title: Correlation between the serum and tissue levels of oxidative stress markers and the extent of inflammation in acute appendicitis.
abstract: OBJECTIVE
  To determine the serum and tissue levels of markers of impaired oxidative metabolism and correlate these levels with the histopathology and Alvarado score of acute appendicitis patients.
  
  
  METHODS
  Sixty-five acute appendicitis patients (mean age, 31.4±12.06 years; male/female, 30/35) and 30 healthy control subjects were studied. The Alvarado score was recorded. Serum samples were obtained before surgery and 12 hours postoperatively to examine the total antioxidant status, total oxidant status, paraoxonase, stimulated paraoxonase, arylesterase, catalase, myeloperoxidase, ceruloplasmin, oxidative stress markers (advanced oxidized protein products and total thiol level) and ischemia-modified albumin. Surgical specimens were also evaluated.
  
  
  RESULTS
  The diagnoses were acute appendicitis (n = 37), perforated appendicitis (n = 8), phlegmonous appendicitis (n = 12), perforated+phlegmonous appendicitis (n = 4), or no appendicitis (n = 4). The Alvarado score of the acute appendicitis group was significantly lower than that of the perforated+phlegmonous appendicitis group (p = 0.004). The serum total antioxidant status, total thiol level, advanced oxidized protein products, total oxidant status, catalase, arylesterase, and ischemia-modified albumin levels were significantly different between the acute appendicitis and control groups. There was no correlation between the pathological extent of acute appendicitis and the tissue levels of the markers; additionally, there was no correlation between the tissue and serum levels of any of the parameters.
  
  
  CONCLUSIONS
  The imbalance of oxidant/antioxidant systems plays a role in the pathogenesis acute appendicitis. The Alvarado score can successfully predict the presence and extent of acute appendicitis.
authors.affiliation: Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Ersin Gürkan
authors.initials: EG
authors.lastname: Dumlu
authors.affiliation: Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tokaç
authors.affiliation: Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Birkan
authors.initials: B
authors.lastname: Bozkurt
authors.affiliation: Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Murat Baki
authors.initials: MB
authors.lastname: Yildirim
authors.affiliation: Department of Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Ergin
authors.affiliation: Department of General Surgery, Yildirim Beyazit University Faculty of Medicine, Bilkent, Ankara, Turkey.
authors.forename: Abdussamed
authors.initials: A
authors.lastname: Yalçin
authors.affiliation: Department of General Surgery, Yildirim Beyazit University Faculty of Medicine, Bilkent, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kiliç
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000032:analysis; D001062:Appendectomy; D001064:Appendicitis / Q000378:metabolism*; D043303:Aryldialkylphosphatase / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D002265:Carboxylic Ester Hydrolases / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D010544:Peroxidases / Q000032:analysis; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000032:analysis* / Q000378:metabolism; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D017382:Reactive Oxygen Species; D012709:Serum Albumin; C561522:ischemia-modified albumin; D010544:Peroxidases; D002265:Carboxylic Ester Hydrolases; C019734:arylesterase; D043303:Aryldialkylphosphatase; D000075462:Serum Albumin, Human