Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC). Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC. Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority. Conclusions In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.

During the highly pathogenic avian influenza (HPAI) H5N8 virus outbreak in Korea, a dog in layer farm contaminated by H5N8 was reported seropositive for HPAI H5N8. To investigate the possibility of adaptation and transmission of HPAI H5N8 to dogs, we experimentally inoculated dogs with H5N8. Viral genes were weakly detected in nasal swabs and seroconversions in inoculated and contact dogs. Although the H5N8 virus did not induced severe clinical signs to dogs, the results suggest that surveillance of farm dogs should continue as a species in which the avian influenza virus may acquire infectivity to mammals through frequent contact with the virus.
Agriculture ; Animal Experimentation ; Animals ; Dogs* ; Genes, Viral ; Influenza in Birds* ; Korea ; Mammals ; Seroconversion ; Virulence

A/Puerto Rico/8/34 (PR8)-derived recombinant viruses have been used for seasonal flu vaccines; however, they are insufficient for vaccines against some human-fatal H5N1 highly pathogenic avian influenza (HPAI) viruses (HPAIV) due to low productivity. Additionally, the polymerase basic 2 (PB2) protein, an important mammalian-pathogenicity determinant, of PR8 possesses several mammalian-pathogenic mutations. We previously reported two avian PB2 genes (01310 and 0028) related to efficient replication in embryonated chicken eggs (ECEs) and nonpathogenicity in BALB/c mice. In this study, we generated PR8-derived H5N1 recombinant viruses harboring hemagglutinin (attenuated) and neuraminidase genes of a clade 2.3.2.1c H5N1 HPAIV (K10-483), as well as the 01310 or 0028 PB2 genes, and investigated their replication and immunogenicity. Compared with a control virus harboring six internal PR8 genes (rK10-483), the recombinant viruses possessing the 01310 and 0028 PB2 genes showed significantly higher replication efficiency in ECEs and higher antibody titers in chickens. In contrast to rK10-483, none of the viruses replicated in BALB/c mice, and all showed low titers in Madin-Darby canine kidney cells. Additionally, the recombinant viruses did not induce a neutralization antibody but elicited decreased protective immune responses against K10-483 in mice. Thus, the highly replicative and mammalian nonpathogenic recombinant H5N1 strains might be promising vaccine candidates against HPAI in poultry.
Animals ; Chickens ; Efficiency ; Eggs ; Hemagglutinins ; Influenza in Birds* ; Influenza Vaccines ; Kidney ; Mice ; Neuraminidase ; Ovum ; Poultry ; Reverse Genetics ; Seasons ; Vaccines ; Virulence

Newcastle disease viruses (NDVs) cause systemic diseases in chickens with high mortality. However, little is known about persistence of NDVs in contaminated tissues from infected birds. In this study, we examined viral replication in the feather pulp of chickens inoculated with viscerotropic velogenic NDV (vvNDV) genotype VII. Reverse transcription real-time PCR and immunohistochemistry were used to investigate viral persistence in the samples. vvNDV was detected in the oropharynx and cloaca and viral antigens were detected in the feathers, suggesting that feathers act as sources of viral transmission.
Animals ; Antigens, Viral/analysis ; Chickens ; Cloaca/virology ; Feathers/*virology ; Microbial Viability ; Newcastle Disease/transmission/*virology ; Newcastle disease virus/isolation & purification/*physiology ; Oropharynx/virology ; Poultry Diseases/transmission/*virology ; Virus Replication/*physiology

Antiviral activity against Influenza virus of 14 Lactobacillus species isolated from food was monitored. Lactobacillus species were isolated from traditional Korean fermented food. Each live Lactobacillus was administered into the nasal cavity of SPF 6-week-old BALB/c mice. After the Lactobacillus treatment, Influenza virus (A/NWS/33/H1N1) was inoculated to each mouse. Clinical signs and mortality was monitored for 21 days. Each Lactobacillus strain showed various level of antiviral activity against Influenza virus. As a result of this study, this mouse experiment model, including intranasal treatment of live Lactobacillus species, could be effective model in evaluating immunomodulatory response of probiotics against respiratory viruses.
Administration, Intranasal* ; Animals ; Influenza, Human ; Lactobacillus ; Mice* ; Models, Animal ; Mortality ; Nasal Cavity ; Orthomyxoviridae* ; Probiotics

PURPOSE: N-acetylcysteine (NAC) is a potent antioxidant, and a free radical scavenger. We investigated the possible effects of NAC after ischemia/reperfusion (I/R) of rat bladder. MATERIALS AND METHODS: I/R injury was induced by abdominal aorta clamping and ischemia for 60minutes, followed by 120minutes reperfusion. Twenty rats were divided into four groups: sham operation + saline group (S+S), sham operation + NAC group (S+NAC), I/R + saline group (I/R+S), I/R + NAC group (I/R+NAC). Blood levels of reactive oxygen species (ROS) were determined using the free oxygen radical tests (FORT). Superoxide generation was measured based on lucigenin-enhanced chemiluminescence. The level of malondialdehyde (MDA) was analyzed in order to measure lipid peroxidation. RESULTS: In I/R+S group, the isometric contractile responses to carbachol were significant lower than other groups and were reversed by the pretreatment with NAC. The level of FORT and MDA showed a marked increase in I/R+S group compared with S+S group. NADPH-stimulated superoxide production was also significantly increased. I/R+NAC decreased these parameters compared with I/R+S group. CONCLUSION: Our results suggest that treatment with NAC reversed the low contractile responses of rat bladder and prevented oxidative stress following I/R.
Acetylcysteine ; Animals ; Aorta, Abdominal ; Carbachol ; Constriction ; Ischemia ; Lipid Peroxidation ; Luminescence ; Malondialdehyde ; Oxidative Stress ; Oxygen ; Panax* ; Rats* ; Reactive Oxygen Species ; Reperfusion ; Superoxides ; Urinary Bladder*

There are growing evidences suggesting a pivotal role of oxidative stress in the pathophysiology of preeclampsia. We investigated oxidative stress in the rat model of preeclampsia, and in clinical cases. Pregnant female rats were injected intraperitoneally with deoxycorticosterone acetate (DOCA) and given 0.9% saline as drinking water during their pregnancy. We assessed plasma F2-isoprostane (8-iso-PGF2alpha) and malondialdehyde (MDA) in a rat model, and the same markers in the plasma of maternal blood and fetal cord blood in pregnant women with preclampsia. Blood samples from the umbilical arteries and veins were collected separately. The concentrations of MDA were increased in the preeclampsia groups of animal and humans, compared with the control group; it was significantly increased in the umbilical artery and vein of the preeclampsia group. The concentrations of F2-isoprostane were elevated in the preeclampsia groups of animal and humans, compared with the control group, and the increase in F2-isoprostane concentration was prominent in the umbilical vein than umbilical artery of the preeclampsia group. Therefore, it appears that the placenta has an important role in the pathophysiology of preeclampsia, and the F2-isoprostanes of the umbilical vein may serve as a relatively reliable marker for ischemic/hypoxic injury to the fetus during the perinatal period.
Animals ; Desoxycorticosterone ; Drinking Water ; F2-Isoprostanes ; Female ; Fetal Blood ; Fetus ; Humans ; Malondialdehyde ; Models, Animal* ; Oxidative Stress ; Placenta ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Rats* ; Umbilical Arteries ; Umbilical Veins ; Veins

BACKGROUND AND OBJECTIVES: This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I PIP, a marker of myocardial fibrosis, was related to the change of the ventricular filling dynamics in patients with early type 2 diabetes mellitus (DM). SUBJECTS AND METHODS: Echocardiography was performed in 28 patients with type 2 DM and 32 age-matched healthy controls, ranging from 31-69 years of age, with normal left ventricular (LV) systolic function and ECG at rest. Subjects with diabetic complications, including microalbuminuria, nephropathy (Cr>1.3 mg/dL), severe obesity (BMI> or =30 kg/m2), LV hypertrophy (LV septal thickness and/or posterior wall thickness 12 mm on M-mode) and hypertension, were excluded. The serum concentrations of PIP and Transforming growth factor TGF-beta1 were measured by enzyme immunoassay methods. RESULTS: The type 2 DM group had lower mitral (Type 2 DM vs. Control: 0.88+/-0.28 vs. 1.17+/-0.34, p<0.01) and tricuspid E/A ratios (1.15+/-0.25 vs. 1.30+/-0.25, p=0.01) than the control group. The level of serum PIP was higher (p<0.05) in patients with type 2 DM than in the control group (131.1+/-45.6 vs. 109.3+/-32.5). The difference in the duration between transmitral forward (A) and pulmonary venous retrograde (Ar) waves (A-Ar) was considered an estimate of a passive diastolic function. A-Ar was inversely related with the serum PIP level in type 2 diabetes (r=-0.43, p=0.03). CONCLUSION: These results show a relationship between the LV diastolic function and the serum concentration of PIP in early type 2 DM. These findings suggest that the determination of the serum level of PIP is a useful method for the screening and early diagnosis of myocardial fibrosis associated with DM.
Collagen Type I ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diastole ; Early Diagnosis ; Echocardiography ; Electrocardiography ; Fibrosis* ; Humans ; Hypertension ; Hypertrophy ; Immunoenzyme Techniques ; Mass Screening ; Obesity, Morbid ; Procollagen ; Transforming Growth Factor beta1 ; Transforming Growth Factors

BACKGROUND AND OBJECTIVES: Receptor for advanced glycosylation end product (RAGE) plays an important role in the development of myocardial fibrosis in diabetics. Activation of peroxisome proliferator activated receptor (PPAR)-gamma agonist, rosiglitazone, reduces the RAGE expression. We investigated whether rosiglitazone could prevent left ventricle (LV) diastolic dysfunction and attenuate the myocardial fibrosis in a type 2 diabetic rat model. MATERIALS AND METHODS: Otsuka Long-Evans Tokushima Fatty (OLETF) rats were treated with rosiglitazone (20 mg/kg/d) for 20 weeks. At the age of 20 and 40 weeks, all rats underwent intraperitoneal glucose tolerance tests, hemodynamic studies and Doppler echocardiography. At the age of 40 weeks, the hearts were examined by performing histopathological and immunohistochemical analyses. RESULTS: At the age of 40 weeks, rosiglitazone significant improved the parameters of the LV diastolic function such as the E/A ratio (treated vs. untreated: 1.7+/-0.1 vs. 1.5+/-0.1, p<0.05), the deceleration time and the isovolumic relaxation time in the OLETF rats, and this was correlated histologically to the reduced LV collagen volume fraction in the rosiglitazonetreated OLETF rats (3.2+/-1.3% vs. 5.7+/-2.0%, respectively, p<0.001). Rosiglitazone also significantly reduced the percentage of staining of the LV CTGF (7.4+/-2.5% vs. 15.4+/-4.7%, respectively, p<0.001) and RAGE (1.1+/-0.4% vs. 2.0+/-0.8%, respectively, p<0.001), as compared with the untreated OLETF rats. CONCLUSION: These results suggest that rosiglitazone could prevent LV diastolic dysfunction and attenuate myocardial fibrosis in type 2 diabetic rats by its inhibition of the RAGE and CTGF expression. PPAR-gamma agonist may provide a potential therapeutic approach for diabetic heart disease.
Animals ; Collagen ; Deceleration ; Echocardiography, Doppler ; Fibrosis* ; Glucose Tolerance Test ; Glycosylation ; Heart ; Heart Diseases ; Heart Ventricles ; Hemodynamics ; Intercellular Signaling Peptides and Proteins ; Models, Animal* ; Peroxisomes ; Rage ; Rats* ; Rats, Inbred OLETF ; Relaxation

Bicuspid aortic valve is the most common form of congenital valvular disease, and its presence may predispose the patients to development of true aortic or dissecting aortic aneurysms. An intrinsic aortic weakness may underlie a bicuspid aortic valve, aortic aneurysm or aortic dissection. We experienced a case of an ascending aortic aneurysm associated with a functionally normal bicuspid aortic valve. A screening echocardiograph was performed due to atypical chest pain, which detected a large ascending aortic aneurysm and a bicuspid aortic valve. The patient underwent an operation for an ascending aortic aneurysm and, is living one year later, and is asymptomatic. To the best of our knowledge, this may be the first case of an ascending aortic aneurysm associated with a bicuspid aortic valve in Korea.
Aortic Aneurysm* ; Aortic Valve* ; Bicuspid* ; Chest Pain ; Humans ; Korea ; Mass Screening