Comparison of 'primary repair' and 'placing a drain without repair' methods in duodenum perforations.

BACKGROUND: Duodenal ulcer perforation is a serious condition. A number of methods have been defined and used in surgical treatment. In this study, it was aimed to compare the effectiveness of 'primary repair' and 'drain placement without repair' methods in duodenal perforations using an animal model. METHODS: Three equivalent groups of ten rats each were formed. Perforation was created in the duodenum in the first (primary repair/sutured group) and the second group (drain placement without repair/sutureless drainage group). In the first group, the per-foration was repaired with sutures. In the second group, only a drain was placed in the abdomen without sutures. In the third group (control group), only laparotomy was performed. Neutrophil count, sedimentation, serum C-reactive protein (CRP), serum total an-tioxidant capacity (TAC), serum total thiol, serum native thiol, and serum myeloperoxidase (MPO) analyses were performed on animal subjects in the pre-operative period and on the post-operative 1st and 7th days. Histological and immunohistochemical (transforming growth factor-beta 1 [TGF-ß1]) analyzes were performed. Blood analysis, histological, and immunohistochemical findings obtained from the groups were compared statistically. RESULTS: There was no significant difference between the first and second groups, except for the TAC on the post-operative 7th day and MPO values on the post-operative 1st day (P>0.05). Although tissue healing was more pronounced in the second group than in the first group, there was no significant difference between the groups (P>0.05). TGF-ß1 immunoreactivity observed in the second group was found to be significantly higher than in the first group (P<0.05). CONCLUSION: We think that the sutureless drainage method is as effective as the primary repair method in the treatment of duo-denal ulcer perforation and can be safely applied as an alternative to the primary repair method. However, further studies are needed to fully determine the efficacy of the sutureless drainage method.

Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and static balance scores.

OBJECTIVE: Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress. METHODS: In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT). RESULTS: The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods. CONCLUSION: This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.