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Xanthogranulomatous cholecystitis:a premalignant condition?

Hepatobiliary & Pancreatic Diseases International 2011年第2期10卷 179-184页

作者： Mila Ghosh Puja Sakhuja anil k agarwal Department of Gastrointestinal Surgery GB Pant Hospita and Maulana Azad Medical College Department of Pathology GB Pant Hospita and Maulana Azad Medical College

BACkGROUND:Xanthogranulomatous cholecystitis(XGC)is an uncommon variant of chronic cholecystitis,characterized by marked thickening of the gallbladder wall and dense local *** often mimics a gallbladder carcinoma(GBC), and may coexist with GBC,leading to a diagnostic dilemma. Furthermore,the premalignant nature of this entity is not *** study was undertaken to assess the p53,PCNA and beta-catenin expression in XGC in comparison to GBC and chronic inflammation. METHODS:Sections from paraffin-embedded blocks of surgically resected specimens of GBC(69 cases),XGC(65), chronic cholecystitis(18)and control gallbladder(10)were stained with the monoclonal antibodies to p53 and PCNA, and a polyclonal antibody to beta-catenin.p53 expression was scored as the percentage of nuclei *** expression was scored as the product of the percentage of nuclei stained and the intensity of the staining(1-3).A cut-off value of 80 for this score was taken as a positive result. Beta-catenin expression was scored as type of expression-membranous,cytoplasmic or nuclear staining. RESULTS:p53 mutation was positive in 52%of GBC cases and 3%of XGC,but was not expressed in chronic cholecystitis and control gallbladders.p53 expression was lower in XGC than in GBC(P<0.0001).PCNA expression was seen in 65%of GBC cases and 11%of XGC,but not in chronic cholecystitis and control *** expression was higher in GBC than XGC(P=0.0001),but there was no significant difference between the XGC,chronic cholecystitis and control gallbladder ***-catenin expression was positive in the GBC,XGC, chronic cholecystitis and control gallbladder *** the expression pattern in XGC,chronic cholecystitis and control gallbladders was homogenously membranous,whereas in GBC the membranous expression pattern was altered to cytoplasmic and ***:The expression of p53,PCNA and beta-catenin in XGC was significantly different from GBC and similar to chronic cholecystitis,

关键词： xanthogranulomatous cholecystitis gallbladder cancer p53 PCNA beta-catenin

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Pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia:report of a case

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Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 553-556页

作者： Rajkumar krishnasamy Shaleen agarwal Shivendra Singh Sunil Puri Puja Sakhuja anil k agarwal Department of Gastrointestinal Surgery Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002India Department of Radiology Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002 Department of Pathology Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002

BACkGROUND:The presence of pancreatic ductal intraepithelial neoplasia in patients with chronic pancreatitis is a risk factor for development of pancreatic adenocarcinoma. METHOD:A case of pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia was diagnosed in the setting of chronic pancreatitis. RESULTS:Distal pancreatectomy combined with splenec- tomy was performed with a diagnosis of pancreatic body *** examination suggested adenocarcinoma associated with pancreatic ductal intraepithelial *** tumor was detected in the remaining head of the pancreas,for which a total pancreatectomy was done. CONCLUSIONS:When a patient with pancreatic ductal intraepithelial neoplasia associated with adenocarcinoma of the pancreas in the setting of chronic pancreatitis is at an increased risk of recurrence in the remaining pancreatic parenchyma,total pancreatectomy may be feasible.

关键词： pancreatectomy pancreatic ductal carcinoma chronic pancreatitis

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Choledochal cyst with large stone cast and portal hypertension

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 647-649页

作者： Shivendra Singh Laxman Singh kheria Sunil Puri Amrinder S Puri anil k agarwal Departments of Gastrointestinal Surgery GB Pant Hospital & Maulana Azad Medical College Radiodiagnosis GB Pant Hospital & Maulana Azad Medical College Gastroenterology GB Pant Hospital & Maulana Azad Medical College

BACkGROUND:Choledochal cysts in adults are more commonly associated with complications such as cystolithiasis,recurrent cholangitis,portal hypertension and malignancy,than in the pediatric age ***:We report a case of adult choledochal cyst with long-term complication of large stone cast and portal hypertension due to secondary biliary ***:A 50-year-old patient presented with obstructive jaundice and *** investigation,she was diagnosed as having a choledochal cyst with large stone cast and portal *** stage resection of the choledochal cyst with Roux-en-Y hepaticojejunostomy was done by meticulous dissection and ligation of ***:Single stage resection of a choledochal cyst is possible in spite of associated portal hypertension,if the portal vein is patent.

关键词： choledochal cyst cystolithiasis portal hypertension

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Management of hypersplenism in non-cirrhotic portal hypertension:a surgical series

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 165-171页

作者： Rajesh Rajalingam Amit Javed Dharmanjay Sharma Puja Sakhuja Shivendra Singh Hirdaya H Nag anil k agarwal Department of Gastrointestinal Surgery G. B. Pant Hospital and Maulana Azad Medical College Delhi University New Delhi India Department of Pathology G. B. Pant Hospital and Maulana Azad Medical College Delhi University New Delhi India

BACkGROUND:Hypersplenism is commonly seen in patients with non-cirrhotic portal hypertension(NCPH).While a splenectomy alone can effectively relieve the hypersplenism,it does not address the underlying portal *** present study was undertaken to analyze the impact of shunt and non-shunt operations on the resolution of hypersplenism in patients with *** relationship of symptomatic hypersplenism,severe hypersplenism and number of peripheral cell line defects to the severity of portal hypertension and outcome was also ***:A retrospective analysis of NCPH patients with hypersplenism managed surgically between 1999 and 2009 at our center was *** 252 patients with NCPH,64(45 with extrahepatic portal vein obstruction and 19 with non-cirrhotic portal fibrosis) had hypersplenism and constituted the study *** analysis was done using GraphPad *** and continuous variables were compared using the chi-square test,ANOVA,and Student’s t *** MannWhitney U test and kruskal-Wallis test were used to compare non-parametric ***:The mean age of patients in the study group was 21.81±6.1 *** was symptomatic in 70.3% with an incidence of spontaneous bleeding at 26.5%,recurrent anemia at 34.4%,and recurrent infection at 29.7%.The mean duration of surgery was 4.16±1.9 hours,intraoperative blood loss was 457±126(50-2000) mL,and postoperative hospital stay 5.5±1.9 *** surgery,normalization of hypersplenism occurred in all *** long-term followup,none of the patients developed hepatic encephalopathy and 4 had a variceal re-bleeding(2 after a splenectomy alone,1 each after an esophago-gastric devascularization and proximal splenorenal shunt).Patients with severe hypersplenism and those with defects in all three peripheral blood cell lineages were older,had a longer duration of symptoms,and a higher incidence of variceal bleeding and postoperative *** addition,patients with t

关键词： portal hypertension hypersplenism splenorenal shunt lienorenal shunt

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Pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia(The Author reply)

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Hepatobiliary & Pancreatic Diseases International 2008年第2期7卷 221-221页

作者： anil k agarwal Department of Gastrointestinal Surgery Govind Ballabh Pant Hospital and Maulana Azad Medical College (Delhi University)MDNew Delhi 110002India

The Editor welcomes submissions for possible publication in the Letters to the Editor section that consist of commentary on an article published in the Journal or other relevant issues.

关键词： The Author reply Pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia

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A Hierarchical Reconfiguration Strategy for Bus-Based Multiprocessors

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Journal of Computer Science & Technology 1990年第2期5卷 175-186页

作者： Ashish Pancholy Fidel Muradali Vinod k.agarwal VLSI Design Laboratory Department of ElectricalEngineeringMcGill University

A method of providing redundancy to a class of bus-based multiprocessor arrays is *** reconfiguration is hierarchical,providing global spare replacement at the array level and local reconfiguration within the spare **... 详细信息

关键词： A Hierarchical Reconfiguration Strategy for Bus-Based Multiprocessors PE

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Magnetic and magnetotransport behavior of overdoped nanocrystalline Nd_(1-x)Sr_xMnO_3 (0.50≤x≤0.63)

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Journal of Rare Earths 2011年第7期29卷 654-659页

作者： Neelam Maikhuri Vasudha agarwal Anurag Gaur H.k.Singh Department of Physics National Institute of Technology Kurukshetra-136119 India National Physical Laboratory New Delhi-110012 India

The nanocrystalline samples of Nd1-xSrxMnO3 （NSMO）（x=0.5, 0.55, 0.60, 0.63） were synthesized by sol-gel based polymeric pre-cursor route. Structural, magnetic and magnetotransport properties were studied systematically. It was found that in the composition range （x=0.50-0.63）, Nd1-xSrxMnO3 showed paramagnetic to ferromagnetic （PM-FM） transition in the vicinity of TC～270 k but the FM phase was weakened as the Sr concentration increased. The appearance of weak ferromagnetism was explained in terms of the core-shell model. More-over, for x=0.63 sample, a second transition is observed below TC at T=185 k, which is possibly due to the appearance of A-AFM/ C-AFM or a mixture of both the phases. Resistivity vs temperature （ρ-T） curve showed that the resistivity of all the samples was much larger than the sin-gle crystals of corresponding compositions due to large contribution of the grain boundaries in the present nanocrystalline samples. In all samples, extrinsic kind of MR behavior dominated because of nanocrystalline nature of the samples, which was nearly of the same order （～10%） in all samples. However, the intrinsic kind of MR behavior was also significant in x=0.50 sample, because of the strongest FM feature in this sample.

关键词： manganites magnetoresistance spin polarized tunnelling rare earths

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Endoscopic management of acute cholangitis in elderly patients

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World Journal of Gastroenterology 2006年第40期12卷 6551-6555页

作者： Naresh agarwal Barjesh Chander Sharma Shiv k Sarin Department of Gastroenterology GB Pant Hospital New Delhi India

AIM: To evaluate clinical presentation, etiology, compli-cations and response to treatment in elderly patients with acute ***: Demographics, etiology of biliary obstruc-tion, clinical features, complications and associated systemic diseases of 175 patients with acute cholangitis were recorded. Endoscopic biliary drainage was performed using nasobiliary drain or stent. The complications related to ERCP, success of biliary drainage, morbidity, mortality and length of hospital stay were evaluated. RESULTS: Of 175 patients, 52 aged ≥ 60 years (groupⅠ, age < 60 years; group Ⅱ, age ≥ 60 years) and 105 were men. Fever was present in 38 of 52 patients of group Ⅱ compared to 120 of 123 in groupⅠ. High fever (fever ≥ 38.0℃) was more common in groupⅠ(118/120 vs 18/38). Hypotension (5/123 vs 13/52), altered sensorium (3/123 vs 19/52), peritonism (22/123 vs 14/52), renal failure (5/123 vs 14/52) and associated comorbid diseases (4/123 vs 21/52) were more common in group Ⅱ. Biliopancreatic malignancy was a common cause of biliary obstruction in group Ⅱ (n = 34) and benign diseases in groupⅠ(n = 120). Indications for biliary drainage were any one of the following either singly or in combination: a fever of ≥ 38.0℃ (n = 136), hypotension (n = 18), peritonism (n = 36), altered sensorium (n = 22), and failure to improve within 72 h of conservative management (n = 22). High grade fever was more common indication of biliary drainage in groupⅠand hypotension, altered sensorium, peritonism and failure to improve within 72 h of conservative management were more common indications in group Ⅱ. Endoscopic biliary drainage was achieved in 172 patients (nasobiliary drain: 56 groupⅠ, 24 group Ⅱ, stent: 64 groupⅠ, 28 group Ⅱ) without any significant age related difference in the success rate. Abdominalpain, fever, jaundice, hypotension, altered sensorium, peritonism and renal failure improved after median time of 5 d in 120 patients in groupⅠ(2-15 d) compared to 10 d in 47 patien

关键词： Acute cholangitis Endoscopic biliary drainage Endoscopic retrograde cholangio-pancreatography Common bile duct stones Carcinoma gall bladder

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The use of Lactobacillus as an alternative of antibiotic growth promoters in pigs:A review

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Animal Nutrition 2017年第1期3卷 1-6页

作者： Runjun Dowarah A.k.Verma Neeta agarwal CAFT in Animal Nutrition Indian Veterinary Research Institute

Antibiotics, often supplemented in feed, used as a growth promoter, may cause their residual effect in animal produce and also trigger antibiotic resistance in bacteria, which is of serious concern among swine farming entrepreneurs. As an alternative, supplementing probiotics gained interest in recent *** being the most commonly used probiotic agent improves growth performance, feed conversion efficiency, nutrient utilization, intestinal microbiota, gut health and regulates immune system in pigs. The characteristics of Lactobacillus spp. and their probiotic effects in swine production are reviewed here under.

关键词： Diarrhea score Gut microbiota Lactobacilli Probiotics

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Effects of Froude number and geometry on water entry of a 2-D ellipse

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Journal of Hydrodynamics 2018年第4期30卷 738-749页

作者：张旭刘沛清屈秋林王睿 Ramesh k.agarwal School of Aeronautic Science and Engineering Beihang University School of Engineering and Applied Science Washington University in St.Louis

By using the finite volume method with volume of fluid model and global dynamic mesh technique, the effects of Froude number and geometry on the water entry process of a 2-D ellipse are investigated numerically. For the time history of the vertical force, the computational fluid dynamics（CFD） results match the experimental data much better than the classical potential-flow theories due to the consideration of the viscosity, turbulence, surface tension, gravity, and compressibility. The results show that the position of peak pressure on ellipse shifts from the spray root to the bottom of ellipse at a critical time. The critical time changes with the geometry and Froude number. By studying the vertical force, the ellipse water entry process can be divided into the initial and late stages based on the critical dimensionless time of about 0.1. The geometry of the ellipse plays a dominant role in the initial stage, while the Froude number is more important in the late stage of entry. The classical Wagner theory is extended to the ellipse water entry, and the predicted maximum value of vertical force coefficient in the initial stage is 4？a/b that matches the CFD results very well, where a and b are the horizontal axis and vertical axis of the ellipse parallel and perpendicular to the initial calm water surface, respectively.

关键词： Water impact water entry fluid-structure interaction Froude number

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