[The clinic as profit center and management with reference figures]. / Die Klinik als Profit-Zentrum und Führung mit Kennzahlen.

Financial responsibility is one of the important aspects of hospital management. At the hospital of Uster a trial with a profit center concept was started in October 1991. This concept included development of management tools such as reference figures to check costs, returns and performance. Thus it was possible to obtain an equilibrium between personnel costs and performance within 6 months. In the first half of 1993 the budgeted performance figures for 1993 have so far been reached. Although a complete implementation of a profit center concept in a public hospital does not seem possible, a profit center-like structure helps to obtain financial control and enables the hospital management to readily adapt to changing conditions.

Influence of sulfinpyrazone on infarct size, hemodynamics, and arrhythmia following coronary occlusion in the pig.

We compared infarct size (nitroblue tetrazolium method), hemodynamic variables, and arrhythmias of a group of seven sulfinpyrazone-treated pigs (30 mg/kg/day for 7 days preoperatively, 30 mg/kg/i.v. 30 min before coronary ligation) with a control group of seven animals. Infarct size after ligation of the left anterior descending coronary artery was 20.3 +/- 1.1% in the sulfinpyrazone group and 20.3 +/- 0.5% in the control group. Heart rate, arterial blood pressure, cardiac output, and stroke volume were comparable in both groups before and for 60 min following ligation. There was no significant difference between the two groups in the number of premature ventricular contractions the PVC grade (Lown) or in the number of episodes of ventricular tachycardia or ventricular fibrillation during the 30-min observation period. We conclude that short-term administration of sulfinpyrazone has no effect on infarct size or arrhythmias in the acutely ischemic myocardium of the pig.

Experimental acute renal artery stenosis. Dynamic CT and renal perfusion.

Unilateral renal artery stenosis of varying degrees was induced in six of seven pigs. Renal perfusion prior to and after stenosing the renal artery was determined by standard renal clearance and by the direct measurement of renal blood flow. Renal blood flow was reduced from 29 to 56% (mean 40%) in the poststenotic ischemic kidneys. A significant correlation was found between the opacification of the poststenotic ischemic kidneys after intraaortic bolus injection and direct renal blood flow (r = 0.89, P less than 0.01). There was also a significant correlation (r = 0.85, P less than 0.01) between the opacification of the kidneys and their respective glomerular filtration rates. Renal opacification determined by CT correlates significantly with renal perfusion.