Browsing by Author "Salgado, S. S."

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Anatomy of the pancreatic vasculature:respect of the duodenum preserving resection of head of pancreas
(College of Surgeons of Sri Lanka, 2008) Salgado, S. S.; Abeysuriya, V.; Pathirana, A.
INTRODUCTION: Duodenum preserving resection of the head of the pancreas is performed mostly in chronic pancreatitis. Knowledge of precise anatomy of the pancreaticoduodenal region especially of the pancreaticoduodenal arteries, which provide blood to the duodenum, is mandatory for safe surgery. MATERIALS AND METHODS: Twenty human cadavers (age 56-87 years) of both sexes (10 males: 10 females) were studied with relevance to the anatomy of the head of the pancreas and duodenum in relation of the regional vascular arcades.RESULTS: The gastroduodenal artery (GDA) originates 3.7cm (3.1cm 5.1cm) from celiac trunk from the common hepatic artery. The Emergence of anterior superior pancreaticoduodenal artery (ASPA) was at 3.4cm (2.9cm - 4.2cm) of the origin of the gastroduodenal artery. After departing from gastroduodenal artery ASPA runs downwards along the medial side of the 2nd part of the duodenum and turned to the posterior aspect of the pancreas to join the anterior inferior pancreaticoduodenal artery (AIPA). Arcade formation between the ASPA and AIPA was found in all cadavers. Posterior superior pancreaticoduodenal artery (PSPA) originates 2.1 cm (1.8cm-2.8cm) from the origin of the gastroduodenal artery. PSPA form an arterial arcade with the branches of the posterior inferior pancreaticoduodenal artery. Posterior vascular arcade always located posterior to the common bile duct. Anterior and posterior vascular arcades were 0.35cm (0.32 cm 0.43cm) and 0.24 cm (0,21 cm 0.34cm) medial to the medial border of the duodenum respectively. CONCLUSION: In duodenal preserving pancreatic surgery, the knowledge of this complex vascularization will help to preserve arterial arcades around head of the pancreas while performing pan create cto my.
Effects of placental infarctions on the fetal outcome in pregnancies complicated by hypertension.
(College of Physicians and Surgeons Pakistan, 2008) Salgado, S. S.; Pathmeswaran, A.
OBJECTIVE: To determine the frequency of placental infarcts and its effects on the fetal outcome in pregnancies complicated by hypertension. STUDY DESIGN: Case control. PLACE AND DURATION OF STUDY: Obstetrics Unit of North Colombo Teaching Hospital, Ragama, Sri Lanka, from January 2003 to January 2004. PATIENTS AND METHODS: Placentae of 150 normotensive women and 200 hypertensive women were studied to detect the number of placentae with infarctions. Apgar score, birth weight and the head circumference of the newborns were measured and analyzed. RESULTS: The frequency of placental infarcts was significantly higher in hypertensive group (30%) compared to normotensive group (18.7%). An association between placental infarction and low Apgar score of the newborn was seen in the hypertensive group (p<0.001). The difference in the birth weight of the newborns in hypertensive and normotensive groups in relation to placental infarction was statistically significant (2.2 vs. 3.1 kg, p<0.001). A highly significant difference was observed in the head circumference of the newborns of hypertensive group compared to normotensive group in relation to placental infarctions (30.7 cm vs. 32.3 cm, p<0.001). CONCLUSION: The frequency of placental infarcts was higher in hypertensive women when compared to normotensives. Placental infarctions had an adverse effect on growth and development of the newborns. This information can be useful in planning and management of future pregnancies.
Microbiology of gallbladder bile in uncomplicated symptomatic cholelithiasis
(Elsevier, 2008) Abeysuriya, V.; Deen, K.I.; Wijesuriya, T.; Salgado, S. S.
BACKGROUND: Few studies have assessed microflora and their antibiotic sensitivity in normal bile and lithogenic bile with different types of gallstones. METHODS: We performed a case control study of 70 bile samples (35 cholesterol and 35 pigment stones from 51 females and 19 males, aged 21-72 years with a median age of 37 years) from patients who underwent laparoscopic cholecystectomy for uncomplicated cholelithiasis, and 20 controls (14 females and 6 males, aged 33-70 years with a median age of 38 years) who underwent laparotomy and had no gallbladder stone shown by ultrasound scan. The bile samples were aerobically cultured to assess microflora and their antibiotic susceptibility. The procedures were undertaken under sterile conditions. RESULTS: Thirty-eight (54%) of the 70 patients with gallstones had bacterial isolates. Nine isolates (26%) were from cholesterol stone-containing bile and 29 isolates (82%) from pigment stone-containing bile (P=0.01, t test). Twenty-eight of these 38 (74%) bile samples were shown positive only after enrichment in brain heart infusion medium (BHI) (P=0.02, t test). The overall bacterial isolates from bile samples revealed E. coli predominantly, followed by P. aeruginosa, Enterococcus spp., Klebsiella spp. and S. epidermidis. There were no bacterial isolates in the bile of controls after either direct inoculation or enrichment in BHI. CONCLUSIONS: Bacterial isolates were found in pigment stone-containing bile. Non-lithogenic bile revealed no bacteria, showing an association between gallstone formation and the presence of bacteria in bile. Antibiotic sensitivity patterns of isolated organisms were similar irrespective of the type of stone.
Ultrastructure of endothelial cells of fetal capillaries of placentae of women with pregnancy induced hypertention
(University of Colombo, 2006) Salgado, S. S.; Angunawela, P.; de Tissera, A.; Sirisena, J.
The present study aimed to compare the ultra structural features of endothelial cells of fetal terminal capillaries of placentae from hypertensive (n=10) and non-hypertensive (n=10) pregnancies. The ultrastructural features of endothelial cells of terminal capillaries from the fetal surface of each placenta were examined under the electron microscope. Micrographs of 8 different endothelial cells from each placenta were prepared for evaluation by stereological analysis using a coherent double lattice test system. The volume fractions of different organelles and cytosol in endothelial cells of placental fetal capillaries of both hypertensive and non-hypertensive pregnancies were deter¬mined by counting the number of grid intersection points falling on the endothelial cell cytoplasm, mitochondria, rough endoplasmic reticulum and glycogen deposits. Ultrastructural changes were noted in endothelial cells of capillaries of placentae of mothers with pregnancy induced hypertension. Statistical analysis showed that the volume fractions of the organelles and the amount of cytoplasm of endothelial cells of placentae from hypertensive pregnancies were significantly higher than those from non-hypertensive pregnanciesThere was a significant increase in some of the organelles and the capacity of cytoplasm of endothelial cells of placentae from hypertensive pregnancies when compared to normotensive pregnancies. These findings may be attributed to compensatory mechanisms operating as a response to hypoxia caused by reduced maternal blood flow to the placenta.
Villous syncytial knots in hypertensive placenta
(Sri Lanka College of Obstetricians and Gynaecologists, 2004) Salgado, S. S.; Angunawela, P.; de Tissera, A.; Sirisena, J.
Syncytial knots are seen on many terminal villi of all mature placentae. Syncytial knots in more than 30 percent of mature terminal villi, is considered as an indication of postmaturity. The aim of this study was to find out whether there is significant increase in syncytial knot formation in pre-eclampsia and to assess the relationship between syncytial knot formation and maternal age, parity, and period of gestation and effects of syncytial knots on the birthweight, and apgar score of the newborn. The study sample consisted of 150 normal and 200 hypertensive mothers. Light microscopic studies were done on sections taken from fetal surface of their placentae. Hundred terminal villi in fetal subdivisions of each placenta were counted and the number of villi with syncytial knots was recorded. Multivariate analysis was done to find out the difference between the number of placentae with high syncytial knot counts in normal and hypertensive groups and the relationship between high syncytial knot counts and the maternal age, parity, period of gestation and birthweight, head circumference and apgar score of the newborn. Statistically significant increase of syncytial knot counts was seen in hypertensive group than the normal group. There was no relationship between syncytial knot formation and maternal age and parity. In normal and hypertensive groups, an increase in the number of placentae with high syncytial counts was observed with increasing maturity. Although the number of placentae with high syncytial knot counts were higher in relation to low apgar score than the normal counts, difference was not statistically significant. A significant difference in the birth weight and the head circumference of newborns in relation to normal and high syncytial knot counts was observed in hypertensive group.