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Papers by Mohd Jamal Alsharif

Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement a... more Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement and functional impairment. Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with pingyangmycin (bleomycin A 5 ) injection alone or in combination with surgery for treatment of oral and facial LMs, and to observe the histologic changes after intralesional injection of pingyangmycin. Patients and Methods: Seventy-nine patients who received intralesional injection of pingyangmycin for the treatment of oral and facial LMs were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 patients received pingyangmycin sclerotherapy solely, 14 patients had sclerotherapy in combination with secondary surgery, and 23 other patients had surgery with sclerotherapy. Patients had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy. Results: Primary anatomic locations of 79 LMs involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per child was 4.2 (range, 3 to 8). Among the 79 patients, 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73.91%; P Ͻ .05). In specimens resected after pingyangmycin injection, histologic examination showed the destructive lymphatic vessels and obvious stromal fibrosis. Conclusions: Intralesional injection of pingyangmycin was effective for over two thirds of the children with oral and facial LMs. Perioperative sclerotherapy may improve the treatment of these malformations.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009

Squamous cell carcinoma is a malignant neoplasm of epithelium, most frequently occurring in intra... more Squamous cell carcinoma is a malignant neoplasm of epithelium, most frequently occurring in intraoral tumors. In this article we describe a rarely reported, because the frequency of oral cancer in young people is extremely low, case of a 16-year-old Chinese girl with squamous cell carcinoma of anterior mandibular gingiva. The clinicopathologic features, etiology, clinical evaluation, management of squamous cell carcinoma of gingiva in young patients are discussed and the applicable literatures are reviewed.

Oral Oncology, 2006

To assess the difference in genetic aberration patterns among the invasive tumor front (ITF), cen... more To assess the difference in genetic aberration patterns among the invasive tumor front (ITF), center/superficiality and the stroma adjacent to oral squamous cell carcinoma (OSCC), we studied loss of heterozygosity (LOH) and microsatellite instability (MI) at chromosome 9p21 and 17p13 on the three regions by combining laser capture microdissection (LCM) and PCR. We studied 20 OSCC patients with TP53 on chromosome 17p13 and RPS6 on chromosome 9p21. Genomic DNA samples from the ITF, center/superficial and stromal cells adjacent to the tumor were prepared from cryosections using laser-assistant microdissection, then LOH and MI were determined. Cells at the ITF, center/superficiality and stroma showed a high frequency of LOH and MI on chromosomes 17p13 (TP53) and 9p21 (RPS6). Comparison of the patterns of allelic loss and MI encountered at the ITF, center/superficial and stromal cells revealed no concordance. The frequency of RPS6 and TP53 aberration at the epithelial compartment (both ITF and center, 64.7%, 11/17; 70.6%, 12/17) was statistically higher than the stroma (23.5%, 4/17; 43.8%, 7/16) (p<0.05). Furthermore, for the epithelial compartment, the aberrations proportions of TP53 rose from 60.0% (9/15) to 64.7% (11/17) between the center/superficial part and ITF. Also the rate of RPS6 increased from 29.4% (5/17) to 58.8% (10/17) between the center/superficial parts and ITF. The overall frequency of the two markers was statistically higher at the ITF (20/32) than the center/superficial part (15/34) (p<0.05). The current study revealed that intratumor genetic heterogeneity exists in the different histological areas of OSCCs and some particular tumor cell genotypes have correlation with histological patterns.

Journal of Oral and Maxillofacial Surgery, 2009

Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement a... more Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement and functional impairment. Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with pingyangmycin (bleomycin A 5 ) injection alone or in combination with surgery for treatment of oral and facial LMs, and to observe the histologic changes after intralesional injection of pingyangmycin. Patients and Methods: Seventy-nine patients who received intralesional injection of pingyangmycin for the treatment of oral and facial LMs were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 patients received pingyangmycin sclerotherapy solely, 14 patients had sclerotherapy in combination with secondary surgery, and 23 other patients had surgery with sclerotherapy. Patients had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy. Results: Primary anatomic locations of 79 LMs involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per child was 4.2 (range, 3 to 8). Among the 79 patients, 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73.91%; P Ͻ .05). In specimens resected after pingyangmycin injection, histologic examination showed the destructive lymphatic vessels and obvious stromal fibrosis. Conclusions: Intralesional injection of pingyangmycin was effective for over two thirds of the children with oral and facial LMs. Perioperative sclerotherapy may improve the treatment of these malformations.

International Journal of Surgical Pathology, 2008

The aim of this study is to document the clinicopathologic features of teratoid cyst of the floor... more The aim of this study is to document the clinicopathologic features of teratoid cyst of the floor of the mouth in 20 Chinese patients, who were treated in Wuhan University. The 20 teratoid cysts were analyzed. All cases were confirmed by pathology. English literature was also reviewed. Our investigations showed that both sexes were equal to have these cysts. The age at diagnosis ranged from 25 days to 34 years, and the greatest frequency was within the first decade. It was found that the congenital cysts were most commonly diagnosed in the midline. All cases were treated by cystectomy, using 1 of the 2 approaches: extraoral or intraoral. Whenever, combined approaches were used in 2 cases. In all, 16 patients were followed-up, and 2 patients had recurrences. The intraoral approach was also effective for the treatment of large lesions and led to very good cosmetic and functional results.

International Journal of Surgical Pathology, 2008

The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at Scho... more The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.

Global Social Policy, 2010

Page 1. Patients beyond borders: A study of medical tourists in four countries ... Abstract This ... more Page 1. Patients beyond borders: A study of medical tourists in four countries ... Abstract This exploratory study assesses the experiences of medical travelers seeking out of country health care in four destination countries: India, China, Jordan and the United Arab Emirates. ...

This exploratory study assesses the experiences of medical travelers seeking out of country healt... more This exploratory study assesses the experiences of medical travelers seeking out of country health care in four destination countries: India, China, Jordan and the United Arab Emirates. It aims to identify the source countries of medical travelers, to understand their reasons for seeking out-of-country care, the type of services they obtained, and their level of satisfaction with the experience. Cost, physician and facility reputation and hospital accreditation were ranked as the most important factors in choosing out-of-country care. Wait times at home or lack of access to care were important motivations for international medical travel. Patient assessment of treatment outcomes is as high as might be found in similar assessments in high-income country facilities. Certain forms of treatment sought by respondents (i.e. organ transplantation) raise specific ethical concerns. Also of concern is that the present health systems in all four countries fail to adequately meet the health needs of their population (notably poorer groups). Evidence and inference strongly suggest that access to health care for poorer groups will worsen in these countries as medical tourism increases, at least in the short term, raising generic ethical and policy challenges over the extent to which access to essential health care by poorer persons is compromised by the public subsidization or promotion of medical tourism.

Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement a... more Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement and functional impairment. Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with pingyangmycin (bleomycin A 5 ) injection alone or in combination with surgery for treatment of oral and facial LMs, and to observe the histologic changes after intralesional injection of pingyangmycin. Patients and Methods: Seventy-nine patients who received intralesional injection of pingyangmycin for the treatment of oral and facial LMs were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 patients received pingyangmycin sclerotherapy solely, 14 patients had sclerotherapy in combination with secondary surgery, and 23 other patients had surgery with sclerotherapy. Patients had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy. Results: Primary anatomic locations of 79 LMs involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per child was 4.2 (range, 3 to 8). Among the 79 patients, 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73.91%; P Ͻ .05). In specimens resected after pingyangmycin injection, histologic examination showed the destructive lymphatic vessels and obvious stromal fibrosis. Conclusions: Intralesional injection of pingyangmycin was effective for over two thirds of the children with oral and facial LMs. Perioperative sclerotherapy may improve the treatment of these malformations.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009

Squamous cell carcinoma is a malignant neoplasm of epithelium, most frequently occurring in intra... more Squamous cell carcinoma is a malignant neoplasm of epithelium, most frequently occurring in intraoral tumors. In this article we describe a rarely reported, because the frequency of oral cancer in young people is extremely low, case of a 16-year-old Chinese girl with squamous cell carcinoma of anterior mandibular gingiva. The clinicopathologic features, etiology, clinical evaluation, management of squamous cell carcinoma of gingiva in young patients are discussed and the applicable literatures are reviewed.

Oral Oncology, 2006

To assess the difference in genetic aberration patterns among the invasive tumor front (ITF), cen... more To assess the difference in genetic aberration patterns among the invasive tumor front (ITF), center/superficiality and the stroma adjacent to oral squamous cell carcinoma (OSCC), we studied loss of heterozygosity (LOH) and microsatellite instability (MI) at chromosome 9p21 and 17p13 on the three regions by combining laser capture microdissection (LCM) and PCR. We studied 20 OSCC patients with TP53 on chromosome 17p13 and RPS6 on chromosome 9p21. Genomic DNA samples from the ITF, center/superficial and stromal cells adjacent to the tumor were prepared from cryosections using laser-assistant microdissection, then LOH and MI were determined. Cells at the ITF, center/superficiality and stroma showed a high frequency of LOH and MI on chromosomes 17p13 (TP53) and 9p21 (RPS6). Comparison of the patterns of allelic loss and MI encountered at the ITF, center/superficial and stromal cells revealed no concordance. The frequency of RPS6 and TP53 aberration at the epithelial compartment (both ITF and center, 64.7%, 11/17; 70.6%, 12/17) was statistically higher than the stroma (23.5%, 4/17; 43.8%, 7/16) (p<0.05). Furthermore, for the epithelial compartment, the aberrations proportions of TP53 rose from 60.0% (9/15) to 64.7% (11/17) between the center/superficial part and ITF. Also the rate of RPS6 increased from 29.4% (5/17) to 58.8% (10/17) between the center/superficial parts and ITF. The overall frequency of the two markers was statistically higher at the ITF (20/32) than the center/superficial part (15/34) (p<0.05). The current study revealed that intratumor genetic heterogeneity exists in the different histological areas of OSCCs and some particular tumor cell genotypes have correlation with histological patterns.

Journal of Oral and Maxillofacial Surgery, 2009

Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement a... more Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement and functional impairment. Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with pingyangmycin (bleomycin A 5 ) injection alone or in combination with surgery for treatment of oral and facial LMs, and to observe the histologic changes after intralesional injection of pingyangmycin. Patients and Methods: Seventy-nine patients who received intralesional injection of pingyangmycin for the treatment of oral and facial LMs were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 patients received pingyangmycin sclerotherapy solely, 14 patients had sclerotherapy in combination with secondary surgery, and 23 other patients had surgery with sclerotherapy. Patients had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy. Results: Primary anatomic locations of 79 LMs involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per child was 4.2 (range, 3 to 8). Among the 79 patients, 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73.91%; P Ͻ .05). In specimens resected after pingyangmycin injection, histologic examination showed the destructive lymphatic vessels and obvious stromal fibrosis. Conclusions: Intralesional injection of pingyangmycin was effective for over two thirds of the children with oral and facial LMs. Perioperative sclerotherapy may improve the treatment of these malformations.

International Journal of Surgical Pathology, 2008

The aim of this study is to document the clinicopathologic features of teratoid cyst of the floor... more The aim of this study is to document the clinicopathologic features of teratoid cyst of the floor of the mouth in 20 Chinese patients, who were treated in Wuhan University. The 20 teratoid cysts were analyzed. All cases were confirmed by pathology. English literature was also reviewed. Our investigations showed that both sexes were equal to have these cysts. The age at diagnosis ranged from 25 days to 34 years, and the greatest frequency was within the first decade. It was found that the congenital cysts were most commonly diagnosed in the midline. All cases were treated by cystectomy, using 1 of the 2 approaches: extraoral or intraoral. Whenever, combined approaches were used in 2 cases. In all, 16 patients were followed-up, and 2 patients had recurrences. The intraoral approach was also effective for the treatment of large lesions and led to very good cosmetic and functional results.

International Journal of Surgical Pathology, 2008

The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at Scho... more The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.

Global Social Policy, 2010

Page 1. Patients beyond borders: A study of medical tourists in four countries ... Abstract This ... more Page 1. Patients beyond borders: A study of medical tourists in four countries ... Abstract This exploratory study assesses the experiences of medical travelers seeking out of country health care in four destination countries: India, China, Jordan and the United Arab Emirates. ...

This exploratory study assesses the experiences of medical travelers seeking out of country healt... more This exploratory study assesses the experiences of medical travelers seeking out of country health care in four destination countries: India, China, Jordan and the United Arab Emirates. It aims to identify the source countries of medical travelers, to understand their reasons for seeking out-of-country care, the type of services they obtained, and their level of satisfaction with the experience. Cost, physician and facility reputation and hospital accreditation were ranked as the most important factors in choosing out-of-country care. Wait times at home or lack of access to care were important motivations for international medical travel. Patient assessment of treatment outcomes is as high as might be found in similar assessments in high-income country facilities. Certain forms of treatment sought by respondents (i.e. organ transplantation) raise specific ethical concerns. Also of concern is that the present health systems in all four countries fail to adequately meet the health needs of their population (notably poorer groups). Evidence and inference strongly suggest that access to health care for poorer groups will worsen in these countries as medical tourism increases, at least in the short term, raising generic ethical and policy challenges over the extent to which access to essential health care by poorer persons is compromised by the public subsidization or promotion of medical tourism.