Supervision of residents by faculty radiologists using home workstations.

Our purpose was to determine if a home-based faculty radiologist equipped with a high-resolution workstation could add new information to residents' readings on overnight computed chest images that was equivalent to the new information generated by faculty reviewers inside the hospital. Teleconferencing software was installed on home workstations for online supervision of residents by faculty on chest images from a cardiothoracic intensive care unit. Critical observations that could affect patient care were recorded by first-year radiology residents before and after teleconferencing with the home-based radiologist.

Diagnosis of obstructive jaundice.

The diagnosis of obstructive jaundice remains difficult yet vital, since operative decompression may relieve extrahepatic blockage, but operation can only harm patients with intrahepatic block or parenchymal cell inflammation or necrosis. Three new diagnostic methods (liver scanning, angiography, and transjugular transhepatic cholangiography) are reviewed, as is bilirubin metabolism, so important in the diagnosis of jaundice. Three clinical problems are discussed: extrahepatic obstruction due to cancer of the pancreas, biliary atresia causing jaundice in the newborn, and the diffuse ductal obstruction known as sclerosing cholangitis.