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Biomedical subjects

K Heim

Publications and source records attributed to K Heim.

At least 37 records · Page 2Linked to original sources
PubMed1994

Island living: the experience of loneliness in a psychiatric hospital.

The purpose of this study was to examine perceptions of loneliness among psychiatric patients. The sample included 12 adults receiving treatment in a psychiatric facility. Data consisted of audiotaped semistructured interviews. Ten empirical categories resulted. Further analysis of empirical data provided a description of psychiatric patient's experiences of loneliness. The metaphor of living on an island illustrated the core category. Subcategories included escape attempts and surviving tidal waves.

Adaptation, Psychological↗
PubMed1994

Effects of isoflurane on regional coronary blood flow and myocardial tissue pressure in chronically instrumented dogs.

BACKGROUND: The effects of isoflurane on distribution of transmural blood flow and transmural intramyocardial tissue pressure (IMP) were studied in chronically instrumented dogs, to address following aims: (1) to evaluate the direct effects of isoflurane on transmural blood flow distribution in the absence of compounding effects of baseline anesthetics, acute surgery, and indirect effects caused by changes in systemic blood pressures and heart rate--factors that were not well controlled in the past studies; (2) to examine the relation between transmural myocardial perfusion pressure and concurrent changes in transmural blood flow distribution during isoflurane anesthesia; and (3) to evaluate the effects of isoflurane on transmural myocardial oxygen supply-demand relation. METHODS: Dogs were allowed to recover at least 1 week after surgery for instrumentation. Blood flow of the left anterior descending coronary artery and subendocardial and subepicardial blood flows, regional IMPs, regional segmental dimension, heart rate, aortic pressure and left ventricular pressure were measured while dogs were awake and during 1.3% isoflurane anesthesia, with and without correction of heart rate and aortic pressure. Concurrently regional myocardial perfusion pressure, regional myocardial stroke work, and systolic pressure time index were calculated, based on direct measurements of IMP in subendocardium and subepicardium. RESULTS: Without correction of aortic pressure, neither left anterior descending coronary artery flow nor transmural blood flow distribution was altered with isoflurane. When aortic pressure and heart rate were corrected to the awake values, left anterior descending coronary artery flow increased (37 +/- 2%) and the increase was preferentially distributed to subendocardium, resulting in a shift in transmural blood flow. The subendocardial/subepicardial blood flow ratio increased from 1.2 +/- 0.3 to 1.4 +/- 0.4 (p, 0.05). The transmural blood flow changes were closely related to changes in regional myocardial perfusion pressure ratio between subendocardium and subepicardium (r = 0.76, P < 0.001). Concurrent with marked increases in blood flow (55 +/- 4% increase), regional myocardial stroke work and systolic pressure time index of subendocardium were decreased more than 50% with isoflurane, resulting in a favorable subendocardial oxygen supply-demand balance. CONCLUSIONS: Isoflurane is a coronary vasodilator and redistributes blood flow in favor of subendocardium and depresses subendocardial work when heart rate and aortic pressure are controlled. These changes in regional myocardial blood flow, regional myocardial stroke work, and systolic pressure time index appear to be a result of changes in regional IMP.

Animals↗
PubMed1993

Interleukin-3, interleukin-6, granulocyte-macrophage colony-stimulating factor and erythropoietin cord blood levels of preterm and term neonates.

The cascade of known haematopoietic growth factors controlling granulomonopoiesis and erythropoiesis includes interleukin-3 (IL-3), interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), and erythropoietin (EPO). Elevated endogenous IL-3 and IL-6 cord blood levels in infection-free premature and mature neonates may reflect their possible role for expansion of haematopoietic progenitor cells, granulocytes and monocytes. Within the erythroid lineage a synergistic action of IL-3, IL-6 and EPO can be assumed. To identify the regulatory role in fetal haematopoietic expansion cord blood plasma levels of these haematopoietic growth factors were assessed in 19 premature and 20 mature infants using commercial enzyme-linked immunosorbent assay and enzyme-amplified sensitivity immuno assay test kits. Peripheral blood IL-3, GM-CSF and EPO were studied in 5 and 10 premature infants respectively. Compared with cord blood levels we found a decline in EPO levels but no decrease of IL-3 and GM-CSF during the 1st month of life. We conclude that postnatal decrease in plasma burst-promoting activity levels in preterm infants is mainly explained by low postnatal EPO levels.

Erythropoietin↗
PubMed1993

[Obstetric data processing with a personal computer].

Update computer technology is an increasingly useful tool in medicine for more accurate documentation, avoidance of multiple documentation, improvement of service performance, quicker and easier data processing and evaluation and hence quality assurance. We developed an obstetric data recording programme for an IBM compatible personal computer according to the MS-DOS command programme. A laser printer with dual paper feed is available. The relational database system Clipper is used for programming. The programme comprises at present 179 data fields and is subdivided on the input side into: data on anamnesis and partus, course of puerperium, infant data. This gives the print-outs: birth protocol, adhesive labels for the temperature curves of the mother and of the infant, respectively, birth record book and mother-infant health passport, furthermore, list print-outs: infant record book, transferred/decreased infants, birth lists relating to midwives, and, in addition, physician's report on the mother and the child, and finally, automated monthly and annual statistics. From August 1990 to July 1992, all events were stored by the computer, so that a total of 5,572 data items have been recorded to date. The primary scope of recording was 98.4% already in the first year of full operation of the database. Computer feed-in was affected directly after each data item became available. Application is fully integrated into normal clinical everyday work. To ensure best possible motivation and acceptance, special attention was paid to user friendliness and immediate print-outs whenever required. Attention was also given to the inclusion of infant follow-up data. The computer programme has been accepted for daily operation, and the necessary data quality has been attained by means of proper choice of the appropriate user groups and manifold measures to ensure integration, safe working, continual servicing and creation of suitable working and data feed conditions.

Attitude to Computers↗
PubMed1991

Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases.

Phylloides tumor is a rare fibroepithelial breast tumor that occasionally has unpredictable clinical behavior. In nine cases of histologically benign tumors and one case of malignant phylloides tumor, the findings on physical examination, mammography, sonography, and aspiration biopsy were correlated retrospectively with the histologic diagnosis of resected specimens. Mammograms showed a round or lobulated benign-appearing opacity in nine cases; one small tumor was missed mammographically. Sonography depicted all tumors as mostly solid masses. Sonographic features included low-level internal echoes, either uniform or scattered; smooth contours; and no significant posterior shadowing. Intramural cysts were shown in six cases. Neither mammography nor sonography allowed reliable differentiation between benign and malignant phylloides tumors. Aspiration biopsy permitted accurate diagnosis of seven benign tumors. The malignant phylloides tumor was classified as a malignant tumor, but the definite differentiation from a carcinoma could not be made. Two histologically benign phylloides tumors were misdiagnosed as carcinomas. Although uncommon, phylloides tumor should be considered in the differential diagnosis of mammographically benign-appearing breast masses, especially if sonography shows intramural cysts within a well-defined solid lesion. Aspiration cytology is unreliable because of the inhomogeneity of the tumor; both intraoperative frozen section and permanent sections are needed for correct histologic diagnosis.

Adult↗