Background：Non-valvular atrial fibrillation (NVAF) in elderly patients is a serious risk factor for cardiogenic cerebral embolism. Aim：Here, we investigated the effect of edoxaban on the occurrence of stroke in NVAF cases. Methods：We investigated the clinical results, based on patient background and incidence of cerebral infarction, of 23 elderly patients aged 65 years or older with NVAF who were treated with edoxaban between April 2013 and March 2017. Results：Mean patient age (18 men, five women) was 77 ± 8 years. Of the cohort, 13 patients (56 %) had chronic NVAF and 10 patients (44 %) had paroxysmal NVAF. The loading amount of edoxaban was 30 mg in 16 cases (70 %) and 60 mg in seven cases (30 %). The mean estimated glomerular filtration rate was 61.6 ± 22.7 mL/min. The mean CHADS2 score was 2 ± 1.1 points. After edoxaban administration, one patient with gastric cancer recurrence required hospitalization for gastrointestinal bleeding. No new cases of cardiac cerebral infarction occurred during the observation period. Conclusions：Our study demonstrates that edoxaban is safe and that it effectively prevents cardiogenic cerebral embolism in elderly NVAF patients.

View full abstract

A 56-year-old woman exhibited a high serum carbohydrate antigen (CA) 19-9 level of 2697 IU/mL and was referred to our department. Cervical to pelvic computed tomography (CT) and positron emission tomography/CT revealed swollen lymph nodes all over the body. Examination of a transbronchial lung biopsy specimen satisfied the histological diagnosis of sarcoidosis. Her CA19-9 level spontaneously decreased to within the normal limit. She presented with few findings specific to sarcoidosis, which was diagnosed upon detection of high serum CA19-9. There have been sporadic reports of increased CA19-9 levels in sarcoidosis.

View full abstract

Clostridium perfringens infection is a rare but rapidly progressive life-threatening condition. Early diagnosis and subsequent prompt treatment are the key to treatment. We report a fulminant case of an apparently immunocompetent 77-year-old woman with a Clostridium perfringens liver abscess and a remote history of resected rectal cancer and hepatectomy. Our case underscores the importance of hepatobiliary tract intervention as a risk factor for the development of a Clostridium perfringens liver abscess, even when the operation was performed decades ago.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract