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S Tarpila

Publications and source records attributed to S Tarpila.

At least 19 recordsLinked to original sources

Budesonide enema in active haemorrhagic proctitis--a controlled trial against hydrocortisone foam enema.

BACKGROUND: The aim was to compare budesonide enema, 2 mg/100 mL (Entocort) and hydrocortisone acetate foam enema, 125 mg (Colifoam) in patients with active haemorrhagic proctitis. METHODS: The trial was a controlled, randomized, investigator-blind study with two parallel groups. Endoscopy, histology and diary cards were used to assess the response to therapy. Safety was assessed by laboratory tests and adverse event recording. RESULTS: Seventy-two patients were included. Investigations were made before treatment and after 2 and 4 weeks. Both treatment groups showed statistically significant improvement in endoscopic scores but significant differences between the groups were not found. In the hydrocortisone group, plasma cortisol was significantly lowered after 4 weeks compared with budesonide. Bowel habits and quality of life variables did not differ between the treatments. The recorded adverse events were mild or moderate and may have been due to the proctitis. CONCLUSIONS: These results suggest that budesonide enema is as effective as hydrocortisone foam enema, but without the potential for side-effects associated with suppression of plasma cortisol.

Adult

Inhibition of human erythrocyte and gastroduodenal catechol-O-methyltransferase activity by nitecapone.

The effect of increasing single oral doses of the novel catechol-O-methyltransferase (COMT) inhibitor, nitecapone, on enzyme activity in red cells (RBC) and gastroduodenal COMT activity has been studied in healthy male volunteers. A dose-dependent decrease in RBC COMT activity was seen in all cases after 1 to 150 mg of the drug. The highest dose of 300 mg did not produce much more inhibition of COMT than 150 mg. The inhibition was not complete; at the highest doses the COMT activity was reduced by 50-60%. The effect and the duration of the inhibition in RBC COMT was strongly correlated with plasma nitecapone concentrations in the dose range up to 150 mg. RBC COMT activity recovered fully in 4 h after medication. Gastric mucosal COMT activity was several-fold higher than that in RBCs. It was also dose-dependently inhibited at the two doses (25 and 100 mg) studied. The inhibition of gastric and duodenal COMT was greater than that in RBCs. This also indicates that nitecapone is locally active in the gastroduodenal tract. The results confirm nitecapone as a potent COMT inhibitor in human tissues. New COMT inhibitors may provide a valuable approach to the treatment of Parkinson's disease in combination with L-dopa and dopa decarboxylase inhibitor therapy.

Adult

Low vs high dietary fiber and serum, biliary, and fecal lipids in middle-aged men.

Cholesterol metabolism was studied in 34 50-y-old men at home on high and low mixed-fiber diets. The high-fiber diet increased fiber intake (26.2 vs 11.6 g/d) and decreased slightly but significantly total energy, carbohydrate, and protein intakes and serum total, low-density-lipoprotein, and high-density-lipoprotein cholesterol values with no effect on dietary cholesterol and fat composition or body weight. Biliary molar lipid percentages were unaffected but deoxycholic acid was increased and chenodeoxycholic acid was decreased by the high-fiber diet. The high-fiber diet changed cholesterol absorption and fecal output of neutral and total sterols nonsignificantly but increased fecal bile acids by 13% (p less than 0.05) and reduced bacterial conversion of fecal sterols to secondary products. The decreased serum cholesterol concentration was probably caused by enhanced fecal output of cholesterol as bile acids resulting in enhanced cholesterol synthesis as indicated by an increased serum concentration of a cholesterol precursor, lathosterol.

Bile

Serum lipids and cholesterol metabolism during guar gum, plantago ovata and high fibre treatments.

Short-term viscous dietary fibres, plantago ovata and guar gum preparations, decreased serum cholesterol, mainly LDL cholesterol, as compared to low fibre or nonviscous high fibre periods, through enhancing cholesterol elimination as fecal bile acids. These changes were associated with significant increases in serum levels of cholesterol precursors, both in methylsterols and demethylated precursor sterols, while that of cholestanol (saturated cholesterol derivative) was decreased. In addition, cholesterol precursor contents were positively related, cholestanol negatively, to fecal cholesterol elimination both on and off viscous fibres. These findings indicate increased cholesterol synthesis, also seen by sterol balance data. As compared to low fibre diet, nonviscous high fibre diet conserved bile acids and decreased cholesterol absorption. Thus, it had no effect on cholesterol synthesis as indicated by fecal total steroids or serum levels of cholesterol precursors.

Cholesterol

Effects of omeprazole in duodenal ulcer patients.

The efficacy of and tolerance to omeprazole, 40 mg/day, was studied in an open-label study in 18 patients with endoscopically verified duodenal ulcers. The effects of the drug on the oxyntic mucosa and pentagastrin-stimulated acid secretion during and after treatment were also studied. Fifteen patients completed the final endoscopy. The ulcers were healed in all after 4 weeks' treatment. Both basal and peak acid output were significantly reduced during omeprazole treatment, whereas 4 weeks after the cessation of treatment neither basal nor peak acid output differed from the pretreatment levels. Fasting serum gastrin levels rose by 56% during treatment but had returned to pretreatment values when tested again 4 weeks after the end of the treatment period. Histological examination of the biopsy specimens taken before and after treatment showed that omeprazole had no significant effect on the volume densities of either parietal or endocrine cells. We conclude that omeprazole is of value in the treatment of duodenal ulcer and that the effects of the drug on acid output and serum gastrin levels are fully reversible.

Adult

Morphology and dynamics of the gastric mucosa in duodenal ulcer patients and their first-degree relatives.

The prevalence of antral and body gastritis was determined in 30 duodenal ulcer patients and in 143 of their first-degree relatives, and compared by conventional mathematical and stochastic analyses with data on gastritis in a representative Finnish population sample. For conventional analysis, the controls for the duodenal ulcer patients and for the duodenal ulcer relatives, were matched for age and sex. For stochastic analysis, the duodenal ulcer patients and their 99 siblings were compared with the total control population of 434 subjects. The prevalence of gastritis affecting mainly the antral mucosa, and both antral and body mucosa to a similar extent was significantly higher in duodenal ulcer patients than in both controls and in relatives. The prevalence of antral and body gastritis in DU relatives and their controls was similar. However, the prevalence of subjects with normal antral and body mucosa was significantly lower. Stochastic analysis revealed more rapid progression of antral gastritis with age in the duodenal ulcer patients than in their siblings or controls and less rapid progression of body gastritis. The overall progression of antral and body gastritis was similar in DU siblings and their controls, but a dichotomy in the mean antral gastritis score of DU sibships was found, indicating high and low antral gastritis liability subgroups. The mean score of DU sibships having a mean age of less than 50 years behaved dynamically like DU patients, while the mean scores of sibships with a higher mean age had a low liability to develop antral gastritis. Most duodenal ulcer siblings who themselves had a duodenal ulcer, ulcer scar or duodenitis were found in the "high antral gastritis liability" subgroup.

Adult

Endoscopic and clinical findings in first-degree relative of duodenal ulcer patients and control subjects.

The first-degree relatives of duodenal ulcer patients and of control probands were evaluated clinically and by gastroduodenal endoscopy for prevalence of duodenal ulcer. The control probands were randomly selected from a control population. 199 relatives of 51 duodenal ulcer probands were interviewed, and 154 of these were endoscoped. 154 control relatives who had been endoscoped were matched with the DU relatives according to sex and age. Endoscopic evidence of present or past duodenal or pyloric ulcer was present in 20 (13.0%) of the DU relatives and in only 6 (3.9%) of the control relatives (p less than 0.01). The frequency of macroscopic duodenitis and gastric erosions was also significantly higher (p less than 0.05) in DU relatives than in controls. A history of epigastric pain was obtained in 54 (35.1%) of endoscoped DU relatives and in 24 (15.6%) of control relatives (p less than 0.01). This study has shown an increased prevalence of endoscopic evidence of duodenal ulcer in the first-degree relatives of duodenal ulcer patients. The finding that duodenitis is also more prevalent in DU relatives than in controls support the view that duodenitis is linked with duodenal ulcer.

Adolescent

[Liver biopsy].

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Biopsy, Needle

Ulcer healing and serum pepsinogen I in cimetidine and glycopyrrolate treated duodenal ulcer patients.

Cimetidine is effective in the treatment of acute duodenal ulcers. 26 endoscopically verified duodenal ulcer patients were treated for four weeks with either cimetidine 0.8 g/day or with the anticholinergic drug glycopyrrolate 4 mg/day on a double-blind basis. Gastroscopical healing was achieved in 10/13 (77%) of cimetidine treated patients and in 4/13 (31%) of glycopyrrolate treated patients (p less than 0.05). There were no major side-effects in either group. In this study cimetidine seemed to be more effective than glycopyrrolate in the treatment of acute duodenal ulcer. The pretreatment level of serum pepsinogen I was elevated (110.1 +/- 42.8 microgram/l; mean +/- SD) in these patients (normal range 20--100 microgram/l) and increased significantly after pentagastrin stimulation to 133.2 +/- 56.4 microgram/l (p less than 0.001). The post-treatment level measured 24 hours after termination of treatment had increased significantly in the cimetidine group but not in the glycopyrrolate group. In the cimetidine group the high pretreatment level of pepsinogen I tended to predict a poor response.

Adult

Relationships between serum lipids and malabsorption of bile acids, neutral sterols, and fats in exocrine pancreatic insufficiency.

The relationship between serum lipids, fecal steroids, and fecal fat was studied in nine men with exocrine pancreatic insufficiency due to chronic pancreatitis. The mean fecal bile acid and fat outputs were significantly increased, the neutral sterol excretion was within normal limits, and total elimination and synthesis of cholesterol were slightly increased. A positive correlation between fecal fat and neutral sterols suggests that the patients actually had cholesterol malabsorption and that the normal neutral sterol excretion was apparently the result of a low biliary cholesterol secretion. In view of the fairly small increase in cholesterol elimination, the serum cholesterol level was surprisingly low, indicating that malnutrition may have limited compensatory increase in cholesterol synthesis. Serum triglycerides were negatively correlated with fecal fat. Thus, severe malabsorption apparently also limited the triglyceride production.

Bile Acids and Salts

Carcinoembryonic antigen in endoscopic brush specimens from benign and malignant gastric lesions.

The measurement of carcinoembryonic antigen (CEA) in serum and endoscopic brush specimens was evaluated for the differential diagnosis of malignant and nonmalignant gastric disease. Brush specimens were studied from 33 patients with gastric cancer and 36 patients with benign gastric lesions or apparently normal gastric mucosa. Demonstrable CEA immunoreactivity was found by radioimmunoassay in brush specimens from 24/33 cancer patients (73%) and from 23/36 patients with benign lesions (64%). Patients with CEA+ tissue in the immunoperoxidase test had somewhat higher CEA concentrations in the brush specimens than cases with CEA- biopsy tissue, although overlap was considerable. Thirty-five per cent of cancer patients had both a positive tissue CEA reaction and a CEA/DNA ratio greater than 10 ng/micrograms, whilst patients with benign lesions had only 15% of positives by these criteria (0.01 greater than P greater than 0.001). The serum CEA concentration was above the upper normal level of 5 ng/ml in 2/39 patients, both of whom had gastric cancer. The CEA immunoreactive material from benign and malignant lesions eluted in gel filtration on Sephadex G-200 in the same volume as CEA purified from liver metastases of cancer of the colon, showing that a glycoprotein sharing immunological and physicochemical properties with CEA is present both in malignant and nonmalignant lesions of the gastric mucosa, and that there is considerable overlapping in the amount of CEA. The estimation of CEA in gastric-brush specimens is therefore of limited value in the differential diagnosis of benign and malignant gastric lesions.

Adult

Areae gastricae and gastritis in double contrast barium meal.

The areae gastricae were studied in patients with different forms of gastritis and with normal gastric mucosa. The material consisted of 57 patients. First gastroscopy was done and biopsies were taken. The stomach was studied on the following day by the double contrast barium meal. The material was divided according to the gastroscopic and biopsy findings into the following groups: normal, superficial gastritis, mixed gastritis, and atrophic gastritis. In the analysis of the surface pattern, special attention was paid to the shape, size and defects of areae gastricae. Corpus and antrum were dealt with separately. In the normal material the areae gastricae were regular in shape, and the size was usually 1--3 mm. Irregular shape, bigger size and more frequent defect areas seemed to point to gastritis. Such changes were especially clear in atrophic gastritis. The significance of the areae gastricae in practice is discussed.

Adult

Effect of cirrhosis of the liver on the pharmacokinetics of chlormethiazole.

The pharmacokinetics of chlormethiazole were studied in eight patients with advanced cirrhosis of the liver and in six healthy volunteers after oral and intravenous administration of the drug. In the patients the systemic bioavailability of oral chlormethiazole was increased about tenfold, whereas its elimination was only slightly retarded. The increased bioavailability was clearly due to decreased first-pass metabolism of chlormethiazole in the cirrhotic liver. The results indicate that chlormethiazole should be used in reduced dosage when given by mouth to patients with cirrhosis of the liver.

Administration, Oral