ジュウニシチョウ カコウキャク ニ ハッセイシタ タハツセイ シュッケツセイ ジュウニシチョウ カイヨウ ノ 1レイ

We report a case of multiple hemorrhagic ulcers of the descending duodenum treated successfullysurgical suture and endoscopic clipping after transcatheter arterial embolization（TAE）. A50 level year-old man was treated in intensive care unit because of multiple organ failure by MRSAinfection after operation of ulcerative colitis. Massive intermittent melena from ileostomy wasoccurred and an endoscopic examination revealed mucosal erosion with massive bleeding from theVater’s papilla. Emergency abdominal angiography was performed because the condition of thepatients was poor. Angiography of common hepatic artery and gastroduodenal artery didn’tshow extravasation. An extravasation of the inferior pancreaticoduodenal artery was revealedand a hemostasis was performed with metal coil embolization. But the hemorrhage occurred repeatedlythree days after TAE. We embolized the gastroduodenal artery and the pancreaticoduonenalartery. We performed surgery after three times TAE. We identified the duodenalulcer with an exposed blood vessel beside the Vater’s papilla and complete hemostasis wasachieved by suturing ulcer through the incision of the anterior wall of the duodenum. The otherhemorrhagic duodenal ulcer of the 2nd portion occurred 25 days after the operation, and this hemorrhagecould be treated by the endoscopic hemostasis using clip

Autonomic function measurements for evaluating fatigue and quality of life in patients with breast cancer undergoing radiation therapy: a prospective longitudinal study

Background: Fatigue during radiation therapy in women with breast cancer can decrease quality of life (QOL), yet it is often underestimated and needs to be evaluated objectively. This longitudinal study aimed to evaluate fatigue and QOL of women with breast cancer undergoing radiotherapy with a simple autonomic function measurement. Methods: Women with breast cancer who underwent postoperative radiotherapy in eight cancer care hospitals in Chubu and Kinki regions in Japan were recruited between October 2021 and June 2022. The women underwent a self-administered questionnaire that included the Cancer Fatigue Scale (CFS) and the Short Form-8 Health Survey (SF-8) and an autonomic nervous function measurement using a simple, non-invasive device before (T0, baseline), mid (T1), and at the end (T2) of treatment. Results: The 57 women showed similar trends, with CFS scores and log LF/HF ratio being the highest at T0 and significantly decreasing at T1 (both p < 0.05). The log LF/HF trends differed between those with high and low baseline log LF/HF values. Women with mental component summary (MCS) score improvement (T0 to T2) had the highest log LF/HF ratio at T0 and had significantly lower log LF/HF values at T1 and T2 than at T0 (p < 0.01 and p < 0.05, respectively). The change of (⊿) MCS from T0 to T1 was negatively correlated with ⊿log LF/HF from T0 to T1 (r = − 0.36, p < 0.01). Conclusions: Measurement of autonomic nerve function with a simple device is useful for objective fatigue assessment during radiotherapy. Psychological support is important as improvement in mental health helps improve autonomic nerve function and, in turn, fatigue.Aoki M., Kuratsune H., Yamamoto S., et al. Autonomic function measurements for evaluating fatigue and quality of life in patients with breast cancer undergoing radiation therapy: a prospective longitudinal study. Radiation Oncology 18, 171 (2023); https://doi.org/10.1186/S13014-023-02362-W