A telemedicine consultative service for the evaluation of patients with urolithiasis.

Objectives: A 6-month pilot teleconsultative project linking Georgetown University Medical Center (GUMC) in Washington, DC, and City Hospital in Martinsburg, West Virginia, 90 miles away, was designed to assess the effectiveness of telemedicine on the clinical decision-making process for patients with urolithiasis.

Methods: The telemedicine system designed and tested for this project was based on a PC-based platform. Videoconferencing and review of the patient's imaging studies were performed over an Integrated Service Digital Network (ISDN) with 3 Basic Rate (BRI) ISDN lines providing a 336-kilobytes/s bandwidth through an Inverse Multiplexor (IMUX).

Thickening of the gallbladder wall in acute hepatitis: ultrasound demonstration.

Thirty-six patients with acute hepatitis and 25 normal volunteers were examined by ultrasound to determine the thickness of the gallbladder wall. Liver enzymes were measured at the time of the examination in all patients. Ten were excluded, since they had other diseases which could lead to wall thickening.

Left pleural effusion in patients with chronic liver disease and ascites. Prospective study of 22 cases.

In a prospective study of 22 cases of left pleural effusion in patients with chronic liver disease and ascites, 16 patients underwent thoracentesis, revealing ten transudates, considered to be hepatic hydrothorax, and six exudates, four of which turned out to be due to tuberculosis. Unilateral left pleural effusion is rare in chronic liver disease with ascites, but if present it is associated with a high incidence of pleuropulmonary tuberculosis (18%).