Notes: Abstract To assess the impact of face-to-face exchange of clinical information between the radiologist and the emergency physician, a study was made of all plain films and computed tomograms (CTs) ordered in the Ohio State University Emergency Department between 11 am and 11 pm over a 4-week period. For each case, interpretations at three different times were recorded: (1) initial interpretation upon reception of the images, (2) interpretation after face-to-face discussion of clinical information with the emergency resident or attending physician, and (3) final interpretation after conferring with the attending radiologist. If any of the three interpretations differed in a given case, the case was flagged for review by a third attending radiologist to determine the clinical significance of the discrepancy. Cases which deviated from the standard model as described were excluded from the study. In total, 519 cases were ordered during the study period. Of which 231 (44.5 %) occurred in the standard order as described in the Methods section. Of these 231 cases, changes in diagnosis were observed in 31 (13 %) cases. In 12 (5.2 %) cases, the changes were judged to be clinically significant. In 19 (6 %) cases, the changes were judged to be clinically insignificant. The remaining 288 (55.5 %) cases diverged from the standard model described in our Methods section and were not included in our study. Of these, 93/519 (18 %) cases had only one interpretation because the resident radiologist, the emergency physician (resident and/or attending), and the attending radiologist were present for a single, simultaneous discussion. 77 (15 %) cases, there were only two interpretations because the initial interpretation occurred in the presence of both the resident radiologist and the emergency physician. In 69 (13 %) cases, there were two interpretations because the initial interpretation occurred in the presence of both the resident radiologist and the emergency physician. In 49 (9 %) cases, no face-to-face exchange between the resident radiologist and the emergency physician was recorded. Our data suggest that teleradiology's lack of face-to-face communication between the radiologist and the emergency physician may have an impact on the radiologic diagnosis, but only infrequently. Information contained in the images and the limited clinical history on the consult sheet appear to be sufficient for most purposes of radiologic interpretation.

Notes: Summary 1) The distributions of ventilation and perfusion in the single elongated lung of the totally aquatic sea snake,Pelamis platurus were studied by observing inspiration and subsequent elimination of133Xe gas and by measuring regional activity of99mTc labelled macroaggregated albumin introduced into the lung via the posterior vena cava. 2) The distributions of the two labels were similar along the lung in snakes floating horizontally (Fig. 6). This indicated a uniformity of ventilation-perfusion ratio throughout the lung that promotes efficient gas exchange. Axial movement of133Xe was slow (Fig. 1) and voluntary mixing of the gas was not observed (Fig. 3). However, head up tilting collapsed the posterior saccular portion of the lung and mixed the gas (Fig. 4). 3) Right to left shunts totalled about 50% of the systemic blood flow during voluntary breathing.

Notes: Abstract Radiochemical procedures are discussed for the isolation and determination of a suite of radionuclides in samples from the Black Sea following their input from the Chernobyl reactor accident. The samples analyzed include discrete water samples and both suspended and dissolved phases collected by in-situ chemisorption techniques. The radiochemical scheme permits the separation and analysis of134Cs,137Cs,90Sr,144Ce,147Pm,106Ru,239Pu,240Pu, and in some instances242Cm,238Pu, and241Am. The detection techniques employed include various instrumental gamma spectrometric methods, low-level beta counting, alpha spectrometry, and mass spectrometry. The method's developments are described and data are presented on some representative samples from the Black Sea. The sensitivity of the analysis for the various nuclides and sample types is summarized and questions of radiochemical interferences are addressed.