Background: Stem cell-based therapy is one of the tools for acute kidney injury (AKI) treatment. Tonsil tissue is a promising alternative source for the high-yield isolation of mesenchymal stem cells (MSCs). This study was undertaken to investigate the effects of tonsil-derived MSCs (T-MSCs) in animal model of AKI induced by gentamicin (GM). Methods: Twenty Sprague-Dawley rats were divided into four groups: Control, GM (70 mg/kg/day, intraperitoneal injection for 10 days), GM + T-MSCs (1 × 107 cells, intravenous injection at 1 day after the last vehicle/GM), and T-MSCs. Renal function, apoptosis, and markers of endoplasmic reticulum stress were measured on day 16 after the first vehicle/GM. Oxidative stress was assessed by measuring urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and the expression of glutathione peroxidase (GPx) and catalase. Effects of T-MSCs on GM-induced apoptosis and oxidative stress in NRK cells were also evaluated using a co-culture technique of NRK cells and T-MSC. Results: In the GM + T-MSCs group, blood urea nitrogen, creatinine, and tubular damage score were lower compared to the GM group. T-MSCs injection decreased apoptotic cells and the expression of Bax, cytochrome c, and cleaved caspase and increased Bcl-2. T-MSC injection decreased urinary 8-OHdG and increased expression of GPx and catalase in the kidneys. Anti-human nuclei and PKH26 staining demonstrated the localization of T-MSCs in the tubules of renal cortex. In-vitro study revealed that T-MSCs or T-MSC-conditioned media ameliorated GM-induced nicotinamide adenine dinucleotide phosphate oxidase-1 expression, hydrogen peroxide generation, and apoptosis of NRK cells. Conclusion Our study demonstrated that T-MSCs ameliorated GM-induced AKI by directly incorporating into the damaged renal tubules and exerting antiapoptotic and antioxidative effects.

Glioblastoma (GBM) remains fatal despite maximal surgical resection, temozolomide chemotherapy, and radiotherapy. Within the GBM microenvironment, tumor-educated microglia and astrocytes adopt immunoregulatory-like STAT3-high and ARG1/TGF-β-high phenotypes, respectively, which shield GBM cells from adaptive immune attack. In this review, we examine emerging adjuvant strategies designed to molecularly reprogram glial cells toward pro-inflammatory C3-high and IFN/NF-κB-high states, amplifying antitumor immunity. First, we summarize key aspects of GBM pathobiology and identify why conventional treatments fail to achieve durable control. Next, we dissect the signaling networks that govern glial phase states, including NF-κB, STAT3, IRF3, NLRP3, and cGAS-STING axes. We then provide a mechanism-centric analysis of pattern-recognition receptor (PRR) agonists, inflammasome modulators, and cyclic-dinucleotide STING agonists, integrating quantitative preclinical data with early clinical trial results. For each adjuvant, we distinguish between direct astrocytic engagement and indirect cytokine-mediated reprogramming.Modulation of glial phase states holds considerable promise for enhancing personalized vaccine efficacy and for converting immunologically “cold” GBM into a T cell-inflamed tumor. Consequently, targeting glial cell phase modulation is a highly attractive strategy for GBM immunotherapy, with the potential to maximize therapeutic benefit. Despite advances in chemo-, radio-, and checkpoint-blockade therapies, the immunosuppressive tumor microenvironment (TME) of GBM and its failure to establish memory immunity limit their impact. Tumor-polarized astrocytes and microglia form a barrier to effective T cell-mediated attack. Emerging evidence shows that redirecting glia toward pro-inflammatory phenotypes can recondition the TME, creating a more permissive landscape for immunotherapy. This review highlights glial phase reprogramming as a promising immunoadjuvant approach, emphasizing molecular circuits, synthetic modulators, and translational prospects.

Subclinical hypothyroidism (SCH), characterized by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine levels, usually presents without symptoms, and is often discovered incidentally during routine blood test. The Task Force of the Korean Thyroid Association Committee of Clinical Practice Guidelines has established a guideline to evaluate and manage SCH; the guideline emphasizes the implementation of diagnostic criteria based on the TSH reference range for Koreans and focuses on the proven health benefits of levothyroxine (LT4) treatment. Based on the Korea National Health and Nutrition Examination Survey (2013-2015), serum TSH level of 6.8 mIU/L is considered the reference value for SCH. SCH can be categorized as mild (TSH 6.8-10.0 mIU/L) or severe (TSH ＞10.0 mIU/L), and patients are classified as adults (age ＜70 years) or elderly patients (age ≥70years) depending on the health effects of LT4 treatment. An initial increase in serum TSH levels should be reassessed with a subsequent measurement, along with the thyroid peroxidase antibody test, preferably 2-3 months after the initial evaluation. Usually, LT4 treatment is not recommended for mild SCH in adults; however, treatment is necessary for severe SCH in patients with underlying coronary artery disease or heart failure and can be considered for coexisting dyslipidemia. LT4 treatment is not recommended for mild or even severe SCH in elderly patients, in general. Patients with SCH who receive LT4 treatment, the LT4 dosage should be personalized, and serum TSH levels should be monitored to ensure optimal LT4 dosage (dosage that is neither excessive nor insufficient). Patients with SCH who do not receive LT4 treatment require periodic follow-up at appropriate testing intervals determined by disease severity. The guideline also provides several educational points applicable in clinical settings.

The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration. RESULTS: The median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.
Dairy Products ; Diet Records ; Diet* ; Education ; Energy Intake ; Humans ; Iodine* ; Milk ; Seaweed ; Seoul ; Sodium ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Vegetables

PURPOSE: The purpose of this study was to investigate the health status and nutritional condition of children living in a low-income community through anthropometric, laboratory evaluation. METHODS: A community-based survey identified children below 15 years living in a low-income community. Their weight, height, visual acuity, hearing level and dental status were measured. Blood sample were obtained on June and July, 2004. Hemoglobin, serum cholesterol, Hepatitis B antigen/antibody, AST and ALT were measured. RESULTS: A total of 285 students(M:F=141:144) aged 6 to 14 years were included in this study. The heights and weights in some grades were smaller than controls. The prevalence of obesity was 10.6 percent in males and 10.7 percent in females. The prevalence of abnormal visual acuity, hearing impairments and dental carries were 20.5 percent, 0.3 percent and 69.4 percent. The prevalence of anemia was 10.1 percent. Serum total cholesterol was over 200 mg/dL in 7 percent. They complained of abdominal pain(22.1 percent) and headache(17.1 percent). Hyperthyroidism, cataract, neurofibromatosis, severe atopic dermatitis, ventricular septal defect, strabismus and inguinal hernia were newly diagnosed. CONCLUSION: Mean heights and weights of children in the low-income community were smaller than controls. The prevalence of abnormal visual acuity, hearing impairment and dental carries were higher than in the 2003 national health survey. Additional research is needed to evaluate the health status of the low-income community.
Anemia ; Cataract ; Child* ; Cholesterol ; Dermatitis, Atopic ; Female ; Health Surveys ; Hearing ; Hearing Loss ; Heart Septal Defects, Ventricular ; Hepatitis B ; Hernia, Inguinal ; Humans ; Hyperthyroidism ; Male ; Neurofibromatoses ; Obesity ; Prevalence ; Strabismus ; Visual Acuity ; Weights and Measures

Isolated left main coronary ostial stenosis is a very rare condition. In the majority of cases there are coexisting diseases in multiple coronary vessels. Here, a case of isolated left main coronary ostial stenosis due to an acute angle take-off, with clockwise rotation of the coronary sinus, confirmed by cardiac MRI is presented. A 44-year old female patient presented with an exertional and stabbing anterior chest pain. The patient had no premedical history. A coronary angiogram showed an isolated left main coronary ostial stenosis due to an acute take-off of the left main coronary artery. A cardiac MRI showed an acute angle take-off of the left main coronary artery, with clockwise rotation of the coronary sinus. The patient underwent surgical angioplasty of the coronary ostia, with a patch of autologous pericardium. This acute angle take-off may be due to rotation of the coronary sinus.
Adult ; Angioplasty ; Chest Pain ; Constriction, Pathologic* ; Coronary Sinus* ; Coronary Stenosis ; Coronary Vessels ; Female ; Humans ; Magnetic Resonance Imaging* ; Pericardium

BACKGROUND: The thickness of the renal cortex is useful in all aspects of nephrology but no normal range has been established. Therefore, we investigated the renal cortex thickness by ultrasonography in normal Korean adults and chronic renal failure (CRF) patients before renal replacement therapy. For the purpose of evaluating the normal range then, we are going to predict the threshold range of cortex thickness in irreVersible renal failure status. METHODS: In 243 healthy Korean adults and 57 CRF patients with the creatinine level, < or =4 mg/dL were measured the renal cortex thickness. Creatinine clearance was calculated on the basis of the Cockcroft-Gault formula. RESULTS: In normal adults, the difference between male and female was 0.74+/-0.15 cm, 0.69+/-0.13 cm respectively, male was greater than female (p<0.005) and the average value of the left and right renal cortex thickness was 0.76+/-0.14 cm, 0.67+/-0.13 cm, the left kidney was greater than right one (p<0.005). The combined average value of the left and right renal cortex was 0.72+/-0.14 cm. In CRF patients, There was no difference of cortex thickness between diabetes patients and non diabetes but in non diabetes patients, the difference between Ccr <30 mL/min and Ccr > or =30 mL/min was 0.63+/-0.10 cm, 0.79+/-0.11 cm (p<0.001). CONCLUSION: The overall mean of cortex thickness in korean normal adults was 0.72+/-0.14 cm (0.41-1.25) and approximately, a threshold of 0.72 cm was identified for the cortex thickness that allowed us to distinguish Ccr <30 mL/min from Ccr > or =30 mL/min in CRF patients. But the cortex thickness alone is not a sufficient marker to predict reversibility. We should consider other invasive procedure such as kidney biopsy.
Adult* ; Biopsy ; Creatinine ; Female ; Humans ; Kidney Failure, Chronic* ; Kidney* ; Male ; Nephrology ; Reference Values ; Renal Insufficiency ; Renal Replacement Therapy ; Ultrasonography*

OBJECTIVE: This study was to investigate the relationship between genotype of Apolipoprotein E (Apo E) and severity of disability after brain injury as well as serum lipid profile. METHOD: One hundred thirty-five brain injured patients (mean age 54.6 16.7 years, 90 male and 45 female) were enrolled. There were 34 patients with ischemic Stroke, 61 hemorrhagic stroke, and 40 traumatic brain injury. Apo E genotype was determined by polymerase chain reaction and polyacrylamide gel electrophoresis. The serum concentra tions of total cholesterol, triglyceride, and HDL-cholesterol were measured. The outcome of brain injury was assessed by functional independence measure (FIM) scores. RESULTS: Most frequent Apo E genotype was E 3/3 (72%). In hemorrhagic stroke patients with Epsilon4 allele, FIM score at admission was significantly lower than that of the patients without Epsilon4 allele (p<0.05). In traumatic brain injury patients with Epsilon4 allele, FIM score change was significantly smaller than that of patients without Epsilon4 allele (p<0.05). The level of total serum cholesterol was lower in the ischemic stroke patients who have Epsilon2 allele in comparison with the patients without that allele. CONCLUSION: The presence of Epsilon4 allele is considered to have relationship with the severity of disability and functional outcome in the patients with brain injury.
Alleles ; Apolipoproteins E ; Apolipoproteins* ; Brain Injuries* ; Brain* ; Cholesterol ; Electrophoresis, Polyacrylamide Gel ; Genotype* ; Humans ; Male ; Polymerase Chain Reaction ; Stroke ; Triglycerides