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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

Palliative surgical bypass for unresectable periampullary carcinoma

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Hepatobiliary & Pancreatic Diseases International 2008年第3期7卷 308-312页

作者： shivendra singh Ajay Kumar Sachdev Adarsh Chaudhary Anil Kumar Agarwal Department of Gastrointestinal Surgery Govind Ballabh Pant Hospital&Maulana Azad Medical CollegeNew Delhi 110002India

BACKGROUND:Around 60%to 80%of patients with periampullary carcinoma are unresectable either due to distant metastasis or local vascular *** the advancement of endoscopic interventional procedures,the role of surgical bypass has ***,surgical bypass is still appropriate in patients with unresectable disease discovered at the time of *** study was conducted to assess the results of palliative surgical bypass for patients with unresectable periampullary carcinoma at our hospital,a tertiary referral center of Northern India. METHOD:The study group comprised 204 patients who had undergone surgical bypass for advanced periampullary carcinoma over the last 15 years. RESULTS:Between January 1990 and December 2004,204 patients(128 males,76 females)consisting of 179 patients with carcinoma of head of the pancreas,14 patients with ampullary carcinoma,8 patients with lower end cholangiocarcinoma and 3 patients with duodenal carcinoma underwent surgical *** average age was 51 years (range 20-78 years).Both biliary and gastric bypasses were done in 158(77.45%),biliary bypass alone in 37(18.13%) and gastric bypass alone in 9(4.32%).Biliary bypass was done by Roux-en-Y hepaticojejunostomy,and gastric bypass by retrocolic *** overall postoperative mortality and morbidity were 0.98%and 26.9%,respectively The patients who died had undergone previously endoscopic *** included wound infection in 12.25%of the patients,bile leak in 5.12%,delayed gastric emptying in 5.38%,ascitic leak from drains in 8.8%,and upper gastrointestinal bleeding in 1.96%.The incidences of wound infection and bile leak both were significantly higher in patients who had had preoperative biliary stenting None of the patients who had undergone Roux-en-Y hepati cojejunostomy+retrocolic gastrojejunostomy required any intervention later in their ***:Surgical bypass is a safe procedure with negligible mortality and minimal mo

关键词： surgical bypass periampullary carcinoma

Multimodality management of gallbladder cancer can lead to a better outcome:Experience from a tertiary care oncology centre in North India

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World Journal of Gastroenterology 2021年第45期27卷 7813-7830页

作者： Shaifali Goel Abhishek Aggarwal Assif Iqbal Vineet Talwar Swarupa Mitra shivendra singh Department of GI and HPB Oncosurgery Rajiv Gandhi Cancer Institute and Research CenterDelhi 110085DelhiIndia Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research CenterDelhi 110085DelhiIndia Department of Radiation Oncology Rajiv Gandhi Cancer Institute and Research CenterDelhi 110085DelhiIndia

BACKGROUND Surgical resection is a treatment of choice for gallbladder cancer(GBC)patients but only 10%of patients have a resectable disease at *** after surgical resection,overall survival(OS)has been poor due to high rates of *** of surgery and systemic therapy can improve outcomes in this aggressive *** To summarize our single-center experience with multimodality management of resectable GBC *** Data of all patients undergoing surgery for suspected GBC from January 2012 to December 2018 was retrieved from a prospectively maintained electronic *** extracted included demographics,operative and perioperative details,histopathology,neoadjuvant/adjuvant therapy,follow-up,and *** know the factors associated with recurrence and OS,univariate and multivariate analysis was done using log rank test and cox proportional hazard analysis for categorical and continuous variables,*** analysis was done using multiple regression *** Of 274 patients with GBC taken up for surgical resection,172(62.7%)were female and the median age was 56 *** exploration,102 patients were found to have a metastatic or unresectable disease(distant metastasis in 66 and locally unresectable in 34).Of 172 patients who finally underwent surgery,93(54%)underwent wedge resection followed by anatomical segment IVb/V resection in 66(38.4%)and modified extended right hepatectomy in 12(7%)*** postoperative mortality at 90 d was 4.6%.During a median follow-up period of 20 mo,71(41.2%)patients developed *** 1-,3-,and 5-years OS rates were 86.5%,56%,and 43.5%,*** 1-and 3-year disease free survival(DFS)rates were 75%and 49.2%,*** multivariate analysis,inferior OS was seen with pT3/T4 tumor(P=0.0001),perineural invasion(P=0.0096),and R+resection(P=0.0125).However,only pT3/T4 tumors were associated with a poor DFS(P<0.0001).CONCLUSION Multim

关键词： Gallbladder cancer Multimodality Surgical resection Adjuvant Chemotherapy Chemoradiotherapy

Leelamine suppresses cMyc expression in prostate cancer cells in vitro and inhibits prostate carcinogenesis in vivo

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 242-253页

作者： Krishna B.singh Eun-Ryeong Hahm shivendra V.singh Department of Pharmacology&Chemical Biology University of Pittsburgh School of MedicinePittsburghPennsylvaniaPA15261USA UPMC Hillman Cancer Center University of Pittsburgh School of MedicinePittsburghPennsylvaniaPA 15213USA

Aim:Leelamine(LLM)inhibits the growth of human prostate cancer cells but the underlying mechanism is not fully *** present study was undertaken to determine the effect of LLM on cMyc,which is overexpressed in a subset of human prostate ***:The effect of LLM on cMyc expression and activity was determined by western blotting/confocal microscopy and luciferase reporter assay,respectively.A transgenic mouse model of prostate cancer(Hi-Myc)was used to determine the chemopreventive efficacy of ***:Exposure of androgen-sensitive(LNCaP)and castration-resistant(22Rv1)human prostate cancer cells to LLM resulted in downregulation of protein and mRNA levels of *** of cMyc partially attenuated LLM-mediated inhibition of colony formation,cell viability,and cell migration in 22Rv1 and/or PC-3 *** treatment decreased protein levels of cMyc targets(e.g.,lactate dehydrogenase),however,overexpression of cMyc did not attenuate these effects.A trend for a decrease in the expression level of cMyc protein was discernible in 22Rv1 xenografts from LLM-treated mice compared with control *** treatment(10 mg/kg body weight,5 times/week)was well-tolerated by Hi-Myc transgenic *** incidence of high-grade prostatic intraepithelial neoplasia,adenocarcinoma in situ,and microinvasion were lower in LLM-treated Hi-Myc mice but the difference was not statistically ***:The present study reveals that LLM inhibits cMyc expression in human prostate cancer cells in vitro but concentrations higher than 10 mg/kg may be required to achieve chemoprevention of prostate cancer.

关键词： Prostate cancer cMyc leelamine chemoprevention

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

Designing a Mini-Core Collection Effectively Representing 3004 Diverse Rice Accessions

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Plant Communications 2020年第5期1卷 141-154页

作者： Angad Kumar shivendra Kumar Kajol B.M.singh Manoj Prasad Jitendra K.Thakur Plant Mediator Lab National Institute of Plant Genome ResearchAruna Asaf Ali MargNew Delhi 110067India

Genetic diversity provides the foundation for plant breeding and genetic *** 3000 rice genomes were recently sequenced as part of the 3K Rice Genome(3KRG)*** added four additional Indian rice accessions to create a panel of 3004 ***,such a large collection of germplasm is difficult to preserve and *** construction of core and mini-core collections is an efficient method for the management of genetic *** this study,we developed a mini-core comprising 520 accessions that captured most of the SNPs and represented all of the phenotypes and geographic regions from the original *** mini-core was validated using different statistical analyses and contained representatives from all major rice groups,including japonica,indica,aus/boro,and aromatic/*** association analyses of the mini-core panel efficiently reproduced the marker–trait associations identified in the original *** analysis validated the utility of the mini-core *** the current era with many ongoing large-scale sequencing projects,such a strategy for mini-core design should be useful in many *** rice mini-core collection developed in this study would be valuable for agronomic trait evaluation and useful for rice improvement via marker-assisted molecular breeding.

关键词： rice mini-core SNPs GWAS 3KRG agronomic trait

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

Molecular targets of cancer chemoprevention by garlic-derived organosulfides

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Acta Pharmacologica Sinica 2007年第9期28卷 1355-1364页

作者： Anna HERMAN-ANTOSIEWICZ Anna A POWOLNY shivendra V singh Department of Molecular Biology University of Gda(sk Kladki 2480-822 GdaskPoland Department of Pharmacology and University of Pittsburgh Cancer Institute University of Pittsburgh School of MedicinePittsburghPennsylvania 15213USA

The medicinal benefits of Allium vegetables,especially garlic,have been notedthroughout recorded *** known health benefits of Allium vegetablesand their constituents include cardiovascular protective effects,stimulation ofimmune function,reduction of blood glucose level,radioprotection,improvementof memory loss,protection against microbial,viral and fungal infections,as well asanticancer ***-based case control studies have suggested aninverse correlation between dietary intake of Allium vegetables and the risk ofdifferent types of *** anticarcinogenic effect of Allium vegetables in-cluding garlic is attributed to organosulfur compounds (OSC),which are highlyeffective in affording protection against cancer in animal models induced by avariety of chemical *** recent studies have shown that certainnaturally occurring OSC analogues can suppress proliferation of cancer cells inculture and in *** OSC-induced changes in the proliferation of cancer cellsare frequently associated with perturbations in cell cycle progression and induc-tion of G2/M phase *** OSC have also been demonstrated to induceapoptosis via the intrinsic pathway by altering the ratio of the Bcl-2 family ofproteins both in cell culture and in in vivo ***-angiogenic activity forgarlic-derived OSC has also been *** article summarizes currentknowledge on molecular targets of cancer chemoprevention by OSC.

关键词： garlic organosulfides apoptosis cell cycle angiogenesis chemoprevention