First exchange neutrophilia: an index of peritonitis during chronic intermittent peritoneal dialysis

During intermittent peritoneal dialysis (IPD) early diagnosis of peritonitis may be difficult, because of paucity in clinical signs and delays in bacteriologic studies. We examined prospectively leucocyte counts and their differential composition in initial ascites and dialysis effluent of patients on IPD and correlated these findings to the presence of subsequently bacteriologically proven clinical peritonitis. Total leucocyte counts from either ascites or first exchange effluent did not differentiate infected from noninfected patients. In contrast, first exchange effluent neutrophilia (greater than 43%) proved to be an early indicator of infection, being 100% sensitive and 94% specific for peritonitis. We conclude that in such patients peritoneal effluent neutrophilia should be considered an indication of possible infection.     

Delayed hypersensitivity and lesions following isoimmunization with modified rat male accessory glands: kinetics of induction

The kinetics of the cellular immune response to rat male accessory glands were studied in Wistar rats isoimmunized with modified rat male accessory glands extract and complete Freund's adjuvant at 0, 30 and 45 days. The animals were divided into seven groups, and each group was sacrificed weekly. One immunization was sufficient for the induction of 2-, 6- and 24-h footpad reactivity. The reaction increased until 21 days post-immunization. After the second injection the reaction decreased and was negative 12 days later. Migration inhibitory factor (MIF) activity monitored by a mixed-direct assay was demonstrated in rats from all groups except in the animals studied at day 42 in which macrophage migration was markedly stimulated. The absence of MIF activity correlated with a lack of delayed type hypersensitivity (DTH) response. The humoral response was studied and detected by passive hemagglutination in a few sera after the first immunization. A second injection was necessary to obtain a more frequent occurrence and higher titres of antibodies. Histological modifications in the target organs started to appear in the group of animals studied at 35 days and were characterized by a mononuclear infiltrate in the prostate, coagulating glands and seminal vesicles. In several cases there was also infiltration of polymorphonuclear cells. Specimens obtained at 35 days showed the most severe lesions.     

Antimicrobial properties of Phrygilanthus acutifolius

Ethanol extract of flowers of Phrygilanthus acutifolius (Ruiz & Pav.) Eichler (Loranthaceae) inhibited the growth of both Gram (+) bacteria (Staphylococcus aureus, Staphylococcus saprophyticus and Enterococcus faecalis) and Gram (-) bacteria (Serratia marcescens, Acinetobacter sp. and Pseudomonas aeruginosa). This extract was bactericidal against Staphylococcus aureus and bacteriostatic against Pseudomonas aeruginosa. Morphological evidence suggests that the extract causes the swelling of the bacterial body of Staphylococcus aureus, the disintegration of the cell surface and the cell death. Bactericidal activity was optimal at pH 7.5 and was not affected by different ionic strengths. The presence of Mg2+ in the culture medium of Phrygilanthus acutifolius diminished the sensitivity of Pseudomonas aeruginosa strain against the extract. Test results would tend to corroborate the folk belief that the flowers of this plant are efficacious against respiratory infections and would justify its further investigation.     

Brugada syndrome with atypical ECG: downsloping ST-segment elevation in inferior leads

We present an unusual case of a young Thai immigrant, symptomatic, who had suffered prior episodes of syncope with strong family background: male, first-degree relatives, younger than 45 years old who had died suddenly. The rest ECG, with the patient asymptomatic at the time, showed persistent ST-segment elevation, in inferior leads and "mirror" image in the anterior wall, which were not modified with sublingual nitrates, in absence of demonstrable structural heart disease by chest X-rays and echocardiogram, hypothermia, ischemia, or electrolytic disorders. Holter monitoring revealed at dawn, a short episode of polymorphic ventricular tachycardia of short onset extrasystole coupling, which evolved into asystole and sudden cardiac death. We believe this is a sudden unexplained death syndrome, although we did not have a chance to conduct a genetic study.     

Protein kinase CK2 modulates developmental functions of the abscisic acid responsive protein Rab17 from maize

The maize abscisic acid responsive protein Rab17 is a highly phosphorylated late embryogenesis abundant protein involved in plant responses to stress. In this study, we provide evidence of the importance of Rab17 phosphorylation by protein kinase CK2 in growth-related processes under stress conditions. We show the specific interaction of Rab17 with the CK2 regulatory subunits CK2 beta-1 and CK2 beta-3, and that these interactions do not depend on the phosphorylation state of Rab17. Live-cell fluorescence imaging of both CK2 and Rab17 indicates that the intracellular dynamics of Rab17 are regulated by CK2 phosphorylation. We found both CK2 beta subunits and Rab17 distributed over the cytoplasm and nucleus. By contrast, catalytic CK2 alpha subunits and a Rab17 mutant protein (mRab17) that is not a substrate for CK2 phosphorylation remain accumulated in the nucleoli. A dual-color image shows that the CK2 holoenzyme accumulates mainly in the nucleus. The importance of Rab17 phosphorylation in vivo was assessed in transgenic plants. The overexpression of Rab17, but not mRab17, arrests the process of seed germination under osmotic stress conditions. Thus, the role of Rab17 in growth processes is mediated through its phosphorylation by protein kinase CK2.