BACKGROUND: When a patient with a prior history of malignancy and radiotherapy develops progressive weakness as a presentation of plexus involvement, the differential diagnosis usually rests between radiation-induced plexopathy and invasion from recurrent tumor. The presence of myokymic discharges is helpful in differentiating radiation-induced from neoplastic plexopathy. OBJECTIVE: To present a case report of a patient with chordoma, a locally aggressive tumor, who was diagnosed with recurrent tumor accompanied by the occurrence of myokymia in needle electromyographic examination. METHOD: A 55-year-old male patient with a history of chordoma and radiotherapy presented to our outpatient clinic with complaints of foot drop, and impaired walking for two months. His latest magnetic resonance imaging (MRI) which wasperformed three months earlier did not show recurrence. Upon electromyographic evaluation, myokymia, the pathognomic electromyography abnormal wave for radiation plexopathy was detected supporting a diagnosis of radiation plexitis rather than recurrent neoplastic invasion. One month later he presented with more severe pain and was re-evaluated by an MRI, on which a mass was detected indicating relapse. CONCLUSION: With this case report, we would like to emphasize that the behaviour of the tumor should be considered and imaging should be repeated when tumors display aggressive or recurrent behaviour.

Finansal bütçe eksikliği, zorlu coğrafik koşullar ve demografik durum gibi çeşitli nedenlerden dolayı ülkemizin birçok şehrinde birleştirilmiş sınıflı okullar bulunmaktadır. Bununla birlikte bu okullar için önemli olan uygulanan eğitim modeli şeklinin olumlu ya da olumsuz yönlerini tartışmak değil, tarafsız bir gözle ele alıp ne yapılması gerektiği konusunda yetkililere öneriler sunabilmektir. Bu okullarda uygulanan öğretim etkinlikleri ve bu etkinliklerin verimliliğinden istenen sonucu elde etmek için, öğretmenlerin birleştirilmiş sınıflı eğitim hakkındaki algıları çok önemli etkileyicilerden biridir. Bu nedenle, bu çalışma sınıf öğretmeni adaylarının birleştirilmiş sınıflı okulları katılımcı, bir araştırma yaklaşımı ile ziyaret ettikten sonra, öğretim uygulamalarını nasıl algıladıklarını araştırmayı amaçlamaktadır. Bu çalışma öncelikle eğitim ve sosyoloji kavramlarını tanımlamak ve kişiselleştirilmiş öğrenmedeki ilerici eğitim yaklaşımını, politik göreceliliği ve eğitim merkezileştirmesinin değerini azaltmak, eğitim öznelciliği ve insancıl faydacılığı yeniden değerlemeyi önermektedir. Çalışma aynı zamanda, birleştirilmiş sınıflı okullardaki sorumluluk ve hesap verebilirlik konusunu ve ilerici eğitimin kişiselleştirilmesine; neden ve nasıl yaklaşılacağını açıklığa kavuşturmayı da amaçlamaktadır. Anahtar Sözcükler: Kişiselleştirilmiş öğrenme, eğitim politikası, eğitim felsefesi ve sosyolojisi, birleştirilmiş sınıflı okullar, sınıf öğretmeni öğretmen adayları Published: XX.XX.XXXX There are many schools of multigrade classes in many cities in Turkey due to the fact that there are various reasons, from a lack of financial budget to a harsh geographic demographic condition. Nevertheless, what should not be forgotten that this schooling is neither good nor bad, or is it neutral. Rather what the important is how they are utilized and how they came to be in the present practices in order to provide particular suggestions to authorities. To achieve the desired educational outcome of effectiveness and efficiency in these schools, the teachers' perception of these schooling is one of the crucial influencers. Therefore, this study aims to investigate how candidates of classroom teachers perceive the educational practices, in particular after visiting several of multigrade classes' schools through a participatory research approach. This study actually introduces the notions of education and sociology; particularly personalized learning in which the aim of progressive education approach ought to devalue political relativism and educational centralization and to revalue educational subjectivism and humanitarian utilitarianism. Particularly, this study aims to clarify the issue of responsibility and accountability in this schooling, and why and how this personalization of progressive education would be approached by whom.

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BACKGROUND: Transforaminal epidural steroid injection (TFESI) is an interventional technique used to relieve disc herniation related back and radicular pain. Although few studies have investigated the factors predicting positive outcomes after TFESI, there is no data concerning the possible relationship between pre-procedure serum 25-hydroxyvitamin D (25(OH)D) levels and the response to TFESI. OBJECTIVES: To investigate the effect of vitamin D deficiency to treatment success of fluoroscopy-guided transforaminal epidural steroid injection. STUDY DESIGN: A retrospective assessment. SETTING: A university hospital interventional pain management center. METHODS: Nine hundred forty-eight patients received lumbosacral TFESI between January 2018 and December 2019 in a university hospital pain management center and were examined retrospectively for eligibility. Clinical and demographic data; magnetic resonance imaging (MRI); pre-procedure laboratory tests, including serum 25(OH)D; pain scores at baseline, third week, and third month follow-ups were collected. RESULTS: A total of 83 patients were recruited and divided into 2 groups with respect to vitamin D status. The number of patients with serum 25(OH)D level below 20 ng/mL was 57 and the number of patients with serum 25(OH)D level above 20 ng/mL was 26. Treatment success rates were significantly lower in vitamin D deficient group at third week and third month (P: 0.006, P: 0.01). LIMITATIONS: Retrospective nature and the absence of functional outcomes. CONCLUSION: Vitamin D deficiency is associated with a lower probability of meaningful pain relief following TFESI. It may worth assessing serum vitamin D level prior to this intervention, although prospective investigation is necessary. KEY WORDS: Lumbar disc herniation, vitamin D deficiency, transforaminal epidural steroid injection, treatment success