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Intrasplenic metastasis of ovarian malignancies are uncommon. From 1986 to 1992 only 12 such cases were diagnosed, being 1.2% of the total number of patients with ovarian malignancies treated in tumor hospital during the same period. Of the 12 metastasis, 6 were poorly differentiated. Diagnosis was made through imaging techniques or surgery. The median interval from the diagnosis of the primary disease to intrasplenic involvement was 28 months. The metastatic lesions, presented themselves as single or multiple nodes within the cortex of the spleen. Clinical features were not remarkable. It was thought that the occurrence of intrasplenic involvement might be due to greater tumor bulk, poor differentiation and decreased host immuno-competence caused by chemotherapy. Most of the intrasplenic metastasis was found after liver metastasis or simultaneously with the latter. The main route of the tumor spread might be via blood vessels. Sole intrasplenic metastasis can be treated by surgery with a temporarily good result. Poor prognosis and high mortality characterize intrasplenic metastasis. The median survival was only 7 months.

For analysing the injurious mechanism of Trichosanthin (TCS) on trophoblast cells, cytotrophoblast cells were separated from placental villi in human early pregnancy and cultured on millipore filters coated with collagen in dual-environmental culture chambers. After 7-10 days culture the cells grew into confluent monolayer. A lot of multinucleated giant cells (synthetial like) could be found under light microscopy. Cytotrophoblast cells and the giant one were characterized as epithelial type by indirect immuno-fluorescent staining with anti-keratin. Because the procedure of separation of trophoblast cells is laborious and the choriocarcinoma cells (JAR) were as sensitive as trophoblast cells to trichosanthin, so the choriocarcinoma cells were used instead of the trophoblast cells in the later experiments. The internalization and distribution of TCS conjugated to 15 nm (in diameter) gold particles were examined. Electron microscopy showed that the TCS-gold particles were bound to the cell membrane and entered via coated pit and then internalized into coated vesicles (endosomes) within 30-60 minutes after treatment. Nevertheless, a number of free TCS-gold particles entered into the cell membrane nonspecifically. In the series of 60-120 minutes treatment, the TCS-gold particles presented in the multivesicular bodies. It is worthy to emphasize that the TCS-gold particles entered the cytosol from the endosomes and distributed nearby the rough endoplasmic reticulum (RER) and ribosomes within 120-180 minutes. In the meanwhile, the cells showed pathological changes markedly. With the same method, human liver carcinoma cells (BE 7402), kidney cells of African green monkey (CV-1) and rat embryonic liver epithelial cells (LW 13) were treated by TCS-gold particles as control. However, no particles had been found on the cell surface or in the cytosol within 60-120 minutes (see Table 1). In addition, trophoblast cells were treated by BSA-gold particles and transferrin-gold particles separately there still no particles could be found. (See Table 2). It is more interesting that TCS-Hepama-1-gold particles internalized into the choriocarcinoma cells with the same manner as TCS-gold entered, and it could not be affected by pretreatment with Hepama-1 an hour. But, TCS-Hepama-1-gold particles bound to the microvilli of human liver carcinoma cells, and it can be inhibited competitively by pretreatment with Hepama-1 for an hour (see Table 3). These results indicated consistently that trichosanthin possesses a high affinity to the membrane of trophoblast cells and choriocarcinoma cells, and the internalization of this plant toxic protein into its target cells characterized by receptor-mediated endocytosis.(ABSTRACT TRUNCATED AT 400 WORDS)

We previously showed that under defined conditions beta-[3H]funaltrexamine (beta-[3H]FNA) covalently labeled mu-opioid receptors with high specificity in bovine striatal membranes. beta-[3H]FNA-labeled mu-opioid receptors migrated as a broad band with a molecular mass range of 68-97 kDa. It is controversial whether beta-FNA binds irreversibly to mu-opioid receptors in other species. In this study, we demonstrated that beta-[3H]FNA also labeled mu-opioid receptors with high specificity in brain membranes of the guinea pig, rat, and mouse. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and fluorography revealed that in each species beta-[3H]FNA specifically bound to a protein in which labeling was greatly reduced by naloxone. These labeled receptors had broad molecular mass ranges, and the molecular masses were different among these species, in the order of cowguinea pigratmouse. Membranes were subjected to solubilization with 2% Triton X-100 and wheat germ lectin (WGL) affinity chromatography. N-Acetylglucosamine eluted a peak of radioactivity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and fluorography showed that in all four species the mu receptor was the only protein labeled with beta-[3H]FNA in the WGL eluate. The molecular masses of labeled mu-opioid receptors were 70-88 kDa (median, 77 kDa) for the cow, 66-80 kDa (median, 72 kDa) for the guinea pig, 60-75 kDa (median, 67 kDa) for the rat, and 60-72 kDa (median, 66 kDa) for the mouse. In addition, we investigated the nature of the carbohydrate moieties linked to the receptor protein and whether the species variation in the molecular mass was due to variable degrees of glycosylation. The bovine WGL eluate was treated with various glycosidases. Neuraminidase treatment decreased the receptor molecular mass by 6-7 kDa, whereas alpha-mannosidase had no effect. Removal of N-linked carbohydrates at asparagine residues by peptide-N4-[N-acetyl-beta-glucosaminyl]asparagine amidase (N-Glycanase) resulted in a much sharper specifically labelled protein band of 43 kDa. These results indicate that mu-opioid receptors are heavily glycosylated and the major carbohydrate moieties are of the complex type, N-linked to asparagine. After the WGL eluates for the four species were treated with N-Glycanase, the labeled receptors became much sharper bands with very similar molecular masses, i.e., 43 kDa for the cow and guinea pig, 39 kDa for the rat, and and 40 kDa for the mouse.(ABSTRACT TRUNCATED AT 400 WORDS)

The state of knowledge of Taiwanese bark and ambrosia beetles (Coleoptera: Curculionidae: Scolytinae) is summarised to serve as a baseline for future studies of the fauna, with a checklist including information on distribution, host trees, biology and taxonomy. Six faunal elements based on geographical distribution are discussed in relation to their breeding sites and habits, and host preferences. One hundred and thirty-three species are recorded from Taiwan, of which thirtyeight are recorded for the first time. The following new synonymy is proposed: Ambrosiodmus lewisi (Blandford) (= Ozopemon tuberculatus Strohmeyer n. syn.), Anisandrus hirtus (Hagedorn) (= Xyleborus taiwanensis Browne n. syn.), Cyclorhipidion fukiensis (Eggers) (= Xyleborus tenuigraphus Schedl n. syn.), Cyrtogenius luteus (Blandford) (=Orosiotes formosanus Schedl n. syn.), Diuncus haberkorni (Eggers) (=Xyleborus taichuensis Schedl n. syn.) , Dryocoetes hectographus Reitter (=Ozopemon ater Eggers n. syn., =Dryocoetes formosanus Nobuchi n. syn.), Hypothenemus taihokuensis (Schedl) (=Hypothenemus cosmoderoides Murayama n. syn.), Xyleborinus artestriatus (Eichhoff) (= Xyleborus beaveri Browne n. syn.), Xyleborus pinicola Eggers (= Xyleborus pinivorus Browne n. syn.). The synonymy of Webbia camphorae Eggers and Webbia medius Eggers with Arixyleborus rugosipes Hopkins is confirmed. The following new combinations are given: Ernoporus formosanus (Browne) from Ptilopodius Hopkins; Ambrosiophilus hunanensis (Browne), A.metanepotulus (Eggers), A. satoi (Schedl), A. subnepotulus (Eggers), Cyclorhipidion formosanus (Browne), C. fukiensis (Eggers), C. ohnoi (Browne), C. xyloteroides (Schedl), Microperus kirishimanus (Murayama), Planiculus minutus (Blandford), all originally described in Xyleborus Eichhoff. Previous records of 23 species are considered dubious and require confirmation.

Fifty three patients with evaluatable ovarian cancer were conducted a clinical trial of a new antineoplastic drug, carboplatin (cp) made in China. Apart from 1 case of stage Ic and 3 cases of stage II, all the remainders had advanced disease including stage III, IV or recurrences, and mainly consisting of epithelial carcinoma (44 cases). Thirty two patients were treated with single cp at the dose of 260-410 mg/m2 and twenty one were treated with combination chemotherapy of cp at a dose of 180-350 mg/m2 plus adriamycin and cyclophosphamide by intravenous infusion without hydration, repeated every 4 weeks, 2-4 courses. The response rate was 56% (18/32) and 48% (10/21), respectively. There were obviously different response rates in patients with previous chemotherapy (25% and 23% in cp single and combination chemotherapy groups) and without chemotherapy (67% and 88% in single and combination groups). It showed that cp was effective in treatment of ovarian cancers with advantages that gastrointestinal reaction was less severe in cp group than in the group using drugs including cis-platin, and no renal toxicity. However, cp showed more marked myelosuppression and hepatic injury in small number of the patients.

Serum CA125 levels were monitored in 30 patients with epithelial ovarian cancer prior to second-look laparotomy. All patients had undergone cytoreductive surgery and multiple courses of chemotherapy and with no clinical and radiologic evidence of tumor. All ten patients who had had negative second-look finding gave normal serum CA125 levels (less than or equal to 35 u/ml). Of the 20 patients who were positive in second-look, 11 had normal CA125 levels, with a false negative rate of 55% including 67% (4/6) patients with microscopic evidence of tumor and 50% (7/14) patients with gross residual tumor. All 9 patients with elevated serum CA125 levels were positive in their second-look. 73% (8/11) patients with residual tumor having greatest diameter less than or equal to 2 cm had normal CA125 with a median value of 13 u/ml. 33% (3/9) patients with tumors having the greatest diameter greater than 2 cm had normal CA125 and the CA125 median value was 114 u/ml. These results show that the size of the residual tumor found in second-look was related to the serum CA125 level. As CA125 level within normal limits gave more false negatives, the necessity of second-look can not be judged by serum CA125 assay though elevated CA125 levels do predict the presence of tumor.

Between 1981-1988, 23 patients with epithelial ovarian cancer underwent second-look laparotomy after initial surgery followed by multiple courses of chemotherapy. There was no evidence of tumor before operation. Six patients (26%) had gross tumor and 5 (22%) had microscopic tumor. One of 3 patients with stage I or II and 50% (10/20) of patients with stage III and recurrent disease had positive second-look. Two of 7 (29%) patients with no residual tumor after initial surgery and 9 of 16 (56%) with residual tumor had positive second-look. It showed that the results of second-look were correlated with stage and residual tumor left after initial surgery. Sixteen patients had CA125 serum immunoassay prior to second-look. CA125 level was in normal limits (less than or equal to 65 U/ml) in 12 patients. Positive second-look findings were observed in 7 patients (58%), of which 5 had microscopic tumors. The results indicate that the second-look laparotomy is probably the best way to evaluate residual tumor in the abdominal cavity.

beta-Funaltrexamine (beta-FNA) was shown to be a reversible kappa agonist and an irreversible mu antagonist. [3H]beta-FNA at low concentrations (less than 10 nM) covalently binds to mu but not delta or kappa opioid receptors in brain membranes. The interaction between beta-FNA and mu opioid receptors was thought to involve two steps; a reversible ligand-receptor complex is formed before the formation of an irreversible complex, based on observations in bioassays in vitro. In this study, we investigated whether such a two-step process occurred in binding using bovine striatal membranes and determined the kinetic parameters by examining the time courses of both reversible and irreversible binding of [3H]beta-FNA to mu opioid receptors. Specific binding was defined as the difference between binding in the presence of levorphanol and dextrorphan (1 microM). Reversible binding was determined as the difference between membrane (reversible and irreversible) binding and irreversible binding. At 25 degrees, the rate of formation of irreversible [3H]beta-FNA-receptor complex increased as the concentration increased and reached a plateau at 2 nM; further increase in [3H]beta-FNA concentration did not enhance the rate of formation, indicating that the rate saturation effect exists for irreversible binding of [3H]beta-FNA to mu opioid receptors. At 10 degrees and low concentrations (less than 1 nM) of [3H]beta-FNA, appreciable reversible binding to opioid receptors occurred before any irreversible [3H]beta-FNA-receptor complex could be detected. These observations support the notion that reversible binding occurs before alkylation of the receptor. The binding of [3H]beta-FNA to mu opioid receptors was thus modeled to allow for such a two-step process: (formula; see text) A mathematical analysis method was derived to allow determination of all kinetic parameters (k+1, k-1, k2, and Kd) of such a two-step reaction. Values of k2, k+1, k-1, and Kd were determined at 10 degrees for 0.5, 0.25, and 0.125 nM [3H]beta-FNA and were found to be very similar among these three concentrations. Raising the incubation temperature from 10 degrees to 37 degrees greatly enhanced the values of k+1, k-1, and k2 without affecting Kd. At 37 degrees incubation without 200 mM NaCl significantly decreased the values of k+1, k-1, and k2 without affecting Kd. NaCl increased the irreversible binding, probably by shifting the equilibrium towards a conformation that binds more easily with beta-FNA. Under all conditions examined, the value of k-1 was found to be at least 5-fold greater than k2, indicating that the majority of the reversible complex dissociates and only a small portion proceeds to form irreversible complex. This finding is consistent with published observations that only a portion of beta-FNA binding to mu opioid receptors is irreversible. In conclusion, [3H]beta-FNA binds reversibly to mu opioid receptors before forming covalent bonding...

Thin films with ultrafine Si nanocrystals and ultraviolet (UV) light emission were prepared by using reactive sputtering of SiO2 and Al targets. The reaction of Al and SiO2 leads to the formation of ultrafine Si nanocrystals with compact Al2O3 shell. Al2O3 shell retards the growth of Si nanocrystals and provides ideal passivation on Si nanocrystals. Intrinsic UV photoluminescence is ascribed to the quantum-confinement effect of Si nanocrystals.

A key to the species of Bostrichidae from Taiwan is provided. Twelve species are recorded from Taiwan for the first time. Twenty-one species are believed to be established in Taiwan. A further seven species are recorded, but are not definitely known to be established. A lectotype is designated for Sinoxylon mangiferae Chujo.

Effects of 24 h pretreatment with inaacerebroventricular (icv) β-FNA on brainμ opioid receptor binding in rats were examined under various conditions. [ 3 H]DAMGO binding was performed under three conditions: (i) preaeatment of membranes with GDP and Na + and binding in the presence of Mg ++ in Tris-HCl buffer containing EGTA and leupeptin for 1.5-3 h; (ii) binding in Tris-HCl buffer containing bacitracin, leupeptin, chymostatin and bestarin for 3-4 h; (iii) binding in Tris-HCl buffer containing EGTA and leupeptin for 45 min. Condition i was shown to convert opioid receptors to a high affinity state for agonists

We recently cloned and expressed a rat κ opioid receptor by emploging polymerase chain reaction (PCR) techniques. Primers were similar to those of Libert et al. (1). Poly(A) + RNA was isolated from the rat striatum and reverse-transcribed into ds cDNA with oligo(dT) primers. PCR was performed on ds cDNA and nucleotide sequences of the PCR products determined. One of the PCR products, which had some homology to the mouse δ opioid receptor, was used to screen a rat striatum λgt10 cDNA library. One positive clone with a 2.2-kb insert (RKOR) was identified. RKOR had an open reading frame of 1140 bp and encoded a 380-amino acid protein. Hydropathy analysis indicated that RKOR had seven putative transmembrane domains with short intra- and extra-cellular loops

To determine the effectiveness and acceptability of general practitioners'opportunistic antismoking interventions by examining detailed accounts of smokers' experiences of these.Qualitative semistructured interview study.South Wales.42 participants in the Welsh smoking intervention study were asked about initial smoking, attempts to quit, thoughts about future smoking, past experiences with the health services, and the most appropriate way for health services to help them and other smokers.Main emerging themes were that subjects already made their own evaluations about smoking, did not believe doctors' words could influence their smoking, believed that quitting was down to the individual, and felt that doctors who took the opportunity to talk about smoking should focus on the individual patient. Smokers anticipated that they would be given antismoking advice by doctors when attending for health care; they reacted by shrugging this off, feeling guilty, or becoming annoyed. These reactions affected the help seeking behaviour of some respondents. Smokers were categorised as "contrary," "matter of fact," and "self blaming," depending on their reported reaction to antismoking advice.Doctor-patient relationships can be damaged if doctors routinely advise all smokers to quit. Where doctors intervene, a patient centred approach-one that considers how individual patients view themselves as smokers and how they are likely to react to different styles of intervention-is the most acceptable.

We report additive-pulse mode locking of lamp-pumped Nd:YAG lasers at both 1.06 and 1.32 microm. Under completely self-starting conditions, stable cw mode-locked trains of 6-psec pulses have been achieved at an average output power of 2.4 W.

Seven patients with primary melanoma of the vagina, five untreated and two recurrent, are reported. The ages ranged from 25-55 years, with an average of 42.3 years. The common symptoms were vaginal bleeding and a vaginal mass, and the most common site was the posterior wall of the vagina (three of seven patients). Two patients survived for more than five years.

Fifty-seven patients with metastatic ovarian cancer arising from extra-genital sites are analysed. 80.8%, 14% and 5.3% of the primary cancers were from gastrointestinal tract (GI), breast and lung, respectively. The primary carcinoma was diagnosed before the discovery of ovarian tumor in 24 patients. The ovarian and primary carcinomas were found simultaneously in 11 patients (including one autopsy), while in 22 patients, the primary cancer was not discovered until the ovarian tumor had been resected. Both ovaries were involved in 60% of GI cancer and 12.5% of breast cancer. 91.2% of the patients were found to have metastasis to other tissues and organs outside the ovary. Of patients with GI cancer, 80.8% had metastasis to the abdomino-pelvic cavity, 73.7% had ascites and 52.2% had lymphatic metastasis. The majority of the patients with breast cancer had lymphatic (75%) and hematogenous (50%) metastases. In this series, the prognosis was poor in all the patients with an average survival time of 11 months. 63.2% and 86% of the patients died within 1 and 2 years. These facts indicate that ovarian involvement may be an important part of widespread dissemination from the primary cancer.

Dynorphin A(1-17), the proposed endogenous ligand for the kappa receptor, has been reported to demonstrate no antinociceptive activity when tested in analgesic assays involving noxious (heat (e.g., tail-flick and hot-plate assays). By using a rat tail-flick analgesic assay that utilizes extreme cold as its noxious stimulus (an ethylene glycol-water mixture maintained at -10 degrees C), we have recently reported a dose-related and naloxone-reversible antinociceptive effect for i.c.v. administered dynorphin A(1-17). To elucidate the biochemical mechanism of this antinociception, we designed a push-pull perfusion system which would allow us to measure changes in neuropeptide release in the spinal cord during exposure to noxious heat or cold. Male Sprague-Dawley rats were implanted surgically with two lengths of PE-10 tubing inserted into the spinal subarachnoid space via the cisterna magna, with the push cannula at the level of T-1, and the pull cannula at the rostral edge of the lumbar enlargement. At the time of testing, samples of cerebrospinal fluid were collected both in the presence and absence of a noxious stimulus. Substance P (SP) and somatostatin (SST) levels were measured by radioimmunoassay. Exposing the animal's tail to the noxious cold (30 sec/min for 20 min) resulted in a significant elevation in SP release (69% above base-line levels), but no change in the level of SST release. Conversely, exposure to noxious heat (50 degrees C, 20 sec/min for 20 min) produced a significant increase in SST release (56% above base line), but no change in the level of SP release.(ABSTRACT TRUNCATED AT 250 WORDS)

[3H]beta-funaltrexamine ([3H]beta-FNA) bound irreversibly to bovine striatal membranes. Naloxone inhibited the irreversible binding of 5 nM [3H]beta-FNA in a dose-dependent manner and maximally inhibited this binding at approximately 1 microM. Thus, the specific irreversible binding of [3H]beta-FNA to opioid receptors was defined as that which could be inhibited by 1 microM naloxone. This specific irreversible binding of [3H]beta-FNA was characterized. Exclusion of Na+ from the incubation medium reduced the specific binding of [3H]beta-FNA, and Na+ could be substituted by Li+ but not by K+, Cs+, Mg2+, or guanylylimidodiphosphate. The specific irreversible binding was saturable, time- and temperature-dependent, and was linearly related to tissue mass. Several drugs were used to characterize this specific binding. Levorphanol was 1000 times more potent as an inhibitor than dextrorphan. mu Opioid ligands (sufentanil and morphine) were much better inhibitors than delta (ICI174,864) or kappa (U50,488H) ligands. The potency of [D-Ala2, D-Leu5]enkephalin (DADLE) was between those of sufentanil and ICI174,864. These results demonstrated that under appropriate conditions [3H]beta-FNA specifically and irreversibly bound to the mu opioid binding site. Membrane preparations labeled with [3H]beta-FNA in the presence or absence of 1 microM naloxone or beta-FNA were subjected to polyacrylamide gel electrophoresis under denaturing and reducing conditions. Fluorograms showed that [3H]beta-FNA specifically bound to a protein (most likely the mu opioid binding site) that migrated as a band with a molecular weight range of 68,000-97,000. Such electrophoretic behavior indicates that it is likely to be a glycoprotein. The glycoprotein nature was confirmed by its adsorption onto a wheat germ lectin-Sepharose column after solubilization and subsequent elution by N-acetyl-D-glucosamine. In this lectin column eluate, the mu opioid receptor was the only protein band labeled by [3H]beta-FNA in the total binding preparation, and no labeled protein was observed in the nonspecific binding preparation. When the wheat germ lectin column eluate of the total binding was treated with peptide:N-glycosidase F, the broad labeled band of Mr 68,000-97,000 became a sharp band of Mr 57,000 with high radioactivity and a faintly labeled band of Mr 49,000.

The effect of beta-funaltrexamine (beta-FNA), an irreversible mu receptor blocker in isolated tissue bioassays, on mu, kappa and delta opioid receptor binding and the binding of beta-[3H]FNA were determined in guinea pig brain membranes. beta-FNA inhibited the binding of mu, kappa and delta opioid ligands to their receptors with Ki values of 2.2, 14 and 78 nM, respectively. Pretreatment of brain membranes with beta-FNA (less than 2 microM) followed by extensive washing inhibited mu binding and to a lesser degree delta binding, without changing kappa binding. The extent of the irreversible inhibition was dependent on the concentration of beta-FNA, and this inhibition on mu binding could be observed with as little as 1 nM beta-FNA. The irreversible inhibition of mu binding by beta-FNA pretreatment was due to a decrease in the number of binding sites with little change in Kd, and was more pronounced in the presence of increasing concentrations of NaCl. Specific binding of beta-[3H]FNA to opioid receptors was demonstrated. The rate of specific binding with 2 nM beta-[3H]FNA was rapid in the initial 10 min and did not reach maximum in 90 min. The dissociation of bound beta-[3H]FNA (5 nM added) by the addition of excess unlabeled naloxone reached maximum at 30 min with approximately 35% of specifically bound beta-[3H]FNA remaining. Mu opioids were most effective in preventing specific binding of beta-[3H]FNA when added before beta-[3H]FNA. Opioids added 1 hr after 2 nM beta-[3H]FNA could displace maximally only 70 to 75% of specific binding.(ABSTRACT TRUNCATED AT 250 WORDS)

Twenty seven patients with dysgerminoma of the ovary were treated in our hospital from 1959 to 1982. 18 of them had no prior treatment and the other 9 had undergone operation and were admitted for recurrence. Among these 18 untreated patients, all were successfully operated. Apart from 4, the others were supplemented by radiotherapy and/or chemotherapy. 17 (94%) were free of disease from 3 to 24 years, only one died of tumor recurrence within 5 years after the initial treatment. The 5 year survival rate was 94%. However, among the 9 recurrent patients, 6 were treated by operation, supplemented by postoperative radiotherapy and/or chemotherapy but only 3 survived for 7, 14 and 15 years respectively without any evidence of disease. The 5 year survival rate was 33%. As those patients who received conservative operation initially gave a high recurrence rate, the authors propose that the patients be treated individually according to the condition of disease. The choice of treatment for the individual patient is discussed.

62 patients with advanced epithelial ovarian adenocarcinoma (37 stage III, 4 stage IV and 22 recurrent lesions) were treated in our hospital from 1977 to 1981, 38 patients underwent surgery. 25 with inoperable tumor initially received preoperative chemotherapy (VCF protocol: vincristine + cyclophosphamide + fluorouracil chiefly) followed by surgery. The response rate of chemotherapy was 48%. Apart from 1 progressive tumor during chemotherapy, 24/25 were explored. There were 10/24 with residual tumor less than 2 cm in diameter, giving a resection rate of 41.7% as compared with the resection rate of 42.1% (16/38) in the operation group. It is shown that the preoperative chemotherapy improves the resection rate. 44 patients received postoperative chemotherapy and 12, radiotherapy combined with chemotherapy or radiotherapy only. The overall 2.3 and 5 year survival rates of these 63 patients were 39.7%, 31.7% and 23.8%. The 2 and 3 year survivals were 41.9% and 32.3% in 31 patients with postoperative chemotherapy using VCF protocol. The results indicate that VCF protocol is effective for advanced epithelial ovarian cancer, especially patients with residual tumor less than 2 cm in size. Chemotherapy with more than 3 courses has better effect.

No summary was available at press time.

BACKGROUND: The early detection and excision of potentially malignant disorders (PMD) of the lip and oral cavity that require intervention may reduce malignant transformations (though will not totally eliminate malignancy occurring), or if malignancy is detected during surveillance, there is some evidence that appropriate treatment may improve survival rates. OBJECTIVES: To estimate the diagnostic accuracy of conventional oral examination (COE), vital rinsing, light-based detection, biomarkers and mouth self examination (MSE), used singly or in combination, for the early detection of PMD or cancer of the lip and oral cavity in apparently healthy adults. SEARCH METHODS: We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID), and MEDION) from inception to April 2013. The electronic databases were searched on 30 April 2013. There were no restrictions on language in the searches of the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA: We selected studies that reported the diagnostic test accuracy of any of the aforementioned tests in detecting PMD or cancer of the lip or oral cavity. Diagnosis of PMD or cancer was made by specialist clinicians or pathologists, or alternatively through follow-up. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. We reported the sensitivity and specificity of the included studies. MAIN RESULTS: Thirteen studies, recruiting 68,362 participants, were included. These studies evaluated the diagnostic accuracy of COE (10 studies), MSE (two studies). One randomised controlled of test accuracy trial directly evaluated COE and vital rinsing. There were no eligible diagnostic accuracy studies evaluating light-based detection or blood or salivary sample analysis (which tests for the presence of bio-markers of PMD and oral cancer). Given the clinical heterogeneity of the included studies in terms of the participants recruited, setting, prevalence of target condition, the application of the index test and reference standard and the flow and timing of the process, the data could not be pooled. For COE (10 studies, 25,568 participants), prevalence in the diagnostic test accuracy sample ranged from 1% to 51%. For the eight studies with prevalence of 10% or lower, the sensitivity estimates were highly variable, and ranged from 0.50 (95% confidence interval (CI) 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00) with uniform specificity estimates around 0.98 (95% CI 0.97 to 1.00). Estimates of sensitivity and specificity were 0.95 (95% CI 0.92 to 0.97) and 0.81 (95% CI 0.79 to 0.83) for one study with prevalence of 22% and 0.97 (95% CI 0.96 to 0.98) and 0.75 (95% CI 0.73 to 0.77) for one study with prevalence of 51%. Three studies were judged to be at low risk of bias overall; two were judged to be at high risk of bias resulting from the flow and timing domain; and for five studies the overall risk of bias was judged as unclear resulting from insufficient information to form a judgement for at least one of the four quality assessment domains. Applicability was of low concern overall for two studies; high concern overall for three studies due to high risk population, and unclear overall applicability for five studies. Estimates of sensitivity for MSE (two studies, 34,819 participants) were 0.18 (95% CI 0.13 to 0.24) and 0.33 (95% CI 0.10 to 0.65); specificity for MSE was 1.00 (95% CI 1.00 to 1.00) and 0.54 (95% CI 0.37 to 0.69). One study (7975 participants) directly compared COE with COE plus vital rinsing in a randomised controlled trial. This study found a higher detection rate for oral cavity cancer in the conventional oral examination plus vital rinsing adjunct trial arm. AUTHORS' CONCLUSIONS: The prevalence of the target condition both between and within index tests varied considerably. For COE estimates of sensitivity over the range of prevalence levels varied widely. Observed estimates of specificity were more homogeneous. Index tests at a prevalence reported in the population (between 1% and 5%) were better at correctly classifying the absence of PMD or oral cavity cancer in disease-free individuals that classifying the presence in diseased individuals. Incorrectly classifying disease-free individuals as having the disease would have clinical and financial implications following inappropriate referral; incorrectly classifying individuals with the disease as disease-free will mean PMD or oral cavity cancer will only be diagnosed later when the disease will be more severe. General dental practitioners and dental care professionals should remain vigilant for signs of PMD and oral cancer whilst performing routine oral examinations in practice.