Gastroenterology Research and Practice

Publications in this journal

• Article: Association of IS605 and cag-PAI of Helicobacter pylori Isolated from Patients with Gastrointestinal Diseases in Taiwan.

  Chih-Ho Lai, Chin-Lin Perng, Keng-Hsin Lan, Hwai-Jeng Lin
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  ABSTRACT: Background. The cag pathogenicity island (cag-PAI) is one of the most important virulent determinants of Helicobacter pylori. An insertion sequence (IS) element of cag-PAI (IS605) has been found to generate H. pylori strains with varying virulence. Aim. To evaluate the impact of IS605 and cag-PAI on H. pylori strains isolated from Taiwanese patients with severity of gastric diseases. Methods. H. pylori isolates were cultured from gastric biopsies from 99 patients with peptic ulcer, chronic gastritis, and gastric carcinoma. Six distinct, well-separated colonies were isolated from each patient and analyzed by genotyping. Results. cagA, cagE, cagM, cagT, orf10, and orf13 were found to be present in 90.0%-100.0% of the H. pylori isolates. A total deletion of cagA, cagE, cagM, cagT, orf10, and orf13 was found in 1 isolate (1.0%). The IS605 element was found to be positive in 15.2% of the isolates. The presence of IS605 was higher in H. pylori isolated from patients with gastric carcinoma (25.0%) than in patients with duodenal ulcer (6.5%) or chronic gastritis (6.3%) (P < 0.001). Conclusions. The majority of the patients examined had intact cag-PAI. IS605 was present in 15.2% and was higher in H. pylori isolated from patients with gastric carcinoma than in those with peptic ulcer.
  Gastroenterology Research and Practice 01/2013; 2013:356217.
• Article: Neurostimulation for neurogenic bowel dysfunction.

  J Worsøe, M Rasmussen, P Christensen, K Krogh
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  ABSTRACT: Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD). It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use. Methods. A systematic literature search of NBD treated by sacral anterior root stimulation (SARS), sacral nerve stimulation (SNS), peripheral nerve stimulation, magnetic stimulation, and nerve re-routing was made in Pubmed, Embase, Scopus, and the Cochrane Library. Results. SARS improves bowel function in some patients with complete spinal cord injury (SCI). Nerve re-routing is claimed to facilitate defecation through mechanical stimulation of dermatomes in patients with complete or incomplete SCI or myelomeningocele. SNS can reduce NBD in selected patients with a variety of incomplete neurological lesions. Peripheral stimulation using electrical stimulation or magnetic stimulation may represent non-invasive alternatives. Conclusion. Numerous methods of neurostimulation to treat NBD have been investigated in pilot studies or retrospective studies. Therefore, larger controlled trials with well-defined inclusion criteria and endpoints are recommended before widespread clinical use of neurostimulation against NBD.
  Gastroenterology Research and Practice 01/2013; 2013:563294.
• Article: GERD-Barrett-Adenocarcinoma: Do We Have Suitable Prognostic and Predictive Molecular Markers?

  Romana Illig, Eckhard Klieser, Tobias Kiesslich, Daniel Neureiter
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  ABSTRACT: Due to unfavorable lifestyle habits (unhealthy diet and tobacco abuse) the incidence of gastroesophageal reflux disease (GERD) in western countries is increasing. The GERD-Barrett-Adenocarcinoma sequence currently lacks well-defined diagnostic, progressive, predictive, and prognostic biomarkers (i) providing an appropriate screening method identifying the presence of the disease, (ii) estimating the risk of evolving cancer, that is, the progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC), (iii) predicting the response to therapy, and (iv) indicating an overall survival-prognosis for EAC patients. Based on histomorphological findings, detailed screening and therapeutic guidelines have been elaborated, although epidemiological studies could not support the postulated increasing progression rates of GERD to BE and EAC. Additionally, proposed predictive and prognostic markers are rather heterogeneous by nature, lack substantial proofs, and currently do not allow stratification of GERD patients for progression, outcome, and therapeutic effectiveness in clinical practice. The aim of this paper is to discuss the current knowledge regarding the GERD-BE-EAC sequence mainly focusing on the disputable and ambiguous status of proposed biomarkers to identify promising and reliable markers in order to provide more detailed insights into pathophysiological mechanisms and thus to improve prognostic and predictive therapeutic approaches.
  Gastroenterology Research and Practice 01/2013; 2013:643084.
• Article: Calprotectin Is a Useful Tool in Distinguishing Coexisting Irritable Bowel-Like Symptoms from That of Occult Inflammation among Inflammatory Bowel Disease Patients in Remission.

  Lars-Petter Jelsness-Jørgensen, Tomm Bernklev, Bjørn Moum
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  ABSTRACT: . In the inflammatory bowel diseases (IBDs), many symptoms are similar to the functional disorder irritable bowel syndrome (IBS). A challenge is thus to distinguish symptoms of IBD from IBS. The aim of this study was to investigate the levels of calprotectin in IBS-positive IBD patients in remission. . Remission was defined as a simple clinical colitis activity index (SCCAI) or simple crohn's disease activity index (SCDAI) score of less than three and less than four, respectively. The Rome II criteria were used to identify cases, and the calprotectin ELISA test was used to quantify calprotectin in stools. . The Rome II criteria were fulfilled in 24.6% of ulcerative colitis (UC) patients, while the comparable number for Crohn's disease (CD) was 21.4%. There was a tendency for elevated fecal calprotectin levels in IBS-positive patients, regardless of diagnosis. However, these differences were only significant in CD. . Calprotectin levels are elevated in subgroups of IBD patients that are in remission and have coexisting IBS-like symptoms. This study underscores the clinical usefulness of a noninvasive marker to distinguish patients in need of intensified followup from those that do not need further workup.
  Gastroenterology Research and Practice 01/2013; 2013:620707.
• Article: High or nonhigh doses of proton pump inhibitors for patients with peptic ulcer bleeding?

  Yu-Hsi Hsieh, Hwai-Jeng Lin
  Gastroenterology Research and Practice 01/2013; 2013:803139.
• Article: The Role of IL-6, 8, and 10, sTNFr, CRP, and Pancreatic Elastase in the Prediction of Systemic Complications in Patients with Acute Pancreatitis.

  E Fisic, G Poropat, L Bilic-Zulle, V Licul, S Milic, D Stimac
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  ABSTRACT: . Early assessment of severity in acute pancreatitis (AP) is a key measure to provide rational and effective management. The aim of our study is to determine the prognostic value of interleukins (IL) 6, 8, and 10, soluble receptor for tumor necrosis factor (sTNFr), pancreatic elastase (E1), and C-reactive protein (CRP) as predictors of systemic complications in AP. . A hundred and fifty patients with confirmed AP were enrolled in the study. The severity of AP was defined according to Atlanta criteria. Measurements of interleukins and sTNFr were performed on the first day of admission. CRP and E1 levels were assessed on admission and after 48 hours. ROC analysis was performed for all parameters. . Interleukins and sTNFr significantly differentiated patients with systemic complications from those without. Elevation of IL-6 showed the highest significance as a predictor ( = 0.001). CRP and elastase levels did not differ between mild and severe cases on admission, but reached statistical significance when measured on the third day ( = 0.002 and = 0.001, resp.). . Our study confirmed that IL-6, IL-8, IL-10, and sTNFr measured on admission, and CRP and pancreatic elastase measured on third day of admission represent valuable prognostic factors of severity and systemic complications of AP.
  Gastroenterology Research and Practice 01/2013; 2013:282645.
• Article: Expression Profiling of Proliferation and Apoptotic Markers along the Adenoma-Carcinoma Sequence in Familial Adenomatous Polyposis Patients.

  Jayson Wang, Nabil El-Masry, Ian Talbot, Ian Tomlinson, Malcolm R Alison, Mona El-Bahrawy
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  ABSTRACT: . Familial adenomatous polyposis (FAP) patients have a germline mutation in the adenomatous polyposis coli () gene. The APC protein interacts with beta-catenin, resulting in the activation of the Wnt signalling pathway. This results in alterations in cell proliferation and apoptosis. We investigated the expression of beta-catenin and related proliferation and apoptotic factors in FAP patients, exploring the expression along the adenoma-carcinoma sequence. . The expression of beta-catenin, p53, bcl-2, cyclin-D1, caspase-3, CD10, and Ki-67 proteins was studied by immunohistochemistry in samples of colonic nonneoplastic mucosa ( = 71), adenomas ( = 152), and adenocarcinomas ( = 19) from each of the16 FAP patients. . The expression of beta-catenin, caspase-3, cyclin-D1, and Ki-67 was increased in both adenomas and carcinomas in FAP patients, compared with normal mucosa. p53 and CD10 expression was only slightly increased in adenomas, but more frequently expressed in carcinomas. Bcl-2 expression was increased in adenomas, but decreased in carcinomas. . This is the first study investigating collectively the expression of these molecules together in nonneoplastic mucosa, adenomas, and carcinomas from FAP patients. We find that beta-catenin and related proliferative and apoptotic factors (cyclin-D1, bcl-2, caspase-3, and Ki-67) are expressed early in the sequence, in adenomas. However, p53 and CD10 are often expressed later in the sequence, in carcinomas.
  Gastroenterology Research and Practice 01/2013; 2013:107534.
• Article: Therapeutic endoscopic ultrasonography: intratumoral injection for pancreatic adenocarcinoma.

  Lawrence A Shirley, Laura K Aguilar, Estuardo Aguilar-Cordova, Mark Bloomston, Jon P Walker
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  ABSTRACT: Pancreatic adenocarcinoma is an aggressive disease that has poor outcomes despite maximal traditional therapies. Thus, treatment of this cancer demands innovative strategies to be used in addition to standing therapies in order to provide new avenues of care. Here, we describe the technique of using endoscopic ultrasound in order to directly inject both novel and conventional therapies into pancreatic tumors. We detail the rationale behind this strategy and the many benefits it provides. We then describe our technique in detail, including our experience injecting the AdV-tk adenoviral vector to create an in situ vaccine effect.
  Gastroenterology Research and Practice 01/2013; 2013:207129.
• Article: Prospective Study about the Utility of Endoscopic Ultrasound for Predicting the Safety of Endoscopic Submucosal Dissection in Early Gastric Cancer (T-HOPE 0801).

  Daisuke Kikuchi, Toshiro Iizuka, Shu Hoteya, Akihiro Yamada, Tsukasa Furuhata, Satoshi Yamashita, Kaoru Domon, Masanori Nakamura, Akira Matsui, Toshifumi Mitani, Osamu Ogawa, Mitsuru Kaise
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  ABSTRACT: Background. Intraoperative bleeding is an important determinant for safety of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study aimed to prospectively evaluate the usefulness of endoscopic ultrasound (EUS) for predicting ESD safety. Methods. A total of 110 patients with EGC were divided into two groups based on EUS findings: group P, almost no blood vessels in submucosa, or ≤4 small vessels per field of view; group R, remaining patients. Primary endpoint was the decrease in Hb after ESD. Secondary endpoints included procedure time and the incidence of muscle injury and clip use. Results. A total of 89 patients were evaluated. Fifty were classified into group P and 39 into group R. Mean decrease in Hb was 0.27 g/dL in group P and 0.35 g/dL in group R, with no significant difference. Mean procedure time was significantly longer in group R (105.4 min) than in group P (65.5 min) (P < 0.001). The incidence of muscle injury and clip use were significantly higher in group R (25.6%/48.7%) than in group P (8.0%/20.0%) (P = 0.02/P = 0.004). Conclusion. Preoperative EUS can predict procedure time and the incidence of muscle injury and clip use and is thus considered useful for predicting gastric ESD safety.
  Gastroenterology Research and Practice 01/2013; 2013:329385.
• Article: PCR-Based Detection and Genotyping of Helicobacter pylori in Endoscopic Biopsy Samples from Brazilian Patients.

  Silvia M Ferreira Menoni, Sandra Helena Alves Bonon, José Murilo Robilota Zeitune, Sandra Cecília Botelho Costa
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  ABSTRACT: Helicobacter pylori (H. pylori) is considered the second most prevalent infection in man. A precise diagnosis is important for treating patients with the indicative gastrointestinal symptoms. The present study analyzes the effectiveness of a molecular biology method (PCR) comparing the results obtained with the histology and with the rapid urease tests. PCR was used in the detection and genotyping of the H. pylori urease-C gene and the patterns which were obtained from the patients studied. 141 biopsy samples from 131 patients were evaluated. 59 paraffin biopsies samples were positive for H. pylori according to the histological examination. Of those, 59/12 (20.3%) were amplified using PCR. Of the 82 samples from the fresh biopsies, 64 were positive for H. pylori according to the rapid urease test (78%); there was an agreement of 100% with PCR. Sixty positive H. pylori samples were genotyped (58 samples of fresh biopsies and 2 samples of paraffin biopsies) using two restriction enzymes. The patterns observed were analyzed with the computational program BIO 1D; 11 patterns with the enzyme HhaI and 12 patterns with the enzyme MboI were found. However, it was not possible to find a statistically significant correlation between the specific genotypes and digestive pathologies. Accordingly, future research should be performed to confirm a statistically significant relationship between genotyping and gastrointestinal symptoms.
  Gastroenterology Research and Practice 01/2013; 2013:951034.
• Article: The prevalence of functional gastrointestinal disorders in the chinese air force population.

  Wenming Wu, Xu Guo, Yunsheng Yang, Lihua Peng, Gaoping Mao, Hyder Qurratulain, Weifeng Wang, Gang Sun
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  ABSTRACT: Background. Functional gastrointestinal disorders (FGIDs) are common in the general population worldwide. However, there is paucity of large sale surveys for prevalence of FGID in the military personnel. Methods. It is a cross-sectional study, using Rome III criteria for the diagnosis of FGID among the Chinese Air Force (CAF) workers. Results. Of 4633 registered male subjects, there were 818 (16.4%) air crew and 4170 (83.6%) ground personnel. FGIDs were identified in 1088 (23.48%) of cases. It was more prevalent in the ground personnel than air crew (24.02% versus 20.33%; P = 0.022). Based on Rome III criteria, the commonest disease category was functional gastroduodenal disorder (37.4%), whereas functional nausea and vomiting disorder (FNV) was the most frequent overall diagnosis. Functional dyspepsia (FD) with irritable bowel syndrome (IBS) was the leading FGIDs' overlap (3.9%). Conclusion. FGIDs in CAF population are rather underestimated. This necessitates preventive strategies according to job characteristics.
  Gastroenterology Research and Practice 01/2013; 2013:497585.
• Article: Efficacy and Tolerability of Peginterferon α -2a and Peginterferon α -2b, Both plus Ribavirin, for Chronic Hepatitis C: A Meta-Analysis of Randomized Controlled Trials.

  Zongguo Yang, Liping Zhuang, Lei Yang, Xiaorong Chen
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  ABSTRACT: Background. The efficacy and tolerability of peginterferon α -2a and peginterferon α -2b in chronic hepatitis C (CHC) patients remain controversial. Methods. PubMed, Ovid, and Cochrane libraries were electronically searched until August 30, 2012. Studies that met the inclusion criteria were systematically evaluated by two reviewers independently. Results. The overall sustained virologic response (SVR) rate of the peginterferon α -2a group was significantly higher than that of the peginterferon α -2b group (46.7% versus 42.4%, P value = 0.01). The same tendency was observed for naïve, genotype 1/4, and genotype 2/3 patients. The early virologic response (EVR) and end-of-treatment response (ETR) rates were significantly higher in the peginterferon α -2a group than in the peginterferon α -2b group (56.1% versus 49.8%, P < 0.0001; 67.9% versus 56.6%, P < 0.00001, resp.). Peginterferon α -2a had a significantly lower discontinuation rate than peginterferon α -2b (27.9% versus 33.9%, P < 0.0001) in naïve patients. In both naïve CHC and hepatitis C virus genotype 1 patients, peginterferon α -2a had a higher relapse rate than peginterferon α -2b. Conclusions. Peginterferon α -2a has superior efficacy with higher EVR, ETR, and SVR than peginterferon α -2b for CHC patients, both plus ribavirin. Peginterferon α -2a might obtain a similar or even lower discontinuation rate than peginterferon α -2b. However, peginterferon α -2a had a higher relapse rate than peginterferon α -2b.
  Gastroenterology Research and Practice 01/2013; 2013:739029.
• Article: The Diagnostic Significance of Coapplying a Rabeprazole Test with the SF-36 for Gastroesophageal Reflux Disease.

  Ying Chen, Feng Wang, Yuanxi Jiang, Chen Wang, Liwen Yao, Ping Wu, Yili Tong, Huihui Sun, Shuchang Xu
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  ABSTRACT: Gastroesophageal reflux disease is a diversity disease that affects life quality of people in the world. Due to the complicated pathogenesis and variations in clinical manifestations, there is still no true gold standard for GERD diagnosis, and it is still difficult to diagnose this disease in some patients. The proton pump inhibitor's diagnostic test (the PPI test) is noninvasive, of low cost, tied to treatment, and widely accepted. Our aim is to evaluate the diagnostic significance of coapplying a rabeprazole test with the SF-36 for GERD in this study. Our study shows that the SF-36 in combination with the rabeprazole test can screen GERD patients and increase the sensitivity and specificity of GERD diagnosis through reference to the change in SF-36 score before and after the treatment (65 in the trial).
  Gastroenterology Research and Practice 01/2013; 2013:419375.
• Article: Endoscopic submucosal dissection for early colorectal neoplasms: clinical experience in a tertiary medical center in taiwan.

  Mei-Yu Tseng, Jung-Chun Lin, Tien-Yu Huang, Yu-Lueng Shih, Heng-Cheng Chu, Wei-Kuo Chang, Tsai-Yuan Hsieh, Peng-Jen Chen
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  ABSTRACT: Objectives. Endoscopic submucosal dissection (ESD) is a promising technique to treat early colorectal neoplasms by facilitating en bloc resection without size limitations. Although ESD for early gastrointestinal epithelial neoplasms has been popular in Japan, clinical experience with colorectal ESD has been rarely reported in Taiwan. Methods. From March 2006 to December 2011, 92 consecutive patients with early colorectal neoplasms resected by ESD at Tri-Service General Hospital were included. ESD was performed for colorectal epithelial neoplasms with a noninvasive pit pattern which had the following criteria: (1) lesions difficult to remove en bloc with a snare, such as laterally spreading tumors-nongranular type (LST-NG) ≧20 mm and laterally spreading tumors-granular type (LST-G) ≧30 mm; (2) lesions with fibrosis or which had recurred after endoscopic mucosal resection with a nonlifting sign. Results. The mean age of the patients was 66.3 ± 12.9 years, and the male-female ratio was 1.8 : 1. The mean tumor size was 37.2 ± 17.9 mm. The en bloc resection rate was 90.2% and the R0 resection rate was 89.1%. Perforations during ESD occurred in 11 patients (12.0%) and all of them were effectively treated by endoscopic closure with hemoclips. No delayed perforation or postoperative bleeding was recorded. There were no procedure-related morbidities or mortalities. Conclusion. ESD is an effective method for en bloc resection of large early colorectal neoplasms and those with a nonlifting sign. An endoscopic technique to close perforations is essential for colorectal ESD.
  Gastroenterology Research and Practice 01/2013; 2013:891565.
• Article: Serum prohepcidin levels are lower in patients with atrophic gastritis.

  Hyung-Keun Kim, Eun-Chul Jang, Ju-Ok Yeom, Sun-Young Kim, Hyunjung Cho, Sung Soo Kim, Hiun-Suk Chae, Young-Seok Cho
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  ABSTRACT: Background/Aim. Hepcidin, an iron regulatory hormone, is increased in response to inflammation and some infections. We investigated the relationships among serum prohepcidin, iron status, Helicobacter pylori infection status, and the presence of gastric mucosal atrophy. Methods. Seventy subjects undergoing esophagogastroduodenoscopy underwent multiple gastric biopsies, and the possibility of H. pylori infection and the degree of endoscopic and histologic gastritis were investigated. In all subjects, serum prohepcidin and iron parameters were evaluated. Results. No correlations were observed between serum prohepcidin levels and the other markers of anemia, such as hemoglobin, serum iron, ferritin, and total iron binding capacity. Serum prohepcidin levels were not significantly different between the H. pylori-positive group and the H. pylori-negative group. Serum prohepcidin levels in atrophic gastritis patients were significantly lower than those in subjects without atrophic gastritis irrespective of H. pylori infection. Conclusion. Serum prohepcidin levels were not altered by H. pylori infection. Serum prohepcidin levels decrease in patients with atrophic gastritis, irrespective of H. pylori infection. It suggests that hepcidin may decrease due to gastric atrophy, a condition that causes a loss of hepcidin-producing parietal cells. Further investigations with a larger number of patients are necessary to substantiate this point.
  Gastroenterology Research and Practice 01/2013; 2013:201810.
• Article: Incidence, mortality, and predictive factors of hepatocellular carcinoma in primary biliary cirrhosis.

  Kenichi Hosonuma, Ken Sato, Masatoshi Yanagisawa, Satoru Kakizaki, Hitoshi Takagi, Junko Hirato, Masatomo Mori
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  ABSTRACT: Background. The study aims to analyze in detail the incidence, mortality using the standardized incidence ratio (SIR), and standardized mortality ratio (SMR) of hepatocellular carcinoma (HCC) in primary biliary cirrhosis (PBC), because no large case studies have focused on the detailed statistical analysis of them in Asia. Methods. The study cohorts were consecutively diagnosed at Gunma University and its affiliated hospitals. Age- or sex-specific annual cancer incidence and deaths were obtained from Japanese Cancer Registry and Death Registry as a reference for the comparison of SIR or SMR of HCC. Moreover, univariate analyses and multivariate analyses were performed to clarify predictive factors for the incidence of HCC. Results. The overall 179 patients were followed up for a median of 97 months. HCC had developed in 13 cases. SIR for HCC was 11.6 (95% confidence interval (CI), 6.2-19.8) and SMR for HCC was 11.2 (95% CI, 5.4-20.6) in overall patients. The serum albumin levels were a predictive factor for the incidence of HCC in overall patients. Conclusions. The incidence and mortality of HCC in PBC patients were significantly higher than those in Japanese general population. PBC patients with low serum albumin levels were populations at high risk for HCC.
  Gastroenterology Research and Practice 01/2013; 2013:168012.
• Article: Changes in Antibiotic Susceptibility of Helicobacter pylori in the Course of Eight Years in the Zaanstreek Region in The Netherlands.

  R J L F Loffeld, B F M Werdmuller
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  ABSTRACT: Background. Failure of anti-Helicobacter therapy is the result noncompliance and resistance to the prescribed antibiotics. Aim. Antibiotic susceptibility of H. pylori was determined in native Dutch patients and patients of Turkish descent. Methods. In a period of eight years a total of 925 strains of H. pylori were cultured. Bacterial susceptibility was successfully determined in 746 (80.6%) of these isolates. Three hundred and nine strains (33%) originated from patients of Turkish descent. Results. In total clarithromycin resistance was found in 146 (20.5%) strains, metronidazole resistance in 147 (19.9%) strains. Amoxicillin resistance was found to be present in five strains. There is a slight but nonsignificant decrease in the percentage of clarithromycin-resistant strains in the consecutive period of eight years from 20% to 18%. No changes were seen in the consecutive years in metronidazole resistance. The number of clarithromycin-resistant strains decreased in Turkish patients, not in native Dutch patients. Conclusion. Resistance did not change significantly in consecutive years. But clinicians should take not only the antibiotic history into account but also ethnicity before prescribing metronidazole or clarithromycin.
  Gastroenterology Research and Practice 01/2013; 2013:625937.
• Article: Hyponatremia is a specific marker of perforation in sigmoid diverticulitis or appendicitis in patients older than 50 years.

  S A Käser, R Furler, D C Evequoz, C A Maurer
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  ABSTRACT: . This study aimed to evaluate symptoms and signs, inflammation markers, electrolytes, and ECG signs of increased vagal tone as markers of colon perforation in sigmoid diverticulitis or appendicitis. . The records of all patients older than fifty years (only these had routine ECG done) admitted to our emergency station between January 2008 and December 2010 with sigmoid diverticulitis ( = 198, diagnosed by computer tomography) or appendicitis ( = 84, diagnosed intraoperatively) were retrospectively evaluated. Pain score, heart rate, blood pressure, and body temperature were assessed at presentation. Before starting infusion therapy, blood was taken to do a blood count and to analyze CRP, the electrolytes, and creatinine levels. Then an ECG was done. . The perforation rate was 37% ( = 103). Body temperature, heart rate, sodium, CRP, and leukocytes correlated significantly with infectious colon perforation. However, only body temperature, CRP, and sodium correlated significantly with infectious colon perforation if compared by logistic regression analysis. The prevalence of hyponatremia (sodium level <136 mmol/L) was 29% in the group with infectious colon perforation and 16% in the group without ( = 0.013). . Hyponatremia is a specific marker of infectious colon perforation in patients older than fifty years.
  Gastroenterology Research and Practice 01/2013; 2013:462891.