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Biomedical subjects

R Ramani

Publications and source records attributed to R Ramani.

At least 19 recordsLinked to original sources
PubMed2006

Low effluent nutrient technologies for wastewater treatment.

The USEPA (2001) water quality nutrient criteria will have a significant impact on water pollution control industry due to stringent N and P requirements. This paper presents an update of findings on successful total N (TN) and total P (TP) technologies being implemented at existing wastewater treatment plants (WWTP) to achieve low TN and TP effluents and some key challenges in achieving lower levels. Plants consistently achieving <5 mg TN/L and < 0.5 mg TP/L were identified from a worldwide literature search and plant data collection. Technology gaps and research needs to improve successful technologies to achieve very low TN and TP effluents are summarised in this paper. The dissolved and colloidal organic N have been identified as major challenges in achieving very low levels of TN. Technical and economic challenges to achieve very low TP effluents include alkalinity deficiency, high chemical usage, high sludge production and lack of sufficient influent BOD for biological P uptake.

Alkalies↗
PubMed2005

Free volume study on calcification process in an intraocular lens after cataract surgery.

An opacified intraocular lens explanted from a patient in the postoperative period after phacoemulsification was investigated to find the cause of opacification. From the UV-visible and energy dispersive X-ray spectroscopy (EDS) measurements, the opacification in the present case seems to be due to calcification of the intraocular lens and not due to modification in the UV absorber material of the lens. The average free volume size of the intraocular lens both in unimplanted and explanted state were obtained from positron lifetime spectroscopy (PLS). Further, the combined FTIR and PLS results indicate that calcium gets into the free volume cavities of the intraocular lens matrix as a cationic moiety, may be in the form of Ca(++). The small decrease in glass transition temperature of the calcified lens seems to indicate the plasticizing action of calcium ions. The present results could be of some use in the design of the intraocular lens material in which calcification would be minimum.

Calcinosis↗
PubMed2004

Delineation of brain metastases on CT images for planning radiosurgery: concerns regarding accuracy.

Conformal radiotherapy requires confidence that the images used for target delineation accurately reflect the pathological dimensions of the target. Radiosurgery, which is a conformal radiotherapy technique, is often used to treat brain metastases. The images of brain metastases can be affected by the method of image acquisition. A prospective study was undertaken to evaluate the effect of delay on CT images of brain metastases selected for radiosurgical treatment. A median delay from contrast administration of 65 min resulted in an increase in the volume of the metastases in 86% of cases when compared with the volumes of the same metastases determined from CT images acquired immediately following the administration of contrast medium. The magnitude of the increase in volume was sufficient to cause radiosurgery planners to select larger collimator sizes for radiosurgery plans based on the delayed CT images in 92% of cases. No significant intraobserver or interobserver variation was found in the group of radiosurgery planners. Differences in image acquisition may account in part for the differences in local control reported in the radiosurgical treatment of brain metastases.

Brain Neoplasms↗
PubMed2002

A free volume microprobe study of water sorption in a contact lens polymer.

The kinetics of moisture uptake in a rigid gas-permeable contact lens material, Fluoroperm60, has been investigated. The free volume changes accompanied by the sorption of water were monitored using the positron lifetime spectroscopy (PLS) technique. The positron results indicated swelling in the initial stages of sorption and the filling of vacant free volume sites with water in the later stages of sorption. The sorption curve suggests that the diffusion process in this polymer follows the dual-mode sorption model. Using this model, it was possible to separate Fickian-controlled diffusion and relaxation-controlled diffusion. Furthermore, the positron results combined with the sorption results indicated that Fujita's free volume theory does not seem to be valid for the diffusion process in the present sample under study. The variation of the permeability as a function of the free volume suggests that the amount of water in a contact lens is a measure of its permeability.

Acrylic Resins↗
PubMed2001

The natural history of hepatitis D virus infection in Illinois state facilities for the developmentally disabled.

OBJECTIVE: We sought to define the natural history of hepatitis D virus infection in an institutionalized, developmentally disabled population and to identify other prognostic factors. METHODS: A retrospective cohort study was conducted on 231 hepatitis B virus carriers, 65 of whom were also infected with hepatitis D virus, at thirteen Illinois state facilities for the developmentally disabled. Demographic, clinical and laboratory data from 1986 to 1998 were obtained by chart review. Cox regression analysis was used to compare those with and without hepatitis D virus infection in terms of overall mortality, mortality from hepatic disease, and risk of developing chronic hepatitis and cirrhosis and to identify other potential prognostic factors. RESULTS: Residents with hepatitis D virus infection were more likely to die of liver disease than uninfected residents (11% vs 0.6%, respectively; relative hazard, 15.2; 95% confidence interval, 1.8-126.6), although there was no significant difference in overall mortality. Twenty-one percent of residents with hepatitis D virus infection were diagnosed to have cirrhosis or chronic hepatitis compared with 9% of those uninfected (relative hazard 2.5, 95% confidence interval 1.2-5.2). Among the other variables tested, none was predictive of risk of dying of liver disease, and only seropositivity for hepatitis B e antigen was predictive of risk of developing cirrhosis or chronic hepatitis. CONCLUSIONS: In an institutionalized, developmentally disabled population of hepatitis B virus carriers, hepatitis D virus infection is associated with a greater risk of liver-associated mortality and of developing chronic liver disease than that associated with hepatitis B virus carriage alone.

Adult↗
PubMed2000

Flow cytometry antifungal susceptibility testing of pathogenic yeasts other than Candida albicans and comparison with the NCCLS broth microdilution test.

Candida species other than Candida albicans frequently cause nosocomial infections in immunocompromised patients. Some of these pathogens have either variable susceptibility patterns or intrinsic resistance against common azoles. The availability of a rapid and reproducible susceptibility-testing method is likely to help in the selection of an appropriate regimen for therapy. A flow cytometry (FC) method was used in the present study for susceptibility testing of Candida glabrata, Candida guilliermondii, Candida krusei, Candida lusitaniae, Candida parapsilosis, Candida tropicalis, and Cryptococcus neoformans based on accumulation of the DNA binding dye propidium iodide (PI). The results were compared with MIC results obtained for amphotericin B and fluconazole using the NCCLS broth microdilution method (M27-A). For FC, the yeast inoculum was prepared spectrophotometrically, the drugs were diluted in either RPMI 1640 or yeast nitrogen base containing 1% dextrose, and yeast samples and drug dilutions were incubated with amphotericin B and fluconazole, respectively, for 4 to 6 h. Sodium deoxycholate and PI were added at the end of incubation, and fluorescence was measured with a FACScan flow cytometer (Becton Dickinson). The lowest drug concentration that showed a 50% increase in mean channel fluorescence compared to that of the growth control was designated the MIC. All tests were repeated once. The MICs obtained by FC for all yeast isolates except C. lusitaniae were in very good agreement (within 1 dilution) of the results of the NCCLS broth microdilution method. Paired t test values were not statistically significant (P = 0.377 for amphotericin B; P = 0.383 for fluconazole). Exceptionally, C. lusitaniae isolates showed higher MICs (2 dilutions or more) than in the corresponding NCCLS broth microdilution method for amphotericin B. Overall, FC antifungal susceptibility testing provided rapid, reproducible results that were statistically comparable to those obtained with the NCCLS method.

Amphotericin B↗
PubMed1999

Loss of FancC function results in decreased hematopoietic stem cell repopulating ability.

Fanconi anemia (FA) is a complex genetic disorder characterized by progressive bone marrow (BM) aplasia, chromosomal instability, and acquisition of malignancies, particularly myeloid leukemia. We used a murine model containing a disruption of the murine homologue of FANCC (FancC) to evaluate short- and long-term multilineage repopulating ability of FancC -/- cells in vivo. Competitive repopulation assays were conducted where "test" FancC -/- or FancC +/+ BM cells (expressing CD45.2) were cotransplanted with congenic competitor cells (expressing CD45.1) into irradiated mice. In two independent experiments, we determined that FancC -/- BM cells have a profound decrease in short-term, as well as long-term, multilineage repopulating ability. To determine quantitatively the relative production of progeny cells by each test cell population, we calculated test cell contribution to chimerism as compared with 1 x 10(5) competitor cells. We determined that FancC -/- cells have a 7-fold to 12-fold decrease in repopulating ability compared with FancC +/+ cells. These data indicate that loss of FancC function results in reduced in vivo repopulating ability of pluripotential hematopoietic stem cells, which may play a role in the development of the BM failure in FA patients. This model system provides a powerful tool for evaluation of experimental therapeutics on hematopoietic stem cell function.

Animals↗
PubMed1997

Clinical dosimetry using MOSFETs.

PURPOSE: The use of metal oxide-silicon field effect transistors (MOSFETs) as clinical dosimeters is demonstrated for a number of patients with targets at different clinical sites. METHODS AND MATERIALS: Commercially available MOSFETs were characterized for energy response, angular dependency of response, and effect of accumulated dose on sensitivity and some inherent properties of MOSFETs. The doses determined both by thermoluminescence dosimetry (TLD) and MOSFETs in clinical situation were evaluated and compared to expected doses determined by calculation. RESULTS: It was observed that a standard calibration of 0.01 Gy/mV gave MOSFET determined doses which agreed with expected doses to within 5% at the 95% confidence limit for photon beams from 6 to 25 MV and electron beams from 5 to 14 MeV. An energy-dependent variation in response of up to 28% was observed between two orientations of a MOSFET. The MOSFET doses compared very well with the doses estimated by TLDs, and the patients tolerated MOSFETs very well. A standard deviation of 3.9% between expected dose and MOSFET determined dose was observed, while for TLDs the standard deviation was 5.1%. The advantages and disadvantages of using MOSFETs for clinical dosimetry are discussed in detail. CONCLUSION: It was concluded that MOSFETs can be used as clinical dosimeters and can be a good alternative to TLDs. However, they have limitations under certain clinical situations.

Calibration↗
PubMed1997

Radiosurgery for arteriovenous malformations: the University of Toronto experience.

BACKGROUND: From July 1989 to February 1996, 130 patients underwent stereotactic radiosurgery. We report the results of the first 50 patients eligible for a minimum of three years of follow-up. METHODS: Twenty women and 30 men, (mean age: 37.5 years) were treated by dynamic rotation on a 6 MV linear accelerator. Prior treatment was embolization in seventeen, surgery in three and embolization and surgery in six. All had DSA and enhanced CT scanning, while some had MRI. Forty-seven treatments used a single isodose. Restricting eloquent normal tissue to 15 Gy, margin doses (at 50-90% isodose) were 12 Gy (one patient); 15 Gy (sixteen patients); 20 Gy (31 patients); 25 Gy (two patients). Maximum diameters were: < 1.5 cm (12 patients); < 2.0 cm (nine patients); < 2.5 cm (twelve patients); < 3.0 cm (thirteen patients; 3.0 cm (four patients). RESULTS: Forty-five patients were evaluable at three years, with thirty-nine having angiography. Twenty-five had angiographically confirmed obliterations; two had parenchymal AVMs obliterated but with residual dural components; four had MRI evidence of obliteration (refused angiography). One patient acutely had a seizure; one patient (with hemorrhages, resection, and embolizations preceding two applications of radiosurgery, separated by 3.5 years) had worsening of memory. CONCLUSIONS: Our uncorrected (five patients unevaluable at three years) and corrected angiographically confirmed obliteration rates are 54% and 60% respectively. Our follow-up (98% accounting of cohort; 78% angiographic rate) and explicit derivation of denominators help delineate the efficacy of radiosurgery at these doses.

Adult↗
PubMed1997

Rapid flow cytometric susceptibility testing of Candida albicans.

A rapid flow cytometric assay for in vitro antifungal drug susceptibility testing was developed by adapting the proposed reference method for broth macrodilution testing of yeasts. Membrane permeability changes caused by the antifungal agent were measured by flow cytometry using propidium iodide, a nucleic acid-binding fluorochrome largely excluded by the intact cell membrane. We determined the in vitro susceptibility of 31 Candida albicans isolates and two quality control strains (Candida parapsilosis ATCC 22019 and Candida krusei ATCC 6258) to amphotericin B and fluconazole. Amphotericin B MICs ranged from 0.03 to 2.0 microg/ml, while fluconazole MICs ranged from 0.125 to 128 microg/ml. This method results in clear-cut endpoints that were reproducible. Four-hour incubation was required for fluconazole, whereas a 2-h incubation was sufficient for amphotericin B to provide MICs comparable to the reference macrodilution method developed by the National Committee for Clinical Laboratory Standards Subcommittee on Antifungal Susceptibility Tests. Results of these studies show that flow cytometry provides a rapid and sensitive in vitro method for antifungal susceptibility testing of C. albicans.

Amphotericin B↗
PubMed1995

Frameless stereotaxy for radiosurgical planning and follow-up.

In our centre, 111 patients have been treated with linear accelerator stereotactic radiosurgery. Angiographic, CT and MRI images are generated and the target coordinates calculated in 3 dimensions. For CT scanning, cross sections of perpendicular and oblique fiducial markers are seen. For follow-up CT scans done without the frame, a virtual frame is generated by means of a computer program that places fiducial markers on each CT scan cut, as if the patient had been wearing the OBT frame and the scan produced with the gantry parallel to the base of the frame. The position of the oblique marker may be calculated by knowing the thickness and position of each CT cut. Various natural fiducial markers (bony landmarks) are identified by coordinates in the scan with the patient wearing the real frame and in the scan with the virtual frame applied. A transformation matrix is utilized to establish the equivalence between the original CT scan with the real frame applied and subsequent scans without the real frame but with the virtual frame applied. In effect, the virtual frame is re-applied in exactly the same position as the real frame. Lesion measurements may then be duplicated and growth or regression accurately established. The uncertainty in this system of re-application resides in possible patient movement, CT scan slice thickness and inter-observer error in the identification of natural fiducial markers.

Brain Neoplasms↗
PubMed1995

A QA phantom for dynamic stereotactic radiosurgery: quantitative measurements.

A spherical acrylic phantom was designed for quality assurance measurements of dynamic radiosurgery. The phantom consists of two mating hemispheres mounted on a base plate. The interhemispheric plane may be oriented at any angle to the base, the angle being identified by visible marks on the base plate of the phantom. The phantom has a set of replaceable, radiologically identifiable markers, suitable for Computed Tomography (CT), Magnetic Resonance (MR), and Digital Subtraction Angiography (DSA) imaging. The frame coordinates of each marker are calculated from its known positions with respect to the center of the sphere. The measured errors of these positions using CT and MR images, were within the voxel size of the displayed image, while for DSA images the error was greater than 2.5 mm at the periphery of the image. The calculated depths from the planning software, for various beam intersection points to the isocenter, agreed within 0.6 mm with the known depths. A variation of 3.6 +/- 2.6 mm in the calculated depths was observed between using MR and CT image data. This difference results in a 1% variation in Tissue Maximum ratio (TMR) calculations. Comparisons of measured and known volumes resulted in differences of 8%-10%.

Acrylic Resins↗
PubMed1995

Implementation of multiple isocentre treatment for dynamic radiosurgery.

Radiosurgery using the dynamic rotation technique with a single isocentre was introduced at the Toronto-Bayview Regional Cancer Centre (T-BRCC) in 1988. Since then, over 100 patients have been treated. It was soon recognized that 25-30% of patients were referred with either non-spherical lesions or multiple lesions located sufficiently close together that consideration had to be given to the overlapping dose distributions throughout the treated volume. To treat these more complex targets a multiple isocentre technique was developed which also took account of these effects and the resulting normalization problem. This technique was implemented in September 1992. Comparisons between calculated doses and actual doses delivered have been undertaken using a spherical phantom containing radiochromic film. Measured dose distributions agreed with the planned distributions to within +/- 1 mm. The effect of multiple isocentres on the penumbra of dose distributions has been examined. The methods adopted for the normalization of treatment plans and clinical examples illustrating the application of the multiple isocentre technique are presented.

Adolescent↗
PubMed1994

Frameless stereotaxy for pre-treatment planning and post-treatment evaluation of radiosurgery.

In our centre, 111 patients have been treated with linear accelerator stereotactic radiosurgery. Angiographic, CT and MRI images are generated and the target coordinates calculated in 3 dimensions. For CT scanning, cross sections of perpendicular and oblique fiducial markers are seen. For follow-up CT scans done without the frame, a virtual frame is generated by means of a computer program that places fiducial markers on each CT scan cut, as if the patient had been wearing the OBT frame and the scan produced with the gantry parallel to the base of the frame. The position of the oblique marker may be calculated by knowing the thickness and position of each CT cut. Various natural fiducial markers (bony landmarks) are identified by coordinates in the scan with the patient wearing the real frame and in the scan with the virtual frame applied. A transformation matrix is utilized to establish the equivalence between the original CT scan with the real frame applied and subsequent scans without the real frame but with the virtual frame applied. In effect, the virtual frame is re-applied in exactly the same position as the real frame. Lesion measurements may then be duplicated and growth or regression accurately established. The uncertainty in this system of re-application residues in possible patient movement, CT scan slice thickness and inter-observer error in the identification of natural fiducial markers.

Brain Neoplasms↗