a number of articles have examined the use of the modified Meek technique in adults and in mixed-age groups. However, there is a paucity of research pertaining to the outcome in the pediatric age group. The aim of this study is to present our favorable outcome in pediatric major burns using the modified Meek technique. Methods: A retrospective review of burn cases in Hospital Universiti Sains Malaysia from 2010 to 2015 was conducted. Cases of major burns among pediatric patients grafted using the Meek technique were examined. Results: Twelve patients were grafted using the Meek technique. Ten (91.7%) patients were male, whereas 2 (8.3%) were female. The average age of patients was 6 years (range, 2-11 years). The average total body surface area was 35.4% (range, 15%-75%). Most burn mechanisms were due to flame injury (66.7%) as compared with scalds injury (16.7%) and chemical injury (16.7%). There was no mortality. All patients were completely grafted with a good donor site scar. The average graft take rate was 82.3%, although 8 cases had positive tissue cultures from the Meek-grafted areas. The average follow-up duration was 3.6 years (range, 1.1-6.7 years). Only 1 case developed contracture over minor joint. Conclusions: The Meek technique is useful when there is a paucity of donor site in the pediatric group. The graft take is good, contracture formation is low, and this technique is cost-effective.
Journal of Taibah University Medical Sciences, 2018
Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dres... more Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dressing and can be an option in the management of superficial and abrasion wounds.
International journal of hematology-oncology and stem cell research, 2017
Blood is considered to be precious because it is the basic necessity for health; our body needs a... more Blood is considered to be precious because it is the basic necessity for health; our body needs a steady provision of oxygen, supplied via blood, to reach billions of tissues and cells. Hematopoiesis is the process that generates blood cells of all lineages. However, platelets are the smallest blood component produced from the very large bone marrow cells called megakaryocytes and they play a fundamental role in thrombosis and hemostasis. Platelets contribute their hemostatic capacity via adhesion, activation and aggregation, which are triggered upon tissue injury, and these actions stimulate the coagulation factors and other mediators to achieve hemostasis. In addition, these coordinated series of events are the vital biological processes for wound healing phases. The aim of this review is to summarize and highlight the important pathways involved in achieving hemostasis that are ruled by platelets. In addition, this review also describes the mechanism action of platelets, includin...
Journal of Cleft Lip Palate and Craniofacial Anomalies, 2017
Introduction: Nonsyndromic cleft lip and/or palate (NSCLP) occurs as a result of multifactorial d... more Introduction: Nonsyndromic cleft lip and/or palate (NSCLP) occurs as a result of multifactorial determinants, involving both genetic and environmental factors. Several candidate genes associated with NSCLP have been discovered through genetic approach, but there is paucity of studies focusing on epigenetic determinants in NSCLP. We are interested to reveal linkage evidence of SATB2 at 2q region in large-extended NSCLP families of Malay population and its methylation activity in causing cleft formation. Materials and Methods: Eight large-extended families were included in this study. Microarray analysis was carried out and genome-wide linkage was determined using GeneHunter Multipoint Linkage Analysis v2.1r5. SATB2 methylation was tested on 100 NSCLP patients by DNA sequencing. Results: Genome-wide linkage analysis has revealed significant nonparametric linkage score and suggestive logarithm of the odds (LOD) score at 2q region in family 50 and family 100. Genome-wide heterogeneity LOD score of 2.63 and α =0.122 were found in total families at 2q33.1-q35 region. Significant copy number loss (P < 0.05) in NSCLP family compared with the normal control supports the linkage evidence of SATB2 in those families with positive linkage. Epigenetic testing found SATB2 unmethylation at DNA promoter region. Discussion: Linkage evidence and significant low copy number of SATB2 in NSCLP family of Malay population confirmed that genetic factors play a major role in causing cleft defects. SATB2 unmethylation could not support the epigenetic occurrence in causing craniofacial deformities. Conclusions: Linkage evidence and significant low copy number of SATB2 in NSCLP family of Malay population confirmed that genetic factors play a major role in causing cleft defects. SATB2 unmethylation could not support the epigenetic occurrence in causing craniofacial deformities.
International Journal on Advanced Science, Engineering and Information Technology, 2017
Hair follicles repeatedly regress and reconstitute themselves, suggesting the presence of intrins... more Hair follicles repeatedly regress and reconstitute themselves, suggesting the presence of intrinsic tissue stem cells. Among the unique characteristics of adult stem cells isolated from hair follicles is their ability to differentiate into keratinocytes. Study on chitosan skin-engineered templates (SETs) as scaffolds for the proliferation of human fibroblasts have shown the promise of SETs in facilitating skin cell growth in three-dimensional culture. High proliferation in three-dimensional culture using human cells allows the researcher to extensively evaluate the cultivation of desirable cell types on chitosan SETs. Therefore, this study aimed to evaluate the in vitro attachment, proliferation and differentiation of hair follicle stem cells (HFSCs) on a chitosan SETs. HFSCs were isolated from human scalp tissues using collagenase type I prior to propagation in supplemented CnT-07 media. The phenotype of the HFSCs was verified using the markers keratin-15 (K15) and CD200, as detected by immunocytochemical staining. The attachment and proliferation of the HFSCs on the chitosan SETs were evaluated using scanning electron microscopy (SEM), an alamar blue assay and a live/dead assay. Subsequently, the HFSCs were differentiated using CnT-2D differentiation media. The cells' differentiation was verified using the markers involucrin and keratin-6 (K6), as detected by immunofluorescence staining. The HFSCs were successfully isolated, proliferated and differentiated according to staining positivity and microscopy imaging. HFSCs are able to proliferate and directly differentiate into keratinocytes on a chitosan SETs, which may facilitate their use in regenerative medicine.
Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vi... more Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vivo or in vitro conditions. The size of mMP is between 0.1 and 1.0 μm. Apart from the size range, mMPs are also identified based on phosphatidylserine and CD14 expression on their surface, though this is not always the case. Monocytic MP are critical players in inflammation, endothelial cell function, and blood coagulation. They exhibit dual function by either helping the progression of such conditions or limiting it, depending on certain factors. Furthermore, the numbers of mMP are elevated in some autoimmune diseases, infectious diseases, and metabolic disorders. However, it is unknown whether mMP play an active role in these diseases or are simply biomarkers. The mechanism of mMP modulation is yet to be identified. In this review, we highlight the mechanism of mMP formation and the roles that they play in inflammation, blood coagulation, and different disease settings.
Open Access Macedonian Journal of Medical Sciences, 2016
BACKGROUND: Von Willebrand disease (vWD) is an inherited hemostatic disorder that affects the hem... more BACKGROUND: Von Willebrand disease (vWD) is an inherited hemostatic disorder that affects the hemostasis pathway. The worldwide prevalence of vWD is estimated to be 1% of the general population but only 0.002% in Malaysia.AIM: Our present paper has been written to disclose the statistical counts on the number of vWD cases reported from 2011 to 2013.MATERIAL AND METHODS: This article is based on sociodemographic data, diagnoses and laboratory findings of vWD in Malaysia. A total of 92 patients were reported to have vWD in Malaysia from 2011 to 2013.RESULTS: Sociodemographic-analysis revealed that 60% were females, 63% were of the Malay ethnicity, 41.3% were in the 19-44 year old age group and 15.2% were from Sabah, with the East region having the highest registered number of vWD cases. In Malaysia, most patients are predominately affected by vWD type 1 (77.2%). Factor 8, von Willebrand factor: Antigen and vWF: Collagen-Binding was the strongest determinants in the laboratory profiles...
International journal of clinical and experimental medicine, 2015
Chitosan-derived biomaterials have been reported to adhere when in contact with blood by encourag... more Chitosan-derived biomaterials have been reported to adhere when in contact with blood by encouraging platelets to adhere, activate and aggregate at the sites of vascular injury, thus enhanced wound healing capacity. This study investigated platelet morphology changes and the expression level of transforming growth factor-β1 (TGF-β1) and platelet-derived growth factor-AB (PDGF-AB) in the adherence of two different types of chitosans in von Willebrand disease (vWD): N,O-carboxymethylchitosan (NO-CMC) and oligo-chitosan (O-C). Fourteen vWD voluntary subjects were recruited, and they provided written informed consent. Scanning electron microscopy and enzyme-linked immunosorbent assay test procedures were employed to achieve the objective of the study. The results suggest that the O-C group showed dramatic changes in the platelet's behaviors. Platelets extended filopodia and generated lamellipodia, leading to the formation of grape-like shaped aggregation. The platelet aggregation oc...
The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that... more The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that several anatomical variations of the lower limb vascular system exist, including peronea arteria magna (PAM). PAM is a rare congenital variation in which both anterior tibial artery and posterior tibial artery are either aplastic or hypoplastic, and as a result, PA will be the dominant blood supply to the foot. This variation was described as type III-C in Kim-Lippert's Classification of the Infra-Popliteal Arterial Branching Variations. The awareness of its existence is crucial as it often precludes FFF from being harvested due to the risk of significant limb ischemia and limb loss. Despite some literature reporting donor site complications and impending limb loss following FFF harvest in PAM, preoperative vascular mapping before FFF transfer remains controversial among the microsurgeons. We present a case with an incidental intraoperative finding of PAM that had a successful FFF h...
INTRODUCTION: Anterior border of the tibia is covered only by a thin layer of protective tissue. ... more INTRODUCTION: Anterior border of the tibia is covered only by a thin layer of protective tissue. Plating of the tibia often results in wound complication and infection if the injury to this area is not recognized. We review our results of managing infection following plating of the tibia using a protocol base on the status of bone healing and the presence of bone or soft-tissue defect. Methods: Eight cases of infection following plating of the tibia were managed according to stage procedures protocols and classification, which is based on the state of bony union and the defect following wound debridement. The soft-tissue defects were managed with local flaps, and the bone defects were managed with Illizarov bone transport. Results: Three patients had more than one bacterium isolated. Gram negative organisms were isolated from seven patients. Methicillineresistant Staphylococcus aureus was isolated in two patients. All patients achieved union with a mean union time of seven months. T...
Parry-Romberg syndrome (PRS) is a rare facial deformity characterised by slowly progressive hemif... more Parry-Romberg syndrome (PRS) is a rare facial deformity characterised by slowly progressive hemifacial atrophy. We present a new case of hemifacial atrophy in an 18-year-old lady. Rudimentary understanding of the pathogenesis poses a challenge in deciding optimal timing and surgical intervention. Current suggested management are reviewed and discussed.
Stem cells have been widely used for treating disease due to the various benefits they offer in t... more Stem cells have been widely used for treating disease due to the various benefits they offer in the curing process. Several treatments using stem cells have undergone clinical trials, such as cell-based therapies for heart disease, sickle cell disease, thalassemia, etc. Adipose-derived stem cells are some of the many mesenchymal stem cells that exist in our body that can be harvested from the abdomen, thighs, etc. Adipose tissue is easy to harvest, and its stem cells can be obtained in higher volumes compared to stem cells harvested from bone marrow, for which a more invasive technique is required with a smaller volume obtained. Many scientists have expressed interest in investigating the role of adipose-derived stem cells in treating disease since their use was first described. This is due to these stem cells’ ability to differentiate into multiple lineages and secrete a variety of growth factors and proteins. Previous studies have found that the hormones, cytokines, and growth fac...
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2020
Background. Replantation of an avulsed digit often poses a surgical challenge even to an experien... more Background. Replantation of an avulsed digit often poses a surgical challenge even to an experienced microsurgeon. Therefore, it is often difficult to choose the treatment path for traumatic amputation of digit following ring avulsion injury, be it completion amputation or replantation. We discuss the surgical challenges encountered and management strategies used in this case of an unfortunate child who sustained an amputation of his dominant thumb. Clinical case. We present the case of a 10-year-old boy who sustained a complete amputation of his right thumb following a ring avulsion injury which was reconstructed with multiple approaches and surgical techniques to address difficulties at different stages. We replanted the avulsed thumb, reconstructed the tendon, soft tissue coverage with the use of allograft skin and local flap, and improvised surgical tactic to overcome complications encountered intra- and post-operative states such as thrombosis of arterial anastomosis and venous...
A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical managem... more A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical management following a failed endovascular approach to relieve central venous occlusion. She had an obstructed left brachiocephalic vein with a history of numerous central vein catheter placements. Alternative routes for new arteriovenous fistula creation had been exhausted due to previous contralateral upper limb fistula rupture and ligation. To the best of our knowledge, no similar cases of airway obstruction in central venous occlusion occurring in hemodialysis patients with AV fistula have been reported. The importance of identifying the possible emergency red flags in hemodialysis patients with central venous occlusion is important to prevent unwanted consequences.
Ukrainian Journal of Nephrology and Dialysis, 2020
Illicit penile augmentation is thought to be a common practice in Southeast Asia. This article ai... more Illicit penile augmentation is thought to be a common practice in Southeast Asia. This article aimed to explore the demographics of the patient who had illicit penile augmentation, its complications, surgical methods employed for removal as well as the long-term outcome following treatment, specifically on sexual satisfaction. Method. Records of patients with a penile foreign body to the Reconstructive Science Unit were retrieved. Demographics, presenting symptoms, surgical methods and outcomes were recorded and analyzed. Results. A total of 14 patients was identified. The median age at implantation and duration is 36 years old and 48 months respectively. The penile subdermal injection was the sole method utilized with the use of liquid silicone in 7 patients. Constant pain, painful erection, and discomfort were common symptoms (42.8%). All patients underwent surgical excision followed with either native (penile skin) full-thickness skin graft (FTSG), distant donor FTSG or primary c...
Recent Clinical Techniques, Results, and Research in Wounds, 2018
In the field of tissue engineering and reconstruction, the development of efficient biomaterial i... more In the field of tissue engineering and reconstruction, the development of efficient biomaterial is in high demand to achieve uncomplicated wound healing. Chronic wounds and excessive scarring are the major complications of tissue repair, and, as this inadequate healing continues to increase, novel therapies and treatments for dysfunctional skin repair and reconstruction are important. Skin substitutes that aid in the closure of extensive wounds with no scarring is the ultimate goal in the field of tissue engineering. The ideal skin substitute is still on high demand to achieve effective and scar-free wound healing. This paper reviews the various aspects of the complications related to wound healing and widely used skin substitutes and focuses on chitosan because of its unique function in accelerating wound healing. The proliferation of keratinocytes is essential for wound closure, and adipose-derived stem cells (ASCs) play a significant role in wound healing. ASCs were used to treat deep burns, skin radiation injuries, and even nonhealing wounds like diabetic ulcers. The usage of cultured cells on skin substitutes exactly mimics the skin which promotes the release of growth factors, cytokines, and chemokines. Thus, chitosan in combination with keratinocytes and adipose-derived stem cells may act as a vehicle for delivering cells, which would increase the proliferation of keratinocytes and help complete recovery from injuries.
Introduction: The modified Meek micrografting technique has been used in the treatment of severel... more Introduction: The modified Meek micrografting technique has been used in the treatment of severely burned patients and a number of articles have examined the use of the modified Meek technique in adults and in mixed-age groups. However, there is a paucity of research pertaining to the outcome in the pediatric age group. The aim of this study is to present our favorable outcome in pediatric major burns using the modified Meek technique. Methods: A retrospective review of burn cases in Hospital Universiti Sains Malaysia from 2010 to 2015 was conducted. Cases of major burns among pediatric patients grafted using the Meek technique were examined. Results: Twelve patients were grafted using the Meek technique. Ten (91.7%) patients were male, whereas 2 (8.3%) were female. The average age of patients was 6 years (range, 2-11 years). The average total body surface area was 35.4% (range, 15%-75%). Most burn mechanisms were due to flame injury (66.7%) as compared with scalds injury (16.7%) and chemical injury (16.7%). There was no mortality. All patients were completely grafted with a good donor site scar. The average graft take rate was 82.3%, although 8 cases had positive tissue cultures from the Meek-grafted areas. The average follow-up duration was 3.6 years (range, 1.1-6.7 years). Only 1 case developed contracture over minor joint. Conclusions: The Meek technique is useful when there is a paucity of donor site in the pediatric group. The graft take is good, contracture formation is low, and this technique is cost-effective.
Journal of Taibah University Medical Sciences, 2018
Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dres... more Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dressing and can be an option in the management of superficial and abrasion wounds.
International journal of hematology-oncology and stem cell research, 2017
Blood is considered to be precious because it is the basic necessity for health; our body needs a... more Blood is considered to be precious because it is the basic necessity for health; our body needs a steady provision of oxygen, supplied via blood, to reach billions of tissues and cells. Hematopoiesis is the process that generates blood cells of all lineages. However, platelets are the smallest blood component produced from the very large bone marrow cells called megakaryocytes and they play a fundamental role in thrombosis and hemostasis. Platelets contribute their hemostatic capacity via adhesion, activation and aggregation, which are triggered upon tissue injury, and these actions stimulate the coagulation factors and other mediators to achieve hemostasis. In addition, these coordinated series of events are the vital biological processes for wound healing phases. The aim of this review is to summarize and highlight the important pathways involved in achieving hemostasis that are ruled by platelets. In addition, this review also describes the mechanism action of platelets, includin...
Journal of Cleft Lip Palate and Craniofacial Anomalies, 2017
Introduction: Nonsyndromic cleft lip and/or palate (NSCLP) occurs as a result of multifactorial d... more Introduction: Nonsyndromic cleft lip and/or palate (NSCLP) occurs as a result of multifactorial determinants, involving both genetic and environmental factors. Several candidate genes associated with NSCLP have been discovered through genetic approach, but there is paucity of studies focusing on epigenetic determinants in NSCLP. We are interested to reveal linkage evidence of SATB2 at 2q region in large-extended NSCLP families of Malay population and its methylation activity in causing cleft formation. Materials and Methods: Eight large-extended families were included in this study. Microarray analysis was carried out and genome-wide linkage was determined using GeneHunter Multipoint Linkage Analysis v2.1r5. SATB2 methylation was tested on 100 NSCLP patients by DNA sequencing. Results: Genome-wide linkage analysis has revealed significant nonparametric linkage score and suggestive logarithm of the odds (LOD) score at 2q region in family 50 and family 100. Genome-wide heterogeneity LOD score of 2.63 and α =0.122 were found in total families at 2q33.1-q35 region. Significant copy number loss (P < 0.05) in NSCLP family compared with the normal control supports the linkage evidence of SATB2 in those families with positive linkage. Epigenetic testing found SATB2 unmethylation at DNA promoter region. Discussion: Linkage evidence and significant low copy number of SATB2 in NSCLP family of Malay population confirmed that genetic factors play a major role in causing cleft defects. SATB2 unmethylation could not support the epigenetic occurrence in causing craniofacial deformities. Conclusions: Linkage evidence and significant low copy number of SATB2 in NSCLP family of Malay population confirmed that genetic factors play a major role in causing cleft defects. SATB2 unmethylation could not support the epigenetic occurrence in causing craniofacial deformities.
International Journal on Advanced Science, Engineering and Information Technology, 2017
Hair follicles repeatedly regress and reconstitute themselves, suggesting the presence of intrins... more Hair follicles repeatedly regress and reconstitute themselves, suggesting the presence of intrinsic tissue stem cells. Among the unique characteristics of adult stem cells isolated from hair follicles is their ability to differentiate into keratinocytes. Study on chitosan skin-engineered templates (SETs) as scaffolds for the proliferation of human fibroblasts have shown the promise of SETs in facilitating skin cell growth in three-dimensional culture. High proliferation in three-dimensional culture using human cells allows the researcher to extensively evaluate the cultivation of desirable cell types on chitosan SETs. Therefore, this study aimed to evaluate the in vitro attachment, proliferation and differentiation of hair follicle stem cells (HFSCs) on a chitosan SETs. HFSCs were isolated from human scalp tissues using collagenase type I prior to propagation in supplemented CnT-07 media. The phenotype of the HFSCs was verified using the markers keratin-15 (K15) and CD200, as detected by immunocytochemical staining. The attachment and proliferation of the HFSCs on the chitosan SETs were evaluated using scanning electron microscopy (SEM), an alamar blue assay and a live/dead assay. Subsequently, the HFSCs were differentiated using CnT-2D differentiation media. The cells' differentiation was verified using the markers involucrin and keratin-6 (K6), as detected by immunofluorescence staining. The HFSCs were successfully isolated, proliferated and differentiated according to staining positivity and microscopy imaging. HFSCs are able to proliferate and directly differentiate into keratinocytes on a chitosan SETs, which may facilitate their use in regenerative medicine.
Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vi... more Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vivo or in vitro conditions. The size of mMP is between 0.1 and 1.0 μm. Apart from the size range, mMPs are also identified based on phosphatidylserine and CD14 expression on their surface, though this is not always the case. Monocytic MP are critical players in inflammation, endothelial cell function, and blood coagulation. They exhibit dual function by either helping the progression of such conditions or limiting it, depending on certain factors. Furthermore, the numbers of mMP are elevated in some autoimmune diseases, infectious diseases, and metabolic disorders. However, it is unknown whether mMP play an active role in these diseases or are simply biomarkers. The mechanism of mMP modulation is yet to be identified. In this review, we highlight the mechanism of mMP formation and the roles that they play in inflammation, blood coagulation, and different disease settings.
Open Access Macedonian Journal of Medical Sciences, 2016
BACKGROUND: Von Willebrand disease (vWD) is an inherited hemostatic disorder that affects the hem... more BACKGROUND: Von Willebrand disease (vWD) is an inherited hemostatic disorder that affects the hemostasis pathway. The worldwide prevalence of vWD is estimated to be 1% of the general population but only 0.002% in Malaysia.AIM: Our present paper has been written to disclose the statistical counts on the number of vWD cases reported from 2011 to 2013.MATERIAL AND METHODS: This article is based on sociodemographic data, diagnoses and laboratory findings of vWD in Malaysia. A total of 92 patients were reported to have vWD in Malaysia from 2011 to 2013.RESULTS: Sociodemographic-analysis revealed that 60% were females, 63% were of the Malay ethnicity, 41.3% were in the 19-44 year old age group and 15.2% were from Sabah, with the East region having the highest registered number of vWD cases. In Malaysia, most patients are predominately affected by vWD type 1 (77.2%). Factor 8, von Willebrand factor: Antigen and vWF: Collagen-Binding was the strongest determinants in the laboratory profiles...
International journal of clinical and experimental medicine, 2015
Chitosan-derived biomaterials have been reported to adhere when in contact with blood by encourag... more Chitosan-derived biomaterials have been reported to adhere when in contact with blood by encouraging platelets to adhere, activate and aggregate at the sites of vascular injury, thus enhanced wound healing capacity. This study investigated platelet morphology changes and the expression level of transforming growth factor-β1 (TGF-β1) and platelet-derived growth factor-AB (PDGF-AB) in the adherence of two different types of chitosans in von Willebrand disease (vWD): N,O-carboxymethylchitosan (NO-CMC) and oligo-chitosan (O-C). Fourteen vWD voluntary subjects were recruited, and they provided written informed consent. Scanning electron microscopy and enzyme-linked immunosorbent assay test procedures were employed to achieve the objective of the study. The results suggest that the O-C group showed dramatic changes in the platelet's behaviors. Platelets extended filopodia and generated lamellipodia, leading to the formation of grape-like shaped aggregation. The platelet aggregation oc...
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Papers by Ahmad Halim