[Treatment of endometriosis with domestic luteinizing hormone--releasing hormone analogue].

Sixty patients with endometriosis, stage I-IV, diagnosed by laparoscopy or laparotomy, were treated with 200 micrograms of domestic luteinizing hormone-releasing hormone analogue (LHRH-A) subcutaneously twice daily, starting from the early follicular phase for 6-10 months. Serum FSH and LH levels elevated at first declined significantly thereafter, and remained low after the sixth day of treatment. Serum E2 concentrations were suppressed below that of the early follicular phase or to the castrated levels after one month of therapy. Symptoms and signs of endometriosis improved markedly during the treatment and patients became anovulatory and amenorrheic. At the end of treatment, resolution of endometriotic implants and softening of adhesions were shown under the second laparoscopy. Endometrial biopsies revealed inactive endometrium. After discontinuation of the treatment, ovulatory menses returned within 34-72 days, more than half of the patients complicated with infertility for 2-10 years became pregnant within 1-8 months. The recurrence rate was 37% after 0.5-5 year follow-up. Side effects were only related to hypooestrogenism. These data indicated that LHRH-A therapy had the effect of temporary reversible medical oophorectomy, and was therefore an effective approach for the treatment of endometriosis.

Scanning electron microscopic investigation of maxillary lateral incisors with a radicular lingual groove.

Fourteen human lateral incisors with a radicular lingual groove were observed under the scanning electron microscope to explore the communications between the groove and the pulp cavity. Observations showed that accessory foramina could be found not only in the groove, but also in the corresponding wall of the pulp cavity and a cross section. A complete lack of closure of the calcified tissues along the groove, allowing for direct connection of the pulp and the periodontium, was not found in these specimens. Therefore, it is suggested that accessory canals are the main way of communication between the pulp and the periodontium of the incisors with a radicular lingual groove. Because the accessory canals could be found either in the crown part or in the root part of the groove, infectious materials may get into the pulp cavity when there are pathologic conditions either through accessory foramina in the crown part or through accessory foramina exposed by localized periodontitis around the groove.

Studies on treatment of acute promyelocytic leukemia with arsenic trioxide: remission induction, follow-up, and molecular monitoring in 11 newly diagnosed and 47 relapsed acute promyelocytic leukemia patients.

Fifty-eight acute promyelocytic leukemia (APL) patients (11 newly diagnosed and 47 relapsed) were studied for arsenic trioxide (As2O3) treatment. Clinical complete remission (CR) was obtained in 8 of 11 (72.7%) newly diagnosed cases. However, As2O3 treatment resulted in hepatic toxicity in 7 cases including 2 deaths, in contrast to the mild liver dysfunction in one third of the relapsed patients. Forty of forty-seven (85.1%) relapsed patients achieved CR. Two of three nonresponders showed clonal evolution at relapse, with disappearance of t(15;17) and PML-RARalpha fusion gene in 1 and shift to a dominant AML-1-ETO population in another, suggesting a correlation between PML-RARalpha expression and therapeutic response. In a follow-up of 33 relapsed cases over 7 to 48 months, the estimated disease-free survival (DFS) rates for 1 and 2 years were 63.6% and 41.6%, respectively, and the actual median DFS was 17 months. Patients with white blood cell (WBC) count below 10 x 10(9)/L at relapse had better survival than those with WBC count over 10 x 10(9)/L (P =.038). The duration of As2O3-induced CR was related to postremission therapy, because there was only 2 of 11 relapses in patients treated with As2O3 combined with chemotherapy, compared with 12 of 18 relapses with As2O3 alone (P =.01). Reverse transcription polymerase chain reaction (RT-PCR) analysis in both newly diagnosed and relapsed groups showed long-term use of As2O3 could lead to a molecular remission in some patients. We thus recommend that ATRA be used as first choice for remission induction in newly diagnosed APL cases, whereas As2O3 can be either used as a rescue for relapsed cases or included into multidrug consolidation/maintenance clinical trials.