Sterile Box Research Articles

One way to improve the quality of a medical manipulator for sterile boxes

Today, the advanced robot-surgeons and medical manipulators are managed by operators. Among the best recognized systems are: Da Vinci, Robodoc, SMR Surgical Versius. Further development of medical robotic surgery field requires new solutions in the engineering and software spheres. The main issues and directions are remote surgical operations online as well as automation of processes in sterile boxes. To overcome such limitations, the system must be of minimal size, but it should not lose its accuracy and power. A large number of solutions are aimed at a specific characteristic: Robodoc (accuracy and automation), Da Vinci (flexibility and remote control), SMR Surgical Versius (modularity and miniaturization). If the system has high accuracy, small dimensions and the possibility of automation, it will significantly accelerate the development of robotic surgery.
 This task can be solved by removing all electronic components from the segments of the manipulator. Such a solution is already available in the robot surgeon Da Vinci, but a cable mechanism is used there at the base of the segments, which does not allow automating the process because of a low accuracy. The solution that will ensure sufficient accuracy and allow automating the processes is using a bevel gear inside the segments. In this way, it is possible to reduce significantly the size and to increase the accuracy (enlarging the number and type of motors), as well as to make the system as modular as possible, which in its turn will simplify the repair and maintenance.
 A manipulator prototype was developed and printed on the NodeMcu hardware platform. The main functionality corresponds to the task. The dimensions of the prototype are 324x324x620 mm, but at the same time, like Da Vinci's robotic surgeon, 7 degrees of freedom remained. Nema17 motors have been used, the accuracy has increased significantly and reaches more than 0.01mm Automation research is still ongoing, but the vibration rate has been significantly reduced because all the motors are placed separately. Technical solutions will allow automating work in sterile boxes, ensuring maximum reliability.

Dosimetry of a self-shielded gamma irradiator small animal whole-body irradiations: comparisons between ionisation chamber and alanine.

Because of reproducibility and repeatability problems with reference measurements made with an ionisation chamber in a self-protected GSRD1 irradiator, a comparison was made with alanine dosimetry for a whole-body mouse irradiation setup in a sterile box. The twisting of the cables in the cable duct and in the irradiator cell and the irradiation of the ionisation chamber connector are likely to have caused the problems encountered. These problems are not observed on other types of irradiators with more suitable cable passages. A difference up to 8.4% was observed between the alanine dosimetry and ionisation chamber. The influence of the number of animals in the sterile box on the whole-body dose of the animals was also evaluated with alanine and found to be <2%.

Propagation of phytosanitary clones by in vitro culture

This article presents the process of accelerated reproduction of healthy clones of grapes, including the following stages: growing young shoots of the original plants of clones, introducing tops into in vitro culture, microclonal cuttings, adaptation of microplants to ex vitro culture, transplanting into cassettes with a soil substrate, transferring plants to a greenhouse for growing to the condition of vegetative seedlings and planting in a pre-propagation mother stock. For the successful implementation of each of the above operations in the SPIHVFT, a Cultural Complex has been equipped, consisting of a number of interconnected premises: a sterile box, a culture chamber and a vegetation chamber. The use of this Complex allows multiplying the required number of plants during the year, to grow vegetative seedlings by the spring of the next year and plant them in the pre-propagation “Pre-base” mother plant. After a year, grafted vegetative seedlings grown from the vines of the mother plant were used for laying the mother stock.

Study of the effectiveness of using decamethoxin-based antiseptic compositions for treating endotracheal tubes in order to prevent the development of ventilator-associated pneumonia in intensive care patients

Annotation. The use of artificial lung ventilation in patients of intensive care unit often leads to airway contamination of conditionally pathogenic microorganisms and the development of ventilator-associated pneumonia. The clinical manifestations of ventilator-associated pneumonia can vary widely from mild to development of critical conditions accompanied by septic shock. This significantly worsens the patient's condition and prognosis for effective treatment. The paper presents the results of the study of the use of adhesive antiseptic compositions based on the domestic antiseptic drug decamethoxin in order to give antimicrobial properties to intubation tubes. An antibacterial adhesive was applied to the surface of segments of the endotracheal intubation tube, after which the samples were dried in a sterile box. The sensitivity of the microorganisms to the components of the antiseptic compositions was studied by the diameter of the growth retardation zone around the studied fragments of endotracheal intubation tubes placed in the thickness of the pre-seeded microorganism’s dense nutrient medium. The results were statistically analyzed using standard application package for biomedical research “STATISTICA 5.5”. It has been proved that adhesive film-forming compositions based on decamethoxin confer pronounced antimicrobial properties to endotracheal intubation tubes. The most susceptible to antimicrobial activity were gram-positive microorganisms of the genus Staphylococcus, and the most resistant were representatives of gram-negative bacteria of the genus Acinetobacter. The obtained research results allow us to predict the effectiveness of the use of adhesive hydrophilic and hydrophobic antiseptic compositions based on the domestic antiseptic decamethoxin to provide protective properties of the surface of endotracheal tubes, prevent the process of bacterial film formation and prevention of ventilator-associated patients.

A Shipping Container-Based Sterile Processing Unit for Low Resources Settings.

Deficiencies in the sterile processing of medical instruments contribute to poor outcomes for patients, such as surgical site infections, longer hospital stays, and deaths. In low resources settings, such as some rural and semi-rural areas and secondary and tertiary cities of developing countries, deficiencies in sterile processing are accentuated due to the lack of access to sterilization equipment, improperly maintained and malfunctioning equipment, lack of power to operate equipment, poor protocols, and inadequate quality control over inventory. Inspired by our sterile processing fieldwork at a district hospital in Sierra Leone in 2013, we built an autonomous, shipping-container-based sterile processing unit to address these deficiencies. The sterile processing unit, dubbed “the sterile box,” is a full suite capable of handling instruments from the moment they leave the operating room to the point they are sterile and ready to be reused for the next surgery. The sterile processing unit is self-sufficient in power and water and features an intake for contaminated instruments, decontamination, sterilization via non-electric steam sterilizers, and secure inventory storage. To validate efficacy, we ran tests of decontamination and sterilization performance. Results of 61 trials validate convincingly that our sterile processing unit achieves satisfactory outcomes for decontamination and sterilization and as such holds promise to support healthcare facilities in low resources settings.

Exploration of Exhaust Gas of Natural Gas Catalytic Combustion in the Aseptic Box

Because exhaust gas of the natural gas catalytic combustion is clean and sterile, the exhaust gas can be used in aseptic boxes, high-temperature exhaust gas pre-sterilization of the aseptic box, the continuous low temperature flue gas pass into the sterile containers, aseptic containers in during use to maintain a clean and sterile, and has greatly improved the device and working environment of the sterile boxes.

Survivability of vancomycin resistant enterococci and fitness cost of vancomycin resistance acquisition

Aims: To investigate the survivability of vancomycin resistant enterococci (VRE) under dry starvation conditions and the fitness cost of vancomycin resistance. Methods: VRE colonies on cotton swabs were incubated at...

A Microbiological Laboratory for Drug Monitoring with Respect to Sterility: Design and Equipment

A requirement of any modern pharmaceutical enterprise, which acquires even greater importance in view of the requirements of the GMP, is thorough monitoring of the quality of drugs. In order to provide conditions for adequate testing, new laboratories are created and existing ones are modified so as to provide for an increased level of analyses. In designing new and/or reconstructing old rooms for laboratories engaged in studying specific microbiological problems, it is necessary to take into account a number of special features crucial for the proper functioning of such quality monitoring departments. Below we present a project of the design, equipment, and functioning of that part of a microbiological laboratory where the tests for drug sterility are to be conducted. A Microbiological Laboratory engaged in testing drugs for injection with respect to sterility must be designed so as to meet the following requirements. (i) The laboratory must be isolated from other parts of the department. (ii) Restricted entrance of visitors (only the laboratory staff is admitted). (iii) “Clean rooms” (sterile box and lock room) must be arranged as far as possible from the laboratory entrance and not to adjoin other rooms with increased humidity and unstable atmosphere (glassware washing, media preparation, sterilization treatment) in order to reduce the risk of contamination of the “clean rooms.” (iv) “Clean rooms” (sterile box and lock room), where the sterility tests are conducted, must not have windows nor allow entrance from the common corridor. (v) The doors of “clean rooms” (sterile box and lock room) must be provided with blocking facilities, whereby the box entrance is blocked when the door to the lock room is open. (vi) The laboratory head cabinet and product stock room should be arranged as close as possible to the laboratory entrance. The dimensions of working rooms depend on the number of table and ground based instruments, the number of personnel, and the furniture employed. The rooms must be large enough to reduce the risk of cross contamination and provide for the free passage and accuracy of operation of the laboratory staff. The equipment should be positioned both near walls and at the center of working rooms. Special working tables should be placed at the sites of minimum vibration so as to avoid draughts and exposure to direct sunlight, or mounted on cantilevers fastened to the bearing wall. The inner walls must be smooth, made of noninflammable materials resistant to detergents and disinfecting agents. Possible materials are, for example, epoxy-based paints and glazed tile or special nonporous nonshining ceramics. The ceiling must be smoothly painted. The rooms must be protected against factors such as high temperature, dust, humidity, steam, noise, vibration, etc., so as to correspond to all labor safety and ecology requirements. The rooms must be well illuminated with hermetic luminaries. The temperature and humidity must be permanently controlled. In the ideal case, there must be no opening of windows in the laboratory. The air should be supplied from an air-conditioning system (15-fold recycling per hour) or via filters (5 m thick) from outside. Reliable (uninterrupted) electric power and tap water supply are necessary conditions. The laboratory furniture must be made of noninflammable materials resistant to chemical factors (plastic-coated wood). Figures 1 and 2 show an example of the microbiological laboratory design, indicating positions of the main equipment and the directions of air flows in the working rooms.

Thoughts for a countdown.

THERE is ambiguity, and some symbolism, in the elaborate ritual observed by each returning expedition of astronauts from the moon. They celebrate first of all the inviolability of the earth, and they re-enact, each time, in stereotyped choreography, our long anxiety about the nature of life. They do not, as one might expect, fall to their knees and kiss the carrier deck; this would violate, intrude upon, contaminate the deck, the vessel, the sea around, the whole earth. Instead, they wear surgical masks. They walk briskly, arms up, untouching, into a sterile box. They wave enigmatically, gnotobiotically, to the President . . .

The Timing of the Asexual Cycles of Plasmodium lophurae and of P. cathemerium

Previous work had shown that with malaria parasites (such as Plasmodium knowlesi, P. cynomolgi, and P. cathemerium) which have a synchronous asexual cycle of 24 or 48 hr, the gametocytes are mature and infective to mosquitoes only for a short period (6 to 12 hr), and the synchronous asexual cycle is timed to ensure that this short-lived infective phase of the gametocytes coincides with the time at which the vector mosquitoes suck blood, i.e., at night; furthermore the synchronous asexual cycle is oriented by the cycle of the host's body temperature. In the present paper we have studied P. lophurae in which the asexual cycle is usually asynchronous and not a multiple of 24 hr. (Note: the present examples of P. lophurae form a somewhat unusual organism, because they are derived from a single isolation made in 1938 and maintained for 30 years since then by syringe passage.) We have found that the asexual cycle of P. lophurae takes 33 to 50 hr (mean, 40 hr). It bears no relation to day/night but it can be synchronized by blood passage at appropriate regular intervals; the cycle is then oriented to the hour of inoculation (so that the timing is a laboratory artifact, with no significance for natural infections). When P. lophurae is studied in chick embryos, the influence of a 24-hr temperature cycle on the asexual cycle is slight or negligible. (By contrast, the asexual cycle of P. cathemerium in duck embryos readily orients itself to a 24-hr temperature cycle in the environment.) The relation of the asexual cycle of P. lophurae to the behavior of its gametocytes cannot now be investigated because our strain of P. lophurae no longer shows gametocytes. This paper reports investigations on the asexual cycles of Plasmodium lophurae and P. cathemerium with particular reference to the degree of synchronicity and to their timing by stimuli supplied by the host. The work forms part of a larger program on the asexual cycles of P. knowlesi, P. cynomolgi, and P. cathemerium which has been reported in detail elsewhere (Hawking et al., 1968). P. lophurae was initially included in this study because its development in chick embryos seemed to facilitate study of the relation of parasite development to host temperature cycles (since the temperature of incubated eggs can be controlled easily). As will be described below, however, it was found that the asexual cycle of P. lophurae is normally not synchronous (except under certain artificial conditions) and that it is probably not very sensitive to entraining influences from the host. The study with embryos was then transferred to P. cathemerium, in which parasite the asexual cycle is more synchronous and is oriented to the cycle of its host. MATERIALS AND METHODS The strain of P. lophurae was kindly supplied by Dr. W. Trager and was described by Siddiqui and Trager (1966). It was maintained by intraReceived for publication 18 April 1969. peritoneal blood inoculation into young ducklings (and sometimes chickens) usually at weekly intervals. (As will be described later, the interval of subinoculation greatly influences the synchronicity.) P. cathemerium (German) was an old laboratory strain kindly supplied by Dr. 0. Dann (see Hawking et al., 1968). All experimental ducks and chickens were kept in a windowless animal room with light on at 07.00 and light off at 23.00. (Times in current British time for that season of the year.) Technique of inoculating and sampling embryos All manipulations (apart from cutting the shell) were performed in a sterile warm flattopped perspex box 45 cm long, 33 cm deep, and 20 cm high. At each end there was access through an opening 11 cm square (covered by a door when not in use). The floor contained a warm plate thermostatically controlled at 37 C. The egg was placed on its side in a small holder in the middle of the box and operations were viewed through a stereo-dissecting microscope (10 X) (with a built-in lamp) mounted above and outside the box. The embryos had been incubated 10 days when used. The inoculations were made intravenously by the standard technique. Briefly, the egg was candled and a suitable vein was marked on the shell. A piece approximately 1 cm square was cut from the shell with a dental drill and abrasive disk. The egg was then transferred to the sterile box described above, the surface was swabbed with alcohol, and the piece of shell was lifted off. The underlying membrane was then removed to expose the vein, great care being taken not to damage any underlying blood vessels. The injec-