The recent emergence and re-emergence of porcine epidemic diarrhea virus (PEDV) underscore the urgent need for the development of novel, safe, and effective vaccines against the prevailing strain. In this study, we generated a cold-adapted live attenuated vaccine candidate (Aram-P29-CA) by short-term passage of a virulent PEDV isolate at successively lower temperatures in Vero cells. Whole genome sequencing identified 12 amino acid changes in the cold-adapted strain with no insertions and deletions throughout the genome. Animal inoculation experiments confirmed the attenuated phenotype of Aram-P29-CA virus in the natural host. Pregnant sows were orally administered P29-CA live vaccines two doses at 2-week intervals prior to parturition, and the newborn piglets were challenged with the parental virus. The oral homologous prime-boost vaccination of P29-CA significantly improved the survival rate of the piglets and notably mitigated the severity of diarrhea and PEDV fecal shedding after the challenge. Furthermore, strong antibody responses to PEDV were detected in the sera and colostrum of immunized sows and in the sera of their offspring. These results demonstrated that the cold-adapted attenuated virus can be used as a live vaccine in maternal vaccination strategies to provide durable lactogenic immunity and confer passive protection to litters against PEDV.
Animals ; Antibody Formation ; Colostrum ; Diarrhea ; Genome ; Genotype ; Humans ; Infant, Newborn ; Parents ; Parturition ; Phenotype ; Porcine epidemic diarrhea virus ; Survival Rate ; Vaccination ; Vaccines ; Vero Cells

The porcine reproductive and respiratory syndrome virus (PRRSV) is a globally ubiquitous swine viral pathogen that causes major economic losses worldwide. We previously reported an over-attenuated phenotype of cell-adapted PRRSV strain CA-2-P100 in vivo. In the present study, CA-2-P100 was serially propagated in cultured porcine alveolar macrophage (PAM) cells for up to 20 passages to obtain the derivative strain CA-2-MP120. Animal inoculation studies revealed that both CA-2-P100 and CA-2-MP120 had decreased virulence, eliciting weight gains, body temperatures, and histopathologic lesions similar to those in the negative control group. However, compared to CA-2-P100 infection, CA-2-MP120 yielded consistently higher viremia kinetics and enhanced antibody responses in pigs. All pigs inoculated with CA-2-MP120 developed viremia and seroconverted to PRRSV. During 20 passages in PAM cells, CA-2-MP120 acquired 15 amino acid changes that were mostly distributed in nsp2 and minor structural protein-coding regions. Among these changes, 6 mutations represented reversions to the sequences of the reference CA-2 and parental CA-2-P20 strains. These genetic drifts may be hypothetical molecular markers associated with PRRSV macrophage tropism and virulence. Our results indicate that the PAM-passaged CA-2-MP120 strain is a potential candidate for developing a live, attenuated PRRSV vaccine.
Animals ; Antibody Formation ; Body Temperature ; Genetic Drift ; Humans ; Kinetics ; Macrophages ; Macrophages, Alveolar ; Parents ; Phenotype ; Porcine Reproductive and Respiratory Syndrome ; Porcine respiratory and reproductive syndrome virus ; Swine ; Tropism ; Vaccines, Attenuated ; Viremia ; Virulence ; Weight Gain

Porcine deltacoronavirus (PDCoV) has emerged in several pig-raising countries and has been a causative pathogen associated with diarrheal diseases in South Korea since 2014. In the present study, we were able to isolate and cultivate a Korean PDCoV strain (KNU16-07) in cell culture and investigate its pathogenicity. PDCoV-inoculated piglets showed watery diarrhea accompanied by acute enteritis in the natural host. Sequencing analysis demonstrated the genetic stability of KNU16-07 for at least thirty serial passages.
Cell Culture Techniques ; Diarrhea ; Enteritis ; Korea ; Serial Passage ; Virulence

PURPOSE: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. METHODS: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. RESULTS: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. CONCLUSION: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.
Aged* ; Education* ; Food Safety* ; Humans ; Occupational Groups

PURPOSE: This study aimed to improve prostate biopsy compliance by analyzing the factors that influence the acceptance of prostate biopsy by patients to whom transrectal ultrasound (TRUS)-guided prostate biopsy is recommended for suspected prostate cancer. MATERIALS AND METHODS: The subjects of this study were 268 patients to whom TRUS-guided prostate biopsy was recommended from January to June 2011 and who completed a questionnaire. Patients who showed a prostate-specific antigen (PSA) increase to more than 4.0 ng/mL or abnormal findings on a digital rectal examination and TRUS were recommended to undergo prostate biopsy. The questionnaire consisted of 9 questions about the subjects' demographic characteristics and 15 questions that assessed their knowledge of prostate disease. Fisher exact probability test was conducted to assess the influence of the demographic characteristics and levels of knowledge of prostate disease on acceptance of prostate biopsy. RESULTS: The mean age of the subjects was 66.2 years (range, 43-83 years). Of the cohort, 188 patients (70.7%) agreed to the prostate biopsy and 78 patients (29.3%) refused. In terms of demographic characteristics, the patients' acceptance of prostate biopsy was associated only with education level. Patients with relatively lower education levels had a higher acceptance rate for prostate biopsy (80.0% vs. 65.9%, p=0.018). Other demographic factors, as well as the degree of knowledge of prostate disease, had no significant effect on the acceptance rate. CONCLUSIONS: The patients' acceptance of prostate biopsy can be influenced by demographic characteristics, especially education level. Therefore, when prostate biopsy is recommended to patients, their demographic characteristics should be taken into consideration.
Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle/methods/psychology ; Health Knowledge, Attitudes, Practice ; Humans ; Kallikreins/blood ; Male ; Middle Aged ; *Patient Acceptance of Health Care ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/*pathology/psychology/ultrasonography ; Republic of Korea ; Socioeconomic Factors ; Ultrasonography, Interventional

PURPOSE: To evaluate the feasibility of the interferon-gamma release assay (IGRA) as a supplementary diagnostic tool for the diagnosis of genitourinary tuberculosis (GUTB). MATERIALS AND METHODS: Fifty-seven patients who were tested with the IGRA to diagnose GUTB were included. All patients had clinical or radiologic features suspicious for GUTB. Signs and symptoms included chronic dysuria with long-standing sterile pyuria, renal calcification with distorted renal calyces and contracted renal pelvis, and chronic epididymitis. Patients who had a history of tuberculosis in other organs were excluded. Tests including IGRA, urine acid-fast bacilli (AFB) stain and culture, urine tuberculosis polymerase chain reaction (UT-PCR), and radiological examinations were performed to confirm GUTB. The medical records of the patients were reviewed retrospectively. RESULTS: The IGRA result was positive in 30 patients (52.6%). The results of the urine AFB stain and culture were positive in 5 patients (8.8%) and 7 patients (12.2%), respectively. The results of UT-PCR were positive in 9 patients (15.8%). The 7 patients who showed positive results in the urine AFB stain and culture also had positive results on the IGRA. A UT-PCR-negative patient was diagnosed with GUTB by positive results on both the IGRA and AFB stain and culture. CONCLUSIONS: The IGRA might feasibly be used as a supplementary or screening tool for the diagnosis of GUTB in addition to urine AFB stain and culture. Further studies for statistical evaluation of its sensitivity, specificity, and efficacy are needed.
Contracts ; Dysuria ; Epididymitis ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Kidney Pelvis ; Male ; Mass Screening ; Medical Records ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Urogenital

PURPOSE: To identify potential predictive factors of incidental prostate cancer (IPca) in patients considering tissue-ablation treatment for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: From the 11 centers, 1,613 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were included. Before surgery, prostate biopsy was performed in all patients with prostate-specific antigen (PSA) > or =4.0 ng/ml or with abnormal digital rectal examination (DRE) findings. The patients with prostate cancer preoperatively or with PSA >20 ng/ml were excluded. As predictive factors of IPca, age, body mass index, PSA, DRE, and transrectal ultrasonography (TRUS) findings, including total prostate volume (TPV), transition zone volume (TZV), and the presence of hypoechoic lesions, were reviewed. PSA density (PSAD) and PSAD in the transition zone (PSAD-TZV) were calculated. RESULTS: IPca was diagnosed in 78 patients (4.8%). DRE findings, PSA, and TZV were independent predictive factors in the multivariate analysis. In the receiver operating characteristic curve analysis of PSA, PSAD, and PSAD-TZV, the area under the curve (AUC) was the largest for PSAD-TZV (AUC, 0.685). CONCLUSIONS: IPca was detected in 4.8% of the population studied. In addition to DRE findings, the combination of TZV and PSA can be useful predictive factors of IPca in patients considering tissue-ablation treatment as well as TURP.
Biopsy ; Body Mass Index ; Cyanoacrylates ; Digital Rectal Examination ; Humans ; Male ; Multivariate Analysis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Hyperplasia ; Prostatic Neoplasms ; ROC Curve ; Transurethral Resection of Prostate

We investigated the clinical significance of large difference (> or = 2 points) between biopsy-derived (bGS) and post-prostatectomy Gleason scores (pGS). At 14 medical centers in Korea, 1,582 men who underwent radical prostatectomy for prostate cancer were included. According to the difference between bGS and pGS, the patients were divided into three groups: A (decreased in pGS > or = 2, n = 30), B (changed in pGS < or = 1, n = 1,361; control group), and C (increased in pGS > or = 2, n = 55). We evaluated various clinicopathological factors of prostate cancer and hazards for biochemical failure. Group A showed significantly higher mean maximal percentage of cancer in the positive cores (max%) and pathological T stage than control. In group C, the number of biopsy core was significantly smaller, however, tumor volume and max% were significantly higher and more positive biopsy cores were presented than control. Worse pathological stage and more margin-positive were observed in group A and C than in control. Hazard ratio for biochemical failure was also higher in group A and C (P = 0.001). However, the groups were not independent factors in multivariate analysis. In conclusion, large difference between bGS and pGS shows poor prognosis even in the decreased group. However it is not an independent prognostic factor for biochemical failure.
Age Factors ; Aged ; Biopsy ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; *Prostatectomy ; Prostatic Neoplasms/*pathology/surgery ; Recurrence ; Severity of Illness Index

PURPOSE: We aimed to verify the current status of transurethral resection of the prostate (TURP) in Korea. MATERIALS AND METHODS: The medical records of 1,341 men who underwent TURP in 9 Korean medical centers between 2004 and 2008 were reviewed. The patients were divided into two groups according to time periods: 2004-2005 (group 1) and 2006-2008 (group 2). To verify differences in the two patient groups, age, prostate volume, indications for TURP, preoperative International Prostate Symptom Score (IPSS), and resected tissue weight were evaluated. RESULTS: The mean age of the patients was 71.2 years and the mean IPSS was 22.7. The patients' characteristics were not significantly different between the two groups. The annual cases of TURP increased over the study period. The proportion of lower urinary tract symptoms (LUTS) as an indication for TURP increased up to 58.3% in group 2 compared with 51.6% in group 1 (p=0.019). However, the proportion of patients who presented with acute urinary retention decreased from 35.5% to 30.3% with marginal statistical significance (p=0.051). Other indications such as hematuria, bladder stone, recurrent urinary tract infection, and hydronephrosis were not significantly different between the groups. The mean resected weights of the prostate were similar (17.5 g in group 1 and 18.3 g in group 2, respectively; p>0.05). CONCLUSIONS: TURP has been steadily performed in patients with benign prostatic hyperplasia and it is expected to remain constant. LUTS was the most common indication for TURP in recent years.
Hematuria ; Humans ; Hydronephrosis ; Lower Urinary Tract Symptoms ; Male ; Medical Records ; Prostate ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urinary Bladder Calculi ; Urinary Retention ; Urinary Tract Infections ; Weights and Measures

PURPOSE: To evaluate the clinical factors that impact ureteral stent-related lower urinary tract symptoms (LUTS) after ureteroscopic ureterolithotomy, including the stent position and medication. MATERIALS AND METHODS: Fifty-three patients who underwent ureteroscopic ureterolithotomy with indwelling a stent were distributed into three groups. On demand analgesics were given to the group 1 (n=18). Daily tamsulosin 0.2 mg was added for group 2 (n=15) and daily tamsulosin 0.2 mg and tolterodine 4 mg was added for group 3 (n=20). The patients were also subclassified into appropriate or inappropriate group according to stent position. All the patients completed a visual analogue scale (VAS) and International Prostate Symptom Score (IPSS) on the 1st and 7th postoperative days. The VAS and IPSS were analyzed according to the medication groups and the stent position. RESULTS: In the appropriate stent potion group, only the storage symptom scores of groups 2 and 3 on the 1st postoperative day were significantly lower than those of the group 1 (p=0.001). This medication effect on LUTS was not observed in the inappropriate stent position group. In this group, total IPSS (p=0.015) and storage symptom scores (p=0.002) were higher than in the appropriate stent position group on the 7th postoperative day. CONCLUSIONS: Correct placement of the stent was more important than medication for lessening stent-related storage symptoms.
Adrenergic alpha-Antagonists ; Analgesics ; Benzhydryl Compounds ; Cholinergic Antagonists ; Cresols ; Humans ; Lower Urinary Tract Symptoms ; Phenylpropanolamine ; Prospective Studies ; Prostate ; Stents ; Sulfonamides ; Ureter ; Ureteroscopy ; Urinary Catheterization ; Urological Manifestations ; Tolterodine Tartrate