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Risk management in the hospital, which is one of the referentiels of the ANAES accreditation manual, may be considered on two levels. Firstly, risk management may be approached globally, in the same way as it is tackled in the accreditation process. Secondly, risk management may be more definite. A specific risk chosen in accordance with the priorities of a particular plan may be dealt with individually. In this respect, the tranfusion process allows the risk management method to be tested and developed.

Résumé

La gestion des risques est mise en œuvre dans le cadre d'un projet d'établissement. Elle représente l'un des référentiels du manuel d'accréditation de l'ANAES. Le dispositif de gestion des risques peut être envisagé selon deux niveaux. Le premier concerne l'approche globale du risque, telle qu'elle a été expérimentée, conformément au référentiel d'accréditation. Le second, dans l'objectif d'une approche globale, consiste à gérer un risque spécifique choisi selon les priorités, les besoins, ou encore dans le cadre d'une planification. À cet égard, le processus transfusionnel permet l'expérimentation et le développement d'une culture du risque transposable. © 1999 Elsevier, Paris
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doi:10.1016/S1297-9570(05)80036-6
Copyright © 2005 Published by Elsevier SAS
Convergence des référentiels de qualité et implications pour la fonction technique biomédicale
A. Achmirowicz, P.-Y. Delobel, C. Kichenassamy-Appou and G. Farges,

Available online 10 March 2006.

References

Paris Anaes, Manuel d'accréditation des établissements de santé http://www.anaes.fr (avril 1999).
Décret no 2001-1154 du 5 décembre 2001 relatif à l'obligation, à la maintenance et au contrôle de qualité des dispositifs médicaux, prévu à l'article L.5212-1 du Code de la santé publique, JO no 284 du 7 décembre 2001. http://www.legifrance.gouv.fr.
Loi no 2004-810 du 13 août 2004 relative à l'Assurance maladie, JO no 190 du 17 août 2004. http://www.legifrance.gouv.fr.
Ordonnance no 96-346 du 24 avril 1996 portant réforme de l'hospitalisation publique et privée, JO no 98 du 25 avril 1996. http://www. legifrance.gouv.fr.
NF Norme, EN ISO 9001, Système de management de la qualité, Éditions Afnor (Décembre 2002).
G. Farges, G. Wahart, J.-M. Denax and H. Métayer, Guide des bonnes pratiques biomédicales en établissements de santé, ITBM-RBM News Vol. 23, Éditions Elsevier (2002) Suppl. 2.
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Applications biologiques de la spectroscopie Raman de résonance et de la spectroscopie micro-Raman de résonance     
R. Cavagnat  F. Cruege  Pham V. Huong   《Biochimie》1982,63(11-12)
Advantages are given to illustrate the possibilities of resonance Raman spectroscopy in the studies of biological systems.A relation giving the size of porphinato-core of metalloporphyrins from resonance Raman frequency is proposed. It can be applied to heme, even in lived state.By illuminating the sample through a microscope, resonance Raman effect can be collected from 1 (μm)2 of sample. Spectra of a vegetal-cell wall (pimento) and of a red corpuscle (hemoglobin) are shown as examples.  相似文献   

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Solubilisation et caractérisation d'une glycoprotéine : fucosyl-transférase cérébrale     
Pierre Broquet  M. Nieves Perez-Gonzalez  Pierre Louisot   《Biochimie》1979,60(11-12)
1. A glycoprotein: fucosyl-transferase activity was demonstrated in sheep cerebral cortex, using desialylated fetuin as exogenous acceptor and detergent Trition X 100 for solubilization.
2. Addition of Triton X 100 to the membrane suspension gave first an activation then a solubilization of the cerebral fucosyl-transferase.
3. Hydrophobic chromatography was investigated for purification of the enzyme. Binding was effective using alkyl-agarose chromatographic columns with two or more than two atoms of carbon, but elution was only possible with ethyl and butyl-agarose.
4. Combination of subcellular fractionation and hydrophobic chromatography on ethylagarose led to a 30 fold purification.
5. After ethyl-agarose chromatography, some properties of fucosyl-transferase were studied: the optimal temperature was 25°C. The optimum pH was about neutrality. Light activation was observed with Mn2+ concentration below 1 mM.
6. Homogeneity was tested using Ultrogel chromatography, polyacrylamide gel electrophoresis and ultracentrifugation.
7. It was concluded that ethyl-agarose hydrophobic chromatography easily bind a few solubilized proteins (about 20 per cent of the ST supernatant). When elution was performed, these proteins, including fucosyl-transferase, were released from ethyl-agarose columns as a stable aggregate, only dissociated with lower ionic strength.
Ethyl-agarose fraction (eluted with KCl 120 mM) showed homogeneity:
— with Ultrogel AcA 22 chromatography (Mw = 300.000).
— with polyacrylamide gel electrophoresis without S.D.S.
— with the analytical ultracentrifugo giving Mw = 280.000; S20 = 10.
But after dialysis overnight against a buffer without KCl, ultracentrifugation technics showed no homogeneity. Futhermore, SDS gel electrophoresis gave more than four bands.  相似文献   

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Préparation et forme sérique de la protéine réactive C de lapin     
M. Pontet  M. Ayrault-Jarrier  J. Burdin  M. Gelin  R. Engler 《Biochimie》1980,61(11-12)
The preparation of rabbit C-reactive protein (CRP) involves a single step affinity chromatography. This preparation takes advantage of the calcium-dependent affinity of CRP for an agarose gel bearing 2-aminoethanol dihydrogen-phosphate as a ligand. A prior chromatography on agarose gel without the ligand allows the uptake of the serum amyloid P-component (SAP).The CRP prepared according to this method is able to form precipitating complexes in agarose with rabbit lipoproteins. The specificity of these interactions is studied. It is demonstrated that CRP-High Density Lipoproteins (HDL) association produces a second precipitation arc when the pure CRP is revealed by a specific antiserum in agarose. Moreover, CRP in the serum is shown to be in the bound form only, and the binding involves Low Density Lipoproteins (LDL) exclusively.  相似文献   

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Dégradation d'acides aminés à l'interface eau-sédiment réconstitué d'une lagune méditerranéenne (Golfe du Lion)     
R. Daumas  F. Gadel  G. Cahet  A. Dinet 《International Review of Hydrobiology》1984,69(2):201-213
Degradation of Amino Acids at a Simulated Water-sediment Interface of a Mediterranean Lagoon Environment, Golfe du Lion The degradation of two 14C and 3H labelled amino acids at the simulated water-sediment interface of a Mediterranean lagoon was studied. The four day experiments included the respiratory activity measurement and the study of incorporation processes of the radioactivity in specific organic fractions of the 14C arginine. After active mineralization occurred during the first day, the radioactivity in the acid-soluble fraction decreased and polycondensed products were progressively incorporated. The radioactivity of the 3H lysine was included mainly in the acid soluble fraction. The nature of the substrate, and the reducing conditions in the environment affect the radioactivity distribution in the organic fractions. The identification of amino acids in the acid-soluble and base soluble fractions shows that the labelled arginine and lysine and other amino acids in the acid soluble and base soluble fractions shows that the labelled arginine and lysine released from the initial compounds are important quantitatively.  相似文献   

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Groupement et ordination appliqués à l''étude de la répartition de l''épifaune benthique de l''estuaire maritime et du Golfe du Saint-Laurent     
Pierre Fradette  Edwin Bourget 《Journal of experimental marine biology and ecology》1981,50(2-3):133-152
Forty-seven navigation buoys were used to collect quantitative samples of epibenthic fauna in the Lower Estuary and Gulf of St. Lawrence. Stations, as described by their sessile species and biomass composition, were grouped using multivariate analysis. A Gower similarity index, modified to take into account the importance of each species in the ecosystem, was used to compare stations. Results obtained by cluster and principal coordinate analyses showed comparable relations between stations. North Shore and Gaspé Coast stations were separated from those of the Lower North Shore, the Mingan Island sector and the Lower Estuary. Stations from the Lower North Shore were also separated from those of the Mingan Island region and of the Lower Estuary, but at a higher level of similarity. All animal assemblages consisted of the following sessile species: Obelia longissima (Pallas), Hiatella arctica (L.), Mytilus edulis L., Balanus balanoides (L.) and B. crenatus (Bruguière). These species formed over 95% of biomass of all sessile species. Differences between the various station assemblages were mainly due to changes in the relative abundance of these species. The geographical gradient of summer surface water temperature best explains the observed clusters. In the Lower Estuary, the spatio-temporal variations of physico-chemical factors and the surface circulation may influence the number of species and their abundance. The circulation systems of the Lower Estuary and near the Mingan Islands might account for the similarity between their assemblages. The same dominant species, Obelia longissima, characterizes the fauna of these two regions.  相似文献   

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