Treatment of adolescent idiopathic scoliosis with global (ROD) derotation maneuver using pedicle screws

Introduction: Adolescent idiopathic scoliosis is a three dimensional deformity. For the treatment of deformity, nature of deformity should be well understood and treatment strategy has to be directed to the coronal, sagittal and axial components of deformity. Global Derotation (GD) maneuver is based on simple rod derotation from concave side aiming to correct the deformity on coronal, sagittal and axial profile. In this report we reviewed AIS surgery results treated by global derotation maneuver with all pedicle screw instrumentation.Material& Methods: Between 2003 and 2011, 253 patients had been operated using GD technique.80 of 253 patients was included to our study. The patients routinely evaluated with preoperative-postoperative and last follow up standing ortho-x-rays. Coronal and sagittal profile parameters measured on x-rays with digital software using Cobb method. Rotational component of the deformity was measured according to Nash-Moe method at the apical vertebra.Results: 80 patients (71 female ; 9 male)had been followed up average 19,8 (7-37) months. Patients age average were 15,1(12-21) at operation date. Coronal cobb angle measure in thoracic curves preoperative were 48,9° decreased to mean 3,2° postoperatively. The mean coronal thoracolumbar curve were 45,8° preoperatively and decreased to mean 2°. Apical vertebra rotation measure regressed to mean 0,68 (0-1). Thoracic kyphosis showed downward tendency from mean 37,8° to mean 27,8°.Conclusion: Rod derotation technique enable to correct coronal and axial profile. Coronal Cobb angle improvement seen obviously with correction of axial profile rotation. Sagittal hypokyphotic effect of GD should be kept in mind

Serumske razine prolaktina u diferencijalnoj dijagnostici pedijatrijskih epileptičnih i neepileptičnih (pseudo-)napadaja

The aim was to determine diagnostic value of serum prolactin levels in the diff erential diagnosis of epileptic and nonepileptic seizures in children. The study included 100 patients aged one month to 18 years, admitted to the hospital for seizure complaints. All patients underwent electroencephalography in the postictal period and their serum prolactin levels were measured at 10 min and 60 min of the postictal period. The mean 10-min serum prolactin level was 37.1±20.09 ng/mL and 16±14.59 ng/mL (p<0.01) in patients with epileptic and nonepileptic seizures, respectively. After grouping of patients with nonepileptic seizures, the mean 10-min serum prolactin level in patients with epileptic seizures and those with syncope was 37.1±20.09 ng/mL and 30.52±19.21 ng/mL (p>0.05), respectively. The mean 10-min prolactin level in patients with epileptic seizures and those with non-syncope epileptic seizures (night terror, conversion and breath holding spells) was 37.1±20.09 ng/mL and 10.9±5.95 ng/mL (p<0.01), respectively. In conclusion, serum prolactin level in the postictal period is an important marker in the diff erential diagnosis of epileptic and nonepileptic seizures. There was no signifi cant diff erence between serum prolactin levels in the diff erential diagnosis of epileptic seizures and syncope, but it had an important role in diff erentiating nonepileptic cases such as breath holding spells, night terror and hysterical conversions from epileptic seizures and syncope.Cilj ovoga ispitivanja bio je utvrditi dijagnostičku vrijednost serumskih razina prolaktina u diferencijalnoj dijagnostici epileptičnih i neepileptičnih napadaja u djece. U ispitivanje je bilo uključeno 100 djece u dobi od jednog mjeseca do 18 godina, primljenih u bolnicu zbog konvulzija. U svih bolesnika učinjena je elektroencefalografi ja u postiktalnom razdoblju, dok su njihove serumske razine prolaktina mjerene u 10. i 60. minuti postiktalnog razdoblja. Srednja 10-minutna razina prolaktina u serumu bila je 37,1±20,09 ng/mL i 16±14,59 ng/mL (p<0,01) u bolesnika s epileptičnim odnosno neepileptičnim napadajima. Nakon grupiranja bolesnika s neepileptičnim napadajima 10-minutna srednja serumska razina prolaktina u bolesnika s epileptičnim napadajima i onih sa sinkopom bila je 37,1±20,09 ng/mL odnosno 30,52±19,21 ng/mL (p>0,05). U bolesnika s epileptičnim napadajima i onih s ne-sinkopnim epileptičnim napadajima (noćne more, konverzija i epizode zadržavanja daha) srednja 10-minutna razina prolaktina bila je 37,1±20,09 ng/mL odnosno 10,9±5,95 ng/mL (p<0,01). Zaključuje se kako je serumska razina prolaktina u postiktalnom razdoblju važan biljeg u diferencijalnoj dijagnostici epileptičnih i neepileptičnih napadaja. Nije bilo značajne razlike među serumskim razinama prolaktina u diferencijalnoj dijagnostici epileptičnih napadaja i sinkope, ali je ta razina imala važnu ulogu u razlikovanju neepileptičnih slučajeva kao što su epizode zadržavanja daha, noćne more i histerične konverzije od epileptičnih napadaja i sinkope

Türkçe Eğitiminde Karikatür Kullanımı ve Eğitsel Değeri

ÖZ: Dil eğitiminde verimliliği belirleyen önemli unsurlardan biri de eğitim ortamı tasarımı ve bu çerçevede materyal kullanımıdır. Bu çalışmada Türkçe Öğretiminde işlevsel değere sahip olan ancak gerektiği kadar yararlanılmayan ‘karikatür’ ele alınmaktadır. Çalışmada ilk olarak eğitim ortamlarında pedagojik bir materyal olarak karikatürün özellikleri, türleri ve eğitimde kullanılmasının önemi üzerinde durulmakta ve literatürde karikatürle ilgili ulaşılabilen çalışmalara değinilmektedir. Ayrıca Türkçe Öğretimi Programında karikatüre yer verilme durumu üzerinde de durulmaktadır. Çalışma sonunda ise karikatürün Türkçe eğitimi metin işleme sürecini çeşitlendirmede pedagojik bir materyal olarak kullanılabilirliğini örneklemek amacıyla karikatür çalışmalarını içeren ders işleyiş etkinliğine yer verilmiştir. Anahtar sözcükler: Türkçe eğitimi, dil becerileri, metin işleme süreci tasarımı, materyal kullanımı, karikatür