J.M. Boon

National Taiwan University

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J.H. Meiring

University of Pretoria

Albert van Schoor

University of Pretoria

Chih‐Cheng Wu

National Taiwan University

Peter Abrahams

University of Warwick

Min‐Tsun Liao

National Taiwan University

Mu‐Yang Hsieh

National Taiwan University Hospital

Tsui‐Shan Lu

National Taiwan Normal University

T. Welch

St. George's University

Tsung-Yan Chen

National Taiwan University Hospital

Jui-Cheng Kuo

National Taiwan University Hospital

Cooperative Institutions

University of Pretoria

National Taiwan University Hospital

National Taiwan University

Radboud University Nijmegen

National Yang Ming Chiao Tung University

Radboud University Medical Center

Cardiovascular Research Center

University of Amsterdam

Maastricht University

Erasmus University Rotterdam

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Anatomical considerations of the anterior approach for central venous catheter placement

Clinical Anatomy (2005)

Roelf Petrus Gerhardus Botha Albert van Schoor J.M. Boon J.H.R. Becker J.H. Meiring

Central venous catheterization (CVC) entails the catheterization of the superior vena cava via either the subclavian or the internal jugular vein (IJV). This study looked at the frequency in which a needle was inserted into the IJV using the anterior CVC approach, which entails inserting the needle into the apex of Sedillot's triangle, formed by the sternal and clavicular heads of sternocleidomastoid (SCM). The ipsilateral distances from the apex of Sedillot's triangle to the superior aspect of the sternoclavicular joint and the diameter of the IJV were also measured. A needle was inserted into the apex of Sedillot's triangle in 36 adult cadavers with mean age of 62 +/- 19 years (mean +/- SD), mean height of 1.6 +/- 0.18 m, and a mean weight of 55 +/- 16 kg. Subsequent dissections of this area revealed the relation of the needle to the IJV. Results indicate that on the right, the needle was inserted into the IJV in 97.14% of the cases. On the left, the needle entered the IJV in 78.79% of the cases. From the sternoclavicular joint, the apex of Sedillot's triangle was found to be 40.87 +/- 1.62 mm and 38.73 +/- 6.34 mm on the right and left, respectively. The IJV diameter was 17.29 +/- 1.07 mm on the right and 15.30 +/- 0.25 mm on the left. We conclude that the anterior CVC approach is an anatomically accurate technique. It is furthermore important to realize that when performing any invasive procedure, a sound anatomical knowledge of the region is extremely important, as complications are often due to lack of understanding or misunderstanding of the relevant anatomy.

Sternoclavicular joint

Apex (geometry)

Central venous catheter

Internal jugular vein

Sternocleidomastoid muscle

Subclavian vein

Sternum

10.1002/ca.20240

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Citations (40)

Cognitive and learning strategies for longstanding temporal lobe lesions in a child who suffered fromHerpes simplexvirus encephalitis: a case study over 10 years

Early Child Development and Care (2005)

Albert van Schoor H. Naudé M. van Rensburg Etheresia Pretorius J.M. Boon

This article presents a case study indicating that Herpes simplex virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes as it discusses the results of a case study extending over 10 years to determine the long‐term effects on both the anatomy of the brain and the intellectual functioning of the subject. Magnetic resonance imaging (MRI) scans were taken of the subject during the initial HSV encephalitis infection and subsequently six months after recovery. Follow‐up MRI scans were taken 10 years later. At this time the Senior South African Individual Scale—Revised IQ test was administered to determine any residual neuropsychological impairment due to HSV encephalitis infection. Follow‐up MRI analysis indicated permanent bilateral necrotic areas in the medial temporal lobe, while the IQ test revealed marked impairment of the short‐term memory, verbal memory, visual memory, visual scanning abilities and gestalt formation, which can be ascribed to temporal lobe lesions.

10.1080/0300443042000244064

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Citations (1)

Proximal great saphenous vein cut down: An evaluation of techniques and anatomical considerations

Clinical Anatomy (2008)

Nanette Briers Ivan Morris J.M. Boon J.H. Meiring Robert Franz

Abstract Cut‐down techniques by which emergency venous access can be achieved are important, particularly, in the resuscitation of haemodynamically depleted patients where percutaneous access to collapsed veins is a problem. The aim was to evaluate the efficacy of different methods that are used to locate the proximal great saphenous vein in the thigh and to describe the vein's immediate course. A further component was to identify the position of the valves in the proximal great saphenous vein. Needles were placed in 42 cadaver thighs as defined by the techniques identified from the literature and surgical practice. After a detailed dissection, the vein's relation to these needles was measured and the course of the vein and number of valves noted in relation to easily identifiable landmarks. Landmarks in 2.5‐cm intervals on a line from the pubic tubercle to the adductor tubercle of the femur were used. The rule of two's, an experimental method by one of the authors, along with Dronen's second method localized the vein most successfully. The course of the vein was scrutinized and found to have a rather direct course as it proceeded medially toward the saphenous hiatus. The largest population of valves could be found in the proximal 5 cm (76%) with a valve in the confluence of the great saphenous vein and the femoral vein being the most common. Valve populations were found to decrease in number from proximal to distal, which would have implications with the placement of catheters into the vein for fluid resuscitation. Clin. Anat. 21:453–460, 2008. © 2008 Wiley‐Liss, Inc.

Great saphenous vein

Venous Valves

Femoral vein

10.1002/ca.20643

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Citations (1)

Relation of the external branch of the superior laryngeal nerve to the superior pole of the thyroid gland: An anatomical study

Clinical Anatomy (2007)

Dhee Naidoo J.M. Boon C J Mieny Piet Becker Albert van Schoor

Abstract The external branch of the superior laryngeal nerve (ELN) is intimately associated with the superior thyroid artery (STA) in relation to the superior pole of the thyroid gland, rendering it vulnerable to injury during the ligation of this vessel during thyroidectomy. Although most texts acknowledge the fact that the nerve is in close relation to the STA, there has not been an anatomical study to relate the position of the ELN to the superior pole of the thyroid gland. The aim of this study was to determine the shortest distance, from the most superior point of the thyroid gland, to the ELN. Bilateral micro‐dissection on 43 adult cadavers, excluding those with thyroid pathology and previous thyroidectomies, was undertaken. The most superior point of the superior pole of the thyroid gland was identified and the shortest distance to the ELN was measured with a digital calliper (accuracy 0.01 mm). The metric study indicated a mean distance from the ELN to the superior pole of a normal sized thyroid gland of 5.76 mm (range: 2.00–11.26) on the right, and 6.17 mm (range: 2.78–13.48) on the left. From the literature, it is clear that the ELN may even be closer to the superior pole of an enlarged thyroid gland. The recommendation to stay on the substance of the superior pole of the thyroid gland when ligating the STA remains valid, as the nerve is extremely close in relation to the superior pole of the normal thyroid gland. Clin. Anat. 20:516–520, 2007. © 2007 Wiley‐Liss, Inc.

Superior laryngeal nerve

Superior thyroid artery

10.1002/ca.20463

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Citations (24)

Serum-Free Amino Acid Concentrations in Low Birth Weight Infants during the First 4 Weeks of Life

Transfusion Medicine and Hemotherapy (1980)

J.M. Boon L.A.H. Monnens J.T. Knuiman J. M. F. Trijbels

To obtain more information about the correct protein intake in low birth weight children, serum amino acid concentrations were determined. In 59 formula-fed, low birth weight children, serum amino acid concentrations were determined at 3, 24 and 72 h after birth and at the age of 1, 2, 3 and 4 weeks. Mean serum concentrations of all amino acids decreased during the first 24 h of life, except of aspartate and tyrosine. This decrease was followed by an increase during the first weeks of life and a variable pattern afterwards. A hypertyrosinemia (serum-tyrosine concentration > 250 mumol/l) was not found in any case. Taurine concentrations decreased gradually, as was expected because of the low taurine concentrations in cow's milk. Mean concentrations of alanine, glycine, proline and valine were higher in small for date children. Concluding, parenteral supplementation of amino acids is advisable during the first days of life to low birth weight children.

Alanine

10.1159/000221089

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Citations (0)

Anatomical considerations on Sudeck's critical point and its relevance to colorectal surgery

Clinical Anatomy (2006)

Jacob John van Tonder J.M. Boon J.H.R. Becker Albert van Schoor

Abstract Sudeck's critical point at the rectosigmoid junction is described as the point of origin of the last sigmoid arterial branch, originating from the inferior mesenteric artery (IMA). There is controversy on the importance of Sudeck's point, and the frequency in which the anastomosis is found. Furthermore, the diameter of the anastomosis, if present, may also impact on the viability of the caudal stump. This study aimed to determine the frequency in which a macroscopic anastomosis occurs, between the superior rectal artery and the last sigmoidal branch, in a cadaver population; the diameter of this anastomosis and the distance from the origin of the IMA to Sudeck's point. Sixty‐four cadavers were included in the study, excluding those with previous surgery to the rectosigmoid junction. Sudeck's point was carefully identified and dissected to establish the presence of an anastomosis. Subsequent measurements were performed using a digital caliper (accuracy = 0.01 mm). A macroscopic anatomosis was absent in three cases (4.7%). The mean diameter of the anastomosis when present was 1.9 mm (SD: 0.5 mm), and the distance from the origin of the IMA to Sudeck's point was 55.5 mm (SD: 14.6 mm). Although an anastomosis is present in the majority of cases, the vessel is very small in diameter, and may not be sufficient to meet the demands of the caudal stump. The distance from the origin of the IMA to Sudeck's point is sufficient enough to allow for ligation of the IMA proximal to Sudeck's point. Clin. Anat. 20:424–427, 2007. © 2006 Wiley‐Liss, Inc.

Inferior mesenteric artery

10.1002/ca.20417

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Citations (46)

Lumbar puncture for the generalist : review article

South African Family Practice (2004)

J.M. Boon Peter Abrahams J.H. Meiring T. Welch

The safe and successful performance of a lumbar puncture demands a working and yet specific knowledge as well as competency in performance. This review aims to aid understanding of the knowledge framework, the pitfalls and complications of lumbar puncture. It includes special reference to three dimensional relationships, functional anatomy, imaging anatomy, normal variation and living anatomy. A lumbar puncture is a commonly performed procedure for diagnostic and therapeutic purposes. Epidural and spinal anaesthesia, for example, are common in obstetric practice and involve the same technique as a lumbar puncture except for the endpoint of the needle being in the epidural space and subarachnoid space respectively. The procedure is by no means innocuous and some anatomical pitfalls include inability to find the correct entry site for placement of the lumbar puncture needle and lack of awareness of structures in relation to the advancing needle. Headache is the most common complication and it is important to avoid traumatic and dry taps, herniation syndromes and injury to the terminal end of the spinal cord. With a thorough knowledge of the contraindications, the regional anatomy and rationale of the technique and adequate prior skills practice, a lumbar puncture can be performed safely and successfully.

Subarachnoid space

Epidural space

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Central venous catheterization—An anatomical review of a clinical skill—Part 1: Subclavian vein via the infraclavicular approach

Clinical Anatomy (2007)

J.M. Boon Albert van Schoor Peter Abrahams J.H. Meiring T. Welch

Abstract The safe and successful performance of a central venous catheterization (CVC) requires a specific knowledge of anatomy in addition to a working knowledge. Misunderstanding the anatomy may result in failure or complications. This review aims to aid understanding of the anatomical framework, pitfalls, and complications of CVC of the subclavian (SCV). CVC is common practice amongst surgeons, anesthesiologists, and emergency room physicians during the preparations for major surgical procedures such as open‐heart surgery, as well as, for intensive care monitoring and rapid restoration of blood volume. Associated with this technique are certain anatomical pitfalls and complications that can be successfully avoided if one possesses a thorough knowledge of the contraindications, regional anatomy, and rationale of the technique. Clin. Anat. 20:602–611, 2007. © 2007 Wiley‐Liss, Inc.

Subclavian vein

10.1002/ca.20486

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Citations (30)

One-year morbidity in very premature infants: prognostic value of duration of pregnancy, birthweight and neonatal morbidity

European Journal of Obstetrics & Gynecology and Reproductive Biology (1985)

Jan Sporken P.R. Hein J.M. Boon

10.1016/0028-2243(85)90142-x

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Citations (3)

Buchbesprechungen

Transfusion Medicine and Hemotherapy (1980)

R. Ackermann H. Böhles W. Fekl J.M. Boon L.A.H. Monnens

10.1159/000221095

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Citations (0)