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Patient characteristics with high or low blood urea nitrogen in upper gastrointestinal bleeding

World Journal of Gastroenterology 2015年第24期21卷 7500-7505页

作者： Minoru Tomizawa Fuminobu Shinozaki Rumiko Hasegawa yoshinori shirai Yasufumi Motoyoshi Takao Sugiyama Shigenori Yamamoto Naoki Ishige Department of Gastroenterology National Hospital Organization Shimoshizu Hospital Department of Radiology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Surgery National Hospital Organization Shimoshizu Hospital Department of Neurology National Hospital Organization Shimoshizu Hospital Department of Rheumatology National Hospital Organization Shimoshizu Hospital Department of Pediatrics National Hospital Organization Shimoshizu Hospital Department of Neurosurgery National Hospital Organization Shimoshizu Hospital

AIM: To examine characteristics of patients with blood urea nitrogen(BUN) levels higher and lower than the normal ***: Patient records between April 2011 and March 2014 were analyzed retrospectively. During this time, 3296 patients underwent upper endoscopy. In total, 50 male(69.2 ± 13.2 years) and 26 female(72.3 ± 10.2 years) patients were assessed. Patients were divided into two groups based on BUN levels: higher than the normal limit(21.0 mg/d L)(H) and lower thanthe normal limit(L). One-way analysis of variance was performed to reveal differences in the variables between the H and L groups. Fisher's exact test was used to compare the percentage of patients with gastric ulcer or gastric cancer in the H and L ***: White blood cell count was higher in the H group than in the L group(P = 0.0047). Hemoglobin level was lower in the H group than in the L group(P = 0.0307). Glycated hemoglobin was higher in the H group than in the L group(P = 0.0264). The percentage of patients with gastric ulcer was higher in the H group(P = 0.0002). The H group contained no patients with gastric ***: Patients with BUN ≥ 21 mg/d L might have more severe upper gastrointestinal bleeding.

关键词： Blood urea nitrogen Forrest classification Hemoglobin White blood cell count

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Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding

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World Journal of Gastroenterology 2015年第20期21卷 6246-6251页

作者： Minoru Tomizawa Fuminobu Shinozaki Rumiko Hasegawa yoshinori shirai Yasufumi Motoyoshi Takao Sugiyama Shigenori Yamamoto Naoki Ishige Department of Gastroenterology National Hospital Organization Shimoshizu Hospital Department of Radiology National Hospital Organization Shimoshizu Hospital Department of Surgery National Hospital Organization Shimoshizu Hospital Department of Neurology National Hospital Organization Shimoshizu Hospital Department of Rheumatology National Hospital Organization Shimoshizu Hospital Department of Pediatrics National Hospital Organization Shimoshizu Hospital Department of Neurosurgery National Hospital Organization Shimoshizu Hospital

AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix patients had upper GI bleeding(Upper group) and 65 had lower GI bleeding(Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiveroperator characteristic(ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin(P = 0.023), total protein(P = 0.0002), and lactate dehydrogenase(P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen(BUN) was higher in the Upper group than in the Lower group(P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vslower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/d L, with a specificity of 93.0%.CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/d L.

关键词： Logistic regression analysis Likelihoodanalysis Receiver-operator characteristic analysis Blood urine nitrogen Hemoglobin

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Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding

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World Journal of Gastroenterology 2014年第5期20卷 1311-1317页

作者： Minoru Tomizawa Fuminobu Shinozaki Rumiko Hasegawa Akira Togawa yoshinori shirai Noboru Ichiki Yasufumi Motoyoshi Takao Sugiyama Shigenori Yamamoto Makoto Sueishi Department of Gastroenterology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Radiology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Surgery National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Neurology National Hos- pital Organization Shimoshizu Hospital Yotsukaido City Department of Rheumatology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Pediatrics National Hospital Organization Shimoshizu Hospital Yotsukaido City

AIM: To investigate the early upper gastrointestinal endoscopy(endoscopy) significantly reduces mortality resulting from upper gastrointestinal(GI) bleeding. METHODS: Upper GI bleeding was defined as 1a, 1b, 2a, and 2b according to the Forrest classification. The hemoglobin(Hb), and C-reactive protein(CRP) were examined at around the day of endoscopy and 3 mo prior to endoscopy. The rate of change was calculated as follows:(the result of blood examination on the day of endoscopy- the results of blood examination 3 mo prior to endoscopy)/(results of blood examination 3 mo prior to endoscopy). Receiver operating characteristic curves were created to determine threshold values. RESULTS: Seventy-nine men and 77 women were enrolled. There were 17 patients with upper GI bleeding: 12 with a gastric ulcer, 3 with a duodenal ulcer, 1 with an acute gastric mucosal lesion, and 1 with gastric cancer. The area under the curve(AUC), threshold, sensitivity, and specificity of Hb around the day of endoscopy were 0.902, 11.7 g/dL, 94.1%, and 77.1%, respectively, while those of CRP were 0.722, 0.5 mg/dL, 70.5%, and 73%, respectively. The AUC, threshold, sensitivity, and specificity of the rate of change of Hb were 0.851,-21.3%, 76.4%, and 82.6%, respectively, while those of CRP were 0.901, 100%, 100%, and 82.5%, respectively. CONCLUSION: Predictors for upper GI bleeding were Hb 21.3% and an increase in the CRP > 100%, 3 mo before endoscopy.

关键词： Receiver operating characteristic Area under curve

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Postoperative complications of umbilical loop colostomy for anorectal malformations in neonates compared with the conventional abdominal stoma: a non-randomized study

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World Journal of Pediatric Surgery 2019年第1期2卷 21-23页

作者： Tatsuma Sakaguchi yoshinori Hamada Takeshi shirai Hiroshi Hamada Yusuke Shigeta Yusuke Nakamura Takashi Doi Department of Surgery Kansai Medical UniversityOsakaJapan

background We previously reported a pilot study of temporary umbilical loop colostomy for neonates with intermediate-type anorectal malformations(ARM)and recommended this technique because of its cosmetic *** herein report the postoperative complications of umbilical stomas(US)compared with traditional abdominal stomas(AS).Methods From our institutional prospective database,we analyzed the patients with ARMs who underwent stoma creation at Kansai Medical University Hospital from January 1995 to November *** surgical technique used to create the US had been performed since *** US and AS were made for 12 and 27 patients with ARMs,*** postoperative complication rates in patients who underwent US and AS had no significant difference(17%and 11%,p=0.6).The complications comprised a wound infection(one case of US),ileus(one case each of US and AS),mucosal prolapse(one case of AS),and depression(one case of AS).No emergency surgery was required for these *** For patients with ARMs,the umbilicus appears to be a safe alternative site for temporary loop colostomy.

关键词： complications abdominal wound

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