Case of Bleeding Ileal Varices after a Colectomy Diagnosed by Capsule Endoscopy / 대한소화기학회지

We report a case of bleeding ileal varices associated with intra-abdominal adhesions after colectomy which was successfully diagnosed using capsule endoscopy. A 77-year-old woman visited the emergency department for several episodes of melena. She had a medical history of neoadjuvant chemo-radiation therapy and subsequent surgery for rectal cancer 6 years previously. Conventional diagnostic examinations including upper endoscopy, colonoscopy, and abdominal computed tomography could not detect any bleeding focus, however, following capsule endoscopy revealed venous dilatations with some fresh blood in the distal ileum, indicating bleeding ileal varices. The patient underwent exploratory laparotomy and the affected ileum was successfully resected. No further gastrointestinal bleeding occurred during the 6 months follow-up. Small intestinal varices are important differential for obscure gastrointestinal bleeding especially in patients with a history of abdominal surgery in the absence of liver cirrhosis, and capsule endoscopy can be a good option for diagnosing small intestinal varices.

Development of Urine CRM for the quality Control of Heavy Matal Determinations / 대한산업의학회지

Urine certified reference material (CRM) has been developed to help clinical labolatories control analytical accuracy. Two levels of freeze-dried urine were prepared. The low level CRM was made from normal urine and the abnormal level CRM was prepared by spiking the normal urine with As, Cd, Cr, Cu, Hg, Ni and Pb. Urine reference materials were analyzed by graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma mass spectrometry (ICP-MS) . Analyte elements were separated from matrix elements by using ion exchange resin and hydride generation. Isotope dilution method was employed to enhance analytical accuracy. Round robin test results are also presented which were carried out with 5 clinical laboratories.