Cloning and characterization of a novel mesophilic xylanase gene Fgxyn3 from Fusarium graminearum Z-1.

In order to search for high specific activity and the resistant xylanases to XIP-I and provide more alternative xylanases for industrial production, a strain of Fusarium graminearum from Triticum aestivum grains infected with filamentous fungus produced xylanases was isolated and identified. Three xylanase genes from Fusarium graminearum Z-1 were cloned and successfully expressed in E. coli and P. pastoris, respectively. The specific activities of Fgxyn1, EFgxyn2 and EFgxyn3 for birchwood xylan were 38.79, 0.85 and 243.83 U/mg in E. coli, and 40.11, 0 and 910.37 U/mg in P. pastoris, respectively. EFgxyn3 and PFgxyn3 had the similar optimum pH at 6.0 and pH stability at 5.0-9.0. However, they had different optimum temperature and thermal stability, with 30 °C for EFgxyn3 and 40 °C for PFgxyn3, and 4-35 °C for EFgxyn3 and 4-40 °C for PFgxyn3, respectively. The substrate spectrum and the kinetic parameters showed that the two xylanases also exhibited the highest xylanase activity and catalytic efficiency (kcat/km) toward birchwood xylan, with 243.83 U/mg and 61.44 mL/mg/s for EFgxyn3 and 910.37 U/mg and 910.37 mL/mg/s for PFgxyn3, respectively. This study provided a novel mesophilic xylanase with high specific activity and catalytic efficiency, thus making it a promising candidate for extensive applications in animal feed and food industry. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-024-03973-0.

Improving the inhibitory resistance of xylanase FgXyn11C from Fusarium graminearum to SyXIP-I by site-directed mutagenesis.

The aim of this study was to improve the inhibitory resistance of xylanase FgXyn11C from Fusarium graminearum to XIP in cereal flour. Site saturation mutagenesis was performed using computer-aided redesign. Firstly, based on multiple primary structure alignments, the amino acid residues in the active site architecture were identified, and specific residue T144 in the thumb region of FgXyn11C was selected for site-saturation mutagenesis. After screening, FgXyn11CT144F was selected as the best mutant, as it displayed the highest enzymatic activity and resistance simultaneously compared to other mutants. The specific activity of FgXyn11CT144F was 208.8 U/mg and it exhibited complete resistance to SyXIP-I. Compared with the wild-type, FgXyn11CT144F displayed similar activity and the most resistant against SyXIP-I. The optimal temperature and pH of the wild-type and purified FgXyn11CT144F were similar at pH 5.0 and 30 °C. Our findings provided preliminary insight into how the specific residue at position 144 in the thumb region of FgXyn11C influenced the enzymatic properties and interacted with SyXIP-I. The inhibition sensitivity of FgXyn11C was reduced through directed evolution, leading to creation of the mutant enzyme FgXyn11CT144F. The FgXyn11CT144F resistance to SyXIP-I has potential application and can also provide references for engineering other resistant xylanases of the GHF11.

Expression and characterization of ß-1,3-1,4-glucanase of Aspergillus usamii in Escherichia coli and its application in sourdough bread making.

A ß-1,3-1,4-glucanase gene (Auglu12A) from Aspergillus usamii was successfully expressed in Escherichia coli BL21(DE3). The recombinant enzyme, reAuglu12A was efficiently purified using the one-step nickel-nitrilotriacetic acid affinity chromatography. The specific activity of reAuglu12A was 694.8 U/mg, with an optimal temperature of 55°C and pH of 5.0. The reAuglu12A exhibited stability at temperatures up to 60°C and within the pH range of 4.0-5.5. The reAuglu12A hydrolytic activity was increased in the presence of metal ions, especially K+ and Na+ , whereas it exhibited a Km and Vmax of 8.35 mg/mL and 1254.02 µmol/min/mg, respectively, toward barley ß-glucan at pH 5.0 and 55°C. The addition of reAuglu12A significantly increased the specific volume (p < 0.05) and reduced crumb firmness and chewiness (p < 0.05) of wheat-barley sourdough bread during a 7-day storage period compared to the control. Overall, the quality of wheat-barley sourdough bread was improved after incorporation of reAuglu12A (especially at 3000 U/300 g). These changes were attributed to the synergistic effect of acidification by sourdough and its metabolites which provided a conducive environment for the optimal action of reAuglu12A in the degradation of ß-glucans of barley flour in sourdough. This stabilized the dough structure, thereby enhancing the quality, texture, and shelf life of the bread. These findings suggest that reAuglu12A holds promise as a candidate for ß-glucanase application in the baking industry.

Directed Modification of a GHF11 Thermostable Xylanase AusM for Enhancing Inhibitory Resistance towards SyXIP-I and Application of AusMPKK in Bread Making.

To reduce the inhibition sensitivity of a thermoresistant xylanase AusM to xylanase inhibitor protein (XIP)-type in wheat flour, the site-directed mutagenesis was conducted based on the computer-aided redesign. First, fourteen single-site variants and one three-amino acid replacement variant in the thumb region of an AusM-encoding gene (AusM) were constructed and expressed in E. coli BL21(DE3), respectively, as predicted theoretically. At a molar ratio of 100:1 between SyXIP-I/xylanase, the majority of mutants were nearly completely inactivated by the inhibitor SyXIP-I, whereas AusMN127A retained 62.7% of its initial activity and AusMPKK retained 100% of its initial activity. The optimal temperature of the best mutant AusMPKK was 60 °C, as opposed to 60-65 °C for AusM, while it exhibited improved thermostability, retaining approximately 60% of its residual activity after heating at 80 °C for 60 min. Furthermore, AusMPKK at a dosage of 1000 U/kg was more effective than AusM at 4000 U/kg in increasing specific bread loaf volume and reducing hardness during bread production and storage. Directed evolution of AusM significantly reduces inhibition sensitivity, and the mutant enzyme AusMPKK is conducive to improving bread quality and extending its shelf life.

Characteristics of the microstructure and the key components of white kidney bean sourdough bread induced by mixed-strain fermentation and its influence on gut microbiota.

In this study, the effect of mixed-strain fermentation using Kluyveromyces marxianus with either Lactobacillus plantarum or Pediococcus pentosaceus on the physiochemical and nutritional properties of white kidney bean flour sourdough was investigated. The results indicated that mixed-strain fermentation reduced the anti-nutritional factors produced from the white kidney bean flour, especially in the sourdough fermented by L. plantarum and K. marxianus (WKS-LK) compared to that by P. pentosaceus and K. marxianus (WKS-JK). Meanwhile, the content of lactic acid and acetic acid and the proportion of peptides with molecular weights ranging from <500 to 5000 Da were increased in the sourdoughs (WKS-LK > WKS-JK). Compared to the control (WK), microstructural characteristics of the dough seemed to be improved in WKS-LK followed by WKS-JK in terms of their corresponding gluten network consistency. Moreover, mixed fermentation led to a reduced starch digestibility accompanied by a higher content of resistant starch and slowly digestible starch. In contrast, protein digestibility was enhanced in WKS-LK and WKS-JK sourdough breads. More importantly, the changes in gut microbiota composition, short-chain fatty acid (SCFA) production, systemic inflammation, glucose tolerance and liver tissue histopathology following 21-day consumption of the sourdough bread were also evaluated via an animal model. The intake of sourdough breads reduced the abundance of the pathogenic microbiota Escherichia shigella. In contrast, the corresponding abundance of Rikenellaceae, Akkermansiaceae, Erysipelotrichaceae, Prevotellaceae and Eubacterium coprostanoligenes was increased, followed by enhanced SCFA generation, with the highest in WKS-LK and then WKS-JK. Meanwhile, a reduced level of pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α in the serum and improved glucose tolerance and liver tissue histopathology following the bread consumption were also achieved in the order of WKS-LK, then WKS-JK mice compared to WK.

A Case Report and Literature Review of Bilateral Cervical Chondrocutaneous Branchial Remnants.

Chondrocutaneous branchial remnants (CCBRs) are rare congenital heterotopic tissue formations originating from the first or second embryonic branchial arches. Clinically, CCBRs are characterized predominantly by unilateral and solitary cartilaginous nodules found on the lower neck region. Herein, we present a case of CCBRs in a 9-year-old male patient who presented with horn-shaped projecting masses on either side of the anterior border of the sternocleidomastoid muscle. The pathological report following surgical resection revealed that the lesion was located in the dermis and consisted primarily of hyaline cartilage tissue enclosed by a fibrous capsule, with few local vascular proliferations. Based on the clinical and pathological features, the patient was ultimately diagnosed with congenital bilateral cervical chondrocutaneous branchial remnants.

Oral Delivery of Mouse ß-Defensin 14 (mBD14)-Producing Lactococcus lactis NZ9000 Attenuates Experimental Colitis in Mice.

Antimicrobial peptides (AMPs) play essential roles in maintaining intestinal health and have been suggested as possible therapeutic strategies against inflammatory bowel disease (IBD). However, the instability of AMPs in the process of transmission in vivo limits their application in the treatment of IBD. In this study, we constructed the mBD14-producing Lactococcus lactis NZ9000 (L. lactis/mBD14) to achieve enteric delivery of mBD14 and evaluated its protective effect on dextran sodium sulfate (DSS)-induced colitis. Mice treated with L. lactis/mBD14 exhibited milder symptoms of colitis (P < 0.01). Additionally, L. lactis/mBD14 treatment reversed DSS-induced epithelial dysfunction and reduced the production of pro-inflammatory cytokines in colon (P < 0.01). Mechanistically, L. lactis/mBD14 significantly inhibited NOD-like receptor pyrin domain containing three inflammasome-mediated pro-inflammatory response (P < 0.05) and regulated microbiota homeostasis by promoting the abundance of probiotic bacteria Akkermansia muciniphila and Faecalibacterium prausnitzii and decreasing the pathogenic Escherichia coli (P < 0.01). Taken together, this study demonstrates the protective effect of L. lactis/mBD14 in DSS-induced colitis, and suggests that oral administration of L. lactis/mBD14 may represent a potential therapeutic strategy for IBD.

Encapsulation of Folic Acid and α-Tocopherol in Lysozyme Particles and Their Bioaccessibility in the Presence of DNA.

Protein particles have been reported as the potential carriers for the co-encapsulation of bioactive components. In this study, lysozyme, a basic protein, was used to simultaneously encapsulate folic acid and α-tocopherol at pH 4.0. The encapsulation efficiency and loading capacity of folic acid or α-tocopherol increased with its respective concentration. Folic acid had no influence on the encapsulation of α-tocopherol. However, the encapsulation of folic acid was improved by α-tocopherol below 40 µg/mL but reduced by α-tocopherol at higher concentrations. The encapsulation by lysozyme shielded folic acid, α-tocopherol, or both partially from the attack of 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) radical cation. No masking effect of lysozyme encapsulation on α-tocopherol was found in DPPH antioxidant activity assay. Furthermore, the DNA coating was used to improve the dispersion of lysozyme with folic acid and α-tocopherol. The lysozyme/DNA particles with folic acid and α-tocopherol showed a homogenous size distribution of 180-220 nm with ζ-potential values between -33 and -36 mV. The release and bioaccessibility of folic acid in lysozyme/DNA with α-tocopherol were similar to that of folic acid alone, while the release of α-tocopherol was delayed and its bioaccessibility was improved by encapsulation in lysozyme/DNA with folic acid. The data gathered here would provide guidance for the use of lysozyme-based co-encapsulating carriers in the development of functional foods.

Rheo-Fermentation Dough Properties, Bread-Making Quality and Aroma Characteristics of Red Bean (Vigna angularis) Sourdough Induced by LAB Weissella confusa QS813 Strain Fermentation.

This study investigated the impact of in situ-formed exopolysaccharides (EPS) in red bean (Vigna angularis) sourdough fermented by Weissella confusa QS813 on dough rheo-fermentation properties, bread-making quality and aroma characteristics of red bean sourdough bread. The EPS formed in red bean sourdough and sourdough-induced acidification improved the maximum dough fermentation height, gas retention coefficient and viscoelastic properties of dough. Doughs had a lower increase rate of total SDS-soluble gluten proteins, a low decline in GMP content and similar free sulfhydryl content to wheat dough. Resultantly, breads showed declines in baking loss and hardness, increase in specific volume and lower moisture loss and staling rate after 7 days of storage. Finally, despite a reduction in the total content of aroma compounds, new aroma compounds such as acetic acid and higher contents of 3-methyl-1-butanol and 2,3-butanediol were enriched in red bean sourdough bread. Sourdough acidification probably promoted interaction of EPS with gluten or red bean proteins through bond interactions to form structures which stabilized gluten in dough and increased water-binding ability in red bean sourdough bread. This study provided a better understanding of the role of EPS in sourdough in improving bread quality and of promising strategies to address consumer demand for nutritious and clean-label products.

High-power diode-end-pumped 1314†nm laser based on the multi-segmented Nd:YLF crystal.

We demonstrate the first multi-segmented Nd:YLF laser, to the best of our knowledge. The multi-segmented crystal was designed to straightforwardly aim for the minimum thermal stress without sacrificing the overall laser efficiency, with the influence of the pump beam waist position considered in particular. Integrating the enhanced thermo-mechanical resistance of multi-segmented crystal and the alleviated heat load of low quantum defect pumping, this end-pumped 1314 nm Nd:YLF laser system delivered a maximum continuous-wave output power of up to 35.5 W under a pump power of 105 W, corresponding to an optical-to-optical efficiency of 33.8%. Furthermore, by incorporating an acousto-optic modulator, an active Q-switching oscillator was accomplished, yielding a maximum average output power of 22.9 W at a pulse repetition frequency (PRF) of 20 kHz and a largest pulse energy of 13.6 mJ at a PRF of 1 kHz.

Potential Health Benefits of Yeast-Leavened Bread Containing LAB Pediococcus pentosaceus Fermented Pitaya (Hylocereus undatus): Both In Vitro and In Vivo Aspects.

This study aimed to investigate the effect of the incorporation of 0-25% pitaya (Hylocereus undatus) fermented by Pediococcus pentosaceus on physicochemical and bioactive properties of yeast-leavened wheat-mung bean bread. The results revealed that ß-glucosidase activity increased during dough proofing, which may contribute to changes in dietary fiber. Compared to wheat bread, experimental bread had an increased content of soluble dietary fiber (SDF), total phenolic, total flavonoid, and slowly digestible starch, especially in wheat-mung bean bread prepared with 15% pitaya fermentates (WMB-15F). The effect of bread consumption on systemic inflammation, glucose tolerance, and blood lipid profiles was also evaluated via a mice model. The results indicated that levels of pro-inflammatory cytokines declined and glucose tolerance improved, while LDL and HDL were positively modified compared to control. Furthermore, an increased abundance of Lactobacillus, Lachnospiraceae, and Bifidobacterium spp. was observed in WMB-15F mice. Acetic acid was the dominant short-chain fatty acids (SCFAs) in feces and serum in all groups. Total SCFAs in circulation were highest in WMB-15F mice compared to other groups. In summary, an increased abundance of beneficial gut microbiota and promoted SCFA production might be highly associated with increased SDF and the release of key phenolic compounds during dough proofing, which exerts health benefits aroused from the consumption of yeast-leavened bread.

Association of gut microbiota characteristics and metabolites reveals the regulation mechanisms under cadmium consumption circumstance.

BACKGROUND: Cadmium is a non-biodegradable heavy metal with a long biological half-life. Although its negative impact on human health has been previously reported, the association of cadmium consumption overdose with changes in the gut microbiota and its corresponding metabolites has not been fully elucidated so far. RESULTS: Cadmium consumption overdose led to a reduced body weight gain accompanied by an enhanced level of the proinflammatory cytokine tumor necrosis factor-α, interleukin-6, and histamine in the serum of the rats in comparison with normal rats. Furthermore, hepatotoxicity was also observed to be induced by cadmium, which was consistent with abnormal hepatic activities of alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase and oxidative stress. In contrast, Lactobacillus rhamnosus-fermented Ganoderma lucidum (FGL) slice supplementation improved the aforementioned physiological properties. More importantly, microbiome and metabolites analysis indicated cadmium exposure significantly reduced the generation of short-chain fatty acids in the gut, particularly butyrate. However, rats in the FGL group had the highest level of butyrate in the feces, characterized with significantly enriched probiotics (Lactobacillus, Bifidobacterium) and butyrate-producing bacteria (Roseburia). CONCLUSION: The targeted regulation of the gut microbial community and its metabolites might be the essential association for attenuating body dysfunction induced by cadmium. The supplementation of FGL, as evidenced in this study, might highlight a novel approach to this field. © 2022 Society of Chemical Industry.

Resveratrol Stabilization and Loss by Sodium Caseinate, Whey and Soy Protein Isolates: Loading, Antioxidant Activity, Oxidability.

The interaction of protein carrier and polyphenol is variable due to their environmental sensitivity. In this study, the interaction between resveratrol and whey protein isolate (WPI), sodium caseinate (SC) and soy protein isolate (SPI) during storage were systematically investigated from the aspects of polyphenol loading, antioxidant activity and oxidability. It was revealed that resveratrol loaded more in the SPI core and existed both in the core of SC micelles and on the particle surface, while WPI and resveratrol mainly formed in complexes. The loading capacity of the three proteins ranked in order SC > SPI > WPI. ABTS assay showed that the antioxidant activity of the protein carriers in the initial state was SC > SPI > WPI. The results of sulfhydryl, carbonyl and amino acid analysis showed that protein oxidability was SPI > SC > WPI. WPI, with the least oxidation, improved the storage stability of resveratrol, and the impact of SC on resveratrol stability changed from a protective to a pro-degradation effect. Co-oxidation occurred between SPI and resveratrol during storage, which refers to covalent interactions. The data gathered here suggested that the transition between the antioxidant and pro-oxidative properties of the carrier is the primary factor to investigate its protective effect on the delivered polyphenol.

Suitability of pitaya fruit fermented by sourdough LAB strains for bread making: its impact on dough physicochemical, rheo-fermentation properties and antioxidant, antifungal and quality performance of bread.

The objective of this study was to investigate the suitability of incorporating pitaya fruit fermented by antifungal LAB strains Lactiplantibacillus plantarum and Pediococcus pentosaceus at 1: 30 °C for 24h or 2: 31 °C for 19.5h as an ingredient with respect to bread making performance and bio-preservation effect. Underlying mechanisms related to gluten protein hydrolysis, starch hydrolysis, and yeast activity in dough were explored. The antioxidant activity, antifungal activity and bread making performance of the resulted breads were analyzed. Also, the antifungal phenolic acids in the breads were identified and quantified. Incorporation of fermented substrates in dough increased yeast activity and gas production capacity, but decreased gas retention capacity. This was attributed to increased dough acidity after incorporating fruit substrates. As a result, reducing sugar and free sulfhydryl (SH) groups increased in these doughs which indicated higher starch and gluten protein hydrolysis, respectively. However, SH groups increased at lower rate in presence of substrates fermented by L. plantarum and P. pentosaceus at condition 2 than 1. This could be due to improvement of gluten network as revealed by decreased α-helix (%) and increased ß-turn (%) in secondary gluten structures in these doughs which subsequently resulted in more homogeneous microstructural properties than in presence of unfermented substrate compared to wheat dough. Subsequently, bread specific volume increased (6.6-20.0%) in presence of fermented substrates, especially fermented by L. plantarum at (2). Moreover, bread incorporated with fermented substrates (P. pentosaceus than L. plantarum at 1 than 2) had enhanced antioxidant activities, lower fungal growth rates based on challenge tests and mold free shelf life. Antifungal phenolic acids such as gallic acids, caffeic acid, protocatechuic acid were only detected in bread incorporated with fruit substrates, and their total content higher in fermented substrates.

Clinical long-term observation of the keyhole microvascular decompression with local anesthesia on diagnosis and treatment of vestibular paroxysmia.

Background: The pathophysiology and etiology of vestibular paroxysmia (VP) remains unclear, moreover, due to the lack of reliable diagnostic features for VP, the clinical diagnosis will be made mainly by exclusion.Aims/objectives: To evaluate the diagnostic value and curative effect of keyhole microvascular decompression with local anesthesia for VP.Material and methods: 54 patients with trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia underwent keyhole microvascular decompression with local anesthesia, twelve of whom were coexistent with VP. The evaluation of the vertigo after operation was performed with symptom report card for 12 patients with VP and the mean follow-up period was 116 months (range 114-118 months).Results: The cochleovestibular neurovascular compression at the root zone of vestibular nerve was found in 12 patients with VP, of whom 11 patients had the neurovascular compressive vertigo induced intra-operatively and the vertigo disappeared postoperatively, moreover, one patient had no neurovascular compressive vertigo induced intra-operatively and the vertigo was not improved significantly after operation. Of 12 patients with VP during the mean 116-month follow-up, 11 patients had no recurrence of neurovascular compressive vertigo and the effective control rate of vertigo was 91.7%.Conclusions and significance: Keyhole microvascular decompression with local anesthesia is not only an effective method for treating VP and controlling neurovascular compressive vertigo, but also has definite clinical significance in the diagnosis of VP.

Comparison of bacterial communities in gliadin-degraded sourdough (Khamir) sample and non-degraded sample.

The study was undertaken to investigate the comparison lying between bacterial communities in autochthonous gliadin-degraded sourdough sample (D13) and non-degraded sample (D50). Degree of gliadin degradation in various samples was determined by Fourier transform infrared spectroscopy and represented samples were selected for 16 S rDNA sequence analysis by Illumina Miseq platform. It was observed, that Proteobacteria (50.65%) and Actinobacteria (6.70%) phyla were more abundant as compared with Firmicutes (42.53%) in D13, however, Firmicutes (83.44) were more abundant, comparatively, in D50 than Proteobacteria (14.97%). Lower taxonomic levels surfaced its more prominent effects. It had been also observed that Lactobacillus genera was the core genera (50.37%) followed by Weissella (27.15%) and Psychrobacter (21.53%) in D50 and D13, respectively. Shannon and Simpson indices indicated that degraded sample had more bacterial diversity and richness compared with non-degraded sample.

Clinical long-term effects of surgical treatment for intractable Meniere's disease: a more than 13-year follow-up after pressure treatment and further surgical treatment for intractable vertigo.

Background: Meniere's disease appears to be a complex inner ear disorder and also remains a controversial and often difficult disease as regards determination of diagnosis, pathogenesis and especially optimal treatment.Aims/objectives: To investigate the long-term effects of progressive surgical treatment in the management of the vertigo attacks of intractable Meniere's disease.Material and methods: Eighteen patients with medically intractable and active Meniere's disease were opted to try Meniett pulse generator (Meniett), endolymphatic sac decompression (ESD) and triple semicircular canal occlusion (TSCO) in order to control the attacks of vertigo. Patients were indicated on the symptom report card the maximum level of vertigo, activity and stress.Results: Of 18 patients with medically intractable and active Meniere's disease during mean 165-month follow-up, the attacks of vertigo were effectively controlled in 14 patients by Meniett (77.78%), 2 patients by Meniett and ESD (11.11%), 2 patients by Meniett, ESD and TSCO (11.11%).Conclusions and significance: It is of great importance for intractable Meniere's disease to select surgically combined treatment process including Meniett, ESD and TSCO to effectively control the attacks of vertigo and a long-term follow-up.

Common and uncommon adverse cutaneous reactions to erlotinib: a study of 20 Chinese patients with cancer.

OBJECTIVE: This study presented common lesions with systemic toxicities and uncommon adverse cutaneous reactions such as anaphylactic dermatitis in patients undergoing treatment with erlotinib for the benefit of practicing dermatologists and oncologists. METHODS: Adverse cutaneous reactions associated with erlotinib were reported in 20 Chinese patients with cancer. RESULTS: Adverse cutaneous reactions reported included six cases of anaphylactic dermatitis, 12 cases of acneiform rash, nine cases of xerosis, five cases of nail changes and four cases of hair changes. One case of anaphylactic dermatitis manifested as erythema with swelling on the face and neck, and others as erosive and scaly erythema on the fold of skin, or red macules, papules, plaques and pigmentation on the whole body. Clinical details indicated anaphylactic reactions, including a high percentage of eosinophils in the peripheral blood, eosinophilic infiltration in the dermis layer and good response to antihistamines and topical steroids. Systemic toxicities accompanied by cutaneous reactions occurred in five patients including one case of anaphylactic dermatitis and four cases of acneiform rash. Elevated hepatic enzymes were observed among all the patients with grade-3 or grade-4 acneiform rashes. One patient with anaphylactic dermatitis and one with acneiform rash discontinued erlotinib administration due to severe lesions, high fever or severe elevation of hepatic enzymes. CONCLUSIONS: Anaphylactic cutaneous reactions caused by erlotinib are rarely described hitherto. Systemic toxicities should be emphasized especially in cases with severe skin disorders. Timely detection and appropriate early intervention in patients who develop severe cutaneous reaction while on erlotinib therapy should be considered clinically.

Acoustic analysis of snoring sounds originating from different sources determined by drug-induced sleep endoscopy.

OBJECTIVE: To discuss the possibility of fundamental frequency (F0) and formant frequency (FF) to generally differentiate the sources of snoring sounds determined by drug-induced sleep endoscopy (DISE). METHODS: A total of 74 snoring subjects underwent DISE and snoring sounds were recorded simultaneously. The noise-suppressed snoring sounds were analyzed and classified into different groups based on the sources of vibration identified by DISE. F0 and FFs were calculated. RESULTS: Totally, 516 snoring sounds from three vibrating sources (the palate, combined the palate and the lateral wall, the lateral wall) of 47 patients were divided into three groups then analyzed. The levels of F0 and FFs for each group follow the order: Group 1 < Group 2 < Group 3. There was statistical difference between Group 1 and other groups in F0 and F2 (p < .05). The area under the receiver-operator curves (AUC) was F0, at 0.727, and the cut-off value was 134.2 Hz; and F2, at 0.654, and the cut-off value was 2028.0 Hz. CONCLUSIONS: F0 and the second formant frequency (F2) are found to be significantly lower in palatal snoring sound. F0 might be a significant in distinguishing palatal snoring sound from non-palatal snoring sound. F2 is more significant than F1 and F3 in identifying the sources of the snoring sounds but is less sensitive than F0.