Aim. To investigate the role of a novel oxidative stress marker, thiol/disulphide homeostasis, in patients diagnosed with acute appendicitis (AA). Methods. In this study, seventy-one (43 male and 28 female) patients diagnosed with AA and 71 (30 male and 41 female) healthy volunteers were included. Age, gender, body mass index (BMI), haemoglobin (Hb), white blood cell (WBC), c-reactive protein (CRP), and thiol/disulphide homeostasis parameters (native thiol, total thiol, disulphide, disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol ratios) were compared between the groups. Thiol/disulphide homeostasis was determined by a newly developed method by Erel and Neselioglu. Results. The native thiol, total thiol, and the native thiol/total thiol ratio levels were statistically significantly decreased in the AA compared with the control group (p < 0.001). Disulphide level and the ratios of disulphide/native thiol and disulphide/total thiol were higher in the AA group than in the control group (p < 0.001). There was a negative correlation of CRP with native thiol, total thiol, and native thiol/total thiol ratio while there was a positive correlation of CRP with disulphide/native thiol and disulphide/total thiol in the AA group. In the stepwise regression model, risk factors as disulphide/native thiol (OR = 1.368; p = 0.018) and CRP (OR = 1.635; p = 0.003) were determined as predictors of perforated appendicitis compared to the nonperforated group. Conclusion. This is the first study examining the thiol/disulphide homeostasis as a diagnostic aid in AA and establishing thiol/disulphide homeostatis balance shifted towards the disulphide formation due to thiol oxidation. Further studies are needed to optimize the use of this novel oxidative stress marker in AA.

Purpose 5-flourourasil (5-FU) is commonly used for early intraperitoneal chemotherapy in colorectal or appendiceal cancer patients with peritoneal carcinomatosis. Due to its effect, anastomosis healing can be impaired and leads to anastomotic leakage. In this study, we aimed to investigate the potential healing effect of platelet-rich plasma (PRP) on colonic anastomosis impaired by intraperitoneal 5-flourouracil application. Methods After ten rats were sacrificed for preparing PRP, forty Wistar-albino rats were subjected to colonic anastomosis, and randomly allocated into four groups including 10 rats each. According to receiving PRP and/or 5-FU application, the groups were formed as control (C), 5-FU without PRP (CT), anastomosis with PRP (C-PRP), and 5-FU with PRP (CT-PRP). CT and CT-PRP groups also received 5-FU intraperitoneally on postoperative day 1 (POD 1). All animals were euthanized on pod 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxiprolin (TH) and histopathological examination of each group were analyzed. Results 5-FU application significantly reduced ABP levels when compared with group C, C-PRP and CT-PRP (for each comparison, p<0,01). PRP application in CT-PRP group raised the measure of ABP up to the levels of C group. Although tissue hydroxyproline levels (THL) levels of CT-PRP group were found higher than CT group, it was not significant (p=0.112). Microscopically, comparing with CT group, PRP application significantly promoted the healing of colonic anastomosis subjected to 5-FU application by improving tissue edema, necrosis, submucosal bridging and collagen formation (p<0.05). Tissue healing in CT-PRP group was observed as good as the control groups. (C, C-PRP, p=0.181, p=0.134; respectively). Conclusion PRP administration on colonic anastomosis significantly promotes the healing process of anastomosis in rats receiving 5-FU. This result encourages further clinical use of PRP to reduce the frequency of AL in patients receiving EPIC.

Erkeklerde meme kanseri görülme sıklığı yaklaşık %1'in altında olup oldukça nadirdir. Kadınlardan farklı olarak yaşla birlikte görülme sıklığı artmaktadır. Erkeklerde meme karsinomunun klinikopatolojik özelliklerini, cerrahi ve rekonstrüktif tekniklerini, adjuvan tedavilerini ve klinik sonuçlarını değerlendirmeyi amaçladık GEREÇ VE YÖNTEM: Ocak 2010-ağustos 2020 tarihleri arasında Osmangazi Üniversitesi Genel Cerrahi Kliniğinde ve Yunus Emre Devlet Hastanesi Genel Cerrahi Bölümünde tedavi edilmiş meme kanseri hastaları retrospektif olarak incelendi. BULGULAR: 16 erkek meme kanseri olgusuna rastlandı. Hastaların klinik, patolojik, adjuvan tedavi, nüks ve sağ kalımlarına ait özellikler kayıt edildi. Ortanca yaş 62 idi. En sık prezentasyon şekli sağ memede retroareolar (%62) bölgede ele gelen kitleydi (%68). Hormon reseptör pozitif (%75-95) ve grade 2 (%62) yaygın görülen özellikti. Küratif cerrahi 15 hastaya yapıldı, 1 hasta metastatik olması nedeniyle palyatif tuvalet mastektomi yapıldı. En yaygın cerrahi işlem olarak modifiye radikal mastektomi (MRM) (%88) yapıldı. Bir hastaya muskülokütanöz flep ile rekonstrüksiyon yapıldı. Ortanca takip süresi 53 aydı. Takip süresince 3 hastada (%19) lokal nüks görülürken 6 hasta (%38) kaybedilmiştir. Bunlardan 4 hastanın (%25) kansere bağlı öldüğü kaydedildi. SONUÇ: Erkeklerde meme kanseri nadir görüldüğü, jinekomasti gibi benign hastalıklarla karışabildiği ve erkeklerde meme kanserinin görülmediği algısı yüzünden geç fark edilir. Bu nedenle de tanı konduğunda sıklıkla ileri evrede karşılaşılabilmekte, lokal nüks ve mortalite oranları daha yüksek gözlenmektedir. Bu durum, erkeklerin dikkatini çekmeyi ve bu hastalığın prevalansı ve risk faktörleri konusunda bilinçlenmeyi gerektirir.

Evaluation of lymphatic spread in early stage breast cancer without clinical and radiological evidence of metastasis can be performed by sentinel lymph node biopsy (SLNB). However, controversies about performing the SLNB in patients who have a history of major breast or axillary region surgery keep going. This case report presents the outcomes of a SLNB performed on a 42-year-old woman who had been previously treated with bilateral nipple and skin-sparing mastectomy and breast reconstruction with areolar complex transfer and silicone breast implants. 0.5% diluted methylene blue solution was injected intradermally as a marker. SLNB is an inexpensive and effective method for adequate axillary evaluation in cases with previous mastectomy history. Intradermal injection of 0.5% diluted methylene blue could reduce the risk of skin necrosis and breast prosthesis rupture.