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Markers for neural degeneration and regeneration:novel highly sensitive methods for the measurement of thrombin and activated protein C in human cerebrospinal fluid

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Neural Regeneration Research 2021年第10期16卷 2086-2092页

作者： Alexandra Gerasimov Valery Golderman Shany Guly Gofrit Shay Anat Aharoni Daniela Noa Zohar Ze’ev Itsekson-Hayosh Tsviya Fay-Karmon Sharon Hassin-Baer Joab Chapman Nicola Maggio Efrat Shavit-Stein Department of Neurology The Chaim Sheba Medical CenterRamat GanIsrael Department of Neurology and Neurosurgery Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael The Movement Disorders Institute Chaim Sheba Medical CenterRamat GanIsrael Sagol School of Neuroscience Tel Aviv UniversityTel AvivIsrael Department of Physiology and Pharmacology Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael Robert and Martha Harden Chair in Mental and Neurological Diseases Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael Talpiot Medical Leadership Program The Chaim Sheba Medical CenterRamat GanIsrael

Inflammation and coagulation are tightly interconnected in the pathophysiology of neuronal ***,a pro-coagulant serine protease is associated with neurodegeneration and its indirect inhibitor,activated protein C(aPC),is considered *** levels of thrombin and aPC activity are readily measured in the blood,similar assays in the cerebrospinal fluid(CSF)have not been *** aim of this study was to establish a specific and sensitive enzymatic assay to measure both thrombin and aPC activity in the *** was collected from 14 patients with suspected normal pressure hydrocephalus served as a control group,while seven patients with central nervous system infections served as an acute neuro-inflammatory study group and one sample of CSF following traumatic lumbar puncture served as a positive *** and aPC activities were measured by fluorescence released by specific proteolytic cleavage in the presence of endopeptidase and amino-peptidase inhibitors to ensure *** of the method was verified by thrombin and serine-protease inhibitors N-alpha-((2-naphthylsulfinyl)glycyl)-DL-p-amidinophenylalanylpiperidine and phenylmethanesulfonyl *** of thrombin activity by CSF samples and levels of specific thrombin inhibitors were also *** and aPC activities were reliably measured and were significantly higher in the CSF of patients with central nervous system infections compared to normal pressure hydrocephalus controls,suggesting the involvement of these factors in *** thrombin activity levels in the presence of known thrombin concentration were high in patients with central nervous system infections,and low in normal pressure hydrocephalus *** of endogenous thrombin inhibitors protease nexin 1,amyloid precursor protein and anti-thrombin III in CSF by western blot indicated a significant elevation of amyloid precursor protein in infectious *** concl

关键词： activated protein C cerebrospinal fluid infection inflammation normal pressure hydrocephalus thrombin

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Hakim-Adams syndrome secondary to syphilis

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Case Reports in Clinical Medicine 2013年第6期2卷 377-379页

作者： Ricardo Krause Martinez de Souza Alexandre Zatera Fernanda Leal Suzano Flavia de Oliveira Braga Samanta Fabrício Blattes da Rocha Ricardo Ramina Pedro Andre Kowacs Ambulatorio de Desordens da Memoria e do Comportamento Instituto de Neurologia de CuritibaCuritibaBrazil Instituto de Psiquiatria do Parana CuritibaBrazil Servico de Neurologia e Neurocirurgia CuritibaBrazil

normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a 79-year-old male was admitted for investigation of a dementia syndrome. The patient presented with clinical features and neuroimaging compatible with NPH. Syphilis serology was reactive and compatible with active disease. The patient was treated with crystalline penicillin (4 million units every 4 hours for 21 days) and was assessed again after three months, when his cognition and gait had improved and the urinary incontinence had resolved. According to this information, we describe a case of syphilis mimicking normal pressure hydrocephalus, making clear the importance of the investigation of sexually transmitted diseases in the differential diagnosis of dementia, even in patients without established risk supposedly.

关键词： Neurosyphilis Hakim-Adams Syndrome Syphilis normal pressure hydrocephalus

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