Fire in the operating theatre. Evacuation pre–planning may save lives

An operating theatre fire and the steps taken to deal with it are described; the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.     

Cytogenetic damage in operation theatre personnel

The study in a group of 24 (11 anaesthetists and 13 support staff) was planned to ascertain the cytogenetic risk in a group of theatre personnel who worked in various city hospitals. Their exposure in terms of duration of service vary from 3-30 years. The control group (n = 24) consisted of people with different occupations matched for possible confounding variables. Cytogenetic risk was assessed in terms of chromosome aberration and sister chromatid exchange in 72-hour lymphocyte cultures. A significant increase in the percentage of chromosome aberration was observed. The sister chromatid exchange was double that of the baseline value in 20% of the exposed individuals. These findings indicate the possible risk of cytogenetic damage for staff working in unscavenged rooms.     

装潢居室空气中挥发性化学物的遗传毒性研究

目的探讨装潢居室空气中挥发性化合物的遗传毒性.方法采用小鼠骨髓嗜多染性红细胞微核试验和小鼠精子畸形试验检测居室装潢后空气中挥发性化合物的遗传毒性.结果该化合物对小鼠呼吸系统有明显的刺激作用,与阴性对照组比较,高、中、低剂量组的微核率、精子畸形率均有显著差异性.结论居室装潢后室内空气中挥发性化合物具有遗传毒性作用.     

Exposure to formaldehyde and phenol during an anatomy dissecting course: sensitizing potency of formaldehyde in medical students

BACKGROUND: The sensitizing potency of formaldehyde and phenol during anatomy dissecting was investigated. The objective was to determine whether exposure induces specific IgE or IgG against formaldehyde-albumin or phenol-albumin. METHODS: In 27 medical students, specific IgE against formaldehyde-albumin by RAST plus ELISA and specific IgE against phenol-albumin by ELISA were assessed. In addition, specific IgG against formaldehyde-albumin was assessed in 23 students. Symptoms before and during dissecting were assessed, and indoor formaldehyde and phenol were measured. RESULTS: Mean indoor formaldehyde was 0.265 +/- 0.07 mg/m3, and mean indoor phenol was 4.65 +/- 2.96 mg/m3. Specific IgE/IgG against formaldehyde-albumin was not found at the beginning. Four students developed specific IgE against formaldehyde-albumin (RAST classes of > or =2.0), and all four also had specific IgE in the ELISA, but IgG against formaldehyde-albumin was not found. Specific IgE against phenol-albumin was not seen. Itch and paresthesia of the hands (P<0.00001), dizziness (P<0.008), burning eyes (P<0.01), headache, sneezing, epistaxis, gingival bleeding, oral or pharyngeal itch, and shortness of breath were experienced. CONCLUSIONS: Formaldehyde exposure during dissecting may induce specific IgE, but not IgG, against formaldehyde-albumin. Sensitization did not correlate with symptoms.     

The multifunctional therapy room of the future: image guidance, interdisciplinarity, integration and impact on patient pathways

With few exceptions the interventional rooms of the present are either imaging suites or sterile operating rooms. Their users are restricted to either percutaneous procedures or to two-staged image-guided surgery without intra-operative imaging control. Since interventional therapy of the future will be minimally invasive and since minimally invasive therapy is essentially image-guided therapy, a new physical place for these activities has to be devised: the multifunctional therapy room of the future integrates sophisticated imaging and image guidance modalities together with advanced surgical and life-support equipment in a sterile environment [1, 2, 3]. Even given a high degree of integration, this will be a complex and costly piece of medical technology. These two factors – complexity and cost – require interdisciplinary technological and medical collaboration to bring it into existence, distribute its cost and maximize usage and medical benefit. Yet another dimension of multifunctionality will be introduced and a significant impact on the care of vitally threatened patients will be exerted by using this room not only for elective image-guided therapy but also for emergent one-stop diagnosis and treatment. Motivation, technology, implementation strategies and funding of this image-guided, integrated and interdisciplinary therapy room, as well as a comprehensive approach combining emergency care and elective computer-assisted therapy (CAT), are discussed in this paper. Received: 28 October 1999; Revised: 18 February 2000; Accepted: 6 April 2000     

植入前遗传学诊断"知情同意"的影响因素与对策

植入前遗传学诊断（Preimplantation Genetic Diagnosis PGD）是辅助生育技术与分子生物学技术相结合而发展的孕前遗传学诊断技术,在植入子宫前淘汰了遗传异常的胚胎,是产前诊断技术的重大进展.但是,由于技术本身存在着一定局限性和不确定性,同时,受到病人认知能力等因素的影响,由此引发了系列伦理学争议.在进行PGD前,一个明了、详尽的患者知情同意过程是必须的.包括通俗全面告知PGD有关信息、手术和检测的局限性和可能结果;充分告知通过PGD所获得的利益和风险.在此基础上针对不同的遗传病检测签署详细的书面知情同意书.