ABSTRACT
Presentamos un caso clínico de perforación uterina durante la colocación de un dispositivo intrauterino con paso del mismo hasta vejiga. Presentamos este caso por la rareza del mismo, pues en la revisión de la literatura mundial sólo hemos encontrado 26 casos incluido el nuestro. La clínica no difiere de la del resto de cuerpos extraños intravesicales. Para el diagnóstico suele ser suficiente una anamnesis detallada y una ecografía. La uretrocistoscopia diagnostica las complicaciones, y en los casos no complicados como el nuestro, es además terapéutica. Si se asocia a complicaciones puede ser precisa la cirugía abierta. Concluimos, que la precocidad en la detección de esta yatrogenia mediante el control ecográfico post-colocación, facilita la extracción del cuerpo extraño y evita la aparición de complicaciones asociadas como la litiasis (AU)
Subject(s)
Middle Aged , Female , Humans , Uterine Perforation , Intrauterine Devices , Foreign-Body MigrationABSTRACT
Quality control and standardized preservation methods are essential in the field of transplantation. The International Organization for Standardization (ISO) has established a common set of manufacturing, trade and communications standards that are applicable worldwide and that provide the basis of a quality plan for Tissuebreak Banks.The Sectorial Tissue Banking (STB) of the Regional Blood Transfusion Center (RBTC) of Córdoba (Spain) is a non-profit-making tissue bank, established in 1992 to provide tissues for surgical procedures to the hospitals in a regional area. In 1998, the STB as a part of the RBTC embarked upon the path of becoming ISO-certified: after two years of the implementation of the project, STB attained ISO 9002 certification, thus becoming one of the first tissue banks in Europe to achieve this qualification. In this paper we describe the process of becoming ISO-certified, to demonstrate the positive impact that it has had on our entire organization.The assistance of an outside consultant who provided the necessary information for implementing an ISO quality management system was required. The initial improvement was: a well-defined quality manual to address all elements of the ISO 9002 standard, an improved document control system, detailed standard operating procedures (SOPs) and improved employees training processes. A quality committee team and developed quality indicators were created. The internal quality auditing program was established by the selection of employees from a cross-section of the organization, who were trained in internal auditing processes. A formal corrective action system was developed and implemented to facilitate process improvement. The consultant conducted a pre-certification audit, and one month later the certification audit was performed.In conclusion, the implementation of an ISO quality program in the STB has helped our center to establish a control process in the manufacturing of products and services to meet the expectations of our customers, by providing components and services that comply with the national regulatory standards and requirements.
ABSTRACT
We describe in this work the chemical and electrokinetic surface characterization of core-shell particles consisting of a practically spherical hematite nucleus coated by a layer of yttrium basic carbonate or yttrium oxide (obtained after calcination of the carbonate-coated particles, following the method of E. Matijevic and B. Aiken (J. Colloid Interface Sci. 126, 645 (1988))). The morphological and surface characteristics of the particles were controlled by modifying the initial yttrium nitrate concentration and the growing time. A total of 14 samples of hematite-yttrium basic carbonate composites were obtained, and three of them (obtained by keeping at 90degreesC solutions containing 6.5 x 10(-4) M alpha-Fe2O3, 1.8 M urea, and 1.1, 3, and 4.9 mM Y(NO3)3, respectively) were then converted into hematite-Y2O3 particles. Transmission electron microscopy was used to ascertain the shape and size of the particles. The spherical geometry of the core hematite is found, as a rule, on the core-shell particles; in general, carbonate samples obtained with intermediate initial concentration of Y(NO3)3 have the maximum coating thickness, whereas increasing that concentration does not lead to thicker coatings. Hence, formation of individual yttrium basic carbonate, together with coated hematite, cannot be completely ruled out under such conditions. Two techniques were employed for the elucidation of the surface composition of the particles, namely EDX and XPS (or ESCA). In particular, XPS data show that the coating of hematite by yttrium carbonate is almost complete in the case of particles obtained with 3 mM Y(NO3)3 concentration and 9-h heating time. The oxide samples obtained after calcination show high contents of yttrium and low iron surface concentration for initial [Y(NO3)3] = 1.1 mM (sample OB9) and 3 mM. According to XPS analysis, both types of particles have a quite similar surface composition and structure. For all types of particles but the carbonate-coated ones obtained at the shortest reaction times, the pHiep was found to be above that of pure hematite, approaching that of yttrium basic carbonate or oxide. In particular, among the oxide-coated particles, it is sample OB9 the one that most closely approaches its pHiep to that of Y2O3, in good agreement with the surface chemical analysis performed with XPS. Copyright 1997 Academic Press. Copyright 1997Academic Press
