Browsing by Subject "Steroids"

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  • Rosenbaum, Nicolai; Schmidt, Lisa; Mohr, Florian; Fuhr, Olaf; Nieger, Martin; Bräse, Stefan (2021)
    In this study, we report a convenient and high yielding formal semisynthesis of demethylgorgosterol, a marine steroid with an intriguing sidechain containing a cyclopropane unit. This was achieved through the synthesis of an advanced ketone intermediate. The synthetic route features a total of ten steps, starting from commercially available stigmasterol, with an overall yield of 27 %. The key step was a stereoselective intermolecular cyclopropanation reaction. This reaction proceeded in 82 % yield, the resulting cyclopropane carboxylic ester shows a trans/cis ratio of 89 : 11, with a diastereomeric ratio for the trans-diastereomers of >99 : 1. A reduction/oxidation sequence afforded the corresponding aldehyde, which was used in a Grignard reaction. A final oxidation step then yielded the desired ketone. This novel route presents a platform to further investigate the medicinal applications of gorgosterol-type steroids and to fully understand their role in coral symbiosis.
  • Savolainen-Peltonen, Hanna; Tikkanen, Matti J.; Mikkola, Tomi (2016)
    Rasva­kudos on eli­mis­tömme suu­rin endok­rii­ninen elin. Hormo­naa­linen sää­tely vai­kuttaa rasva­ku­doksen toi­mintaan ja kerty­miseen, jo­ka on eri­laista nai­silla ja mie­hillä se­kä ke­hon eri osissa. Rasva­kudos on myös merkit­tävä ste­roi­di­hor­monien läh­de, etenkin ­vaih­de­vuosien jäl­keen. Li­havuus ai­heuttaa rasva­ku­doksen toimin­nassa muu­toksia, muun muas­sa kroo­nisen tuleh­dus­reaktion. Häi­riöt rasva­ku­doksen toimin­nassa voi­vat ol­la yhtey­dessä kroo­nisten sai­rauksien, ku­ten rinta­syövän, ­dia­be­teksen se­kä sy­dän- ja veri­suo­ni­tautien syn­tyyn ja nii­den pahe­ne­miseen. Rasva­ku­doksen hormo­ni­toi­minnan ja rasva­so­lujen tuot­tamien välit­tä­jäai­neiden, adi­po­kiinien, tutki­minen aut­taa ymmär­tämään pa­remmin liha­vuuteen liit­tyvien sai­rauksien pato­fy­sio­logiaa ja luo uu­sia hoito­mah­dol­li­suuksia.
  • Hölttä, Tuula; Jalanko, Hannu (2019)
    Nefroottisen oireyhtymän (NS) taustalla on epäyhtenäinen ryhmä munuaissairauksia, joita esiintyy kaiken ikäisillä. Steroidihoitoon reagoiva nefroottinen oireyhtymä on lapsuuden yleisin munuaiskeräsen sairaus. Ennuste on hyvä. Lääkehoito tehoaa huonosti noin 20 %:lla potilaista. Heistä pienellä osalla oireyhtymän aiheuttaa geenivirhe. Geenitutkimuksia suositellaan muun muassa potilaille, joilla ensimmäinen sairausjakso on todettu alle vuoden ikäisenä. Samoin, jos sairaus ei rajoitu munuaisiin tai suunnitellaan munuaisensiirtoa.
  • Nordic Pediat Surg Study Consortiu (2018)
    Background/purpose: Biliary atresia is the most common reason for newborn cholestasis and pediatric liver transplantation. Even after normalization of serum bilirubin after portoenterostomy, most patients require liver transplantation by adulthood due to expanding fibrosis. We addressed contemporary outcomes of biliary atresia in the Nordic countries. Methods: Data on center and patients characteristics, diagnostic practices, surgical treatment, adjuvant medical therapy after portoenterostomy, follow-up and outcomes were collected from all the Nordic centers involved with biliary atresia care during 2005-2016. Results: Of the 154 patients, 148 underwent portoenterostomy mostly by assigned surgical teams at median age of 64 (interquartile range 37-79) days, and 95 patients (64%) normalized their serum bilirubin concentration while living with native liver. Postoperative adjuvant medical therapy, including steroids, ursodeoxycholic acid and antibiotics was given to 137 (93%) patients. Clearance of jaundice associated with young age at surgery and favorable anatomic type of biliary atresia, whereas annual center caseload >3 patients and diagnostic protocol without routine liver biopsy predicted early performance of portoenterostomy. The cumulative 5-year native liver and overall survival estimate was 53% (95% CI 45-62) and 88% (95% CI 83-94), respectively. Portoenterostomy age 3 patients were predictive for long-term native liver survival, while normalization of serum bilirubin after portoenterostomy was the major predictor of both native liver and overall 5-year survival. Conclusions: The outcomes of biliary atresia in the Nordic countries compared well with previous European studies. Further improvement should be pursued by active measures to reduce patient age at portoenterostomy. Retrospective prognosis study: Level II. (C) 2017 Elsevier Inc. All rights reserved.
  • Jokela, Johanna; Haapaniemi, Aaro; Mäkitie, Antti; Saarinen, Riitta (2018)
    The aim of this prospective study was to evaluate the efficacy of sialendoscopy in the management of adult chronic recurrent parotitis without sialolithiasis. In addition, preliminary results of an initial randomized placebo-controlled trial of single-dose intraductal steroid injection given concurrently with sialendoscopy, are presented. Forty-nine adult patients with chronic recurrent parotitis without sialoliths were included in this study. They underwent sialendoscopy and were randomized to receive either a concurrent intraductal injection of isotonic saline solution or 125 mg of hydrocortisone. Symptom severity was evaluated with visual analogue scale (VAS) and by recording symptom frequency and course with a multiple-choice questionnaire completed preoperatively and at 3, 6, and 12 months after the procedure. The mean VAS score was 5.6 preoperatively and dropped to 2.9 at 3 months, 3.0 at 6 months, and 2.7 at 12 months after the procedure. The VAS score and the frequency of symptoms were significantly lower at 3 (p <0.001), 6 (p <0.001) and 12 (p <0.001) months after the procedure when compared with the preoperative scores indicating that sialendoscopy reduces the symptoms of recurrent parotitis. However, complete permanent resolution of symptoms was rare. Single-dose steroid injection concomitant to sialendoscopy provided no additional benefit, but the current study is not sufficiently powered to determine a clinical difference between the steroid and non-steroid groups. Sialendoscopy appears to reduce the symptoms of chronic recurrent parotitis. While total permanent symptom remission is rare, sialendoscopy can be considered a safe and relatively efficacious treatment method for this patient group.