Background: Renal fibrosis is characterized by the accumulation of extracellular matrix proteins and interstitial fibrosis. Alantolactone is known to exert anticancer, anti-inflammatory, antimicrobial and antifungal effects; however, its effects on renal fibrosis remains unknown. Here, we investigated whether alantolactone attenuates renal fibrosis in mice unilateral ureteral obstruction (UUO) and evaluated the effect of alantolactone on transforming growth factor (TGF) signaling pathway in renal cells Methods: To evaluate the therapeutic effect of alantolactone, cell counting kit-8 (CCK-8) assay, histological staining, Western blot analysis, and real-time quantitative polymerase chain reaction were performed in UUO kidneys in vivo and in TGF-β-treated renal cells in vitro. Results: Alantolactone (0.25 to 4 µM) did not affect the viability of renal cells. Mice orally administered 5 mg/kg of alantolactone daily for 15 days did not show mortality or liver toxicity. Alantolactone decreased UUO-induced blood urea nitrogen and serum creatinine levels. In addition, it significantly alleviated renal tubulointerstitial damage and fibrosis and decreased collagen type I, fibronectin, and α-smooth muscle actin (α-SMA) expression in UUO kidneys. In NRK-49F cells, alantolactone inhibited TGF-βstimulated expression of fibronectin, collagen type I, plasminogen activator inhibitor-1 (PAI-1), and α-SMA. In HK-2 cells, alantolactone inhibited TGF-β-stimulated expression of collagen type I and PAI-1. Alantolactone inhibited UUO-induced phosphorylation of Smad3 in UUO kidneys. In addition, it not only decreased TGF-β secretion but also Smad3 phosphorylation and translocation to nucleus in both kidney cell lines. Conclusion Alantolactone improves renal fibrosis by inhibiting the TGF-β/Smad3 signaling pathway in obstructive nephropathy. Thus, alantolactone is a potential therapeutic agent for chronic kidney disease.

Papillary fibroelastoma is the second most common benign cardiac tumor, usually involving the cardiac valve. Papillary fibroelastoma attached at the right coronary cusp of the aortic valve was found in a 51-year-old woman, who was presented with chest pain and dyspnea. During the operation, the tumor mass was excised without causing damage on the aortic valve leaflet.
Aortic Valve* ; Chest Pain* ; Dyspnea ; Female ; Heart Neoplasms ; Heart Valves ; Humans ; Middle Aged ; Thorax*

In 2016, the clinical chemistry proficiency-testing program consisted of 21 programs, including the general chemistry program of the Korean Association of External Quality Assessment Service. The general chemistry program consisted of 28 test items and was conducted using two level control materials four times per year. Based on the information and results for each test item entered by each institution, statistical analysis data according to test method, instrument, and reagent were reported. The report comprised a general statistics report showing the characteristics of all participating institutions and a separate institutional report showing the evaluation data of individual institutions. The statistics included the number of participating institutions and the mean, standard deviation, coefficient of variation, median, minimum, and maximum values for each group. Each report was composed of a table, histogram, and Levey-Jennings chart showing the statistics for each test item. The results of each institution and the statistics for each classification are presented in the table showing the statistics, and a standard deviation index is presented together with a method classification and a classification by reagent companies. A total of 14 items, including albumin, were evaluated by more than 1,000 institutions. There was no significant difference in the distribution of the measurement methods compared with those used in the previous year. The coefficient of variation showed a tendency to increase as the concentration of the level control material decreased and as the number of participating institutions decreased for each test item. Most of them showed a coefficient of variation within 10%. These statistical data will be useful when interpreting the survey results from the institutions and selecting a test method.
Chemistry ; Chemistry, Clinical* ; Classification ; Korea* ; Methods

A 85-day-old infant was successfully operated on for truncus arteriosus (type I) with interrupted aortic arch (type A) using one-stage anterior approach without circulatory arrest. Aortic arch was reconstructed by direct anastomosis of ascending aorta and descending aorta with regional perfusion and continuity of right ventricle to pulmonary artery was established with Shelhigh(R) pulmonic conduit. The patient experienced left bronchus compression by descending aorta immediately postoperatively, which was improved with positional change and physiotherapy. The patient had reoperation due to stenosis of valved conduit at 13 months later. The patient is currently well under follow-up of 14 months from initial repair.
Aorta ; Aorta, Thoracic* ; Bronchi ; Constriction, Pathologic ; Follow-Up Studies ; Heart Ventricles ; Humans ; Infant ; Perfusion ; Pulmonary Artery ; Reoperation ; Truncus Arteriosus*

Mitral stenosis was developed after Duran ring annuloplasty in two growing children during follow up period of 8 years and 5 years respectively, which may be due to pannus overgrowth and patient's growing. Only removal of pannus and prosthetic ring has resulted in complete relieving of Mitral stenosis. With time, even adult-sized annuloplasty ring may induce stenosis in growing children.
Child* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Mitral Valve Stenosis*

Direct injection of the vascular endothelial growth factor (VEGF) gene plasmid DNA into the myocardium was shown to induce development of new blood vessels to increase the circulation in the heart of patients with coronary artery diseases. However, such angiogenic gene therapy (via naked DNA) was limited by low level of gene expression. Furthermore, the temporal and spatial characteristics of VEGF gene transfer in the heart are not known. In this study, we demonstrated that a plasmid vector, containing the human cytomegalovirus immediate early (HCMV IE) promoter and enhancer, induces greater expression of gene in the rat heart monitored by gene fused to the chloramphenicol acetyl transferase (CAT) reporter, than four different viral and cellular promoters. Interestingly, expression of VEGF121 protein showed an earlier peak, a shorter duration, and a wider distribution than that of CAT only. Therefore, a plasmid vector with an HCMV IE promoter/enhancer provides clear advantages over other previously developed plasmids. Furthermore, expression profile of VEGF121 gene may provide useful information in the design of angiogenic gene therapy in the heart
Animals ; Chloramphenicol O-Acetyltransferase/analysis/genetics ; Comparative Study ; Cytomegalovirus/*genetics ; DNA, Viral/*administration & dosage/*genetics ; Endothelial Growth Factors/analysis/*genetics ; *Enhancer Elements (Genetics) ; Gene Expression Regulation, Viral ; Gene Fusion ; *Gene Transfer Techniques ; Genes, Viral ; Genetic Vectors ; Intercellular Signaling Peptides and Proteins/analysis/*genetics ; Lymphokines/analysis/*genetics ; Male ; Myocardium/*metabolism ; Plasmids/genetics ; *Promoter Regions (Genetics) ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

Direct injection of the vascular endothelial growth factor (VEGF) gene plasmid DNA into the myocardium was shown to induce development of new blood vessels to increase the circulation in the heart of patients with coronary artery diseases. However, such angiogenic gene therapy (via naked DNA) was limited by low level of gene expression. Furthermore, the temporal and spatial characteristics of VEGF gene transfer in the heart are not known. In this study, we demonstrated that a plasmid vector, containing the human cytomegalovirus immediate early (HCMV IE) promoter and enhancer, induces greater expression of gene in the rat heart monitored by gene fused to the chloramphenicol acetyl transferase (CAT) reporter, than four different viral and cellular promoters. Interestingly, expression of VEGF121 protein showed an earlier peak, a shorter duration, and a wider distribution than that of CAT only. Therefore, a plasmid vector with an HCMV IE promoter/enhancer provides clear advantages over other previously developed plasmids. Furthermore, expression profile of VEGF121 gene may provide useful information in the design of angiogenic gene therapy in the heart
Animals ; Chloramphenicol O-Acetyltransferase/analysis/genetics ; Comparative Study ; Cytomegalovirus/*genetics ; DNA, Viral/*administration & dosage/*genetics ; Endothelial Growth Factors/analysis/*genetics ; *Enhancer Elements (Genetics) ; Gene Expression Regulation, Viral ; Gene Fusion ; *Gene Transfer Techniques ; Genes, Viral ; Genetic Vectors ; Intercellular Signaling Peptides and Proteins/analysis/*genetics ; Lymphokines/analysis/*genetics ; Male ; Myocardium/*metabolism ; Plasmids/genetics ; *Promoter Regions (Genetics) ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors