Radiologic and endoscopic assessment of the skull base in children with recurrent meningitis

Meningitis is a potentially fatal disease. Recurrence of the attacks should alert the physician to the possibility of an underlying cause. Six children who had between 2 to 6 episodes of meningitis were investigated by computed tomography, magnetic resonance imaging, fluorescein endoscopy and cisternography in order to find the cause of recurrence. Cerebrospinal fluid rhinorrhea was confirmed in three patients. Cerebrospinal fluid otorrhea was confirmed in one patient. Streptococcus pneumonia was isolated from the CSF of four patients. The following findings were found: [1] bone defect and CSF fistula in the region of the cribriform plate; [2] CSF fistula in the region of the sphenoid sinus; [3] bone defect and encephalocele in the region of the cribriform plate/glabella; [4] bone defect in the roof of the ethmoid sinus; [5] bone defect and CSF fistula in the region of the tegmen antri; [6] one patient did not have any congenital defects in the skull base, but had complement defects and immunoglobulin subclass defects. Duraplasty was done for the patients by using endonasal, transfacial, trans- frontal and transmastoid approaches. In patients with recurrent meningitis, modern diagnosis methods should be used to search for congenital defects of the skull base. The necessary surgical repair should be performed to prevent the further occurrence of potentially fatal attacks of meningitis

Immunohistochemical localization of phosphorylated AMPA-type glutamate receptors in cerebellar Purkinje cell layer

Twenty adult albino rats were used in this work. The skull of each animal was opened carefully to obtain the cerebellum after killing the animal and the vermis was dissected. Each vermis was cut sagittally into many slices [200 mum in thickness]. The cerebellar slices were treated by different chemicals [AMPA, 8-bromo-cGMP and antibody against peptide 12 [12p3]] for 5-30 minutes and one of the protein kinase inhibitors [staurosporine] was added to some cerebellar slices. After a previous chemical treatment, the cerebellar slices were fixed in a suitable fixative for 72 hours before light and electron microscopic preparation and examination. The phosphorylation [staining of Purkinje cell bodies and their dendrites] of AMPA receptors was rapid after exposure to AMPA, but this phosphorylation was transient and disappeared within 20 minutes. 12p3 immunoreactivity in long-term desensitization persisted for more than 30 minutes after its application, which was demonstrated by an immunohistochemical study of Purkinje cells. Protein kinase inhibitor [staurosporine] application abolished the staining of Purkinje cell dendrites due to its inhibitory action. So, phosphorylation of AMPA- type glutamate receptors in Purkinje cell layer of the cerebellum may be used in the potentiation or desensitization of this cell layer

Specific circulating immune complexes in sera of children infected with S. haematobium

Schistosomiasis is a major health problem in our country. This work is carried out for detection of specific circulating immune complexes [CICs] in S. haematobium infected children as a trial to evaluate their potential use in immunodiagnosis of the disease and in assessment of disease intensity and morbidity. Sixty seven Egyptian children from El-Minia and Sharkia Governorates were included in this study, 50 of them were infected with S. haematobium [active cases], 5 infected with parasites other than Schistosoma [infected control] and 12 children were parasites free [normal control]. Sera of all cases were examined to detect specific schistosomal circulating immune complexes. Indirect ELISA assay using monoclonal antibody 128C3/3/21 as a coating antibody was used. Forty seven out of fifty actively infected cases had positive circulating immune complexes level yielding a test sensitivity of 94 percent. All of the normal control group had negative CIC level yielding a test specificity of 100 percent. The level of CICs was significantly higher in heavily infected children [those excreting >50 eggs/l0ml urine] when compared with those with light infection [excreting <50 eggs/l0ml urine]. ELISA using highly purified monoclonal antibody appeared to be a specific and sensitive test for detection of schistosomal CICs level in the serum and evaluating the intensity of infection