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Bansal VK, Misra MC, Agarwal AK, Agrawal JB, Agarwal PN, Aggarwal S, Aslam M, Krishna A, Baksi A, Behari A, Bhattacharjee HK, Bhojwani R, Chander J, Chattopadhyay TK, Chintamani, Chowbey P, Dalvi A, Dash NR, Dhawan IK, Gamangatti S, Garg PK, Gupta NM, Gupta R, Gupta SK, Gupta V, Kaman L, Kapur BML, Kataria K, Khan M, Khanna AK, Khullar R, Kumar A, Kumar A, Kumar S, Kumar S, Lal P, Maurya SD, Moirangthem GS, Pal S, Panwar R, Parshad R, Pottakkat B, Prajapati OP, Puntambekar S, Ranjan P, Rathore YS, Sahni P, Sarangi R, Seenu V, Sharma R, Shukla VK, Singh DP, Singh J, Singh R, Sinha R, Sikora SS, Srivastava A, Srivastava A, Srivastava KN, Thomas S, Verma GR, Wig JD, Kapoor VK. SELSI Consensus Statement for Safe Cholecystectomy—Prevention and Management of Bile Duct Injury—Part B. Indian J Surg 2021. [DOI: 10.1007/s12262-019-01994-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pal S, George J, Singh AN, Mathur S, Dash NR, Garg P, Sahni P, Chattopadhyay TK. Posterior Superior Mesenteric Artery (SMA) First Approach vs. Standard Pancreaticoduodenectomy in Patients with Resectable Periampullary Cancers: a Prospective Comparison Focusing on Circumferential Resection Margins. J Gastrointest Cancer 2017; 49:252-259. [DOI: 10.1007/s12029-017-9933-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Chattopadhyay TK. Advances in Gastrointestinal Surgery. GI Surgery Annual 2015. [PMCID: PMC7123414 DOI: 10.1007/978-981-10-2010-0_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Carcinoma of the stomach is a global disease with the highest incidence in Asia, South America and Eastern Europe. The disease is least common in USA and Western Europe [1]. The disease is common among smokers. Other risk factors are H. pylori infection, atrophic gastritis, Menetrier’s disease and previous gastrectomy. The disease can be genetic as in familial adenomatous polyposis, hereditary non-polyposis colorectal cancer, Peutz-Jegher’s syndrome, etc. [2]. Screening for gastric carcinoma is done in high incidence areas such as Japan, Korea and China.
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Khiria LS, Pal S, Peush S, Chattopadhyay TK, Deval M. Impact on outcome of the route of conduit transposition after transhiatal oesophagectomy: A randomized controlled trial. Dig Liver Dis 2009; 41:711-6. [PMID: 19577967 DOI: 10.1016/j.dld.2009.02.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 02/22/2009] [Accepted: 02/25/2009] [Indexed: 12/11/2022]
Abstract
AIM To assess the influence of the route of conduit transposition after transhiatal oesophagectomy on the postoperative morbidity and mortality and late outcome at 6 months. METHODS Patients with oesophageal carcinoma, undergoing transhiatal oesophagectomy (gastric conduit), were randomized to either anterior or posterior route of conduit transposition. Patients with advanced tumour, distant metastasis, extensive invasion of the stomach, previous gastric surgery, any anterior mediastinal abnormality detected on preoperative imaging, ASA grade III/IV and poor preoperative pulmonary function were excluded. Intraoperative complications, postoperative morbidity and mortality and late outcomes were compared. RESULTS Of the 49 patients (34 men), 24 patients were randomized to the anterior mediastinal route and 25 to the posterior. The mean duration of the operative procedure (anterior: 235min; posterior: 225min) and the mean blood loss (anterior: 531ml; posterior: 538ml) were not statistically different. The most common complications were pulmonary and cardiac and comparable in both groups. Four patients died postoperatively. At 6-month follow-up the incidence of dysphagia, anastomotic stricture, anastomotic recurrence, aspiration and reflux symptoms and weight gain were similar. CONCLUSIONS The route of conduit transposition did not affect the outcome. However, an individualized approach depending upon the operative findings, radicality of the procedure, and perceived need for postoperative adjuvant therapy may be useful.
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Affiliation(s)
- L S Khiria
- Department of Gastro-intestinal Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
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Chinnakotla S, Pande GK, Sahni P, Gupta SD, Maulik M, Kumari R, Nundy S, Chattopadhyay TK. Evaluation of Pringle Maneuver During Liver Resection in a Rat Model of Surgical Obstructive Jaundice. J INVEST SURG 2009; 18:107-13. [PMID: 16036781 DOI: 10.1080/08941930590956129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Temporary portal triad clamping (Pringle maneuver) during liver resection reduces intraoperative blood loss. A normal liver can safely tolerate normothermic ischemia for up to 60 min. However, its safety in patients with surgical obstructive jaundice (SOJ) is not known. Therefore, we investigated the effect of hepatic ischemia in an experimental rat model of SOJ created by ligating the bile duct. Four groups of rats were created: Group I (sham operation, 10 days later, liver resection); Group II (sham operation, 10 days later, liver resection with 5 min of hepatic ischemia); Group III (bile duct ligation, 10 days later, liver resection); and Group IV (bile duct ligation, 10 days later, liver resection with 5 min of hepatic ischemia). The ischemic injury was assessed by the survival of rats, liver tissue malondialdehyde and total glutathione (markers of free radical injury), serum alanine aminotransferase, aspartate aminotransferase, and liver histology. The results showed decreased survival (47.6% vs. 90% [p = .046]), increased liver tissue malondialdehyde (161 +/- 35 vs. 129 +/- 33 microg/gm liver tissue [p = .05]), and decreased liver tissue total glutathione (565 +/- 169 vs. 1075 +/- 276 nmol/gm liver tissue [p = .05]) in rats with SOJ subjected to hepatic ischemia when compared to nonjaundiced rats. The changes in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase showed an increasing trend in the SOJ group but were not statistically significant. Ischemic changes in liver histology were seen more often in the SOJ group but were not statistically significant. These data suggest that temporary portal triad clamping in an experimental model of SOJ is detrimental to the outcome of liver resection.
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Affiliation(s)
- Srinath Chinnakotla
- Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India.
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Kapoor VK, Chattopadhyay TK. Treatment of pleomorphic adenomas. Br J Surg 2005. [DOI: 10.1002/bjs.1800731033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- V K Kapoor
- Department of Surgery, All India Institute of Medical Sciences, New Delhi-110029, India
| | - T K Chattopadhyay
- Department of Surgery, All India Institute of Medical Sciences, New Delhi-110029, India
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Batra Y, Pal S, Dutta U, Desai P, Garg PK, Makharia G, Ahuja V, Pande GK, Sahni P, Chattopadhyay TK, Tandon RK. Gallbladder cancer in India: a dismal picture. J Gastroenterol Hepatol 2005; 20:309-14. [PMID: 15683437 DOI: 10.1111/j.1440-1746.2005.03576.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gallbladder cancer (GBC) is one of the most common gastrointestinal malignancies. The data regarding GBC are, however, limited. METHODS Records of 634 patients with GBC over a 10-year period were examined with regard to the clinical presentation, investigative findings, treatment, operative findings and outcome. RESULTS The mean age of patients was 51 +/- 11 years and men : women ratio was 0.36:1.00. Pain, jaundice and hepatomegaly were seen in 81.0%, 76.0% and 61.5% patients, respectively. On imaging, a mass replacing the gallbladder was seen in 73% patients. Gallstones were present in 54% patients. Surgery was carried out in 291 (46%) patients and endoscopic treatment in 72 (19%) patients but no intervention was carried out in the remaining patients because of disseminated disease. Among the patients who were operated on, 2.0% had stage I GBC, 3.4% stage II, 17.5% stage III, 47.0% stage IVa and 29.8% stage IVb. Radical resection was possible in 133 (46%) patients. The 30-day mortality was 10% with most (90%) deaths in patients with stage IV disease. The median survival after simple cholecystectomy and radical surgery was 33.5 and 12.0 months, respectively. However, among those who underwent debulking, palliative bypass or exploratory laparotomy alone, the survival ranged between 1 and 3 months. Logistic regression analysis showed that only radical resection improved the long-term survival (P < 0.05). CONCLUSIONS The majority of patients with GBC in India have advanced unresectable disease. Detection of GBC at an early stage is incidental and rare but is associated with long-term survival. Radical surgery, when feasible, is the only option for achieving long-term survival.
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Affiliation(s)
- Yogesh Batra
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110-029, India
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Abstract
Thoracic duct injury is an uncommon complication of esophagectomy. Experience in managing these cases is limited to large centers performing esophagectomies in good numbers. We analyzed the prospectively maintained esophageal diseases database of patients presenting to a surgical unit between 1982 and 2002. Among 552 esophagectomies during this period we had encountered 14 cases of chylothorax (2.54%). We analyzed the type and site of lesion and the impact of neoadjuvant therapy on the incidence of thoracic duct injury. Among 459 patients of transhiatal esophagectomy, 11 developed postoperative chylothorax (2.40%). In 93 transthoracic resections, there were three cases of chylothorax (3.23%; (P = 0.9185)). The incidence following preoperative radiotherapy was 2.17%. None of the 31 patients, who had undergone esophagectomy for benign diseases had developed chylothorax. In the carcinoma group the incidence in middle third lesions was 5.85% and in lower third lesions was 0.80% (P = 0.0018). Seven patients were managed conservatively. Two of these patients, for whom surgery had been planned, died before they could be taken up for surgery. In the remaining seven patients transthoracic ligation of the thoracic duct was performed. Two patients in this group died. The average hospital stay was 20 days in the conservative group and 12 days in the surgery group. Among the factors studied, patients with middle third lesions were at increased risk of developing postoperative chylothorax, when compared to upper or lower third lesions.
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Affiliation(s)
- D V L N Rao
- Department of GI Surgery & Liver Transplantation, All India Institute of Medical Sciences, New Delhi-110029, India
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Makharia GK, Nandi B, Kumar V, Garg PK, Gupta SD, Chattopadhyay TK, Tandon RK. Intussusception due to gastrointestinal stromal tumour of the colon: diagnosis by colonoscopy. Trop Gastroenterol 2003; 24:29-30. [PMID: 12974213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Intussusception of the intestine is rare in adults. We report a case of a 45-year-old male who presented with long-standing pyrexia of unknown origin, abdominal pain, gastrointestinal bleeding and constitutional symptoms. Colonoscopic examination revealed a large invaginated mass suggestive of colonic intussusception due to gastrointestinal stromal tumour of the colon. His symptoms disappeared after surgical removal of the tumour.
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Affiliation(s)
- Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029
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Naidu KRC, Kapoor S, Chattopadhyay TK. Corrosive strictures of the oesophagus. Natl Med J India 2002; 15:185-7. [PMID: 12296469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Rao YG, Saxena R, Sahni P, Pande GK, Chattopadhyay TK. Functional outcome and patient satisfaction after ileal pouch anal anastomosis for ulcerative colitis in a developing country. Trop Gastroenterol 2002; 23:66-9. [PMID: 12632971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
AIM To study the long-term outcome and patient satisfaction of patients with an ileal pouch-anal anastomosis (IPAA) for ulcerative colitis in India. PATIENTS AND METHODS We studied 35 patients who had undergone IPAA for ulcerative colitis between 1985 and 1998 and had intestinal continuity restored for more than 6 months. These patients were asked to answer a detailed questionnaire on their bowel function, urogenital function, etc. A complete haemogram, serum iron studies, liver function tests and D-Xylose absorption test were done. In addition hepatobiliary ultrasound, stool microscopy, pouchoscopy and pouch biopsies were also performed. Patient satisfaction after the procedure was also evaluated. RESULTS Thirty-five patients (17 men and 18 women) underwent a complete evaluation. The duration after restoration of continuity ranged from 6 months to 164 months (mean 78.6 months). The mean stool frequency was 7.2 stools per 24 hours. Five patients had urgency of stool, 9 had occasional soiling and 1 had major incontinence. Four patients had minimal restriction of social activities and 1 discontinued his employment. All patients were sexually satisfied except one man who had impotence and one woman who had dyspareunia. Fifteen patients had abnormal serum iron studies (Haemoglobin < 9 g/dl in 11). Eleven patients had D-Xylose absorption below normal values. Two patients were found to have gallstones. All pouch biopsies showed chronic inflammation and 1 patient had histological evidence of pouchitis. Eighty-five percent of patients reported that they were very satisfied with the procedure. CONCLUSION Good functional recovery and acceptance of the procedure over the long term suggests that it is a valid procedure to be recommended for patients with ulcerative colitis in India.
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Affiliation(s)
- Y Govardhana Rao
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
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12
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Mathew R, Arora S, Mathur M, Chattopadhyay TK, Ralhan R. Esophageal squamous cell carcinomas with DNA replication errors (RER+) are associated with p16/pRb loss and wild-type p53. J Cancer Res Clin Oncol 2001; 127:603-12. [PMID: 11599796 DOI: 10.1007/s004320100249] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Microsatellite instability (MSI) as a determinant of propensity to esophageal squamous cell carcinoma (ESCC) at seven microsatellite markers at 2p (2p15-16), 3p (3p13, 3p14.1-3, 3p25, and 3p26) and 16q (16q12.1-3) was investigated to analyze their putative role as indicators of predisposition to esophageal malignancies. METHODS Seven microsatellite loci were amplified by polymerase chain reaction, from surgically resected tumor tissues from 30 ESCC patients from Indian population, to assess the loss of heterozygosity (LOH) and replication error repeats (RER) and to correlate these alterations with aberrations in major cell cycle regulatory proteins and histopathological parameters. RESULTS LOH and RER analyses at these loci demonstrated moderate microsatellite alterations, suggesting the involvement of MSI in esophageal tumorigenesis in a subset of the Indian population. MSI, defined as RER in at least two or more of the loci studied, was observed in ten of 30 (33%) patients. Twenty-two of 30 patients (73%) showed LOH at one or more loci, while 17 of the 30 patients (60%) showed RER in at least one of the loci studied. RER-positive patients showed a trend towards better prognosis when compared to RER-negative patients. MSI demonstrated a significant association with concomitant loss of p16 and pRb (p16-/pRb- phenotype) (P=0.046). Interestingly, we observed an inverse correlation between MSI and p53 mutations (P=0.03) suggesting that MSI may provide a p53-independent pathway for esophageal tumorigenesis in RER+ patients. MSI showed a trend towards longer survival and absence of distant organ metastasis (P=0.06). CONCLUSIONS The present study demonstrates the probable role of MSI in esophageal squamous cell carcinoma in the Indian population. Instability associated with the repetitive sequences--the revealing marks of loss of DNA replication fidelity may serve as an indicator of predisposition to esophageal cancer.
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Affiliation(s)
- R Mathew
- Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
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Seenu V, Pal H, Chattopadhyay TK. Quality of life after total oesophagectomy for oesophageal cancer. Trop Gastroenterol 2001; 22:7-13. [PMID: 11398254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- V Seenu
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India
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Ralhan R, Arora S, Chattopadhyay TK, Shukla NK, Mathur M. Circulating p53 antibodies, p53 gene mutational profile and product accumulation in esophageal squamous-cell carcinoma in India. Int J Cancer 2000. [PMID: 10709097 DOI: 10.1002/(sici)1097-0215(20000315)85:6<791::aid-ijc9>3.0.co;2-k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Esophageal cancer (EC) in the Indian population presents in advanced stages with poor prognosis and warrants the identification of a non-invasive marker for early detection and better prognostic assessment. We have previously reported high prevalence of p53 protein accumulation in esophageal squamous-cell carcinomas (ESCCs). The present study was designed to determine (i) if esophageal cancer patients elicit a humoral immune response to intra-tumoral p53 protein accumulation and (ii) their relationship with p53 gene mutations. The goal was to compare the cellular events, p53 protein accumulation and gene mutations with the presence of serum anti-p53 antibodies (p53-Abs) and to assess the utility of serological p53-Ab analysis as a surrogate marker for p53 alterations in esophageal cancer. A high prevalence of circulating p53-Abs was observed in 36 of 60 (60%) ESCC patients. In a subset of 44 ESCCs, exons 5-9 of the p53 gene were examined for mutations by PCR and direct sequencing of PCR products. Mutational data have been correlated with p53-Abs and p53 protein accumulation in ESCCs. Circulating p53-Abs in ESCC patients were significantly associated with intra-tumoral p53 protein accumulation (p=0.0005). A strong correlation observed between humoral immune response against p53 protein, missense gene mutations and protein accumulation warrants the application of serological p53-Abs as a non-invasive surrogate marker in screening high-risk populations for early detection of malignancy.
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Affiliation(s)
- R Ralhan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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15
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Ralhan R, Arora S, Chattopadhyay TK, Shukla NK, Mathur M. Circulating p53 antibodies, p53 gene mutational profile and product accumulation in esophageal squamous-cell carcinoma in India. Int J Cancer 2000. [PMID: 10709097 DOI: 10.1002/(sici)1097-0215(20000315)85:6%3c791::aid-ijc9%3e3.0.co;2-k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Esophageal cancer (EC) in the Indian population presents in advanced stages with poor prognosis and warrants the identification of a non-invasive marker for early detection and better prognostic assessment. We have previously reported high prevalence of p53 protein accumulation in esophageal squamous-cell carcinomas (ESCCs). The present study was designed to determine (i) if esophageal cancer patients elicit a humoral immune response to intra-tumoral p53 protein accumulation and (ii) their relationship with p53 gene mutations. The goal was to compare the cellular events, p53 protein accumulation and gene mutations with the presence of serum anti-p53 antibodies (p53-Abs) and to assess the utility of serological p53-Ab analysis as a surrogate marker for p53 alterations in esophageal cancer. A high prevalence of circulating p53-Abs was observed in 36 of 60 (60%) ESCC patients. In a subset of 44 ESCCs, exons 5-9 of the p53 gene were examined for mutations by PCR and direct sequencing of PCR products. Mutational data have been correlated with p53-Abs and p53 protein accumulation in ESCCs. Circulating p53-Abs in ESCC patients were significantly associated with intra-tumoral p53 protein accumulation (p=0.0005). A strong correlation observed between humoral immune response against p53 protein, missense gene mutations and protein accumulation warrants the application of serological p53-Abs as a non-invasive surrogate marker in screening high-risk populations for early detection of malignancy.
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Affiliation(s)
- R Ralhan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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16
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Abstract
Esophageal cancer (EC) in the Indian population presents in advanced stages with poor prognosis and warrants the identification of a non-invasive marker for early detection and better prognostic assessment. We have previously reported high prevalence of p53 protein accumulation in esophageal squamous-cell carcinomas (ESCCs). The present study was designed to determine (i) if esophageal cancer patients elicit a humoral immune response to intra-tumoral p53 protein accumulation and (ii) their relationship with p53 gene mutations. The goal was to compare the cellular events, p53 protein accumulation and gene mutations with the presence of serum anti-p53 antibodies (p53-Abs) and to assess the utility of serological p53-Ab analysis as a surrogate marker for p53 alterations in esophageal cancer. A high prevalence of circulating p53-Abs was observed in 36 of 60 (60%) ESCC patients. In a subset of 44 ESCCs, exons 5-9 of the p53 gene were examined for mutations by PCR and direct sequencing of PCR products. Mutational data have been correlated with p53-Abs and p53 protein accumulation in ESCCs. Circulating p53-Abs in ESCC patients were significantly associated with intra-tumoral p53 protein accumulation (p=0.0005). A strong correlation observed between humoral immune response against p53 protein, missense gene mutations and protein accumulation warrants the application of serological p53-Abs as a non-invasive surrogate marker in screening high-risk populations for early detection of malignancy.
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Affiliation(s)
- R Ralhan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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Azmi S, Dinda AK, Chopra P, Chattopadhyay TK, Singh N. Bcl-2 expression is correlated with low apoptotic index and associated with histopathological grading in esophageal squamous cell carcinomas. Tumour Biol 2000; 21:3-10. [PMID: 10601836 DOI: 10.1159/000030105] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to examine the relationship between apoptosis, protein expression of apoptosis mediator and inhibitor genes p53 and bcl-2 and various histopathological grades of squamous cell carcinoma of the esophagus. Apoptotic index was evaluated in thirty human esophageal squamous cell carcinomas and adjoining normal tissue by terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL). Protein expression of bcl-2 and p53 was measured by immunohistochemical staining of cryocut sections and Western blotting. Apoptototic cells were seen mainly around areas of keratinization and the apoptotic index was highest in well-differentiated squamous cell carcinomas. High Bcl-2 expression correlated inversely with the apoptotic index. p53 protein expression did not correlate with the grade of the tumor or the apoptotic index. We propose that deregulation of apoptosis contributes to the pathogenesis of esophageal squamous cell carcinoma.
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Affiliation(s)
- S Azmi
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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Lisgarten JN, Chattopadhyay TK, Pitts JE, Palmer RA, Reynolds CD, Dao-Thi MH, Van Driessche E, Beeckmans S. Crystallization of Helix pomatia agglutinin (HPA), a protein from the edible snail. Acta Crystallogr D Biol Crystallogr 1999; 55:1903-5. [PMID: 10531490 DOI: 10.1107/s0907444999007957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Crystals of Helix pomatia agglutinin (HPA) have been grown by the hanging-drop technique using polyethylene glycol as the precipitant at 293 K. Over a period of one to two weeks the crystals grew to maximum dimensions of 0.10 x 0.05 x 0.02 mm. The crystals belong to space group P6(3)22, with unit-cell dimensions a = b = 63.3, c = 105. 2 A and Z = 12 identical monomers of M(r) = 13 kDa, aggregating into two 78 kDa hexameric protein molecules per unit cell, each with symmetry 32 (D(3)). The diffraction pattern extends to 3.6 A at 293 K.
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Affiliation(s)
- J N Lisgarten
- Department of Crystallography, Birkbeck College, Malet Street, London WC1E 7HX, England
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Chattopadhyay TK, Lisgarten JN, Brechtel R, Rüdiger H, Palmer RA. Crystallization of Pleurotus ostreatus (oyster mushroom) lectin. Acta Crystallogr D Biol Crystallogr 1999; 55:1589-90. [PMID: 10489455 DOI: 10.1107/s0907444999007945] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Crystals of Pleurotus ostreatus (oyster mushroom) lectin have been grown by the hanging-drop technique using ammonium sulfate as the precipitant at 293 K. Over a period of between two and three weeks, crystals of hexagonal bipyramidal morphology grew to maximum dimensions of 0.2 x 0.2 x 0.5 mm. The crystals belong to space group P6(1)22 or P6(5)22, with unit-cell parameters a = b = 155.9, c = 149. 8 A, V = 3153078 A(3), Z = 12 (assuming 50% solvent), and diffract to 4.1 A at 293 K.
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Affiliation(s)
- T K Chattopadhyay
- Department of Crystallography, Birkbeck College, Malet Street, London WC1E 7HX, England
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Sharma ND, Balasubramanian S, Khanna N, Bahadur S, Chattopadhyay TK, Singh N. Telomerase activity in Indian patients with carcinomas of the aerodigestive tract. Tumour Biol 1999; 20:225-32. [PMID: 10393533 DOI: 10.1159/000030067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The activation of telomerase, a ribonucleoprotein maintaining telomeric length, might represent an additional required event in the multigenetic process of tumorigenesis in human cancer. To investigate whether telomerase activity is a prerequisite or a useful indicator of malignant potential, we assayed the enzyme in squamous cell carcinomas and tried to observe any correlation with clinical staging and histopathological grading. We have studied telomerase activity in 23 samples of squamous cell carcinomas of the aerodigestive tract and in 22 corresponding samples of adjoining tissues using the telomerase repeat amplification assay. Telomerase activity was detected in 100% of the tumor samples studied. The telomerase activity increased with tumor grading, but was not statistically significant. Low levels of enzyme activity were also detected in 60.86% of the adjoining normal tissue samples. Reactivation of telomerase may play an important role in the carcinogenesis of aerodigestive tract tumors. Detection of enzyme activity in the adjoining normal tissue is suggestive of microinvasion of tumor cells and/or early activation of telomerase in the progression towards cancer, before possible pathological identification.
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Affiliation(s)
- N D Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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21
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Parshad R, Singh RK, Kumar A, Gupta SD, Chattopadhyay TK. Adenocarcinoma of distal esophagus and gastroesophageal junction: long-term results of surgical treatment in a North Indian Center. World J Surg 1999; 23:277-83. [PMID: 9933700 DOI: 10.1007/pl00013179] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This retrospective study reports our experience managing 78 patients with adenocarcinoma of the esophagus and gastroesophageal junction operated between January 1982 and December 1996. Altogether 18 patients presented with stage I and II disease, and 60 patients had stage III and IV disease at presentation; 56 patients (71.8%) were found to have resectable disease. Of these, transhiatal esophagectomy was possible in 51 patients. Transthoracic esophagectomy was done in 3 patients, and a left thoracoabdominal approach was used in 2 patients. The stomach was used as conduit in 50 patients and the colon in 6 patients. Twenty-two patients were found to have unresectable lesions at laparotomy and underwent various palliative procedures. Overall operative mortality was 6.3%. Mortality in the resectable group was only 3.6%. Follow-up ranges from 3 to 128 months, with four patients lost to follow-up at 1, 6, 8, and 10 months. The 5-year survival of the whole group according to Kaplan and Meier survival analysis was 21.27% with a median survival of 13.48 months. Univariate analysis using the log-rank test revealed stage of the disease and resectability to be significant predictors of survival. On multivariate analysis, curative resection appeared to be the most significant predictor of survival in patients undergoing resection.
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Affiliation(s)
- R Parshad
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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22
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Kumar A, Mohan A, Sharma SK, Kaul V, Parshad R, Chattopadhyay TK, Pande JN. Video assisted thoracoscopic surgery (VATS) in the diagnosis of intrathoracic pathology: initial experience. Indian J Chest Dis Allied Sci 1999; 41:5-13. [PMID: 10639759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
We report our experience with the use of video-assisted thoracoscopic surgery [VATS] in the diagnosis of intrathoracic disease of unknown origin. In the last two years, 32 patients (18 males) underwent this procedure for diagnostic purposes. Of them, 18 patients had lung pathology, eight mediastinal and six pleural disease. All attempts at achieving a tissue diagnosis were unrewarding. In all of them, diagnostic thoracotomy was being contemplated to procure tissue for histopathological diagnosis. Diagnostic thoracoscopy was successful in providing tissue diagnosis in all the patients with lung disease; seven of the eight patients with mediastinal pathology and five of the six patients with pleural lesions. Diagnostic thoracoscopy was associated with minimal morbidity, short hospital stay, better cosmetic result and quicker return to work as compared to conventional thoracotomy. We conclude that video-assisted thoracoscopy is an excellent diagnostic tool to confirm tissue diagnosis in patients with undiagnosed chest diseases.
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Affiliation(s)
- A Kumar
- Department of Surgery, All India Institute of Medical Sciences, New Delhi.
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23
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Kumar M, Prashad R, Kumar A, Sharma R, Acharya SK, Chattopadhyay TK. Relative merits of ultrasonography, computed tomography and cholangiography in patients of surgical obstructive jaundice. Hepatogastroenterology 1998; 45:2027-32. [PMID: 9951858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Fifty consecutive patients with surgical obstructive jaundice were evaluated prospectively with ultrasonography (US), computed tomographic scans (CT scan) and cholangiography-percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangio-pancreaticography (ERCP). The diagnostic accuracy of ultrasound in defining the level of obstruction was 86% as compared to 86% and 94.8% for CT scan and cholangiography, respectively. To measure the etiology of the obstruction, the accuracy of ultrasound, CT scan and cholangiography were 84%, 86% and 75%, respectively. The sensitivity of CT scans and cholangiography in the diagnosis of choledocholithiasis was 100%, 81.8% and 90%, respectively, whereas specificity was 97%, 100% and 100%, respectively. Sensitivity for a diagnosis of malignant disease was 100% for both US and CT scans whereas specificity was 90% and 81%, respectively. Ultrasonography as a single radiological investigation is sufficient in the evaluation of the majority of patients with surgical obstructive jaundice. CT scan and cholangiography should be done only when US gives equivocal findings or if concomitant therapeutic procedures like basketing and stenting are also planned.
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Affiliation(s)
- M Kumar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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24
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Sinha S, Padhy AK, Chattopadhyay TK. Dumping syndrome in the intra-thoracic stomach. Trop Gastroenterol 1997; 18:131-133. [PMID: 9385862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Thirty seven patients who survived at least 6 months after oesophagectomy and cervical oesophagogastrostomy for benign and malignant diseases of the oesophagus were evaluated for dumping syndrome. Twenty two of these patients had a pyloroplasty and fifteen had no drainage procedure. All these patients were subjected to a dumping provocation test. Evidence of dumping was noted in four patients, all having a pyloroplasty. Clinically, these four patients had mild symptoms which improved with dietary adjustment. We conclude that dumping does occur following thoracic transposition of the stomach and seems to occur more in patients with pyloroplasty than those without it.
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Affiliation(s)
- S Sinha
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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25
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Sinha S, Sharma DC, Miri B, Gupta V, Chattopadhyay TK. Splenic abscess--case report and review of literature. Trop Gastroenterol 1997; 18:134-135. [PMID: 9385863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Isolated splenic abscess is a rarity and remains a diagnostic dilemma. The presentation is nonspecific and diagnosis is often delayed. We present a case which had roentgenographic signs suggestive of splenic suppuration at admission. Of particular interest was the isolation of Salmonella paratyphi in this patient. Antibiotic therapy alone is insufficient and splenectomy remains the treatment of choice. The literature on splenic abscess is briefly reviewed.
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Affiliation(s)
- S Sinha
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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26
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Srivastava M, Kapil U, Chattopadhyay TK, Shukla NK, Sundaram KR, Sekaran G, Nayar D. Nutritional factors in carcinoma oesophagus: a case-control study. Asia Pac J Clin Nutr 1997; 6:96-98. [PMID: 24394709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A case control study was conducted on 170 patients with oesophageal cancer. An equal number of healthy persons (attendants of patients) were included in the study as controls to identify nutritional risk factors for oesophageal cancer. The majority (55%) of the patients were of low socio-economic status and from Northern parts of India. They were predominantly male (66%). Increase in risk was associated with low consumption of green leafy vegetables, other vegetables and fresh fruits, milk and milk products. Heavy use of spices and use of very hot tea or food were also associated with increased risk. Differences in the past dietary consumption patterns of oesophageal cancer patients and controls suggest a role for nutritional factors in oesophageal cancer pathogenesis. At the same time substance abuse by cigarette or bidi smoking, alcohol consumption, paan and tobacco chewing also increased risk. After multivariate analysis, green leafy vegetables, other vegetables spices, bidi usage and fresh fruits provided protection against oesophageal cancer.
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Affiliation(s)
- M Srivastava
- Department of Human Nutrition and Department of Surgery, New Delhi, India
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27
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Sinha S, Chattopadhyay TK. Short segment oesophago-cardiomyotomy for achalasia cardia. Trop Gastroenterol 1997; 18:34-6. [PMID: 9197174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Over a seven year period, 25 patients of achalasia cardia underwent a transabdominal short segment oesophago-cardiomyotomy. There was no operative mortality. Two patients had a mucosal tear, detected intraoperatively and promptly repaired. All patients were regularly followed up (range 1 to 7 years). Clinical results were excellent in 76%, good in 20% and fair in 4%. No patient developed reflux or required reoperation for residual dysphagia. We conclude that a transabdominal short segment oesophago-cardiomyotomy performed carefully is a safe and effective procedure in the treatment of achalasia.
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Affiliation(s)
- S Sinha
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
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28
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Manjari R, Padhy AK, Chattopadhyay TK. Emptying of the intrathoracic stomach using three different pylorus drainage procedures--results of a comparative study. Surg Today 1996; 26:581-5. [PMID: 8855488 DOI: 10.1007/bf00311660] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Patterns of gastric emptying in the vagotomized intrathoracic stomach (used for esophageal replacement) were studied using radioisotope techniques. Following esophagectomy and gastric mobilization, the patients were randomized into three groups: group 1, pyloroplasty; group 2, pyloromyotomy; and group 3, pylorus stretching. A total of 30 patients surviving the operation and who were still alive at least 3 months afterwards were included in this study. Gastric emptying (GE) was evaluated 6-8 weeks after the operation. The mean GE time for liquids was 3.3 +/- 2.7, 4.1 +/- 3.1, and 5.5 +/- 4.3 min in the three groups, respectively. The corresponding GE time for solids in the three groups was 9.9 +/- 5.1, 10.31 +/- 6.6, and 7.7 +/- 3.4 min. No statistical difference was observed in the GE in the three groups even though liquids tend to empty faster than solids. Clinically there was also no significant difference in their ability to tolerate normal meals. When evaluated for clinical evidence of altered GE (effect of vagotomy) there did not appear to be any significant differences between the three groups. It is therefore concluded that all pylorus drainage procedures behave in much the same way. Patients may develop some problems, but these disappear in due course after proper adjustments have been made in both posture and diet.
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Affiliation(s)
- R Manjari
- Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
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29
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Kataria R, Agarwala S, Mitra DK, Kaur G, Chattopadhyay TK, Bal CS, Menon PS. Primary hyperparathyroidism in children. Pediatr Surg Int 1996; 11:374-7. [PMID: 24057719 DOI: 10.1007/bf00497816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/1995] [Indexed: 11/27/2022]
Abstract
Primary hyperparathyroidism is an uncommon condition in childhood that is easily amenable to surgical treatment with excellent results. Pathologically, the parathyroid glands may show generalized hyperplasia or, more commonly, adenoma formation, the latter frequently being seen in adolescence. Two girls with solitary parathyroid adenomas and predominantly skeletal manifestations resembling rickets are reported, underlining the need to suspect and appropriately investigate these children. The literature on the subject is reviewed.
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Affiliation(s)
- R Kataria
- Department of Pediatric Surgery, All India Institute of Medical Sciences, 110029, New Delhi, India
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30
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Sharma AK, Sarda AK, Chattopadhyay TK, Kapur MM. The role of estimation of the ratio of preoperative serum thyroglobulin to the thyroid mass in predicting the behaviour of well differentiated thyroid cancers. J Postgrad Med 1996; 42:39-42. [PMID: 9715297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Although serum thyroglobulin (STg) is a useful tumour marker to detect the recurrence of tumour in well differentiated thyroid carcinoma, it has as yet not been reported to be of value in predicting the behaviour of thyroid cancer. In the present study of 20 patients, the measurement of preoperative Stg/thyroid mass has been utilised to find out Tg synthesizing capacity of the tumour. This ratio was significantly higher in the patients with follicular variety than in papillary thyroid carcinoma. It was significantly higher in the metastasis group than in the group of patients without metastasis. The patients with functioning metastasis had a higher than average value of this 'ratio' than those with non functioning metastasis, though the difference was not statistically significant. Despite the limitation of a small number of patients included in this study, it is possible to highlight the possible utility of preoperative Stg estimation as a tumour marker in categorization of the patients of carcinoma of the thyroid gland.
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Affiliation(s)
- A K Sharma
- Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
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31
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Chattopadhyay TK, Sinha S, Singh MK, Pandhy AK, Shoushtari MH. Structural and functional aspects of the thoracic stomach. Trop Gastroenterol 1996; 17:55-8. [PMID: 8783978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The acid secretory and emptying function of the thoracic stomach was evaluated in 10 patients, following total oesophagectomy and gastric pull-up for oesophageal cancer. All patients had a Heinecke Mickulicz pyloroplasty. Endoscopic features and histological review of endoscopic biopsies were also studied in these patients. Acid secretion was higher in those with prolonged emptying. This was however, not statistically significant. Gastritis was more severe in those with prolonged emptying. Endoscopic diagnosis of gastritis was found unreliable while histopathology of endoscopic biopsy gave definite evidence of gastritis.
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Affiliation(s)
- T K Chattopadhyay
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
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32
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Babu M, Mathur M, Gupta SD, Chattopadhyay TK. Prognostic significance of argyrophilic nucleolar organizer regions (AGNOR) in oesophageal cancer. Trop Gastroenterol 1996; 17:57-60. [PMID: 8693588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AgNOR (Argyrophilic nucleolar organiser region) has been shown in recent times, to have value in knowing the prognosis of carcinoma oesophagus. We have evaluated the significance of AgNOR in oesophageal cancer with reference to prognosis following treatment. Fifty patients of histologically proven squamous cell carcinoma of the oesophagus were studied. Following oesophagectomy the specimens removed were evaluated for AgNOR number. Of the resected specimens, 25 (50%) had an AgNOR count < or = 3.0, 18 (36%) had an AgNOR count of more than 3 per nucleus and in the remaining 7 cases, AgNOR number was not quantifiable due to the total absence of tumour tissue in the postoperative specimen due to preoperative radiotherapy. When followed up for an average period of 25 months (3 to 47 months), it was seen that patients with AgNOR count of < or = 3.0 per nucleous had a similar mean survival (30.39 +/- 3.29 months) as those with counts > 3.0 per nucleus (27.80 + 3.33 months). The survival in the seven patients in whom no tumour was present following preoperative radiotherapy, was 30.30 +/- 2.42 months. An analysis was done for the presence of change in the AgNOR count before and after radiotherapy in twenty eight case of carcinoma oesophagus treated with preoperative radiotherapy. It was found that the counts on an average were lower in patients after radiotherapy (2.89 +/- 1.04 per nucleus), than before radiotherapy (3.17 +/- 9.69). This was found in 24 cases, while the remaining 4 cases showed no change in count after radiotherapy. This suggested that radiotherapy caused a reduction in AgNOR counts. Mean survival in those with decreased count after radiotherapy was 33.65 (+/- 3.35) months. Since the AgNOR counting is a simple method and can be applied to paraffin embedded section, estimation of the AgNOR number may help in determination of prognosis in patients with oesophageal carcinoma. Preoperative radiotherapy seems to decrease AgNOR count with improved survival. These observations need however, to be reproduced with a larger sample size.
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Affiliation(s)
- M Babu
- Department of Surgery and Pathology, All India Institute of Medical Sciences, New Delhi
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Abstract
A case of recurrent massive haemoptysis in whom primary actinomycotic lung abscess was diagnosed following right pneumonectomy is reported.
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Affiliation(s)
- A Mohan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Goel AK, Sinha S, Chattopadhyay TK. Role of gastrografin study in the assessment of anastomotic leaks from cervical oesophagogastric anastomosis. Aust N Z J Surg 1995; 65:8-10. [PMID: 7818433 DOI: 10.1111/j.1445-2197.1995.tb01738.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Gastric pull-up with cervical oesophagogastric anastomosis is a common procedure after oesophageal resection. Contrast studies are used by many surgeons for detection of anastomotic leaks but may be unnecessary. A prospective study was undertaken to compare gastrografin study and test feeding using water for detection of cervical anastomotic leaks. In 25 patients, gastrografin study showed three leaks, two of which were clinically silent and patients did not have any problems. One patient had aspiration of contrast and the study could not be completed. Two of the leaks detected clinically were missed by contrast study (one because of an incomplete study and the other was a satisfactory study). Delayed leaks occurred in two patients. All leaks healed spontaneously. A contrast study may thus be unnecessary for evaluation of a cervical oesophagogastric anastomosis and can be replaced with the simpler and safer technique of 'test feeding' using water.
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Affiliation(s)
- A K Goel
- Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), New Delhi
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Abstract
A middle-aged man with a 2-month history of lower abdominal pain was found to have a large left-sided abdominal lump. Radiological investigations (barium enema, ultrasound, and computed tomography scan) revealed a mass lesion in the area of the descending colon, the sigmoid colon, and the rectum. Flexible sigmoidoscopy showed only mucosal edema and luminal narrowing. At laparotomy, a diffuse thickening of both the descending and sigmoid mesocolon extending into the mesorectum was seen, which suggested an inflammatory pathology. A left hemicolectomy with Hartmann's procedure was performed. After obtaining a histopathological diagnosis of liposarcoma of the mesocolon, an abdominoperineal resection of the rectum was done. The patient was advised to undergo postoperative radiotherapy but he did not comply and was thereafter lost to follow-up.
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Affiliation(s)
- A K Goel
- Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), New Delhi
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Goel AK, Sinha S, Kumar A, Chattopadhyay TK. Spontaneous hemoperitoneum due to rupture of hepatocellular carcinoma. Trop Gastroenterol 1993; 14:152-5. [PMID: 8171731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Spontaneous rupture with hemoperitoneum is one of the atypical modes of presentation of hepatocellular carcinoma (HCC), common in the orient (8-14% cases) but reported only once from India. Another case is being reported here. Hemostasis can be achieved by transcatheter hepatic artery ligation, intralesional alcohol injection, microwave application, curettage with suturing or gauze packing. Resectional surgery, preferably at a second stage, has the best long term outcome. Prognosis remains poor with few long term survivors.
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Affiliation(s)
- A K Goel
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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38
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Bouckaert J, Maes D, Lisgarten JN, Chattopadhyay TK, Palmer RA, Mazid MA, Gazi DM. Structures of chromium(III) cyclam complexes. 5. Structure of trans-dichloro(1,4,8,11-tetraazacyclotetradecane)chromium(III) isothiocyanate. Acta Crystallogr C 1993. [DOI: 10.1107/s010827019300054x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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39
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Kumar A, Lal BK, Chattopadhyay TK. Hydatid disease of the liver--non surgical options. J Assoc Physicians India 1993; 41:437-8, 443. [PMID: 8300491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- A Kumar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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Abstract
Bile acid concentration and symptoms were evaluated in 24 patients after total oesophagectomy and gastric pull-up. Patients were randomly allocated to receive pyloroplasty or not. After operation all were followed for a minimum of 6 months. Bile acid concentration in the gastric juice was estimated. The mean(s.d.) bile acid concentration 6 months after surgery was similar in patients with and without pyloroplasty (34.9(30.1) and 25.0(24.2) mg/dl respectively). Postprandial discomfort and bilious eructations were the two most commonly observed symptoms in both groups. Other features noted were vomiting, anaemia and anorexia. These did not however seem to be related to intragastric bile acid concentration of individual patients in either group and occurred irrespective of whether pyloroplasty was performed or not.
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Affiliation(s)
- T K Chattopadhyay
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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41
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Chattopadhyay TK, Palmer RA, Lisgarten JN. X-ray structural and potential energy studies on zentropil (5,5-diphenyl-2,4-imidazolidine dione). ACTA ACUST UNITED AC 1993. [DOI: 10.1007/bf01195449] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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42
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Affiliation(s)
- A Kumar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Dehli
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Sinha S, Goel AK, Kumar A, Chattopadhyay TK. Priapism in malaria. J Assoc Physicians India 1992; 40:769. [PMID: 1307550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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44
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Chattopadhyay TK, Palmer RA, Lisgarten JN, Wyns L, Gazi DM. Structures of chromium(III) cyclam complexes. 4. Structure of trans-bromochloro(1,4,8,11-tetraazacyclotetradecane)chromium(III) bromide displaying structural enantiomorphism with the dibromo complex. Acta Crystallogr C 1992. [DOI: 10.1107/s0108270192000039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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45
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Kumar A, Kataria R, Chattopadhyay TK, Karak PK, Tandon RK. Biliary peritonitis secondary to perforation of common bile duct: an unusual presentation of chronic calcific pancreatitis. Postgrad Med J 1992; 68:837-9. [PMID: 1461860 PMCID: PMC2399518 DOI: 10.1136/pgmj.68.804.837] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Common bile duct perforation causing biliary peritonitis is an unusual entity and a pancreatic calculus causing this perforation is all the more rare, and to our knowledge has not been reported previously. Such an unusual presentation of chronic calcific pancreatitis is herein reported.
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Affiliation(s)
- A Kumar
- Department of Surgery, All India Institute of Medical Sciences, New Delhi
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Abstract
Congenital tracheo-oesophageal fistula (TEF) is rare in adults. Patients who present with repeated attacks of chest infection since birth or cough, choking and cyanosis during feeding should be investigated for TEF. It should be possible to detect all cases of tracheo-oesophageal fistulae using bronchoscopy, oesophagoscopy and CT either singly or in combination. These investigations also help in deciding on the route of exploration and the type of surgery. Disconnection of the abnormal fistulous tract brings dramatic relief of symptom and prevents further pulmonary damage.
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Affiliation(s)
- S Ramaswamy
- Department of Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
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47
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Kumar A, Lal BK, Chattopadhyay TK. Hydatid disease of the liver surgical options. Trop Gastroenterol 1992; 13:102-5. [PMID: 1488795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- A Kumar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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Kumar A, Ahuja MM, Chattopadhyay TK, Padhy AK, Gupta AK, Kapila K, Goel AK, Karmarker MG. Fine needle aspiration cytology, sonography and radionuclide scanning in solitary thyroid nodule. J Assoc Physicians India 1992; 40:302-6. [PMID: 1483988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
One hundred and ninety three consecutive patients with solitary thyroid nodule (STN), with a mean age of 36.0 +/- 12.8 years and male to female ratio of 5.6:1, were studied. Ninety five percent of patients came from iodine deficient regions. Seventy two percent presented for local neck swelling, 12.4% for hyperthyroid state and in 7.7% STN was discovered incidentally. Scintigraphically, 77.7% of nodules were cold, 12.4% hot and 8.5% warm. Sonographic evaluation did not reveal any characteristic echotexture diagnostic of malignancy, but detected clinically nonpalpable accessory nodules in 20.6% of patients. Fine needle aspiration cytology was positive for malignancy in 6.2% of patients. Features of follicular and Hurthle cell neoplasm were seen in 12.9% of aspirates. Eighty eight (45.6%) STN were resected surgically. Histologically, there was one false positive and one false negative aspirate and a case of parathyroid adenoma on aspiration proved to be parathyroid carcinoma on histology.
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Affiliation(s)
- A Kumar
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi
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Singh BP, Kumar A, Chattopadhyay TK. Intussuscepting ileal hemangioma with perforation. Indian J Gastroenterol 1992; 11:94-5. [PMID: 1428044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A rare case of solitary intussuscepting capillary hemangioma in the distal ileum with perforation and peritonitis is presented. The diagnosis was made only at surgery for presumed acute intestinal obstruction.
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Affiliation(s)
- B P Singh
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
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Chattopadhyay TK, Gupta S, Kumar A, Kapoor VK. Peroperative cholangiogram--routine or selective results of a prospective study. Trop Gastroenterol 1992; 13:75-7. [PMID: 1413103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Peroperative cholangiography (POC) performed as a routine during cholecystectomy for cholelithiasis was evaluated in 102 patients. POC was normal 93 patients. Nine patients had abnormal POCs: 5 were true positive--CBD stones (4) and sphincteric fibrosis (1): 4 were false positive--air bubbles (2) and sphincteric spasm (2). Preoperative indication of CBD stones were present in 12 patients-5 of these had abnormal POC (4 true positive and 1 false positive). CBD exploration was avoided in 7 patients with normal POC. Ninety patients did not have any preoperative indication of CBD stones-4 of these had abnormal POC (1 true positive and 3 false positive). None of the patients with a normal POC had any clinical evidence of residual stones on follow up for one year. POC did not help in any case to delineate biliary ductal anatomy. Routine POC during cholecystectomy should be abandoned and should be performed selectively in patients suspected to have CBD stones only to avoid a negative CBD exploration.
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Affiliation(s)
- T K Chattopadhyay
- Department of Surgery, All India Institute of Medical Sciences, New Delhi
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