ABSTRACT
Paediatric surgical training has changed significantly since the birth of the specialty. It has evolved from the apprenticeship system to a complex, demanding, but ultimately time-limited experience for today's trainees. Historical development is reviewed, and the challenges of training within the current UK health care system is discussed.
Subject(s)
Education, Medical/history , General Surgery/education , General Surgery/history , History, 20th Century , Humans , United KingdomABSTRACT
Liver transplantation is just as successful in infants as in older children, but more challenging. This relates to the low weight of the recipients and to their rapidly deteriorating clinical condition (malnutrition and end-stage liver disease) ( J Pediatr 1990;117:205-210; BMJ 1993;307:825-828; Ann Surg 1996;223:658-664; Transplantation 1997;64:242-248; J Pediatr Surg 1998;33:20-23). In addition, higher rates of diaphragmatic complications have been shown to significantly correlate with a younger age ( Transplantation 2002;73:228-232; Transpl Int 1998;11:281-283; Pediatr Transplant 2000;4:39-44), but diaphragmatic hernia has never been reported as a complication of liver transplantation. In this report, 2 patients who developed diaphragmatic hernia after liver transplantation are presented. The possible role of several contributing factors resulting in diaphragmatic hernia is discussed. These factors include (1) diaphragm thinness related to low weight and malnutrition, (2) direct trauma at operation (dissection and diathermy), (3) increased abdominal pressure after transplantation caused by the use of a slightly oversized liver graft, and (4) the medial positioning of the partial liver graft in the abdomen.
Subject(s)
Hernia, Diaphragmatic/etiology , Liver Transplantation , Postoperative Complications , Body Weight , Female , Functional Laterality , Humans , Infant , Male , Risk FactorsABSTRACT
Phospholipids are major components of biological membranes. Without chemical derivatization, it is difficult to identify and quantitate phospholipids in biological samples. Chemical derivatization can improve both the selectivity and sensitivity of the analytes. This paper gives a full review, through March, 2002, of derivatization methods used for phospholipids in HPLC, CE and GC as well as the spray reagent used for TLC in the early days.
Subject(s)
Phospholipids/chemistry , Chromatography, High Pressure Liquid , Chromatography, Thin Layer , Electrophoresis, Capillary , Mass Spectrometry , Phospholipids/isolation & purification , Spectrophotometry, UltravioletABSTRACT
Gradient RP-HPLC analysis of a phospholipid, E5564, utilizing water, methanol and phosphoric acid occasionally results in the appearance of a broad unknown peak in the chromatogram before a well-resolved E5564 peak. This unknown peak does not elute in a reproducible fashion with regards to peak shape and retention time, and is not present in chromatograms resulting from injections of the diluent alone. Investigation of this phenomenon revealed that iron ions in sub-ppm levels in the HPLC mobile phase chelated E5564 and the resultant complex(es) comprised the broad peak. The iron source was identified as phosphoric acid, which was used as a mobile phase modifier. Further studies were conducted to characterize the nature of the phospholipid-iron association and resultant complex.
