Background Erythropoietin (EPO), which is associated with anemia, exerts neuroprotective effects in ischemic stroke. In cases of stenosis or narrowing of the main cerebral blood vessel, the prognosis is favorable if collateral blood circulation is well developed in acute stroke. Several studies have investigated the relationship between EPO administration and stroke outcomes. The present study investigated the correlation between serum EPO level and cerebral collateral circulation, which could result in favorable clinical outcomes.
Methods The study subjects were patients diagnosed with acute ischemic stroke who underwent initial brain magnetic resonance imaging between January 2020 and March 2022. Following brain computed tomography perfusion for collateral flow, serum EPO levels were measured. Collaterals were assessed according to the Mass system and divided into good collateral (GC) or poor collateral (PC) groups. Serum EPO levels were determined using a chemiluminescence immunoassay method. A correlation coefficient analysis was conducted to determine the correlation between serum EPO levels and GC. A receiver operating characteristic curve analysis determined the cutoff value of EPO for GC.
Results Serum EPO levels were significantly higher in the GC than that in the PC group (P<0.05). The cut-off level of serum EPO for a good outcome was 9.1 mIU/mL.
Conclusion A high serum EPO (>9.1 mIU/mL) could be a marker of GC in patients with acute ischemic stroke that predicts good clinical outcomes.
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Background Cadmium is a toxic element in cigarette smoke associated with ischemic vascular disease. Its association with cerebral aneurysm is unknown.
Methods We retrospectively analyzed the medical records of patients with headache who underwent imaging studies between March 2014 and August 2016. An unruptured intracranial aneurysm (UIA) was confirmed by brain magnetic resonance angiography or computed tomography angiography. A control group included age- and sexmatched patients without an UIA. Whole blood and random urine tests were used for detection of cadmium and arsenic levels, respectively. Student t-test was used to compare subject characteristics, mean cadmium and arsenic levels between groups, and differences between groups with small (<4-mm) and large (≥4-mm) UIAs. Multivariate regression analysis was used to identify risk factors for aneurysm incidence.
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Conclusion UIA incidence was associated with pack-years of smoking and serum cadmium level, but aneurysm size was not associated with serum cadmium level.
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Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis) is a rare disease characterized by lymphadenitis with fever. It is self-limited within one to four months, and is generally diagnosed by an excisional biopsy of the affected lymph node. Kikuchi-Fujimoto disease has a wide variety of nonspecifi c symptoms and it is sometimes misdiagnosed as malignant lymphoma, lymph node tuberculosis, or systemic lupus erythematosus. Because clinical course and treatment of this disease differ from those of others, Kikuchi-Fujimoto disease must be included in differential diagnosis of enlarged lymph node. In this report, we discribed a case of 24-year-old male patient who visited the clinic complaining of fever, petechiae, and enlarged lymph node. He was diagnosed as Kikuchi-Fujimoto disease and immune thrombocytopenic purpura.
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