Han Su Kim

Min Ji Lee, Se-Young Oh, Soo Yeon Jung, Ha Yeong Kim, So Jeong Kim, Han Su Kim. IJSC -0001;0:. https://doi.org/10.15283/ijsc25106

A 54-year-old male with hyperlipidemia presented with a 2-week history of throat discomfort and blood-tinged saliva. Biopsy of the ulcerative mass in the right palatine tonsil suggested pleomorphic sarcoma or poorly differentiated carcinoma. Imaging revealed a 1.8-cm tonsillar mass and systemic lesions in the left lung, left hilum, and small intestine. Endobronchial ultrasound- guided biopsy confirmed non-small cell lung carcinoma (NSCLC), and repeat tonsillar biopsy demonstrated poorly differentiated metastatic carcinoma consistent with the lung primary. The patient subsequently developed intussusception due to small bowel metastasis, which was resected and confirmed as showing identical histology. Given the disseminated disease, pembrolizumab immunotherapy and tonsillar radiotherapy were initiated. This case illustrates tonsillar metastasis as the initial manifestation of NSCLC and highlights the importance of considering distant metastasis in atypical tonsillar masses.

Background Diabetes mellitus, characterized by β-cell dysfunction and loss, results in impaired insulin secretion and chronic metabolic complications. Mesenchymal stem cells represent a promising source for β-cell regeneration owing to their endodermal differentiation potential. This study optimized the differentiation of human tonsil-derived mesenchymal stem cells (TMSCs) into pancreatic β-like cells through the comparative evaluation of two signaling-based protocols. Methods TMSCs were isolated from human tonsils, and passages 5–7 were used for characterization and β-like cell differentiation. Two protocols were tested in both two-dimensional (2D) and three-dimensional (3D) cultures: Protocol I induced direct differentiation into pancreatic β-like cells without sequential developmental stages, whereas Protocol II followed stepwise progression from definitive endoderm to pancreatic progenitors, and finally pancreatic β-like cells. Results In 2D culture, cells cultured under protocol II maintained a typical morphology and high confluency, whereas cells cultured under protocol I displayed a thinner shape with reduced confluency. Protocol II effectively induced definitive endoderm differentiation, as demonstrated by the increased expression of SOX17, FOXA2, and CXCR4 at the mRNA and protein levels. Both protocols upregulated pancreatic progenitor (HNF6 and NGN3) and pancreatic β-cell markers (Insulin, NKX6.1, and PDX1), but protocol II consistently produced higher pancreatic β-cell marker expression, except for MafA. In 3D spheroid culture, insulin, PDX1, and MafA levels increased, with protocol II showing superior expression over protocol I. Additionally, differentiated cells exhibited glucose-responsive C-peptide secretion, indicating the acquisition of early β-cell–like functional properties. Conclusion Stepwise, developmentally guided differentiation (Protocol II) more effectively directs TMSCs toward pancreatic β cell lineage commitment, highlighting the importance of stage specific signaling cues and supporting the potential of TMSCs for pancreatic β cell–based regenerative applications.

Background: Previous attempts to classify lymphoma subtypes based on metabolic features extracted from ¹⁸F-FDG PET imaging have been hindered by inconsistencies in imaging protocols, scanner types, and inter-institutional variability. To overcome these limitations, we propose a multimodal deep learning framework that integrates harmonized PET imaging features with structured clinical information. The proposed framework is designed to perform hierarchical classification of clinically meaningful lymphoma subtypes through two sequential binary classification tasks. Methods: We collected multi-center data comprising ¹⁸F-FDG PET images and structured clinical variables of patients with lymphoma. To mitigate domain shifts caused by different scanner manufacturers, we integrated a Scanner-Conditioned Normalization (SCN) module, which adaptively harmonizes feature distributions using manufacturer-specific parameters. Performance was validated using internal and external cohorts, with the statistical significance of performance gains assessed via DeLong’s test and bootstrap-based CI analysis. Results: The proposed model achieved an area under the curve (AUC) of 0.89 (internal) and 0.84 (external) for Hodgkin lymphoma versus non-Hodgkin lymphoma classification and 0.84 (internal) and 0.76 (external) for diffuse large B-cell lymphoma versus follicular lymphoma classification (p > 0.05). These results were obtained using a multimodal model that integrated anterior and lateral maximum intensity projection (MIP) images with clinical data. Conclusions: This study demonstrates the potential of a deep learning-based approach for lymphoma subtype classification using non-invasive ¹⁸F-FDG PET imaging combined with clinical data. While further validation in larger, more diverse cohorts is necessary to address the challenges of rare subtypes and biological heterogeneity, LymphoMAP serves as a meaningful step toward developing assistive tools for early clinical decision-making. These findings underscore the feasibility of using automated pipelines to support, rather than replace, conventional diagnostic workflows in personalized lymphoma management.

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.

The precise localization of stones within the submandibular duct is crucial for the successful intraoral removal in sialolithiasis. Customizing surgical approaches based on the stone’s ductal location is imperative. Particularly challenging are stones beneath the lingual nerve, requiring a landmark-guided approach due to their non-palpable nature. This study aimed to comprehend stone positioning, location-specific characteristics, and develop suitable surgical approaches. We conducted a thorough analysis of numerous preoperative computed tomography (CT) scans for this purpose. We performed a retrospective review of the medical records of patients who underwent intraoral stone removal between 2006 and 2022. Two different surgical approaches were applied based on the stone location as determined by preoperative CT scans. The mediolingual approach was used for superficial stones, while the laterogingival approach was reserved for deeper stones. Patient demographics, sialolithiasis features, and postoperative complications were analyzed. T-test was performed to compare stone characteristics between different locations, and a receiver operating characteristic curve analysis was used to identify the critical size threshold for predicting stone location. Medical records of 465 patients were reviewed. Out of 616 stones, 614 were successfully removed with two distinct surgical approaches guided by preoperative CT scans. Two patients reported retention, and 11 experienced postoperative tongue sensation changes. The hilum was the most common stone location, and deeper stones, approached laterolingually, were generally larger. Analysis identified a 4.25 mm width as the most sensitive and specific threshold for deep stones. Stone volume showed no statistically significant difference between smokers and non-smokers, alcohol consumers and non-consumer. The result of the study underscore the significance of precise stone localization and endorse the efficacy of landmark-guided surgical approaches in managing sialolithiasis.

Background: Otorhinolaryngology is a medical specialty that focuses on the clinical study and treatments of diseases within head and neck regions, specifically including the ear, nose, and throat (ENT), but excluding eyes and brain. These anatomical structures play significant roles in a person’s daily life, including eating, speaking as well as facial appearance and expression, thus greatly impacting one’s overall satisfaction and quality of life. Consequently, injuries to these regions can significantly impact a person’s well-being, leading to extensive research in the field of tissue engineering and regenerative medicine over many years. Methods: This chapter provides an overview of the anatomical characteristics of otorhinolaryngologic tissues and explores the tissue engineering and regenerative medicine research in otology (ear), rhinology (nose), facial bone, larynx, and trachea. Results and conclusion: The integration of tissue engineering and regenerative medicine in otorhinolaryngology holds the promise of broadening the therapeutic choices for a wide range of conditions, ultimately improving quality of a patient’s life.