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Biomedical subjects

R R Lee

Publications and source records attributed to R R Lee.

6 recordsLinked to original sources

Flow dynamics of cerebrospinal fluid: assessment with phase-contrast velocity MR imaging performed with retrospective cardiac gating.

To visualize the flow of cerebrospinal fluid (CSF) throughout the ventricles and subarachnoid space, measure mean and maximum CSF velocities, and quantitate CSF flow through the aqueduct of Sylvius, magnetic resonance (MR) imaging was performed with a sagittal technique that is flow-sensitive in the craniocaudal direction (along the readout axis) and a high-resolution axial technique sensitive to through-plane flow in three healthy subjects and 19 patients with known or suspected disorders of the CSF circulation. In both techniques, retrospective cardiac gating was used to cover the complete cardiac cycle. The sagittal technique was superior in overall assessment of CSF flow dynamics, including the motion of adjacent brain parenchyma. The high-resolution axial technique provided an accurate measurement of the rate of CSF flow through the aqueduct; only this technique provided sufficient accuracy to enable distinction between normal and hyperdynamic CSF flow. It is concluded that assessment of CSF flow dynamics is a useful adjunct to routine MR imaging in communicating and obstructive hydrocephalus.

Adult

The reverse selfobject experience.

A reverse selfobject experience occurs when an infant functions as a selfobject for the mother. While reverse selfobject experiences are a part of healthy development, excessive experiences (a) traumatize the infant, (b) contribute to a pathological grandiose self, and (c) lead to severe treatment resistance in the early stages of psychotherapy.

Ego

Marital therapy when one spouse has a primary affective disorder.

The authors explain why marital disharmony when one spouse has a primary affective disorder is difficult to treat but suggest that such couples can be treated successfully if the therapist is flexible and sets realistic goals. Because of the variability of the disease and the many unsubstantiated etiologies associated with it, the authors recommend a modified general system theory approach to treatment that includes a combination of psychotherapy and somatotherapy.

Bipolar Disorder

Homogamous and heterogamous marriages.

This paper explores two marital constructs set forth by Peter Giovacchini. The first is based on a symbiotic reenactment in which the investment of both partners is tenacious and reciprocal, an attachment which Giovacchini refers to as a "character object" relationship. It represents intrapsychic homogramy. In the second construct, this deep form of attraction is absent and the dyadic bond is superficial, frequently transitory. The latter couples do not require an elementary, intrapsychic bond but do share particular defensive traits or symptoms. Thus these unions are termed "symptom object" relationships and are characterologically heterogamous. By means of a group case study approach, this distinction was statistically supported. Furthermore, it was found that homogamous marriages stay in treatment longer, maintain a lower divorce rate, and respond best to individual psychoanalytic psychotherapy. Heterogamous marriages, by contrast, show a higher divorce rate and tend to leave therapy prior to termination. The research also suggests that the initial treatment of choice for this type of marriage may well be conjoint or group psychotherapy.

Compulsive Personality Disorder

Quantitative P-31 MR spectroscopy of the liver in alcoholic cirrhosis.

To determine the cause of reduced urea synthesis in cirrhosis, absolute concentrations of phosphorus metabolites in the human liver have been measured in vivo with magnetic resonance (MR) spectroscopy. One-dimensional chemical shift imaging was used to obtain phosphorus-31 spectra from five healthy volunteers and five patients with alcoholic cirrhosis. A reference standard included in all studies enabled the calculation of absolute concentrations. In contrast to hepatic metabolite ratios, absolute concentrations reveal that in the cirrhotic patients, concentrations of adenosine triphosphate (ATP) were significantly reduced and concentrations of phosphomonoesters slightly reduced. Intracellular pH was unchanged. Histologic evidence suggests that the amount of ATP per cell was unchanged and could not account for the reduced urea production. Instead, urea synthesis depends on the functional liver cell mass, which was reduced by 31% in alcoholic cirrhosis. Quantitative in vivo P-31 MR spectroscopy of liver has potential clinical applications and can supplement the more generally used P-31 metabolite ratios.

Adenosine Triphosphate