Michael Timins - Academia.edu (original) (raw)

Papers by Michael Timins

Acta Cytologica, 2007

Extrapulmonary Pneumocystis carinii (EPC) infection is an uncommon condition, regardless of HIV s... more Extrapulmonary Pneumocystis carinii (EPC) infection is an uncommon condition, regardless of HIV status, and can occur as a complication of P carinii pneumonia (PCP). However, PCP is the most common severe opportunistic infection in patients with AIDS. The incidence of EPC is variable, and in HIV-1-infected individuals it has been estimated to be 0.06-2.5%. A case of generalized lymphadenopathy was referred to us for fine needle aspiration cytology (FNAC). The patient was a 9-year-old boy who had a toxic facies and manifested multiple skin lesions all over the body. Fever was present during the examination. HIV status was confirmed from the history and test report. FNAC was done from a cervical lymph node and smears stained with hematoxylin-eosin and with Giemsa and Papanicolaou stain. The presence of P carinii was suspected in Giemsa- and hematoxylin-eosin-stained smears, and silver methenamine stain was used to confirm the diagnosis. Fungal spores were seen as small, spherical cysts of variable sizes, more or less the size of erythrocytes. The diagnosis was thus established as EPC infection. Lymph node involvement is the most common site of pneumocystosis in AIDS patients. Fine needle aspiration diagnosis of EPC infection is a possibility in such cases with lymphadenopathy and must be included in the differential diagnosis of lymph node swellings in AIDS.

Radiologic Clinics of North America

This article describes MR imaging of acute and chronic injuries of the ankle and foot, elbow, and... more This article describes MR imaging of acute and chronic injuries of the ankle and foot, elbow, and hand and wrist. Conditions discussed include ligament and tendon injuries, fractures and bone bruises, osteochondral defects, foreign bodies, and posttraumatic ganglions. Other topics covered include fasciitis, nerve and muscle injuries about the elbow, and triangular fibrocartilage tears.

Radiology Case Reports, 2015

Portal annular pancreas is a rare pancreatic variant in which the uncinate process of the pancrea... more Portal annular pancreas is a rare pancreatic variant in which the uncinate process of the pancreas extends and fuses to the dorsal surface of the body of the pancreas by surrounding the portal vein. It is asymptomatic, but it can be mistaken for a pancreatic head mass on imaging and could also have serious consequences during pancreatic surgery, if unrecognized. We report this case of a 53-year-old female patient who was diagnosed to have portal annular pancreas on the basis of an unusual course (ring appearance) of the main pancreatic duct on magnetic resonance cholangiopancreatography, not described earlier in the radiology literature.

Journal of Thoracic Imaging, 1991

Seminars in Nuclear Medicine, 1997

Over the last several decades bone scanning has been used extensively in the evaluation of oncolo... more Over the last several decades bone scanning has been used extensively in the evaluation of oncology patients to detect bone involvement. It can provide information about disease location, prognosis, and the effect of therapy. Bone scanning offers the advantages of whole body evaluation and the detection of lesions earlier than other techniques. However, as newer diagnostic tools become available, indications for bone scanning must be revised and the results combined with these other tests in order to provide optimum patient care. Advances in instrumentation and the subsequent improvement in image quality have allowed nuclear medicine physicians to provide more accurate bone scan interpretations. By optimizing image acquisition, it is often possible to determine lesion characteristics, which are more likely to represent malignancy. Knowledge of disease psthophysiology and other specific properties of the patient's primary tumor, along with subsequent correlation of scan abnormalities to patient history, physical examination, previous studies, and other radiological examinations, is essential for determining lesion significance. The differential diagnosis of a scan abnormality should also include consideration of both false normal and abnormal causes. The final interpretation should be clearly communicated to the clinician with appropriate recommendations for further evaluation. Only through careful attention to the patient, the clinician, and appropriate study acquisition parameters will bone scanning maintain its place in the evaluation of oncology patients.

Journal of Diagnostic Medical Sonography, 1999

James Joyce Quarterly, 2010

As an academic radiologist at the Medical College of Wisconsin in Milwaukee, at first I felt unsu... more As an academic radiologist at the Medical College of Wisconsin in Milwaukee, at first I felt unsure about something so foreign, my first major Joycean event, the XXII North American Joyce conference at the Huntington Library, Caltech, and Environs in Pasadena, California. Still, once past Wisconsin with its overflowing brick cheeses, bratwurst, beer, and medical conferences with their constant interpersonal buzz devoted to topics medical or sports-related, it felt good to get away from it all geographically and spiritually. My wife and I set out westward and found Eden. Albert Einstein himself said that Pasadena was “like Paradise.”1 Those luscious, tall, blue-blooming jacaranda trees, the gorgeous botanical gardens all around the Huntington Library, the opportunity to meet so many new people, and the magnificent temperate climate all led to a rib-tickling feeling every day. That week, while my wife and son explored the international array of cacti in the desert garden with geckoes angling about, the Chinese garden with orange koi touching the surface of the pool, the jungle garden waterfall, the lazy lotus flowers out among the lilies, the sculptures on the lawns, and all the stately bonsai trees, I took a number of hard swallows and did my mingling. After a stirring reception Sunday night at the Huntington, on the first regular conference day, there were that impressionistic California light, a short bus ride from the Sheraton Hotel, cups of coffee and delicious scones, and the beginning of paper presentations—far too many for my inadequate memory—mostly under the thematic rubric “Joyce in Science and Art.” Aida Yared began with what felt like an operatic performance on the issue of child abuse in Joyce’s fiction, particularly in “A Little Cloud” and “Counterparts.” As a pediatrician—and with projected photos overhead of turn-of-the-century “humorous” postcards of spanked children—she gave a very sobering talk. Later in the morning, in the session titled “Rags and Fish Wraps,” James Reppke spoke about Joyce’s journalistic career, the power and influence of the written media, and James Duffy’s reaction to those influences regarding the newspaper article in “A Painful Case.” Brandon Kershner gave a wonderful rundown of the light weeklies at the end of the nineteenth century and their varied impact on Joyce’s works, in particular, Titbits with its short fictions and anecdotes, readers’ contributions, and contests—to which Joyce’s father was addicted. Midday on Monday, after lunch outside at the grand Huntington mausoleum, the astute Jeff Drouin, of the University of Tulsa, delivered a stimulating

Foot & Ankle International, 1998

A new protocol for computed tomography (CT) imaging of the midfoot is described. This imaging tec... more A new protocol for computed tomography (CT) imaging of the midfoot is described. This imaging technique places the CT cuts parallel to and perpendicular to the talus-first metatarsal axis, as viewed on the lateral CT scout image. For imaging the midfoot, this technique is an improvement over previously described hindfoot or midfoot protocols.

CLINICAL NUCLEAR MEDICINE, 1998

The diagnostic efficacy of (1) combined three-phase bone scintigraphy and In-111 labeled WBC scin... more The diagnostic efficacy of (1) combined three-phase bone scintigraphy and In-111 labeled WBC scintigraphy (Bone/WBC), (2) MRI, and (3) conventional radiography in detecting osteomyelitis of the neuropathic foot was compared. Conventional radiography was comparable to MRI for detection of osteomyelitis. MRI best depicted the presence of osteomyelitis in the forefoot. Particularly in the setting of Charcot joints, Bone/WBC was more specific than conventional radiography or MRI.

American Journal of Roentgenology, 1993

In the past, MR imaging of the ankle and foot has been performed by scanning both extremities sim... more In the past, MR imaging of the ankle and foot has been performed by scanning both extremities simultaneously to provide a normal side for comparison. More recently, unilateral imaging with small local coils has been favored to maximize spatial resolution through use of small fields of view or large matrices. Such clarity of detail, however, demands a greater knowledge of normal anatomy and anatomic variants. We illustrate the MR appearances of a number of variants involving muscle, tendons, ligaments, and osseous structures of the foot and ankle. Familiarity with these findings is essential to prevent errors in the interpretation of MR images.

American Journal of Roentgenology, 1995

James Joyce Quarterly, 2012

By analyzing the trivial details in “The Sisters,” this essay suggests that Father Flynn and his ... more By analyzing the trivial details in “The Sisters,” this essay suggests that Father Flynn and his siblings share the disease neurosyphilis. These details include Nannie’s severe stooping, her oddly worn footwear, her deafness, her muteness, and her torpor. Eliza also has unusual quirks: her need for pneumatic tires indicating hyperacusis associated with vertigo, her malapropisms, and her frequent pauses during speech. Given the epidemic nature of syphilis at the turn of the twentieth century, and given Joyce’s medical knowledge, the unfortunate possibility of a familial disease seems likely.