Exploring gingerol glucosides with enhanced anti-inflammatory activity through a newly identified α-glucosidase (ArG) from Agrobacterium radiobacter DSM 30147.

Gingerols are phenolic biomedical compounds found in ginger (Zingiber officinale) whose low aqueous solubility limits their medical application. To improve their solubility and produce novel glucosides, an α-glucosidase (glycoside hydrolase) from Agrobacterium radiobacter DSM 30147 (ArG) was subcloned, expressed, purified, and then confirmed to have additional α-glycosyltransferase activity. After optimization, the ArG could glycosylate gingerols into three mono-glucosides based on the length of their acyl side chains. Compound 1 yielded 63.0 %, compound 2 yielded 26.9 %, and compound 3 yielded 4.37 %. The production yield of the gingerol glucosides optimally increased in 50 mM phosphate buffer (pH 6) with 50 % (w/v) maltose and 1000 mM Li+ at 40 °C for an 24-h incubation. The structures of purified compound 1 and compound 2 were determined as 6-gingerol-5-O-α-glucoside (1) and novel 8-gingerol-5-O-α-glucoside (2), respectively, using nucleic magnetic resonance and mass spectral analyses. The aqueous solubility of the gingerol glucosides was greatly improved. Further assays showed that, unusually, 6-gingerol-5-O-α-glucoside had 10-fold higher anti-inflammatory activity (IC50 value of 15.3 ± 0.5 µM) than 6-gingerol, while the novel 8-gingerol-5-O-α-glucoside retained 42.7 % activity (IC50 value of 106 ± 4 µM) compared with 8-gingerol. The new α-glucosidase (ArG) was confirmed to have acidic α-glycosyltransferase activity and could be applied in the production of α-glycosyl derivatives. The 6-gingerol-5-O-α-glucoside can be applied as a clinical drug for anti-inflammatory activity.

MRI-based lesion quality score assessing ossification of the posterior longitudinal ligament of the cervical spine.

BACKGROUND CONTEXT: No method currently exists for MRI-based determination of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine using objective criteria. PURPOSE: The purpose of this study was to develop an MRI-based score to determine whether a lesion represents a cervical OPLL lesion and to establish the objective diagnostic value. STUDY DESIGN: Retrospective cohort in a single medical institution. PATIENT SAMPLE: Thirty-five patients undergoing surgery for OPLL (Group A) and 99 patients undergoing cervical disc arthroplasty for soft disc herniation (Group B) between 2011 and 2020 were retrospectively included. All OPLL lesions on unenhanced MRI scan were correlated with a corresponding CT scan. Demographics were comparable between the two groups. OUTCOME MEASURES (PHYSIOLOGIC MEASURES): Using unenhanced magnetic resonance imaging (MRI), the T1- and T2- lesion quality (LQ) scores were calculated. Receiver operating characteristic (ROC) analysis was performed to calculate the area-under-the-curve (AUC) of both LQ scores as a predictor of the presence of OPLL. Computed tomography (CT)-based Hounsfield unit (HU) values of OPLL lesions were obtained and compared with both LQ scores. The LQ scores for MRI scanners from different manufacturers were compared using Student's t test to confirm the validity of the LQ score by scanner type. METHODS: The regions of interest for signal intensity (SI) were defined as the darkest site of the lesion and the cerebrospinal fluid (CSF) at the cerebellomedullary cistern. The T1 and T2 LQ scores were measured as the ratio of the SI at the darkest site of the lesion divided by the SI of the CSF. RESULTS: The T1 and T2 LQ scores in Group A were significantly lower than those in Group B (p<.001). ROC analysis determined that T1 and T2 LQ scores of 0.46 and 0.07, respectively, could distinguish the presence of OPLL with an accuracy of 0.93 and 0.89, respectively (p<.001). When the T1 LQ score of the lesion is <0.46, a diagnosis of OPLL may be suspected with 100% sensitivity and 92.3% specificity. The HU of the lesion had a moderate negative correlation with the T1 LQ score (r=-0.665, p<.0001). Both LQ scores were unaffected by manufacturer type. CONCLUSIONS: This study found a correlation between the MRI-based T1 LQ scores and CT-based HU value for identifying OPLL lesions. Additional studies will be needed to validate that the T1 LQ score from the unenhanced MRI scan can identify cervical OPLL.

The correlation between hip alpha angle and acetabular labral tear location and size: A cross-sectional study.

BACKGROUND: Explore the correlation between hip morphology and labral tear location/size. METHODS: This retrospective study analyzed patients with hip pain who received magnetic resonance (MR) arthrography at our institution, between January 2017 and December 2020. Imaging analysis includes labral tear location and size, and hip morphology measurement with alpha angle, lateral center-edge (CE) angle, anterior CE angle, and femoral neck version. The correlation between hip morphology angles and labral tear location/size was evaluated using multiple regression, followed by stratification analysis with Chi-square test to investigate interactions between the variables. RESULTS: A total of 103 patients (105 hips) with hip pain who received MR arthrography (mean age, 50 years ± 15 [SD]) were included, with mean alpha angle of 57.7° ± 9.9° [SD], mean lateral CE angle of 32.6° ± 6.8° [SD], mean anterior CE angle of 58.2° ± 8.1° [SD], mean femoral neck version of 17.1° ± 8.2° [SD]. Large alpha angle (>57°) and older age were both correlated with superior and posterosuperior labral tear incidence ( p < 0.05) and larger tear size ( p < 0.05). Furthermore, alpha angle is significantly correlated with superior labral tear incidence in young-age subgroup (age <45 years) ( p < 0.05), also significantly correlated with posterosuperior labral tear incidence and larger tear size in middle-age subgroup (45 ≤ age ≤ 60 years) ( p < 0.05). CONCLUSION: A large alpha angle (>57°) is significantly correlated with increased incidence of superior and posterosuperior labral tear, and larger tear size in patients with hip pain, and the relationships depend on age.

Can imaging distinguish between low-grade and dedifferentiated parosteal osteosarcoma?

BACKGROUND: Most instances of the parosteal osteosarcoma (OGS) are low-grade tumors. However, some parosteal OGSs undergo dedifferentiated transformation. Dedifferentiated parosteal OGS can cause distant metastasis and poor survival, and preoperative chemotherapy may be warranted. This study provides imaging clues for dedifferentiated parosteal OGS before treatment. METHODS: The study retrospectively enrolled 23 patients with histologically proven parosteal OGS, including 69.6% (n = 16) low-grade and 30.4% (n = 7) dedifferentiated types. Preoperative images including radiography and magnetic resonance imaging were reviewed. The following imaging parameters and clinical outcomes were evaluated: 1) average age; 2) sex; 3) tumor size; 4) presence of string sign; 5) necrosis; 6) hemorrhage; 7) solid soft tissue component; 8) perforating vessels; 9) ossification grade; 10) marginal ossification; 11) periosteal reaction; 12) sunburst reaction; 13) bone marrow edema; 14) bone marrow invasion; 15) perifocal soft tissue edema; 16) adjacent joint involvement; 17) adjacent neurovascular bundle compression; 18) regional lymph node; 19) bone metastasis; 20) preoperative lung metastasis; 21) follow-up lung metastasis; and 22) recurrence. RESULTS: The average maximal tumor sizes were 7.1 cm and 10.9 cm in low-grade and dedifferentiated types, respectively (p = 0.033). Sunburst periosteal reaction was visualized in two cases of low-grade type (12.5%) and four cases of the dedifferentiated type (57.1%) (p = 0.025) of parosteal OGS. None of our studied cases revealed preoperative lung metastasis. In the follow-up chest computed tomography, lung metastasis was noted in two cases of conventional type (14.2%), and four cases of dedifferentiated type (57.1%) (p = 0.040) of parosteal OGS. In receiver operating characteristic (ROC) curve analysis, the average tumor size and sunburst periosteal reaction showed good specificity (AUC = 0.070 and 0.072, respectively). CONCLUSION: Compared with low-grade types, dedifferentiated parosteal OGS exhibits a considerably larger tumor size, more sunburst periosteal reaction, and a more frequent development of lung metastasis in the disease course. Tumor size and sunburst periosteal reaction are the most crucial imaging diagnostic factors.

Effectiveness of 2 rotavirus vaccines against rotavirus disease in Taiwanese infants.

BACKGROUND: Two rotavirus (RV) vaccines (Rotarix and RotaTeq) are available on the private market in Taiwan, but are not recommended for routine use. We examined RV vaccine effectiveness (VE) against severe RV acute gastroenteritis (AGE) among Taiwanese infants to inform policymakers on the potential benefits of national RV vaccine introduction. METHODS: From May 2009 to April 2011, a case-control assessment of VE against severe RV AGE was conducted at 3 hospital-based surveillance sites in Taiwan. Case-patients included children aged 8-35 months, hospitalized with laboratory-confirmed RV AGE. Controls included children age-matched within 1 month of age of the case-patient, hospitalized with RV-negative AGE or seen for non-AGE illnesses at the same hospitals. Vaccination history was confirmed through vaccination card or hospital record review. VE was calculated as (1--odds ratio of vaccination) × 100%. RESULTS: We enrolled 184 case-patients with RV AGE, 904 RV-negative AGE and 909 non-AGE controls. Two-dose Rotarix series VE against RV gastroenteritis hospitalization was 90.4% [95% confidence interval (CI): 70.3%, 98.1%) and 92.5% (95% CI: 77.1%, 98.5%) with RV-negative AGE and non-AGE controls, respectively. Three-dose RotaTeq series VE was 96.8% (95% CI: 82.3%, 100%) and 97.1% (95% CI: 84%, 100%) with RV-negative AGE and non-AGE controls, respectively. CONCLUSIONS: Both vaccines provided excellent protection against severe RV AGE hospitalization. Addition of RV vaccination into Taiwan's National Immunization Program could substantially decrease AGE hospitalizations among children <3 years. Our findings should help inform policymakers in Taiwan and other similar Asian countries when deciding whether to include RV vaccination into their national immunization programs.

Management of life-threatening celiac-hepatic arterial hemorrhage after pancreaticoduodenectomy: usefulness of temporary balloon occlusion.

When a large visceral artery is ruptured, uncontrolled bleeding may lead to hemodynamic collapse. Use of endovascular occlusion balloon catheter may provide rapid control of hemorrhage and facilitate definitive therapy. We reported two patients with massive hemorrhage from ruptured celiac-hepatic artery after pancreaticoduodenectomy, who were initially treated percutaneously by temporary selective balloon occlusion. They became critically hemodynamic unstable during the angiographic procedure. Through an 8Fr sheath, a 6Fr compliant latex occlusion balloon was placed proximal to the celiac trunk and inflated, and upon patient stabilization surgical revision and stent-graft placement were successfully performed in the two patients, respectively. Temporary selective balloon occlusion provides fast and effective bleeding control for patient with critically uncontrollable visceral arterial hemorrhage, permitting subsequent use of conventional techniques for management of the arterial bleeding source.

Transradial approach for transcatheter selective superior mesenteric artery urokinase infusion therapy in patients with acute extensive portal and superior mesenteric vein thrombosis.

The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 +/- 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 +/- 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 +/- 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.

Acute extensive portal and mesenteric venous thrombosis after splenectomy: treated by interventional thrombolysis with transjugular approach.

AIM: To present a series of cases with symptomatic acute extensive portal vein (PV) and superior mesenteric vein (SMV) thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolysis. METHODS: A total of 6 patients with acute extensive PV-SMV thrombosis after splenectomy were treated by transjugular approach catheter-directed thrombolysis. The mean age of the patients was 41.2 years. After access to the portal system via the transjugular approach, pigtail catheter fragmentation of clots, local urokinase injection, and manual aspiration thrombectomy were used for the initial treatment of PV-SMV thrombosis, followed by continuous thrombolytic therapy via an indwelling infusion catheter in the SMV, which was performed for three to six days. Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. RESULTS: Technical success was achieved in all 6 patients. Clinical improvement was seen in these patients within 12-24 h of the procedure. No complications were observed. The 6 patients were discharged 6-14 d (8 +/- 2.5 d) after admission. The mean duration of follow-up after hospital discharge was 40 +/- 16.5 mo. Ultrasound and contrast-enhanced computed tomography confirmed patency of the PV and SMV, and no recurrent episodes of PV-SMV thrombosis developed during the follow-up period. CONCLUSION: Catheter-directed thrombolysis via transjugular intrahepatic access is a safe and effective therapy for the management of patients with symptomatic acute extensive PV-SMV thrombosis.