Aortic balloon occlusion simplifies dissected thoracoabdominal aortic aneurysm repair after frozen elephant trunk.

Here, we report a case of a dissected thoracoabdominal aortic aneurysm repair after frozen elephant trunk implantation, using aortic balloon occlusion technique to simplify the proximal anastomosis and avoid deep hypothermic circulatory arrest.

Antagonistic Interactions between Arsenic, Lead, and Cadmium in the Mouse Gastrointestinal Tract and Their Influences on Metal Relative Bioavailability in Contaminated Soils.

Soils are often co-contaminated with As, Pb, and Cd. To what extent ingested metal(loid)s interact with each other in the gastrointestinal tract and influence their RBA (relative bioavailability) is largely unknown. Three soils predominantly contaminated with As (MS, mining/smelting impacted), Pb (WR, wire rope production impacted), and Cd (EP, enamel pottery production impacted) were administered to mice individually or in binary and tertiary combinations with sodium arsenate, Cd chloride, and/or Pb acetate. In binary combinations, ∼10-fold higher Pb addition decreased As-RBA in MS (26.0 ± 6.28% to 17.1 ± 1.08%), while ∼10-fold higher As addition decreased Pb-RBA in WR (61.3 ± 2.41% to 28.8 ± 5.45%). This was possibly due to the formation of insoluble Pb arsenate in mouse intestinal tract, as indicated by the formation of precipitates when As and Pb co-occurred in water or simulated human gastrointestinal fluids. Due to competition for shared absorption transporters, ∼10- and 100-fold higher Pb addition decreased Cd-RBA in EP (95.8 ± 12.9% to 67.8 ± 12.8% and 62.8 ± 8.24%). Tertiary combinations showed that interactions between two metal(loid)s were affected by the presence of the third metal(loid). Our study suggests that As oxyanion could interact with Pb or Cd ions in the mouse gastrointestinal tract, and the interactions vary depending on concentration and solution characteristics.

Arsenic Concentrations, Speciation, and Localization in 141 Cultivated Market Mushrooms: Implications for Arsenic Exposure to Humans.

Mushrooms accumulate arsenic (As), yet As concentrations, speciation, and localization in cultivated mushrooms across a large geographic distribution are unknown. We characterized 141 samples of nine species from markets in nine capital cities in China, with samples of Lentinula edodes, Pleurotus ostreatus, and Agaricus bisporus being analyzed for As speciation and localization. Total As concentrations ranged from 0.01 to 8.31 mg kg-1 dw, with A. bisporus (0.27-2.79 mg kg-1) containing the most As followed by P. ostreatus and L. edodes (0.04-8.31 and 0.12-2.58 mg kg-1). However, As in A. bisporus was mostly organic including nontoxic arsenobetaine, while P. ostreatus and L. edodes contained mainly inorganic As (iAs). On the basis of in situ imaging using LA-ICP-MS, As in L. edodes was localized to the surface coat of the cap, while As in P. ostreatus was localized to the junction of the pileus and stipe. When As speciation and daily mushroom consumption (1.37 g d-1 dw) are considered, daily mushroom consumption may result in elevated iAs exposure, with increased bladder and lung cancer rates up to 387 cases per 100000. Our study showed that market mushrooms could be a health risk to the general public so its production should be monitored.

Antibiotic exposure decreases soil arsenic oral bioavailability in mice by disrupting ileal microbiota and metabolic profile.

Oral bioavailability of arsenic (As) determines levels of As exposure via ingestion of As-contaminated soil, however, the role of gut microbiota in As bioavailability has not evaluated in vivo although some in vitro studies have investigated this. Here, we made a comparison in As relative bioavailability (RBA) estimates for a contaminated soil (3913 mg As kg-1) using a mouse model with and without penicillin perturbing gut microbiota and metabolites. Compared to soil exposure alone (2% w/w soil in diets), addition of penicillin (100 or 1000 mg kg-1) reduced probiotic Lactobacillus and sulfate-reducing bacteria Desulfovibrio, enriched penicillin-resistant Enterobacter and Bacteroides, and decreased amino acid concentrations in ileum. With perturbed gut microbiota and metabolic profile, penicillin and soil co-exposed mice accumulated 2.81-3.81-fold less As in kidneys, excreted 1.02-1.35-fold less As in urine, and showed lower As-RBA (25.7-29.0%) compared to mice receiving diets amended with soil alone (56 ± 9.63%). One mechanism accounted for this is the decreased concentrations of amino acids arising from the gut microbiota shift which resulted in elevated iron (Fe) and As co-precipitation, leading to reduced As solubilization in the intestine. Another mechanism was conversion of bioavailable inorganic As to less bioavailable monomethylarsonic acid (MMAV) and dimethylarsinic acid (DMAV) by the antibiotic perturbed microflora. Based on in vivo mouse model, we demonstrated the important role of gut microbiota and gut metabolites in participating soil As solubilization and speciation transformation then affecting As oral bioavailability. Results are useful to better understand the role of gut bacteria in affecting As metabolism and the health risks of As-contaminated soils.

Geogenic nickel exposure from food consumption and soil ingestion: A bioavailability based assessment.

Accumulation and oral bioavailability of nickel (Ni) were rarely assessed for staple crops grown in high geogenic Ni soils. To assess exposure risk of geogenic Ni, soil, wheat, and rice samples were collected from a naturally high background Ni area and measured for Ni oral relative bioavailability (RBA, relative to NiSO4) using a newly developed mouse urinary Ni excretion bioassay. Results showed that soils were enriched with Ni (80.5 ± 23.0 mg kg-1, n = 58), while high Ni contents were observed in rice (2.66 ± 1.46 mg kg-1) and wheat (1.32 ± 0.78 mg kg-1) grains, with rice containing ∼2-fold higher Ni content than wheat. Ni-RBA was low in soil (14.8 ± 7.79%, n = 18), but high in wheat and rice with rice Ni-RBA (85.9 ± 19.1%, n = 9) being ∼2-fold higher than wheat (46.1 ± 21.2%, n = 16). A negative correlation (r = 0.61) was observed between Ni-RBA and iron content in rice and wheat, suggesting the low iron status of rice drives its high Ni bioavailability. The higher Ni accumulation and bioavailability for rice highlights that rice consumption was a more important contributor to daily Ni intake compared to wheat, while Ni intake from direct soil ingestion was negligible. This study suggests a potential health risk of staple crops especially rice when grown in high geogenic Ni areas.

As, Cd, and Pb relative bioavailability in contaminated soils: Coupling mouse bioassay with UBM assay.

The robustness of in vitro bioaccessibility assays to predict oral relative bioavailability (RBA) of multiple metals in contaminated soils requires validation using additional soil samples. In this study, 11 contaminated soils from mining/smelting areas were analyzed for As-, Cd-, and Pb-RBA using a mouse bioassay and metal bioaccessibility via the UBM gastric phase assay. Metal-RBA varied considerably among soils, with As-RBA (2.5-23%, mean 12%) being generally lower than Cd-and Pb-RBA (3.4-88 and 3.3-59%, mean 42 and 28%), due to higher proportions of As in the residual fractions. Metal-RBA generally decreased with increasing metal concentrations probably due to reduced labile metal fractions. In addition, strong negative correlations were observed between total Fe with As-, Cd-, and Pb-RBA (R2 = 0.46-0.77), suggesting the role of Fe in controlling metal-RBA in soils. Like RBA, metal bioaccessibility by the UBM assay also varied among samples. However, strong in vivo-in vitro correlations (IVIVCs) were observed between metal-RBA and bioaccessibility (R2 = 0.52-0.81). Further, there were little differences when As-, Cd-, and Pb-IVIVCs established using soils from this study and soils pooled from literature were compared, suggesting the robustness of the UBM assay to predict metal-RBA in contaminated soils.

Coupling bioavailability and stable isotope ratio to discern dietary and non-dietary contribution of metal exposure to residents in mining-impacted areas.

Both dietary and non-dietary pathways contribute to metal exposure in residents living near mining-impacted areas. In this study, bioavailability-based metal intake estimation coupled with stable Pb isotope ratio fingerprinting technique were used to discern dietary (i.e., rice consumption) and non-dietary (i.e., housedust ingestion) contribution to As, Cd, and Pb exposure in residents living near mining-impacted areas. Results showed that not only rice (n = 44; 0.10-0.56, 0.01-1.77, and 0.03-0.88 mg kg-1) but also housedust (n = 44; 2.15-2380, 2.55-329, and 87.0-56,184 mg kg-1) were contaminated with As, Cd, and Pb. Based on in vivo mouse bioassays, bioavailability of As, Cd, and Pb in rice (n = 11; 34 ±â€¯15, 59 ±â€¯13, and 31 ±â€¯15%) were greater than housedust (n = 14; 17 ±â€¯6.7, 46 ±â€¯10, and 25 ±â€¯6.8%). Estimated daily intake of As, Cd, and Pb after incorporating metal bioavailability showed that As intake via rice was 5-fold higher than housedust for adults, whereas As intake via housedust was 3-fold higher than rice for children. For both adults and children, rice was the main source for Cd exposure, while housedust was the predominant Pb contributor. To ascertain the dominant Pb source from housedust ingestion, stable Pb isotope ratios (207Pb/206Pb and 208Pb/206Pb) of hair samples of local residents (n = 27, 0.8481 ±â€¯0.0049 and 2.0904 ±â€¯0.0102) were compared to housedust (n = 27, 0.8485 ±â€¯0.0047 and 2.0885 ±â€¯0.0107) and rice (n = 27, 0.8369 ±â€¯0.0057 and 2.0521 ±â€¯0.0119), showing an overlap between hair and housedust, but not rice, confirming that incidental housedust ingestion was the main source of Pb exposure. This study coupled bioavailability and stable isotope techniques to accurately identify the source of metal exposure as well as their potential health risk.

An unusual gallbladder carcinoma with tumor thrombus in the common bile duct.

We described a special infiltration manner of gallbladder carcinoma with tumor thrombus in the common bile duct. Between February 2003 and January 2005, the patients with gallbladder carcinoma who were identified of tumor thrombus in the common bile duct in surgical procedure were retrospectively analyzed. Abdominal ultrasound and magnetic resonance cholangiopancreatography were used for preoperative diagnosis. All three patients were given radical operation. All three patients recovered well after surgery, who were respectively alive for 30 months, 17 months, and 23 months without tumor recurrence, and 58 months, 41 months, and 40 months for survival time after operation. Gallbladder carcinoma with tumor thrombus in the common bile duct was very rare but with relatively special clinical manifestation and characteristic radiography manifestation.