Exogenous PGE1 at pharmacological doses suppresses acute and chronic inflammation manifestations. As periodontitis possesses features of both acute and chronic inflammation, attenuation of periodontal destruction in hamsters was attempted by using 15-M-PGE1, a stable PGE1 analog. The agent was tested at 2 different doses (100 and 150 micrograms/kg/d) and its effects were matched against disease-free and periodontitis-affected animals. No effect was found with the 100 micrograms regimen. In contrast, in the 150 micrograms group, in the gingiva around the first right mandibular molar the pocket epithelium and infiltrated connective tissue (ICT) areas, the mean vascular lumen, the number of PMNLs adherent to blood vessels and infiltrating the ICT were significantly reduced. The number of osteoclasts was markedly diminished as well, but their intrinsic activity was enhanced. Bone formation was totally inhibited in this treatment group. These results indicated that 15-M-PGE1 effectively improved gingival inflammation mostly by reducing edema and PMNL recruitment and controlled alveolar bone destruction by reducing the osteoclast recruitment. From a therapeutic point of view the complete inhibition of formation seems to contraindicate its use.
From 1972 to 1986, 246 patients, with a large majority of alcoholics, were operated on for chronic pancreatitis. Mean age was 44.2 ± 23.4 years and the male/female sex ratio was 217/29. In 223, 22 and 1 patients, 1, 2 or 3 laparotomies were performed, respectively. In 12 patients laparotomy was only explorative. In all others, at each laparotomy, 1 surgical procedure was performed in 207 patients, 2 procedures in 42, 3 procedures in 8 and 4 procedures in 1. These various procedures were as follows: external drainage: 17; biliary, gastric, pancreatic, cystic internal diversions: 142; distal pancreatectomy: 51; pancreaticoduodenectomy: 47; total pancreatectomy: 1. Abdominal pain was the most frequent symptom (60%). Morphological features other than pancreatic abnormalities were frequent: biliary and duodenal obstructions account for 40 and 23.5% of the surgical indications, respectively. The choice among these numerous surgical options are presented in detail and discussed. Overall operative mortality was 7.7% (patients), 7% (laparotomy), 9% in the resection group and 5.8% in the other group. Our best long-term results were observed after the Whipple procedure with a 15-year survival rate of 74.5%.
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