T he neuroinvasive mechanism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully understood. SARS-CoV-2 may enter the central nervous system hematogenously, with other proposed routes, including the olfactory and trigeminal nerves, cerebral spinal fluid (CSF), and lymphatic system (1). Neurologic manifestations in pediatric patients with coronavirus disease 2019 (COV-ID-19) have uncommonly been reported. Herein, we report a presumptive case of ischemic stroke due to focal cerebral arteriopathy (FCA) associated with COVID-19. Case Presentation A previously healthy 12-year-old-boy with a new onset of generalized seizures was initially treated with diazepam. Shortly thereafter, he developed right-sided hemiparesis and dysarthria. There was no previous history of fever, cough, shortness of breath, skin rash, hemoglobinopathy, or recent trauma. No one in his family had a known history of COVID-19 infection. The diagnosis of COVID-19 was made according to the presence of SARS-CoV-2 viral nucleic acid in the nasopharyngeal swab using 2019 novel coronavirus real-time reverse-transcriptase polymerase chain reaction assay. Test results for the presence of SARS-CoV-2 viral nucleic acid in the CSF were also positive. Viral genome was extracted using a viral RNA kit (High Pure; Roche, Basel, Switzerland), with a multiplex one-step reverse-transcriptase realtime polymerase chain reaction test (Pishtaz Teb Zaman Diagnostics, Tehran, Iran) to amplify COVID-19 E, N, and ORF1ab and/or RdRp genes. A CSF bacterial culture showed no growth after 3 days, and tests for herpes simplex viruses 1 and 2 and varicella-zoster virus (QIAGEN, Hilden, Germany) were negative. The serum ferritin level was 86.7 ng/L, the C-reactive protein level was 3 mg/L, and the erythrocyte sedimentation rate was 45 mm/h. CSF analysis demonstrated 21 mg/dL of protein, 62 mg/dL of glucose, 100 red blood cells per cubic millimeter (using traumatic lumbar puncture), and no white blood cells. The CSF opening pressure was 25 mm of H 2 O. d-dimer level was not obtained. The platelet count was 285310 3 /µL, the prothrombin time was 12.1 seconds, the international normalized ratio was 0.9, and the partial thromboplastin time was 27 seconds. The antinuclear antibody level was normal.

The aim of this study was to evaluate the protein and mRNA expressions of matrix metalloproteinase-14 (MMP14) and CDK7 in gastric cancer (GC) tissues. Upregulation of MMP14 mRNA level was observed in GC tissues when compared with the matched normal tissues (mean 6 SD: 3.92 6 1.15 vs. 1.35 6 0.81, P < 0.001). This study indicated that mRNA levels of CDK7 were statistically overexpressed in GC when compared with matched normal tissues (4.12 6 0.84 vs. 1.43 6 0.71, P < 0.001). The protein levels of MMP14 were found to be increased in GC (60.41%; P < 0.001). The expression of CDK7 was higher in GC tissues than matched normal tissues (70.83; P < 0.001). We found that high MMP14 expression was related to advanced TNM stage (P 5 0.004), tumor grade (P 5 0.002), and lymph node metastasis (P 5 0.015), but no association with other clinical variables (P > 0.05). In addition, high expression of CDK7 was significantly linked to advanced TNM stage (P 5 0.001), pathological grade (P 5 0.012), and presence of lymph node metastasis (P 5 0.009), while no correlation between CDK7 expression and other clinical variables, such as age and gender, distance metastasis. The patients with high expression of MMP14 and CDK7 exhibited worse survival time than those with higher levels. Cox multivariate regression analysis clearly showed that high expression of MMP14 and CDK7 was independent prognostic factors for overall survival in patients with GC. Taken together, these results indicated the overexpression of above markers in the progression and the tumorigenesis of GC and overall patient survival. V C 2016 IUBMB Life, 68(10): [799][800][801][802][803][804][805] 2016