PubMed Health⌕ Search

Biomedical subjects

T Hakulinen

Publications and source records attributed to T Hakulinen.

At least 19 recordsLinked to original sources
PubMed1992

Long-term survival of 1986 patients with intracranial meningioma diagnosed from 1953 to 1984 in Finland. Comparison of the observed and expected survival rates in a population-based series.

Intracranial meningioma was diagnosed and histologically verified in 1986 patients, 597 men and 1389 women, between 1953 and 1984 in Finland. The closing date of this survival study was December 31, 1987, and the follow-up was complete. Meningiomas, usually slowly growing and surgically curable benign tumors, caused considerable short-term mortality, with a relative survival rate (RSR) of 83% at 1 year, and slight but continual long-term mortality, with RSR of 71% at 15 years. From 1979 to 1984, when computed tomography (CT) was available, the mortality at 3 months for the patients who had surgical procedures was 2% in those younger than 45 years and 10% in those older than 64 years; patients who did not have operations had 1-year mortality of 61%. The short-term and long-term excess mortalities are associated significantly with old age, no surgical procedure, and the period of diagnosis; the long-term excess mortality also is associated with male gender.

Adolescent↗
PubMed1992

Serum ceruloplasmin and the risk of cancer in Finland.

The relationship between serum ceruloplasmin level and cancer incidence was investigated in a case-control study nested within a longitudinal study of 39,268 Finns participating in the Social Insurance Institution's Mobile Clinic Health Examination Survey carried out in 1968-1972. During a median follow-up of 8 years, 766 cancer cases were identified. Ceruloplasmin levels were determined from stored serum samples collected at the baseline from these cancer cases and from two matched controls per case. The overall incidence of cancer was positively associated with serum ceruloplasmin level. The association was strongest for lung cancer and other cancers related to smoking and, consequently, in males. The smoking-adjusted relative risk of lung cancer among men was 4.3 (95% confidence interval (CI) = 1.8-10.6) in the highest quintile of serum ceruloplasmin as compared with that in the lowest quintile. The corresponding relative risks for cancers related to smoking combined, and for cancers not related to smoking were 3.9 (CI = 1.9-8.4) and 0.9 (CI = 0.6-1.5), respectively. The elevated risk of lung cancer at high concentrations of serum ceruloplasmin persisted after further adjustment for several potential confounding factors such as serum levels of vitamins A and E and selenium. The risk was stronger during the first 6 years of follow-up than later, and strongest during the first 2 years. The most likely explanation of the present results thus is that high serum ceruloplasmin levels in lung cancer are mainly due to occult cancer.

Adolescent↗
PubMed1992

Prediction of cancer mortality in the Nordic countries in 2005: effects of various interventions.

Rough estimates of the effect in 2005 of various preventive measures aimed at reducing cancer mortality in the Nordic countries were made using the American software CAN*TROL. The effect was measured as the percentage reduction in cancer mortality in 2005. The calculations were performed for changes in the smoking, dietary and sunbathing habits of the population (primary prevention), earlier diagnosis (secondary prevention) and improvements in survival resulting from better treatment (tertiary prevention). The calculations incorporate many assumptions, some of them more firmly based than others, such as uniformity of incidence trend in all the Nordic countries and also concerning the causality of various relations. For lack of evaluated Nordic data, we have used American figures concerning stage distributions and stage-specific relative survival rates. These assumptions should be borne in mind when drawing conclusions from the results obtained. The results show that there is a potential of up to several tens of percent for reducing total cancer mortality by the year 2005.

Female↗
PubMed1992

Factors affecting operative and excess long-term mortality in 935 patients with intracranial meningioma.

Between 1953 and 1980, a total of 935 patients underwent surgery for intracranial meningioma in the Department of Neurosurgery of the Helsinki University Hospital. The patients were followed up until death or the end of the year 1987. The cumulative observed survival rate was 91% at 3 months, 89% at 1 year, and 63% at 15 years. The relative survival rate, that is, the ratio of the the observed and the expected rates, was 91% at 3 months, 89% at 1 year, and 78% at 15 years. Significant risk factors for operative mortality (7%) for the 652 patients operated on from 1966 to 1980 were poor preoperative clinical condition, absence of epilepsy, old age, incomplete tumor removal, pulmonary embolism, and an intracranial hematoma requiring evacuation. For those 828 patients who survived the first postoperative year, the factors predicting an excess risk of death for up to 15 years were incomplete tumor removal, poor pre- and postoperative clinical condition, anaplasia of the tumor, and hyperostosis. Patients whose tumors were not completely removed had a 4.2-fold relative excess risk of death as compared with patients whose tumors were completely removed, and patients who had malignant tumors had a 4.6-fold risk as compared with those who had benign tumors.

Adolescent↗
PubMed1992

Lung cancer and smoking in Finland and the Czech Republic. Recent trends and predictions.

Trends of mortality from lung cancer in 1953-1989, age-specific lung cancer death rates of five-year birth cohorts, and the cigarette consumption were compared in Finland and the Czech Republic. While the lung cancer mortality and the smoking habits were fairly similar in Finland and the Czech Republic in the 1950s and early 1960s, contrasting differences gradually developed over the subsequent three decades in favor of Finland. In the year 1989, the Czech lung cancer death rates were much higher than the Finnish rates: in males 75.8 vs. 48.1 per 100,000; in females 9.3 vs. 6.6 per 100,000 (adjusted to the world standard population). Results obtained by descriptive epidemiologic methods support the opinion that a major part of the positive changes in the lung cancer epidemic in Finland can be explained as a consequence of the comprehensive smoking control program introduced in this country, including a significant decline in tar yield of cigarettes. In view of a long latency period between exposure and the development of disease, a continuing upward trend in lung cancer mortality is to be expected in the Czech Republic, particularly in females, resulting in an increase in the gap between Czech and Finnish lung cancer mortality. To achieve in future a falling trend in lung cancer rates even in the Czech Republic, amendments in the smoking control system according to the recommendations of the World Health Organization and International Union against Cancer are of importance.

Adult↗
PubMed1992

[Prediction of cancer mortality in Scandinavia in 2005. Effect of various interventions].

Approximate estimates have been made of the effect by the year 2005 of various preventive measures to reduce cancer mortality in Scandinavia. Figures have been calculated for changes in smoking, diet and exposure to sunlight (primary prevention), for earlier diagnosis (secondary prevention), and improved survival as a result of improved treatment (tertiary prevention). The calculations have been performed with the American program CAN TROL, the effect being expressed as the percentage reduction in cancer mortality by the year 2005. The results give promise of a substantial overall reduction in cancer mortality in Scandinavia.

Diet↗
PubMed1991

A population-based study on the incidence and survival rates of 3857 glioma patients diagnosed from 1953 to 1984.

Intracranial glioma was diagnosed during the patient's life and histologically verified in 3857 patients between 1953 and 1984 in Finland. Their survival up to the end of 1987 was analyzed, the follow-up being complete. The treatment was by operation in 1193 cases, radiation in 459 cases, both operation and radiation in 1486 cases, and neither operation nor radiation in 719 cases. The 1-year, 5-year, 10-year, and 15-year cumulative relative survival rates were 0.53, 0.29, 0.20, and 0.18, respectively. The newborn to 14-year-olds lost 56% of their life expectancy; the 15-year-olds to 44-year-olds, 71%; the 45-year-olds to 64-year-olds, 88%; and the 65-year-olds to 99-year-olds, 91%. According to the model with the best fit in regression analysis the prognosis was significantly better among young, recently diagnosed patients who had undergone both operation and radiation.

Adolescent↗
PubMed1991

Serum micronutrients and risk of cancers of low incidence in Finland.

The associations between serum alpha-tocopherol, beta-carotene, retinol, retinol-binding protein, and selenium levels and the subsequent occurrence of different cancers of low incidence were investigated in a nested case-control study of 39,268 men and women participating in the Social Insurance Institution's Mobile Clinic Health Examination Survey in Finland. During follow-up from the baseline in 1968-1972 to the end of 1977, a total of 115 cancers of the lip, oral cavity, pharynx, larynx, esophagus, liver, gallbladder, kidney, urinary bladder, brain, and skin were reported to the nationwide Finnish Cancer Registry. Alpha-tocopherol, beta-carotene, retinol, retinol-binding protein, and selenium concentrations were determined from stored serum samples collected from these cancer cases and matched controls at baseline. Several sites indicated an elevated risk of cancer at low levels of the serum variables, although only a few of these associations were statistically significant. Only melanoma patients had significantly lower serum alpha-tocopherol and beta-carotene levels than corresponding controls. Since the numbers of cancer cases were small, no firm conclusions can be drawn from these results until they have been confirmed in studies based on larger cohorts or on pooled data from several small samples.

Adult↗
PubMed1991

[Do cancer patients survive longer today than before? Survival analysis of cancer patients in the Saar region from 1972 to 1986].

In the Saarland there is a population-based cancer registry, which has collected information about cancer cases over a long period. An important task of population-based cancer registries is the analysis of its data in respect to incidence, mortality and survival of cancer patients. Not all patients who have been diagnosed with cancer die of that disease. In order to evaluate the survival of cancer patients in respect of their particular disease, survival rates are calculated after the determination of the influence of other causes of death. The so-called relative survival rates (calculated for the first five years after diagnosis) are also used in order to evaluate simultaneously the prognostic importance of variables such as sex, age and year of diagnosis. This analysis with data from the cancer registry of the Saarland deals with 9 tumor localizations: stomach, colon, rectum; breast, cervix uteri and corpus uteri; prostate, lung, malignant skin melanoma. In general the 5-year relative survival rates slightly increased when the time period 1972-1976 was compared with 1982-1986. Cancer of the corpus uteri was one exception, in that the relative survival rate was constant over time, and cancer of the cervix uteri was another, in that a decrease of relative survival rate was found, which together with the decreasing incidence might be ascribed to a successful early detection program. There was no significant improvement in the relative survival time for lung or breast cancer patients.

Adult↗
PubMed1991

Predictions of epidemiology and the evaluation of cancer control measures and the setting of policy priorities.

Cancer incidence predictions may be constructed for administrative and scientific purposes. For administrative purposes it is often important that the predictions come true. The resources planned on the basis of the predictions and allocated on the diagnostics, treatment and rehabilitation can then be optimally utilized. However, predictions that do not materialize can also be useful. The effects of intervention or early detection programmes express themselves as failures of predictions that have been made in the absence of such programmes. Predictions of cancer incidence in Finland are used as examples. The prerequisite for the predictions is a well-functioning population-based cancer registry. The predictions were constructed using time trends and differentials in cancer incidence with or without the aetiological or other risk factors. Short-term, 10-15 year predictions with no explicit use of risk factors, have proven successful with most cancers, e.g. those of the colon, rectum, pancreas and urinary organs, and lymphomas. The marked prediction failures have occurred for cancers of the lung and breast. Predictions for these cancers have been improved by taking aetiological or other risk factors explicitly into account. The cancer consequences of the preventive cardiovascular programme in North Karelia have been evaluated using predictions. The effectiveness of screening for cervical cancer at population level was predicted on the basis of estimated parameters of the natural history of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Vitamin E and cancer prevention.

Some animal experiments and human studies suggest that vitamin E may protect against cancer. Serum alpha-tocopherol concentration was studied for its prediction of cancer in a cohort of 36,265 adults in Finland. During a mean follow-up of 8 y, cancer was diagnosed in 766 persons. The levels of serum alpha-tocopherol were determined from stored serum samples (at -20 degrees C) taken from these cancer patients and from 1419 matched control subjects. Individuals with a low level of alpha-tocopherol had about a 1.5-fold risk of cancer compared with those with a higher level. The strength of the association between serum alpha-tocopherol level and cancer risk varied for different cancer sites and was strongest for some gastrointestinal cancers and for the combined group of cancers unrelated to smoking. The association was strongest among nonsmoking men and among women with low levels of serum selenium. The findings agree with the hypothesis that dietary vitamin E in some circumstances protects against cancer.

Animals↗
PubMed1991

[International research in family dynamics].

The purpose of this study is to describe the family dynamics of families expecting their first or second child. The aim is to describe how mothers and fathers differ in their views on family dynamics and what differences there are between families expecting their first or second child. The study forms part of an international comparison study which is currently under way in the United States, Estonia and in the Nordic Countries. In the theoretical part of the study family dynamics is examined using the framework developed by Barnhill (1979). The study was carried out in the Turku and Rauma regions where a total of 136 families were involved. The families were clients of maternity clinics and were expecting their first or second child. Family dynamics was studied during the third trimester of pregnancy. A family dynamics questionnaire and measure developed by the Family Research Group in the United States were used in the study. Both instruments were based on Barnhill's (1979) conceptual framework of the functioning of healthy families. As statistical methods frequencies, correlations and the T-test were used. Both mothers and fathers reported moderate individuation and flexibility, clear communication, mutuality and role reciprocity. Mothers reported more role conflict than fathers who reported more isolation, rigidity and distorted communication than mothers. There were no significant differences between families expecting their first or second child in terms of individuation, flexibility, stability and communication. After childbirth the latter reported more isolation and role conflict.

Child Rearing↗
PubMed1990

Serum selenium and subsequent risk of cancer among Finnish men and women.

The association between the serum selenium level and the subsequent incidence of cancer was investigated in a longitudinal study of 39,268 men and women participating in the Social Insurance Institution's Mobile Clinic Health Examination Survey in Finland. The baseline examinations, including the collection of blood samples, were performed in 1968-1972. During a median follow-up of 10 years, 1,096 new cancer cases were identified from the files of the Finnish Cancer Registry. Selenium concentrations were measured from the stored serum samples collected from these cancer cases and from two controls per case, matched for sex, municipality, and age. The mean serum selenium level was 59.1 micrograms/L among all male cancer cases and 62.5 micrograms/L among controls. The difference was statistically significant (P less than .001). Corresponding values among women were 63.6 and 63.9 micrograms/L, respectively. Low serum selenium levels were associated with an increased risk of developing cancer at several sites, especially cancers of the stomach and lung among men. The relative risk of lung cancer between the highest and lowest decile of serum selenium was 0.11, and it differed significantly from unity (P less than .001). These findings are in agreement with the hypothesis that low selenium intake may increase the risk of some cancers among men.

Adolescent↗
PubMed1990

Serum vitamin A and subsequent risk of cancer: cancer incidence follow-up of the Finnish Mobile Clinic Health Examination Survey.

From 1968 to 1977, the association between the level of vitamin A in serum and the subsequent incidence of cancer was examined in a longitudinal study of 36,265 persons initially aged 15-99 years in 25 population groups in Finland. During a mean follow-up of 8 years, 766 cancers were diagnosed. Serum retinol, retinol-binding protein, and beta-carotene levels were measured from frozen serum samples (stored at -20 degrees C) drawn from these persons before the start of follow-up and from 1,419 controls matched for sex, age, and place of residence who did not develop cancer during follow-up. The mean level of serum retinol among the cancer cases was 645 micrograms/liter for men and 587 micrograms/liter for women. The corresponding levels in the controls were 3.3% and 2.8% higher. There was an inverse gradient between serum retinol level and the occurrence of cancer among men. This association was, however, mainly concentrated in the first 2 years of follow-up. The mean level of serum beta-carotene was 72.3 micrograms/liter among male cases and 119.5 micrograms/liter among female cases. The corresponding levels of the controls were 14.0% and 5.5% higher. The differences were particularly clear with regard to lung cancer. These findings suggest that the association between retinol and cancer may be due to preclinical cancer and that there may be an association between beta-carotene and cancer.

Adolescent↗