A Case of Brain Abscess Caused by Two Species of Anaerobic Periodontal Pathogens / 日本農村医学会雑誌

　　Here, we report a case of a brain abscess caused by two species of anaerobic periodontal pathogens. In June 20XX, a 45-year-old man visited a nearby clinic for weakness and abnormal sensation in the left arm. He was diagnosed with brain infarction based on head computed tomographic (CT) findings and was prescribed antiplatelet agents. However, he was subsequently referred to our department because of paralysis on the left side and underwent keyhole surgery to release the pus of a brain abscess which was diagnosed based on head magnetic resonance imaging findings. The identify of causal bacteria remains unknown in 30% of patients with an abscess due to anaerobic infection. Therefore, we collected multiple samples to identify the two species of anaerobic periodontal pathogens as the causal pathogens in the present case. The findings of this study suggest that the brain abscess was caused by a bacterial complex with a corn-cob structure that was transported to the cerebral cortex because of periodontal bacteremia in the patient, who had severe periodontal disease. Despite the difficulties in selecting antibiotics and deciding the method of administration, the outcome of a 14-week duration of postoperative antibiotics given with oral care and well-planned dental treatment was satisfactory.

Daily Intake of Sulforaphane-Rich Broccoli Sprouts Suppresses H. pylori Colonization and Attenuates H. pylori-induced Gastritis via Upregulation of Nrf2-dependent Antixodaint Enzymes / 日本補完代替医療学会誌

<i>Background</i>: Sulforaphane (SFN), a compound abundant in broccoli sprouts (BS), protects cells from oxidative injury by activating nrf2-mediated antioxidant enzymes. Sulforaphane also shows bactericidal activity against <i>H. pylori in vitro</i>. The aim of this study was to determine if daily intake of SFN-rich BS inhibits <i>H. pylori </i>colonization and mitigated gastritis in <i>H. pylori</i>-infected gastric mucosa in mice and humans.<br> <i>Methods</i>: Study 1: Nrf2+/+ and nrf2−/− C57BL/6 female mice were infected with <i>H.pylori</i> Sydney Strain; SS1. Mice were maintained for 2 mo. on a high salt diet (7.5% NaCl), supplemented with or without BS containing approximately 2.5 mM SFN. Degree of gastritis was evaluated by updated Sydney system. Study 2: Fifty subjects infected with <i>H. pylori </i>were randomly assigned to either the BS group (n=25) or the Alfalfa Sprouts (AS) group (n=25). All subjects were asked to eat BS 70 g/day (containing approximately 180 mg SFN) or AS 70 g/day (no SFN) for 2 months. <i>H.pylori</i> colonization was evaluated by measurement of HpSA. The degree of gastritis was evaluated by measuring serum levels of pepsinogen (PG) I and II.<br> <i>Results</i>: Study 1: BS treatment decreased Hp colonization and mitigated gastritis in nrf2+/+ but not in nrf2−/− mice. Study 2: Two months intervention with BS decreased HpSA values and serum levels of PG I and II, while AS showed on effect.<br> <i>Conclusion</i>: Daily intake of SFN-rich BS suppresses <i>H.pylori</i> colonization and improves gastritis in <i>H. pylori</i>-infected gastric mucosa via nrf2-dependent mechanisms.<br>