Watery diarrhea,hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma

Watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome caused by vasoactive intestinal polypeptide (VIP) -producing tumor only rarely occurs in patients with nonpancreatic disease. A 49-year-old woman was referred for evaluation of a right adrenal tumor incidentally diagnosed by abdominal ultrasound during the investigation of chronic watery diarrhea. Laboratory findings showed hypokalemia and excessive production of VIP and catecholamines. After surgical resection of the tumor, diarrhea subsided and both electrolytes and affected hormone levels normalized. Immunohistochemical examination confirmed a diagnosis of pheochromocytoma, which contained VIP-positive ganglion-like cells. We herein present the clinical and histogenetic implications of this rare clinical entity, with literature review.

Treasures From a Watery Grave

Archaeologists exploring a well-preserved shipwreck prove a forgotten marine trade route The first probing of the ancient merchant vessel Nanhai No.1 after the wreck was put into a museum pool of simulated seawater successfully recovered porcelain and stone artifacts from its cabin on September 27.

Physiological Responses of Clam(Ruditapes philippinarum)to Transport Modes with Different Temperatures

Given the increased circulation time after fishing,a series of changes take place in live clams,leading to a deterioration in quality even after death.Thus,in this study,we aimed to explore the optimal mode of transportation of clams.The container for holding clams was reformed,and a water circulation temperature control system was established.The physiological responses of clams during anhydrous and watery transportation at two temperatures(4 and 15℃)were investigated based on the aforementioned system.When comparing the transportation patterns after 3 d of transport,a higher survival rate was observed at 4℃(97%)than at 15℃(63%)in the anhydrous transportation groups and a lower survival rate was observed at 4℃(93%)than at 15℃(99%)in the watery transportation groups.In addition,the glycogen content,condition index(CI),and adenylate energy charge(A.E.C)value were higher at4℃((40.87±0.99)mg g^(-1),13.71%±0.50%and 57.45%±1.60%)than at 15℃((30.54±0.81)mg g^(-1),9.09%±0.30%and 43.12%±1.65%)in the anhydrous transportation groups.In the watery transportation groups,a lower glycogen content,CI,and A.E.C.value were observed at 4℃((33.78±0.84)mg g^(-1),9.78%±0.50%and 64.65%±1.25%)than at 15℃((41.53±0.93)mg g^(-1),12.72%±0.83%and 71.58%±1.27%).Results from this study show that anhydrous transportation(4℃)is the optimal transport condition for clams to maintain a high quality and good physiological conditions.Thus,this study will be particularly useful for establishing shellfish transportation systems.

Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea

AIM： To assess the efficacy and safety of Saccharomyces boulardii （S. boulardii） in acute watery diarrhoea and its role in reducing the frequency of episodes of diarrhoea in subsequent two months. METHODS： Children from 2 mo to 12 years of age, with acute diarrhoea were selected according to inclusion criteria and randomised in S. boulardii group （treated with ORS, nutritional support and S. boulardii, 250 mg bid） and in control group （treated with ORS and nutritional support only）. Active treatment phase was 5 d and each child was followed for two months afterwards. Frequency and consistency of stools as well as safety of drug was assessed on every visit. A comparison of two groups was done in terms of number of diarrhoeal episode in subsequent two months. RESULTS： There were fifty patients in each group. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By d 3 it reduced to 2.7 and 4.2 stools per d respectively and by d 6 it reduced to 1.6 （5. boulardii Group） and 3.3 （control group）. The duration of diarrhoea was 3.6 d in S. boulardii group whereas it was 4.8 d in control group （P = 0.001）. In the following two months, S. boulardii group had a significantly lower frequency of 0.54 episodes as compared to 1.08 episodes in control group. The drug was well accepted and tolerated. There were no reports of the side effects during treatment period CONCLUSION： S. boulardii significantly reduces the frequency and duration of acute diarrhoea. The consistency of stool also improves. The drug is well-tolerated.

Microscopic colitis

Microscopic colitis may be defined as a clinical syndrome, of unknown etiology, consisting of chronic watery diarrhea, with no alterations in the large bowel at the endoscopic and radiologic evaluation. Therefore, a definitive diagnosis is only possible by histological analysis. The epidemiological impact of this disease has become increasingly clear in the last years, with most data coming from Western countries. Microscopic colitis includes two histological subtypes [collagenous colitis (CC) and lymphocytic colitis (LC)] with no differences in clinical presentation and management. Collagenous colitis is characterized by a thickening of the subepithelial collagen layer that is absent in LC. The main feature of LC is an increase of the density of intra-epithelial lymphocytes in the surface epithelium. A number of pathogenetic theories have been proposed over the years, involving the role of luminal agents, autoimmunity, eosinophils, genetics (human leukocyte antigen), biliary acids, infections, alterations of pericryptal fibroblasts, and drug intake; drugs like ticlopidine, carbamazepine or ranitidine are especially associated with the development of LC, while CC is more frequently linked to cimetidine, non-steroidal antiinflammatory drugs and lansoprazole. Microscopic colitis typically presents as chronic or intermittent watery diarrhea, that may be accompanied by symptoms such as abdominal pain, weight loss and incontinence. Recent evidence has added new pharmacological options for the treatment of microscopic colitis:the role of steroidal therapy, especially oral budesonide, has gained relevance, as well as immunosuppressive agents such as azathioprine and 6-mercaptopurine. The use of anti-tumor necrosis factoragents, infliximab and adalimumab, constitutes a new, interesting tool for the treatment of microscopic colitis, but larger, adequately designed studies are needed to confirm existing data.

Current status and challenges in drug discovery against the globally important zoonotic cryptosporidiosis

The zoonotic cryptosporidiosis is globally distributed,one of the major diarrheal diseases in humans and animals.Cryptosporidium oocysts are also one of the major environmental concerns,making it a pathogen that fits well into the One Health concept.Despite its importance,fully effective drugs are not yet available.Anti-cryptosporidial drug discovery has historically faced many unusual challenges attributed to unique parasite biology and technical burdens.While significant progresses have been made recently,anti-cryptosporidial drug discovery still faces a major obstacle:identification of systemic drugs that can be absorbed by patients experiencing watery diarrhea and effectively pass through electron-dense(ED)band at the parasite-host cell interface to act on the epicellular parasite.There may be a need to develop an in vitro assay to effectively screen hits/leads for their capability to cross ED band.In the meantime,non-systemic drugs with strong mucoadhesive properties for extended gastrointestinal exposure may represent another direction in developing anti-cryptosporidial therapeutics.For developing both systemic and non-systemic drugs,a non-ruminant animal model exhibiting diarrheal symptoms suitable for routine evaluation of drug absorption and anti-cryptosporidial efficacy may be very helpful.

Calculation of VPP basing on functional analyzing method

The establishment and realization of the VPP calucation's model for the functional analytic theory are discussed in this paper.Functional analyzing method is a theoretical model of the VPP calculation which can eliminate the influence of the sail and board's size skillfully,so it can be regarded as a brief standard of the sailboard's VPP results.As a brief watery dynamical model,resistance on board can be regarded as a direct proportion to the square of the boat-velocity.The boat-velocities at the state of six wind-velocities(3m/s-8m/s) with angles of 25°-180° are obtained by calculating,which provides an important gist of the sailing-route's selection in upwind-sailing.

Inevitability of an Enhanced Monitoring Strategy to Reduce Water Borne Illness Combining Indicators of Sanitary Protection and Measuring Water Quality

Background: Diarrhoea is the second leading cause of childhood mortality in children under five years old. Water is a major contributing risk factor for this disease that is a common illness and a global killer. Material and Methods: Water samples from different areas of Karachi were collected and were processed by MPN technique to evaluate the presence of microbiological substances. Results: Out of the processed samples, 64% were positive for the presence of mix enteric pathogen from different areas of Karachi;from Bhens colony, 74% were positive for the presence of fecal coli forms, among which 4% were positive for EHEC isolated from storage tank and water tank. Conclusion: The abovementioned results reflect the presence of organisms of public health importance in different sources of drinking water. According to WHO guidelines, there should be zero tolerance of these organisms in water.

Ultrastructure of compatible and incompatible interactions in phloem sieve elements during the stylet penetration by cotton aphids in melon

Resistance of the melon line TGR-1551 to the aphid Aphis gossypii is based on preventing aphids from ingesting phloem sap. In electrical penetration graphs （EPGs）, this resistance has been characterized with A. gossypii showing unusually long phloem salivation periods （waveform El） mostly followed by pathway activities （waveform C） or if followed by phloem ingestion （waveform E2）, ingestion was not sustained for more than 10 min. Stylectomy with aphids on susceptible and resistant plants was performed during EPG recording while the stylet tips were phloem inserted. This was followed by dissection of the penetrated leaf section, plant tissue fixation, resin embedding, and ultrathin sectioning for transmission electron microscopic observation in order to study the resistance mechanism in the TGR. The most obvious aspect appeared to be the coagulation of phloem proteins inside the stylet canals and the punctured sieve elements. Stylets of 5 aphids per genotype were amputated during sieve element （SE） salivation （El） and SE ingestion （E2）. Cross-sections of stylet bundles in susceptible melon plants showed that the contents of the stylet canals were totally clear and also, no coagulated phloem proteins occurred in their punctured sieve elements. In contrast, electron-dense coagulations were found in both locations in the resistant plants. Due to calcium binding, aphid saliva has been hypothesized to play an essential role in preventing/suppressing such coagulations that cause occlusion of sieves plate and in the food canal of the aphid＇s stylets. Doubts about this role of E 1 salivation are discussed on the basis of our results.