Comparison of Broder's and Bryne's Grading System for Oral Squamous Cell Carcinoma With Lymph Node Metastases and Prognosis: A Scoping Review

Oral squamous cell carcinoma (OSCC) has the highest mortality rate of any type of head and neck squamous cell carcinoma. For many eons, the clinical TNM (tumor size, nodal metastasis, and distant metastasis) classification and histological grading of malignancies have been used to predict clinical behavior, confusing it with prognosis and overall survival. This review aimed to systematically identify and evaluate the prognostic value of Broder's and Bryne's grading system for OSCC. Electronic resources such as PubMed, Cochrane Database of Systematic Reviews, Google Scholar, Scopus, and direct web searches were used to conduct a thorough search. The titles were examined to identify relevant papers, which were then reviewed for inclusion by reading the abstract. To incorporate studies published outside of the electronic database, the bibliography of all recognized papers was scanned. This review examined all research that investigated the prognostic value of Broder's and Bryne's grading systems in OSCC. The electronic database search identified 221 articles. After reading full articles, based on the titles and abstracts and after removing duplicates, six articles were screened. Finally, six articles were selected based on their ability to meet the inclusion criteria and answer the research question. All studies analyzed the competence of this histological grading system in predicting the prognosis of OSCC patients. Four studies evaluated lymph node metastasis and two studies analyzed the histological grading of OSCC. While evaluating the histological grade, we recommend the application of Bryne's (1992) system for grading OSCC. The standardization of a single, effective method would make it easier to compare results from various studies. This grading system yields better interobserver agreement and bears a prognostic value which may help in devising a treatment strategy for better patient outcomes.

Association between protein bound sialic acid and high sensitivity C-reactive protein in prehypertension: a possible indication of underlying cardiovascular risk

The global burden posed by cardiovascular disease due to a rising incidence of known risk factors like essential hypertension underlines an urgent need to identify other potential risk factors like dyslipidemia, elevated levels of high-sensitivity CRP (hsCRP), Apo-B, and sialic acid in prehypertensive subjects. This study sought to examine the possible alteration in the levels of hsCRP, plasma protein bound sialic acid, and other lipid risk factors and the possible interactions among these parameters in prehypertensive subjects. Forty prehypertensive and 34 normotensive male subjects were enrolled in the study. Lipid profile, hsCRP, Apo-B, sialic acid, and lipid risk ratios were estimated in both the groups. There was no significant difference between fasting glucose and BMI in either group. The levels of total cholesterol, triglycerides, direct LDL-cholesterol, non-HDL cholesterol, and Apo-B were significantly increased in prehypertensive subjects compared with controls. The risk ratios calculated as direct LDL-cholesterol/Apo-B, total cholesterol/HDL-cholesterol, non-HDL-cholesterol/HDL-cholesterol were significantly elevated in prehypertensive subjects. There was also a significant increase in hsCRP and protein bound sialic acid in prehypertensive subjects in comparison with normotensive subjects. Correlation analysis revealed a significant association between the protein bound sialic acid with hsCRP, LDL cholesterol, and LDL-C/Apo-B. The findings of the present study suggest that in prehypertension, there is an association between protein bound sialic acid and hsCRP that reflects the clustering of cardiovascular risk factors in these subjects.

A novel tilt table testing protocol for investigating patients suspected to have neurally mediated syncope

We have observed that a series of 3 Valsalva maneuvers performed at 1-minute intervals between the 15th and 18th minute of a drug-free tilt table test resulted in intense presyncope and hypotension in a 32 yr old male with micturition syncope. In contrast, five apparently healthy subjects tolerated a 70 degree head-up tilt table test for 45 min with five Valsalva maneuvers incorporated into the testing protocol. Thus, we hypothesize that the use of a series of Valsalva maneuvers during a drug free head-up tilt table test might improve the diagnostic yield without compromising test specificity in patients suspected to have neurally mediated syncope.

Altered oxidant-antioxidant status in non-obese men with moderate essential hypertension

BACKGROUND

Although a wide number of experimental evidences are available regarding oxidant-antioxidant disturbance in hypertension, clinical data supporting it is lacking in men in early stages of hypertension.

AIMS

The objective of the study was to evaluate oxidative status and antioxidant activities in males with stage I essential hypertension.

MATERIALS AND METHODS

Thirty hypertensives and 21 normotensives were included in the study. Protein carbonyl, reduced glutathione, glutathione peroxidase, catalase and fasting glucose were assessed in both the groups.

STATISTICAL ANALYSIS

Results were analyzed by student's 't' test and linear regression analysis test.

RESULTS

Plasma protein carbonyl and glutathione peroxidase were significantly increased and catalase and GSH were significantly reduced in the hypertensive group compared to normotensive subjects. There was a significant negative correlation between glutathione peroxidase and catalase in the test group.

CONCLUSIONS

The data from the present study indicates an alteration in oxidant-antioxidant status in non-obese men in early stages of essential hypertension.

Effect of estrogen on plasma ceruloplasmin level in rats exposed to acute stress

BACKGROUND

Plasma ceruloplasmin, a copper containing protein, belongs to a class called acute phase proteins. Reduced level of ceruloplasmin was associated with Wilson's disease and Menke's kinky hair disease in man, primarily affecting copper metabolism. Stress was known to increase Ceruloplasmin. Several stress associated changes were commonly observed in women at menopause and also those who underwent overiectomy. Present experiment investigated the effect of estrogen on ceruloplasmin level in acute stress.

AIMS

To assess the estradiol induced changes in plasma ceruloplasmin concentration on exposure of the rats to acute stress.

SETTINGS AND DESIGN

Acute stress was induced by forcing the rats to swim till exhaustion. The rats were overiectomised bilaterally to remove the primary source of sex hormones. And hormone replacement was done later.

MATERIAL AND METHODS

Wistar albino female rats were used. Acute stress was induced before overiectomy, following recovery from surgery, and again after Estradiol Valerate injection (for 10 days) in same group of rats. The plasma ceruloplasmin was estimated immediately after stress during each stage--that is preoperative control, stressed control, after overiectomy and then following treatment with Estradiol Valerate.

STATISTICAL ANALYSIS USED

Paired sample T test was applied to analyze the findings.

RESULTS

We found lowest ceruloplasmin level after stress in overiectomised animals, while on substitution of estradiol the trend appeared to be reversed.

CONCLUSION

The result suggested a direct effect of estrogen on hepatic ceruloplasmin production/release and this could account for some of the beneficial effects of hormone replacement therapy.

A quantitative assay of porphyrins in leprosy patients. A spectrophotometric study

Quantitative estimations of porphyrin in the blood, urine, and feces of 30 leprosy patients under treatment with dapsone, ten untreated cases, and 100 normal subjects were done by Rimington's method. Dapsone had no adverse effect on porphyrin metabolism because none of the cases of leprosy under study developed statistically significantly raised porphyrin levels in the blood, urine, and stools. Although erythrocyte coproporphyrin levels were significantly higher in leprosy patients than controls and urinary uroporphyrin levels significantly lower, most values fell within the normal range. These differences did not appear to have any clinical significance, and their cause remains unknown.