• Title/Summary/Keyword: 4D Planning

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Microbe Hunting: A Curious Case of Cryptococcus

  • Bartlett, Karen H.;Kidd, Sarah;Duncan, Colleen;Chow, Yat;Bach, Paxton;Mak, Sunny;MacDougall, Laura;Fyfe, Murray
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2005.06a
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    • pp.45-72
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    • 2005
  • C. neoformans-associated cryptococcosis is primarily a disease of immunocompromised persons, has a world-wide distribution, and is often spread by pigeons in the urban environment. In contrast, C. gattii causes infection in normal hosts, has only been described in tropical and semi-tropical areas of the world, and has a unique niche in river gum Eucalyptus trees. Cryptococcosis is acquired through inhalation of the yeast propagules from the environment. C. gattii has been identified as the cause of an emerging infectious disease centered on Vancouver Island, British Columbia, Canada. No cases of C. gattii-disease were diagnosed prior to 1999; the current incidence rate is 36 cases per million population. A search was initiated in 2001 to find the ecological niche of this basidiomycetous yeast. C. gaftii was found in the environment in treed areas of Vancouver Island. The highest percentage of colonized-tree clusters were found around central Vancouver Island, with decreasing rates of colonization to the north and south. Climate, soil and vegetation cover of this area, called the Coastal Douglas fir biogeoclimatic zone, is unique to British Columbia and Canada. The concentration of airborne C. gattii was highest in the dry summer months, and lowest during late fall, winter, and early spring, months which have heavy rainfall. The study of the emerging colonization of this organism and subsequent cases of environmentally acquired disease will be informative in planning public health management of new routes of exposure to exotic agents in areas impacted by changing climate and land use patterns. Cryptococcosis is an infection associated with an encapsulated, basidiomycetous yeast Cryptococcus neoformans. The route of entry for this organism is through the lungs, with possible systemic spread via the circulatory system to the brain and meninges. There are four cryptococcal serogroups associated with disease in humans and animals, distinguished by capsular polysaccharide antigens. Cryptococcus neoformans: variety grubii (serotype A), variety neoformans (serotype D), and variety gattii (serotypes B and C) (Franzot et at. 1999). C. neoformans variety gattii has recently been elevated to species status, C. gattii. C. neoformans val. grubii and var. neoformans have a world-wide distribution, and are particularly associated with soil and weathered bird droppings. In contrast, C. gattii (CG) is not associated with bird excrement, is primarily found in tropical and subtropical climates, and has a restricted environmental niche associated with specific tree species. (Ellis & Pfiffer 1990) Ellis and Pfeiffer theorize that, as a basidiomycete, CG requires an association with a tree in order to become pathogenic to mammals. In Australia, CG has been found to be associated with five species of Eucalypts, Eucalyptus camaldulensis, E. tereticornis, E. blakelyi, E. gomphocephala, and E. rudis. Eucalypts, although originally native to Australia, now have a world-wide distribution. CG has been found associated with imported eucalypts in India, California, Brazil, and Egypt. In addition, in Brazil and Columbia, where eucalypts have been naturalized, native trees have been shown to harbour CG (Callejas et al. 1998; Montenegro et al. 2000). In British Columbia, Canada, since the beginning of 1999, there have been 120 confirmed cases of cryptococcal mycoses associated with CG in humans, including 4 fatalities (data from British Columbia Centre for Disease Control), and over 200 cases in animal pets in BC (data from Central Laboratory for Veterinarians). What is remarkable about the BC outbreak of C. gattii-cryptococcosis is that all of the cases have been residents of, or visitors to, a narrow area along the eastern coast of Vancouver Island, BC, from the tip of the island in the south (Victoria) to Courtenay on the north-central island as illustrated in Figure 1. Of the first 38 human cases, 58% were male with a mean age of 59.7 years (range 20 - 82): 36 cases (95%) were Caucasian. Ten cases (26%) presented with meningitis, the remainder presented with respiratory symptoms. Cultures recovered from cases of cryptococcosis associated with the outbreak were typed as serogroup B, which is specific to CG (Bartlett et al. 2003). This was the first reported outbreak of CVG in Canada, or indeed, the world. Where infection with CG is endemic, for example, Australia, the incidence of cryptococcosis ranges from 1.8 - 4.7 per million between the southern and northern states (Sorrell 2001). However, the overall incidence of cryptococcosis in immunocompenent individuals has been estimated at 0.2 per million population per year (Kwon-Chung et al. 1984). The population of Vancouver Island is approximately 720,000,consequently, even if the organism were endemic, one would expect a maximum of 0.15 cases of cryptococcal disease annually.

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Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea (우리나라 정신장애인 직업재활 현황 조사연구)

  • Han, Myung Hun;Kim, Ji-Woong;Kim, Do Yoon;Park, Hye Sun;Park, Hanson;Hwang, Tae-Yeon;Seo, Yongjin;Kim, Seung-Jun;Im, Woo-Young;Lee, Sang Min
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.145-152
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    • 2017
  • Objectives : There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. Methods : We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. Results : Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was 'worries about being excluded from beneficiary of National Basic livelihood Protection Act'. Conclusions : Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

Relationship Between Standardized Precipitation Index and Groundwater Levels: A Proposal for Establishment of Drought Index Wells (표준강수지수와 지하수위의 상관성 평가 및 가뭄관측정 설치 방안 고찰)

  • Kim Gyoo-Bum;Yun Han-Heum;Kim Dae-Ho
    • Journal of Soil and Groundwater Environment
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    • v.11 no.3
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    • pp.31-42
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    • 2006
  • Drought indices, such as PDSI (palmer Drought Severity Index), SWSI (Surface Water Supply Index) and SPI (Standardized Precipitation Index), have been developed to assess and forecast an intensity of drought. To find the applicability of groundwater level data to a drought assessment, a correlation analysis between SPI and groundwater levels was conducted for each time series at a drought season in 2001. The comparative results between SPI and groundwater levels of shallow wells of three national groundwater monitoring stations, Chungju Gageum, Yangpyung Gaegun, and Yeongju Munjeong, show that these two factors are highly correlated. In case of SPI with a duration of 1 month, cross-correlation coefficients between two factors are 0.843 at Chungju Gageum, 0.825 at Yangpyung Gaegun, and 0.737 at Yeongju Munjeong. The time lag between peak values of two factors is nearly zero in case of SPI with a duration of 1 month, which means that groundwater level fluctuation is similar to SPI values. Moreover, in case of SPI with a duration of 3 month, it is found that groundwater level can be a leading indicator to predict the SPI values I week later. Some of the national groundwater monitoring stations can be designated as DIW (Drought Index Well) based on the detailed survey of site characteristics and also new DIWs need to be drilled to assess and forecast the drought in this country.

Development and Validation of the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC) (한국형 긍정적 행동지원 3차 실행충실도 척도(KT3-FC)의 개발과 타당화)

  • Won, Sung-Doo;Chang, Eun Jin;Cho Blair, Kwang-Sun;Song, Wonyoung;Nam, Dong Mi
    • Korean Journal of School Psychology
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    • v.17 no.2
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    • pp.165-180
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    • 2020
  • As a tiered system of supports, School-Wide Positive Behavior Support (SWPBS) is an evidence-based practice in the educational system of Korea. An important aspect of SWPBS is the ongoing progress monitoring and evaluation of implementation fidelity. This study aimed to develop and validate the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC). The preliminary KT3-FC consisted of a 37-item, 6-factor checklist. In the first phase of the study, 10 experts reported that the range of content validity of the KT3-FC was adequate. In the second phase of the study, 185 teachers (52 men and 133 women) who implemented SWPBS completed the KT3-FC, Individualized Supports Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. An exploratory factor analysis resulted in a 5-factor structure, with 20 items, instead of 37 items, consisting of: (a) progress monitoring and evaluation of the individualized supports, (b) provision of supports by aligning and integrating mental health and SWPBS, (c) crisis management planning, (d) problem behavior assessment, and (e) establishment of individualized support team. The internal consistency of the KT3-FC was good (full scale α = .950, sub-factor α = .888 ~ .954). In addition, the KT3-FC showed good convergent validity, having statistically significant correlations with the Individualized Support Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and the PBS Effectiveness Scale. Finally, the confirmatory factor analysis showed that the 5-factor model of the KT3-FC had some good model fits, indicating that the newly developed fidelity measure could be a reliable and valid tool to assess the implementation of Tier 3 supports in Korean schools. Accordingly, the KT3-FC could contribute to implement SWPBS as an evidence-based behavioral intervention for Korean students.

Evaluation of Factors Used in AAPM TG-43 Formalism Using Segmented Sources Integration Method and Monte Carlo Simulation: Implementation of microSelectron HDR Ir-192 Source (미소선원 적분법과 몬테칼로 방법을 이용한 AAPM TG-43 선량계산 인자 평가: microSelectron HDR Ir-192 선원에 대한 적용)

  • Ahn, Woo-Sang;Jang, Won-Woo;Park, Sung-Ho;Jung, Sang-Hoon;Cho, Woon-Kap;Kim, Young-Seok;Ahn, Seung-Do
    • Progress in Medical Physics
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    • v.22 no.4
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    • pp.190-197
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    • 2011
  • Currently, the dose distribution calculation used by commercial treatment planning systems (TPSs) for high-dose rate (HDR) brachytherapy is derived from point and line source approximation method recommended by AAPM Task Group 43 (TG-43). However, the study of Monte Carlo (MC) simulation is required in order to assess the accuracy of dose calculation around three-dimensional Ir-192 source. In this study, geometry factor was calculated using segmented sources integration method by dividing microSelectron HDR Ir-192 source into smaller parts. The Monte Carlo code (MCNPX 2.5.0) was used to calculate the dose rate $\dot{D}(r,\theta)$ at a point ($r,\theta$) away from a HDR Ir-192 source in spherical water phantom with 30 cm diameter. Finally, anisotropy function and radial dose function were calculated from obtained results. The obtained geometry factor was compared with that calculated from line source approximation. Similarly, obtained anisotropy function and radial dose function were compared with those derived from MCPT results by Williamson. The geometry factor calculated from segmented sources integration method and line source approximation was within 0.2% for $r{\geq}0.5$ cm and 1.33% for r=0.1 cm, respectively. The relative-root mean square error (R-RMSE) of anisotropy function obtained by this study and Williamson was 2.33% for r=0.25 cm and within 1% for r>0.5 cm, respectively. The R-RMSE of radial dose function was 0.46% at radial distance from 0.1 to 14.0 cm. The geometry factor acquired from segmented sources integration method and line source approximation was in good agreement for $r{\geq}0.1$ cm. However, application of segmented sources integration method seems to be valid, since this method using three-dimensional Ir-192 source provides more realistic geometry factor. The anisotropy function and radial dose function estimated from MCNPX in this study and MCPT by Williamson are in good agreement within uncertainty of Monte Carlo codes except at radial distance of r=0.25 cm. It is expected that Monte Carlo code used in this study could be applied to other sources utilized for brachytherapy.

Landscape Composition Based on Placement and Harmony in the Namgea Suhwon (치(置)와 화(和)의 개념으로 분석한 남계서원의 경관짜임)

  • Rho, Jae-Hyun;Shin, Sang-Sup
    • Journal of the Korean Institute of Landscape Architecture
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    • v.37 no.4
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    • pp.72-85
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    • 2009
  • This study attempts to examine the principles of landscape composition for a 'Suhwon(書院)' and the meaning and value of its traditional landscape architecture, in order to apply the results to the design of modern landscape architecture. A 'Suhwon' is a vital space containing the form and meaning of human activity. This study analyzes the characteristics of landscape composition in the construction of the Namgea Suhwon, located in Hamyang, by examining the form and meaning of its area and composition. The Namgea Suhwon was constructed with a suitable configuration and harmony in a good location, neither field nor mountain, and which encompasses transcendence and a return after passage through a period of birth and abundance. Its appearance means 'life existence and hidden death(生居死幽)'. Its spatial system is a reflection of the idea of Samshinoje(三神五帝: The three abilities of Providence and its five subjects) connected with Ilsangje -Samshin -Ohje. It was built based on the idea of Biryebudong(非禮不動) meaning that one should follow only good decorum and avoid discourtesy, complying with "the frame of decorum" developed by the family rites of Chu Hsi. The environmental design of the Namgea Suhwon was interrupted by the material confrontation between mountains and water and a binary code system, such as front to rear, length to breadth, and movement to stillness. The design did not adhere to stiff axes, but pursued the harmonic principles of asymmetric balance in the building and the yard, which are very naturalistic. The name 'Namgea Suhwon' is closely related with the view of placement(置) and harmony(和), which are unified with the function and meaning formed by connecting Sung Confucianism with the Pungsu-Sasinsa structure in the layout of the grounds. When examining the D/H ratio of the building and yard, it can be seen that the spaces of Ganghak, Yusang and Jehyang were built appropriately, according to the natural characteristics of each space, such as a sense of openness, enclosure, tension, relief, enhancement, and hierarchical order. The spaces also reflect human scale concepts that take advantage of auditory features. The transition process after the construction of 'Namgea Suhwon' reveals the intentions of the builder to create an ecological landscape composition based on Placement and Harmony. Placement embodies' a purposeful space in which nature and the building are connected naturally, 'incomplete open space pursuing completion', and 'potential beauty in which tension and relaxation are repeated'. Harmony embodies 'order and continuity having a sense of unity with the natural environment' and the 'sharing of daily life and memory'. 'Namgea Suhwon' contains many ideas for landscape planning, land use and the design of a campus environment.

On-line Image Guided Radiation Therapy using Cone-Beam CT (CBCT) (콘빔CT (CBCT)를 이용한 온라인 영상유도방사선치료 (On-line Image Guided Radiation Therapy))

  • Bak, Jin-O;Jeong, Kyoung-Keun;Keum, Ki-Chang;Park, Suk-Won
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.294-299
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    • 2006
  • $\underline{Purpose}$: Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. $\underline{Materials\;and\;Methods}$: We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). $\underline{Results}$: In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 0.1 cm. $\underline{Conclusion}$: Through the on-line IGRT using cone beam CT, we could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients.

CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

Analysis Corrosion Products Formed on the Great Buddha Image of Kotokuin Temple in Kamakura (고덕원 국보 동조아미타여래좌상의 표면에 생성한 부식생성물의 해석)

  • Matsuda Shiro;Aoki Shigeo;Kang, Dai-il
    • 보존과학연구
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    • s.17
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    • pp.161-182
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    • 1996
  • In natural atmosphere, copper and copper alloy have been used to make buddha statues and ornaments of historic buildings since the abovementioned metals have corrosion resistance in some extent, and the patinaformed on the surface of the metals has provided the people aesthetic satisfaction with its beauty. But in atmosphere polluted by $SO_x$and $NO_x$, the patina layer does not work as a protective film, and it allows damages of the metal. Since 1992, Tokyo National Research Institute of Cultural Properties(TNRICP)has conducted studies on the influence of atmospheric pollution on metal cultural property held under open air. The Great Buddha Image which is located in Kamakura about 50km west from Tokyo, has been selected as one of the objects to study because it is made by copper alloy and it has stood exposed in the air for about a few hundreds years. Furthermore it is also the reason to study on it that there are many cultural properties in the surroundings of it. We have analysed the components and the structure of the corrosion products formed on the surface of the Buddha, have carried out exposure tests using the alloy samples which have simulated the components of the Great Image, and have observed climated and polluted air in order to discuss the relation between corrosion of metals in open air and conditions of the atmosphere. In this paper, the authors have described the components and the structure of the corrosion product formed on the surface of the Great Image by means of X-ray fluorescence spectroscopy and X-ray diffraction. The conclusions are as follows. (1) Sulfate patina composed mainly with brochantite were detected on the all sides of the Image and the amount of the patina is found more on the back of the Image facing to north. (2) Antlerite were detected on the back and a park of the left side facing to west, and formation of it was considered to have close relation with malignant atmosphere. (3) A big amount of chloride patina which mainly composed of atacamite were observed on the front facing to south. (4) Carbonate patina mainly composed of malachite were detected on the area where brochantite was often detected as well. It suggested that malachite had been transformed into brochantite by deteriorated atmosphere. (5) On the all sides of the Image, patina were observed together with copper oxides mainly composed of cuprous oxide. It showed that the surface layer of the Image consists of two layers : inner layer of oxide and outer layer of patina. (6) Corrosion products of lead which was a component of copperalloy were detected on the all sides : the main lead product found on the front was chlorophosphate whereas the one on the back was sulfate.

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Dose Distribution According to the Tissue Composition Using Wedge Filter by Radiochromic Film (쐐기필터 사용 시 레디오크로믹 필름을 이용한 조직에 따른 선량분포 연구)

  • Kim, Yon-Lae;Lee, Jeong-Woo;Park, Byung-Moon;Jung, Jae-Yong;Park, Ji-Yeon;Suh, Tae-Suk
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.157-164
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    • 2012
  • The purpose of this study is to analyze the dose distribution when wedge filter is used in the various tissue electron density materials. The dose distribution was assessed that the enhanced dynamic wedge filter and physical wedge filter were used in the solid water phantom, cork phantom, and air cavity. The film dosimetry was suitable simple to measure 2D dose distribution. Therefore, the radiochromic films (Gafchromic EBT2, ISP, NJ, USA) were selected to measure and to analyze the dose distributions. A linear accelerator using 6 MV photon were irradiated to field size of $10{\times}10cm^2$ with 400 MUs. The dose distributions of EBT2 films were analyzed the in-field area and penumbra regions by using dose analysis program. In the dose distributions of wedge field, the dose from a physical wedge was higher than that from a dynamic wedge at the same electron density materials. A dose distributions of wedge type in the solid water phantom and the cork phantom were in agreements with 2%. However, the dose distribution in air cavity showed the large difference with those in the solid water phantom or cork phantom dose distributions. Dose distribution of wedge field in air cavity was not shown the wedge effect. The penumbra width, out of the field of thick and thin, was observed larger from 1 cm to 2 cm at the thick end. The penumbra of physical wedge filter was much larger average 6% than the dynamic wedge filter. If the physical wedge filter is used, the dose was increased to effect the scatter that interacted with photon and physical wedge. In the case of difference in electron like the soft tissue, lung, and air, the transmission, absorption, and scattering were changed in the medium at high energy photon. Therefore, the treatment at the difference electron density should be inhomogeneity correction in treatment planning system.