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Biomedical subjects

K Weingarten

Publications and source records attributed to K Weingarten.

At least 19 recordsLinked to original sources

A consideration of intimate and non-intimate interactions in therapy.

Viewing therapy as a conversation among participants, rather than as an interview concluding with an intervention selected by an expert, allows one to consider the contributions of each member of the conversation in comparable terms. I propose a distinction between intimate interaction, in which meaning is co-created or shared, and non-intimate interaction, in which meaning is rejected, provided, or misunderstood. I suggest that intimate interaction between therapists and clients is therapeutic and that non-intimate interaction rarely is. However, it is in the acknowledgment and repair of the inevitable lapses of intimate interaction that occur between therapists and clients that there is an opportunity for a profoundly meaningful collaboration.

Family Therapy

Detection of residual or recurrent meningioma after surgery: value of enhanced vs unenhanced MR imaging.

The enhanced and unenhanced MR examinations obtained after surgery for meningioma in 38 patients were reviewed to determine the value of enhanced vs unenhanced MR imaging for the detection of residual or recurrent tumor. Enhanced images improved delineation of the extent of tumor in seven of 13 cases in which meningioma was identified on unenhanced images and allowed more definitive detection or exclusion of residual or recurrent meningioma in 18 of 21 cases with equivocal findings on unenhanced images. In addition, enhanced images were helpful for detecting small recurrences, identifying en plaque growth, and showing subtle progression on serial studies. Enhanced MR imaging also allowed detection of two morphologic patterns of dural enhancement adjacent to the surgical bed: (1) thin and smooth, which was seen in patients both with and without residual or recurrent tumor, and (2) thick and nodular, which was seen only in patients with findings indicative of, or at least suggestive of, residual or recurrent meningioma. Unenhanced images failed to detect, or poorly detected, these dural abnormalities. Unenhanced sequences were necessary for accurate interpretation of the enhanced images (e.g., identification or exclusion of hemorrhage). The combination of unenhanced and enhanced MR imaging is recommended for the detection of residual or recurrent meningioma after surgery.

Adult

The discourses of intimacy: adding a social constructionist and feminist view.

Though most people desire intimacy in their primary relationships, it is more elusive than not. I argue that people's assumptions about intimacy interfere with their creation of it. Using a social constructionist and feminist perspective, two prevailing discourses of intimacy that shape our ideas about intimacy are identified and critiqued. Both tend to direct attention away from an assessment of particular interactions to a global assessment of the capacity of an individual or a relationship to provide intimacy. An alternative is proposed in which intimacy is conceptualized as built up from single intimate or non-intimate interactions that can produce a variety of experiences, including connection and domination. My critique of the two discourses of intimacy rests fundamentally on the belief that they obscure crucial distinctions that a discourse of intimacy as meaning-making would reveal, in particular, that there are politics nestled in the heart of intimacy.

Adaptation, Psychological

The effect of cadmium and other metals on vascular smooth muscle of the dogfish shark, Squalus acanthias.

The effect of Cd2+ and related metals (Ni2+, Hg2+, Pb2+, Co2+, Sn2+ Cu2+ and Zn2+) on vascular tension was studied using isolated rings of endothelium-free, smooth muscle from the ventral aorta of the shark, Squalus acanthias. Both Cd2+ and Ni2+ produced significant vasoconstriction at concentrations at or above 10(-6) M (112 and 59 ppb, respectively); the other metals were either marginally constrictive (Hg2+ and Sn2+) or were without effect (Pb2+, Co2+, Cu2+, and Zn2+). We suggest that previously published vascular effects of Hg2+ and Pb2+ may have been secondary to responses of the vascular endothelium, and that the role of Ni2+ in hypertension should be investigated further. Our data indicate that the effects of metals on this vascular smooth muscle are specific and not generic. Moreover, this system could be utilized to investigate the mechanisms of metal-induced vasoconstriction.

Animals

Intraspinal extension of an air cyst of the lung: case report.

We report the diagnostic evaluation and treatment of a cystic paraspinal and epidural lesion originally thought to be a neurofibroma or an arachnoid cyst. Intraoperatively, the lesion was found to be an air cyst of the lung that was successfully ligated.

Adult

Subdural and epidural empyemas: MR imaging.

The MR images of six patients with extraaxial empyemas (five subdural and four epidural) were reviewed and compared with CT scans. MR demonstrated convexity and interhemispheric collections, which were mildly hyperintense relative to CSF and hypointense relative to white matter on short TR pulse sequences and hyperintense relative to CSF and white matter on long TR pulse sequences, allowing distinction from sterile effusions and most chronic hematomas. A hypointense rim, representing displaced dura, was depicted at the interface between the lesion and brain in epidural empyemas, a feature absent in subdural empyemas. Inflammation-induced parenchymal abnormalities, including edema, mass effect, and reversible cortical hyperintensity, were well depicted on MR imaging. MR was superior to CT in demonstrating the presence, nature, and extent of these lesions in all cases. Because early and accurate diagnosis will significantly improve the prognosis of these serious infections, MR is preferred to CT for patients in whom an acute intracranial infection is suspected.

Adolescent

MR imaging of brain abscesses.

The MR images and CT scans of 14 patients with surgically verified pyogenic cerebral abscesses were reviewed. The MR findings correlated well with those seen on CT and were believed to be sufficiently characteristic to allow early and accurate diagnosis with MR alone. These features include (1) peripheral edema producing mild hypointensity on short TR/short TE and marked hyperintensity on long TR/intermediate to long TE scans; (2) central necrosis with abscess fluid hypointense relative to white matter and hyperintense relative to CSF on short TR/short TE scans and hyperintense relative to gray matter on long TR/intermediate to long TE scans (the fluid had concentric zones of varying intensity in seven cases, a finding not previously identified in other lesions); (3) extraparenchymal spread (intraventricular or subarachnoid), which was detected more easily on MR than on CT and was manifested by increased intensity relative to normal CSF on both short TR/short TE and long TR/intermediate TE scans; and (4) visualization of the abscess capsule, which was iso- to mildly hyperintense relative to brain on short TR/short TE scans and iso- to hypointense relative to white matter on long TR/intermediate to long TE scans. On the long TR scans, the relative hypointensity of the rim allowed for visualization of the typical morphologic features of the capsule, which in turn aided in differentiation of abscesses from other lesions (as it does on CT). To investigate the cause of the capsular intensity, pathologic studies of the capsules were reviewed when available (10 cases). Fibrosis was identified in all mature abscess capsules, but the combination of the intensities seen on short TR/short TE and long TR/intermediate to long TE scans as well as the temporal changes in intensity were believed to be incompatible with fibrosis as a cause of the capsular changes. Intensity patterns were suggestive of hemorrhage, but neither acute nor chronic hemorrhage was identified on routine H and E stains, while iron stain revealed scant hemorrhage in only two of the eight patients in whom these stains were used. We believe the capsular intensity (in particular the hypointense rims on long TR scans) may reflect paramagnetic T1, and to a greater extent T2, shortening, possibly due to the presence of heterogeneously distributed free radicals that are products of the respiratory burst produced by actively phagocytosing macrophages in the capsule wall. Distinctive MR features of pyogenic abscesses should afford early and accurate diagnosis.

Brain

Family awareness for nonclinicians: participation in a simulated family as a teaching technique.

This paper describes a course in family theory geared to "well" family members that combines didactic and experiential teaching techniques. A key feature of the course is that students participate in a simulated family for twelve weeks. Family therapists are skilled at using techniques that powerfully dramatize family process; they can provide a needed and useful service to the community by teaching the dynamics of families functioning to people who have a personal or professional interest in learning more about families.

Awareness

Computed tomography of nontuberculous spinal infection.

The CT findings in 16 patients with nontuberculous spinal infections were reviewed. The specificity of certain CT features as well as the usefulness of intravenous contrast medium administration are discussed. The associated clinical presentations and predisposing factors are outlined. Emphasis is placed on a combined clinical, radiographic approach in facilitating an early diagnosis.

Abscess