Auditing complications of laparoscopy in a major tertiary hospital in Australia

Objective To review complications in both diagnostic and operative laparoscopic procedures at a university-affiliated major teaching hospital and to assess possible risk factors for complications. Design and setting A retrospective review of all laparoscopic procedures at the Royal Women's Hospital Brisbane, Australia, from 1990 to 1997 inclusive. A non-medical or nursing independent assessor reviewed charts. Data were collected on a standard form. Incomplete charts were excluded from analysis. Results There was a total of 1505 procedures. Analysis was based on 1435 complete data records. The overall complication rate was 2.86% with infection (1.3%) being the most common. The rate of gastrointestinal injury was 0.14%. Compared with women who had diagnostic laparoscopies, a higher rate of complication was found in women who had undergone operative laparoscopic procedures. However, this difference did not reach statistical significance. The complication rate was unrelated to seniority of the surgeon. Conclusion Complications can occur in any laparoscopic procedure. Regular reviews, especially in teaching hospitals, will provide feedback to clinicians to improve quality of care.

Effects of surface heterogeneity on the adsorption of nitrogen on graphitized thermal carbon black

In this paper, we study the surface heterogeneity and the surface mediation on the intermolecular potential energy for nitrogen adsorption on graphitized thermal carbon black (GTCB). The surface heterogeneity is modeled as the random distribution of effective carbonyl functional groups on the graphite surface. The molecular parameters and the discrete charges of this carbonyl group are taken from Jorgensen, et al. (J. Am. Chem. Soc., (1984) 106, 6638) while those for nitrogen (dispersive parameters and discrete charges) are taken from Murthy et al. (Mol. Phys., (1983) 50, 531) in our Grand Canonical Monte Carlo (GCMC) simulation. The solid surface mediation in the reduction of intermolecular potential energy between two fluid molecules was taken from a recent work by Do et al. (Langmuir, (2004) 20, 7623). Our simulation results accounting for the surface heterogeneity and surface mediation on intermolecular potential energy were compared with the experimental data of nitrogen at 77 and 90 K. The solid-fluid dispersive parameters are determined from the Lorentz-Berthelot (LB) rule. The fraction of the graphite surface covered with carbonyl functional groups was then derived from the consideration of the Henry constant, and for the data of Kruk et al. (Langmuir, (1999) 15, 1435) we have found that 1% of their GTCB surface is covered with effective carbonyl functional groups. The damping constant, due to surface mediation, was determined from the consideration of the portion of the adsorption isotherm where the first layer is being completed, and it was found to take a value of 0.0075. With these parameters, we have found that the GCMC simulation results describe the data over the complete range of pressure substantially better than any other MC models in the literature. The implication of this work is demonstrated with local adsorption isotherms of 10 and 20 A slit pores. One was obtained without allowance for surface mediation, while the other correctly accounts for these factors. The two local isotherms differ substantially, and the implication is that if we used incorrect local isotherms (i.e. without the surface mediation) the pore size distribution would be incorrectly derived.