Changes in the Brain Microstructure of Children with Primary Monosymptomatic Nocturnal Enuresis: A Diffusion Tensor Imaging Study

Background: Primary monosymptomatic nocturnal enuresis (PMNE) is a common disorder in school-aged children. Previous studies have suggested that a developmental delay might play a role in the pathology of children with PMNE. However, microstructural abnormalities in the brains of these children have not been thoroughly investigated. Methodology/Principal Findings: In this work, we evaluated structural changes in the brains of children with PMNE using diffusion tensor imaging (DTI). Two groups consisting of 26 children with PMNE and 26 healthy controls were scanned using magnetic resonance DTI. The diffusion parameters of fractional anisotropy (FA) and mean diffusivity (MD) were subjected to whole-brain, voxel-wise group comparisons using statistical parametric mapping (SPM). When compared to healthy subjects, children with PMNE showed both a decrease in FA and an increase in MD in the thalamus. MD also increased in the frontal lobe, the anterior cingulate cortex and the insula; these areas are all involved in controlling micturition. The significant changes seen in the thalamus could affect both urine storage and arousal from sleep. Conclusions/Significance: The microstructure abnormalities were observed in the thalamus, the medial frontal gyrus, the anterior cingulate cortex and the insula, which are involved in micturition control network. This indicates developmenta

Detection of Helicobacter pylori in children with otitis media with effusion: A preliminary report

Objective: To determine the presence of Helicobacter pylori in the middle ear effusion of patients with otitis media with effusion (OME) by polymerase chain reaction (PCR). Study Design: A prospective study in patients with OME. Methods. The study was performed in 38 patients with OME who were admitted to the ENT Clinic, Firat University from June 2003 to April 2004. In all cases, a myringotomy operation (with or without placement of a ventilation tube) was carried out. The effusion samples aspirated from the middle ear were analyzed with PCR assay. Results: A total of 55 aspiration samples collected from 38 children ranging in age from 2 to 12 were included in the study. Fifteen of the subjects were girls, and 23 were boys. In 17 patients, both ears demonstrated effusions, whereas in 21 patients, only one ear had effusions. Nine (16.3%) of 55 the middle ear effusion samples were shown to be H. pylori positive by PCR. Conclusions. H. pylori was detected in the middle ear effusion of some patients with OME. These results may have interesting implications for a possible role of H. pylori in OME. In addition, these results suggest that further studies are needed to investigate the role of H. pylori in the etiology of OME. Key Words: Otitis media with effusion, H. pylori, polymerase chain reaction

Identification of Chlamydia trachomatis with polymerase chain reaction in middle ear fluid in otitis media with effusion

In this study, 78 middle ear aspiration samples from 59 children between the ages of 2-14 who have undergone myringotomy tinder general anesthesia were included. The presence of DNA genome of Chlamydia trachomatis was analyzed with polymerase chain reaction in the aspiration material. The relationship between the nature of the effusion fluid and the presence of Chlamydia trachomatis was investigated. Of the seventy-eight middle ear effusions, 26 (33.3%) were serous, 31 were (39.7%) mucoid and 21 (26.9%) were sero-mucoid in nature. Chlamydia trachomatis DNA genome was. identified in seven (8.9%) effusion samples. Of these, three were mucoid (42.8%), three were serous (42.8%) and one was sero-mucoid (14.2%) in character. We think that during the bacteriological analyses carried out for the cases of otitis media with effusion, Chlamydia trachomatis should be taken into consideration both at the time of diagnosis and the treatment