PubMed Health⌕ Search

Biomedical subjects

K Koskela

Publications and source records attributed to K Koskela.

At least 37 records · Page 2Linked to original sources
PubMed1998

Plasma cell leukemia 3 months after autologous blood cell transplantation for multiple myeloma.

We describe a patient with multiple myeloma who was treated with intensive therapy and autologous blood cell transplantation as her first-line treatment. The disease relapsed 3 months after the transplant as plasma cell leukemia and the patient succumbed in 4 weeks. We suggest that an aggressive plasma cell clone may be selected during the course of intensive treatment. Complex karyotypic findings are also presented.

Adult↗
PubMed1998

Costimulatory function of CD28 in avian gammadelta T cells is evolutionarily conserved.

CD28 costimulatory signals are required for T-cell proliferation and lymphokine production. In this work, the functional conservation of CD28 was studied in avian gammadelta T cells. The avian CD28 molecule is expressed on all alphabeta T cells and is capable of giving a costimulatory signal. Most peripheral gammadelta T cells are CD28 negative; however, we identified a CD28-positive gammadelta T-cell subset from peripheral blood comprising about 12% of gammadelta T cells. The peripheral CD28+ gammadelta T-cell subset included all CD8+ gammadelta T cells known to be a responding subset during activation. After polyclonal activation, the frequency of CD28+ gammadelta T cells was increased and the activation also up-regulated CD5, CD25 and major histocompatibility complex (MHC) class II molecules. These changes were detected after both polyclonal and antigen-specific T-cell activation. In addition, we also showed that CD28 can give a costimulatory signal to gammadelta T cells and that this signal leads to up-regulation of IL-2 and bcl-x transcripts. These results indicate that the function of CD28 is evolutionarily conserved and can already be detected in avian gammadelta T cells.

Animals↗
PubMed1998

Suicidal ideation and parasuicide in the Finnish general population.

In a sample of the Finnish general population (n=4868), 2.4% of women and 2.3 % of men reported having thought about suicide during the preceding 12 months. The prevalence of parasuicide was correspondingly 0.9% in women and 1.1% in men, higher figures than have previously been found or estimated. Most suicidal individuals (85%) had contacted general practitioners or other primary care services during the previous 12 months, and a minority (20%) had made contact with psychiatric services. General practitioners and other primary care services are thus in a key position to identify suicidal behaviour in the Finnish general population.

Adolescent↗
PubMed1998

Debt and suicidal behaviour in the Finnish general population.

We studied the significance of debt as a risk factor for suicidal ideation and suicide attempts in a nation-wide sample (n = 4868) of the Finnish general population. Those experiencing difficulties in repaying their debts more often than others (37 vs. 16%, P<0.001) had a probable minor mental disorder (GHQ-12 score > or =3). Nevertheless, difficulties in repaying debts were found to be a factor independently associated with suicidal ideation (OR, 2.8; 95% CI, 1.9-4.2). The clinical implication of these findings is that individuals experiencing difficulties in repaying their debts may require psychiatric evaluation as well as socio-economic counselling.

Adolescent↗
PubMed1997

Serum oncostatin M in multiple myeloma: association with prognostic factors.

The serum concentration of oncostatin M (OSM) was measured in 40 multiple myeloma patients at diagnosis. Serum OSM level exceeded the sensitivity limit of the ELISA assay in eight (20%) of these patients (OSM+ patients). The serum levels of IL-6, another member of the gp180 cytokine family and C-reactive protein (CRP) as a surrogate of IL-6 were significantly higher in OSM+ patients. There was a trend towards higher serum beta 2M concentration in OSM+ patients, whereas there was no difference in the serum sIL-6R level or clinical data (age, gender, myeloma protein or stage) between the two groups. Two human myeloma cell lines secreted OSM and IL-6, but not IL-11 or leukaemia inhibitory factor (LIF), which suggests an important role for OSM and IL-6 in supporting growth of myeloma cells.

Aged↗
PubMed1997

p53 gene mutations are rare in patients but common in patient-originating cell lines in multiple myeloma.

We have shown previously that detectable serum concentration of p53 protein is associated with poor prognosis in multiple myeloma (MM). In this study, we studied p53 gene mutations in 29 bone marrow samples of MM patients using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and direct sequencing. No p53 mutations were found in these patients although 41% of the patients had an elevated serum p53 protein concentration. This result indicates that the detectable serum level of p53 protein is not associated with p53 mutations. In addition, we have also analysed three MM cell lines established from bone marrow samples. All the cell lines contained p53 mutations in exon 5. However, bone marrow samples of the patients associated with the cell lines did not have these mutations at the time of diagnosis, nor did the original samples which were used to establish the cell lines. This indicates that p53 mutations can arise during the cell passages.

Adult↗
PubMed1995

The association between economic and social factors and mental health in Finland.

The aim of the study was to examine the social and economic variables associated with mental health by means of telephone interviews of a randomly chosen population sample (n = 1557) in Finland in 1993. Mental health was evaluated by means of a 12-item General Health Questionnaire. A mental disorder, indicated by the GHQ score, was detected in 18.3% of the interviewees. Mental disorders were more common in women than in men. Other factors associated with a mental disorder were unemployment, financial difficulties and insufficient social support from other people. Mental disorders, indicated by the GHQ score, were common in the long-term unemployed, users of hypnotics and sedatives, and in those who were uncertain about their future. In stepwise logistic regression analyses the statistically independent associates with impaired mental health were suicidal thoughts, receiving of housing allowance and female sex. On the other hand, being on salary was a protective factor.

Adolescent↗
PubMed1995

Smart Habit Xylitol campaign, a new approach in oral health promotion.

A national 'Smart Habit' Xylitol campaign was organised in Finland in autumn 1992. The aim of the campaign was to increase consumption of xylitol chewing gum in 13-year-old school children, to promote their oral health. The campaign was conducted in elementary schools in the form of a quiz and lesson related to xylitol. Seventh form children from schools in 12 local health authority areas in 10 provinces took part in the campaign. Six thousand seven hundred children were involved. Data were collected with a series of three separate postal questionnaires. The study group consisted of 1,281 children exposed to the campaign. A control group was formed from 1,227 children in the same provinces not exposed to it. Questionnaires were distributed before and after the campaign. A third one was sent out a month later. A high number of the children had consumed xylitol chewing gum even before the campaign. The majority of the respondents reported no changes in consumption of xylitol chewing gum after meals in the first two questionnaires. The results showed that the consumption of xylitol chewing gum after meals increased more in the group exposed to the campaign than in the control group (P = 0.002). Girls in the study group increased their consumption of xylitol chewing gum more than boys (P = 0.016). Also an increase in the daily use of xylitol chewing gum was achieved by the campaign; differences between the study and the control group being significant (P < 0.05). Even though there was knowledge about the beneficial properties of xylitol beforehand, an increase in knowledge was achieved by the campaign. There seems to be potential for positive oral health promotion by means of this type of xylitol campaign.

Adolescent↗
PubMed1994

Long-term Results of Gastroplasty for Morbid Obesity: Binge-Eating as a Predictor of Poor Outcome.

We investigated the long-term results after vertical banded gastroplasty (VBG) for morbid obesity and evaluated some predictors of poor outcome. Twenty-seven morbidly obese patients (mean BMI 50 kg/m(2)) who underwent VBG a mean of 5.4 years earlier were studied. The mean weight loss was 31 kg or 40.5% of excess weight. Ten patients (37%) were within 50% of their ideal weight. The patients were classified as bingers (n = 10) and non-bingers (n = 17) according to the modified Binge Eating Scale. One-year postoperative weight losses were 55% and 57% respectively of excess weight, but at the time of the study weight losses were 24% and 50% of excess weight (p = 0.04) in the bingers and non-bingers, respectively. The mean weight regain was 23 kg in the bingers vs 8 kg in the non-bingers, p = 0.01. Two bingers had excellent weight loss results, but otherwise an unsuccessful outcome. Weight reduction did not correlate with age, sex or age of onset of obesity. These results show that binge-eating strongly predicts poor weight loss maintenance after gastroplasty in the long-term, though initial weight reduction is good. We suggest that binge-eating should be evaluated before gastroplasty and taken into consideration in the design of treatment.

Journal Article↗
PubMed1993

Unemployment and mental wellbeing: a factory closure study in Finland.

The mental wellbeing of the entire personnel (n = 211) of a wood-processing factory located in Hämeenlinna, Finland was studied by mailing a questionnaire to the subjects 6 months after the factory was closed down. The entire personnel (n = 305) of a similar wood-processing factory acted as a control group. Mental wellbeing was measured by means of the 12-item General Health Questionnaire (GHQ score), the 13-item Beck Depression Inventory (BDI score), and the 13-item questionnaire assessing psychosomatic symptoms. Seventy-nine per cent of the study group and 65% of the control group returned the questionnaire. The two groups were similar sociodemographically. Mental wellbeing was poorer in the men of the study group than in the controls. No such difference was detected in women. Mental wellbeing was poorer in all age groups in the study group, especially in married men, than in the controls. The impaired mental wellbeing in the men in the study group was associated with insufficient social support, subjectively poor health, low income and uncertainty about the future. Based on a discriminant analysis, the two groups differed most in terms of GHQ score, income, sex and BDI score.

Adult↗
PubMed1993

The impact of unemployment on psychosomatic symptoms and mental well-being.

The relationship between psychosomatic symptoms and mental well-being among unemployed (N = 132) and employed (N = 187) personnel of two similar wood-processing factories was studied. Mental well-being was measured by means of the 12-item General Health Questionnaire (GHQ-score) and the 13-item Beck Depression Inventory (BDI-score). The 13-item questionnaire assessing psychosomatic symptoms was used (PS-score). The 33 and 66 percentiles (tertiles) were formed on the basis of PS-score of the two groups separately. The highest PS-score percentile was compared with the combined first and second percentile. Higher PS-score implied impaired mental well-being especially in the unemployed but also in the control group. Insufficient social support and uncertainty about the future was associated with highest PS-score in the study group but not in the control group. High PS-score was associated with subjective mental problems in both groups. Impaired health and PS-score were associated in both groups. Our results suggest that unemployment is a powerful external stress factor and that psychosomatic symptoms were associated with impaired mental well-being.

Adaptation, Psychological↗
PubMed1993

VAD regimen in the treatment of resistant multiple myeloma: slow or fast infusion?

The VAD regimen is effective in the treatment of resistant and relapsing multiple myeloma. In the original VAD regimen, vincristine (V) and doxorubicin (A) are given as continuous infusions together with peroral dexamethasone (D). For practical reasons, we have shortened the infusion times: 8 hours for vincristine and 1 hour for doxorubicin. In this retrospective analysis, we have compared the efficacy and toxicity of the original and modified VAD protocols in the treatment of myeloma patients at our institution. Of the 31 consecutive patients with myeloma, primarily or secondarily resistant to alkylating agents, 16 were treated by the original and 15 by the modified VAD protocol. We found no significant difference in the response rates (good responses 31% and 20% respectively), survival times (17 and 9 months respectively) or toxicity between the two protocols. VAD may well be modified so as to consist of short infusions of V and A. The overall efficacy of the traditional and modified regimens is, however, rather unsatisfactory in patients with advanced myeloma.

Aged↗
PubMed1992

National TV smoking cessation program and contest in Finland.

BACKGROUND: In the fall of 1986 the North Karelia Project in cooperation with Finnish TV 2 arranged an eight-part nationwide smoking cessation TV program. The Project, also arranged a smoking cessation contest coinciding with the TV program in cooperation with four major voluntary public health organizations and the national health service. The TV program featured two studio groups of local volunteers: one from Turku (southwestern Finland) and the other from North Karelia, where there was more intensive community support for the activity. RESULTS: Based on a national survey of a representative population sample, the reported viewing rates (at least one part) of the working-age population (15-64 years, smokers and nonsmokers) were 64% in North Karelia, 45% in Turku, and 46% nationally (P less than 0.001). Among smokers who had watched at least one session of the TV program, 7.7% reported to have tried to quit smoking in North Karelia, 4.1% in Turku, and 7.5% nationally. Altogether, 16,089 smokers participated in the contest; again the highest participation rate was in North Karelia. The 6-month success rate among the smokers who participated in the contest was 22% in North Karelia, 18% in Turku, and 17% nationally (P less than 0.05). Men were more likely to succeed in quitting: among men the 6-month success rate was 22% and among women 15% (P less than 0.001). CONCLUSIONS: The results and experiences indicate high viewing and participation and a beneficial cost-effect ratio. They also stress the importance of community support activities in enhancing the effects of a media-based health promotion program.

Adolescent↗
PubMed1991

Psychological symptoms and behavioural changes in Finns caused by fear of AIDS.

The purpose of the study was to explore personal fears about AIDS and their consequences in terms of psychological symptoms and behaviour. 1902 individuals, 15 to 64 years old, were selected at random from the Finnish population and interviewed by telephone (94%) or in person (6%). 2.5% regarded AIDS as a personal threat, while 12-13% exhibited psychological symptoms such as insomnia, depression, anxiety or episodes of fear. About 20% had taken measures to prevent HIV infection: 9% had increased their use of condoms, 6% had had themselves tested for HIV, and 5% had taken precautionary measures at work. The psychological status of individuals who feel at risk of AIDS should be assessed within the health care system because persistent feelings of danger may be a sign of incipient psychological decompensation.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Finland's attitude to HIV-infection--a 5-year follow-up study].

Changes in the Finns' knowledge of attitudes to and behaviour in connection with HIV infection between 1986 and 1990 were studied. In 1986, 1013 Finns aged 15 to 64 years were chosen at random from the entire population. During the years 1987-1990, about 1900 more Finns were selected in the same way. All subjects were interviewed at home or by telephone, using a structured questionnaire. Knowledge of modes of transmission of HIV infection, of the test method, and of where testing could be done was good. Knowledge of the proven modes of transmission of HIV improved significantly between 1986 and 1990. Misconceptions decreased over the same period. Many Finns changed their behaviour because of the risk of HIV infection during this period. For example, 75 per cent informed themselves about AIDS, 9 per cent increased their use of condoms, and 6 per cent had themselves tested for HIV. The improvement in knowledge of AIDS, the change in behaviour, and decrease in the number of cases of HIV detected in Finland, all occurred after widespread public discussion and nationwide information campaigns. It was therefore concluded that the knowledge of AIDS increased, and the behaviour of the general public changed as a result of providing information.

Adolescent↗
PubMed1990

Interaction in health education.

The usefulness of the application of the psychodynamic frame of reference in person-to-person health education is examined in the present study. The health educator's proper understanding of his client through an integrative use of his own cognitive and emotional responses to the client is first discussed. Depending on the level of maturity of their personalities, and on the nature of their formative relations, the clients will develop different modes of interaction in their relationships with the health educator. Learning to adequately recognize and meet clients showing different interactional modes is considered to substantially increase the prospects of the health educator helping his clients to accomplish a change in health behaviour. Four levels of interaction and their proper encountering are described and discussed. It is concluded that health education and individual health educators would benefit from an increased familiarity with, and use of, the psychodynamic body of knowledge.

Countertransference↗