Biomedical subjects
Publications and source records attributed to K D Miller.
Magnetic resonance (MR) imaging of traumatic lumbosacral nerve root avulsion and pseudomeningocele formation at multiple nerve root levels is presented. We report a case of this rare clinicopathologic entity identified by MR imaging in conjunction with more traditional lumbar myelography.
Breast cancer remains a common and devastating disease that affects approximately 180,000 women and results in more than 43,000 deaths annually in the United States. Although only 10% of patients have overt metastatic disease at the time of diagnosis, as many as one third of those who present with lymph node-negative disease and half of those who present with lymph node-positive disease eventually develop metastatic breast cancer. With few exceptions, metastatic breast cancer is largely incurable, and the median duration of survival remains 18 to 24 months. Over the past 3 decades, both laboratory and clinical efforts to increase survival have focused on dose intensity in chemotherapy regimens.
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PURPOSE: To assess the value of an added gradient echo in the same pulse sequence with a T1-weighted spin echo for determining the presence of an abnormal fluid collection in the temporomandibular joint with no additional imaging time. MATERIALS AND METHODS: Using a standard T1-weighted sequence used in cine temporomandibular joint imaging, a readout gradient reversal was added and the resulting gradient echo collected. This image was compared with standard T1- and T2-weighted sequences, a short inversion recovery imaging sequence, and a small flip angle fast low-angle shot gradient-echo sequence. RESULTS: The T1-weighted spin echo preceding the added gradient echo is not affected by the gradient reversal, but the additional gradient echo adds T2* contrast information that displays fluid as bright as and compares favorably with other fluid detection sequences. CONCLUSION: The added gradient-echo technique adds sensitivity for the detection of an abnormal increase in fluid in the temporomandibular joint without adding to the overall imaging time of a routine T1-weighted sequence.
A retrospective evaluation of the use of the peripherally inserted central catheters that were inserted by a small, credentialed nursing staff to provide ongoing venous access in the general adult and pediatric patient population at the University of Rochester Medical Center in Rochester, New York. Between 1993 and 1995, 602 catheters were inserted in 775 suitable patients. Correct catheter tip placement in the superior vena cava was achieved in 95% of placements with a catheter dwell time ranging from less than 1 day to 353 days (average, 24 days). Strict adherence to obtaining and monitoring quality assurance kept catheter complications to a minimum.