Toshihiko Kudo

Mechanisms for development of functional tricuspid regurgitation determined by pulsed Doppler and two-dimensional echocardiography

Mechanisms for the development of functional tricuspid regurgitation (TR) were studied in 41 patients by ultrasound. The severity of TR was classified into 4 grades according to the extent of the regurgitant signal by pulsed Doppler echocardiography (echo). No TR signal was detected in 11 patients; the grade of TR was 1+ in 9 patients, 2+ in 10, 3+ in 8 and 4+ in 9. Using 2-dimensional echo, the tricuspid anular area was estimated from a horizontal and a sagittal diameter of the anulus, and systolic configurations of the tricuspid valve was observed. The tricuspid anular area corrected for body surface area increased with the grade of TR. Anterior displacement of the tips of the tricuspid leaflets was seen in 10 patients with TR of 2+ or greater severity, and its frequency also increased with the grade of TR. Loss of coaptation was seen in 3 patients with 4+ TR and malaligned coaptation was seen in 4 patients with TR of variable degrees. Tricuspid anular dilatation and anterior displacement of the tricuspid leaflet tips causes a separation between the leaflet tips and appears to be the main mechanisms for the development of functional TR. Malaligned coaptation also plays a role in the development of functional TR.

PACS experience at the University of Hokkaido Medical School

Seven months experiences of a filmless PACS (named HU-PACS) which covers Radiology, Orthopedic, Internal medicine and General Surgery departments are reported. The PACS has only 20 Image terminals but handles more than 50% of images produced which is about 1000 images per working day. Physicians of the departments have many criticisms and opinions on the PACS but generally speaking it is well accepted and inspiring the physicians to improve the PACS in its image quality and other functions instead of being discarded. Preliminary clinical assessment are performed and reported also.

A Report On Pacs At Hokkaido University

A PACS or IMAC-SYSTEM has been installed since June 1989 at Hokkaido University Hospital. The system has been under test run since. This paper describes our basic philosophy, impact on radiology, out -line of the system along with problems inherited.

Application of Optical Disc System to Medical Use —Special Focus on PACS—

Two years of clinical experience with picture archiving and communication system (PACS) at Hokkaido University Hospital is described. Both magnetic and write-once optical discs are indispensable for medical data storage of the PACS. Data compression of medical images is routinely employed without significant degradation of image quality, to reduce data sorage space and data transferring time. Image quality of the work station and data access time are acceptable in clinical use of the PACS.