Algorithmic Approach for Safe Optimization and Surgical Planning in Hilar Blocks- Single Center Experience

( Rohan Jagat Chaudhary ),( V. Sagar Puppala ),( Thiagarajan S. ),( Prashant Bhangui ),( Amit Rastogi ),( Tarun Piplani ),( S. Baijal ),( V. Vohra ),( Arvinder Singh Soin ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: To study the outcomes of our algorithmic-approach for safe optimisation and surgical planning in patients with Hilar- Block. Methods: Retrospective-analysis of prospectively-maintained database of patients undergoing surgery for hilar-block from Jan2013-May2019 was done.Our approach includes Imaging, Biliary-decompression, Future-liver-remnant-Volume(FLR)augmentation based on CT-Volumetry and FLR-function assessment. Results: 45cases of hilar-blocks underwent resections.32were Hilar-cholangiocarcinoma,5-Intrahepatic-cholangiocarcinoma, 6-Ca-Gall-Bladder with hilar-block,2-IgG4-sclerosing- cholangitis-presenting as malignant-masquerade. The mean age was57±12years and 30(67%) were males. On MRCP, hilar-blocks types 2,3a,3b,4 were 3,15,17,10 respectively. Pre-operative biliary-decompression of FLR were done in 21cases[19 PTBD(Percutaneous-Transhepatic-biliary-drainage)/ 2 EBD(Endoscopic-biliary-drainage)]. Additional PTBD were done in 2 cases for inadequate fall in SB, and 3 for cholangitis. The mean SB(Serum-Total-Bilirubin) at presentation was 9.57±5.58mg/dl. The rate of fall of S.bilirubin was faster in patients < 50yrs of age and type-3 hilar-blocks than in type-4 hilar- blocks. PVE was performed in 14cases and FLR hypertrophy of 11.3± 3.03%was achieved.The quality of FLR was assessed with LAI(n=39),fibroscan(n=17), ICGR15(n=12), HVPG (n=35), and selective-remnant-biopsy(n=14,if HVPG >10 mm Hg,ICGR15> 15%, or in-suspected steatosis or fibrosis).After optimization, surgical procedures done were Right-Hepatectomy(7), Right-TriSectorectomy(7), Extended-Right-Hepatectomy(9), Left-Hepatectomy(6),Extended-Left-Hepatectomy(5), Left-Trisectorectomy( 8) and Bile-duct-excision-alone(3).Eleven patients required concomitant vascular-resections and reconstructions(- 8portal-vein-resections, 2 hepatic-arterial-resection,1both) to obtain R0. R0 and R1 resections were achieved in 42(93%) and 3 patients. Clavien-Dindo-Grade3/4 complications were 22.2%(n=10). 8(18%)patients had Post-Hepatectomy-Liver- Failure.Overall operative-mortality was 5/45(11.1%). Conclusions: Our algorithmic approach for safe optimization by preoperative-biliary-drainage, FLR-augmentation and FLR-functional- assessment have led to a high rate of R0 major liver resection and good outcomes in patients with hilar-blocks.Augmentation of FLR can also increase resectability in borderline resectable cases.

Numerical analysis of geocell reinforced ballast overlying soft clay subgrade

Saride, Sireesh,Pradhan, Sailesh,Sitharam, T.G.,Puppala, Anand J. Techno-Press 2013 Geomechanics & engineering Vol.5 No.3

Geotextiles and geogrids have been in use for several decades in variety of geo-structure applications including foundation of embankments, retaining walls, pavements. Geocells is one such variant in geosynthetic reinforcement of recent years, which provides a three dimensional confinement to the infill material. Although extensive research has been carried on geocell reinforced sand, clay and layered soil subgrades, limited research has been reported on the aggregates/ballast reinforced with geocells. This paper presents the behavior of a railway sleeper subjected to monotonic loading on geocell reinforced aggregates, of size ranging from 20 to 75 mm, overlying soft clay subgrades. Series of tests were conducted in a steel test tank of dimensions $700mm{\times}300mm{\times}700mm$. In addition to the laboratory model tests, numerical simulations were performed using a finite difference code to predict the behavior of geocell reinforced ballast. The results from numerical simulations were compared with the experimental data. The numerical and experimental results manifested the importance that the geocell reinforcement has a significant effect on the ballast behaviour. The results depicted that the stiffness of underlying soft clay subgrade has a significant influence on the behavior of the geocell-aggregate composite material in redistributing the loading system.

Expiration-Day Effects on Index Futures: Evidence from Indian Market

Ravi Kumar SAMINENI,Raja Babu PUPPALA,Ramesh MUTHANGI,Syamsundar KULAPATHI 한국유통과학회 2020 The Journal of Asian Finance, Economics and Busine Vol.7 No.11

Nifty Bank Index has started trading in futures and options (F&O) segment from 13th June 2005 in National Stock Exchange. The purpose of the study is to enhance the literature by examining expiration effect on the price volatility and price reversal of Underlying Index in India. Historical data used for the current study primarily comprise of daily close prices of Nifty Bank which is the only equity sectoral index in India which is traded in derivatives market and its Future contract value is derived from the underlying CNX Bank Index during the period 1st January 2010 till 31st March 2020. To check stationarity of the data, Augmented Dicky Fuller test was used. The study employed ARMA- EGARCH model for analysing the data. The empirical results revealed that there is no effect on the mean returns of underlying Index and EGARCH (1,1) model furthermore shows there is existence of leverage effect in the Bank Index i.e., negative shocks causes more fluctuations in the Index than positive news of similar magnitude. The outcome of the study specifies that there is no effect on volatility on the underlying sectoral index due to expiration days and also observed no price reversal effect once the expiration days are over.

Evaluation of Geotechnical Parameters of a Lagoonal Clay Deposit in Jiangsu Lixia River Area of China by Seismic Piezocone Tests

Guojun Cai,Songyu Liu,Anand J. Puppala 대한토목학회 2016 KSCE JOURNAL OF CIVIL ENGINEERING Vol.20 No.5

The use of the Seismic Piezocone Test (SCPTU) in geotechnical site investigation offers field assessment on stratigraphy and soil behavior. Compared with some traditional investigation methods such as drilling, sampling and field inspecting method or laboratory test procedures, SCPTU can greatly accelerate the field work and hereby reduce corresponding operation cost. The results of a site investigation on the soft, normally to slightly overconsolidated, Lixia River lagoonal clay deposit underlying several expressway lines, including a seismic piezocone penetration test, undisturbed sampling from an adjacent borehole, and laboratory testing, are reported. The determination of soil profile and the main geotechnical properties is facilitated by the use of seismic piezocone penetration test that can provide up to four independent reading with depth from a single sounding. The coupled use of normalized cone resistance and pore pressure parameter provides a simple and quick soil classification for highly interbedding of Lixia River lagoon ground. Comparison of the results reveals the validity of SCPTU tests to interpret the engineering properties of Lixia River lagoonal clay. These data will also be particularly useful for future local construction work.

A Study on Unfolding Asymmetric Volatility: A Case Study of National Stock Exchange in India

Ravi Kumar SAMINENI,Raja Babu PUPPALA,Syamsundar KULAPATHI,Shiva Kumar MADAPATHI 한국유통과학회 2021 The Journal of Asian Finance, Economics and Busine Vol.8 No.4

The study aims to find the asymmetric effect in National Stock Exchange in which the Nifty50 is considered as proxy for NSE. A return can be stated as the change in value of a security over a certain time period. Volatility is the rate of change in security value. It is an arithmetical assessment of the dispersion of yields of security prices. Stock prices are extremely unpredictable and make the investment in equities risky. Predicting volatility and modeling are the most profuse areas to explore. The current study describes the association between two variables, namely, stock yields and volatility in equity market in India. The volatility is measured by employing asymmetric GARCH technique, i.e., the EGARCH (1,1) tool, which was used in building the study. The closing prices of Nifty on day-to-day basis were used for analysis from the period 2011 to 2020 with 2,478 observations in the study. The model arrests the lopsided volatility during the mentioned period. The outcome of asymmetric GARCH model revealed the subsistence of leverage effect in the index and confirms the impact of conditional variance as well. Furthermore, the EGARCH technique was evidenced to be apt in seizure of unsymmetrical volatility.

Chemopreventive Effects of Korean Angelica versus Its Major Pyranocoumarins on Two Lineages of Transgenic Adenocarcinoma of Mouse Prostate Carcinogenesis

Tang, Su-Ni,Zhang, Jinhui,Wu, Wei,Jiang, Peixin,Puppala, Manohar,Zhang, Yong,Xing, Chengguo,Kim, Sung-Hoon,Jiang, Cheng,Lü,, Junxuan American Association for Cancer Research 2015 CANCER PREVENTION RESEARCH Vol.8 No.9

<P>We showed previously that daily gavage of <I>Angelica gigas</I> Nakai (AGN) root ethanolic extract starting 8 weeks of age inhibited growth of prostate epithelium and neuroendocrine carcinomas (NE-Ca) in the transgenic adenocarcinoma of mouse prostate (TRAMP) model. Because decursin (D) and its isomer decursinol angelate (DA) are major pyranocoumarins in AGN extract, we tested the hypothesis that D/DA represented active/prodrug compounds against TRAMP carcinogenesis. Three groups of male C57BL/6 TRAMP mice were gavage treated daily with excipient vehicle, AGN (5 mg per mouse), or equimolar D/DA (3 mg per mouse) from 8 weeks to 16 or 28 weeks of age. Measurement of plasma and NE-Ca D, DA, and their common metabolite decursinol indicated similar retention from AGN versus D/DA dosing. The growth of TRAMP dorsolateral prostate (DLP) in AGN- and D/DA-treated mice was inhibited by 66% and 61% at 16 weeks and by 67% and 72% at 28 weeks, respectively. Survival of mice bearing NE-Ca to 28 weeks was improved by AGN, but not by D/DA. Nevertheless, AGN- and D/DA-treated mice had lower NE-Ca burden. Immunohistochemical and mRNA analyses of DLP showed that AGN and D/DA exerted similar inhibition of TRAMP epithelial lesion progression and key cell-cycle genes. Profiling of NE-Ca mRNA showed a greater scope of modulating angiogenesis, epithelial–mesenchymal transition, invasion–metastasis, and inflammation genes by AGN than D/DA. The data therefore support D/DA as probable active/prodrug compounds against TRAMP epithelial lesions, and they cooperate with non-pyranocoumarin compounds to fully express AGN efficacy against NE-Ca. <I>Cancer Prev Res; 8(9); 835–44. ©2015 AACR</I>.</P>

Characterization of Spatial Variability of CPTU Data in a Liquefaction Site Improved by Vibro-compaction Method

Guojun Cai,Jun Lin,Songyu Liu,Anand J. Puppala 대한토목학회 2017 KSCE JOURNAL OF CIVIL ENGINEERING Vol.21 No.1

Vibro-compaction is a ground improvement technique in which the weak or loose soil deposits are compacted by the vibrating probe or vibroflot penetration. The Piezocone Penetration Test (CPTU) has been found to be one of the best methods to assess the effect of ground improvement due to its continuous, reliable and repeatable data collected. The spatial variability of a liquefactionsusceptible site improved by vibro-compaction was assessed using random field theory. The CPTU soundings were conducted to characterize the variation of random field model parameters. Given the relatively high data frequency of the cone tip resistance in vertical direction, the vertical random field parameters are determined with the modified Bartlett random field estimation procedure. Due to the lack of data in horizontal direction, the horizontal random field parameters are evaluated using a less rigorous way of the autocorrelation. It is shown that the normalized cone resistance is a well estimator of spatial variability. The statistical results suggest that both Scale of Fluctuation (SOF) and the Coefficient of Variation (COV) varied in different way after vibro-compaction.

Engineering Properties and Microstructural Characteristics of Foundation Silt Stabilized By Lignin-based Industrial By-product

Tao Zhang,Guojun Cai,Songyu Liu,Anand J. Puppala 대한토목학회 2016 KSCE JOURNAL OF CIVIL ENGINEERING Vol.20 No.7

This paper presents details of a study that deals with determination of engineering properties and microstructural characteristics of a foundation soil (silt) sedimented in Jiangsu Province of China when it is stabilized by lignin-based industrial by-product. A series of laboratory tests were carried out with respect to evaluate the effect of lignin content and curing time on the overall soil properties including Atterberg limits, pH, unconfined compressive strength, stress-strain characteristics, secant modulus, and California bearing ratio. In addition, scanning electron microscopy, X-ray diffraction, and mercury intrusion porosimetry studies were conducted to understand the microstructural characteristics and stabilization mechanism of the stabilized silt. The results reveal that lignin has a great potential to improve engineering properties of silt and shows a promising prospect as a new environmentally friendly soil stabilizer. Curing time and lignin content have significant influence on the basic engineering properties and microstructural characteristics of the lignin stabilized silt. The optimum content of lignin for foundation silt in Jiangsu Province of China is approximately 12%. The precipitated cementing material is formed after stabilization of lignin with a period of curing. The stabilized silt switches over its response from a brittle to ductile material in the presence of lignin. Peak analysis results of the pore-size distribution curves demonstrates that the lignin stabilized silt exhibits bimodal behavior when the lignin content less than 8%, whereas it displays unimodal type when the lignin content is more than or equal to 8%. These observations provide enhanced understanding of lignin-based industrial by-product as a soil stabilizer at the foundation construction.