We introduced a "Surgical support system", consisting of an automatic transporter, instrument sterilizer, sterilized containers, and vertical rotary storage system to increase efficiency, reduce the work-load, and prevent infection in the operating theatre. Systematizing the cleaning processes, such as washing the surgical instruments, improved the quality of work, reduced secondary infections arising from the surgical instruments, and saved time. In addition, this system simplified the storage room. Computerized control of stock with a vertical rotary storage system allowed easier access and usage of the contents, as well as enabling better data collection regarding stock such as expiry dates and frequency of usage of the sterilized containers. This system has been in place for one year and has provided a good management tool for the whole operating department.
In uremia, toxins such as urea accumulate in the blood and therefore need to be removed. The effectiveness and efficiency of removal can be assessed accurately by determining the concentration of uremic toxins in the blood. For that purpose a selective analytical method is required. Current techniques for analysis of urea used in clinical practice include the ionselective methods is conversion of urea to ammonium with urease and then determination of ammonium (ionselective electrode method), coloring ammonium with reagents (Indophenol method), or automatic analysis predominantly based on colorimetry. Another method is determination of absorbance at 340 nm of NADH from NAD combined with a transaminase. These methods all have the problem of not being able to differentiate urea from endogenous ammonia. Furthermore in current clinical tests, differential analysis of free and bound urea is not possible. It is essential to selectively determine the free urea. In order to do this ion-exchange chromatography has been shown to be the most appropriate for differentiating urea from endogenous ammonium and separating it from other components in the serum. Selective free urea analysis can be attained by ultrafiltration.
Intraoperative infrared imaging by thermographic unit is presented. The infrared camera of medical thermograph unit is installed to the operating microscope using an exclusively designed attachment device. Infrared imaging during open neurosurgery clearly demonstrated intraoperative thermal change of cerebral cortex in video mode. Intraoperative infrared imaging provides several significant findings for complecated cerebrovascular lesions such as arteriovenous malformations. Future possibilities of infrared imaging from a view of medical instrumentology is discussed.