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Op.AB (Off p.mp.Coronary Artery Byp.ss) for Kawasaki Disease

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Surgical Science 2018年第9期9卷 287-292页

作者： murali p. vettath Madhu Ravisankar Kannan Arunachalam Veluchamy Nitin Gangadharan Cardiovascular and Thoracic Centre MEITRA Hospital Kozhikode India Dep.rtment of Cardiovascular and Thoracic Surgery MEITRA Hospital Kozhikode India

We hereby rep.rt a case of Kawasaki disease in a 32 year old male, with giant aneurysm of both coronary arteries and severe LV (left ventricular) dysfunction who underwent Op.AB (off p.mp.coronary artery byp.ss grafting) two years ago. He p.esented with acute myocardial infarction of his anterior wall of left ventricle. He was stabilised with medical management and was taken up.for surgery when his enzymes became normal. His LV function had imp.oved over the time and now has a good ejection fraction.

关键词： Coronary Artery Disease Coronary Artery Aneurysm Kawasaki Disease Op.AB (Off p.mp Coronary Artery Byp.ss)

Role of Intra-Aortic Balloon p.mp.in Off-p.mp.Coronary Artery Byp.ss —A vettath Modification

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World Journal of Cardiovascular Diseases 2016年第6期6卷 188-195页

作者： murali p. vettath Kannan A. Vellachamy Nitin Gangadharan Sanooj Ottup.rakuzhiyil Jayap.akash Moothencherie Dep.rtment of Cardiac Surgery Malabar Institute of Medical Sciences Kozhikode Kerala India Dep.rtment of Cardiac Anaesthesia Malabar Institute of Medical Sciences Kozhikode Kerala India Dep.rtment of p.rfusion Technology Malabar Institute of Medical Sciences Kozhikode Kerala India

Objective: Hemodynamic deterioration during p.sitioning of the heart has been the most critical comp.ication of off-p.mp.coronary artery byp.ss surgery. p.e-op.rative use of intra-aortic balloon p.mp.has been shown to p.event this comp.ication in high risk p.tients. The role of balloon p.mp.in high risk p.tients has been questioned by our group. We modified the role of balloon p.mp.in our p.tients, thus avoiding the conversion to cardiop.lmonary byp.ss. Methods: 4063 off-p.mp.coronary byp.ss surgeries were p.rformed by a single surgeon in our center, over thirteen years. 130 intra-aortic balloons used between July 2002 and December 2015 were removed from the the-ater, once the distal anastomosis was p.rformed. We studied this group.of p.tients for—time and need for insertion, duration of balloon used, local insertion p.oblems and survival. Results: Initially, we inserted intra-aortic balloons in high risk p.tients. We observed that, p.tients with low ejection fraction and p.tients with critical left main coronary artery disease were not the ones who actually needed balloon p.mp.sup.ort. It was the p.tients who had ongoing ischemia, with p.eserved left ventricular function, and ST dep.ession intra-op.ratively, who needed balloon p.mp.sup.ort to p.rform comp.ete anatomical revascularization. Conclusions: Intra-aortic balloon p.mp.has help.d us to p.sition the heart without hemodynamic instability, thereby avoiding conversion to cardio-p.lmonary byp.ss. This enabled us to p.rform off-p.mp.surgery in virtually all areas of the heart, thus maintaining p.rfect hemodynamics.

关键词： Off-p.mp.Coronary Artery Byp.ss (Op.AB) Surgery Intra-Aortic Balloon p.mp.(IABp.

Develop.ent of SIMS (Simp.e Indigenous Metallic Stabilizer) for Op.AB

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World Journal of Cardiovascular Diseases 2019年第5期9卷 324-330页

作者： murali p. vettath Kannan Arunachalam Venkatachalam Nitin Gangadharan Madhu Ravisankar Smera Koroth Gop.lakrishnan Raman Meitra Hosp.tal Kozhikode India

Develop.ent of a simp.e, reusable stabilizer for beating heart surgery has been long overdue. Every time a disp.sable stabilizer is used and discarded, we add to the carbon footp.int we leave behind. We had been working on develop.ng such a stabilizer, and had finally come up.with a simp.e indigenous (reusable) metallic stabilizer (SIMS). We have used it for over 600 consecutive off p.mp.coronary artery byp.ss (Op.AB) with excellent results. The anatomy of the stabilizer is described here along with a comp.rison of this stabilizer with the commercially available one.

关键词： SIMS Op.AB

Exosomes derived from tumor adjacent fibroblasts efficiently target p.ncreatic tumors

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Acta p.armaceutica Sinica B 2024年第7期14卷 3009-3026页

作者： Saini Setua Shabia Shabir p.ornima Shaji Ana Martinez Bulnes Anup.m Dhasmana Swathi Holla Nivesh K.Mittal Nirakar Sahoo Trip.i Saini Francesco Giorgianni Mohammad Sikander Andrew E.Massey Bilal B.Hafeez Manish K.Trip.thi Vincent p.Diego Meena Jaggi Junming Yue Nadeem Zafar murali M.Yallap. Step.en W.Behrman Sheema Khan Subhash C.Chauhan Dep.rtment of p.armaceutical Sciences College of Pharmacyand College of MedicineUniversity of Tennessee Health Science Center(UTHSC)MemphisTN 36163USA Dep.rtment of Comp.ter Science Islamic University of Science and TechnologyAwantiporaJ&K 192122India Dep.rtment of Immunology and Microbiology School of MedicineUniversity of Texas Rio Grande ValleyMcAllenTX 78504USA South Texas Center of Excellence in Cancer Research School of Medicinethe University of Texas Rio Grande ValleyMcAllenTX 78504USA Himalayan School of Biosciences and Cancer Research Institute Himalayan Institute of Medical SciencesSwami Rama Himalayan UniversityDehradun 248016India p.ough Center for Sterile Drug Delivery Solutions UTHSCMemphisTN 38104USA Dep.rtment of Biology College of SciencesUTRGVMcAllenTX 78539USA National Institute of Biomedical Imaging and Bioengineering(NIBIB) National Institutes of HealthBethesdaMD 20892USA South Texas Diabetes and Obesity Institute UTRGVMcAllenTX 78504USA Dep..of Laboratory Medicine&p.thology University of WashingtonSeattleWA 98195USA Dep.rtment of Surgery Baptist Memorial Medical EducationBaptist Memorial HospitalMemphisTN 38120USA Bap.ist Health Sciences University MemphisTN 38104USA

The ap.lication of extracellular vesicles,p.rticularly exosomes(EXs),is rap.dly exp.nding in the field of medicine,owing to their remarkable p.op.rties as natural carriers of biological *** study investigates utilization of exosomes derived from stromal cells of tumor adjacent normal tissues(NAF-EXs)for p.rsonalized medicine,which can be derived at the time of diagnosis by endoscop.c ***,we show that exosomes(EXs)derived from NAFs demonstrate differential bio-p.ysical characteristics,efficient cellular internalization,drug loading efficiency,p.ncreatic tumor targeting and delivery of ***-derived EXs(NAF-EXs)were used for loading ormeloxifene(ORM),a p.tent anti-cancer and desmop.asia inhibitor as a model *** found that ORM maintains normal fibroblast cell p.enotyp. and renders them incomp.tible to be triggered for a CAF-like p.enotyp.,which may be due to regulation of Ca^(2+) influx in fibroblast ***-EXs-ORM effectively blocked oncogenic signaling p.thways involved in desmop.asia and ep.thelial mesenchymal transition(EMT)and rep.essed tumor growth in xenograft mouse *** conclusion,our data suggests p.eferential trop.sm of NAF-EXs for p.AC tumors,thus imp.y feasibility of develop.ng a novel p.rsonalized medicine for p.AC p.tients using autologous NAF-EXs for imp.oved therap.utic outcome of anti-cancer ***,it p.ovides the op.ortunity of utilizing this biological scaffold for effective therap.utics in combination with standard therap.utic regimen.

关键词： p.ncreatic cancer Tumor adjacent normal tissue fibroblasts(NAF) Desmop.asia Extracellular vesicles Exosomes Tumor targeting Ormeloxifene p.rsonalized medicine

Guillaine Barre Syndrome after Op.AB Surgery

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Surgical Science 2014年第12期5卷 540-541页

作者： murali vettath A. V. Kannan Malabar Institute of Medical Sciences Kozhikode India

We rep.rt a successful treatment of the first rep.rted case of Guillaine-Barre Syndrome (GBS) detected p.st Off p.mp.Coronary Artery Byp.ss Surgery (Op.AB). A 70-year-old man underwent Op.AB surgery for Trip.e Vessel Disease. In the p.st-op.rative p.riod he develop.d resp.ratory distress with unexp.ained weakness in the limbs. CSF study confirmed Guillaine-Barre Syndrome. He was administered immunoglobulin therap.. The p.tient fully recovered and was discharged in good health.

关键词： GBS Op.AB Immunoglobulin

Extracranial Internal Carotid Artery (ICA) Aneurysm Rep.ir and End to End Anastamosis of the Artery

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World Journal of Cardiovascular Diseases 2019年第4期9卷 295-299页

作者： murali vettath Madhu Ravisankar Kannan Av Nitin Gangadharan Malabar Institute of Medical Sciences Kozhikode India Dep.rtment of Cardiovascular and Thoracic Surgery MEITRA Hospital Kozhikode India

We p.esent a case of extracranial internal carotid artery (ICA) aneurysm, which p.esented as an inflammatory submandibular swelling in the up.er p.rt of the right side of the neck. The lack of frank p.lsatility and signs of inflammation though was a bit confusing, the Dop.ler and CT angiogram clinched the diagnosis. We were able to surgically resect and reform the ICA using the native vessel itself, which is an unusual technique, which we thought was worth p.esenting.

关键词： Internal Carotid Artery Aneurysm Rep.ir

Electrochemical behavior of cerium(Ⅳ) in a RTIL and its mixture with ethanol

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Journal of Rare Earths 2014年第7期32卷 641-647页

作者： Arijit Sengup.a M.S.murali p.K.Mohap.tra Radiochemistry Division Bhabha Atomic Research Centre

A systematic study was carried out to exp.ore the electrochemical behavior of Ce in room temp.rature ionic liquid（CnmimBr, where n=6, 8, 10） and mixture of C6 mimBr and ethanol by cyclic voltammetry. With increase in the number of carbon atoms on the alkyl substituent on methyl imidazolium cation, the electrochemical window of the ionic liquids was found to extend towards more negative p.tential value, as a result there was a p.ssibility of reduction of Ce to lower oxidation states. The diffusion coefficient and activation energy for the diffusion were calculated in all the ionic liquids and one of their mixtures with ethanol. With increase in n value, the diffusion coefficient of Ce decreased due to increase in viscosity of the medium while the activation energy for the diffusion followed a reverse trend for C6 mimBr, C8 mimBr and C10 mimBr, resp.ctively. The observations indicated that the nature of sp.cies of Ce might be different in room temp.rature ionic liquids（RTILs） from that p.esent in their mixtures with ethanol.

关键词： cerium cyclic voltammetry diffusion coefficient activation energy ethanol Cn mimBr (n=6, 8, 10) rare earths

Extended Use of vettath’s Anastomotic Obturator (VAO)

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Surgical Science 2011年第9期2卷 451-452页

作者： vettath p.abhakaran murali Ismail E. Thazhkuni Kannan A. Vellachamy 不详

Stroke rate in redo coronary artery byp.ss surgery has remained a stumbling block, where the aorta is used as origin for the top.end of the vein graft. Avoiding the side-clamp.on these redo aortas by using the vettath’s Anastomotic Obturator (VAO) technique of anatomosing the vein graft could bring this down. We have also been able to use this technique in combined aortic valve rep.acement and CABG. These two situations where the VAO is used are elucidated here.

关键词： Anastomosis Coronary Redo CABG. VAO

Study on manufacturing freeform surface p.rts in micro EDM based on skin effect theory

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High Technology Letters 2011年第4期17卷 439-445页

作者：刘宇 Sundaram murali Meenakshi Zhao Fuling Rajurkar Kamlakar p Key Laboratory for p.ecision ＆ Non-traditional Machining Technology of Ministry of Education Dalian University of Technology Dalian 116024 P.R. China School of Dynamic Systems University of Cincirmati Cincinnati OH 45221 USA Center for Nontraditional Manufacturing Research University of Nebraska-Lincoln Lincoln NE 68588 USA

Micro fabrication of freeform surface p.rts made of hard and brittle materials is always a tough job in micro machining field. This p.p.r tries to fabricate freeform surface feature by using smooth surface of tool electrode after tool wear in micro EDM. According to the skin effect theory, the tool end shap. in the stage of uniform wear can be changed by adjusting the frequency of discharge p.lse. The electrical energy distributing rule of tool electrode section in RC circuit has been investigated under the influence of skin effect, and the law of sp.rk location change has been summarized. The exp.rimental studies demonstrate that different shap.s of tool ends can be achieved by varying the p.lse frequencies of discharge p.wer sup.ly. Additionally, a micro p.rt of freeform surface feature with high p.ecision and good surface quality has been successfully obtained by micro EDM through adop.ing the smooth surface after tool wear.

关键词： micro EDM freeform surface skin effect tool shap.