Browsing by Author "Nanayakkara, B.G."

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Anatomical dimension of the Caudate lobe of the liver
(University of Kelaniya, 2011) Widanagama, M.A.; Prabodha, L.B.L.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
On the posterior surface of the liver, the Caudate lobe lies between the inferior vena cava and the fissure for the ligamentum venosum. It is connected to the right lobe of the liver by the Caudate process. However, functionally it belongs to the left lobe. In left hepatic lobectomy, the left lobe together with most of the Caudate lobe is removed. Furthermore, the diameters of right lobe and Caudate lobe have been used to distinguish between the normal and cirrhotic livers. This study was carried out to establish the anatomical dimensions of the Caudate lobe in a group of adult Sri Lankans. A total of 26 apparently healthy livers obtained from formalin fixed cadavers were studied. The Caudate lobe was measured along its maximum antero-posterior and transverse diameters using a sliding caliper capable of measuring to the nearest 0.01 mm. Maximum transverse diameter of the right lobe of the liver was taken to compare the ratio between the right lobe and the Caudate lobe. The mean maximum antero-posterior and transverse diameters of the Caudate lobe was 51.6 ± 4.6 mm and 27.6 ± 4.5 mm respectively. The transverse diameter of the right lobe was 85.05± 13.2 mm. The mean ratio of the transverse diameter of the Caudate lobe to that of the right lobe was found to be 0.32 ± .06. The results of the study demonstrate the anatomical dimensions established for the Caudate lobe for a group of adult Sri Lankan population. These data will facilitate in improving the outcome of surgical procedures of the liver.
Anatomical dimensions of the portal vein: A cadaver study
(12th Annual Research Symposium, University of Kelaniya, 2011) Pinsara, G.H.M.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
The portal vein is formed by union of the superior mesenteric and splenic veins. It lies in front of the inferior vena cava and runs vertically upwards in the free edge of the lesser omentum finally reaching the porta hepatis. In liver transplantation and pancreatectomy, a length of portal vein is removed for anastomose with the recipient vessels. A complete knowledge of the anatomic variations in portal venous anatomy is an essential prerequisite for the outcome of these procedures. Despite the significance of the portal vein little is known about its dimensions in Sri Lankans. The present study was undertaken to investigate the diameter and length of portal vein in a group of adult Sri Lankan population and to compare the results with other published data. The characteristics of cadavers including age, gender, weight and height were recorded. A total of twenty four apparently healthy livers obtained from cadavers were utilized. The diameter of the portal vein at a predetermined sites and the length up to the porta hepatis were recorded. All measurements were taken using a sliding caliper capable of measuring to the nearest 0.01 mm. Results were expressed as mean ± SD. Statistical analysis was performed using the t test. P value <0.05 was considered statistically significant. Portal vein anatomy was normal and mono-pad in all cases studied. The mean diameter of the portal vein at the porta hepatis was found to be 8.96±1.26mm and the mean length was 8.28±2.33cm. The results indicated that in our study population, the portal veins are longer but their diameters were smaller than when compared with the reported measurements in the anatomy texts. These may be attributed to racial differences. Precise knowledge of the expected normal portal vein diameter at a given anatomic location is the first step towards developing a quantitative estimate of the severity of the portal vein abnormalities. This study provides a reference data set for adult Sri Lankans against which to compare the diameters of the portal vein in various pathological conditions.
Coracobrachialis muscle: morphology, morphometry and gender differences
(Springer, 2016) Ilayperuma, I.; Nanayakkara, B.G.; Hasan, R.; Uluwitiya, S.M.; Palahepitiya, K.N.
PURPOSE:Coracobrachialis (CBM) is a complex muscle with a wide range of variations in its morphology and innervation. The goal of this study was to elucidate the morphology, morphometry, gender differences of CBM and precise anatomical position of the musculocutaneous nerve (MCN) with reference to surrounding anatomical landmarks in an adult Sri Lankan population. METHOD: Cadaveric upper limbs (n = 312) were examined for the proximal and distal attachments, length, width, thickness of CBM and its relationship with the MCN. RESULTS: The CBM originated from the tip of the coracoid process of the scapula and lateral, posterior and medial aspects of the tendon of short head of biceps brachii. Gender differences were observed in all morphometrical parameters of CBM. In 83.33 %, MCN perforated the CBM. In 50 % the MCN pierced the middle one-third of CBM while none pierced the lower one-third. The distance from the coracoid process to the point of entry of MCN into CBM (distance P) was 50.62 mm. A positive correlation was observed between the arm length and distance P indicating that arm length provides an accurate and reliable means of gauging the distance P of an individual. CONCLUSION: The present study provides new evidence pertaining to the origin of CBM. Further, it was revealed that the predicted distance P of any upper extremity can be calculated by dividing the arm length by 5. Precise anatomical location of MCN in relation to CBM using unequivocal and well-defined anatomical landmarks will be imperative in modern surgical procedures.
Could sternomastoid tumour be inherited?
(Sri Lanka Medical Association, 1996) de Silva, D.G.H.; Amarasena, T.S.; Fernando, A.J.; Nanayakkara, B.G.
No Abstract Available
Evaluation of 22q11.2 deletion in Cleft Palate patients.
(Mumbai : Medknow Publications, 2012) Prabodha, L.B.; Dias, D.K.; Nanayakkara, B.G.; de Silva, D.C.; Chandrasekharan, N.V.; Ileyperuma, I.
BACKGROUND: Cleft palate is the commonest multifactorial epigenetic disorder with a prevalence of 0.43-2.45 per 1000. The objectives of this study were to evaluate the clinical features and identify the 22q11.2 deletion in patients with cleft palate in Sri Lanka. MATERIALS AND METHODS: Cleft patients attending a Teaching Hospital in Sri Lanka were recruited for this study. The relevant data were obtained from review of case notes, interviews, and examination of patients according to a standard evaluation sheet. Quantitative multiplex polymerase chain reaction (PCR) was performed to identify the 22q11.2 deletion. A gel documentation system (Bio-Doc) was used to quantify the PCR product following electrophoresis on 0.8% agarose gel. RESULTS AND CONCLUSION: There were 162 cleft palate patients of whom 59% were females. A total of 92 cleft palate subjects (56.2%) had other associated clinical features. Dysmorphic features (25.27%) and developmental delays (25.27%) were the commonest medical problems encountered. The cleft was limited to the soft palate in 125 patients, while in 25 patients it involved both the hard and the soft palate. There were seven subjects with bifid uvula and five subjects with submucous cleft palate. None of the patients had 22q11.2 deletion in this study population. A multicentered large population-based study is needed to confirm the results of this study and to develop guidelines on the appropriate use of 22q11.2deletion testing, which are valid for cleft palate patients in Sri Lanka.
Incidence of pyramidalis muscle
(University of Kelaniya, 2011) Rajawasam, P.P.; Prabodha, L.B.L.; Gamage, U.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
Pyramidalis is a triangular muscle that lies in front of the lower part of rectus abdominis muscle within the rectus sheath. This muscle is known to vary considerably in size and present either unilaterally or bilaterally. A large number of studies supports the racial variation in its occurrence. This preliminary study was carried out to investigate the incidence of pyramidalis muscle and also to establish its anatomical dimensions in a sample group of Sri Lankans. A total of forty two cadavers were studied during the routine gross anatomy dissections. The presence or absence of the muscle either bilaterally or unilaterally was noted on visual inspection. The maximum length and width of the pyramidalis was measured using a sliding caliper capable of measuring to the nearest 0.01mm. Pyramidalis was present bilaterally in 85.71% and absent in 14.28% of the subjects. The maximum length of the muscle was 6.24 ± 0.12 cm on right side and 7.09 ± 0.20 cm on left side. The maximum width was 1.32 ± 0.14 cm on right side and 1.52 ± 0.18 cm on left side. Bilateral variation in the dimensions of the muscle was statiscally significant. The occurrence of pyramidalis muscle was established for a group of adult Sri Lankan population. Our results reveal there is a racial trend in the incidence of pyramidalis muscle between Sri Lankan and other races such as black and white populations.
Molecular diagnosis of Velocardiofacial Syndrome in a cohort of Sri Lankan patients
(Sri Lanka Medical Association, 2014) Thevarajan, I.; Ranaweera, D.M.; de Silva, D.; Prabodha, L.B.L.; Gunasekera, R.; Dias, D.K.; Nanayakkara, B.G.; Basnayake, S.; Jayathilake, M.; Chandrasekharan, N.V.
INTRODUCTION AND OBJECTIVES: Velocardiofacial Syndrome (VCFS) is caused by a 3 Mb deletion encompassing around 40 genes on chromosome 22qll.2. It is characterised by variable features including congenital malformations of the palate and heart, growth and developmental delay, immunological anomalies, hypocalcaemia and other problems. Clinical diagnosis is difficult due to its variability within and between families. Early diagnosis enables appropriate management of the affected cases. Objective was to establish a reliable and cost effective molecular diagnostic test for VCFS. METHODS: Nineteen clinically suspected patients with palatal and facial features suggestive of VCFS from Lady Ridgeway Hospital, Colombo and the Teaching hospital, Karapitiya were recruited following informed consent and prior ethical clearance. A semi-quantitative multiplex poiymerase chain reaction (PCR) was established to identify the deletion using dosage analysis. The PCR assay was carried out using DNA from patients (P), unaffected person (N) and a positive control (with a FISH confirmed deletion} using STS markers within the deleted region and CFTR (Cystic Fibrosis Transmembrane Regulatory Conductance) control primers outside the deleted region. Following agarose gel electrophoresis the PCR products were quantified. A ratio of P: N of 0.5 was taken to indicate a deletion while a ratio of 1 indicated absence of the deletion. RESULTS: Among nineteen clinically suspected VCFS cases, five cases had the deletion. CONCLUSIONS: This semi-quantitative PCR assay was able to identify.deletions in clinically suspected patients. However further validation is required before its clinical usage.
Morphometrical analysis of the human palatine sutures
(University of Kelaniya, 2011) Udayanga, L.B.M.; Prabodha, L.B.L.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Ambikaipakan, S.
The hard palate is traversed by a crucial suture which consists of mid palatal, interpalatine and transverse palatine sutures. The defects of the fusion of these palatine sutures lead to cleft palate. The goal of this study is to investigate the length and the gender differences of the palatine sutures in dried Sri Lankan skulls. A total of 63 (38 male; 25 female) dried human skulls were included in the study. The combined straight lengths of the midpalatal and interpalatine sutures and transverse palatine sutures were measured following the standard procedures with a spreading caliper capable of measuring to the nearest 0.01 mm. The mean combined lengths of the midpalatal and interpalatine sutures and transverse palatine sutures were (male: 46.76 ± 3.43; female: 44.96 ± 3.12); (male: 36.12 ± 4.6; female: 34.14 ± 2.9) respectively. Gender differences in the lengths of the palatine sutures were statistically significant (p<0.05). The results of this preliminary study establish the existence of a statistically significant sexual dimorphism in the lengths of the palatine sutures. Further, it provides a reference set of data on the lengths of the palatine sutures for an adult Sri Lankan population. Such data will facilitate the understanding of the etiopathogenesis of malformations of this cranial region and artificial teeth mould industry.