Objective Deep brain stimulation (DBS) surgery has increasingly been performed for the treatment of movement disorders and is associated with a wide array of complications. We aimed to present our experience and discuss strategies to minimize adverse events in light of this contemporary series and others in the literature. Methods A retrospective chart review was conducted to collect data on age, sex, indication, operation date, surgical technique, and perioperative and late complications. Results A total of 181 patients (113 males, 68 females) underwent DBS implantation surgery (359 leads) in the past six years. Indications and targets were as follows: Parkinson's disease (STN) (n=159), dystonia (GPi) (n=13), and essential tremor (Vim) (n=9). Mean age was 55.2 ± 11.7 (range 9–74) years. Mean follow-up duration was 3.4 ± 1.6 years. No mortality or permanent morbidity was observed. Major perioperative complications were confusion (6.6%), intracerebral hemorrhage (2.2%), stroke (1.1%), and seizures (1.1%). Long-term adverse events included wound (7.2%), mostly infection, and hardware-related (5.5%) complications. Among several factors, only surgical experience was found to be related with overall complication rates (early period: 31% versus late period: 10%; p=0.001). Conclusion The rates of both early and late complications of DBS surgery are acceptably low and decrease significantly with cumulative experience.

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Previous studies on in vitro rooting for improved micropropagation of eucalypts indicated that root graviperception and postacclimatisation architecture are determined by the relative exogenous auxin analogue and its stability, supplied during the pre-rooting culture stages. The specific roles of indole-3-acetic acid (IAA) and indole-3-butyric acid (IBA) in the rooting medium on the in vitro root morphological processes were explored using a good-rooting clone. In vitro rooting percentage was significantly reduced when either of the auxin inhibitors 2,3,5-triiodobenzoic acid (TIBA) and ρ-chlorophenoxyisobutyric acid (PCIB) or the auxin antagonist kinetin was supplied at rooting, with or without exogenous auxin. For all treatments, at the time of root induction, shoots did not possess a vascular cambium, only procambial tissue, from where adventitious roots formed. However, when the inhibitors or the antagonist were supplied to the roots 3 days after root induction, they affected root growth and graviperception. Kinetin and PCIB significantly reduced the mean root diameter from 552.8 µm (control) to 129.2 µm and 278.6 µm, respectively, over 3 weeks. While the PCIB treatment resulted in a significant increase in Δ root length over this period, the TIBA treatment significantly decreased ∆ root length and increased mean root diameter to 833.4 µm. Restricting IAA transport with TIBA further altered root vascular patterning and, as with PCIB, resulted in the collapse of the columella region. Nevertheless, only a disruption in IAA transport and subsequent auxin distribution by TIBA treatment resulted in altered root graviperception. The results suggest the necessary inclusion of IAA in eucalypt micropropagation protocols to ensure good quality roots.

AIm:To determine the role of intraoperative ultrasonography (IOUSG) in the surgical management of patients with intradural spinal tumors. mAteRIAl and methods: Twenty-six patients with intradural spinal cord tumors were surgically treated under intraoperative ultrasonographic guidance between January 2007 and May 2011. Guidance with IOUSG was used in 26 patients, of which 14 fourteen had extramedullary and 12 had intramedullary tumors. Intraoperative ultrasound assistance was used to localize each tumor exactly before opening the dura. The extent of tumor resection was verified using axial and sagittal sonographic views. The extent of tumor resection achieved with IOUSG guidance was assessed on postoperative early control MRI sections.Results: Total tumor resection was achieved in 22 (84%) of 26 cases. All of the residual tumors were typically intramedullary and infiltrative. The sensitivity of IOUSG for the determination of the extent of resection was found to be 92%. Ultrasonography was found to be effective in identification of tumor boundaries and protection of spinal cord vessels. The average time spent for IOUSG assessment was 7 minutes. ConClusIon:Intraoperative ultrasonography is practical, reliable and highly sensitive for spinal cord surgery. It not only enhances surgical orientation, but also reduces morbidity and helps to resect the tumor completely.