The surgical treatment of patients with adrenal tumors

USMF “N. Testemițanu”, Catedra Chirurgie nr 2, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere. Conform datelor OMS ponderea tumorilor suprarenale constitue 0,6%. Conduita terapeutică şi chirurgicală a acestor pacienți depinde de natura acestora, dimensiunile şi rezultatele analizelor histologice, respectând criteriile de diagnostic şi tratament pre- şi postoperatoriu. Scopul lucrării - aprecierea particularităților clinico-paraclinice si elaborarea tratamentului contemporan al pacienților cu tumori suprarenale. Material şi metode. Studiul este bazat pe un lot ce cuprinde 116 pacienți tratați în Clinica Chirurgie nr. 2, USMF „N.Testemițanu” pe parcursul anilor 1996-2011, din care 20(26,72%) cu aldosterom, 15(12,93%) cu corticosterom, 16(13,79%) cu feocromocitom, 10(8,62%) cu androsterom şi 44(37,93%) cu tumori hormonal-inactive. Raportul pe sexe indică predominarea sexului feminin (85 de bolnave, 73,28%) față de cel masculin (31 pacienți, 26,72%), vârsta medie constituind 36,7 ± 1,3 ani. Prin abord laparoscopic au fost operați 34(29,31%), prin abord deschis- 82(70,68%) bolnavi. Rezultate. S-a propus un algoritm contemporan de diagnostic în baza căruia s-au stabilit indicațiile pentru tehnicile adrenalectomiei. În adrenalectomia deschisă s-au constatat: complicații intraoperatorii - 6(7,3%) cazuri, în adrenalectomii laparoscopice - 0 cazuri; complicații postoperatorii în AED - 7 (7,6%) cazuri, în AEL - 1 (1,09%) cazuri, pierderi sanguine în AED -350±50ml, în AEL - 80±10ml; durata spitalizării după operație în AED - 7 (5-16) zile, în AEL - 3 (3-4) zile; necesitatea postoperatorie a opioidelor în AED - 2 (1-3) zile, AEL - 0,5 zile. Conform valorilor postoperatorii ale TA, rezultate bune s-au înregistrat la 18(46,15%) bolnavi, satisfăcătoare s-au atins la 20 (51,28%) bolnavi; iar rezultate nesatisfăcătoare – la 1 (2,56%) pacient. Concluzii. Rezultatele obținute demonstrează corectitudinea programului propus de diagnostic şi tratament chirurgical al bolnavului cu formațiuni de volum suprarenale, iar alegerea corectă a accesului chirurgical în adrenalectomie este imperativă pentru reducerea traumatismului intraoperatoriu şi reabilitarea mai curândă a pacienților adrenalectomizați, AEL fiind prioritară atât din punct de vedere chirurgical, cât şi socioeconomic. Introduction.Recording WHO data, the adrenal tumors represent 0,6 % from all tumors. The surgical approach and therapy depends on nature of them, and histological results, without miss the diagnostic criteria and pre- and postoperative treatment. The goal of the study was appreciation of the clinical particularities and to propose a modern surgical treatment to the patients with adrenal tumors. Material and methods. The article is based on a study which included 116 patients treated in Clinic of Surgery 2 of State Medical University ”N. Testemitanu” during the period of 1996-2011 years, 20(26,72%) of them were with aldosteromas, 15(12,93%) with corticosteromas, 16(13,79%) pheochromocytomas, 10(8,62%) with androsteromas and 44(37,93%) patients with non-active tumors. The sex ratio demonstrated female predomination (85 patients, 73,28 %) versus male (31 patients, 26,72%), the age 36,7 ± 1,3 years. Were performed adrenalectomy by transabdominal approach in 82(70, 68%) cases, laparoscopic adrenalectomy in 34(29, 31%) cases. Results. A contemporary diagnostic algorithm was proposed which established the indications for adrenalectomy techniques. In open adrenalectomia there were operative complications in 6(7,3%) cases, in laparoscopic adrenalectomia - 0 cases; postoperative complications were established in OAE - 7 (7,6%) cases, in LAE - 1 (1,09%) cases; blood loss in OAE -350±50ml, in LAE - 80±10ml; the length of hospital stay in OAE - 7 (5- 16) days, in LAE - 3 (3-4) days, postoperative pain medication in OAE - 2 (1-3) days in LAE - 0,5 days. Good results were assessed in 18 (46,15 %) patients, satisfactory results were achieved in 20(51.28%) patients, and unsatisfactory results at 1 (2.56%) patient. Conclusions. The results demonstrate the correctness of the proposed program of diagnosis and surgical treatment of the patient with adrenal tumors, it is very important to select the correct surgical approach for adrenal removed to minimize the operative trauma and quicker return to normal activity of patients, and laparoscopic approach is preferred by surgical and economical point of view

Modified Cooperative Integrated Reading and Composition to Promote Students' Reading Comprehension Achievement

Tujuan penelitian ini adalah untuk mengetahui: 1) efektifitas teknik DBCIRC untuk meningkatkan kemampuan pemahaman membaca; 2) persepsi mahasiswa terhadap penerapan teknik DBCIRC. Peneliti menggunakan one class pre-test post-test design. Sampel penelitian terdiri atas 16 mahasiswa STKIP Muhammadiyah Kotabumi yang dipilih secara purposive. Dalam mengumpulkan data, peneliti menggunakan tiga instrumen yaitu test pemahaman membaca, angket dan pedoman wawancara. Data dianalisis secara kuantitatif dan kualitatif. Hasil analisis data menunjukan bahwa (p) value yang diperoleh dari perhitungan paired t-test adalah 0.000. Dapat dilihat bahwa (p) value (0.000) lebih kecil dari taraf signifikan (0.05). Artinya adalah Ho ditolak dan Ha diterima. Disamping itu, hasil angket dan wawancara menunjukan bahwa persepsi mahasiswa terhadap penerapan teknik DBCIRC adalah positif. Jadi dapat disimpulkan bahwa penerapan teknik DBCIRC sangat efektif untuk meningkatkan kemampuan pemahaman mahasiswa dalam membaca. This study aimed to examine: 1)the effectiveness of DBCIRC technique to promote students' reading comprehension achievement; 2) the students' perception about the implementation of DBCIRC technique. This study employed one class-pre test post-test design. The sample consisted of 16 students of STKIP Muhammadiyah Kotabumi who were selected purposively. To gather the data, the researcher used reading comprehension test, questionaire and interview guideline. The data were analyzed both quantitatively and qualitatively. The results show that (p) value gotten from paired t-test was 0.000. It can be seen that (p) value (0.000) is less than significant level (0.05). In other words, H0 is rejected and Ha is accepted. Besides, the result of students' questionaire and interview reveal that students' perception about the implementation DBCIRC technique was positive. Therefore, it can be concluded that DBCIRC technique was effective to be used to promote students' reading comprehension achievement

The Effect Of Using Pre-questioning On Students' Reading Comprehension Achievement

Membaca merupakan keterampilan yang rumit untuk dicapai karena siswa menunjukkan kesulitannya dalam pelajaran ini. Tujuan penelitian ini untuk mengetahui adakah perbedaan yang signifikan pada prestasi pemahaman membaca siswa sebelum dan setelah pemberian pre-questioning dan mengetahui masalah-masalah yang dihadapi siswa dalam pemahaman membaca dan pre-questioning. Populasinya adalah siswa kelas dua SMPN 1 Seputih Banyak. VIII A diplih sebagai kelas penelitian. Penelitian ini menggunakan pre-test dan post-test satu kelompok. T-test pengukuran berulang digunakan untuk menganalisa data. Nilai rata-rata pre-tes 53.52 dan post test 69.15. Jadi, ada peningkatan sebesar 15.64. Hasil t-test menunjukkan t-ratio lebih tinggi daripada t-table (18.485 > 2.042) dengan signifikan level p 2.042) with the level of significant is p < 0.05 and significant two tail is p=0.000. It can be said that pre-questioning technique has effect on students’ reading comprehension achievement

Adaptasi Dan Stabilitas Hasil Galur-galur Aromatik Padi Sawah Di Sumatera Utara

This research was aimed to describe the yield stability and growth adaptation of elite lines of aromatic rice in rice production centers of North Sumatra. The experiments were conducted at 10 sites during dry season (DS) 2001 and DS 2002. Research materials consisted of 12 elite lines introduced from IRRI with IR64 as check variety. The treatments were arranged in a randomized block design (RBD) with three replications. Stability analysis was performed using methods of Eberhart and Russell, Finlay and Wilkinson, and Francis and Kanennberg. The results showed that the interaction of genotype x environment effect was very significant, indicating the presence of specific line adaptation on a particular environment. Genotypes which had the highest average yield were not always stable genotypes, as was shown by IR71137-49-1-2 which was more suitable to the sub-optimum environment. Lines IR71143-223-3-2-2-3, IR71146-97-1-2-1-3, IR65610-24-3-6-3-2-3, IR66696-49-1-2, IR71146-407-2-1-2-1, IR71146-122-1-1-2-1 were considered as stable genotypes according to the three analysis methods and each line showed high average yield. Those genotypes are suggested to be planted in the high productivity environments in order to obtain its optimum genetic expressivity on grain yiel

Analisis Stabilitas Hasil Gabah Galur-galur Padi Melalui Pendekatan Parametrik Dan Nonparametrik

The failure of a genotype to perform relatively the same in different environments is defined as the interaction Genotype x Environment (G x E interaction). The existence of G x E is often causing breeders facing difficulty to select superior genotypes to be tested further. Efforts to quantify the interaction between the average yields of genotype with environment can be done by parametric and nonparametric approaches. Experiments were conducted at 16 sites in dry season of 2008 and 2009. A total of 14 rice genotypes were tested using randomized complete block design. Combined analyses of variances of 16 sites showed highly significant effects of locations, genotypes, and genotypes x locations. Parametric stability analysis using the coefficient of variability (CVi) showed 6 lines (BP1808-1F-25, BP1352-1G-KN, IR76510-24-3, BP1178-2F-26, OM 5240, OM 1490) were stable. Based on parametric analysis of variance stability (Sv), however only 3 lines namely BP1808-1F-25, S4616-PN-7-3, and IR76510-24-3 were stable. Cultivar superiority method of parametric stability showed that BP1808-1F-25, OM 5240 and OM 1490 were stable, while OM4495 was stable based on Nassar and Huehn nonparametric methods. Results of Spearman's correlation analysis showed that between CVi and Sv, and CVi and Pi were significantly correlated with r = 0.556, and r = 0.560, respectively. It indicated that those three stability parameters had equal strength for determining the stability of the lines or cultivars tested. Based on the three stability approaches BP1808-1F-25 was considered as stable line, while check cultivar Dodokan was unstable. Parametric stability was found more accurate than nonparametric ones, when assumption of the data distribution was fulfilled

The Application of Interactive Comprehensible Written Input-Output Instruction for Teaching Writing

This study was aimed at finding out whether there was a difference on students\u27 writing ability in general as well as students\u27 aspects of writing in particular and exploringwhether there would be a difference on students\u27 prediction of Narrative and Anecdote Text as a part of Interactive Comprehensible Written Input-Output Instruction.The study involved 36 MathematicsEducation students in the first semester of academic year 2016/2017. To collect the data, the researcher administered writing testsand collected students\u27 writing drafts. Then, the data were analyzed both quantitatively and qualitatively. The results showed there was a significant difference on both students\u27 writing ability and aspects of writing after the application of this instruction. Then, there was also a difference on their prediction of two texts that it was easier for the students to predict the continuation of the story in Narrative Text rather than in Anecdote one.Penelitian ini bertujuan untuk mengetahui apakah ada perbedaan dari kemampuan menulis mahasiswa secara umum dan aspek-aspek menulis mereka secara khusus dan untuk menelusuri apakah ada perbedaan dari prediksi mahasiswa terhadap Teks Narasi dan Anekdot sebagai bagian dari Instruksi Input-Output Tertulis Terpahami yang Interaktif. Penelitian ini melibatkan 36 mahasiswa Pendidikan Matematika pada tahun ajaran 2016/2017. Untuk mengumpulkan data, penelitian mengadakan tes menulis dan mengumpulkan draft-draft tulisan mereka. Data-data tersebut kemudian dianalisa secara kuantitatif dan kualitatif. Hasil penelitian menunjukkan bahwa ada perbedaan dari kemampuan menulis mahasiswa secara umum dan aspek-aspek menulis mereka secara khusus setelah penerapan instruksi ini. Selain itu, terdapat perbedaan prediksi yang dibuat terhadap dua tekster sebut dengan lebih mudahnya mahasiswa untuk memprediksi kelanjutan cerita pada Teks Narasi dibandingkan Teks Anekdot

The Influence Of Using Parlour Games Towards Students’ Vocabulary Achievement

Penelitian ini bertujuan untuk mengetahui apakah ada pengaruh terhadap pencapaian vocabulary siswa setelah diajarkan melalui parlour games dan untuk mengetahui respon siswa terhadap pengajaran vocabulary melalui parlour games.Hasil menunjukkan bahwa siswa diajarkan melalui permainan ini tampaknya lebih menyenangkan dan tertarik untuk belajar kosakata sejak siswa dapat memberikan respon yang baik selama proses belajar mengajar. Proses belajar mengajar menantang dan melibatkan semua siswa dalam permainan. Hal ini dapat dilihat dari peningkatan nilai rata-rata siswa. Skor rata-rata siswa dari pretest adalah 56,50 sedangkan nilai rata-rata posttest adalah 63,40. Setelah membandingkan hasil pretest dan skor posttest, ditemukan bahwa ada peningkatan yang signifikan, skor rata-rata siswa meningkat 6,9 setelah treatment. Berdasarkan hasil, dapat disimpulkan bahwa mengajar vocabulary melalui permainan Parlour dapat memberikan pengaruh positif untuk meningkatkan prestasi kosakata siswa secara signifikan. This research was intended to find out whether there was an influence of students’ vocabulary achievement after being taught through parlour games and to know students’ response toward teaching vocabulary through parlour games. The results show that the students taught through parlour games seemed to be more enjoyable and interested in learning vocabulary since the students could provide a good response during teaching learning process. The teaching learning process challenged and involved all students in the game. It can be seen from the increase of the students’ mean score. The students’ mean score of the pretest was 56.50 while the mean score of the posttest was 63.40. After comparing the result of the pretest and the posttest scores, it was found that there was a significant increase, the mean score of the students had increased 6.9 after the treatments. Based on the results, it can be concluded that teaching vocabulary through Parlour games can give positive influence to increase students’ vocabulary achievement significantly.