Search

In current practice, optimal placement of deep-brain stimulators (DBSs) used to treat movement disorders in patients with Parkinson's disease and essential tremor is an iterative procedure. A target is chosen preoperatively based on anatomical landmarks identified on magnetic resonance images. This point is used as an initial position that is refined intraoperatively using both microelectrode recordings and macrostimulation. In this paper, we report on our current progress toward developing a system for the computer-assisted preoperative selection of target points and for the intraoperative adjustment of these points. The system consists of a deformable atlas of optimal target points that can be used to select automatically the preoperative target, of an electrophysiological atlas, and of an intraoperative interface. Results we have obtained show that automatic prediction of target points is an achievable goal. Our results also indicate that electrophysiological information could be used to resolve structures not visible in anatomic images, thus improving both preoperative and intraoperative guidance. Our intraoperative system has reached the stage of a working prototype and we compare targeting accuracy as well as the number of paths needed to reach the targets with our system and with the method in current clinical use. Index Terms--Atlas-based methods, computer-assisted surgery, deep brain stimulation, electrophysiological atlas, nonrigid registration.

Background: The aim of this study was to evaluate the content of oral habit videos on YouTube™.Materials and Methods: The four keywords "Oral Habits," "Thumb Sucking," "Tongue Thrust", and "Finger Sucking" relevant terms oral habits were searched on YouTube™. The videos sorted by view count were screened and evaluated. The following exclusion criteria were defined as; non-English videos, unrelated to a topic, poor audio-video quality, and duplication. A hundred videos were analyzed for general video characteristics (number of views, likes, dislikes, number of comments, and uploaded date) the purpose of the video, information content, audio-visual quality, and viewers' interaction index.Results: The top hundred videos have been viewed an average of 26,870.83 times. Most videos were uploaded by dentists (n = 29; 29.0%). Most of the videos (44.0%) were classified as having moderate general information content and 38.0% were rated as good, and 18.0% were rated as poor. Videos generally involved information about oral habits (82.0%), followed by personal experience (12.0%). The viewers' interaction index of all evaluated YouTube™ videos was 0.59. Good content videos had a significantly higher interaction index than the other groups (P = 0.011).Conclusions: YouTube™ videos about the oral habits are generally inadequate and patients must be recommended to view them with caution. High quality and more informative videos about oral habits in dentistry should be uploaded to YouTube™ by professionals. [ABSTRACT FROM AUTHOR]

Fluoroquinolones which are in use since 1986, are effective agents both against gram-positive and gram-negative bacteria. Quinolones show bactericidal effect as a result of inhibition of DNA gyrase and topoisomerase IV enzymes. Main quinolone resistance mechanisms are chromosomal mutations in these enzymes and decreased intracellular accumulation due to efflux pumps or decreased membrane uptake. Recently a new quinolone resistance mechanism mediated by plasmids has been defined. These plasmids carry genes called as qnr. Qnr genes do not cause quinolone resistance but they cause decreased quinolone susceptibility and lead to higher minimum inhibitory concentrations. Currently there are qnrA, qnrB, qnrC, qnrD and qnrS genes. This study was aimed to investigate the presence of plasmid-mediated quinolone resistance determinants in Enterobacteriaceae isolates collected from four different centers in Turkey. A total of 647 isolates (387 from Trabzon, Black Sea region; 82 from Canakkale, Trace region; 96 from Ankara, Central Anatolia region; 82 from Tokat, Black Sea region) belonging to the Enterobacteriaceae family collected between May-July 2009, were included in the study. Presence of qnrA, qnrB, qnrS and qnrC genes were investigated by multiplex polymerase chain reaction (PCR) method and confirmed by gene sequencing. The results of the PCR amplification revealed that 2 isolates were positive for qnrA, 12 isolates were positive for qnrB, 4 isolates were positive for qnrC and 10 isolates were positive for qnrS. However, the number of positive strains decreased with the use of gene sequencing, and this method led to the identification of qnrA1 in two isolates [Enterobacter cloacae (code. 796), Salmonella group B (code. 491)], qnrB1 in two isolates [Salmonella group B (code. 491), Citrobacter freundii (code. 768)], qnrB6 in one isolate [Escherichia coli (code. CC1800)], qnrB9 in one isolate [E.coli (code. CC1873)], qnrB24 in one isolate [Citrobacter koseri (code. MP5200)], qnrB27 in one isolate [C.freundii (code. 842)], qnrS1 in two isolates [E.coli (code. CC1705), E.coli (code.159)] and qnrB2 in one isolate [E.coli (code. 843)]. One of the isolates that carried the qnr gene was ciprofloxacin-resistant and two isolates were nalidixic-acid resistant. Transferable quinolone resistance due to the dissemination of qnr genes may have important impacts in terms of infection control and treatment problems. Survey of plasmid mediated quinolone resistance will help to determine the size of the issue and guide the measures that should be taken to avoid escalation of resistance and dissemination problem.

The aim of this study was to investigate the effects of efflux pump inhibitors on the minimal inhibitory concentration (MIC) values of ciprofloxacin (CIP) in fluoroquinolone-resistant 42 Pseudomonas aeruginosa (n= 42), Escherichia coil (n= 97), Acinetobacter baumannii (n= 58) and Staphylococcus aureus (n= 80) strains isolated from clinical specimens. For this purpose phenylalanyl-arginyl-beta-naphthylamide (PA beta N) was used for P. aeruginosa, E. coli, A. baumannii and reserpine for S. aureus isolates as pump inhibitors. Fluoroquinolone resistance of the clinical isolates were determined by VITEK2 Compact (BioMerieux, France) automated system and confirmed with standard broth microdilution method. For the investigation of the effects of inhibitor agents, the MIC values were also determined in the presence of 25 microg/ml and 100 microg/ml PA beta N and 20 microg/ml reserpine. In the presence of 25 mg/l PA beta N, 61.9% of CIP resistant P. aeruginosa strains converted to susceptible ones, while this rate was 73.8% in the presence of 100 mg/l PA beta N. In A. baumannii clinical isolates, 8.6% and 15.5% of CIP-resistant strains have become susceptible in the presence of 25 mg/l and 100 mg/l PA beta N, respectively. Similarly the MIC values for CIP have decreased > or = 4 folds in 42.2%, and > or = 2 folds in 30.9% of E. coli isolates, in the presence of 25 mg/l PA beta N, however, there was no change in MICs of 26.9% of E. coli strains. The MIC values have also been lowered for > or = 4 folds in 83.6%, and two folds in 13.4% of E. coli strains by the use of 100 mg/l PA beta N concentration, however, no decrease in MIC values was detected in 3% of the isolates. 20 mg/l of reserpine have caused a decrease of > or = 4 folds in 8.75%, and two folds in 33.75% of S. aureus isolates, while there was no change in MIC values of 57.5% of S. aureus strains. Our results showed that PA beta N causes significant reduction in MIC values for CIP in the clinical isolates of P. aeruginosa, E. coli and A. baumannii and this effect may be attributed to efflux pump inhibition. In contrast, it was concluded that reserpine does not have a considerable effect on the MIC values of S. aureus against ciprofloxacin.

Objectives: Application of image-guided surgery to otology has been limited by the need for submillimeter accuracy via a fiducial system that is easily usable (noninvasive and nonobstructive)., Methods: A dental bite-block was fitted with a rigid frame with 7 fiducial markers surrounding each external ear. The temporal bones of 3 cadaveric skulls were removed and replaced with surgical targets arranged in a bull's-eye pattern about the centroid of each temporal bone. The surgical targets were identified both within CT scans and in physical space using an infrared optical tracking system. The difference between positions in CT space versus physical space was calculated as target registration error., Results: A total of 234 independent target registration errors were calculated. Mean +/- standard deviation = 0.73 mm +/- 0.25 mm., Conclusions: These findings show that image-guided otologic surgery with submillimeter accuracy is achievable with a minimally invasive fiducial frame. Significance In vivo validation of the system is ongoing. With such validation, this system may facilitate clinically applicable image-guided otologic surgery., Ebm Rating: A.