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Biomedical subjects

W E Miller

Publications and source records attributed to W E Miller.

At least 73 records · Page 4Linked to original sources
PubMed1985

Learning arthroscopy.

Problems have been uncovered in learning arthroscopy at the resident level or for the beginner at any level of orthopedic practice. The problems are varied, and are not all present in the same individual. This study delineates problems involving vision impairments, depth perception, spatial recognition, speed of accommodation, and data confrontation requiring immediate action. Speed is an additional factor in relation to accomplishing a task within an acceptable time limit. Through testing mechanisms, surgeons can discover their own inadequacies and thus learn to perform well in this new field.

Arthroscopy↗
PubMed1984

Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study.

The initial (prevalence) radiologic and cytologic screening for lung cancer in the Mayo Clinic study (Mayo Lung Project) involved 10,933 outpatients. All were men at high risk for lung cancer, but none were suspected of having it when they entered the Mayo Clinic. Screening identified 91 lung cancers (8.3 per 1,000 screened). Nearly two thirds of the prevalence lung cancers were detected by chest roentgenography alone. Half of these cancers were resected. Only a fifth of the cancers were detected by sputum cytologic examination alone; however, all but 1 of these were resected. Compared with a group of lung cancers encountered in contemporary clinical practice at the Mayo Clinic, the prevalence cancers were more than twice as likely to be (1) resectable, (2) postsurgical Stage I or II (AJCC), and (3) associated with survival 5 yr after treatment.

Adenocarcinoma↗
PubMed1983

Lung cancer detected during a screening program using four-month chest radiographs.

Ninety-two lung cancers were detected in the Mayo Lung Project in patients undergoing chest radiography every four months for screening. Fifty patients had a peripheral nodule, 16 had a perihilar nodule, 20 had hilar or mediastinal enlargement, and six had pneumonitis. The peripheral cancers grew slowly. Ninety per cent were visible in retrospect for months or even years. Despite this, 70% of the peripheral cancers were classified as postsurgical American Joint Committee (AJC) Stage 1. The central cancers grew rapidly, usually presenting as hilar or mediastinal enlargements after normal findings on the previous radiograph obtained four months earlier. Most were classified as AJC Stage 3 tumors.

Adenocarcinoma↗
PubMed1982

General considerations in the examination of the foot and ankle in your patient in office practice.

This article contains observations regarding history taking and physical examination of the foot and ankle which previously have not been compiled in this exact manner. The significance of the chief complaint in relation to problem solving is a major feature. The steps in the actual physical examination are related in a practical order. Terminology is reviewed. Documentation is stressed. The panorama of those involved in decisions relating to solving foot problems is placed in perspective. The general considerations reflect long-standing involvement in minuscule attention required to accurately arrive at a diagnosis. There may be more than one solution for a problem but only one accurate diagnosis.

Ankle↗
PubMed1982

Villonodular synovitis: pigmented and nonpigmented variations.

During the past 20 years, 34 cases of pigmented villonodular synovitis have been seen at Jackson Memorial Hospital, University of Miami Medical Center. There were 18 cases in the knee, eight in the hip, one in the elbow, two in the finger, three in the ankle, one in the wrist, and one in the sternoclavicular joint. In reviewing the pathology slides, it was difficult to differentiate fibrous histiocytoma from villonodular synovitis. The cause is considered to be inflammatory. The treatment is subtotal synovial resection with joint replacement as necessary. Recurrences after synovectomy are rare, with none in our series of 34, and only two cases lost to follow-up. I believe synovectomy and debridement to be the treatment of choice, although in the hip, the more destructive pressures involving the acetabulum may force the replacement of the total joint. Radiation therapy has not been used in the treatment of this condition at the University of Miami.

Debridement↗
PubMed1981

Idiopathic localized dilatation of the ileum in adults.

The clinical and radiological features of idiopathic aneurysmal dilatation of the ileum in 3 adult patients are described. This uncommon lesion presents as an aperistaltic saccular segment in direct continuity with the normal ileal lumen. On barium examination of the small bowel, however, it may closely resemble and be mistaken for a Meckel's diverticulum. Previous reports about this entity manifesting in the pediatric age group are reviewed.

Adult↗
PubMed1980

A disabling sports injury of the great toe.

An unusual and disabling sports injury of the hallux is described. This consisted of a torn lateral conjoined tendon, capsule, and collateral ligaments, causing varus metatarsophalangeal instability. The surgical treatment is described along with the follow-up evaluation.

Adolescent↗
PubMed1980

Transthoracic needle biopsy: accuracy and complications in relation to location and type of lesion.

Transthoracic needle biopsy has become a frequently used method for obtaining tissue for diagnosis of pulmonary lesions. The procedure carries an inherent risk of pneumothorax and hemorrhage, the latter usually manifested by transient hemoptysis. Data on 430 patients who underwent transthoracic needle aspirations from 1968 through 1977 were studied to determine accuracy and complications of this procedure as related to lesion type and location. Malilgnant disease, most often metastatic, was present in all but 10 patients. Also, 86% of patients were more than 50 years of age and most were not candidates for operation. Sufficient tissue for diagnosis was obtained in 82% of cases. The diagnostic yield diminished significantly in central lesions less than 2 cm in size. Pneumothorax and hemoptysis or pulmonary hemorrhage were the most common complications. Biopsy of central lesions, especially those in the mediastinum, were more often associated with pneumothorax, whereas lesions near the hilar region were more susceptible to hemorrhagic complications. Two deaths occurred, both from hemorrhage after biopsy in cavitating lesions with air/fluid levels. The incidence of pneumothorax was also higher in cavitating lesions. Fewer complications occurred with biopsy of lesions along the pleural surface and lesions in the periphery of the lung.

Adult↗
PubMed1977

Adjuvant role of radiation in soft tissue sarcoma in adults.

Forty-seven patients with soft tissue sarcomas were analyzed retrospectively. Treatment was non-randomized between surgery alone, preoperative radiation of 5,000 rads/5 weeks, postoperative radiation of 6,000 rads/6 weeks following total gross tumor removal, and postoperative radiation (variable dosees) for residual gross or unresectable tumor. Preoperative radiation was not statistically better for local control or survival compared to postoperative radiation after local excision of gross tumor. Wide excision, higher postoperative radiation dosage, and/or enlarged radiation portals perhaps would improve results. Additional adjuvant therapies, such as chemotherapy or immunotherapy, needs to be investigated.

Adult↗
PubMed1977

Nonoperative retrieval of an impacted long intestinal tube.

A patient with recurrent intestinal obstruction and jejunocutaneous fistula was referred for treatment of the latter condition. Management with total parenteral nutrition was complicatied by bacteremia. Subsequently, a double-lumen tube was passed via an existing gastrostomy for purposes of aspirating above the level of the fistula and infusing appropriate nutrients and fluids distally. A period of marked clinical improvement was followed by increased fistula output and evidence of intestinal obstruction secondary to gaseous distention of a sealed latex terminal balloon which was retrieved only after percutaneous puncture. The unusual complication of prolonged intestinal intubation is discussed with special reference to this nonsurgical method of managing the impacted balloon and tube. Factors affecting balloon distention are discussed and the necessity of venting intestinal balloons reemphasized.

Female↗
PubMed1977

Computed tomography of the retroperitoneal space.

Computed body tomography is an easily accomplished method that precisely displays the normal and pathologic anatomy of the retroperitoneal space. Suspected retroperitoneal disorders, which are often clinically confusing or obscure, can now be detected or excluded with remarkable accuracy. Few innovations in radiology have more effectively fulfilled such a conspicuous need.

Abscess↗