Antimicrobial Activity of Ferulic Acid Against Cronobacter sakazakii and Possible Mechanism of Action.

Cronobacter sakazakii is an opportunistic pathogen transmitted by food that affects mainly newborns, infants, and immune-compromised adults. In this study, the antibacterial activity of ferulic acid was tested against C. sakazakii strains. Minimum inhibitory concentration of ferulic acid against C. sakazakii strains was determined using the agar dilution method. Changes in intracellular pH, membrane potential and intracellular ATP concentration were measured to elucidate the possible antibacterial mechanism. Moreover, SYTO 9 nucleic acid staining was used to assess the effect of ferulic acid on bacterial membrane integrity. Cell morphology changes were observed under a field emission scanning electron microscope. The minimum inhibitory concentrations of ferulic acid against C. sakazakii strains ranged from 2.5 to 5.0 mg/mL. Addition of ferulic acid exerted an immediate and sustained inhibition of C. sakazakii proliferation. Ferulic acid affected the membrane integrity of C. sakazakii, as evidenced by intracellular ATP concentration decrease. Moreover, reduction of intracellular pH and cell membrane hyperpolarization were detected in C. sakazakii after exposure to ferulic acid. Reduction of green fluorescence indicated the injury of cell membrane. Electronic microscopy confirmed that cell membrane of C. sakazakii was damaged by ferulic acid. Our results demonstrate that ferulic acid has moderate antimicrobial activity against C. sakazakii. It exerts its antimicrobial action partly through causing cell membrane dysfunction and changes in cellular morphology. Considering its antimicrobial properties, together with its well-known nutritional functions, ferulic acid has potential to be developed as a supplement in infant formula or other foods to control C. sakazakii.

Antimicrobial activity of syringic acid against Cronobacter sakazakii and its effect on cell membrane.

Syringic acid (SA) has been reported to exhibit antibacterial ability against various microorganisms, but little work has been done on its effect on Cronobacter sakazakii. In this study, minimum inhibitory concentrations (MICs) of SA against various C. sakazakii strains were determined. Moreover, changes in intracellular ATP concentration, intracellular pH (pHin), membrane potential and membrane integrity were measured to evaluate the influence of SA on cell membrane. Finally, field emission scanning electron microscope (FESEM) was used to assess the morphological changes of bacterial cells caused by SA. It was shown that the MICs of SA against all tested C. sakazakii strains were 5mg/mL. SA retarded bacterial growth, and caused cell membrane dysfunction, which was evidenced by intracellular ATP concentration decrease, pHin reduction, cell membrane hyperpolarization and changes in cellular morphology. These findings indicated that SA has potential to be developed as a natural preservative to control C. sakazakii in foods associated with this pathogen and prevent related infections.

Anxiety and depression are improved by continuous positive airway pressure treatments in obstructive sleep apnea.

Background Obstructive sleep apnea involves repeated nocturnal desaturation and sleep fragmentation that leads to poor sleep quality, anxiety, and depression. This study aimed to investigate short- and long-term improvements in the anxiety and depression of patients with different obstructive sleep apnea treatments. Methods This is a prospective, non-randomized hospital-based study evaluated 55 patients (46 male, 9 female) with obstructive sleep apnea. The patients were divided into three groups based on different treatment: uvulopalatopharyngoplasty group, continuous positive airway pressure group, and no treatment group (by their own decision). They completed the Beck Depression Inventory II, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index before treatment and at one and six months after treatment. Results Compared to the no treatment group, the surgery and continuous positive airway pressure groups had higher body mass index, AHI, and Epworth sleepiness scale, but no difference in Pittsburgh Sleep Quality Index, Chinese Health Questionnaire-12, Beck Depression Inventory II, and Beck Anxiety Inventory. The continuous positive airway pressure and surgery groups still had no improvements in Pittsburgh Sleep Quality Index, Chinese Health Questionnaire-12, Beck Depression Inventory II, and Beck Anxiety Inventory scores one month after treatment. At six months after treatment, the continuous positive airway pressure group had significantly decreased Pittsburgh Sleep Quality Index, Chinese Health Questionnaire-12, Beck Depression Inventory II, and Beck Anxiety Inventory, whereas the surgery group had significant difference in Beck Anxiety Inventory only and the no treatment group still had no significant difference in any of the parameters. Conclusions Continuous positive airway pressure can improve the sleep quality, quality of life, depression, and anxiety of obstructive sleep apnea patients after six months of treatment. However, surgery can significantly improve anxiety only in the same period.

Methylation status of insulin-like growth factor-binding protein 7 concurs with the malignance of oral tongue cancer.

BACKGROUND: Aberrant insulin-like growth factor-binding protein 7 (IGFBP-7) expression has been found in various cancers such as prostate, breast, and colon. IGFBP-7 induced the apoptosis of tumor and potentially predicted the clinical outcome in some cancers is further demonstrated. This study investigates the causes and underlying mechanisms of aberrant IGFBP-7 expression in unravelling head and neck squamous cell carcinoma (HNSCC). METHODS: A total of 47 oral tongue cancer patient samples were primarily analyzed for the methylation status in 5' region of IGFBP-7 by methylation-specific PCR (MS-PCR). Subsequently the invasion, overexpression, and knockdown of IGFBP-7 in the HNSCC A253 invasive subpopulation were employed to examine the effect of IGFBP-7. The epithelial-mesenchymal transition (EMT) marker genes and AKT/GSK3ß/ß-catenin signaling were further evaluated by Western blot for the understanding the role of aberrant IGFBP-7 expression and thereof putative mechanism. RESULTS: EMT expressed in the invasive subpopulation of HNSCC cell lines (A253 and RPMI 2650) was contemporary with the down-regulation of IGFBP-7. After treatment with 5-AZA-2' deoxycytidine, the de-methylated CpG sites in the 5' region of IGFBP-7 were observed and IGFBP-7 mRNA expression was also restored. Accordingly, re-expression IGFBP-7 in invasive subpopulation of A253 could induce the mesenchymal-epithelial transition (MET) and concurrently inhibited the cell invasion. Moreover, IGFBP-7 methylation status of 47 oral tongue tumors showed a positive correlation to invasive depth of the tumor, loco-regional recurrence, and cancer sequence. CONCLUSIONS: IGFBP-7 can alter EMT relative marker genes and suppress cell invasion in A253 cell through AKT/GSK3ß/ß-catenin signaling. The epigenetic control of IGFBP-7 in the invasion and metastasis of HNSCC was reported, suggesting that IGFBP-7 could be a prognostic factor for the probability of invasion and a therapeutic remedy.

Snoring in a sitting position and neck circumference are predictors of sleep apnea in Chinese patients.

BACKGROUND: Snoring is a common symptom among the adult population, and it is the most common complaint in patients with obstructive sleep apnea (OSA) syndrome. Patients who snore in a sitting position while taking a nap or sleeping may have a narrower upper airway. The aim of this study was to evaluate if snoring in a sitting position is a predictor of OSA in patients. METHOD: We prospectively enrolled 166 SS+ (with a history of snoring in a sitting position) subjects and 139 SS- (who denied having a history of snoring in a sitting position) patients. All of the participants received questionnaires as well as a standard polysomnography thereafter. RESULT: Patients with self-reported snoring in a sitting position (with a tilt position greater than 70°, SS+ group) had a higher body mass index as well as greater neck, waist, and buttock circumference and scored higher on the Epworth Sleepiness Scale. During the polysomnographic study, the SS+ group had a higher percentage of N1 sleep and lower percentage of N2 sleep. In addition, the SS+ group had a higher apnea-hypopnea index (AHI) as well as higher arousal index and oxygen desaturation index. The sensitivity and specificity of the SS+ group for OSA (defined as AHI ≥ 5) were 0.59 and 0.73, respectively, with a positive predictive value of 0.93. The likelihood ratio was 2.2. On the other hand, the sensitivity and specificity of the SS+ group for moderate to severe OSA (defined as AHI ≥ 15) were 0.82 and 0.48, respectively. Both SS+ and greater neck circumference have a high likelihood ratio for diagnosing OSA. CONCLUSION: In the present study, the symptoms of self-reported snoring in a sitting position and greater neck circumference can be useful clinical predictors of OSA in Chinese patients.

Respiratory-inductive-plethysmography-derived flow can be a useful clinical tool to detect patients with obstructive sleep apnea syndrome.

BACKGROUND/PURPOSE: Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent episodes of a complete or partial collapse of the upper airway during sleep. The disease is traditionally diagnosed by overnight polysomnography with detection flow limitation by nasal pressure cannulas. The aim of this study was to evaluate the accuracy of flow (X flow) from calibrated respiratory inductive plethysmography. METHODS: We studied 60 male and 26 female patients who came to our sleep center in 2007. All the participants received overnight polysomnography and data were graded blindly and randomly by two experienced technicians. RESULTS: Patients with OSA were predominantly male, with higher body mass index, higher percentage of snorers, and more events of oxygen desaturation and arousal than those without OSA. There was a good correlation of X flow and flow from nasal pressure cannulas, regardless of total apnea-hypopnea, apnea or hypopnea events. The correlation was especially strong in severe OSA patients. The sensitivity and specificity to find OSA (apnea-hypopnea index ≥5) from X flow versus standard polysomnography was 98% and 100%, respectively. Positive predictive value was 100% and negative predictive value was 97%. CONCLUSION: X flow could be a good clinical tool to be used instead of flow from nasal pressure cannulas in OSA patients.

Facial palsy as unusual complication of spontaneous intraparotid hematoma.

A 55-year-old healthy female without trauma history visited our hospital for rapidly progressive enlarging right side painful neck mass within 5 days and also with comorbid House-Brackmann Grade V facial palsy for 2 days. Magnetic resonance imaging showed heterogenous mass derived from parotid to parapharyngeal space. Much blood clot could be observed at exploratory operation. Only inflammatory change, but not tumor, was mentioned in pathology report. Facial palsy was kept stationary in Grade III from postoperative 6 months.

Predictors of locoregional recurrence in early stage oral cavity cancer with free surgical margins.

Locoregional recurrence in patients with early stage oral cavity squamous cell carcinoma (ESOSCC) after surgery remains a problem and can affect their survival. We sought to identify new high-risk factors in these patients, who need further adjuvant therapy. We retrospectively reviewed records for 148 patients who underwent surgery for ESOSCC between 2002 and 2006 with negative surgical margins. The primary endpoint was locoregional recurrence. Recurrence-free survival (RFS) and overall survival (OS) were calculated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify independent predictors of locoregional recurrence. All patients were grouped into the low- and high-risk groups according to the odds ratios (OR) of the predictors. Recurrence rates of the low- and high-risk groups were then predicted. Recurrence was observed in 17 of 148 (11.5%) patients at the end of this study. None of the patients received postoperative radiotherapy or chemotherapy. At 3 years, the RFS rate was 89.7% and the OS rate at 3 years was 84.1%. Univariate analysis of the RFS revealed three significant prognostic factors: lymphovascular permeation (LVP, p<0.001), perineural infiltration (PNI, p=0.08), and non-T4 muscular invasion (non-T4MI, p<0.005). Multivariate analysis demonstrated that LVP (p=0.007, OR=10.7) and non-T4 MI (p=0.001, OR=8.347) were independent predictors. The recurrence rate was 1.96% in patients without LVP or non-T4MI, and it increased to 26.47% in patients with non-T4MI, to 50% in patients with LVP, and to 50% in patients with both. According to the status of LVP and non-T4MI, patients were divided into two groups: low-risk (no factors present) and high-risk (one or both factors present) groups. The 2-year RFS was lower in the high-risk group (84.13%) than in the low-risk group (93.91%); the 3-year RFS was also lower in the high-risk group (70.49%) than in the low-risk group (91.99%) (p=0.008). Subgroup analysis revealed that elective neck dissections did not affect the outcome or change the pattern of failure. For patients with elective neck dissections, the RFS was lower in the high-risk group than in the low-risk group (p=0.03). In ESOSCC (pT1-2N0), LVP and non-T4MI significantly increased the recurrence rate. The presence of one or both factors (LVP and/or non-T4MI) should be considered as a high-risk condition for locoregional recurrence, and adjuvant therapy is needed in such cases.