Abstract:

The need to create a new kind of operating room (OR) is obvious from the situation today. Although a number of innovative and even futuristic OR concepts have been proposed, the challenge to implement the OR of the future has never been met. In the Integrated OR System project we came to the conclusion that we have to proceed to new values and new approaches to make the OR of the next millennium happen. By following those new roads we will not only overcome the deficiencies of the OR today but also create a platform that allows easy inclusion of upcoming technology.

Authors:

Thomas Reichert, Dirk Birrenbach - Siemens Medical Engineering, Erlangen, Germany

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Abstract:

Recent improvements in surgical techniques and procedures have been accompanied by attempts to develop adhesives to seal wounds. In the 1940s, Young et al., in animal studies, attempted to connect nervous tissue with a fibrin adhesive, however, as separation and purification of blood constituents were still in a primitive state, their efforts did not progress to clinical usage.

Authors:

H. Osada, M.D., Ph.D.; T.K. Fujii, M.D., Ph.D.; H. Tanaka, M.D., Ph.D.; K. Tsubata, M.D., Ph.D.; T. Yoshida, M.D., Ph.D.; K. Satoh, M.D., Ph.D. - Nihon University Schoolf of Medicine, Tokyo, Japan

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Abstract:

Natural rubber latex (NRL) has been exploited commercially for more than 100 years. It is derived from the milky sap of the Hevea brasiliensis tree, found in tropical climates such as Southeast Asia. Latex is harvested from the tree by a process called tapping, which has been described as a controlled wounding of the tree. The world's total consumption of natural rubber latex is about 5,5 million tons per year. The liquid which is collected from the tree is called field latex and is made up of water, 30%to 40% rubber, and about 3% nonrubber material.

Authors:

Patricia Ann Fleming, R.N., B.A. - Ansell Perry, Inc., Massillon, Ohio

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Abstract:

Phenomenal progress has occurred in the art of liver resection. Only a decade ago massive blood transfusion, liver failure, bile leak, or sepsis were alI frequent attendants of major resection, and intraoperative death from torrential bleeding from hepatic veins or vena cava was not uncommon. Now, major liver resection may be accomplished routinely without blood transfusion, and operative mortality of 0% to 2% is standard in expert hands. Uncontrolled hemorrhage remains the primary cause of intraoperative death. Mortality in the early postoperative period is usually related to delayed hemorrhage, inadequate hepatic reserve, or injury to vital blood supply or biliary drainage in the liver remnant.

Authors:

A.M. James Shapiro, M.B.B.S., B.Med.Sci., F.R.C.S.; Charles H. Scudamore, M.D., F.R.C.S.(C), F.A.C.S.; Andrzej K. Buczkowski, M.D.; Steven W. Chung, M.D., Ph.D., F.R.C.S.(C); Emma J. Patterson, B.Sc. (Hon), M.D.; S. Gul, B.Sc. - University of British Columbia, Vancouver, Canada

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Abstract:

Today,s healthcare facilities face many challenges, two of which are the management of bloodborne pathogen exposures and staff training. Despite new advances and the best efforts of dedicated staff, little progress has been made toward resolving these problems.

Authors:

G. Michael Swor, M.D., F.A.C.O.G., F.A.C.S. - University of South Florida, Sarasota, Fla.

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Abstract:

This review discusses immunotoxins as they apply to organ transplantation and as they have been tested in preclinical studies in primate renal allograft models. The scientific basis of immunotoxin construction and the clinical implications of T-lymphocyte depletion using immunotoxin are discussed. The benefits as well as the disadvantages of immunotoxin technology are reviewed in the context of preclinical use and potential clinical application in the field of organ transplantation. The author's perspectíve is of a clinical organ transplant surgeon, who has an interest in reducing reliance on long-term immunosuppressive therapy as it is currently practiced and with the hope of seeing patients accept their organ and tissue transplants in the absence of expensive and potentially hazardous drugs.

Authors:

Stuart J. Knechtle, M.D., FACS, University of Wisconsin Medical School, Madison, Wis.

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Abstract:

Surgical patients are often treated with vitamins, such as vitamin C, postoperatively. Many surgical patients may have been depleted of essential nutrients through poor diet, debilitation, lack of adequate oral nutrition, or other effects of prolonged hospitalization. Vitamins are essential cofactors in many of the normal wound healing processes. Furthermore, vitamin therapy is thought to carry no risk of harm. While this is generally true, oversupplementation with vitamin C can increase the risk of oxalosis in patients who are predisposed.

Authors:

Rhoda Makoff, Ph.D. - R & D Laboratories, Inc. Marina Del Rey, Calif.

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Abstract:

Primary and secondary malignant disease of the liver remains a major health problem in the United States and abroad. It is estimated that over 130,000 new cases and 55,000 deaths will result from colorectal carcinoma in 1997. In this same year, 13,600 new cases and 12,400 deaths are also expected to result from primary hepatic tumors. Worldwide, hepatocellular carcinoma results in approximately 250,000 deaths yearly.

Authors:

Fred T. Lee, Jr., M.D.; Peter J. Littrup, M.D.; Susan G. Chosy, B.S. - University of Wisconsin Hospital & Clinics, Madison, Wis. and Wayne State University, Detroit, Mich.

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