Knotted urethral catheter in an 80-year-old woman: prevention and management of this unusual complication.

Intravesical catheter knotting represents a rare event, especially described in paediatric literature. We report a case of a catheter knot, occurring in an 80-year-old woman, managed by means of sustained traction.

Correlation between gender and spontaneous C-cell tumors in the thyroid gland of the Wistar rat.

In many rat strains, C-cell hyperplasia occurs in an age-dependent manner and is often associated with multifocal C-cell carcinoma. The purpose of this study was to investigate the spectrum of spontaneous, proliferative C-cell disorders by gender in Wistar rats throughout their lifespan. The incidence of C-cell hyperplasia shows a significant increase with age (P<0.001) and is much higher in female rats than in male rats (P<0.05). From 3 to 24 months of life, 27.5% of female rats showed a normal C-cell pattern, 55.0% showed C-cell hyperplasia, and 17.5% showed C-cell tumors; while 57.5% of male rats showed a normal C-cell pattern, 32.5% showed C-cell hyperplasia, and 10% showed C-cell tumors. Although the overall frequency of C-cell neoplasms in females was nearly double that in males, these data are not statistically significant. However, the number of C-cell tumors showed a significant increase with age (P<0.05). Therefore, we can conclude that there were significant differences in the incidence of the total spectrum of C-cell proliferative abnormalities in the thyroid gland of Wistar rats that were both age-dependent and gender-dependent.

Molecular characterization of PcpA: a novel choline-binding protein of Streptococcus pneumoniae.

The gene pcpA that encodes a novel pneumococcal choline-binding protein has been cloned and characterized. Northern blot analysis revealed that pcpA is expressed during the exponential phase of growth of pneumococci as a monocistronic transcript of about 2.3 kb. The transcription start site has been located 132 bp upstream of the start codon and the proposed -35 and -10 boxes that are highly similar to those of the typical sigma 70 promoters from Escherichia coli. This gene encodes a putative 79 kDa protein that contains a typical C-terminal choline-binding domain (ChBD). The ChBD of PcpA is built up by 11 identical motifs of 20 amino acids plus a tail of 19 amino acids, which represents the longest ChBD that has been characterized so far. Interestingly, two tandem arrays of five characteristic amphipathic leucine reach repeats (LRRs) of 22-26 amino acids in length have been found in the N-terminal region of PcpA. Since LRRs have been proposed to be involved in protein-protein and protein-lipid interactions our findings suggests a role for PcpA in pneumococcal adhesion.

Identification and characterization of IS1381, a new insertion sequence in Streptococcus pneumoniae.

A new insertion sequence (IS1381) was identified in the genome of Streptococcus pneumoniae R6 as an 846-bp segment containing 20-bp terminal inverted repeats and flanked by 7-bp direct repeats. The three sequenced copies of this element have two overlapping open reading frame (ORF) genes named orfA and orfB. However, significant variations between individual copies were found, suggesting that inactivating mutations have occurred in an original single ORF. Accordingly, the consensus IS1381 element derived from the comparison of the three available copies should contain a single ORF sufficient to encode a basic protein of 267 amino acids which exhibited high similarity to the putative transposases of ISL2 from Lactobacillus helveticus and of IS702 from the cyanobacterium Calothrix sp. strain PCC 7601. A minimum of five to seven copies were detected by hybridization experiments in the R6 genome. In remarkable contrast with the two previously reported pneumococcal insertion sequences, several copies of IS1381 have been detected in all of the clinical isolates tested so far. Interestingly, Streptococcus oralis NCTC 11427 (type strain), a close relative of pneumococcus, does not contain this element, but its occurrence in the type strain of Streptococcus mitis (NCTC 12261) suggests that this species has exchanged DNA with S. pneumoniae directly or through an intermediate species.

Molecular characterization of a family of choline-binding proteins of Clostridium beijerinckii NCIB 8052. Evolution and gene redundancy in prokaryotic cell.

Three genes homologous to cspA, which encodes the major secretable protein of Clostridium beijerinckii NCIB 8052 have been cloned and sequenced. The Csp proteins showed the typical modular structure of cell-wall associated proteins and, that found in the choline-binding proteins of Streptococcus pneumoniae. The variable number of repeats that constitute the C-terminal choline-binding domain suggests that the csp genes have evolved by deletion-duplication events. Northern blot analysis indicated that under the culture conditions employed only two genes, cspA and cspC, are efficiently expressed and their products are detected in the culture medium. The csp genes are not contiguously located in the chromosome and appear to be expressed independently. Primer extension experiments located a transcription start site 29 bp upstream of the cspA initiation codon. The -10 and -35 promoter regions are closely related to the consensus sequence of Escherichia coli sigma 70 promoters. The cell wall binding capacity of the clostridial proteins, their abundance in the extracellular media, together with the existence of gene redundancy suggest that the Csp proteins should play an important role in the interaction of this microorganism with its surrounding environment.

Tracking the evolution of the bacterial choline-binding domain: molecular characterization of the Clostridium acetobutylicum NCIB 8052 cspA gene.

The major secreted protein of Clostridium acetobutylicum NCIB 8052, a choline-containing strain, is CspA (clostridial secreted protein). It appears to be a 115,000-M(r) glycoprotein that specifically recognizes the choline residues of the cell wall. Polyclonal antibodies raised against CspA detected the presence of the protein in the cell envelope and in the culture medium. The soluble CspA protein has been purified, and an oligonucleotide probe, prepared from the determined N-terminal sequence, has been used to clone the cspA gene which encodes a protein with 590 amino acids and an M(r) of 63,740. According to the predicted amino acid sequence, CspA is synthesized with an N-terminal segment of 26 amino acids characteristic of prokaryotic signal peptides. Expression of the cspA gene in Escherichia coli led to the production of a major anti-CspA-labeled protein of 80,000 Da which was purified by affinity chromatography on DEAE-cellulose. A comparison of CspA with other proteins in the EMBL database revealed that the C-terminal half of CspA is homologous to the choline-binding domains of the major pneumococcal autolysin (LytA amidase), the pneumococcal antigen PspA, and other cell wall-lytic enzymes of pneumococcal phages. This region, which is constructed of four repeating motifs, also displays a high similarity with the glucan-binding domains of several streptococcal glycosyltransferases and the toxins of Clostridium difficile.