As the BIM designing technology has been applied recently in the construction field, architectural design education in the field of work and university has been changing to 3D modeling. Nevertheless, architectural design & drafting education in the construction specialized vocational high school is not responding appropriately to change. Despite the fact that students need to have 3D modeling design ability, there is a very lack of 3D housing design instructional material that can satisfy the change. The purpose of this study is to develop BIM-based 3D modeling instruction material and apply to analyze effect on interest and task performance ability on Housing Design. The 3D modeling instruction material used in this study was developed through four stages of preparation, development, implementation and evaluation according to the PDIE model procedure. Also, the experimental design model for hypothesis testing was used nonequivalent control group pretest-posttest design. Based on the experimental design model, BIM-based 3D modeling instruction material was performed in the experimental group and 2D CAD-based standard instruction material was taught in the control group. Experimental treatment was conducted on the students of construction specialized vocatinonal high school, and applied to the subject of Professional Drafting in the 12 hours. Before and after the experimental treatment, the interest and task performance ability on Housing Design were tested. Based on the test results, we analyzed the effects of the 3D modeling instruction material through the independent samples t-test. The results of the study are as follows. First, BIM-based 3D modeling instruction material was developed of 'Housing Design & Drafting' unit on the subject of Professional Drafting in construction specialized vocational high school. Second, the application of 3D modeling instruction material has shown to be effective in improving students' interest. Third, the application of 3D modeling instruction material has shown to be effective in improving students' task performance ability on Housing Design.
Consecutive brain 〔Tc-99m〕ECD SPECT studies before and after acetazolamide (Diamox) administration have been performed with patients for the evaluation of cerebrovascular hemodynamic reserve. However, the quantitaitve potential of SPECT Diamox imaging is limited as a result of degrading fractors such as finite detector resolution, attenuation, scatter, poor counting statistics, and methods of data analysis. Making physical measurements in phantoms filled with known amounts of radioactivity can help characterize and potentially quantify the sensitivities. However, it is often very difficult to make a realistic phantom simulating patients in clinical situations. By computer simulation, we studied the sensitivities of ECD SPECT before and after Diamox administration. The sensitivity is defined as ($\Delta$N/N)/($\Delta$S/S)$\times$100%, where $\Delta$N denotes the differences in mean counts between post-and pre-Diamox in the measured data, N denotes the mean counts before Diamox in the measure data, $\Delta$S denotes the differences in mean counts between post-and pre-Diamox in the model, and S denotes the mean counts before Diamox in the model. In clinical Diamox studies, the percentage changes of radioactivity could be determined to measure changes in radioactivity concentration by Diamox after subtracting pre-from post-Diamox data. However, the optimal amount of subtraction for 100% sensitivity is not known since this requires a thorough sensitivity analysis by computer simulation. For consecutive brain SPECT imaging model before and after Diamox, when 30% increased radioactivity concentrations were assingned for Diamox effect in model, the sensitivities were measured as 51.03, 73.4, 94.00, 130.74% for 0, 100, 150, 200% subtraction, respectively. Sensitivity analysis indicated that the partial voluming effects due to finite detector resolution and statistical noise result in a significant underestimation of radioactivity measurements and the amount of underestimation depends on the. % increase of radioactivity concentration and % subtraction of pre-from post-Diamox data. The 150% subtraction appears to be optimal in clinical situations where we expect approximately 30% changes in radioactivity concentration. The computer simulation may be a powerful technique to study sensitivities of ECD SPECT before and after Diamox administration.
This study aims to evaluate the accuracy of the collapsed cone convolution (CCC) algorithm for dose calculation in a treatment planning system (TPS), CorePLAN$^{TM}$. We implemented beam models for various setup conditions in TPS and calculated radiation dose using CCC algorithm for 6 MV and 15 MV photon beam in $50{\times}50{\times}50cm^3$ water phantom. Field sizes were $4{\times}4cm^2$, $6{\times}6cm^2$, $10{\times}10cm^2$, $20{\times}20cm^2$, $30{\times}30cm^2$ and $40{\times}40cm^2$ and each case was classified as open beam cases and wedged beam cases, respectively. Generated beam models were evaluated by comparing calculated data and measured data of percent depth dose (PDD) and lateral profile. As a result, PDD showed good agreement within approximately 2% in open beam cases and 3% in wedged beam cases except for build-up region and lateral profile also correspond within approximately 1% in field and 4% in penumbra region. On the other hand, the discrepancies were found approximately 4% in wedged beam cases. This study has demonstrated the accuracy of beam model-based CCC algorithm in CorePLAN$^{TM}$ and the most of results from this study were acceptable according to international standards. Although, the area with large dose difference shown in this study was not significant region in clinical field, the result of our study would open the possibility to apply CorePLAN$^{TM}$ into clinical field.
Digital Radiography (DR) has rapidly developed in megavoltage X-ray imaging (MVI). Thus, a very simple and general quality assurance (QA) method is required. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE) for MVI using general QA method and computed radiography (CR) device. We used tungsten edge block with $19{\times}10{\times}1cm^3$ thickness and 6MV energy. For detector, CR-IP (image plate), CR-IP-lead, the CR-IP-back (lanex TM fast back screen), CR-IP-front (lanex TM fast front screen) were used and pre-sampling MTF was calculated. The MTF of CR-IP-front showed the highest value with 1.10 lp/mm although the CR-IP showed the only 0.70 lp/mm. The best NPS was observed in CR-IP front screen. According to the increase in spatial frequency, our results showed that DQE was approximately 1.0 cycles/mm. The present study demonstrates that the QA method with our home-made edge block can be used to evaluate MTF, NPS and DQE for MVI.
Although MR imaging is generally applicable to depict knee joint deterioration it, is sometimes occurred to mis-read and mis-diagnose the common knee joint diseases. In this study, we employed magnetization transfer ratio (MTR) method to improve the diagnosis of the various knee joint diseases. Spin-echo (SE) T2-weighted images (TR/TE 3,400-3,500/90-100 ms) were obtained in seven cases of knee joint deterioration, FSE T2-weighted images (TR/TE 4,500-5,000/100-108 ms) were obtained in seven cases of knee joint deterioration, gradient-echo (GRE) T2-weighted images (TR/TE 9/4.56/$50^{\circ}$ flip angle, NEX 1) were obtained in 3 cases of knee joint deterioration, In six cases of knee joint deterioration, fat suppression was performed using a T2-weighted short T1/tau inverse recovery (STIR) sequence (TR/TE =2,894-3,215 ms/70 ms, NEX 3, ETL 9). Calculation of MTR for individual pixels was performed on registration of unsaturated and saturated images. After processing to make MTR images, the images were displayed in gray color. For improving diagnosis, three-dimensional isotropic volume images, the MR tristimulus color mapping and the MTR map was employed. MTR images showed diagnostic images quality to assess the patients' pathologies. The intensity difference between MTR images and conventional MRI was seen on the color bar. The profile graph on MTR imaging effect showed a quantitative measure of the relative decrease in signal intensity due to the MT pulse. To diagnose the pathologies of the knee joint, the profile graph data was shown on the image as a small cross. The present study indicated that MTR images in the knee joint were feasible. Investigation of physical change on MTR imaging enables to provide us more insight in the physical and technical basis of MTR imaging. MTR images could be useful for rapid assessment of diseases that we examine unambiguous contrast in MT images of knee disorder patients.
The application of a respiratory gated radiotherpy method to the lung radiation surgery was evaluated compared with the conventional method in which the whole tumor motion range is considered in the delineation of PTV (Planning target volume). The four dimensional CT simulation images were acquired for the five NSCLC (Non-small cell lung cancer) patients for radiation surgery. The respiratory gated plan was prepared with the 50% phase CT images and the conventional method was planned based on the ITV (Internal target volume) which include all the target volumes created in each phase CT images within a whole respiratory period. The DVH (Dose volume histogram) of OAR (Organ at risk) which calculated in each method was compared for the evaluation of the plan properness. The relative decrease of OARs' DVH were verified in the application of respiratory gated method. The average decrease rate were $16.88{\pm}9.97%$ in the bronchus, $34.13{\pm}19.15%$ in the spinal cord, $28.42{\pm}18.49%$ in the chest wall and $32.48{\pm}16.66%$ in the lung. Based on these results, we can verified the applicability and the effectiveness of the respiratory gated method in the lung radiation surgery.
Purpose: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compares the results of high resolution, fast speed slice interpolation MRA and DSA thereby examing the potentiality of primary non-invasive screening test. Materials and Methods: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine (Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. The settings include TR/TE/FA=30/6.4/25, matrix $160{\times}512$, FOV $150{\times}200$, 7minutes 42 seconds of scan time, effective thickness of 0.7 mm and an entire thickness of 102. 2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction (MPR) technique was used in cases of intracranial aneurysm. Results: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than IOmm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitivity. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. Conclusion: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary non-invasive screening test in the future.
Mitchell Donald G.;Hann Hie-Won L.;Parker Laurence;Kim, Mi-Young
Investigative Magnetic Resonance Imaging
/
v.10
no.2
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pp.81-88
/
2006
Purpose : To evaluate the MR imaging findings of bowel wall thickening in patients with minimal to moderate cirrhosis, and analyze their clinical significances comparing with laboratory findings. Materials and Methods : We assessed retrospectively the MRI findings of 123 patients with minimal to moderate cirrhosis, and compared these with the clinical laboratory findings. We evaluated the involved sites and MR image findings of thickened bowel wall, as well as the presence of collateral vessels, ascites, and splenic size. These were compared with serum albumin and bilirubin levels, and prothrombin time. Results : Gastrointestinal wall thickening was detected at 37 sites in 25 patients (20%), and more frequently detected in moderate cirrhosis (29%) than in minimal cirrhosis (17%). Jejunum and ascending colon were the most common sites of bowel wall thickening; each was involved at 22 and 9 sites, respectively. Ascending colonic wall thickening was more commonly detected in moderate cirrhosis than in minimal cirrhosis. The thickened bowel wall showed symmetric contour, high signal intensity on T2-weighted images, mixed iso- and low signal intensity on T1-weighted images, and homogeneous or target-like enhancement. Serum albumin level was significantly lower in patients with bowel wall thickening ($3.3{\pm}0.9$ g/dl vs. $3.9{\pm}0.7$ g/dl; p=0.0024). Serum bilirubin level was significantly higher in patients with bowel wall thickening ($1.7{\pm}1.0$ mg/dl vs. $1.4{\pm}1.2$ mg/dl; p=0.0160). Bowel wall thickening did not significantly correlate with the presence of collateral vessels, ascites, splenic size, and prolongation of prothrombin time. Conclusion : In minimal to moderate cirrhosis, the MR imaging evaluation of bowel wall thickening was useful for estimating the severity of cirrhosis and laboratory findings.
Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.
Byun, Sung Wan;Kim, Han Wool;Yoon, Seo Hee;Park, In Ho;Kim, Kyung-Hyo
Pediatric Infection and Vaccine
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v.22
no.2
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pp.106-112
/
2015
Purpose: The long-term administration of antibiotics interferes with bacterial culture in the middle ear fluids (MEFs) of young children with otitis media with effusion (OME). The purpose of this study is to determine whether molecular diagnostics can be used for rapid and direct detection of the bacterial pathogen in culture-negative MEFs. Methods: The specificity and sensitivity of both polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) to the lytA gene of Streptococcus pneumoniae were comparatively tested and then applied for pneumococcal detection in the clinical MEFs. Results: The detection limit of the PCR assay was approximately $10^4$ colony forming units (CFU), whereas that of LAMP was less than 10 CFU for the detection of S. pneumoniae. Both PCR and LAMP did not amplify nucleic acid at over $10^6$ CFU of H. influenzae or M. catarrhalis, both of which were irrelevant bacterial species. Of 22 culture-negative MEFs from children with OME, LAMP positivity was found in twelve MEFs (54.5%, 12/22), only three of which were PCR-positive (25%, 3/12). Our results showed that the ability of LAMP to detect pneumococcal DNA is over four times higher than that of PCR (P<0.01). Conclusions: As a high-resolution tool able to detect nucleic acid levels equivalent to <10 CFU of S. pneumoniae in MEFs without any cross-reaction with other pathogens, lytA -specific LAMP may be applied for diagnosing pneumococcus infection in OME as well as evaluating the impact of a pneumococcal conjugate vaccine against OME.
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