Eosinophilia complicated with venous thromboembolism: A case report.

BACKGROUND: Eosinophilia is an increase of more than 0.5 × 109/L in the number of eosinophils; it is a systemic condition with an unknown etiology and is often accompanied by multiple impaired organ functions. The clinical manifestations of the disease are highly variable and diverse, rendering identification of the diagnosis challenging; hence, diagnosis and treatment are often delayed. Very few reports of this disease exist globally, especially with rare manifestations of cerebral venous sinus thrombosis and hemorrhage. CASE SUMMARY: A 32-year-old woman with eosinophilia presented to the hospital with bilateral lower-limb edema as the first clinical manifestation, followed by an extensive maculopapular rash throughout the body. She subsequently developed cerebral venous sinus thrombosis along with bilateral lower-limb deep vein thrombosis. Two weeks earlier, she had received a single course of antibiotics from a local hospital for a low-grade fever and sore throat. After various treatments were administered for anticoagulation, maintaining blood circulation, and relieving blood stasis, the lower extremity edema improved significantly; however, the patient's eosinophil count gradually increased. She experienced cerebral venous sinus thrombosis, cerebral hemorrhage, and deep vein thrombosis of the lower limbs before being declared brain dead. In this case report, we have elaborated the diagnosis and management of deep vein thrombosis manifested as eosinophilia, thrombocytopenia, and elevated D-dimer levels. CONCLUSION: Because proper diagnosis is challenging, clinical vigilance is required for patients with eosinophilia, as it can lead to thrombus formation.

Application of UV absorbance and fluorescence indicators to assess the formation of biodegradable dissolved organic carbon and bromate during ozonation.

This study examined the significance of changes of UV absorbance and fluorescence of dissolved organic matter (DOM) as surrogate indicators for assessing the formation of bromate and biodegradable dissolved organic carbon (BDOC) during the ozonation of surface water and wastewater effluent. Spectroscopic monitoring was carried out using benchtop UV/Vis and fluorescence spectrophotometers and a newly developed miniature LED UV/fluorescence sensor capable of rapidly measuring UVA280 and protein-like and humic-like fluorescence. With the increase of O3/DOC mass ratio, the plots of BDOC formation were characterized of initial lag, transition slope and final plateau. With the decrease of UV absorbance and fluorescence, BDOC concentrations initially increased slowly and then rose more noticeably. Inflection points in plots of BDOC versus changes of spectroscopic indicators were close to 35-45% loss of UVA254 or UVA280 and 75-85% loss of humic-like fluorescence. According to the data from size exclusion chromatography (SEC) with organic carbon detection and 2D synchronous correlation analyses, DOM fractions assigned to operationally defined large biopolymers (apparent molecular weight, AMW>20 kDa) and medium AMW humic substances (AMW 5.5-20 kDa) were transformed into medium-size building blocks (AMW 3-5.5 kDa) and other smaller AMW species (AMW<3 kDa) associated with BDOC at increasing O3/DOC ratios. Appreciable bromate formation was observed only after the values of UVA254, UVA280 and humic-like fluorescence in O3-treated samples were decreased by 45-55%, 50-60% and 86-92% relative to their respective initial levels. No significant differences in plots of bromate concentrations versus decreases of humic-like fluorescence were observed for surface water and wastewater effluent samples. This was in contrast with the plots of bromate concentration versus UVA254 and UVA280 which exhibited sensitivity to varying initial bromide concentrations in the investigated water matrixes. These results suggest that measurements of humic-like fluorescence can provide a useful supplement to UVA indices for characterization of ozonation processes.

A Formate Dehydrogenase Confers Tolerance to Aluminum and Low pH.

Formate dehydrogenase (FDH) is involved in various higher plant abiotic stress responses. Here, we investigated the role of rice bean (Vigna umbellata) VuFDH in Al and low pH (H(+)) tolerance. Screening of various potential substrates for the VuFDH protein demonstrated that it functions as a formate dehydrogenase. Quantitative reverse transcription-PCR and histochemical analysis showed that the expression of VuFDH is induced in rice bean root tips by Al or H(+) stresses. Fluorescence microscopic observation of VuFDH-GFP in transgenic Arabidopsis plants indicated that VuFDH is localized in the mitochondria. Accumulation of formate is induced by Al and H(+) stress in rice bean root tips, and exogenous application of formate increases internal formate content that results in the inhibition of root elongation and induction of VuFDH expression, suggesting that formate accumulation is involved in both H(+)- and Al-induced root growth inhibition. Over-expression of VuFDH in tobacco (Nicotiana tabacum) results in decreased sensitivity to Al and H(+) stress due to less production of formate in the transgenic tobacco lines under Al and H(+) stresses. Moreover, NtMATE and NtALS3 expression showed no changes versus wild type in these over-expression lines, suggesting that herein known Al-resistant mechanisms are not involved. Thus, the increased Al tolerance of VuFDH over-expression lines is likely attributable to their decreased Al-induced formate production. Taken together, our findings advance understanding of higher plant Al toxicity mechanisms, and suggest a possible new route toward the improvement of plant performance in acidic soils, where Al toxicity and H(+) stress coexist.

Characterization of an inducible C2 H2 -type zinc finger transcription factor VuSTOP1 in rice bean (Vigna umbellata) reveals differential regulation between low pH and aluminum tolerance mechanisms.

The rice bean (Vigna umbellata) root apex specifically secretes citrate through expression activation of Vigna umbellata Multidrug and Toxic Compound Extrusion 1 (VuMATE1) under aluminum (Al(3+) ) stress. However, the underlying mechanisms regulating VuMATE1 expression remain unknown. We isolated and characterized a gene encoding Sensitive to Proton Rhizotoxicity1 (STOP1)-like protein, VuSTOP1, from rice bean. The role of VuSTOP1 in regulating VuMATE1 expression was investigated using the yeast one-hybrid assay. We characterized the function of VuSTOP1 in Al(3)  (+)  - and H(+) -tolerance using in planta complementation assays. We demonstrated that VuSTOP1 has transactivation potential. We found that VuSTOP1 expression is inducible by Al(3+) and H(+) stress. However, although VuSTOP1 binds to the promoter of VuMATE1, the inconsistent tissue localization patterns of VuSTOP1 and VuMATE1 preclude VuSTOP1 as the major factor regulating VuMATE1 expression. In addition, when a protein translation inhibitor increased expression of VuSTOP1, VuMATE1 expression was inhibited. In planta complementation assay demonstrated that VuSTOP1 could fully restore expression of genes involved in H(+) tolerance, but could only partially restore expression of AtMATE. We conclude that VuSTOP1 plays a major role in H(+) tolerance, but only a minor role in Al(3+) tolerance. The differential transcriptional regulation of VuSTOP1 and VuMATE1 reveals a complex regulatory system controlling VuMATE1 expression.