Publications by authors named "Miettinen T"

Fecal sterol analysis showed that excretion of beta-sitosterol, a major component of poorly absorbable dietary vegetable sterols, is subnormal in patients with diverticular disease of the colon. Thus, the patients had evidently consumed a diet low in plant materials. The finding agrees with the current opinion that diverticular disease of the colon is associated with dietary fibre deficiency and suggests that fecal beta-sitosterol provides a rough measure of the vegetable intake.

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Kinetic aspects of cholesterol dynamics are described, with flux from the gut, to the liver, to the tissues, and back to the liver and gut, with a discussion of modifying mechanisms, synthesis, and transport. Overproduction of cholesterol, and bile acid and cholesterol malabsorption, are related to clinical problems.

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The concentration of serum immunoreactive prolyl hydroxylase (SIRPH) was measured in thirty patients with chronic active hepatitis, thirteen with primary biliary cirrhosis, four with alcoholic or idiopathic cirrhosis, and four with acute hepatitis; the values were compared with those in twenty-three control subjects. Increases in SIRPH were found in all the groups with liver diseases, individual values being highest in primary biliary cirrhosis in which about two-thirds of patients had values more than two standard deviations above the mean value in the control subjects. No correlation was found between SIRPH and other tests of liver function or some routine laboratory tests.

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A comparison was made of the therapeutic effectiveness of cholestyramine and an ileal by-pass operation as hypocholesterolaemic measures in thirteen patients with familial xanthomatotic type II hypercholesterolaemia. Serum cholesterol and faecal steroids were measured before and at the end of a 10 day course of cholestyramine (32 g/day), and subsequently after an ileal by-pass operation. The mean decrease in serum cholesterol caused by cholestyramine (-17%) was significantly less than that caused by the surgical procedure (-33%).

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Pectin, 40-50 g/day for two weeks administered to nine normolipidemic and hyperlipidemic patients, had no effect on serum triglycerides but did cause a significant decrease in the serum total and unesterified cholesterol of hypercholesterolemic subjects in particular. This was associated with increased excretion of fecal bile acids and total steroids and increased concentration of plasma methyl sterols. Thus, the serum cholesterol reduction by pectin appears to be caused by increased cholesterol elimination into stools as bile acids which is then balanced by enhanced cholesterol synthesis.

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The purpose of the study was to develop a kinetic method for measurement of different parameters of cholesterol metabolism in man using labeled cholesterol precursors that could initially be incorporated even into the slowly exchangeable cholesterol pool. For this purpose, tritiated water and [2-14C]mevalonate were given to five normocholesterolemic subjects and the activities for serum cholesterol and body water were measured serially for up to eight weeks. Elimination of cholesterol was measured by fecal analysis of neutral and acidic steroids.

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Six cases are described where death occurred in connection with chlormethiazole (Heminevrin) infusion. The close time relationship and indirect evidence strongly suggest that chlormethiazole had an important role in the fatal outcome of the patients, but definite proof of this way was not possible to obtain. Present or past alcohol abuse and respiratory, liver, cardiac or CNS diseases of different degrees seemed to be features in common for the patients possibly rendering them susceptible to the suggested detrimental effect of chlormethiazole therapy.

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The efficacy of an anion-exchange gel, Secholex, as a hypocholesterolemic agent was assessed in 46 patients in 4 different studies and the effects were compared with those of cholestyramine. All patients had severe Type II-a or II-b hyperlipoproteinemia. In short-term metabolic studies Secholex (15 g/day) and cholestyramine (16 g/day) decreased serum cholesterol levels and increased total fecal sterol output and serum methyl sterol concentration to a similar extent, but cholestyramine was more effective than Secholex in increasing fecal bile acid excretion.

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Article Synopsis
  • A study analyzed clinical, biochemical, and immunological data from patients with chronic active hepatitis (CAH) and primary biliary cirrhosis (PBC), focusing on the differences between orcein-negative (ON) and orcein-positive (OP) cases.
  • Marked elevations in serum bile acids, alkaline phosphatase, and cholesterol were found in OP cases, along with a significant decrease in bile acids and an increase in fecal fat levels.
  • Treatment with prednisone and azathioprine was effective in all ON-CAH patients but resulted in treatment failures for all OP-CAH and OP-PBC patients, indicating that orcein-positivity is linked to poor treatment response.
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The effect of a synthetic steroid, oxandrolone, on total postheparin plasma lipolytic activity, postherpain hepatic lipase activity, lipoprotein lipase and phospholipase A1 was studied in seven patients with hypertriglyceridemia. The mean total postheparin lipolytic activity increased 100 per cent during oxandrolone tratement (p smaller than 0.05).

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The fat cells of rat epididymal adipose tissue contain an average of 0.5 mg of cholesterol per gram of triglyceride. Of this cholesterol, 90% is nonesterified and 80% is located in the lipid storage compartment.

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Administration of probucol to 23 patients with familial xanthomatotic hypercholesterolaemia reduced the serum cholesterol level during the 9-month study by 9%, while in 15 patients with less severe hypercholesterolaemia the decrease was on an average 15%. A reduction of more than 10% was obtained in 57% of the former and 80% of the latter subjects. In a double blind trial a greater reduction was obtained in serum cholesterol by probucol than by placebo.

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