Browsing by Author "Anthony, D.J."

Now showing 1 - 4 of 4

Anatomic description of the distal great saphenous vein to facilitate peripheral venous access during resuscitation: a cadaveric study
(BioMed Central,London, 2023) Senevirathne, S.A.M.D.R.U.; Nimana, H.K.V.; Pirannavan, R.; Fernando, P.; Salvin, K.A.; Liyanage, U.A.; Malalasekera, A.P.; Mathangasinghe, Y.; Anthony, D.J.
The distal great saphenous vein is a popular site for venous access by means of percutaneous cannulation or venous cutdown in a hemodynamically unstable patient. The aim of this study was to precisely define the surface anatomy and dimensions of the distal part of the great saphenous vein to facilitate the aforementioned procedures. Cross-sectional anatomy of the distal saphenous vein was studied in 24 cadaveric ankles sectioned at a horizontal plane across the most prominent points of the medial and lateral malleoli. The curvilinear distance from the most prominent point of the medial malleolus to the center of the saphenous vein, its widest collapsed diameter and skin depth were obtained. The great saphenous vein was located at a mean distance of 24.4 ± 7.9 mm anterior to the medial malleolus. The mean widest collapsed diameter was 3.8 ± 1.5 mm. The mean distance from the skin surface to the vein was 4.1 ± 1.2 mm. These measurements could be used to locate the saphenous vein accurately, particularly in hemodynamically unstable patients with visually indiscernible veins.
Anatomical landmarks for ankle block
(BioMed Central, 2023) Nimana, K.V.H.; Senevirathne, A.M.D.S.R.U.; Pirannavan, R.; Fernando, M.P.S.; Liyanage, U.A.; Salvin, K.A.; Malalasekera, A.P.; Mathangasinghe, Y.; Anthony, D.J.
We aimed to describe anatomical landmarks to accurately locate the five nerves that are infiltrated to accomplish anaesthesia of the foot in an ankle block. Twenty-four formaldehyde-fixed cadaveric ankles were studied. Photographs of cross sections of the frozen legs, cut at a horizontal plane across the most prominent points of the medial and lateral malleoli, were analysed. The curvilinear distance from the most prominent point of the closest malleolus to each of the five cutaneous nerves and their depth from the skin surface were measured. Sural, tibial, deep peroneal, saphenous and medial dorsal cutaneous nerves were located 5.2 ± 1.3, 9.2 ± 2.4, 7.4 ± 1.9, 2.8 ± 1.1, 2.1 ± 0.6 mm deep to the skin surface. The curvilinear distances from the medial malleolus to the tibial, deep peroneal and saphenous nerves were 32.5 ± 8.9, 62.8 ± 11.1 and 24.4 ± 7.9 mm, respectively. The curvilinear distances from the lateral malleolus to the sural and medial dorsal cutaneous branches of superficial peroneal nerves were 27.9 ± 6.3 and 52.7 ± 7.3 mm, respectively. The deep peroneal nerve was found between the tendons of the extensor hallucis longus and the extensor digitorum longus in the majority of specimens, while the medial dorsal cutaneous nerve was almost exclusively found on the extensor digitorum longus tendon. The sural and tibial nerves were located around halfway between the most prominent point of the relevant malleolus and the posterior border of the Achilles tendon. In conclusion, this study describes easily identifiable, palpable bony and soft tissue landmarks that could be used to locate the nerves around the ankle.
Histological and Microbiological Assessment of the Role of Micro Organisms in Chronic Anal Fistula
(University of Kelaniya, 2012) Kumara, A.A.J.P.; Jayaratne, D.L.; Anthony, D.J.
Fistula in ano is one of the commonest ailments pertaining to the ano-rectal area and said to arise from crypto glandular infection of the anal gland, which lies within the intersphincteric space. Infection would seem to be an integral part of the pathogenesis of fistula in ano. The microbiology of acute anorectal sepsis is well documented, but the studies on chronic anal fistula have continuously raised doubts about the relevance of infection in fistula persistence. The present histological study complements the earlier work, which used microbiological methods alone where important organisms might have been overlooked. Granulation tissue from twenty patients with non specific fistula in ano was processed within 4h of medicated seton (Kshara sutra) therapy. Three samples from the intersphincteric part of the fistula were obtained.Two samples were studied microbiologically. The pus smear was taken from the fistulous opening by sterile cotton swab and sent to the Department of Microbiology, in a sterile container, and pus culture was done. Pus swab was inoculated on nutrient agar medium. The plated media were incubated at 37 C and examined at 48, hours. Smears from colonies that grew on the nutrient agar media were stained with Gram-stain. Gram-positive organisms and Gram-negative organisms were identified by conventional biochemical techniques. The third sample was fixed in 10 per cent formal saline for histological processing. Multiple 4 μm paraffin sections were stained using haematoxylin and eosin, gram, cresyl fast violet, periodic acid – Schiff and Ziehl – Neelsen stains. The results show the incidence of fistula in ano and the origin of the predominant microorganism present in ano rectal fistula. These were investigated using 100 pus samples obtained from the 20 patients.Isolates of Staphyloccus aureus, streptococus Spp and Corynebactrium spp. were identified as skin derived organisms. Isolates of Enterococcus spp., Escherichia coli, Bacteriodes spp were considered gastro intestinal tract derived organisms. No mycobacterium species was grown from any of the eight specimens. Sections of tissue from all twenty specimens showed a similar pattern of intense active chronic inflammatory change characterized by a large number of plasma cells, scattered multinucleate foreign-body giant cells and prominent vascular proliferation. Acute inflammatory change (of variable degree) was superimposed. No granulomas were seen in any specimen. Vegetable matter was demonstrated on the granulation tissue surface in one specimen only and bacteria were seen on histological examination and subsequent Gram staining. Relatively large numbers of organisms were grown from specimen. Stains for Helicobacter species, mycobacterium tuberculosis and fungi were negative in all specimens. The present study has confirmed the relative paucity of organisms and demonstrates through micro biological study but the histological examination does not reveal many organisms. In fact, i9t is difficult to obtain a detailed picture through microbiological examinations. But details of the inflammatory changes can be witnessed through histological examination. In other circumstances, histological examination has been used to demonstrate important pathogens such as tuberculosis, Mycobacterium leprae and Helicobacter Pylori.
Morphological variations of the human ejaculatory ducts in relation to the prostatic urethra
(Alan R. Liss, Inc, 2018) Malalasekera, A.P.; Sivasuganthan, K.; Sarangan, S.; Thaneshan, K.; Weerakoon, D.N.; Mathangasinghe, Y.; Gunasekera, C.L.; Mallawaarachchi, S.; Nanayakkara, N.D.; Anthony, D.J.; Ediriweera, D.
PURPOSE: Loss of ejaculation can follow transurethral resection of the prostate (TURP). Periverumontanal prostate tissue is preserved in ejaculation-preserving TURP (ep-TURP). Knowledge of ejaculatory duct anatomy in relation to the prostatic urethra can help in ep-TURP. This was evaluated in cross-sections of the prostate using a 3D model to determine a safe zone for resecting the prostate in ep-TURP. MATERIALS AND METHODS: A 3D reconstruction of the ejaculatory ducts was developed on the basis of six prostate gland cross-sections. The measurements obtained from the 3D model were standardized according to the maximum width of the prostate. Simple linear regressions were used to predict the relationships of the ejaculatory ducts. RESULTS: The maximum widths of the prostates ranged from 22.60mm to 52.10mm. The ejaculatory ducts entered the prostate with a concavity directed posterolaterally. They then proceeded towards the seminal colliculus in a fairly straight course, and from that point they angulated anteromedially. As they opened into the prostatic urethra they diverged. Significant regression models predicted the relationships of the ejaculatory ducts to the prostatic urethra based on the sizes of the prostates. CONCLUSIONS: The 3D anatomy of ejaculatory ducts can be predicted on the basis of prostate width. The ejaculatory ducts can be preserved with 95% accuracy if a block of tissue 7.5 mm from the midline on either side of the seminal colliculus is preserved, up to 10mm proximal to the level of the seminal colliculus, during TURP.