The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

<p><b>BACKGROUND:</b> The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT) and C-reactive protein (CRP) measurements in the acute appendicitis.</p><p><b>METHODS:</b> This prospective study was conducted between March 1^st, 2010 and July 1^st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1), gangrenous appendicitis (Group 2), perforated appendicitis (Group 3) and negative appendectomy (Group 4) according to the surgical findings and histopathological results.</p><p><b>RESULTS:</b> Of 78 patients, 54 (69.2 %) were male and 24 (30.8 %) were female, and the mean age was 25.4 &#177; 11.1 years (range, 18 to 69 years). 66 (84.6 %) patients had increased leukocyte count (white blood cell count). The PCT values were higher than the upper normal limit in 20 (25.6%) patients, followed by D-dimer in 22 (28.2 %) patients and CRP in 54 (69.2 %) patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p&#60;0.05). However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively).</p><p><b>CONCLUSION:</b> An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.</p

Paraoxonase and Arylesterase Activities, Lipid Profile, and Oxidative Damage in Experimental Ischemic Colitis Model

Objective. In the present study, since PON1 is known as an HDL-associated antioxidant enzyme that inhibits the oxidative modification of LDL and oxidative stress plays a role in the pathogenesis of mesenteric ischemia, we investigated the changes in PON1 activity and lipid profile in an experimental ischemic colitis model. Methods. Forty male Wistar albino rats were divided into two groups: the control group (N=15) and the experimental group (N=25). All animals were anesthetized with ether and ketamine anesthesia to undergo a midline laparotomy. Ischemic colitis was induced by marginal vessel ligation in the splenic flexura (devascularization process). A sham laparotomy was performed in the control group. All animals were sacrificed on the seventh postoperative day. Oxidative stress marker (malonyldialdehyde, MDA), lipid profile, and paraoxonase (PON-1) and arylesterase activities were determined. Histopathological evaluation was done under light microscopy, after sectioning and staining with hematoxyline and eosin. Statistical analysis was conducted using Student’s t-test and Mann-Whitney U test, and P<0.05 was considered as statistically significant. Results. There was a significant decrease in both serum and tissue PON1 activity in ischemic colitis group (P<0.01, for each). Similarly, arylesterase levels showed a parallel decrease in both tissue and serum of the experimental group (P<0.01 and P<0.001, retrospectively). MDA, an oxidative stress marker, was seen to increase in the experimental group (P<0.01, tissue; P<0.05, serum). In experimental group, there was a significant rise in serum total cholesterol and LDL levels (P<0.001, for each). However, HDL level decreased significantly (P<0.001). Triglycerides did not show any change between the groups (P>0.05). Conclusions. PON1 and arylesterase play an important role in the pathophysiology of ischemic colitis

Paraoxonase and Arylesterase Activities, Lipid Profile, and Oxidative Damage in Experimental Ischemic Colitis Model

Objective. In the present study, since PON1 is known as an HDL-associated antioxidant enzyme that inhibits the oxidative modification of LDL and oxidative stress plays a role in the pathogenesis of mesenteric ischemia, we investigated the changes in PON1 activity and lipid profile in an experimental ischemic colitis model. Methods. Forty male Wistar albino rats were divided into two groups: the control group (N = 15) and the experimental group (N = 25). All animals were anesthetized with ether and ketamine anesthesia to undergo a midline laparotomy. Ischemic colitis was induced by marginal vessel ligation in the splenic flexura (devascularization process). A sham laparotomy was performed in the control group. All animals were sacrificed on the seventh postoperative day. Oxidative stress marker (malonyldialdehyde, MDA), lipid profile, and paraoxonase (PON-1) and arylesterase activities were determined. Histopathological evaluation was done under light microscopy, after sectioning and staining with hematoxyline and eosin. Statistical analysis was conducted using Student's t-test and Mann-Whitney U test, and P 0.05).Conclusions. PON1 and arylesterase play an important role in the pathophysiology of ischemic colitis

Effect of Laparoscopic Greater Curve Plication on Glucose and Lipid Metabolism in Turkish Obese Subjects

Background: In obese subjects with type 2 diabetes mellitus (T2DM), the effect of laparoscopic greater curvature plication (LGCP) on the clinical improvement of T2DM is unknown. This study aims to investigate the effect of LGCP in improving the clinical profile of patients with T2DM

Effect of Laparoscopic Greater Curve Plication on Glucose and Lipid Metabolism in Turkish Obese Subjects

Background: In obese subjects with type 2 diabetes mellitus (T2DM), the effect of laparoscopic greater curvature plication (LGCP) on the clinical improvement of T2DM is unknown. This study aims to investigate the effect of LGCP in improving the clinical profile of patients with T2DM