OBJECTIVE: To determine whether the size of a perfusion defect seen at myocardial perfusion MR imaging represents the extent of irreversibly damaged myocardium in acute reperfused myocardial infarction. MATERIALS AND METHODS: In nine cats, reperfused myocardial infarction was induced by occlusion of the left anterior descending coronary artery for 90 minutes and subsequent reperfusion for 90 minutes. At single-slice myocardial perfusion MR imaging at the midventricular level using a turbo-FLASH sequence, 60 short-axis images were sequentially obtained with every heart beat after bolus injection of gadomer-17. The size of the perfusion defect was measured and compared with both the corresponding unstained area seen at triphenyl tetrazolium chloride (TTC) staining and the hyperenhanced area seen at gadophrin-2-enhanced MR imaging performed in the same cat six hours after myocardial perfusion MR imaging. RESULTS: The sizes of perfusion defects seen at gadomer-17-enhanced perfusion MR imaging, unstained areas at TTC staining, and hyperenhanced areas at gadophrin-2-enhanced MR imaging were 20.4+/-4.3%, 29.0+/-9.7%, and 30.7+/-10.6% of the left ventricular myocardium, respectively. The perfusion defects seen at myocardial perfusion MR imaging were significantly smaller than the unstained areas at TTC staining and hyperenhanced areas at gadophrin-2-enhanced MR imaging (p < .01). The sizes of both the perfusion defect at myocardial perfusion MR imaging and the hyperenhanced area at gadophrin-2- enhanced MR imaging correlated well with the sizes of unstained areas at TTC staining (r = .64, p = .062 and r = .70, p = .035, respectively). CONCLUSION: In this cat model, the perfusion defect revealed by myocardial perfusion MR imaging underestimated the true size of acute reperfused myocardial infarction. The defect may represent a more severely damaged area of infarction and probably has prognostic significance.
Animal ; Cats ; Contrast Media ; Gadolinium ; Gadolinium DTPA/diagnostic use ; *Magnetic Resonance Imaging ; Mesoporphyrins/diagnostic use ; Metalloporphyrins/diagnostic use ; Myocardial Infarction/*pathology/therapy ; *Myocardial Reperfusion ; Myocardium/pathology ; Support, Non-U.S. Gov't

A computerized hospital equipment utilization review system has been developed and implemented in a tertiary care utilization hospital in order to provide real-time equipment utilization with income information to be used in budgeting and strategic planning. Among various hospital fixed and clinical equipment, 283 (purchase price over US$15,000 per unit) were selected initially for utilization review. The application was written in Power Builder which was then loaded on Pentium client or on-line service. The data base management and statistical transactions were done by Oracle v 7.3.4 on NUMA Q2000 server. The utilization and associated income information of operating tables and other clinical equipment were automatically collected from physician order information in the hospital information system. Those information on other equipment which (lid not have direct utility information linked to physician order entry in the hospital information system were manually entered by users .Various utilization reports can be generated by users through computer menus; reports include name of equipment, using department, purchase price and year, frequency of use for inpatients and outpatients separately, income generated by such usage, and etc. The out put can also be generated by department, by instrument. by any interval as selected. The automated hospital equipment utilization review system has been developed and used since March, 2000 and is proven to he an essential tool for the hospital budget planners and managers. The outcome has been increasingly satisfactory.
Budgets ; Equipment and Supplies, Hospital* ; Hospital Information Systems ; Humans ; Inpatients ; Operating Tables ; Outpatients ; Tertiary Healthcare ; Utilization Review*

Pheochromocytoma is usually associated with a combination of various clinical manifestations caused by the overproduction of catecholamines. It is frequently accompanied by impaired glucose tolerance operating through 2-and-adrenergic mechanisms. A 41-year-old-woman was admitted to the hospital because of poorly-controlled diabetes mellitus and hypertension. She had suffered intermittent paroxysmal attacks of headache and chest discomfort and had been treated intermittently over a 2 year period for diabetes mellitus and hypertension. At admission, the levels of serum epinephrine, norepinephrine urinary excretion of total metanephrine, and VMA were all abnormally elevated. Adrenal CT showed a well-defined, homogenous mass in the right adrenal region and the tumor was diagnosed as pheochromocytoma. After tumor resection, the increased blood level of catecholamines, the urinary excretion of total metanephrine, and VMA were normalized, as was the hyperglycemia state. Diabetes mellitus of the patient was considered permanently resolved after tumor removal by the result of glucose tolerance in 75g oral glucose tolerance test.
Catecholamines ; Diabetes Mellitus* ; Epinephrine ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Headache ; Humans ; Hyperglycemia ; Hypertension ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Thorax

Leriche syndrome is an aortoiliac occlusive disease. The aortoiliac junction is the most common sites of chronic obliterative atherosclerosis. Leriche syndrome has a variety of clinical symptoms attributed to the obstruction of the infrarenal aorta. Common clinical symptoms include thigh, hip, and buttock claudication as well as erectile impotence, usually in association with diminished femoral pulses. But acute anuric renal failure as first manifestation of Leriche syndrome is very uncommon. Contrast-enhanced 3D MRA appears to be well suited for assessment of patients with suspected Leriche syndrome. We report a 75-year-old man who presents anuria as first manifestation of Leriche syndrome.
Acute Kidney Injury ; Aged ; Anuria* ; Aorta ; Atherosclerosis ; Buttocks ; Erectile Dysfunction ; Hip ; Humans ; Leriche Syndrome* ; Male ; Renal Insufficiency ; Thigh