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Neuroimmunology and Neuroinflammation 2016年第1期3卷 104-108页

作者： murali Krishna Menon Thara Prathap Muhammed Jasim Abdul Jalal Department of Neurology Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia Department of Radiology Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia Department of Family Medicine Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia

Spontaneous intracranial hypotension treatment can be complicated by concomitant cerebral venous thrombosis and subdural hematoma.A 48 years old male,presenting orthostatic headache and neck pain for 1 month displayed sagittal sinus thrombosis and bilateral subdural effusions,as well as extradural fluid collection at T3-T8 level,upon magnetic resonance *** fluid opening pressure was 50 mmH2O,and a leak was confirmed at C2-C3 level by computed tomography(CT)*** presence of subdural hematoma precluded anticoagulation *** autologous epidural blood patch at C2-C3 level under CT guidance improved the patient’s condition,remaining free of residual symptoms or recurrence at six-month follow-up.

关键词： Spontaneous intracranial hypotension cerebral venous thrombosis subdural effusion autologous epidural blood patch

SAR of tricyclic sulfones as γ-secretase inhibitors

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Science China Chemistry 2011年第11期54卷 1688-1701页

作者： COLE David ASBEROM Ted BARA Tom BENNETT Chad BURNETT Duane A. CLADER John DOMALSKI Martin GREENLEE William J. HYDE Lynn JOSIEN Hubert McBRIAR Mark McKITTRICK Brian PISSARNITSKI Dmitri RAJAGOPALAN murali SASIKUMAR Thavalakulamgara Merck Research Laboratories 2015 Galloping Hill RoadKenilworth New Jersey 07033 USA

Novel tricyclic sulfones as γ-secretase inhibitors have been reported by this laboratory for the treatment of Alzheimer's disease. Compounds in this series have comparable or better in vitro activities and in vivo efficacies than sulfonamide analogues re- ported previously by this laboratory. Based on the previously reported tricyclic sulfone scaffold, additional SAR studies of C ring were carried out. Various C-ring structures including cyclohexane, pyran, and piperidine were tolerated. Additionally, the 7- and 8- positions of the C-ring were identified as the best sites to introduce substituent for modulating the pharmacokinetic properties of compounds from this series.

关键词：酶抑制剂三环特区分泌阿尔茨海默氏症砜磺胺类药物动力学性质

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甘蓝型油菜不同发育时期角果重量的遗传分析

浙江大学学报（农业与生命科学版） 2009年第1期35卷 45-50页

作者：李云侠 Variath murali-Tottekkaad 吴建国石春海浙江大学农业与生物技术学院农学系浙江杭州310029

采用可以估算不同发育时期基因累加效应和特定发育时期净遗传效应的遗传模型和统计分析方法,研究油菜角果成熟过程中其重量的发育遗传规律.结果表明,控制不同发育时期油菜角果重量表现的基因累加效应以加性效应为主,仅在第22d时其显性... 详细信息

采用可以估算不同发育时期基因累加效应和特定发育时期净遗传效应的遗传模型和统计分析方法,研究油菜角果成熟过程中其重量的发育遗传规律.结果表明,控制不同发育时期油菜角果重量表现的基因累加效应以加性效应为主,仅在第22d时其显性效应大于加性效应.条件分析的结果表明,控制角果重量的基因在角果多数发育时期中均有新的表达,且其表达方式有所不同,其中角果重量的净遗传效应表达量以开花后第16～22d最大.角果重量在不同发育时刻具有较高的狭义遗传率,低世代选择可以取得良好的育种效果.亲本遗传效应分析表明,双20-4、中R-888和Tower3个亲本有利于增加杂种后代的角果重量,其中以中R-888最优.杂种优势分析表明,角果发育的前中期(16～29d)群体平均优势明显大于其他发育时期.

关键词：油菜角果重量发育遗传遗传率杂种优势

清醒下冠状动脉搭桥术在升主动脉严重钙化患者中的应用

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江苏医药 2005年第9期31卷 690-691页

作者：曹彬 murali chak.avarthy Vivek Jawali Srinivasan Kolar 南京大学附属鼓楼医院心胸外科 210008 Wockhardt hospital&Heart institute BangaloreKarnatakaIndia

目的探讨清醒下冠状动脉搭桥术对升主动脉严重钙化病人术中观察神经系统并发症的可行性。方法在高位胸段硬膜外麻醉下对32例升主动脉严重钙化的病人行清醒下冠状动脉搭桥手术,均无气管内插管。结果搭桥98支。除2例因术中发生室颤转为体... 详细信息

目的探讨清醒下冠状动脉搭桥术对升主动脉严重钙化病人术中观察神经系统并发症的可行性。方法在高位胸段硬膜外麻醉下对32例升主动脉严重钙化的病人行清醒下冠状动脉搭桥手术,均无气管内插管。结果搭桥98支。除2例因术中发生室颤转为体外循环外,其余均为非体外循环心脏跳动下冠状动脉搭桥手术。术后在外科监护室和病房的住院时间分别为(18·6±3·4)h和(4·48±2·3)d。无手术死亡及神经系统并发症。结论升主动脉严重钙化的病人行清醒下冠状动脉搭桥手术,术中可观察到脑栓塞等神经系统并发症的发生,及时给予相应的处理,避免出现严重后果。

关键词：硬膜外麻醉冠状动脉搭桥手术升主动脉钙化神经系统并发症冠状动脉搭桥术升主动脉非体外循环心脏跳动下钙化清醒胸段硬膜外麻醉

Spectrophotometric Determination of Etravirine in Bulk and Pharmaceutical Formulations

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American Journal of Analytical Chemistry 2014年第2期5卷 77-82页

作者： D. murali S. V. Venkatrao C. Rambabu Department of Chemistry Acharya Nagarjuna University Guntur India

Two simple, rapid, sensitive, accurate, precise and economical Visible Spectrophotometric methods have been developed for the determination of Etravirine in pure and pharmaceutical formulations. These methods (A and B) were based on nucleophilic substitution and oxidative coupling reactions of Etravirine by 1,2-naphtha quinone-4-sulphonate (NQS) in alkaline medium and 3-methyl-2-benzothiazolinone hydrazone (MBTH) in acidic medium with the maximum absorbance at 414 nm and 635 nm respectively. Linearity was obtained in the concentration range of 5 -30 μg/ml and 2 -10 μg/ml which was corroborated by the correlation coefficient (r) values of 0.9995 and 0.9996 respectively. The methods developed were validated with respect to linearity, accuracy (recovery), precision, Sandell’s sensitivity, molar extinction coefficient and specificity. The proposed methods are successfully applied for the determination of Etravirine in bulk and pharmaceutical formulations and results were validated statistically by recovery studies.

关键词： Etravirine 1 2-Napthaquinone 4-Sulphonate 3-Methyl-2-Benzothiazolinone Hydrazone

Awake off-pump coronary artery bypass surgery in 25 patients

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South China Journal of Cardiology 2003年第2期4卷 66-71页

作者：郭惠明 murali chak.avarthy Vivek Jawali K Jayaprakash NV Shivananda Guangdong Provincial Cardiovascular Institute Guangzhou 510100 China Wockhardt Heart Institute Bangalore 560052 India Wockhardt Heart Institute Bangalore 560052 Indiabjectives To test the feasibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing off pump coronary artery bypass surgery avoiding general anesthesia. Methods Between October 2002 to April 2003 twenty five cases underwent beating heart coronary artery revascularization without endotracheal general anesthesia using high thoracic epidural anesthesia and analgesia. All the patients underwent epidural catheterization on the evening before the surgery. Resuits The patients in all received 71 grafts (single n = 11 double n = 5 triple n = 6 quadruple n = 3). Six patients underwent repeat coronary artery bypass. Except one was converted to general anesthesia and cardiopulmonary bypass the other patients underwent off-pump coronary artery bypass graft surgery 2 patients underwent grafting via left thoracotomy (MIDCAB) and the rest through mid sternotomy. There was no mortality. Mean length of stay in the intensive care unit was 16 .2 ( 4.2 hours and hospital was 3.0(1.2 days. Conclusions Our experience confirms the feasibility of performing multiple coronary artery bypasses in conscious patients without endotracheal general anesthesia

Objectives To test the feasibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing off pump coronary artery bypass surgery, avoiding general anesthesia. Methods Between October 2002 to April 2003, twenty five cases underwent beating heart coronary artery revascularization without endotracheal general anesthesia, using high thoracic epidural anesthesia and analgesia. All the patients underwent epidural catheterization on the evening before the surgery. Resuits The patients in all received 71 grafts (single n = 11, double n = 5, triple n = 6, quadruple n = 3). Six patients underwent repeat coronary artery bypass. Except one was converted to general anesthesia and cardiopulmonary bypass, the other patients underwent off-pump coronary artery bypass graft surgery, 2 patients underwent grafting via left thoracotomy (MIDCAB) and the rest through mid sternotomy. There was no mortality. Mean length of stay in the intensive care unit was 16 .2 ( 4.2 hours and hospital was 3.0(1.2 days. Conclusions Our experience confirms the feasibility of performing multiple coronary artery bypasses in conscious patients without endotracheal general anesthesia

关键词： High thoracic epidural anesthesia Off pump coronary artery bypass (OPCAB) surgery Conscious patients

Artery of Percheron occlusion:role of diffusion-weighted imaging in the early diagnosis

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Neuroimmunology and Neuroinflammation 2016年第1期3卷 14-16页

作者： murali Krishna Menon Suma Mariam Jacob Muhammed Jasim Abdul Jalal Department of Neurology Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia Department of Radiology Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia Department of Family Medicine Lakeshore Hospital and Research CentreErnakulam 682040KeralaIndia

Bilateral thalamic infarcts have a low frequency among different subtypes of *** it does not involve a particular vascular territory,it therefore usually involves the occlusion of the artery of Percheron(AOP).Here we report a 79-year-old right-handed Parkinsonian female patient,who was found unresponsive in *** examination,the patient was drowsy with a Glasgow Coma Score(GCS)of 10/15(E2M5V3).She had absent doll’s eye response with anisocoric pupils and intermittent vertical gaze *** the patient had no apparent motor deficits,she was in a state of persistent somnolence with memory impairment and lack of ***-weighted magnetic resonance imaging(MRI)of the brain showed focal areas of restricted diffusion in the medial part of the thalami bilaterally and the rostral part of mid-brain(right>left)(bilateral paramedian thalamic with mid-brain pattern),suggestive of a hyper-acute infarct in the territory of *** patient was anticoagulated with 40 mg subcutaneous low molecular weight heparin and was started on double anti-platelets along with supportive *** level of consciousness is improved at a slow rate to a GCS of 12/15(E4M5V3).The patient had marked abulia with periods of drowsiness interspersed with periods of restlessness and uttering of abnormal sounds,but she was able to execute simple *** conclusion,occlusion of the AOP is a rare cause of coma in elderly ***-weighted MRI is the imaging modality of choice for early *** diagnosis of AOP occlusion may lead to favorable outcomes.

关键词： Artery of Percheron bilateral thalamic infarcts coma diffusion-weighted imaging thalamic dementia

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 Prabhakaran murali Ismail E. Thazhkuni Kannan A. Vellachamy 不详

Stroke rate in redo coronary artery bypass 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 replacement and CABG. These two situations where the VAO is used are elucidated here.

关键词： Anastomosis Coronary Redo CABG. VAO

OPCAB (Off Pump Coronary Artery Bypass) 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 Department of Cardiovascular and Thoracic Surgery MEITRA Hospital Kozhikode India

We hereby report 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 OPCAB (off pump coronary artery bypass grafting) two years ago. He presented 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 improved over the time and now has a good ejection fraction.

关键词： Coronary Artery Disease Coronary Artery Aneurysm Kawasaki Disease OPCAB (Off Pump Coronary Artery Bypass)

Role of Intra-Aortic Balloon Pump in Off-Pump Coronary Artery Bypass —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 Ottuparakuzhiyil Jayaprakash Moothencherie Department of Cardiac Surgery Malabar Institute of Medical Sciences Kozhikode Kerala India Department of Cardiac Anaesthesia Malabar Institute of Medical Sciences Kozhikode Kerala India Department of Perfusion Technology Malabar Institute of Medical Sciences Kozhikode Kerala India

Objective: Hemodynamic deterioration during positioning of the heart has been the most critical complication of off-pump coronary artery bypass surgery. Pre-operative use of intra-aortic balloon pump has been shown to prevent this complication in high risk patients. The role of balloon pump in high risk patients has been questioned by our group. We modified the role of balloon pump in our patients, thus avoiding the conversion to cardiopulmonary bypass. Methods: 4063 off-pump coronary bypass surgeries were performed 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 performed. We studied this group of patients for—time and need for insertion, duration of balloon used, local insertion problems and survival. Results: Initially, we inserted intra-aortic balloons in high risk patients. We observed that, patients with low ejection fraction and patients with critical left main coronary artery disease were not the ones who actually needed balloon pump support. It was the patients who had ongoing ischemia, with preserved left ventricular function, and ST depression intra-operatively, who needed balloon pump support to perform complete anatomical revascularization. Conclusions: Intra-aortic balloon pump has helped us to position the heart without hemodynamic instability, thereby avoiding conversion to cardio-pulmonary bypass. This enabled us to perform off-pump surgery in virtually all areas of the heart, thus maintaining perfect hemodynamics.

关键词： Off-Pump Coronary Artery Bypass (OPCAB) Surgery Intra-Aortic Balloon Pump (IABP)