Quantitative analysis of the lactic acid and acetaldehyde produced by Streptococcus thermophilus and Lactobacillus bulgaricus strains isolated from traditional Turkish yogurts using HPLC

The present study was conducted to evaluate the lactic acid- and acetaldehyde-producing abilities of lactic acid bacterial species isolated from traditionally manufactured Turkish yogurts using HPLC. The lactic acid bacterial species purified from the yogurts were the 2 most widely used species in industrial yogurt production: Streptococcus thermophilus and Lactobacillus bulgaricus. These bacteria have the ability to ferment hexose sugars homofermentatively to generate lactic acid and some carbonyl compounds, such as acetaldehyde through pyruvate metabolism. The levels of the compounds produced during fermentation influence the texture and the flavor of the yogurt and are themselves influenced by the chemical composition of the milk, processing conditions, and the metabolic activity of the starter culture. In the study, morphological, biochemical, and molecular characteristics were employed to identify the bacteria obtained from homemade yogurts produced in different regions of Turkey. A collection of 91 Strep. thermophilus and 35 L. bulgaricus strains were investigated for their lactic acid- and acetaldehyde-formation capabilities in various media such as cow milk, LM17 agar, and aerobic-anaerobic SM17 agar or de Man, Rogosa, and Sharpe agar. The amounts of the metabolites generated by each strain in all conditions were quantified by HPLC. The levels were found to vary depending on the species, the strain, and the growth conditions used. Whereas lactic acid production ranged between 0 and 77.9 mg/kg for Strep. thermophilus strains, it ranged from 0 to 103.5 mg/kg for L. bulgaricus. Correspondingly, the ability to generate acetaldehyde ranged from 0 to 105.9 mg/kg in Strep. thermophilus and from 0 to 126.9 mg/kg in L. bulgaricus. Our study constitutes the first attempt to determine characteristics of the wild strains isolated from traditional Turkish yogurts, and the approach presented here, which reveals the differences in metabolite production abilities of the wild lactic acid bacteria strains, holds the potential for the selection of the most desirable strains to be used as starters in commercial yogurt manufacture in the future.

The outcome of adding peripheral neuromodulation (Stoller afferent neuro-stimulation) to anti-muscarinic therapy in women with severe overactive bladder

OBJECTIVE

Anti-muscarinic treatment alone and peripheral neuromodulation with concomitant anti-muscarinic treatment were compared in patients with severe overactive bladder.

METHODS

In this prospective study, 40 women with severe overactive bladder according to the 7-day voiding diary without any prior treatment completed the Incontinence Impact Questionnaire (IIQ-7) and were randomised into anti-muscarinic-alone and combination treatment groups. Twenty women received daily 4 mgs of tolterodine orally and in 20 women Stoller afferent neuro-stimulation (SANS) therapy was performed concomitantly for 12 weeks to the same anti-muscarinic regimen. After 12 weeks of therapy, two of the patients drop out of the study and remaining patients filled out the IIQ-7 questionnaire and the 7-day voiding diary again. Pretreatment and post-treatment QoL scores and the 7-day voiding diaries were compared. Mann-Whitney U, Wilcoxon and two sided significance tests were used.

RESULTS

Thirty-eight women fulfilling the criteria were included in the study. Severity of overactive bladder symptoms decreased significantly in both treatment groups. However, the decrease in combination treatment group was more significant than the anti-muscarinic-alone group. Adverse events were similar between the two groups.

CONCLUSION

Combining SANS and anti-muscarinic therapy resulted in significantly better clinical outcomes and IIQ-7 scores as compared with anti-muscarinic treatment alone in patients with severe overactive bladder.

Polysaccharidase and glycosidase production of avicel grown rumen fungus Orpinomyces sp. GMLF5

Extracellular and cell-associated enzyme preparations were obtained from ruminal anaerobic fungi Orpinomyces sp. GMLF5 grown in culture containing microcrystalline cellulose (avicel) as sole energy source and degradation capacities of the preparations towards several polysaccharides and glycosides were studied. Fungus showed substantial increases in xylanase, carboxymethyl cellulase (CMCase), lichenase, amylase, beta-xylosidase, beta-glucosidase and alpha-L-arabinofuranosidase activities between 72 and 168 hours. High amounts of cell associated beta-xylosidase were noted in 4 and 5 days old cultures. Optimum temperature and pH of the polysaccharidases were found at 50 degrees C and 6.0-6.5, respectively. Xylanase was found to be virtually stable at 50 degrees C, CMCase and lichenase were stable at 40 degrees C for 200 min, however amylase was found more sensitive to heat treatment. The fibrolytic enzymes of the isolate GMLF5 were observed to be capable of hydrolyze the avicel.

Sertoli cell tumor of the testis: a case with late metastasis

We report on a 20-year-old male who underwent a radical orchidectomy when he was 12 years old which revealed a Sertoli cell tumor in his right testis, and who presented with a 5 x 3 cm retroperitoneal metastatic mass 8 years after orchidectomy. Current experience on Sertoli cell tumor of the testis (SCTT) is insufficient to prognosticate the clinical behavior of the primary tumor on the long term. Case reports in the literature on patients with late metastases suggest a very long followup after orchidectomy may be required.

Comparing the therapeutic outcome of different alpha-blocker treatments for BPH in the same individuals

OBJECTIVE

Alpha-blockers are the most widely used agents to treat lower urinary tract symptoms in males, and switching between alpha-blockers is a frequent management option when the desired effect could not be obtained. There is no data in the literature that reveal the outcome of treatments with different alpha-blockers within the same patient. We sought the answer to this question in a setting where the same individuals were treated with two different agents during different time frames.

MATERIALS AND METHODS

Forty males with benign prostatic hyperplasia (BPH) applying to the Department of Urology with lower urinary tract symptoms (LUTS) were enrolled in the study consecutively. Patients were evaluated with detailed medical history, IPSS forms, digital rectal examination (DRE), urinary ultrasound, PSA, and uroflowmetry. The subjects received terazosin 5 mg daily for 3 months, and controlled release form of alfuzosin 10 mg daily for another 3 months, leaving a 1-month clearance period in between. The above-mentioned detailed evaluations were carried out before and after each alpha-blocker regimen.

RESULTS

Mean age and PSA level was 63.3+/-1.6 years (45-80), and 2.1+/-0.4 ng/ml (0.16-6.3 ng/ml). IPSS and Qmax values before treatment with terazosin and alfuzosin were similar. Improvements in IPSS and Qmax values after treatments with both terazosin and alfuzosin were significant. There was no statistically significant difference between the drugs in terms of percent improvements in IPSS and Qmax with alpha-blocker treatment. No untoward effect except for transient dizziness in one case with terazosin treatment was encountered.

CONCLUSION

Different alpha-blockers, which are used during different time frames in the same individuals, provide similar efficiency outcome. When the desired effect in the treatment for BPH could not be obtained with one alpha-blocker, there may not be any benefit in switching to another one.

A new modification of dismembered pyeloplasty for primary ureteropelvic junction obstruction

AIM

To present the results of a new modification of dismembered pyeloplasty performed to prevent the occurrence of secondary obstruction.

METHODS

Modified dismembered pyeloplasty was performed in 35 children (age range 3 months to 16 years) who had unilateral ureteropelvic junction obstruction. In postoperative follow-up, presence of hydronephrosis on ultrasonography, differential renal function (DRF) and renal drainage half-time on technetium-99m diethylenetriaminepentaacetic acid (DTPA) renography were recorded and compared with preoperative data.

RESULTS

Mean anteroposterior renal pelvic diameter, mean preoperative DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 61.4 mm, 38.6% and 34.3 min in children with prenatal hydronephrosis, and 67.5 mm, 37.6% and 39.4 min in children that presented with symptoms, respectively. After surgery, mean anteroposterior renal pelvic diameter, mean DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 10.9 mm, 45.9% and 11.9 min in children with prenatal hydronephrosis, and 20 mm, 41.9% and 15.2 min in children that presented with symptoms, respectively. No failure was observed in any patient at an average follow-up of 26 months (range 1-5 years).

CONCLUSIONS

Open dismembered pyeloplasty is the treatment of choice for intrinsic ureteropelvic junction obstruction. The modification of dismembered pyeloplasty that we performed is an alternative for the prevention of secondary obstruction.

Repairing urethrocutaneous fistula in adults: is a catheter necessary?

OBJECTIVES

To demonstrate that urethrocutaneous fistulas can be repaired under local anesthesia in adult patients without catheters.

METHODS

From 1998 to 2006, 96 patients with urethrocutaneous fistulas underwent repair under local anesthesia. The patients were divided into two groups in terms of whether they did or did not have a catheter placed. The catheterized group included 45 patients and the uncatheterized group included 51 patients. The uncatheterized patients were discharged on the operation day, and the catheterized patients were discharged 1 to 4 days postoperatively. Patients were reevaluated on the 7th postoperative day and after 3 months in terms of wound infection, urethral stricture, and fistula recurrence.

RESULTS

All patients tolerated the fistula repair well under local anesthesia. The success rate of fistula repair was 93.3% and 94.1% in the catheterized and uncatheterized groups, respectively. Wound infection was seen in 6 patients in the first group but was not noted in the uncatheterized group. Fistulas recurred in 3 patients in each group (6.6% and 5.8%) after 3 months postoperatively.

CONCLUSIONS

Catheterless fistula repair with local anesthesia in adults is an effective, safe, and inexpensive procedure.

An important issue in the management of elimination dysfunction in children: parental awareness of constipation

The scale of parental awareness concerning children's bowel habits and its effects on voiding dysfunction were investigated. Parents of toilet-trained children older than 4 years were given questionnaires during the first interview and after follow-up of their children's bowel habits for symptoms and signs of constipation and urinary complaints. Diagnosis of constipation was made according to the Rome III criteria. Eighty-nine patients were included in the study. The number of constipated patients almost doubled after the observation period. Most of the urinary problems resolved upon treatment of constipation. History at first interview was misleading in 42% of the patients who would benefit from a simple treatment. Most of the parents were unaware of their children's bowel habits. Before proceeding with more complicated tests or treatment of voiding dysfunction, the symptoms and signs of constipation should be sought during a close parental observation period.

Epididymoorchitis due to Brucella melitensis: review of 19 patients

INTRODUCTION

We describe the clinical characteristics, treatment and long-term outcome of 19 patients with Brucella epididymoorchitis treated at the Department of Urology.

MATERIALS AND METHODS

Between 1998 and 2005, a total of 19 cases with epididymoorchitis due to Brucella melitensis were diagnosed at our hospital. The diagnosis of Brucella was made by isolating Brucella species from blood culture or epididymal aspiration or by standard tube agglutination testing and slide agglutination testing together with clinical findings.

RESULTS

Seven cases (36.8%) had undulant fever. Brucella species was isolated from blood cultures in 11 patients and from epididymal aspiration in 3 patients. Rose Bengal tests were positive in all patients. Total recovery was obtained in 12 cases with a 6-week treatment. Five patients (26.3%) did not respond to therapy and another 2 (10.5%) relapsed.

CONCLUSIONS

Brucella orchitis should be considered in the differential diagnosis of scrotal pathologies where Brucella is endemic.

Regulation of the ribonucleotide reductases in Lactococcus lactis subsp. cremoris

Lactococcus lactis has two essential ribonucleotide reductases for DNA biosynthesis and repair which are affected in the presence or absence of oxygen. Expression of glutaredoxin like protein (NrdH), the hydrogen donor for ribonucleotide reductase, was found to be regulated by the FNR like proteins (FlpA and FlpB). Proteomics study demonstrated that expression level of NrdH significantly decreased in the flpA and flpAB deletion mutants. The nrdH gene is located in an nrdHIEF operon and encoding the NrdEF ribonucleotide reductase, which is active under aerobic and anaerobic conditions. Regulation of expression of the nrdHIEF operons was investigated using beta-galactosidase as a reporter gene. The 588 bp fragment containing the nrdH promoter and gene cloned into the pORI vector immediately upstream of a promoterless lacZ gene. Constructed plasmid was transferred into wild type (MG1363), single mutant (flpA orflpB) and double mutant (flpAB). Aerobically, nrdH promoter activity is 15-fold higher than anaerobic expression.

Distal hypospadias repair in adults: the results of 97 cases

INTRODUCTION

We reviewed our 9-year experience on 97 men with distal hypospadias who had undergone hypospadias surgeries.

SUBJECTS AND METHODS

Patients were divided into two groups: group 1 included 17 men who had one or more unsuccessful surgeries in their childhood, and group 2 included 80 men with no previous hypospadias repairs. Meatal positions were glanular in 6, coronal in 35 and subcoronal in 56 patients. Our 97 hypospadias surgeries involved 42 meatal advancement and glanuloplasty, 41 Mathieu and 14 tubularized incised plate urethroplasty procedures.

RESULTS

The overall success rate was 88% (86 of the 97 patients). The success rate was 76.5% for group 1 (13 of the 17 patients) and 91.3% for group 2 (73 of the 80 patients). Better voiding function and good cosmetic appearance was achieved in all patients. Urinary flow rates were significantly higher in all groups postoperatively. The success rates were 91.4 and 85% for the patients with preoperative coronal and subcoronal meatal positions, respectively. The success rate was significantly lower in crippled cases and in cases with longer neourethra.

CONCLUSION

Although the same techniques are used for children and adults in hypospadias surgery, the results in adults differ from those in children. The success rate for primary adult cases is quite acceptable, but it is decreased in patients having longer neourethra and having multiple previous interventions.