Sirt6-Mediated Cell Death Associated with Sirt1 Suppression in Gastric Cancer.

BACKGROUND: Gastric cancer, one of the leading causes of cancer-related death, is strongly associated with H. pylori infection, although other risk factors have been identified. The sirtuin (Sirt) family is involved in the tumorigenesis of gastric cancer, and sirtuins can have pro- or anti-tumorigenic effects. METHODS: After determining the overall survival rate of gastric cancer patients with or without Sirt6 expression, the effect of Sirt6 upregulation was also tested using a xenograft mouse model. The regulation of Sirt6 and Sirt1, leading to the induction of mouse double minute 2 homolog (MDM2) and reactive oxygen species (ROS), was mainly analyzed using Western blotting and immunofluorescence staining, and gastric cancer cell (SNU-638) death associated with these proteins was measured using flow cytometric analysis. RESULTS: Sirt6 overexpression led to Sirt1 suppression in gastric cancer cells, resulting in a higher level of gastric cancer cell death in vitro and a reduced tumor volume. ROS and MDM2 expression levels were upregulated by Sirt6 overexpression and/or Sirt1 suppression according to Western blot analysis. The upregulated ROS ultimately led to gastric cancer cell death as determined via Western blot and flow cytometric analysis. CONCLUSION: We found that the upregulation of Sirt6 suppressed Sirt1, and Sirt6- and Sirt1-induced gastric cancer cell death was mediated by ROS production. These findings highlight the potential of Sirt6 and Sirt1 as therapeutic targets for treating gastric cancer.

Delayed Horner's Syndrome After Multiple Penetrating Stab Injury of the Neck.

Horner's syndrome is characterized by a triad of symptoms (ipsilateral miosis, ptosis, and anhidrosis) with damage of the sympathetic nervous system. The condition may be congenital or acquired from traumatic conditions including cardiovascular surgery. Horner's syndrome can be also caused by neck trauma especially when cervical vital structures such as blood vessels, the aerodigestive tract, and nerves are disrupted. This report describes a 16-year-old woman with delayed Horner's syndrome who initially presented with internal jugular vein injury caused by multiple penetrating stab injury to the neck. To the best of our knowledge, this is the first reported case of Horner's syndrome resulting from neck trauma of which symptoms were presented after a couple of weeks after initial trauma. Understanding this rare clinical course may help surgeons pay attention to not only early hospital course but also long-term complications of patients with neck trauma.

Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis.

OBJECTIVES: In case of insufficient voice improvement after injection laryngoplasty (IL), additional IL will be one of the next option of treatments. However, little is known about the voice outcomes regarding an additional IL. STUDY DESIGN: Retrospective comparative study in single institution. METHODS: We enrolled the patients of unilateral vocal fold paralysis (UVFP), who received IL (N = 76) twice because of insufficient voice improvement. The etiologies of UVFP were related with thoracic and esophageal surgery (51.3%), neck surgery (30.3%), skull base surgery (7.9%), or unknown (10.5%). The subjective and objective voice parameters were collected before and after (mean: 5.3 months) each IL. RESULTS: Aspiration, maximum phonation time (MPT), jitter percentage, shimmer percentage, and noise to harmonic ratio (NHR) were significantly improved after both the first and second rounds of IL (P < .05). Voice handicap index (VHI)-30 was also significantly improved after both the first and second rounds of IL (P < .001). Regarding GRBAS score, overall grade of dysphonia (G), roughness (R), and breathiness (B) were significantly improved after the first IL, but only G and R after the second IL (P < .05). In comparison between postprocedural voice parameters of the first and second ILs, MPT was significantly improved from 5.5 ± 3.5 seconds to 7.3 ± 7.5 seconds (P = .001). Grade of dysphonia (1.9 ± 0.8) and breathiness (1.7 ± 0.9) of post-first IL were significantly (P < .001) improved to those of post-second IL (1.3 ± 0.7 and 1.2 ± 0.7, respectively). VHI-30 of post-first IL (72.0 ± 20) was significantly improved (P < .001) to those of the second IL (57.2 ± 23.7). CONCLUSIONS: In selected patients, additional IL could provide further improvement of voice in patient who had unsatisfactory voice results despite of initial IL. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020.

Guidelines for the Surgical Management of Oral Cancer: Korean Society of Thyroid-Head and Neck Surgery.

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to "surgical management of oral cancer" published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.