Objective To study the characteristics, therapies and prognosis of the patients with epithelial ovarian cancer (EOC) that are initially categorized as extra abdominal adenocarcinoma of unknown primary Methods Twenty five patients with EOC, who were treated in the Cancer Hospital of Fudan University from Jan 1986 to Dec 1997, and manifesting as extra peritoneal or liver parenchyma metastases at the time of presentation, without detectable ovarian tumors, were retrospectively studied Results Supraclavicular and inguinal lymph node metastases were common in this group of patients, with 6 and 5 cases respectively, and 6 patients with more than two sites metastases simultaneously 16 patients (64%) were optimally surgical debulked 20 patients with stage Ⅳ EOC initially presenting as extra abdominal metastases experienced a better prognosis, with an estimated median survival of 24 months. Of whom the median survival was 30 months in patients presenting with pleural effusion or supraclavicular lymph node metastases Vs 19 months in those with other sites spread ( P =0 026 4) Conclusions The prognosis of such cases, particularly for those with supraclavicular lymphadenopathy or malignant pleural effusion, is a lot better than other stage Ⅳ EOC patients, probably because of most of the patients initially presenting with distant metastases being generally in a good condition competent for aggressive surgery or multi cycle chemotherapy

6) of platinum based intravenous chemotherapy prolonged the survival of patients with suboptimal cytoreduction Intraperitoneal chemotherapy was one of the dominant long term survival determinants, and mainly on those with size of residual disease less than 1 cm

1 cm after secondary cytoreduction.

AIM: To investigate the relationship of microRNA-7 ( miRNA-7 ) over-expression and epidermal growth factor receptor (EGFR)/phosphatidylinositol kinase-3 (PI3K)/protein kinase B (PKB, also called Akt) pathway in human nasopharyngeal carcinoma 5-8F cells.METHODS:The 5-8F cells were transfected with miRNA-7 mimics (car-rying by Lipofectamine 2000).The expression of miRNA-7 was detected by real-time PCR.The cell proliferation was ana-lyzed by CCK-8 assay.The cell colony-forming capability was determined by cell colony formation test.The expression of EGFR/PI3K/Akt at mRNA and protein levels was examined by real-time PCR and Western blotting.RESULTS:The ex-pression level of miRNA-7 was significantly increased in 5-8F cells compared with negative control ( NC) group and control group ( P<0.01) .The proliferation of NPC 5-8F cells was decreased extremely after tansfected with the miRNA-7 mimics (P<0.01), so did the result of the cell colony-formation test.The expression of EGFR/PI3K/Akt at mRNA and protein levels was significantly down-regulated compared with NC group and control group (P<0.01).CONCLUSION:Over-ex-pression of miRNA-7 significantly inhibits the proliferation and colony-forming ability of nasopharyngeal carcinoma 5-8F cells by down-regulation of EGFR/PI3K/Akt pathway.

1cm, there was a significant statistical difference in median survival of 61 and 12 months, respectively (? 2 =16.60, P =0.0001). The median survival for patients with and without peritoneal chemotherapy were 27 and 12 months, respectively (? 2 =3.45, P =0.0633). Residual disease, FIGO stage, recurrent ascites, uterus muscle involvement were independent prognostic determinants of survival identified by Cox's stepwise regression analysis. Conclusions Aggressive surgical cytoreduction should be performed in elderly AEOC patients as well as in younger patients, but multi-course platinum-based chemotherapy should be used in accordance with the performance status of elder women.

Objective To explore the method of demonstrating main operative section of facial recess approach with multi-slice CT by using double oblique muttiplanar reconstruction.MethodsSimilarly as surgical procedure of facial recess approach,30 (60 eras) normal temporal bones in cadavers were reconstructed to observe main operative sections and anatomical marks.Main images of operative section of facial recess approach were reconstructed using double oblique multiplanar reconstruction on multislice CT.With the reference of operative anatomical marks,the ratios of visibility of anatomical marks on the transverse plane,coronal plane,sagittal plane and double oblique were calculated and compared.The degree,of which major anatomical landmarks were displayed on the same plane ( axial,coronal,sagittal,or doubleoblique sagittal plane),was classified using the following criteria: level 4: 100％ of anatomical landmarks were presented in the same plane; level 3: 90％ to 99％ of anatomical landmarks were presented in the same plane; level 2: 80％ to 89％ of anatomical landmarks were presented in the same plane; level 1: 70％ to 79％ of anatomical landmarks were presented in the same plane ; level 0: ＜ 70％ of anatomical landmarks were presented in the same plane.Classification data were tested by chi-square test.Results Four key operative section were involved in facial recess approach,which were of oblique sagittal orientation.The central mark of the first key operative section was semicircular canal by using double oblique multi-planar reformation.On reconstructed images of the first key operative section,horizontal reference line was short process of incus,and the angle adjusting the reference line on the transverse plane was 22.15° ±5.22°.On the reconstructed images of the first key operative section,coronal reference line was tympanic segment of facial canal,and the angle adjusting the reference line on the coronal plane was 14.35° ± 4.02°.On the reconstructed images of the second key operative section,the central mark was fossa incudis,the horizontal reference line was short process of incus and the angle was 20.15° ± 5.52°,while the coronal reference line was tympanic segment of facial cana,and the angle was 13.15° ± 3.33°.On the reconstructed operative images of the third key section,the central mark was pyramidal eminence,the horizontal reference line was the horizontal portion of the facial nerve and the angle was 32.53° ±5.22°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.05° ± 4.43°.On the fourth reconstructed images of the key operative section,the central mark was the posterior border of round window,the horizontal reference line was the superior border of oval window,and the angle was 50.15° ± 8.02°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.25° ± 4.12°.For the four planes (double-oblique sagittal,axial,coronal,or sagittal plane),the results of the degree to which they could include the major anatomical landmarks in the same layer of the first section were: level 4 in 60 sides,level 2 in 12 sides and level 3 in 48 sides,level 2 in 15 sides and level 3 in 45 sides,level 3 in 10 sides and level 4 in 50 sides,respectively.The results of the second section were: level 4 in 60 sides,level 2 in 11 sides and level 3 in 49 sides,level 2 in 13 sides and level 3 in 47 sides,level 3 in 11 sides and level 4 in 49 sides,respectively.The results of the third section were: level 4 in 60 sides,level 2 in 10 sides and level 3 in 50 sides,level 2 in 11 sides and level 3 in 49 sides,level 3 in 9 sides and level 4 in 51 sides,respectively.The results of the fourth section were: level 4 in 60 sides,level 2 in 9 sides and level 3 in 51 sides,level 2 in 8 sides and level 3 in 52 sides,level 3 in 5 sides and level 4 in 55 sides,respectively.The four planes differed significantly in the degree to which they could include the major anatomical landmarks in the same layer ( x2 =123.3200,121.4231,122.4011,125.4213,all,P ＜ 0.05 ).The visibility ratio of every section is 100％ (60/60).Conclusion Double oblique multi-planar reformation is a new method to demonstrate landmarks of operative section of facial recess approach in one slice.The reconstructive images of operative section with double oblique multi-planer reconstruction may provide valuable information for operation.

OBJECTIVETo study the role of secondary cytoreductive surgery (SCR) in patients with recurrent advanced epithelial ovarian cancer.

METHODSFrom Jan. 1986 to Dec. 1997, 60 women with recurrent advanced epithelial ovarian cancer treated with SCR were retrospectively reviewed. Survival curves were computed using the Kaplan-Meier method with differences in survival estimated by log-rank test. Independent prognostic factors were identified by Cox's stepwise regression, and the affecting factors of SCR evaluated by Logistic stepwise regression.

RESULTSOf the 60 patients, 23 (38.3%) were cytoreduced to small macroscopic residual (

CONCLUSIONSecondary cytoreductive surgery is definitely effective in the treatment of recurrent advanced epithelial ovarian carcinoma, particularly in those who have received primary optimal cytoreduction with a progression-free interval > 12 months and without refractory ascites.

Adult ; Female ; Humans ; Logistic Models ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Neoplasm, Residual ; surgery ; Ovarian Neoplasms ; surgery ; Prognosis ; Survival Analysis

Purpose To investigate the clinical value of three-dimensional hysterosalpingo-contrast-sonography (3D-HyCoSy) in the assessment of fallopian tubal patency.Materials and Methods Fallopian tubal patency of 33 infertile women was assessed using transvaginal 3D-HyCoSy, and the results were compared with laparoscopically salpingoraphy, the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of 3D-HyCoSy were evaluated.Results 3D-HyCoSy showed 20 passable fallopian tubes, 10 partially passable fallopian tubes and 36 obstructed tubes, while lapascopically salpingoraphy showed 23 passable fallopian tubes, 7 partially passable fallopian tubes and 36 obstructed tubes. The total coincidence rate of 3D-HyCoSy to assess the fallopian tubal patency was 86.4% (57/66), with the sensitivity of 93.0% (40/43), specificityof 73.9% (17/23), positive likelihood ratio of 7.15, and negative likelihood ratio of 0.20.Conclusion Tubal patency can be efficiently and accurately assessed using 3D-HyCoSy, but patients with obstructed or partially passable fallopian tubes should undergo laparoscopy to clarify.

Purpose To analyze the clinicopathologic and immunohistochemical features, differential diagnosis and prognosis of papil-lary renal cell carcinoma (PRCC). Methods Thirty-two cases of PRCC diagnosed were reviewed. A retrospective study was per-formed including reviewing the clinical documents, pathological sections and immunohistochemical stainning and follow-up was made of 32 cases of PRCC. Twenty-one patients were treated with radical nephrectomy, eleven patients were treated with partial nephrectomy. Results Among 770 cases of renal epithelial tumors 32(4. 2%) cases of PRCC were detected. Histologically, the PRCC were charac-terized by varying proportions of papillary and tubular architecture covered by single or multiple layer of tumor cells with scanty or volu-minous basophilic or eosinophilic cytoplasm. Foam cells and psammoma bodies were seen in some papillary cores and stroma, and the cytoplasm of some tumor cells contained hemosiderin. Of these 32 patients, 18 and 14 were diagnosed type-Ⅰand type-IIPRCC, re-spectively. Type-I, with small cuboid cell and pale cytoplasm, 16 of them were low in Fuhrman grading, Type-II, with large colunmar cells, rich in eosinophilic cytoplasm, 12 of them were high in Fuhrman grading. Immunohistochemically, the PRCC showed positive immunostaining for vimentin, EMA, CK(AE1/AE3), CK7, CD10 and AMACR. All the tumors studied were negative for CK (34βE12) and TFE-3. Follow-up data were available for 31 cases, 4 patients died of cancer specific causes, 1 with type-Ⅰand 3 with type-II tumors after surgery. The other 27 patients were alive without recurrence or metastasis. High Fuhrman grading, intravascular tumor emboli, lymph node metastasis and high clinical stage were prognostic indicators in PRCC. Conclusions PRCC with unique pathological features is not a common subtype of renal cell carcinoma in China. The presence of higher nuclear grade, sarcomatoid ele-ments or clear cell carcinoma structure may indicate an aggressive biologic behavior and poor prognosis. Close attention to the cytologic and growth pattern characteristics will allow us to arrive at the proper diagnosis in most cases, although sometimes immunohistochemis-try and rarely molecular genetic evaluation may be needed.

OBJECTIVE: To evaluate the safety of the circular round window and discus anatomic landmarks of posterior wall of internal auditory canal by investigating the microscopic anatomy of internal auditory canal area of the retrosigmold approach, which can provide the anatomical basis for acoustic neutrinomas surgery. METHOD: Fifteen adult cadaver heads (30 sides) fixed with formalin were used in the study. The retrosigmold approach operations were imitated to dissect the blood vessels and nerves in internal auditory canal area by opening round bony window and removing posterior wall of internal auditory canal. RESULT: Fifteen specimens of 30 sides circular bone window were opened without injury with transverse sinus and sigmoid sinus. The vertical distance between the highest point of bone window margo superior and the lowest point of transverse sinus margo inferior was (4.02 ± 0.32) mm. The vertical distance from the most anterior point of bone window leading edge to the most posterior point of sigmoid sinus trailing edge was (6.31 ± 0.43) mm. The internal auditory canal tubercle located in the anterior superior position of internal auditory canal. The vertical distance from the highest point of internal auditory canal tubercle to the upper margin of internal auditory canal was (2.31 ± 0.32) mm. To expose the whole internal auditory canal, the length and width of the internal auditory canal posterior wall removal was (7.29 ± 0.32) mm, (4.12 ± 0.29) mm. Within this removal range, no case of cochlea, semicircular canal or venous was injured in 30 specimens. CONCLUSION The method of opening round window through retrosigmold approach is simple, practial and convenient. With little variation and easiness of location, the sinternal auditory canal tubercle can be used in the identification of the internal auditory canal. When exposing the whole internal auditory canal, the removal scope of the posterior wall should be paid more attention to, in order to avoid the damage of cochlea, semicircular canal and jugular bulb.
Adult ; Cranial Sinuses ; Ear Canal ; Ear, Inner ; Humans ; Round Window, Ear ; anatomy & histology ; Semicircular Canals ; anatomy & histology ; Temporal Bone