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    Erythrocyte and plasma superoxide dismutase activities in acute appendicitis
    (1998) Koltuksuz U.; Uz E.; Gursoy H.; Demircan M.; Aydinc M.; Mutus M.; Cetin S.
    Although the role of oxygen free radicals in many inflammatory diseases has been well known, it has not been thoroughly investigated in the inflammatory diseases, of the abdomen. In order to investigate the possible role of oxygen free radicals in the mechanism of progression following the onset of inflammation, blood samples from 18 patients diagnosed as acute appendicitis and 10 healthy children as controls were collected. After plasma and erythrocytes of the blood samples were separated, superoxide dismutase (SOD) activities were measured in these compartments. Additionally, the patients with appendicitis were divided into perforated (n=8), and nonperforated (n=10) subgroups, according to intraoperative examination findings and histopathological classification. SOD activities were compared statistically between these two groups, and the control group. A significant difference in SOD activity between perforated and nonperforated appendicitis in both plasma and erythrocyte was observed (plasma: 4.2±1.7 and 2.0±0.7 U/ml, p<0.05; erythrocyte: 1690.7±799.6 and 1104.2±225.1 U/grHb, p<0.05). The difference between the nonperforated group and control group was not significant, whereas there was a significant difference between the perforated and control groups (plasma: 4.2±1.7 and 2.6±0.9 U/ml, p<0.05; erythrocyte: 1690.7±799.6 and 1148.8±152.2 U/grHb, p<0.05). According to these results, we may speculate that free oxygen radicals released from polymorphonuclear leucocytes following an inflammatory condition may play an important role in the progression of acute appendicitis with the contribution of some other possible factors.
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    Plasma D-lactic acid level: A useful marker to distinguish perforated from acute simple appendicitis
    (Elsevier (Singapore) Pte Ltd, 2004) Demircan M.; Cetin S.; Uguralp S.; Sezgin N.; Karaman A.; Gozukara E.M.
    Early diagnosis of perforated appendicitis is important for reducing morbidity rates. The aim of this study was to determine the value and utility of plasma D-lactic acid levels in identifying the type of appendicitis. In this clinical study, plasma D-lactic acid levels were assessed in 44 consecutive paediatric patients (23 with acute appendicitis, 21 with perforated appendicitis) before laparotomy. D-lactic acid levels were determined by an enzymatic spectrophotometric technique using a D-lactic acid dehydrogenase kit. Patients with perforated appendicitis had higher D-lactic acid levels (3.970 ±0.687 mg/dL) than patients in the control group (0.478 ± 0.149 mg/dL) and patients with acute appendicitis (1.409 ±0.324 mg/dL; p < 0.05). For a plasma D-lactic acid level greater than 2.5 mg/dL, the sensitivity and specificity of the D-lactic acid assay were 96% and 87%, respectively. The positive predictive value was 87%, the negative predictive value was 96%, and the diagnostic value was 91%. These results suggest that the measurement of plasma D-lactic acid levels may be a useful adjunct to clinical and radiological findings in distinguishing perforated from acute non-perforated appendicitis in children.