Small bowel ileus due to the parasitic infection caused by omophagia of freshwater fish is relatively rare. We present a case of small bowel ileus possibly caused by inflammatory change associated with Gnathostoma doloresi infection. A 62-year-old man underwent partial resection of the small bowel under a diagnosis of ileus due to complete obstruction of the small bowel. He had eaten a few slices of raw freshwater fish four weeks before abdominal pain appeared, and he contracted creeping disease with several welts on the abdominal wall. Chronic inflammatory change suggestive of parasite infection was observed in the resected specimen. An immunoserodiagnostic study using microenzyme-linked immunosorbent assay led to a diagnosis of Gnathostoma doloresi infection. The postoperative course was favorable, and the patient was discharged 12 days after surgery. Only two cases of ileus due to Gnathostoma doloresi infection have ever been reported.

　　We report a case of vaginal cuff dehiscence after total laparoscopic hysterectomy that was successfully managed by a newly developed vaginal double-layer circular incision-closure method through a transvaginal approach. The nulligravid postmenopausal patient with cervical cancer received a diagnosis of vaginal evisceration on postoperative day 24. The eviscerated small intestine was pushed back after vaginal douching with normal saline before the procedure. The vaginal mucosa was incised circularly in two layers at the levels of 10 mm and 15 mm from the vaginal stump, and the edges apposed with double-layer closures. She was discharged on postoperative day 3 and followed up for 5 years, with no recurrence of cancer or vaginal dehiscence. This operative method is especially useful for a nulligravida with a small vagina.

Introduction: We analyzed the concentrations of the trace elements [chromium (Cr), arsenic (As), cadmium (Cd), cesium (Cs), lead (Pb), thorium (Th), and uranium (U)] in commercial bottled water consumed in the town of Angono, Rizal province, Luzon island, Philippines to evaluate the health risks of the trace elements in drinking water. There are some arguments that water resources available in the Philippines are heavily polluted by various materials, inparticular heavy metal elements. Method: The concentrations of seven trace elements in commercial bottled water produced and consumed in the Philippines were analyzed using a solution nebulization inductively coupled plasma mass spectrometry (SN−ICP−MS). Result: The concentrations of the trace elements except for Cs, which does not yet have a WHO guideline value, in the locally produced bottled water were below the WHO guideline values. The Cs concentrations (<0.6 μg/L) of the bottled water of the Philippines were generally similar to those of the bottled water produced and consumed in other countries such as Japan, China, and Indonesia. Conclusion The concentrations of trace elements in bottled water consumed in Angono, Philippines can be regarded as being at safe levels, as well as those of daily life water (i.e. tap, well, and spring water) consumed in the said town.
Drinking Water ; Trace Elements ; Philippines

Objective: The present study aims to determine the concentrations of seven trace elements [chromium (Cr), arsenic (As), cadmium (Cd), cesium (Cs), lead (Pb), thorium (Th), and uranium (U)] in tap, well, spring, river, and lake waters in the town of Angono, Rizal in the Philippines, consumed for drinking, cooking, bathing, and washing. In the town of Angono, both of the tap and purified tap waters produced in the refilling station are consumed as the water for drinking. Methods: Water samples from six unpurified tap, six purified taps, 10 wells, two springs, two rivers, and one lake water were obtained in October 2015. Samples were analyzed using solution nebulization inductively coupled plasma mass spectrometry. Results were evaluated for health risks of the trace elements in the water samples using WHO guideline values. The provisional WHO guideline values are as follows: Cr: 50 μg/L, As: 10 μg/L, Cd: 3 μg/L, Pb: 10 μg/L, and U: 30 μg/L. That of Cs has not been proposed yet. The WHO guideline value for the naturally occurring radioactive isotope 232Th in drinking water is 1 Bq/L, which is equivalent to 250 μg/L. Results: The concentrations of the trace elements in the tap water samples were <0.5% of the WHO guideline values, except Cs and Cd, with those of Cd being ~9% of the WHO guideline value. Purified tap waters contained the seven trace elements in lower concentrations, with the exception of Pb, which may have been added in small amounts from equipment used for water purification. The concentrations of the trace elements in water samples from the wells and springs in Angono were more variable than those of the tap waters, and these were also below the WHO guideline values. The concentrations of Cs in all water samples were <0.3 μg/L. The trace-element concentrations of the waters from Angono River and Laguna Lake were almost the same as those of the well and spring waters. Conclusion At present, the concentrations of trace elements in daily life water consumed in Angono are at safe levels.
Trace Elements