Object. Thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) is a rare entity, most evident in Japan. The authors studied the clinical manifestations, radiological aspects, surgical treatment, and pathogenesis of this disease.Methods. Eighteen patients with OLF-induced thoracic myelopathy underwent laminectomy. The severity of myelopathy varied. Complete paraplegia was seen in three cases. Compression of the upper and middle third of the thoracic spine was evident in six cases and of the lower third in 12 cases. Multilevel OLF was demonstrated in 13 cases. In most cases, the ossified ligamentum flavum appears as a V-shaped lesion on computerized tomography and magnetic resonance images. In all patients the diameter of the posterior spinal canal, already narrowed, was further exacerbated by the OLF.Laminectomy was limited to the levels of compression, and the ligamentum flavum was resected in all cases. The symptoms and signs improved in 13 cases and stabilized in four cases. In one case symptoms recurred as a result of ossified lesions forming at other sites. Histological examination showed that the mode of development of the ossified ligaments was endochondral ossification.Conclusions. Reports of OLF-induced myelopathy are rare and mainly described in Japan. The incidence also seems high in North Africa. An early laminectomy limited to the level of compression is recommended. Ossified ligamentum flavum is different from the calcification of the ligamentum flavum, which is due to crystal deposits.
Among a series of 155 brain hydatid disease patients hospitalized between 1965 and 1998, 117 were children. The mean age was approximately 7.2 years, with a slight male predominance. Eighteen patients presented with another visceral localization. Symptoms and signs of intracranial hypertension are currently encountered (75%) followed by hemiparesis, epilepsy, mental changes, skull deformities and, more rarely, dyskinetic phenomenon. Brain hemispheric localization is the rule, with some exceptions. CT scans reveal an intra-parenchymal lesion with clearly defined, rarely enhanced margins. Medical treatment has virtually no place in the management of cerebral solitary cyst. Albendazole has been used in cases of multiple involvement, with controversial results. Surgical hydrostatic expulsion is the only effective treatment. Recovery is expected when the cyst is extracted completely unruptured.
Student-centered learning approaches such as project-based learning and flipped classroom stress the active role of the learner by applying knowledge rather than absorbing knowledge, and preparing higher education students for professional development. Student-centered learning environments are more effective when students regulate their learning and learn autonomously. There-fore, the purpose of this study is to examine the impact of a proposed ap-proach of flipped project-based learning on various facets of students' self-regulated learning, including motivational beliefs and learning strategies in higher education. A flipped project-based learning environment was designed and developed to improve students’ self-regulated learning skills. In this regard, multiple case studies were conducted according to a pretest-posttest quasi-experiment design to investigate the effectiveness of the proposed approach by four groups of students from different disciplines. The study employed a mixed-method research approach for data collection. Overall, the results re-vealed that the flipped project-based learning approach significantly enhanced students’ self-regulated learning skills. It was found that the approach fostered the students’ self-regulation performance among different groups across dif-ferent disciplines and levels.
Moreover, participants also claimed that the approach was useful and ef-fective. The findings indicated that students who actively engaged within flipped PBL activities demonstrated increases in cognitive and metacognitive functioning both individually and collaboratively. This study contributes to an advance in the understanding of how the development of SRL can be inte-grated into a flipped project-based learning environment in higher education.
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