[A case report of recurrent small bowel adenocarcinoma successfully treated with monoclonal antibody against EGFR and S-1].

A man in 30s was admitted to our hospital with a complaint of abdominal and back pain. Abdominal CT scan showed a large mass and double balloon endoscopy detected a tumor of the jejunum. The pathological diagnosis of biopsy samples was poorly differentiated adenocarcinoma. After radical resection, adjuvant chemotherapy with mFOLFOX6 was administered, however, a recurrent lesion developed. Although the lesion was successfully removed again, it did not react to the combination therapy with irinotecan and cisplatin. Because the tumor showed a high percentage of epidermal growth factor receptor (EGFR) expression and also had a wild-type KRAS status, a therapeutic strategy targeting EGFR was selected. The patient started on panitumumab associated with S-1 and obtained a complete response on CT 6 weeks later. Small bowel adenocarcinoma is an aggressive malignancy with a poor prognosis and little information about its definitive chemotherapy. Analysis of molecular characterization, an increase in reported experience, and prospective trials are needed to improve a prognosis.

Effects of the feeding of wild Yeso sika deer (Cervus nippon yesoensis) on the prevention of damage due to bark stripping and the use of feeding sites.

Feeding sites for wild Yeso sika deer around Lake Akan, Japan, were established. Effects on the number of deer using the feeding sites, the prevention of bark stripping damage, the amount of feeding, and eating time in a 5-year period (1999-2003) were evaluated. The number of deer using feeding sites increased with years during the feeding period. The damaged tree ratio after the initiation of feeding markedly decreased compared with 16.5% before the initiation of feeding. After the start of feeding, there were no trees with damage the entire circumference. According to tree species, the number of damaged trees of Ulmus laciniata Mayr as a percentage of all investigated trees was high (5.2%). The total amount of beet pulp feeding increased with the feeding year, showing 4.5-fold increase. At feeding sites in deer culling, eating behavior was observed during the night. The preventive effects on bark stripping damage continued during the 5-year feeding period. However, with the course of feeding years, the number of deer using feeding sites and the level of feeding increased.

[Role of palliative chemotherapy and shift from anticancer therapy to palliative care in patients with advanced or recurrent breast cancer].

We examined the role of palliative chemotherapy and the shift from anticancer therapy to palliative care in 30 patients who had died of advanced or recurrent breast cancer. Patients who received more than four chemotherapy regimens had a longer survival and started analgesics later than those who received less than three regimens. In addition, median survival time was prolonged in patients treated with both anthracycline- and taxane-containing regimens. Presence of bone metastases did not influence survival time, but extended the period of last hospitalization. In the average process of advanced or recurrent breast cancer, use of analgesics was started on the 500 th day and the last hospitalization was on the 760 th day from the diagnosis. Last chemotherapy was performed 29 days before death, and the median survival length was 811 days. Patients were treated as outpatients in 94% of the period from their recurrence until death. Therefore, it is especially important to support outpatients physically and mentally from the early stage of recurrence.