Effects of natural honey on polymicrobial culture of various human pathogens.

INTRODUCTION: Honey has a wide range of antimicrobial activity. All previous studies have considered honey's effect on a single microbe. The present study investigated activity of honey towards a high dose of single or polymicrobial culture. MATERIAL AND METHODS: 10 µl specimens of Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Escherichia coli (E. coli) and Candida albicans (C. albicans) were cultured in 10 ml of 10-100% (wt/v) honey diluted in broth. Six types of polymicrobial microbial cultures were prepared by culturing the isolates with each other onto broth (control) and broth containing various concentrations of honey (10-100% wt/v). Microbial growth was assessed on solid plate media after 24 h incubation. RESULTS: Honey (30-70%) prevents growth of 10 µl specimens of all the isolates. Greater reduction in growth of E. coli was observed when cultured with S. aureus. Culturing of S. aureus with S. pyogenes, C. albicans, or E. coli increased its sensitivity to honey. S. aureus and S. pyogenes increased sensitivity of C. albicans to honey while E. coli and C. albicans decreased sensitivity of S. pyogenes. CONCLUSIONS: It might be concluded that honey prevents and inhibits growth of single and polymicrobial pathogenic cultures. Polymicrobial culture affects growth of the isolates and increases their sensitivity to honey.

Improvement in human semen quality after oral supplementation of vitamin C.

This study was carried out to monitor the effect of oral supplementation of vitamin C on various semen parameters in oligospermic, infertile, otherwise healthy individuals. Various semen parameters, including sperm motility, sperm count, and sperm morphology, were studied before and after the vitamin C treatment. A total of 13 infertile patients were included. Their ages ranged between 25 and 35 years. They had no genital infection or varicocele. Physical examination and other routine laboratory investigations were normal. General semen analysis revealed oligozoospermia (mean sperm count was 14.3 +/- 7.38 x 10(6) sperms/mL, mean sperm with normal morphology was 43 +/- 7.87%, and mean sperm motility was 31.2 +/- 9.61%). Testicular biopsy was not done. These patients received in an open trial of 1,000 mg of vitamin C twice daily for a maximum of 2 months. Results showed that the mean sperm count was increased to 32.8 +/- 10.3 x 10(6) sperms/mL (P < .001) after 2 months of vitamin C intake. The mean sperm motility was increased significantly to 60.1 +/- 8.47% (P < .001), and mean sperms with normal morphology increased significantly to 66.7 +/- 4.77% (P < .001). This study showed that vitamin C supplementation in infertile men might improve sperm count, sperm motility, and sperm morphology and might have a place as an additional supplement to improve the semen quality towards conception.

Segmental variation in the in vitro cell metabolism of nucleus pulposus cells isolated from a series of bovine caudal intervertebral discs.

STUDY DESIGN: This study focuses on the association between cell metabolism and molecular matrix composition of nucleus pulposus (NP) tissue with spine level in sequential bovine caudal intervertebral discs. OBJECTIVE: To explore the hypothesis that the molecular composition of NP tissue and corresponding cell metabolism varies with caudal spine. A secondary hypothesis is tested that potential cellular differences are maintained after monolayer culture. SUMMARY OF BACKGROUND DATA: In articular cartilage, cell metabolism and molecular matrix composition are influenced by loading history. This may also be a feature of intervertebral discs in series. METHODS: NP cells (nonpooled or level pooled) were isolated from four sequential bovine caudal intervertebral discs (levels 3-4, 4-5, 5-6, and 6-7) and cultured in alginate beads immediately or following monolayer culture. Levels of 3H-TdR (proliferation) and 35SO4 (GAG synthesis) incorporation were determined from 14 animals. In a separate set of 6 animals, total content of water, DNA, collagen (and type), GAG (and type) were also determined. RESULTS: The rate of 3H-TdR and 35SO4 incorporation in freshly isolated NP cells increased nonlinearly from level 3-4 to 6-7 (P < 0.05). Monolayer cultured cells retained level-specific differences for 35SO4 and 3H-TdR incorporation similar to that of freshly isolated cells. GAG content and chondroitin sulfate proportion decreased distally (P < 0.05); however, total collagen and Type I proportion increased distally (P < 0.05). No significant differences in water or DNA content could be determined. CONCLUSIONS: The results support the hypothesis that level-specific differences in NP cell metabolism and molecular composition are dependent on spine level potentially reflecting subtle mechanical differences between levels. Retention of level-specific differences in monolayer may suggest a certain level of cell "programming." This may be important for cellular strategies to repairspecific sites of degeneration.

Effect of nicotine on spinal disc cells: a cellular mechanism for disc degeneration.

STUDY DESIGN: Experimental investigation to determine the effect of nicotine on intervertebral spinal disc nucleus pulposus (NP) cells cultured in vitro. OBJECTIVES.: To evaluate the effects of nicotine on cell proliferation, extracellular matrix production, and viability of NP cells in three-dimensional alginate constructs cultured in vitro. SUMMARY OF BACKGROUND DATA: Numerous studies confirm that smoking is a strong risk factor for back pain. The most widely accepted explanations for the association between smoking and disc degeneration is malnutrition of spinal disc cells by carboxy-hemoglobin-induced anoxia or vascular disease. Nicotine, a constituent of tobacco smoke, present in most body fluids of smokers is known to have detrimental effects on a variety of tissues. It may also be directly responsible for intervertebral disc (IVD) degeneration by causing cell damage in both the nucleus pulposus and anulus fibrosus. The effect of nicotine on IVD cells has not previously been investigated. METHODS: Bovine chondrocytic intervertebral disc cells were isolated by sequential digestion of nucleus pulposus and seeded in 2% alginate. The constructs were cultured for 21 days either in growth medium containing freebase nicotine (Sigma) at concentrations found in the serum of smokers (25 nmol/L-300 nmol/L) or in standard nicotine free-medium as controls. Samples were collected at time points 3, 7, 14, and 21 days and a quantitative assay was performed for DNA, glycosaminoglycans (GAG), and hydroxyproline. Samples were also processed for qualitative histologic analysis including immunolocalization of collagen types I and II. RESULTS: There was both a dose- and time-dependent response to nicotine, with constructs cultured in low-nicotine concentration media demonstrating an early increase in DNA, GAG, and collagen content, while constructs cultured in high nicotine concentration media demonstrated a late decrease in these parameters. At 25 nmol/L dose of nicotine, there was a significant increase (P < 0.05) in the above parameters at day 7 compared with the controls. At higher doses, there was a significant dose-dependent decrease (P < 0.05) in these parameters compared to controls; however, this was only significant at day 14 for the 300 nmol/L group and at day 21 for the 100 nmol/L, 200 nmol/L, and 300 nmol/L groups. Adverse morphologic changes were observed on histology, which included reduced cell proliferation, disrupted cell architecture, disintegration of cells, and extracellular matrix. Immunohistochemistry revealed the presence of type I collagen in the extracellular matrix rather than the normal type II collagen seen in the controls. CONCLUSIONS: Nicotine has an overall detrimental effect on NP disc cells cultured in vitro. There was significant inhibition of cell proliferation and extracellular matrix synthesis. Nicotine in tobacco smoke may have a role in pathogenesis of disc degeneration.

Functional outcome in trauma patients with spinal injury.

STUDY DESIGN: A retrospective data analysis of all trauma patients admitted the Helicopter Emergency Medical Service was performed. OBJECTIVE: To assess the long-term outcome of trauma patients with spinal injuries using Functional Independence Measure scores. SUMMARY OF BACKGROUND DATA: Mortality after severe multiple trauma is well documented. However, evaluating morbidity in survivors of multiple trauma is complex, and less information is available regarding functional outcome. There are very few systems that can effectively predict the outcome for patients sustaining multiple trauma with spinal injuries. The Functional Independence Measure scoring system, which is easy to use, can be used to assess disability after hospital discharge, and may also be used to predict the long-term outcome for patients after spinal injuries. METHODS: The records of 1500 trauma patients admitted over a 6-year period by the Helicopter Emergency Medical Service were examined. All patients with documented injuries to the spinal column were selected for study. The distribution and pattern of spinal injury, the injury severity score, and the radiologic findings were determined for each patient, along with clinical outcome measures at 1 year using Functional Independence Measure scores. RESULTS: Among the 1500 trauma patients, 263 patients (17.5%) (195 men and 68 women; mean age, 37 years; range, 3-92 years) had sustained an injury to the spinal column. Mortality (70/263; 27%) was significantly higher (P < 0.02) in these patients than in those without spinal injury (247/1237; 20%). Injury severity scores higher than 16 were found in 96 patients (55%). The median Functional Independence Measure score was 40 on admission, 86 at discharge from the hospital, 113 at 3 months, 119 at 6 months, and 124 at 12 months. There was significant correlation between discharge Functional Independence Measure (FIM) scores (FIM = 86) and 12-month FIM scores (FIM = 124) (P < 0.01). CONCLUSIONS: Most of the patients had poor initial Functional Independence Measure scores, but there was significant improvement by 12 months. Discharge FIM scores were a good indicator for functional outcome at one year.

Treatment of severe tricyclic antidepressant overdose with extracorporeal sorbent detoxification.

Tricyclic overdose can be a medical emergency, and therapy with intravenous bicarbonate is not always successful in preventing cardiac toxicity or coma. Mortality in patients developing these complications is from 1% to 15%. Extracorporeal detoxification with sorbents has been used in treatment of patients with very high drug levels and declining clinical condition. Ten patients with serious drug overdose caused by tricyclics failed to respond quickly to standard therapy and were in stage 3-4 encephalopathy. Nine of these patients were on respirator support, 5 had hypotension, and 6 had QRS widening. Average level was 1,423 microg/L at presentation. Enteral activated charcoal and intravenous (IV) bicarbonate were initiated in the emergency room. The patients were treated for 3 to 4 hours with the Liver Dialysis Unit, a hemodiabsorption device using a cellulosic plate dialyzer and sorbent suspension as dialysate. Inflow and outflow blood levels indicated that the hemodetoxifier removed modest amounts of the tricyclics, metabolites, and other consumed drugs. The clinical improvement of the patients was dramatic, with patients reaching stage 0 or 1 encephalopathy during the treatment. Ventilator support was removed at the end of treatment for 3 patients who had not already developed pneumonia, and for others was prolonged up to 48 hours because of pneumonia, rather than mental status. Average length of stay in the intensive care unit (ICU) was 4.8 days (range 1 to 7 days). None of the patients died despite their high risk for ventricular arrhythmias, seizures, and death. Clinical improvement may have been attributable to removal of free drug from the blood or to removal of drug metabolites.