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Locoregional lymph node evaluation is a crucial process for staging many solitary cancers. Identifying and localizing the primary draining lymph node can be challenging, particularly in anatomically complex regions, such as the head and neck. The first lymph node(s) that receive lymphatic drainage from a primary tumour is termed the sentinel lymph node (SLN) and can be predicative of metastatic disease. Several SLN mapping techniques have been described to identify and locate the SLN. Near infrared fluorescence imaging (NIRF) is one technique that has been used successfully in human medicine, and requires a fluorescent contrast agent, commonly, indocyanine green (ICG). However, NIRF has not been extensively investigated in veterinary medicine. Furthermore, a combination of preoperative and intraoperative SLN mapping modalities has been suggested to improve the accuracy of SLN detection. The purpose of this research was to evaluate the use of NIRF for SLN mapping in dogs. The objective of the first study was to determine the agreement between preoperative computed tomography lymphography (CTL) using iohexol and intraoperative NIRF lymphography for SLN detection in dogs with oral tumours. A fair agreement between preoperative and intraoperative SLN mapping modalities was identified. Near infrared fluorescence imaging was effective in localizing SLNs intraoperatively resulting in a high SLN detection rate. In addition, the combination of preoperative and intraoperative modalities resulted in high SLN detection rates. A novel dual-modality imaging contrast agent, Nanotrast-CF800, incorporates both iohexol and ICG within a liposomal nanoparticle for the use of preoperative CTL and intraoperative NIRF for SLN mapping. The feasibility of CF800 and the development of potential associated local and systemic adverse events were assessed in a healthy canine population following local administration within the oral cavity and following intravenous administration in two separate studies. Prolonged retention of the contrast agent within SLNs identified on CT images and/or NIRF were observed. No significant local or systemic adverse events were observed following local and intravenous administration of CF800. The administration of CF800 is safe to use in healthy dogs with prolonged retention within targeted tissues. OVC Pet Trust, Nanovista

Background: Myeloid sarcoma (MS) is a solid malignant tumour associated with infiltration of immature myeloid precursor cells in an extramedullary site. The term MS has replaced the term granulocytic sarcoma and chloroma, which were used in the past. MS in the oral cavity is very uncommon, with less of 40 cases reported until recently. Case Report: We report the first case, the features, and the diagnostic sequence, of intraoral MS with bilateral palatal involvement, which presented as an initial manifestation, and preceded the appearance of acute myeloid leukemia (AML). Diagnostic confirmation of such oral mucosal lesions usually requires biopsy, histopathological examination with additional immunohistochemical investigation. MS can occur during the course of acute or chronic myelogenous leukemia, and myelodysplastic syndromes. In the vast majority of the reported cases, only one site was involved with a single intraoral MS lesion, and the cases predominantly associated with AML. Conclusion: The majority of intraoral MS occurs in patients with known AML, but in some of them, presented as an initial manifestation, and preceded the appearance of the disease. Therefore, clinicians should carefully evaluate all unusual oral lesions of unknown origin.

A central odontogenic fibroma (COF) is a rare tumor of odontogenic origin with a diverse histopathology found in both the mandible and the maxilla. It can often be difficult to diagnose; therefore, it is necessary to evaluate the clinical, radiographic, and histopathological analyses of COF and co-relate them in a manner to make definitive diagnosis easier for the treating physician. Herein, we report and discuss the first known case of central odontogenic fibroma in Pakistan: a 16-year-old boy presenting as a hard bony painless swelling of the left mandibular region. It appeared as a large, well-defined unilocular radiolucency on the orthopantomogram, making it indistinguishable from other radiolucent tumors of the mandible. Histologically, the lesion consisted of nests of odontogenic epithelium in between the fibroblastic stroma, confirming a definitive diagnosis of COF. It was treated by conservative surgical excision followed by curettage and no postoperative complications were reported.

The Malaysian nationwide survey on oral mucosal lesions (OML) in 1993/94 showed a low prevalence of OML in particular oral cancer and precancer (OPC) among Malays as compared to the Indians and the Indigenous people of Sabah and Sarawak. A low prevalence of quid chewing habit was also noted in the Malays in that survey. The present study was conducted to investigate whether the low prevalence of OPC in the Malays was attributed to the low prevalence of quid users among the Malays and/or whether the quid contents used were different. Two examiners were trained prior to the survey. The interexaminer consistency of diagnosing the presence or absence of lesions was 91.3%. An interview on their oral habits was also done. The mean age of 276 subjects examined was 61.1± 10.1 years. There were 23.6% men and 76.4% women. Among the subjects interviewed, 41.7% were smokers and 37.7% were quid chewers. The prevalence of OML was 20.3% while OPC was found in only 1.4% of the subjects examined. Among the quid chewers and non-quid chewers, the prevalence of OML was found to be 35.6% and 11% respectively. However the prevalence of OPC (only leukoplakia and lichen planus were detected; cancer, erythroplakia and oral submucous fibrosis were absent) was equally low in both groups (1.9% among quid chewers and 1.2% among non-quid chewers). Such low prevalence of OPC among Malay quid chewers differed from reported higher prevalences of OPC in the Malaysian Indians and the Indigenous people of Sarawak. A further analysis of the quid contents showed a low usage of tobacco (3.8%) in the quid mixtures chewed by these subjects as compared to the quid mixtures reportedly used by the Indian and the Indigenous people Sarawak. It is concluded that the lack of tobacco in the quid mixtures used by the Malays may be related to the low prevalence of OPC in Malay quid chewers. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A ressecção do ramo ascendente da mandíbula ocasiona um déficit funcional e estético considerável. OBJETIVO: Comparar a mandibulectomia marginal e segmentar de tumores avançados de loja amigdalina e região retromolar sem envolvimento ósseo mandibular detectado no período pré-operatório, em relação à sobrevida e recidiva loco-regional. Forma de Estudo: Estudo de coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Compararam-se 20 pacientes tratados com mandibulectomia marginal e 22 tratados com mandibulectomia segmentar de outubro de 1994 a dezembro de 2001 em serviço de referência em Cirurgia de Cabeça e Pescoço. RESULTADOS: Dos 20 pacientes tratados com mandibulectomia marginal, 35% morreram com doença, 15% por recidiva local, 15% por recidiva regional e 5% por recidiva loco-regional. Dos 22 pacientes tratados com mandibulectomia segmentar 45,4% morreram pela doença, sendo 31,8% por recidiva local e 13,6% por recidiva à distância. Na análise pelo método de Kaplan-Meier o grupo tratado com mandibulectomia marginal apresentou uma taxa de 55%, e o grupo tratado com ressecção segmentar 45% com p= 0,8329. CONCLUSÕES: A análise dos dois grupos evidenciou que a conservação do ramo ascendente da mandíbula, mesmo em lesões avançadas, sem envolvimento mandibular, não aumenta o índice de recidiva.Resection of the ascending ramus of the mandible can result in considerable functional and esthetic damage. AIM: To compare the survival rate and local and regional recurrence in marginal and segmental mandibulectomy for advanced tonsil and retromolar trigone tumours with no mandibular invasion. PLACE AND PERIOD: Reference Head & Neck Service, between October 1994 and December 2001. MATERIAL AND METHOD: 20 stage IV patients undergoing marginal mandibulectomy and 22 undergoing segmental mandibulectomy were compared. CASE STUDY: a contemporary cross-sectional cohort study. RESULTS: Of 20 patients undergoing marginal mandibulectomy, 35% died of the disease, 15% due to local recurrence, 15% due to regional recurrence and 5% due to local and regional recurrence. Of 22 patients undergoing segmentary mandibulectomy, 36,4% died of the disease, 31,8% due to local recurrence and 13,6% due to distant recurrence. The Kaplan-Meier analysis showed a 55% survival rate for the marginal mandibulectomy group, and a 45% survival rate for the segmental group (p= 0.8329). CONCLUSIONS: Analysis of the two groups showed that conservation of the ascending ramus of the mandible, even in advanced lesions with no mandibular involvement, does not increase the recurrence rate.

resseccao do ramo ascendente da mandibula ocasio-na um deficit funcional e estetico consideravel. Objetivo: Comparar a mandibulectomia marginal e segmentar de tumores avancados de loja amigdalina e regiao retromolar sem envolvimento osseo mandibular detectado no periodo pre-operatorio, em relacao a sobrevida e recidiva loco-re-gional. Forma de Estudo: Estudo de coorte contemporânea com corte transversal. Material e Metodo: Compararam-se 20 pacientes tratados com mandibulectomia marginal e 22 tratados com mandibulectomia segmentar de outubro de 1994 a dezembro de 2001 em servico de referencia em Cirurgia de Cabeca e Pescoco. Resultados: Dos 20 pacientes tratados com mandibulectomia marginal, 35% morreram com doenca, 15% por recidiva local, 15% por recidiva regional e 5% por recidiva loco-regional. Dos 22 pacientes tratados com man-dibulectomia segmentar 45,4% morreram pela doenca, sendo 31,8% por recidiva local e 13,6% por recidiva a distância. Na analise pelo metodo de Kaplan-Meier o grupo tratado com mandibulectomia marginal apresentou uma taxa de 55%, e o grupo tratado com resseccao segmentar 45% com p= 0,8329. Conclusoes: A analise dos dois grupos evidenciou que a conservacao do ramo ascendente da mandibula, mesmo em lesoes avancadas, sem envolvimento mandibular, nao aumenta o indice de recidiva.Maria Beatriz Nogueira Pascoal

Introduction: The risk of cancer has been extensively investigated with the intake of single food items but food consumption in an individual is usually complex, made up by combinations of different food items. This study aims to identify dietary patterns of Malaysians, and establishing relationship between dietary pattern and oral cancer risk. Methods A hospital-based, case-control study was conducted on 300 Malaysians who seek treatment at participating hospitals between January 2003 and December 2010. The subjects consisted of 150 cases and 150 controls that were matched for gender, age (5 years) and ethnicity. Dietary intake was measured using Food Frequency Questionnaire (FFQ). Factor Analysis (FA) was performed to identify dietary consumptions pattern based on the intake of nine major food groups. Logistic Regression was done to compute the odds ratio (OR) for the components retained by FA. Results: FA had identified four patterns that accounted for 69.4% of total variability within the sample. The first pattern labeled as 'modern' was loaded with processed foods and snacks intakes whereas the second pattern 'prudent' was characterized by the intakes of fruits and vegetables. The third pattern 'traditional' consisted of beverages and starches intakes while the fourth pattern 'combination' was loaded with intakes of dairy foods, fermented foods and meat/byproducts. A significant reduced risk was found for 'prudent' (aOR 0.42, 95%CI: 0.21–0.83, p < 0.05), whereas a significant increased risk was found for both 'traditional' (aOR 2.06, 95%CI: 1.05–4.02) and 'combination' (aOR 3.45, 95%CI: 1.75–6.77, p < 0.05) pattern. Discussion: These findings suggest that intake of 'prudent' pattern may confer protection against oral cancer risk of up to 58% whereas the highest consumption of both 'traditional' and 'combination' pattern may induce twice and thrice the risk of oral cancer. FA was also found to be a useful tool to identify dietary pattern and its relationship with oral cancer. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: Oral cancer is a debilitating disease and the survival rates for these patients have not improved over the past decades. Tobacco smoking is one of the most common risk factor associated with oral cancer. Objectives: To explore and identify differential genes expression associated with tobacco smoking. Methodology: Next generation sequencing using the Illumina Genome Analyzer was done to sequence five fresh frozen oral cancer tissue samples from smoking patients, two of which were former smoker and an additional 8 samples consisting of normal oral mucosal tissues from the alveolar mucosa of non-cancer patients where 4 were smokers and another 4 were non-smokers. The tissues and socio- demographic information were obtained from the Malaysian Oral Cancer Data and Tumour Bank System (MOCDTBS) at the Oral Cancer Research and Coordinating Centre (OCRCC). High quality poly A+ RNA was extracted from macrodissected tumour and normal epithelial tissue to obtain >70. Validation of second generation sequencing was done using commercial and custom microarrays. Principle component analysis (PCA) was applied to the sequenced generated data. Results and discussion: PCA showed distinct clusters separating groups of current and former smokers. The former smoker who ceased smoking >25 years clustered closely with normal non-smoker suggesting expression levels of some of the genes related to tobacco smoking could return to levels similar to never smokers upon cessation of smoking. When comparing differential gene expression between tumor in former and current smokers, ACTC1, MYH2, DES, MYBPH, MYLPF were the top 5 most down-regulated genes. Meanwhile, CYP2W1, FAIM2, OLFML1, KRT13 were found to be up-regulated when comparing differential gene expression between these groups (fold change > 8). Despite prolonged smoking cessation, some gene expression could appear to be permanently altered and these irreversible changes may account for oral cancer risk despite smoking cessation. Conclusion: These findings illustrate the potential for next generation sequencing to provide insights into the unique gene expression profiles associated with risk habits which will be useful in developing biomarkers for prognostic and therapeutic applications in the future. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: HPV infection has been associated with a subset of head and neck cancers and current evidence suggest that it may be an important risk factor for oral cancer. Using polymerase chain reaction (PCR) and sequencing, we recently demonstrated the presence of HPV in more than 50 of oral squamous cell carcinoma (OSCC) patients and that high-risk HPV is significantly associated with OSCC. Serological detection of HPV has been reported the most convenient method for detecting HPV. However, currently there is a lack of serological assays for the detection of the HPV. The HPV E6 viral oncoprotein is known to play crucial role in tumorigenesis, therefore detecting the presence of the E6 protein could be a useful biomarker for HPV detection.Methods: A pGEX plasmid containing HPV 16 E6 gene was ligated with KT3 oligonucleotide. Constructed plasmid was then transformed into Escherichia coli for production of the recombinant protein which was used as antigen in ELISA assay. ELISA was optimized using anti KT3 antibody to detect the recombinant antigen. HPV ELISA was performed on sera from 18 healthy and 15 OSCC patients obtained from the Malaysian Oral Cancer Database & Tissue Bank System (MOCDTBS) which is coordinated by Oral Cancer Research & Coordinating Centre (OCRCC). Sera that have net OD above calculated cutoff value were determined as HPV seropositive. Fisher's Exact test was used for statistical evaluation.Results: An ELISA method to detect the presence of HPV16 E6 protein was successfully developed. Using this method, 33.3 (5/15) of OSCC and 16.7 (3/18) of healthy patients were found to be HPV 16 seropositive. No significant association was found between HPV 16 seropositivity and OSCC occurrence (P value = 0.428).Discussion: Although there is a trend to support our previous findings using PCR where a larger proportion of OSCC patients were HPV positive in comparison to healthy individuals, our results using ELISA method did not show any statistical significance. This remains to be tested in a larger sample set to confirm pur preliminary result that could more representative of our patient population. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: ITCs found in cruciferous vegetables has been reported to reduce cancer risk by inducing phase II conjugating enzymes, in particular GSTs. Interestingly, these enzymes also metabolize ITCs therefore; the protective effects of ITCs would depend on the activity of GSTs. This study aimed to determine association between dietary ITCs, GSTs polymorphisms and risk habits (cigarette smoking, alcohol drinking and betel-quid chewing) with oral cancer.Method: Included in this study were 115 OSCC patients and 116 healthy subjects. Information on ITC intake from cruciferous vegetables was collected via a semi-quantitative FFQ. Peripheral blood lymphocytes were obtained for genotyping of GSTM1, GSTT1 and GSTP1 using PCR multiplex and PCR-RFLP. Chi-square and logistic regression were performed to determine the association of ITC and GSTs polymorphism and risk of oral cancer.Results: When dietary ITC was categorized into high (greater than/equal to median) and low (less than median) intake, ITC consumption was higher among cases (51.3%) than controls. However, it was not statistically significant (p = 0.645). Discussion: Odd ratios analysis showed no significant association between ITC intake, GSTM1, GSTT1 or GSTP1 genotypes with oral cancer risk. However, GSTP1 wild-type was associated with later disease onset in women above 55 years of age (p = 0.017). Among men above 45 years of age, there was a significant 17-year difference in the age of OSCC onset between those with GSTP1 wild-type ? low ITC intake and GSTP1 polymorphism ? high ITC intake (p < 0.001). Similarly further analysis stratified by risk habits (drinking and chewing), showed that GSTP1 polymorphism ? high ITC intake was associated with earlier disease onset (p < 0.001). This study suggests that combinatory effects between dietary ITCs, GSTP1 polymorphism and risk habits may be associated with risk of oral cancer and modulate the age of disease onset. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Purpose: The purpose of this study was to evaluate the role of HPV and p53 polymorphisms in oral squamous cell carcinomas (OSCC) affecting Malaysian population. Methods: We analysed frozen samples from 105 OSCC as well as 105 oral specimens derived from healthy individuals. PCR assays targeting two regions of the virus were used. PCR amplification for the analysis of p53 codon 72 arginine/proline alleles was carried out in a separate reaction. Results: HPV DNA was detected in 51.4% OSCC samples, while 24.8% controls were found to be HPV positive. HPV was found to be significantly associated with OSCC (P < 0.001, OR = 4.3 after adjustment for habits) when compared to controls. High-risk HPV was found to be significantly associated with OSCC cases (P < 0.05). Demographic profiles of age, gender, race and habits were not associated with HPV presence in cases and controls. However, significantly less HPV positivity was seen in poorly differentiated compared to well-differentiated OSCCs. No significant association was found between HPV positivity and p53 polymorphisms in cases and control groups. Additionally, we found no association of codon 72 polymorphism with oral cancer. Conclusions: This study indicates that high-risk HPV infection is one of the contributing factors for OSCCs. HPV 16 was the predominant type found in Malaysian patients with OSCC. Further, we did not find any association between p53 codon 72 polymorphism and HPV infection or between the p53 polymorphism and the risk of oral cancer. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: Several molecular markers have been studied for their usefulness as prognostic markers in oral squamous cell carcinoma (OSCC). One such molecular marker is cyclin D1 which is a proto-oncogene located on 11q13 in humans. Objective: To explore the feasibility of using cyclin D1 as a prognostic marker in tongue and cheek SCC by the fluorescent-in-situ hybridization (FISH) method. Methods: Fifty paraffin-embedded samples (25 each of cheek and tongue SCCs) were obtained from the archives of the Oral Pathology Diagnostic Laboratory. Sociodemographic data, histopathologic diagnoses, lymph node status and survival data were obtained from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS)coordinated by the Oral Cancer Research and Coordinating Centre (OCRCC), University of Malaya. The FISH technique was used to detect the amplification of cyclin D1 using the Vysis protocol. Statistical correlations of cyclin D1 with site and lymph node status were analyzed using the Fisher exact test. Kaplan-Meier and Log Rank (Mantel-Cox) test were used to analyze cyclin D1 amplification and median survival time. Results: Positive amplification of cyclin D1 was detected in 72 (36) of OSCCs. Detection of positive amplification for cyclin D1 was observed in 88 (22) and 56 (14) of the tongue and cheek tumors, respectively, where the difference was statistically significant (P=0.012). Lymph node metastasis of cheek SCCs showed a trend towards a significant association (P= 0.098) with cyclin D1 amplification whereas the lymph node metastasis of tongue SCC was clearly not significant (P=0.593).There was a statistically significant correlation between cyclin D1 positivity and survival rate (P=0.009) for overall SCC cases and (P

The implementation of information technology in healthcare is a significant focus for many nations around the world. However, information technology support for clinical care, research and education in oral medicine is currently poorly developed. This situation hampers our ability to transform oral medicine into a 'learning healthcare discipline' in which the divide between clinical practice and research is diminished and, ultimately, eliminated. This paper reviews the needs of and requirements for information technology support of oral medicine and proposes an agenda designed to meet those needs. For oral medicine, this agenda includes analyzing and reviewing current clinical and documentation practices, working toward progressively standardizing clinical data, and helping define requirements for oral medicine systems. IT professionals can contribute by conducting baseline studies about the use of electronic systems, helping develop controlled vocabularies and ontologies, and designing, implementing, and evaluating novel systems centered on the needs of clinicians, researchers and educators. Successfully advancing IT support for oral medicine will require close coordination and collaboration among oral medicine professionals, information technology professionals, system vendors, and funding agencies. If current barriers and obstacles are overcome, practice and research in oral medicine stand ready to derive significant benefits from the application of information technology. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Objectives: This study was done to investigate the role of single nucleotide polymorphisms(SNPs) within genes of phase I (CYP1A1) and phase II (GSTM1, GSTT1,GSTP1) of the xenobiotic metabolism and its association with oral cancer risk.Methods: An unmatched case-control study was conducted using 207 newly diagnosed oral cancer patients and 117 non-cancer subjects selected from the OCRCC database. Peripheral blood was obtained from consented individuals and the CYP1A1, GSTM1, GSTT1 and GSTP1 genotypes were determined using polymerase chain reaction (PCR) and restriction enzyme digestion (RFLP). Simple and multiple logistic regression yielding odds ratio (OR and aOR) were employed to measure the association between genetic polymorphisms and risk of oral cancer. Results: In comparing cases and controls for CYP1A1, GSTM1 and GSTT1 polymorphism, the OR was 0.84 (95 CI 0.534 - 1.330), 0.99 (95 CI 0.627 - 1.554) and 0.87 (95 CI 0.541 - 1.388) respectively. However, the adjusted OR for GSTP1 polymorphism, as compared to the wild-type, was 0.43 (95 CI 0.221 - 0.837). It was noted that polymorphism of GSTP1 conferred a 57 reduction in risk of oral cancer as compared to individuals with the GSTP1 wild type genotype. Meanwhile individuals with combination of betel quid chewing habit and/or GSTP1 polymorphism has 1.6 times the risk of oral cancer although it was not statistically significant (95 CI 0.974 - 2.635). Conclusions: Analysis suggested that polymorphism of GSTP1 seems to have protective effect on the risk of oral cancer. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Objectives: To characterize differential gene expression between oral cancerous tissues and the normal mucosal tissues of oral cancer patients and oral mucosal tissues of cancer free patients using second generation sequencing. Methods: Five fresh frozen oral cancer tissue samples from smoking patients, with 2 samples of proximal normal were included in this study. An additional 8 samples consisting of normal oral mucosal tissues from the alveolar mucosa of non-cancer patients who had their wisdom tooth removed where 4 were smokers and another 4 were non-smokers was also included. The tissues and socio-demographic information were obtained from the Malaysian Oral Cancer Data and Tumour Bank System (MOCDTBS) at the Oral Cancer Research and Coordinating Centre (OCRCC). Manual macrodissection was used to obtain >70% tumour or normal epithelial tissue. High quality poly A+ RNA was extracted from the macrodissected tissues and second generation sequencing was done using the Illumina Genome Analyzer. Validation of second generation sequencing was done using commercial and custom microarrays. Results: Among the differentially expressed genes, KRT76 which encodes a filament protein that is responsible for the structural integrity of epithelial cells was the most down-regulated gene when comparing all tumours to all normals (excluding proximal normals). KRT76 is the second most down-regulated gene when comparing differential expression between proximal normal and normal non-cancer samples. Further comparison of all tumors against all normals, including the proximal normals, still indicates down-regulation of KRT76, but to a much lesser degree. A similar pattern was also observed for other down-regulated genes such as the KRT2, KRT3, ANKS1B, CPLX2, FGB, HIST1H3A, HIST1H3G, HIST1H4I, LOR and ZFHX2.Conclusions: This pattern of partial cancerisation of proximal normal samples issuggestive of the possible presence of _field cancerisation'.Relevance: The ''field cancerisation'' theory was postulated by Slaughter whereby the occurrence of multiple independent primary tumours was explained by the fact that the upper aerodigestive tract is chronically exposed to carcinogens. Various conventional molecular methods including microarray based technologies have been applied. Nevertheless, there have been no reports utilizing second generation sequencing to elucidate differentially expressed genes in relation to _field cancerisation' in oral carcinogenesis. Using second generation sequencing to discover genes involved in _field cancerisation' may be useful in predicting the outcome of different management strategies for oral cancer patients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Background: Application of PCR techniques requiring only minute amounts of Genomic DNA. Thus, a less invasive, simpler to perform, and cheaper method to obtain DNA from exfoliated cells is desirable. We aim to develop a method that can obtain high quality of genomic DNA from one sample that allows for numerous application of PCR analysis. Objective: This study describes a simple, inexpensive and non invasive protocol to isolate a high quality of genomic DNA from exfoliated cells by using swish method. Methodology: Twenty two subjects vigorously swished 10 ml of normal saline in their mouth for 60 s and spitted into a collection tube. DNA extraction assay was performed by using saliva DNA isolation kit (Norgen, USA). The washed pellets were suspended in TE buffer and analyzed for the quality and purity of DNA content by using the NanoDrop Spectrophotometer. A ratio of A260/A280 was calculated. The extracted genomic DNA was amplified with primers of p53 intron 6 by using PCR machine. The presence of amplified DNA was then confirmed by electrophoreses analysis, which DNA bands were scanned by Typhoon 9410 variable imager. Results: In this study, the extracted genomic DNA demonstrated an average value of 1.94 O.D. in DNA content purity and 42.9 \backslashensuremath\ensuremathμg/\backslashensuremath\ensuremathμl in DNA yields. The electrophoresis images of the DNA products showed visible and detectable bands of higher molecular weight DNA in all the samples. Conclusion: The results showed that the extracted genomic DNA from the exfoliated cells by applying the swish method, that provides substantially larger amounts and higher molecular weight of DNA for down-stream DNA identification application. In addition, all samples were successfully genotyped by PCR-based assays for p53 gene intron 6 regions, which confirmed that the quality of isolated DNA was reliable in supporting the PCR amplification for the molecular studies. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A ressecção do ramo ascendente da mandíbula ocasiona um déficit funcional e estético considerável. OBJETIVO: Comparar a mandibulectomia marginal e segmentar de tumores avançados de loja amigdalina e região retromolar sem envolvimento ósseo mandibular detectado no período pré-operatório, em relação à sobrevida e recidiva loco-regional. Forma de Estudo: Estudo de coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Compararam-se 20 pacientes tratados com mandibulectomia marginal e 22 tratados com mandibulectomia segmentar de outubro de 1994 a dezembro de 2001 em serviço de referência em Cirurgia de Cabeça e Pescoço. RESULTADOS: Dos 20 pacientes tratados com mandibulectomia marginal, 35% morreram com doença, 15% por recidiva local, 15% por recidiva regional e 5% por recidiva loco-regional. Dos 22 pacientes tratados com mandibulectomia segmentar 45,4% morreram pela doença, sendo 31,8% por recidiva local e 13,6% por recidiva à distância. Na análise pelo método de Kaplan-Meier o grupo tratado com mandibulectomia marginal apresentou uma taxa de 55%, e o grupo tratado com ressecção segmentar 45% com p= 0,8329. CONCLUSÕES: A análise dos dois grupos evidenciou que a conservação do ramo ascendente da mandíbula, mesmo em lesões avançadas, sem envolvimento mandibular, não aumenta o índice de recidiva. Resection of the ascending ramus of the mandible can result in considerable functional and esthetic damage. AIM: To compare the survival rate and local and regional recurrence in marginal and segmental mandibulectomy for advanced tonsil and retromolar trigone tumours with no mandibular invasion. PLACE AND PERIOD: Reference Head & Neck Service, between October 1994 and December 2001. MATERIAL AND METHOD: 20 stage IV patients undergoing marginal mandibulectomy and 22 undergoing segmental mandibulectomy were compared. CASE STUDY: a contemporary cross-sectional cohort study. RESULTS: Of 20 patients undergoing marginal mandibulectomy, 35% died of the disease, 15% due to local recurrence, 15% due to regional recurrence and 5% due to local and regional recurrence. Of 22 patients undergoing segmentary mandibulectomy, 36,4% died of the disease, 31,8% due to local recurrence and 13,6% due to distant recurrence. The Kaplan-Meier analysis showed a 55% survival rate for the marginal mandibulectomy group, and a 45% survival rate for the segmental group (p= 0.8329). CONCLUSIONS: Analysis of the two groups showed that conservation of the ascending ramus of the mandible, even in advanced lesions with no mandibular involvement, does not increase the recurrence rate.

Purpose: To assess the expression of pRb and EGFR in oral epithelial lesions using TMA technique. Methods: Paraffin embedded specimens were selected from the archives of the Diagnostic Laboratories at the Faculty of Dentistry, University of Malaya and Universiti Kebangsaan Malaysia. Selected epithelial areas were cored and developed into tissue microarray blocks. A total of 32 samples for pRb and 50 samples for EGFR were analysed using immunohistochemical techniques. Results: Abnormal pRb staining (1+ or less) was seen in 80% (8/10) OSCC, 38.5% (5/13) dysplastic and 22.2% (2/9) normal/hyperplastic epithelium. Positive EGFR staining was observed in 25/35 (71.4%) OSCC cases with 11 cases (31.4%) showing staining of 2+ or more. Out of 5 epithelial dysplasia and 10 normal/hyperplastic epithelium, positive EGFR staining was noted in 3 (60%) and 8 (80%) cases respectively. Interestingly, only 1(20%) epithelial dysplasia and 1(10%) normal/hyperplastic epithelium showed staining of 2+ or more. Conclusion: High frequency of abnormal expression of pRb is observed in OSCC cases as compared to dysplastic and normal/hyperplastic epithelium. EGFR is expressed in OSCC as well as epithelial dysplasia and normal/hyperplastic epithelium. However, higher EGFR positivity is more common in OSCC cases. This study supports the feasibility and ease of using TMA technique for immunohistochemical studies. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Purpose: Human b-Defensin (hBDs) is an epithelial origin, cationic antimicrobial peptides. Their expression is reported in oral mucosa, gingiva and salivary glands. However, their protective role is not well understood. It has been suggested that bacterial and viral infection are an important factors in the process of carcinogenesis. This study investigated the expression of hBD-3 in oral squamous cells carcinoma (OSCC). Methods: 29 OSCC and 23 samples of normal and dysplastic tissues were obtained from Oral Pathology diagnostic laboratory, faculty of Dentistry, UKM and UM. The tissues were arrayed and the expression of hBD-3 was analysed using immunohistochemistry technique. Results: Higher levels of hBD-3 expression were found in stage II and II of OSCC compared to stage I and IV. Expression of hBD-3 was also seen higher in the tumour front arrays. Healthy and dysplastic tissues also seen to expressed hBD-3 but most are moderately stained. Conclusion: High levels of hBD-3 expression is seen especially in stage II and III as well as in tumour front suggest a potential tumour marker, correlation between level of expression and probable infective cancer causes need to be investigate further. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: The variability of clinical outcomes in oral cancer patients and the heterogeneity of the disease are the main challenges for the improvement of current treatment modalities. Efforts in our laboratory have focused on the molecular profiling of oral cancer to understand the mechanisms underlying the disease. In a previous microarray study, we found Guanine nucleotide binding protein alpha-12 (GNA12) to be up-regulated in oral cancer. Materials and methods: In this study, we validated the expression of GNA12 at the mRNA level in 47 oral squamous cell carcinoma (OSCC) and 18 non-malignant oral mucosa tissues, by quantitative polymerase chain reaction (qPCR). Further, GNA12 protein expression was accessed by immunohistochemistry (IHC) on 44 tumors and 23 non-malignant oral mucosa tissues. Using OSCC cell lines, we examined the effects of GNA12 signaling by in vitro functional assays. Results: We demonstrated that GNA12 mRNA levels were significantly up-regulated in OSCC in comparison to the non-malignant oral mucosa tissues. Consistently, high levels of GNA12 protein expression were detected in 75% of OSCC tissues, while the non-malignant tissues showed negative or weak expression. We demonstrated that expression of activated GNA12 (GQ231L) promoted oral cancer cell migration in a monolayer wound healing assay and cell invasion through the matrigel barrier, but cell proliferation was not changed. Correspondingly, exogenous expression of the regulator of G-protein signaling (RGS) blocked G12 family signaling through RhoA, which resulted in the inhibition of cancer cell migration and invasion. Discussion: In summary, we demonstrated for the first time in OSCC that GNA12 is over-expressed in a large percentage of these patients and notably, the over-expression drives migration and invasion of oral cancer cells. Taken together, this information indicates that targeting GNA12 could benefit oral cancer patients by preventing the spread of the disease. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Darier disease, also known as keratosis follicularis, dyskeratosis follicularis, and benign dyskeratosis, is a rare disorder of keratinisation that primarily affects the skin and, to a lesser extent, the oral mucosa. It was described independently by both Darier and White in 1889. It has a prevalence of 1:100,000 of the population and is inherited as an autosomal dominant trait.1 The age of onset is childhood or adolescence. Patients usually present with multiple small firm reddish-brown papules on the forehead, scalp, neck, shoulders, chest, and limbs. Other cutaneous signs include punctate keratotic pits of the palms and soles and dystrophy of the nails, which is characterised by a red and white sandwich of streaks associated with a V-shaped notch. The oral lesions are usually asymptomatic and are seen as multiple, normal-coloured or white flat-topped papules that predominantly affect the palate. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Introduction: We have established a cell line ORL-48(T) from a surgically resected specimen of an untreated primary human oral squamous cell carcinoma of the mandible.This patient did not appear to have any oral habits which have been reported to be associated with oral cancer Materials and Method: The in vitro growth characteristics, epithelial origin, in vitro anchorage independency, HPV infection, microsatellite instability status, karyotype and the status of various cell cycle regulators and gatekeepers of the ORL-48(T) cell line were investigated. Results: The ORL-48(T) cell line is immortal, 3T3- independent and grew as a monolayer with the doubling time of 48h. Immunohistochemistry staining of cytokeratins confirmed the cell line is of epithelial origin. Soft agar assays demonstrated that ORL-48(T) expressed a low degree of anchorage independency (CFE

Oral tumours are common worldwide and are attributed to factors like tobacco smoke, ill-fitting dentures, alcohol, and syphilis. Viruses like HPV and HIV play an important role in some premalignant conditions like leukoplakia. This is a retrospective analysis of 210 oral tumours see at the Pathology department of the ABUTH, Zaria from 1987 - 1996. There were 54 benign and 156 malignant tumours. The benign oral tumours were made up of 12 squamous cell papillomas; 11 haemangiomas; 7 fibromas; 6 myxomas; 5 lipomas; 4 neurofibromas; and 11 unclassified lesions. The M:F ratio was 1:1.1 for benign tumours. The malignant tumours were made up of 115 squamous cell carcinomas; 6 fibrosarcomas; 4 malignant melanomas; 2 heamangiopericytomas; and 27 unclassified malignant lesions. The M:F ratio was 2.3:1 for malignant tumours. It is concluded that squamous cell carcinoma is the commonest oral neoplasm seen in Zaria and it occurs at a younger age than is seen in more developed western countries (Nig J Surg Res 2000;2:21-25) KEY WORDS: Oral tumours; Squamous cell carcinoma; Fibrosarcoma; Papilloma; Heamangioma; Human papilloma virus

Aim: A pilot study was carried out in the state of Kelantan, north-east of Malaysia, to determine the feasibility of using pathological and hospital databases to acquire incidence on oral cancer. Method: Data on OC patients (ICD-10: C00.3-00.5, C02-06) were obtained from incident surgical biopsy records of the two main referral centres for head and neck surgery in Kelantan namely, the Department of Pathology, Faculty of Medicine, University of Science and the Oral Surgery clinic, Kota Baru Hospital between January 1994 to December 1998. The crude and age-specific incidence rates were calculated based on the annual population census of Kelantan and this was standardised to the world population. Results: There were forty-three OC cases during that period. The incidence of OC was 6.1 per million annually (males, 1.4 per million; females, 1.0 per million). The age-standardised incidence was 1.7 per million. The main leading sites of OC were the gum and the buccal mucosa/vestibule/retromolar areas. Conclusion: Pathological and hospital records provide an alternative way of obtaining important epidemiological data on OC, crucially in places where population-based cancer registries have not been established. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

The expression of Tenascin-C, an adhesion modulating or anti- adhesive extracellular matrix protein, was evaluated in betel quid associated lesions of oral mucosa showing focal hyperkeratosis (n=15), dysplasia (n=15), oral submucous fibrosis (n=7) and oral squamous cell carcinoma (n=8). All the patients were chewers of betel quid containing betel leaves, areca nuts, lime and tobacco. The results obtained from this study were compared to similar lesions in smokers and non-quid users cited in the literature (Shrestha et al, Oral Oncol, 1994). An enhanced expression of TN-C was observed in epithelial connective tissue interface of quid associated hyperkeratotic and dyplastic mucosa. However, the expression was less extensive as compared to similar lesions among smokers or those without smoking or quid habits although the enhanced expression observed in the stromal tissue surrounding the carcinoma cells in carcinoma arising at sites where quids were often placed did not differ. Oral submucous fibrosis showed no or a faint linear immunoreactivity to an intense reactivity often abruptly ending at the epithelial-connective tissue interface. Areas of subepithelial hyalinization in oral submucous fibrosis remained unreactive. These variations in oral submucous fibrosis were observed in different areas of the same specimen. Oral squamous cell carcinoma, however, showed no difference in the expression of TN-C among these two groups of patients. The result of the present study suggest that epithelial hyperproliferation with or without dysplastic changes in quid related oral lesions may induce an altered epithelial-mesenchymal interactions and may be a factor in an enhanced expression of TH-C. However, the reaction products may be less widespread as compared to lesions among smokers or those without smoking or quid habits. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A retrospective study of odontogenic keratocysts in the Malaysia-Singapore region was done. The purpose of this study is to present the clinicopathological features of odontogenic keratocysts in the Oriental population and to compare the data with those from other reported studies. Biopsy records from 1981 to 1992 of 61 cases of odontogenic keratocysts in Malaysia and Singapore showed that there were 42.6% female and 57.4% male patients. The cysts occurred in 75.4% Chinese, 6.6% Malays, 9.8% Indian, and 8.2% other ethnic groups. The mean age of these patients was 26.98 ± 15.38 years with peak incidence in the second to fourth decades. The location of the lesion was more often in the mandible (65.5%) than the maxilla (31.0%). There is marked predilection for the posterior mandible. Odontogenic keratocysts presenting at the site of dentigerous a cyst was observed in 7 cases (11.5%). Histologically, 90.2% of the cyst were lined by parakeratinised stratified squamous epithelium while only 3.3% of the cyst with orthokeratinised stratified squamous epithelium. Mixed parakeratinised and orthokeratinised epithelial lining was observed in 4 cases (6.5%). Inflammation of cyst wall was found in 42 cases (68.8%). Stellate-like inflamed lining epithelium was observed in 9.8% of the cases while 6.6% of the cases demonstrated Rushton bodies in the epithelial lining. Keratin in the lumen was observed in 19.7% of the cases. Satellite cyst was observed in only 6 cases (9.8%). In conclusion, most clinical and histological features seen in this study similar to that for the Caucasian. The only clinical feature that differs is the peak incidence which ranged from the second to fourth decades with an absence of the second peak for our study. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

The aim of this study was to determine the periodontal status and treatment needs among the Indian estate population. The Community Periodontal Index of Treatment Needs was used to obtained clinical data on 208 Indian subjects residing in three estates in the state of Selangor. The prevalence of periodontal disease among the subjects was 100. Less than 1 of the subjects had bleeding on probing as the highest CPITN score. About 97 of the subjects showed evidence of periodontal pocket of 4mm or more. Of these, half showed pocketing of 6mm or more. No statistically significant difference (p> 0.05) was observed between males and females in terms of the most severe periodontal conditions encountered. About 2.5, 1.6 and 0.9 sextants were involved with pocketing of 4-5mm, calculus and pocketing of 6mm or more respectively. Again this pattern of sextants involvement shows no significant difference by gender (p>0.05). All subjects required oral hygiene instruction and 97.4 required scaling. Complex periodontal care was required by 48.7 of the subjects. The findings of this study indicate an urgent need for an oral health promotion programme to be instituted aimed at the prevention of periodontal disease and the utilization of appropriate manpower for the control and management of the existing disease in the Indian estate population. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A retrospective study of 11 cases of traumatic granulomas was done. The objective of this study is to present the clinicopathological features of traumatic granulomas in some malaysian patients and to compare this data with data from other reported studies, which have been predominantly from Caucasian population. Biopsy records from 1985 to 1998 of 18 cases of traumatic granulomas were obtained. There were 13 male and 5 female patients. The granulomas occured in 38.9 Malay, 38.9 Chinese, 11.1 Indian and 11.1 other ethnic groups. The age of these patients range from 8 to 86 years, with mean of 41.9 ± 17.7 years. The most common location for the lesions was the tongue, other locations were on the floor of mouth-tongue junction, retromolar region, buccal gingiva, lower lip, and anterior mandible with one case presenting with multiple ulcers in different locations. The provisional diagnoses given by the clinicians prior to biopsy include traumatic ulcer, squamous cell carcinoma, lichen planus, recurrent apthous ulcer, Wegener's granulomatosis, pyogenic granuloma, infectious ulcer (tuberculosis) and squamous cell papilloma. Some of the patients (66.7) have past/current medical condition, which include diseases of the endocrine, gastrointestinal, cardiovascular system, malignancy, venereal disease, autoimmune disease, and one Human Immunodeficiency Virus positive patient. Histologically, pseudoinvasion of plasma cells and histiocytes between muscle bundles are evident in all cases. Eosinophils are consistently found in all but one case. In conclusion, most of the clinical and histological features present in these cases are comparable to cases in Caucasian reported in the literature. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

The Malaysian nationwide survey on oral mucosal lesions (OML) in 1993/94 showed a low prevalence of OML in particular oral cancer and precancer (OPC) among the Malays as compared to the Indians and the Indigenous people of Sabah and Sarawak. A low prevalence of quid chewing habit was also noted in the Malays in that survey. The present study was conducted to investigate whether the low prevalence of OPC in the Malays was attributed to the low prevalence of quid users among the Malays and/or whether the quid contents used were different. Two examiners were trained prior to the survey. The interexaminer consistency of diagnosing the presence or absence of lesions was 91.3%. An interview on their oral habits was also done. The mean age of 276 subjects examined was 61.1±10.0 years. There were 23.6% men and 76.4% women. Among the subjects interviewed, 41.7% were smokers and 37.7% were quid chewers. The prevalence of OML was 20.3% while OPC was found in only 1.4% of the subjects examined. Among the quid chewers and non-quid chewers, the prevalence of OML was found to be 35.6% and 11% respectively. However ,the prevalence of OPC ( only leukoplakia and lichen planus were detected; cancer, erythroplakia and oral submucous fibrosis were absent) was equally low in both groups (1.9% among quid chewers and 1,2 % among non-quid chewers). Such low prevalence of OPC among Malay quid chewers, differed from reported higher prevalences of OPC in the Malaysian Indians and the indigenous people of Sarawak. A further analysis of the quid contents showed a low usage of tobacco (3.8%) in the quid mixtures chewed by these subjects as compared to the quid mixtures reportedly used by the Indians and the indigenous people of Sarawak. It is concluded that the lack of tobacco in the quid mixtures used by the Malays may be related to the low prevalence of OPC in Malay quid chewers. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A house to house random survey on elderly subjects was undertaken in the District of Klang in Malaysia. The objective of this study was to investigate the prevalence of oral mucosal lesions (OML) among the elderly in this area. The primary units in the sampling frame were the Enumeration Blocks (EBs) as defined under the population census. All households of the selected EBs were considered as sampling units and members aged 60 and above were considered as respondents. There was a slight preponderance of females, with the Malays comprising the majority of the subjects. Of the 486 respondents, mean aged 69.1 +/- 7.3 yr, 111 had at least one oral mucosal lesion, a prevalence of 22.8. A total of 145 lesions were detected. The prevalence of OML was highest among Indians and least among the Chinese. The most common finding was tongue lesions, recording a prevalence of 10.7, followed by oral pigmentation (4.9) and white lesions (4.3). Denture related lesions were comparatively low at 2.5. Two cases of oral cancer if representative would give a relatively high prevalence of 0.4. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

A clinical analysis of 304 cases of pyogenic granuloma (excluding pregnancy tumour) were obtained from the clinical evaluations submitted by clinicians while sending specimens for biopsy. The average age of the patients with pyogenic granuloma was 28.9 years with a peak age incidence in the second decade. More female patients were affected and the lesions present mainly in the Chinese. The majority of the lesions were ulcerated and pedunculated. The lesions had a mean diameter of 10.8 mm with a mean lesion duration of 6.0 months. The gingiva was the prevalent site for these lesions with a greater number being located in the maxilla. The recurrence rate was found to be 14.1. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

Se describe la maxilectomía parcial caudal como tratamiento de una dísplasia fibrosa invasiva que afectaba la zona maxilar derecha de un perro mastín de los pirineos de 8 años de edad (caso nº1); y una maxilectomía parcial central de un teckel de 13 años que padecía un melanoma amelanótico en el maxilar derecho. Se describe la técnica en sus distintas fases, utilizando un colgajo a partir de la mucosa labial para tapar el defeco anatómico creado en el paladar duro. En ambos casos el postoperatorio no presentó complicaciones. El caso nº1 necesitó tratamiento hemostático durante 2 días y se produjo una dehiscencia parcial de la sutura que se resolvió sin problemas. En el caso nº2, el perro presentó problemas respiratorios suaves durante los 3 primeros días hasta que aprendió a respirar por la boca. La displasia fibrosa se reprodujo en la zona infraorbital a los 60 días en el caso nºl , debido a su localización caudal y a su gran extensión. En el caso nº2 no se conoce recurrencia ni existencia de metástasis a los 30 días. En ambos casos el resultado estético final fué bueno. Partial maxillectomy is described in an eight years old dog, mastin de los pirineos, affected with a fibrous dysplasia in the rigbt maxillar (case n.o 1), it extends through the zigomaticus bone and infraorbital area, and a central partial maxillectomy in a teckel 13 years old, with a amelanotic melanoma. Both cases were classificated in stage III in the TNM system. Surgical pbases are documented and a labial mucoseflap was employed to cover the anatomical defecto Case nº1 had partial suture dehiscence with no further complications. Fibrous dysplasia recurred in case nº1, 60 days later; and case nº 2 had free tumour appearence after 30 days. Cosmetic results were satisfactory.

A study on the oral health status of 198 factory workers (in Antara Steel, Pasir Gudang, Johor) was carried out in November 1986. The subjects were predominantly male (94%) and Malay (91%) with an average age of 27.4 years. The prevalence of caries was 87.4% with a mean DMFT of 7.1 + 5.4. There were 3 subjects with full upper, lower dentures and 16 subjects with partial dentures. Two subjects examined needed dentures but were not wearing them. Thirty five (17.7%) of those examined needed urgent extractions, and 8 needed emergency treatment for fillings. Enamel opacities were found in 141 subjects (75.6%) but only 9 were aware of these defects. Dental health was very poor with 72% examined needing scaling. Seventeen (9%) had gross supra and subgingival calculus. There was a total of 107 (54%) smokers and heavy nicotine stains were found in 41 (20.7%), of the population examined. Examination of soft tissues showed 111 (56%) subjects with recurrent aphthous ulcers whilst 15 (7.6%) suffered from herpes labialis. Five subjects (2.5%) suffered from denture stomatitis whilst the prevalence of other soft tissue lesions was very low. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

The association between cigarette smoking and the prevalence of oral mucosal lesions was examined in 495 Malaysian army personnel. No associations between cigarette smoking and recurrent aphthous ulcerations, pre-leukoplakia and frictional keratosis could be obtained in this study. Positive associations were found between cigarette smoking and leukoedema as well as denture stomatitis. There was a negative association between cigarette smoking and the presence of coated tongue. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

29 patients with buccal carcinoma were reviewed for the clinical signs and symptoms. The TNM classification following the UICC categories were used for the clinical staging of the lesion. The patient?s race, age, sex and habits were also noted. Most of these patients presented with advanced lesions. The most common signs and symptoms were pain and ulcerations (62%). The histopathology of a well-differentiated squamous cell carcinoma forms a great majority of these lesions (62%). Each of the sign and symptom is discussed in relation to other findings that had been reported. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.