To evaluate humoral immunity against the SARS-associated coronavirus (SARS-CoV), we studied the profiles of IgG antibodies to the nucleocapsid (N) and spike (S) proteins of SARS-CoV. Serum specimens from 10 SARS patients were analyzed by Western blotting and an enzyme-linked immunosorbent assay (ELISA) using purified recombinant N and truncated S (S1, S2, and S3) proteins as antigens. Western blotting results demonstrated that 100% of the SARS patients tested positive for N protein-specific antibodies, 50% for S1 protein-specific antibodies, 30% for S2 protein-specific antibodies, and 70% for S3 protein-specific antibodies. The ELISA results, which showed positive rates of IgG reactivity against recombinant proteins N, S1, S2, and S3, were, respectively, 28.57, 14.29, 14.29, and 14.29% at week 1, 77.78, 55.56, 44.44, and 66.67% at week 2, 100, 75, 75, and 87.5% at week 3, and 100, 77.78, 77.78, and 88.89% after 3 weeks. The average titers of IgG against recombinant proteins N, S1, S2, and S3 were, respectively, 691, 56, 38, and 84 after 3 weeks. These results suggest that the recombinant proteins N and S3 are potentially useful antigens for a serological diagnosis of SARS. In consideration of possible cross-reactivity among N proteins of SARS-CoV and other coronaviruses, immunoassays using recombinant N protein in combination with S3 as antigens might improve the specificity of SARS diagnoses.

Patients with trigeminal neuralgia frequently undergo magnetic resonance imaging (MRI) prior to surgery. In patients without the signs and symptoms of face discomfort, MRI has shown the presence of neurovascular contact (NVC) in humans. Therefore, its capacity to accurately exclude NVC of the trigeminal nerve is not properly understood. A meta-analysis of the literature satisfied the criteria to further explore the value of MRI for the diagnosis of classical trigeminal neuralgia (CTN). The association between the symptomatic and asymptomatic trigeminal nerves, NVC, root entry zone (REZ), non-REZ, and anatomical variation was measured by a comprehensive review and meta-analysis of 13 observational studies using MRI for CTN neurovascular compression diagnosis. This study aimed to evaluate the effectiveness of MRI in detecting the neurovascular compression that causes symptoms in individuals with classic trigeminal neuralgia. This study was conducted at the Department of Neurosurgery, Yantai Yuhuangding Hospital, Qingdao University. Digital searches of PubMed, Embase, and the Cochrane Library were performed to identify studies published until December 31, 2023. The following were evaluated: (1) MRI evidence of NVC in symptomatic and asymptomatic trigeminal nerves; (2) MRI indication of NVC at the REZ in symptomatic and asymptomatic trigeminal nerves; (3) MRI substantiation of non-REZ neurovascular contact in patients with CTN; and (4) asymptomatic and symptomatic anatomical changes at the NVC site of the trigeminal nerves. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the fixed effects models. We identified 13 observational studies (1 prospective and 12 retrospective studies) with data collected from 1770 nerves (728 symptomatic and 1042 asymptomatic) were meta-analyzed. First, MRI of 649/728 (88.2%) symptomatic versus 378/1042 (36.3%) asymptomatic trigeminal nerves revealed marked differences in NVC in the REZ (OR = 16.3; CI 95%=12.2–21.8; p < 0.00001). Second, pooled data showed that REZ NVC was detected in 206/262 (78.6%) symptomatic and in 129/340 (37.9%) asymptomatic nerves (OR = 5.0; CI 95% = 3.4–7.3; p < 0.00001); Third, no significant differences were detected between 44/267 (16.5%) symptomatic and 23/189 (12.1%) asymptomatic nerves on MRI examination of NVC in the NON-REZ (OR = 0.9; CI 95% 0.5–1.6) (p = 0.77); Finally, MRI revealed marked differences in 302/567 (53.2%) symptomatic and 73/919 (7.9%) asymptomatic anatomic changes (atrophy, dislocation, distorsion, flattening or indentation) at the NVC site of the trigeminal segments (OR = 11.9; CI 95% = 8.8–16.2; p < 0.00001). Despite the systematic evaluation of 13 observational studies, large-scale randomized controlled trials should be conducted, focusing on the specificity of MRI for the diagnosis of trigeminal neuralgia and evaluating the specificity of the imaging findings and the impact of the patient’s postoperative treatment. A previous meta-analysis showed that patients with CTN were more likely to have NVC-specific anatomical changes. MRI of patients with CTN can detect anatomical changes in the REZ NVC with higher sensitivity.

AIM: To conduct a meta-analysis for investigating the safety and efficacy of endoscopic third ventriculostomy (ETV) and extracranial shunting for patients with obstructive hydrocephalus. MATERIAL and METHODS: Randomized controlled trials (RCTs) of ETV and ventriculoperitoneal shunting (VPS) for obstructive hydrocephalus were analyzed systematically by using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also perused. Postoperative infection, postoperative cerebrospinal fluid (CSF) leakage, mortality and surgical success were the main outcomes of the analysis. RESULTS: Among 841 selected studies, 6 RCTs evaluated ETV and VPS. Compared to VPS, ETV had lower postoperative infection incidence (risk ratio [RR]: 0.19, 95% confidence interval [CI]: 0.08-0.43, p=0.0001), postoperative CSF leakage (RR: 5.10, 95% CI: 1.19-21.89, p=0.03) VPS. VPS had no mortality as compared to ETV (RR 0.64, 95% CI: 0.26-1.56, p=0.32). CONCLUSION: While VPS had no mortality in comparison to ETV, the latter showed lower incidences of major complications, such as postoperative infection and CSF leakage, than those of the former for patients with obstructive hydrocephalus.

Meningiomas are extra-axial neoplasms that originate from the arachnoid cap cells located on the inner surface of the meninges. Approximately 36% of central nervous system tumors are meningiomas. Based on earlier findings to be benign in most cases, they are categorized as slow-growing tumors that form gradually over time. Meningiomas are usually asymptomatic and discovered inadvertently. They rarely present with immediate clinical symptoms or abrupt hemorrhagic strokes. However, tumor hemorrhage can be fatal in high-grade meningiomas, particularly those with vascularization. We describe a 58-year-old man who was hospitalized after experiencing an unexpectedly acute headache. The right cerebellar hemisphere and vermis cerebellar hemorrhage were detected on computed tomography (CT), and the cerebellar hemorrhage was explained by a diagnosis of hypertension. When additional analysis of the patient’s chest CT indicated lung mass lesions, we assumed that the lung cancer had spread to the brain. However, the pathological outcomes of a guided definite pulmonary aspiration biopsy, in conjunction with resection of the cerebellar tumor, suggested a subtentorial meningioma with ruptured hemorrhage and pulmonary meningioma metastasis. The patient was transferred to a hospital closer to home for ongoing follow-up and, after 2 months, he had recovered well.