Cancer-promoting proinflammatory microenvironment influences colorectal cancer (CRC) development. We examined the biomarkers of inflammation, intestinal differentiation, and DNA activity correlated with the clinical parameters to observe progression and prognosis in the adenocarcinoma subtype of CRC. Their immunohistology, immunoblotting, and RT-PCR analyses were performed in the adenocarcinoma and neighboring healthy tissues of 64 patients with CRC after routine colorectal surgery. Proinflammatory nuclear factor kappa B (NFκB) signaling as well as interleukin 6 (IL-6) and S100 protein levels were upregulated in adenocarcinoma compared with nearby healthy colon tissue. In contrast to nitrotyrosine expression, the oxidative stress marker 8-Hydroxy-2′-deoxyguanosine (8-OHdG) was increased in adenocarcinoma tissue. Biomarkers of intestinal differentiation β-catenin and mucin 2 (MUC2) were inversely regulated, with the former upregulated in adenocarcinoma tissue and positively correlated with tumor marker CA19-9. Downregulation of MUC2 expression correlated with the increased 2-year survival rate of patients with CRC. Proliferation-related mammalian target of rapamycin (mTOR) signaling was activated, and Ki67 frequency was three-fold augmented in positive correlation with metastasis and cancer stage, respectively. Conclusion: We demonstrated a parallel induction of oxidative stress and inflammation biomarkers in adenocarcinoma tissue that was not reflected in the neighboring healthy colon tissue of CRC. The expansiveness of colorectal adenocarcinoma was confirmed by irregular intestinal differentiation and elevated proliferation biomarkers, predominantly Ki67. The origin of the linked inflammatory factors was in adenocarcinoma tissue, with an accompanying systemic immune response.

The use of negative pressure in wound therapy is an innovative therapeutic method that accelerates the wound healing process. This technique is applied to various types of acute and chronic wounds and can shorten their healing time and improve the quality of the scars. Negative pressure therapy acts on the wound by improving blood circulation, reducing swelling, promoting the growth of granulation tissue, reducing the risk of infection, and improving the quality of scar formation. At the molecular level, negative pressure increases the expression of cytokines and growth factors that promote angiogenesis, extracellular matrix remodeling, and tissue regeneration. Negative pressure therapy, as one of the techniques for temporary abdominal closing, is used in situations where the abdominal cavity must remain open for some time, in complex injuries, infections, and where there is a risk of compartment syndrome. In recent years, endoscopic vacuum therapy, a minimally invasive modality of treatment in colorectal surgery and surgery of the upper gastrointestinal tract, has emerged. The possibilities of this therapy have not been completely exhausted. In addition to its multiple applications, it has been shown that negative pressure therapy reduces treatment costs, shortens the duration of hospital stay, and enables faster patient recovery.

BACKGROUND: Acute appendicitis is one of the most common conditions in emergency surgery and appendectomy is the most frequently performed surgical procedure. The complexity of this pathology is reflected in the numerous congenital malformations and anatomical variations of the vermiform appendix. Anatomical variations are mainly related to its length and position. The average length of the appendix was found to be 9.5 cm in the male and 8.7 cm in the female, but different length has been reported, from 1 cm to even a 33 cm on the cadaver. CASE PRESENTATION: A 34-year-old man was admitted to the general surgery department due to symptoms that began the previous day. The patient complained of lumbar pain which later migrated to the periumbilical region and the right lower quadrant (RLQ) of the abdomen followed by fever, nausea, and vomiting. On clinical examination, he had a tenderness in RLQ with abdominal guarding. Laboratory analyzes showed leukocytosis and high markers of inflammation. Urinalysis and abdominal ultrasound were normal. Taking into consideration the clinical presentation and laboratory parameters, a decision was made to proceed for an open appendectomy. Intraoperatively, the appendix was inflamed, very long, partly retrocaecal, and partly paracolic in position, with two coils, extending upward. After dividing the mesoappendix, it measured 20 cm in length. The appendectomy was performed. Post-operative recovery was without complications. The patient was discharged from the hospital on the 3rd post-operative day. CONCLUSION: Although acute appendicitis is very frequent condition in emergency surgery, making the diagnosis could be challenging due to numerous differential diagnostic dilemmas. The position of the appendix and direction of its extension could lead to misdiagnosis. The synthesis of clinical examination, laboratory analyzes, and diagnostic procedures should lead clinicians to the right diagnosis and surgical treatment, avoiding possible complications and additional costs.