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  1. Fulltext A Preliminary Study of Human Amniotic Membrane as a Potential Chondrocyte Carrier
    Boo, L., Sofiah, S., Selvaratnam, L., Tai, C.C., Pingguan-Murphy, B., Kamarul, T.
    Malays Orthop J, 2009;3(2):16-23.
    MyJurnal
    Purpose:To investigate the feasibilty of using processed human amniotic membrane (HAM) to support the attachment and proliferation of chondrocytes in vitro which it turn can be utilised as a cell delivery vehicle in tissue engineering applications. Methods: Fresh HAM obtained from patients undergoing routine elective ceasarean sections was harvested., processed and dried using either freez drying (FD) or air drying (AD) methods prior to sterilisation by gamma irradiation. Isolated, processed and characterised rabbit autologous chondrolytes were seeded on processsed HAM and cultured for up to three weeks. Cell attachment and proliferation were examined qualitatively using inverted brightfield microcospy. Results: Processed HAM appeared to allow cell attachment when implanted with chrondocytes. Although cells seeded on AD and FD HAM did not appear to attach as strongly as those seeded on glycerol preserved intact human amniotic membrane, these cells to be proliferated in cell culture conditions. Conclusion: Prelimanary results show that processed HAM chondrocyte attachment and proliferation.
    Matched MeSH terms: Sterilization; Sterilization, Reproductive
  2. A comparison of different disinfectants on the microbiological quality of water from the Dental Unit Waterlines of a Military Hospital
    Mei Siang Ma, Zalini Yunus, Zukri Ahmad, Farizah Abdul Fatah
    Sains Malaysiana, 2015;44:187-192.
    Water from the dental unit waterlines (DUWLs) is known to contaminate with microbial from the biofilm that formed in the tubing system. The water quality from DUWLs is important to patients and dental health care professionals as they could be infected either directly from the contaminated water or aerosol that is generated during dental procedures. Suppliers claimed that dental units supplied to the hospital can only use a specific disinfectant which is uneconomic compared with the others. The aims of this study were to evaluate and compare the efficacy of different disinfectant on the water quality of DUWLs. Four disinfectants (Calbenium, A-dec ICX tablet, Dentel 5, Metassys) and distil water were evaluated. 350 mL water sample was collected separately, from the outlet of high-speed handpiece, scaler, 3-ways syringe and cup filler into a sterile thiosulfate bag on the 1st, 2nd, 4th, 8th, 12th and 24th weeks of the study. The samples were tested on the following day for total viable count (TVC). There is significant difference in the efficacies of the different disinfectants. Only one disinfectant consistently produces water quality within the recommended level of American Dental Association (ADA). Within the limitation of this study, it was found that there is alternative disinfectant that can reduce the TVC to the level recommended by ADA. However, the water qualities produced with these disinfectants were not consistent although they did not cause any technical problem to the dental units during the period of study.
    Matched MeSH terms: Sterilization
  3. A five-year review of diagnostic laparoscopy and female sterilizations in 52 centers in Malaysia
    Ang Eng Suan, Arshat H
    Malays J Reprod Health, 1987 Jun;5(1):1-9.
    PMID: 12269175
    Matched MeSH terms: Sterilization, Reproductive*
  4. A need-responsive programme in post-partum female sterilisation
    Arshat H
    Malays J Reprod Health, 1986 Dec;4(2):51-5.
    PMID: 12314884
    Matched MeSH terms: Sterilization, Reproductive*
  5. A six-year review of tubal sterilization at a district hospital (1981-1986)
    Sivalingam N, Bhagat S, Pereira R
    Family Physician, 1989;1:23-27.
    Matched MeSH terms: Sterilization
  6. A study of menstrual patterns following laparoscopic sterilization with silastic rings
    Goh TH, Puvan IS, Wong WP, Sivanesaratnam V, Sinnathuray TA
    Int. J. Fertil., 1981;26(2):116-9.
    PMID: 6114062
    The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.
    Matched MeSH terms: Sterilization, Tubal/adverse effects; Sterilization, Tubal/instrumentation*
  7. A study on the effects of increment and decrement repeated fed-batch feeding of glucose on the production of poly(3-hydroxybutyrate) [P(3HB)] by a newly engineered Cupriavidus necator NSDG-GG mutant in batch fill-and-draw fermentation
    Biglari N, Orita I, Fukui T, Sudesh K
    J Biotechnol, 2020 Jan 10;307:77-86.
    PMID: 31669355 DOI: 10.1016/j.jbiotec.2019.10.013
    This study investigates the effect of strategies on poly(3-hydroxybutyrate) [P(3HB)] production in bioreactor. In the production of P(3HB), urea and glucose feeding streams were developed to characterize the fed-batch culture conditions for new Cupriavidus necator NSDG-GG mutant. Feeding urea in repeated fed-batch stage (RFB-I) at 6, and 12 h in cultivation led to insignificant kinetic effect on the cell dry mass (CDM) and P(3HB) accumulation. Feeding glucose in repeated fed-batch stage (RFB-II) demonstrated that the incremental feeding approach of glucose after urea in fill-and-draw (F/D) mode at 24, 30, 36, 42, and 48 h in fermentation increased CDM and P(3HB) concentration. In the 1st cycle in RFB-II, the cumulative CDM reached the value of 26.22 g/L and then it increased with the successive repeated fed-batches to attain biomass of 145 g/L at the end of 5th cycle of RFB-II. The final cumulative P(3HB) concentration at the end of 5th cycle of RFB-II reached 111 g/L with the overall yield of 0.50 g P(3HB) g gluc- 1; the CDM productivity from the RFB-II cycles was in the range of 0.84-1.3 g/(L·h). The RFB-II of glucose in an increment mode produced nearly 2.2 times more increase in CDM and P(3HB) productivities compared to the decrement RFB-II mode. Repeated cultivation had also the advantage of avoiding extra time required for innoculum preparation, and sterilization of bioreactor during batch, thereby it increased the overall industrial importance of the process.
    Matched MeSH terms: Sterilization; Sterilization, Reproductive
  8. Fulltext A systematic review of randomized controlled trials on sterilization methods of extracted human teeth
    Western JS, Dicksit DD
    J Conserv Dent, 2016 Jul-Aug;19(4):343-6.
    PMID: 27563183 DOI: 10.4103/0972-0707.186457
    AIM OF THIS STUDY: The aim was to evaluate the efficiency of different sterilization methods on extracted human teeth (EHT) by a systematic review of in vitro randomized controlled trials.
    METHODOLOGY: An extensive electronic database literature search concerning the sterilization of EHT was conducted. The search terms used were "human teeth, sterilization, disinfection, randomized controlled trials, and infection control." Randomized controlled trials which aim at comparing the efficiency of different methods of sterilization of EHT were all included in this systematic review.
    RESULTS: Out of 1618 articles obtained, eight articles were selected for this systematic review. The sterilization methods reviewed were autoclaving, 10% formalin, 5.25% sodium hypochlorite, 3% hydrogen peroxide, 2% glutaraldehyde, 0.1% thymol, and boiling to 100°C. Data were extracted from the selected individual studies and their findings were summarized.
    CONCLUSION: Autoclaving and 10% formalin can be considered as 100% efficient and reliable methods. While the use of 5.25% sodium hypochlorite, 3% hydrogen peroxide, 2% glutaraldehyde, 0.1% thymol, and boiling to 100°C was inefficient and unreliable methods of sterilization of EHT.
    KEYWORDS: Autoclaving; extracted human teeth; formalin; sterilization methods; systematic review
    Matched MeSH terms: Sterilization
  9. An Outbreak of Leaf Spot Caused by Stemphylium solani on Eggplant in Malaysia
    Nasehi A, Kadir JB, Esfahani MN, Mahmodi F, Ghadirian H, Ashtiani FA, et al.
    Plant Dis, 2013 May;97(5):689.
    PMID: 30722195 DOI: 10.1094/PDIS-10-12-0901-PDN
    In 2011, a severe gray leaf spot was observed on eggplant (Solanum melongena) in major eggplant growing areas in Malaysia, including the Pahang, Johor, and Selangor states. Disease incidence was >70% in severely infected areas of about 150 ha of eggplant greenhouses and fields examined. Symptoms initially appeared as small (1 to 5 mm diameter), brownish-black specks with concentric circles on the lower leaves. The specks then coalesced and developed into greyish-brown, necrotic lesions, which also appeared on the upper leaves. Eventually, the leaves senesced and were shed. Tissue cut from the edges of leaf spots were surface-sterilized in 1% NaOCl for 2 min, rinsed in sterilized water, dried, and incubated on potato dextrose agar (PDA). Fungal colonies were greyish green to light brown, and produced a yellow pigment. Single, muriform, brown, oblong conidia formed at the terminal end of each conidiophore, were each 21.6 to 45.6 μm long and 11.5 to 21.6 μm wide, and contained 2 to 7 transverse and 1 to 4 longitudinal septa. The conidiophores were tan to light brown and ≤220 μm long. Based on these morphological criteria, 25 isolates of the fungus were identified as Stemphylium solani (1). To produce conidia in culture, 7-day-old single-conidial cultures were established on potato carrot agar (PCA) and V8 juice agar media under an 8-h/16-h light/dark photoperiod at 25°C (4). Further confirmation of the identification was obtained by molecular characterization in which fungal DNA was extracted and the internal transcribed spacer (ITS) region of ribosomal DNA amplified using primers ITS5 and ITS4 (2), followed by direct sequencing. A BLAST search in the NCBI database revealed that the sequence was 99% identical with published ITS sequences for two isolates of S. solani (Accession Nos. AF203451 and HQ840713). The amplified ITS region was deposited in GenBank (JQ736023). Pathogenicity testing of a representative isolate was performed on detached, 45-day-old eggplant leaves of the cv. 125066-X under laboratory conditions. Four fully expanded leaves (one wounded and two non-wounded leaflets/leaf) were placed on moist filter paper in petri dishes, and each leaflet inoculated with a 20-μl drop of a conidial suspension containing 1 × 105 conidia/ml in sterilized, distilled water (3). The leaves were wounded by applying pressure to leaf blades with the serrated edge of forceps. Four control leaves were inoculated similarly with sterilized, distilled water. Inoculated leaves were incubated in humid chambers at 25°C with 95% RH and a 12-h photoperiod. After 7 days, symptoms similar to those observed in the original fields developed on both wounded and non-wounded inoculated leaves, but not on control leaves, and S. solani was reisolated consistently from the symptoms using the same method as the original isolations. Control leaves remained asymptomatic and the fungus was not isolated from these leaves. The pathogenicity testing was repeated with similar results. To our knowledge, this is the first report of S. solani on eggplant in Malaysia. References: (1) B. S. Kim et al. Plant Pathol. J. 20:85, 2004. (2) Y. R. Mehta et al. Curr. Microbiol. 44:323, 2002. (3) B. M. Pryor and T. J. Michailides. Phytopathology 92:406, 2002. (4) E. G. Simmons. CBS Biodiv. Series 6:775, 2007.
    Matched MeSH terms: Sterilization
  10. Fulltext An evaluation of knowledge and awareness of disinfection and sterilization among health care workers
    Keah KC, Jegathesan M, Tan SC, Chan SH, Che OM, Cheong YM, et al.
    Southeast Asian J. Trop. Med. Public Health, 1995 Mar;26(1):51-6.
    PMID: 8525420
    Awareness of the disinfection and sterilization policy among hospital staff and their knowledge in basic principles and methods of disinfection and sterilization were studied before and after intervention using a self-administered questionnaire. Survey results showed that awareness (56.2%) before intervention was unsatisfactory. The nurses were more aware of the policy than other groups of medical personnel. Those unaware of the policy perform duties from memory or verbal instructions. A significant increase in awareness to 73.3% was observed after intervention (p < 0.05). Knowledge on methods of decontamination, disinfection and sterilization of equipment varies widely from 28.8% to 90.1%. 23.1% were unaware of the temperature used for sterilization while 72.4% did not know how containers of disinfectant should be refill. Only 14.7% knew the recommended method for washing containers. With education improvement was observed. The average knowledge improved from 44.4% to 57.3%. Our results indicated that continuous in-service education is needed to improve, supplement and update knowledge in this field after basic training. In addition orientation programs for new staff should also be aimed at creating awareness and providing information on guidelines and policies related to their duties.
    Matched MeSH terms: Sterilization/methods*; Sterilization/standards
  11. Fulltext Application of supercritical carbon dioxide (SC-CO2 ) on the microbial and physicochemical quality of fresh chicken meat stored at chilling temperature
    Ismail Fitry Mohammad Rashedi, Safiullah Jauhar, Chong, ?Gun Hean, Nor Khaizura Mahmud @ Ab Rashid, Wan Zunairah Wan Ibadullah
    International Food Research Journal, 2020;27(1):103-110.
    MyJurnal
    Supercritical carbon dioxide (SC-CO2 ) is a non-thermal technique implemented by food, pharmaceutical, and similar industries with the aim of inhibiting the microorganisms and apply effective sterilisation. Presently, limited number of studies has reported the application of SC-CO2 on fresh chicken meat. The present work therefore aimed to reveal the microbial and physicochemical quality of the SC-CO2 -treated fresh chicken meat. The fresh chicken meat was subjected to the SC-CO2 at 14 MPa and 45°C for 40 min and was stored at 4°C for 0, 3, and 7 days. The obtained results indicated that the treatment with SC-CO2 significantly decreased the total plate count and, yeast and mould count from log10 5.90 to 2.00 CFU/g and from log10 5.02 to 2.00 CFU/g at day 7 of storage, respectively. The values of pH, cooking loss, and water holding capacity were not affected by the treatment. The results revealed that the SC-CO2 -treated samples displayed harder texture, higher lightness and yellowness, and lower redness. In addition, lipid peroxidation of SC-CO2 and control samples resulted in values of 1.9 and 0.5 MDA/mg of meat at day 7 of storage time and did not significantly change in the rest of the evaluation days. In summary, the application of SC-CO2 was capable of enhancing the microbial quality and certain physicochemical attributes. However, alteration of certain parameters of SC-CO2 might enhance the overall meat quality.
    Matched MeSH terms: Sterilization
  12. Bacterial adherence and biofilm formation on medical implants: a review
    Veerachamy S, Yarlagadda T, Manivasagam G, Yarlagadda PK
    Proc Inst Mech Eng H, 2014 Oct;228(10):1083-99.
    PMID: 25406229 DOI: 10.1177/0954411914556137
    Biofilms are a complex group of microbial cells that adhere to the exopolysaccharide matrix present on the surface of medical devices. Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device. Medical implants used in oral and orthopedic surgery are fabricated using alloys such as stainless steel and titanium. The biological behavior, such as osseointegration and its antibacterial activity, essentially depends on both the chemical composition and the morphology of the surface of the device. Surface treatment of medical implants by various physical and chemical techniques are attempted in order to improve their surface properties so as to facilitate bio-integration and prevent bacterial adhesion. The potential source of infection of the surrounding tissue and antimicrobial strategies are from bacteria adherent to or in a biofilm on the implant which should prevent both biofilm formation and tissue colonization. This article provides an overview of bacterial biofilm formation and methods adopted for the inhibition of bacterial adhesion on medical implants.
    Matched MeSH terms: Sterilization/methods*
  13. Bio-hydrogen production using a two-stage fermentation process
    Alalayah WM, Kalil MS, Kadhum AA, Jahim JM, Jaapar SZ, Alauj NM
    Pak J Biol Sci, 2009 Nov 15;12(22):1462-7.
    PMID: 20180320
    A two-stage fermentation process consisting of dark and photo-fermentation periods was carried out in a batch reactor. In the first stage, glucose was fermented in the dark stage using Clostridium saccharoperbutylacetonicum N1-4 (ATCC 13564; CSN1-4) to produce acetate, CO2 and H2. The acetate produced in the first stage is fermented to H2 and CO2 by Rhodobacter sphaeroides NCIMB 8253 for further hydrogen production in the second, illuminated stage. The yield of hydrogen in the first stage was about 3.10 mol H2 (mol glucose)(-1) at a glucose concentration of 10 g L(-1), pH 6 +/- 0.2 and 37 degrees C and the second stage yield was about 1.10-1.25 mol H2 (mol acetic acid)(-1) at pH 6.8 +/- 0.2 and 32 degrees C, without removal of the Clostridium CSN1-4. The overall yield of hydrogen in the two-stage process, with glucose as the main substrate was higher than single-stage fermentation.
    Matched MeSH terms: Sterilization
  14. Fulltext Browning assessment methods and polyphenol oxidase in UV-C irradiated Berangan banana fruit
    Phebe, Ding, Yap, Shi Ling
    International Food Research Journal, 2014;21(4):1667-1674.
    MyJurnal
    Ultraviolet (UV) light especially UV-C has been used to sterilize fruits and vegetables. However, overdose of UV-C irradiation could cause brownish-red colouration to products such as banana fruit. Therefore, the objectives of this study were to: (1) examine the effect of UV-C irradiation at different doses on the surface colour of Berangan banana fruit during ripening; (2) determine polyphenol oxidase (PPO) activity after irradiated with different doses of UV-C, and (3) examine the effectiveness of three browning assessment methods (subjective score, browning index derived from Lab colour space and optical density of 420 nm) in response to PPO activity of UV-C irradiated Berangan banana fruit. Mature green Berangan banana fruit were irradiated with 0, 0.01, 0.02, 0.03 and 0.04 kJ/m2 UV-C. After irradiation, the fruit were initiated to ripening using 1 mL/L ethylene for 24 h. Then, the fruit were allowed to ripen in 27oC and fruit of day 0, 1, 3 and 5 were sampled for peel colour (L*, a*, b*, C* and ho), browning assessment (three methods) and PPO assay. The peel colour, browning assessment using subjective score and optical density, and PPO activity of Berangan banana fruit were affected significantly (P ≤ 0.05) by interaction of radiation dose x ripening day. The values of L*, b*, C* and ho decrease while a* values increase as fruit irradiated with 0.03 and 0.04 kJ/m2 UV-C indicating brownish-red has occurred. Fruit irradiated with 0.04 kJ/m2 UV-C discoloured by ripening day 3 while those irradiated with 0.03 kJ/m2 discolored by day 5. Similar result was obtained when fruit assessed for its browning using subjective score and optical density. A contrary result was obtained in PPO activity where UV-C irradiation has inhibited Berangan banana fruit PPO activity by ripening day 5. Correlation analysis showed that browning index that derived from colour space is highly related to PPO activity with coefficients of 0.93. As conclusion, the lethal dose causing browning for Berangan banana fruit is 0.03 kJ/m2 and browning index that derived from colour space is most effective to correlate browning with PPO activity.
    Matched MeSH terms: Sterilization
  15. Clinical solid waste management practices and its impact on human health and environment--A review
    Hossain MS, Santhanam A, Nik Norulaini NA, Omar AK
    Waste Manag, 2011 Apr;31(4):754-66.
    PMID: 21186116 DOI: 10.1016/j.wasman.2010.11.008
    The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This article summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.
    Matched MeSH terms: Sterilization/economics; Sterilization/legislation & jurisprudence; Sterilization/methods
  16. Comparative evaluation of bioburden and sterility of indigenously prepared bone allograft with and without gentamicin
    Makker K, Lamba AK, Faraz F, Tandon S, Sheikh Ab Hamid S, Aggarwal K, et al.
    Cell Tissue Bank, 2019 Jun;20(2):243-253.
    PMID: 30903410 DOI: 10.1007/s10561-019-09763-w
    During bone allograft processing, despite stringent donor screening and use of aseptic techniques, microbial invasion may occur due to the porous nature of the graft and cause potentially fatal infections. The aim of the present study was to prepare bone allograft with and without gentamicin and to compare bioburden and sterility in the obtained grafts to evaluate the role of antibiotic in enhancing graft safety. Fifty samples of demineralized freeze-dried bone allograft were prepared from suitable donors according to international standards. Randomly selected 25 samples were placed in 8 mg gentamicin/gram bone solution for 1 h. Packaging and sealing was done to ensure no microbial ingress during transportation. 40 samples were selected for bioburden testing. Remaining 10 were subjected to 25 kGy gamma radiation and tested for sterility. Microbiological evaluation revealed no evidence of colony forming units in all the samples of both the groups (Bioburden = 0). Post-radiation sterility testing also revealed no bacterial colony in the tested samples from both the groups. Favorable results validate the processing protocol while comparable results in both groups indicate no additive benefit of gentamicin addition. Nil bioburden may be used in further studies to determine a lower radiation dose to achieve adequate sterility and minimize the disadvantages of radiation like collagen cross-linking and decreased osteoinductive capacity.
    Matched MeSH terms: Sterilization/methods*
  17. Fulltext Comparative study on the acceptance and use of contraceptive methods in a rural population in Kelantan
    Kamalanathan JP
    Malays J Reprod Health, 1990 Dec;8(2):66-71.
    PMID: 12343150
    PIP: Contraceptive prevalence was determined in the Kelantan region of Malaysia, an area with relatively poor health indices. 350 women attending health clinics on rubber and palm-oil estates and living in surrounding suburbs were surveyed by clinic workers or during home visits. The sample included 273 Malays, 64 Indians and 13 Chinese. This area of Peninsular Malaysia is noted for the highest infant mortality rate (17.7), second highest crude birth rate (35.2) and highest dependency ratio (88%) in the country. 44.9% practiced contraception, highest in Chinese and lowest in Indians. Methods used were pills by (55%), traditional methods (19%), tubal ligation (18%), safe period (14%), injections (5.5%), IUD (4.7%), and condom (2.3%). The Malaysian traditional methods are herbal preparations from tree bark or roots, herb pills, and exercises after coitus. 34% of the non contraceptors had used contraception before but stopped because of side effects, religious or spousal objections, or desire to conceive. 74% had married in their teens. 46% of the non-contraceptors were spacing their children by prolonged breastfeeding.
    Matched MeSH terms: Sterilization, Reproductive*
  18. Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s
    Davanzo J, Starbird E, Reboussin D, Tan Boon Ann, Abdullah SH
    Malays J Reprod Health, 1988 Jun;6(1):1-21.
    PMID: 12281591
    Matched MeSH terms: Sterilization, Reproductive
  19. Cross-infection control in Malaysian dental practice
    Razak IA, Lind OP
    Singapore Dent J, 1995 Jul;20(1):11-5.
    PMID: 9582683
    A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.
    Matched MeSH terms: Sterilization/methods; Sterilization/statistics & numerical data
  20. Fulltext Deep-Freezing Temperatures During Irradiation Preserves the Compressive Strength of Human Cortical Bone Allografts: A Cadaver Study
    Yang Harmony TC, Yusof N, Ramalingam S, Baharin R, Syahrom A, Mansor A
    Clin Orthop Relat Res, 2022 Feb 01;480(2):407-418.
    PMID: 34491235 DOI: 10.1097/CORR.0000000000001968
    BACKGROUND: Gamma irradiation, which minimizes the risk of infectious disease transmission when human bone allograft is used, has been found to negatively affect its biomechanical properties. However, in those studies, the deep-freezing temperature during irradiation was not necessarily maintained during transportation and sterilization, which may have affected the findings. Prior reports have also suggested that controlled deep freezing may mitigate the detrimental effects of irradiation on the mechanical properties of bone allograft.

    QUESTION/PURPOSE: Does a controlled deep-freezing temperature during irradiation help preserve the compressive mechanical properties of human femoral cortical bone allografts?

    METHODS: Cortical bone cube samples, each measuring 64 mm3, were cut from the mid-diaphyseal midshaft of five fresh-frozen cadaver femurs (four male donors, mean [range] age at procurement 42 years [42 to 43]) and were allocated via block randomization into one of three experimental groups (with equal numbers of samples from each donor allocated into each group). Each experimental group consisted of 20 bone cube samples. Samples irradiated in dry ice were subjected to irradiation doses ranging from 26.7 kGy to 27.1 kGy (mean 26.9 kGy) at a deep-freezing temperature below -40°C (the recommended long-term storage temperature for allografts). Samples irradiated in gel ice underwent irradiation doses ranging from 26.2 kGy and 26.4 kGy (mean 26.3 kGy) in a freezing temperature range between -40°C and 0°C. Acting as controls, samples in a third group were not subjected to gamma irradiation. The mechanical properties (0.2% offset yield stress, ultimate compression stress, toughness, and the Young modulus) of samples from each group were subsequently evaluated via axial compression loading to failure along the long axis of the bone. The investigators were blinded to sample group during compression testing.

    RESULTS: The mean ultimate compression stress (84 ± 27 MPa versus 119 ± 31 MPa, mean difference 35 [95% CI 9 to 60]; p = 0.005) and toughness (3622 ± 1720 kJ/m3 versus 5854 ± 2900 kJ/m3, mean difference 2232 [95% CI 70 to 4394]; p = 0.009) of samples irradiated at a higher temperature range (-40°C to 0°C) were lower than in those irradiated at deep-freezing temperatures (below -40°C). The mean 0.2% offset yield stress (73 ± 28 MPa versus 109 ± 38 MPa, mean difference 36 [95% CI 11 to 60]; p = 0.002) and ultimate compression stress (84 ± 27 MPa versus 128 ± 40 MPa, mean difference 44 [95% CI 17 to 69]; p < 0.001) of samples irradiated at a higher temperature range (-40°C to 0°C) were lower than the nonirradiated control group samples. The mean 0.2% offset yield stress (73 ± 28 MPa versus 101 ± 28 MPa, mean difference 28 [95% CI 3 to 52]; p = 0.02; effect size = 1.0 [95% CI 0.8 to 1.2]) of samples irradiated at higher temperature range (-40°C to 0°C) were no different with the numbers available to those irradiated at deep-freezing temperature. The mean toughness (3622 ± 1720 kJ/m3 versus 6231 ± 3410 kJ/m3, mean difference 2609 [95% CI 447 to 4771]; p = 0.02; effect size = 1.0 [95% CI 0.8 to 1.2]) of samples irradiated at higher temperature range (-40°C to 0°C) were no different with the numbers available to the non-irradiated control group samples. The mean 0.2% offset yield stress, ultimate compression stress, and toughness of samples irradiated in deep-freezing temperatures (below -40°C) were not different with the numbers available to the non-irradiated control group samples. The Young modulus was not different with the numbers available among the three groups.

    CONCLUSION: In this study, maintenance of a deep-freezing temperature below -40°C, using dry ice as a cooling agent, consistently mitigated the adverse effects of irradiation on the monotonic-compression mechanical properties of human cortical bone tissue. Preserving the mechanical properties of a cortical allograft, when irradiated in a deep-freezing temperature, may have resulted from attenuation of the deleterious, indirect effects of gamma radiation on its collagen architecture in a frozen state. Immobilization of water molecules in this state prevents radiolysis and the subsequent generation of free radicals. This hypothesis was supported by an apparent loss of the protective effect when a range of higher freezing temperatures was used during irradiation.

    CLINICAL RELEVANCE: Deep-freezing temperatures below -40°C during gamma irradiation may be a promising approach to better retain the native mechanical properties of cortical bone allografts. A further study of the effect of deep-freezing during gamma radiation sterilization on sterility and other important biomechanical properties of cortical bone (such as, tensile strength, fracture toughness, and fatigue) is needed to confirm these findings.

    Matched MeSH terms: Sterilization/methods*
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