The potential biotechnological applications of the exopolysaccharide produced by the halophilic bacterium Halomonas almeriensis

We have studied the extracellular polysaccharide (EPS) produced by the type strain, M8(T), of the halophilic bacterium Halomonas almeriensis, to ascertain whether it might have any biotechnological applications. All the cultural parameters tested influenced both bacterial growth and polysaccharide production. EPS production was mainly growth-associated and under optimum environmental and nutritional conditions M8(T) excreted about 1.7 g of EPS per litre of culture medium (about 0.4 g of EPS per gram of dry cell weight). Analysis by anion-exchange chromatography and high-performance size-exclusion chromatography indicated that the exopolysaccharide was composed of two fractions, one of 6.3 × 10(6) and another of 1.5 × 10(4) Daltons. The monosaccharide composition of the high-molecular-weight fraction was mannose (72% w/w), glucose (27.5% w/w) and rhamnose (0.5% w/w). The low-molecular-weight fraction contained mannose (70% w/w) and glucose (30% w/w). The EPS has a substantial protein fraction (1.1% w/w) and was capable of emulsifying several hydrophobic substrates, a capacity presumably related to its protein content. The EPS produced solutions of low viscosity with pseudoplastic behaviour. It also had a high capacity for binding some cations. It contained considerable quantities of sulphates (1.4% w/w), an unusual feature in bacterial polysaccharides. All these characteristics render it potentially useful as a biological agent, bio-detoxifier and emulsifier.

Characterization of the exopolysaccharide produced by Salipiger mucosus A3, a halophilic species belonging to the Alphaproteobacteria, isolated on the Spanish Mediterranean seaboard

We have studied the exopolysaccharide produced by the type strain of Salipiger mucosus, a species of halophilic, EPS-producing (exopolysaccharide-producing) bacterium belonging to the Alphaproteobacteria. The strain, isolated on the Mediterranean seaboard, produced a polysaccharide, mainly during its exponential growth phase but also to a lesser extent during the stationary phase. Culture parameters influenced bacterial growth and EPS production. Yield was always directly related to the quantity of biomass in the culture. The polymer is a heteropolysaccharide with a molecular mass of 250 kDa and its components are glucose (19.7%, w/w), mannose (34%, w/w), galactose (32.9%, w/w) and fucose (13.4%, w/w). Fucose and fucose-rich oligosaccharides have applications in the fields of medicine and cosmetics. The chemical or enzymatic hydrolysis of fucose-rich polysaccharides offers a new efficient way to process fucose. The exopolysaccharide in question produces a solution of very low viscosity that shows pseudoplastic behavior and emulsifying activity on several hydrophobic substrates. It also has a high capacity for binding cations and incorporating considerable quantities of sulfates, this latter feature being very unusual in bacterial polysaccharides.

Exopolysaccharides produced by the recently described halophilic bacteria Halomonas ventosae and Halomonas anticariensis

We studied exopolysaccharides (EPSs) produced by Halomonas ventosae and Halomonas anticariensis, two novel species of halophilic bacteria. Under optimum environmental and nutritional conditions, H. ventosae strains Al12(T) and Al16 excreted 28.35 mg and 28.95 mg of EPS per 100 ml of culture medium (34.55 and 38.6 mg of EPS per gram of dry cell weight) respectively. The molecular masses of the polymers were about 50 kDa and their main components were glucose, mannose and galactose. They had high protein fractions and showed emulsifying activity on several hydrophobic substrates. Under optimum environmental and nutritional conditions, H. anticariensis strains FP35(T) and FP36 excreted about 29.65 and 49.95 mg of EPS per 100 ml of culture medium (43.6 and 50.95 mg of EPS per gram of dry cell weight) respectively. The molecular masses of the polymers were about 20 and 46 kDa respectively and were composed mainly of glucose, mannose and galacturonic acid. All EPSs produced solutions of low viscosity and pseudoplastic behaviour. They also had a high capacity for binding cations and incorporated considerable quantities of sulphates, which is highly unusual in bacterial polysaccharides. All strains assayed formed biofilms both in polystyrene wells and borosilicate test tubes.

Penetrating trauma to the male external genitalia

BACKGROUND

We report on 40 patients with penetrating trauma to the external genitalia. Initial evaluation and management, operative findings, and treatment outcomes are reviewed.

METHODS

We retrospectively reviewed the medical records of all patients presenting to our facility with penetrating trauma to the external genitalia since 1988.

RESULTS

Of the 40 patients reviewed, 22 sustained isolated scrotal trauma, 10 sustained isolated penile trauma, and 8 had both scrotal and penile injuries. Twenty-nine of the 30 men with scrotal injuries underwent surgical exploration, and 21 of these were found to have injuries to the spermatic cord or testes (in 2 patients, bilateral injuries were noted). The testicular salvage rate was 35%. Penile trauma occurred in 18 patients. Eight corporal injuries and four urethral injuries were managed with debridement and primary repair. Erection and normal voiding was present in all men undergoing reconstruction who returned for follow-up. Thirty-eight percent of tested patients were positive for hepatitis B, C, or both. More than 60% of tested patients were legally intoxicated at the time of injury. Injuries separate from genitourinary trauma were identified in 72% of the men.

CONCLUSION

Early surgical exploration with conservative debridement and primary repair of injured structures is recommended for most men who sustain penetrating injuries to the external genitalia. Selected patients with superficial injuries can be managed nonoperatively, but delayed wound complications are not uncommon. Although universal precautions are recommended for all patients, the high prevalence of hepatitis B and C in this group reemphasizes their importance. Long-term follow-up in this largely young, mobile, indigent population was poor.

Influence of hepatic function on serum levels of prostate specific antigen

PURPOSE

Recent studies have suggested that the primary site of metabolism for prostate specific antigen (PSA) is the liver. We evaluated men undergoing liver transplantation to determine whether chronic hepatic insufficiency affected serum PSA levels and whether improved hepatic function altered serum PSA levels.

MATERIALS AND METHODS

Ten men with a mean age of 46 years (range 23 to 67) undergoing liver transplantation were evaluated. Liver function tests, including serum bilirubin, serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic transaminase, as well as serum PSA were determined 1 day before and a mean of 12.6 months (range 4 to 18) after transplantation.

RESULTS

Serum bilirubin and serum glutamic-oxaloacetic transaminase declined significantly after liver transplantation. There was no difference in mean serum PSA levels before and after liver transplantation.

CONCLUSIONS

Our results suggest that severe hepatic dysfunction does not significantly alter the serum concentration of PSA. These data, combined with recent investigations demonstrating an intrahepatic mechanism for PSA elimination, suggest that the liver has a significant reserve to metabolize the relatively small quantities of PSA in the circulation.

Cellular PSA in benign and malignant prostate

To determine the relationship of carcinoma of the prostate and cellular production of prostate-specific antigen, cytosol levels of PSA were measured in benign and malignant fresh prostate tissue harvested from radical prostatectomy specimens. Wedge biopsies were taken from benign (N = 21) and malignant (N = 74) prostate tissue and were immediately fixed in liquid nitrogen, and then homogenized and differentially centrifuged, and the cytosol fractions extracted. The remaining specimen was sent for routine pathologic assessment. The Hybritech methodology was used to measure the cytosol PSA and standard protein analysis was used for cytosol protein (CP) measurement. There was a significantly greater concentration of PSA in malignant tissue (P = 0.046). Also, when benign and malignant tissue were available from a single prostate (N = 17), these differences in cytosol PSA were even greater (P = 0.002). In addition, there was no significant difference when serum PSAs from the malignant tissue were ranked according to Gleason score and placed into three different histologic grades (i.e., Gleason scores 2-4, 5-6, and 7-10).

Techniques for bypassing and stenting ureteral obstructions

The advent of current endourological equipment and combined cystoscopic fluoroscopy allows the urologist to divert and/or stent the majority of benign and malignant ureteral obstructions in either a retrograde or antegrade fashion. We report on our recent experience in managing 105 obstructed renal units to formulate a troubleshooting endourological algorithm for bypassing and stenting ureteral obstructions. The methods described allow for safe and successful stent diversion in the majority of patients with ureteral obstruction requiring initial or primary endourological management. The algorithm presents alternative techniques for bypassing and stenting ureteral obstructions.

Evaluation of the current incidence of nodal metastasis from prostate cancer

To determine the influences of transrectal ultrasonography, prostate-specific antigen (PSA), and heightened public awareness of prostate cancer stage at diagnosis, we prospectively evaluated our most recent 173 patients who had a pelvic lymphadenectomy from 1987 to 1991. All patients had clinically localized prostate cancer and underwent bilateral limited pelvic lymph node dissections (N = 173); 19 (10.7%) were found to have nodal metastasis. Pathologic tumor stage and grade information was available for 168 patients who had a simultaneous radical prostatectomy. Clinical T-stage data revealed that only one patient had a T3 lesion. Pathologic T stage showed 7.1% to be T1a (12/168), 4.1% to be T1b (7/168), 13.7% to be T2a (23/168), 34.5% to be T2b (58/168), and 40.5% to be T3 lesions (68/168). Metastatic nodal involvement was not seen in any T1a, T1b, or T2a lesions. A Gleason's score of less than 5 lesions was predictive of no nodal metastasis. The clinical stage was upstaged pathologically in none of the T1a, 16.7% of the clinical T1b, 75% of the T2a, and 73% of the T2b lesions. With regard to serum PSA, 27% of those patients with a level > 20 ng/ml had nodal metastasis (6/22) in this series. Although an elevated PSA was not predictive of tumor nodal metastasis, no patient with a normal PSA had nodal metastasis. Although the distribution of pathologic T stages is similar to that reported in the literature, our low incidence of nodal metastasis may suggest that prostate cancer is being diagnosed earlier.

Anatomic, functional, and pathologic changes from internal ureteral stent placement

The anatomic, hydrodynamic, functional, and pathologic changes associated with unilateral internal ureteral stenting were evaluated in 20 female canines. Selective glomerular filtration rates (GFR) were measured with technetium 99m diethylenetriamine pentaacetic acid (DTPA) renal scans (N = 14) prior to and several weeks after unilateral internal stent placement. Cystometry and cystography were done at weekly intervals to determine if reflux occurred and to measure the intravesical pressure to produce this reflux (N = 16). Ureteral lumenal capacities of mid 6-cm ureteral segments of stented and unstented ureters were compared. The mid-ureteral lumenal volumes were three times greater in the stented ureters (p < 0.002). There were no significant differences in the selective GFR before and after stenting. Low-pressure vesicoureteral reflux occurred at a mean intravesical pressure of 13.7 cm of water and was present in 84.6 percent (11/13) of the canines whose stents did not migrate or obstruct from encrustation. There were no significant alterations in serum chemistries or blood counts. Fluoroscopic imaging also showed ineffective ureteral peristalsis. This study confirms that internal ureteral stents cause vesicoureteral reflux and significant lumenal dilation without altering renal function.

Acquired immunodeficiency syndrome manifesting as prostate nodule secondary to cryptococcal infection

We report the first case of acquired immunodeficiency syndrome (AIDS) presenting as prostate nodularity secondary to mycotic granulomatous prostatitis which mimicked prostatic cancer on digital rectal examination. Transrectal ultrasonography revealed hypoechoic areas in the peripheral zone, which on biopsy specimen were found to represent cryptococcal infection. Subsequent serologic evaluation of the patient confirmed human immunodeficiency virus (HIV) positivity and later AIDS developed in the patient.

Evaluation of a new tumor marker for localized prostate cancer

Adenocarcinoma associated antigen (ACAA) is a large molecular weight protein that is normally found in low serum levels. Recent data have revealed elevations in patients with adenocarcinomas, including prostate cancer. To evaluate the relationship of ACAA levels with prostate cancer, we measured the cytosol content in malignant and nonmalignant prostate tissue and compared these results to those of the standard markers, prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA). Enzyme solid phase immunoassay was used to quantitate PSA and ACAA levels, and the enzymatic method was used to measure PAP. Wedge resection from the right and left posterior lobes of 50 fresh radical retropubic prostatectomy specimens were used for cytosol analysis. All foci of within each prostate gland were carefully mapped by a single pathologist. When all malignant wedges (N = 74) were compared to all the benign wedges (N = 21), only the PSA levels showed significant elevation (p less than 0.02). However, when benign and malignant tissue from the same prostate were available for comparison, both PSA (N = 17) and ACAA (N = 16) showed significant elevations in the cytosol of the malignant tissue (p less than 0.002 and p less than 0.03, respectively). Although not statistically significant, the cytosol PAP did show a consistent trend to be greater in malignant tissue. It appears that there is an association of increased cytosol ACAA and PSA with prostate cancer.

Ureteral injury in abdominal vascular reconstructive surgery

Iatrogenic ureteral injuries in vascular reconstructive surgery are rarely reported. We present a case of ureteral transection during repair of an aortic aneurysm in a patient with a previously placed aortobifemoral graft. In reported series of surgical ureteral injuries, 17 of 381 injuries occurred during vascular procedures. A review of the literature and management scheme for ureteral complications in the presence of prosthetic vascular grafts is presented in light of current endourologic materials and techniques.

Penile malignant melanoma in association with squamous cell carcinoma of the penis

We report a case of malignant melanoma of the penis in association with penile squamous cell cancer. Previous regional lymphadenectomy did not prevent subsequent development of regional recurrence. This clinical presentation and the literature are discussed.

Ultrasound guided percutaneous renal biopsy using an automatic core biopsy system

With real-time ultrasound visualization and an automatic core biopsy system 23 percutaneous renal biopsies were performed with the use of local anesthesia in 22 patients. Adequate tissue for diagnosis was obtained in all 23 cases, with 1 patient undergoing bilateral renal biopsy and 1 requiring repeat biopsy. One patient had an asymptomatic perirenal hematoma and 1 experienced a single episode of transient gross hematuria. There were no major complications. The use of an automatic core biopsy system guided by real-time ultrasound is an important technique that may be added to the urological armamentarium.

Incidental ileal carcinoid associated with multiple urologic malignancies

Although associated primary neoplasms frequently occur with carcinoid tumors, associated nonendocrine urologic malignancies are uncommonly encountered. We report the first case of an incidental ileal carcinoid associated with bilateral renal cell carcinoma and prostatic adenocarcinoma.

Ureteral catheter tip separation: potential risk using the open-end Flexi-Tip ureteral catheter

Ureteral catheters are a vital part of the urological armamentarium. We report 2 cases in which the flexible tip portion of an open-end Flexi-Tip ureteral catheter became disjointed from the shaft within the renal collecting system during endourological procedures. The etiology, prevention and management of this complication are discussed.

Unresectable calcified bladder tumor: hemiacidrin irrigation as an adjunct to resection

Radiographic calcification of urothelial malignancies is an uncommon finding. To our knowledge, calcification of transitional cell carcinoma of the bladder preventing transurethral resection has not been reported previously. We report a case of an initially unresectable radiopaque bladder tumor and discuss the successful, conservative management with continuous bladder irrigation with hemiacidrin followed by complete transurethral resection.

Acute urinary retention in a child with appendiceal abscess: diagnostic dilemma

Rarely do children with appendiceal abscess present with acute urinary retention as the only sign or symptom. This presentation may delay diagnosis and definitive therapy, thereby causing additional morbidity and possible mortality. We report the eighth case of acute urinary retention in a child associated with an appendiceal abscess.

Fournier's gangrene in children

Necrotizing fasciitis of the genitalia is a rare urologic emergency that is especially uncommon in children. We report a case of Fournier's gangrene in a four-year-old boy and analyze the data from 55 previously reported cases. Pediatric cases have been successfully managed with a more conservative surgical approach and have had a significantly lower mortality rate than adult cases.

Maxi-pouch: a new technique for ileal conduit conversion to continent urinary reservoir

We present an alternative technique for conversion of an ileal conduit to a continent urinary diversion that uses a combination of ileal and ileocolonic substitutions. Filling pressure studies and radiography of the pouch, endoscopy and excretory urography revealed a reservoir capacity of 850 cc, no reflux, normal urinary tracts and no uninhibited contractions. In complex cases of neuropathic and nonneuropathic bladders or patients who have undergone cystectomy and have an unacceptable lower urinary tract for undiversion, we propose this technique of continent urinary reservoir as an alternative.

Testicular metastasis as the first manifestation of colon carcinoma

Metastatic carcinoma to the testes is uncommon, and it is most often found incidentally at autopsy or after orchiectomy for prostatic carcinoma. One of the rarest causes of testicular tumor is metastasis from another primary site. It is even more unusual when the metastasis to the testicle is the first manifestation of the tumor. We report a case of asymptomatic colon carcinoma presenting as metastases to the testis and epididymis, which was diagnosed after biopsy of testicular nodules. Although nonlymphomatous cancer presenting as an intrascrotal mass is extremely rare, seldom detected clinically and almost never the first sign of disease, it should be considered a possibility, even in the young adult who presents with a mass involving the testicle or epididymis.

Leiomyoma of the female urethra

Smooth muscle tumors of the female urethra are uncommon lesions. Only a few cases of leiomyoma of the female urethra have been reported in the literature. We describe 2 additional cases, review the literature on this rare neoplasm and discuss its management.

Urinary ascites: complication of umbilical artery catheterization

In the newborn, intraperitoneal extravasation of urine from a urachal laceration may follow an attempt at umbilical artery catheterization. Clinical results of this injury are neonatal ascites, anuria, and azotemia. Herein, we describe a case of iatrogenic bladder injury with successful management following late detection. The anatomy of the urachus and bladder in the newborn are reviewed as well as clues to the diagnosis of neonatal urinary ascites.