PURPOSE: New alternative bait rabies vaccines applicable to pet dogs and wild animals are needed to eradicate rabies in Korea. In this study, recombinant rabies virus, ERAG3G strain was constructed using reverse genetic system and the safety, efficacy and immunogenicity of the ERAG3G strain was evaluated in mice and dogs. MATERIALS AND METHODS: Using the full-length genome mutated amino acid at position 333 of glycoprotein of rabies virus (RABV) and helper plasmids, the ERAG3G strain was rescued in BHK/T7-9 cells successfully. Mice were inoculated with the ERAG3G strain for safety and efficacy. Safety and immunogenicity of the dog inoculated with the ERAG3G strain (1 mL, 10(8.0) FAID50/mL) via intramuscular route was evaluated for 28 days after inoculation. RESULTS: The ERAG3G strain rescued by reverse genetic system was propagated well in the mouse neuroblastoma cells revealing titer of 10(8.5) FAID50/mL and was not pathogenic to 4- or 6-week-old mice that received by intramuscular or intracranical route. Immunization with the ERAG3G strain conferred complete protection from lethal RABV in mice. Dogs inoculated with the vaccine candidate via intramuscular route showed high neutralizing antibody titer ranging from 2.62 to 23.9 IU/mL at 28 days postinoculation. CONCLUSION: Our findings suggest that the ERAG3G strain plays an important role in inducing protective efficacy in mice and causes to arise anti-rabies neutralizing antibody in dogs.
Animals ; Animals, Wild ; Antibodies, Neutralizing ; Dogs ; Genome ; Glycoproteins ; Immunization* ; Korea ; Mice* ; Neuroblastoma ; Plasmids ; Rabies Vaccines ; Rabies virus* ; Rabies*

Methods: Fifty-six patients (13 males and 43 females) with an average age of 80.2±9.2 years admitted to the hospital for FFS between 2006 and 2021 were analyzed retrospectively. The following patient data were collected using medical records: pain regions, a history of trauma, initial diagnoses, and rates of fracture detection using radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Results: Forty-one patients presented with low back and/or buttock pain, nine presented with groin pain, and 17 presented with thigh or leg pain. There was no history of trauma in 18 patients (32%). At the initial visit, 27 patients (48%) were diagnosed with sacral or pelvic fragility fractures. In contrast, 29 patients (52%) were initially misdiagnosed with lumbar spine disease (23 patients), hip joint diseases (three patients), and buttock bruises (three patients). Fracture detection rates for FFS were 2% using radiography, 71% using CT, and 93% using MRI. FFS was diagnosed definitively using an MRI with a coronal short tau inversion recovery (STIR) sequence. Conclusions Some patients with FFS have leg pain with no history of trauma and are initially misdiagnosed as having lumbar spine disease, hip joint disease, or simple bruises. When these clinical symptoms are reported, we recommend considering FFS as one of the differential diagnoses and performing lumbar or pelvic MRIs, particularly coronal STIR images, to rule out FFS.

A 39-year-old man with fever and dyspnea from 3 days earlier was taken to the emergency room. He was diagnosed with infective endocarditis because echocardiography showed a mobile 10 mm-sized vegetation on the aortic valve and severe aortic regurgitation. Acute coronary syndrome was negative because the tests at the first visit did not show an increase in myocardial deviation enzymes or a decrease in wall motion. However, his hemodynamics deteriorated during the same day, so he underwent emergency surgery. The left and right leaflets and the right aortic annulus were highly destroyed, and the aortic annulus was reconstructed with his pericardium and the valve was replaced by a mechanical valve. After declamping of the aorta, the wall motion of the left ventricle was extremely reduced, and the cardiopulmonary bypass(CPB) was not able to be withdrawn. Since the left anterior descending (LAD) coronary artery may have been occluded by vegetation, we added bypass surgery to the LAD under cardiac arrest using a saphenous vein graft. After the bypass surgery, the wall motion of the left ventricle improved, and we were able to withdraw the CPB. Though he developed a cerebral infarction as a complication and required long-term rehabilitation, he was able to be discharged from the hospital 74 days after the operation. We evaluated the coronary arteries after his discharge and found an occlusion that was thought to be due to vegetation scattered in the LAD. No preoperative coronary artery evaluation was performed, however, the graft was anastomosed to the distal side of the LAD occlusion. Currently, 3 years and 2 months have passed and the infection has not recurred.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.