Almanac - Retrieval-Augmented Language Models for Clinical Medicine

BACKGROUND

Large language models (LLMs) have recently shown impressive zero-shot capabilities, whereby they can use auxiliary data, without the availability of task-specific training examples, to complete a variety of natural language tasks, such as summarization, dialogue generation, and question answering. However, despite many promising applications of LLMs in clinical medicine, adoption of these models has been limited by their tendency to generate incorrect and sometimes even harmful statements.

METHODS

We tasked a panel of eight board-certified clinicians and two health care practitioners with evaluating Almanac, an LLM framework augmented with retrieval capabilities from curated medical resources for medical guideline and treatment recommendations. The panel compared responses from Almanac and standard LLMs (ChatGPT-4, Bing, and Bard) versus a novel data set of 314 clinical questions spanning nine medical specialties.

RESULTS

Almanac showed a significant improvement in performance compared with the standard LLMs across axes of factuality, completeness, user preference, and adversarial safety.

CONCLUSIONS

Our results show the potential for LLMs with access to domain-specific corpora to be effective in clinical decision-making. The findings also underscore the importance of carefully testing LLMs before deployment to mitigate their shortcomings. (Funded by the National Institutes of Health, National Heart, Lung, and Blood Institute.).

Evaluation of Usefulness of Yeast-Based Biological Phantom and Preliminary Study for Verification of Hypoxic Effect of Flash Radiotherapy

PURPOSE/OBJECTIVE(S)

As a basic hypothesis for the effectiveness of flash radiation therapy, the effect of preserving normal tissue during flash radiation is due to the instantaneous chemical depletion of oxygen. A yeast-based biological phantom was created to verify the hypoxic effect of flash radiation therapy. A study to upgrade the previously developed X-Band LINAC to a flash irradiation mode is in progress, and a preceding study is conducted to evaluate the usefulness of a yeast-based biological phantom manufactured by analyzing the change in oxygen by irradiating a high dose in a general radiation therapy device.

MATERIALS/METHODS

Freeze-dried yeast sample (Saccharomyces cerevisiae, S288C) is activated and sub-cultured. For mass production of yeast samples, yeast culture medium is prepared by adding yeast colonies to the ypd medium. This study was conducted to verify the hypoxic effect among the biological mechanisms that occur during flash radiation therapy at the basic stage, and the oxygen concentration change during general radiation irradiation was measured in real time using a DO (Dissolved oxygen) meter and fiber optic sensor designed to do that. To prevent scatter, which is a concern during flash irradiation, the fiber form was used, and precise experiments are possible as a non-invasive oxygen concentration measurement method. Based on 10MV of general radiation therapy device, high-dose radiation of 500-10,000 cGy is irradiated to measure real-time oxygen concentration change.

RESULTS

As a result of irradiation with high-dose (500-10,000 cGy) radiation of general LINAC, it was confirmed that the oxygen concentration of the yeast culture medium decreased by 5.7-63.2%, and the usefulness of the biological phantom fabricated based on the yeast culture medium was evaluated.

CONCLUSION

Prior to the analysis of oxygen concentration change in yeast cells during X-Band LINAC flash irradiation, a preliminary study was conducted at a high dose in a general LINAC to obtain a significant result of oxygen concentration change and confirm the usefulness of the yeast-based biological phantom. Prior research was conducted and verified as a general irradiation experiment using a yeast-based biological phantom manufactured based on a DO meter and a fiber optic oxygen sensor. After irradiation with high-dose radiation, the oxygen concentration of the yeast culture medium was measured 5 times, and it was confirmed that there was a change in oxygen concentration of 5.7-63.2%, verifying the usefulness and stability of the biological phantom. The usefulness of the yeast-based biological phantom for high doses was confirmed, and it is expected that the usefulness of the biological phantom for flash radiation can be verified by additionally measuring the change in oxygen concentration of the biological phantom according to the high dose rate in the future.

Almanac: Retrieval-Augmented Language Models for Clinical Medicine

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n= 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Patient-Reported Barriers and Enablers to Deprescribing Recommendations During a Clinical Trial (Shed-MEDS)

BACKGROUND AND OBJECTIVES

Effective deprescribing requires shared decision making between a patient and their clinician, and should be used when implementing evidence-based deprescribing conversations. As part of the Shed-MEDS clinical trial, this study assessed barriers and enablers that influence patient decision making in deprescribing to inform future implementation efforts and adaptations.

RESEARCH DESIGN AND METHODS

Shed-MEDS, a randomized controlled deprescribing trial, included hospitalized older adults discharging to post-acute care facilities. A trained clinician reviewed each participant's medical history and medication list to identify medications with potential for deprescribing. The study clinician then conducted a semistructured patient-centered deprescribing interview to determine patient (or surrogate) concerns about medications and willingness to deprescribe. Reeve et al.'s (2013) framework was used to categorize barriers and enablers to deprescribing from the patient's perspective, including "appropriateness of cessation," "fear," "dislike of a medication," "influences," and "process of cessation."

RESULTS

Overall, participants/surrogates (N = 177) agreed with 63% (883 total medications) of the study clinician's deprescribing recommendations. Thematic analysis revealed that "appropriateness" of a medication was the most common barrier (88.2%) and enabler (67.3%) to deprescribing. Other deprescribing enablers were in the following domains: "influences" (22.7%), "process" (22.5%), "pragmatic" (19.4%), and "dislike" (5.3%).

DISCUSSION AND IMPLICATIONS

Use of a semistructured deprescribing interview conversation tool allowed study clinicians to elicit individual barriers and enablers to deprescribing from the patient's perspective. Participants in this study expressed more agreement than disagreement with study clinicians' deprescribing recommendations. These results should inform future implementation efforts that incorporate a patient-centered framework during deprescribing conversations.

CLINICAL TRIALS REGISTRATION NUMBER

NCT02979353.

Search for the Pair Production of Dark Particles X with K_{L}^{0}→XX, X→γγ

We present the first search for the pair production of dark particles X via K_{L}^{0}→XX with X decaying into two photons using the data collected by the KOTO experiment. No signal was observed in the mass range of 40-110  MeV/c^{2} and 210-240  MeV/c^{2}. This sets upper limits on the branching fractions as B(K_{L}^{0}→XX)<(1-4)×10^{-7} and B(K_{L}^{0}→XX)<(1-2)×10^{-6} at the 90% confidence level for the two mass regions, respectively.

Study of the K_{L}→π^{0}νν[over ¯] Decay at the J-PARC KOTO Experiment

The rare decay K_{L}→π^{0}νν[over ¯] was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of (7.20±0.05_{stat}±0.66_{syst})×10^{-10}, three candidate events were observed in the signal region. After unveiling them, contaminations from K^{±} and scattered K_{L} decays were studied, and the total number of background events was estimated to be 1.22±0.26. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of 4.9×10^{-9} on the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level.

Search for K_{L}→π^{0}νν[over ¯] and K_{L}→π^{0}X^{0} Decays at the J-PARC KOTO Experiment

A search for the rare decay K_{L}→π^{0}νν[over ¯] was performed. With the data collected in 2015, corresponding to 2.2×10^{19} protons on target, a single event sensitivity of (1.30±0.01_{stat}±0.14_{syst})×10^{-9} was achieved and no candidate events were observed. We set an upper limit of 3.0×10^{-9} for the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level (C.L.), which improved the previous limit by almost an order of magnitude. An upper limit for K_{L}→π^{0}X^{0} was also set as 2.4×10^{-9} at the 90% C.L., where X^{0} is an invisible boson with a mass of 135  MeV/c^{2}.

Response of six neutron survey meters in mixed fields of fast and thermal neutrons

Calibration neutron fields have been developed at KAERI (Korea Atomic Energy Research Institute) to study the responses of commonly used neutron survey meters in the presence of fast neutrons of energy around 10 MeV. The neutron fields were produced by using neutrons from the (241)Am-Be sources held in a graphite pile and a DT neutron generator. The spectral details and the ambient dose equivalent rates of the calibration fields were established, and the responses of six neutron survey meters were evaluated. Four single-moderator-based survey meters exhibited an under-responses ranging from ∼9 to 55 %. DINEUTRUN, commonly used in fields around nuclear reactors, exhibited an over-response by a factor of three in the thermal neutron field and an under-response of ∼85 % in the mixed fields. REM-500 (tissue-equivalent proportional counter) exhibited a response close to 1.0 in the fast neutron fields and an under-response of ∼50 % in the thermal neutron field.

Detection of residual brain arteriovenous malformations after radiosurgery: diagnostic accuracy of contrast-enhanced four-dimensional MR angiography at 3.0 T

OBJECTIVE

To evaluate the diagnostic accuracy of four-dimensional MR angiography (4D-MRA) at 3.0 T for detecting residual arteriovenous malformations (AVMs) after Gamma Knife (Elekta Instrument AB, Stockholm, Sweden) radiosurgery (GKRS).

METHODS

We assessed 36 angiographically confirmed AVMs in 36 patients who had been treated with GKRS. 4D-MRA was performed after GKRS and the time intervals were 39.4 ± 26.0 months [mean ± standard deviation (SD)]. 4D-MRA was obtained at 3.0 T after contrast injection, with a measured voxel size of 1 × 1 × 1 mm and a temporal resolution of 1.1 s (13 patients) or a voxel size of 1 × 1 × 2 mm and a temporal resolution of 0.98 s (23 patients). X-ray angiography was performed as the standard reference within 53 ± 47 days (mean ± SD) after MRA. To determine a residual AVM, the 4D-MRA results were independently reviewed by two readers blinded to the X-ray angiography results. We evaluated diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 4D-MRA for detection of a residual AVM.

RESULTS

A residual AVM was identified in 13 patients (13/36, 36%) on X-ray angiography. According to Readers 1 and 2, 4D-MRA had a sensitivity of 79.6% and 64.3%, a specificity of 90.9% and 100%, a PPV of 84.6% and 100% and an NPV of 90% and 81.5%, respectively, and a diagnostic accuracy of 86.1% for Readers 1 and 2, for detecting residual AVMs after GKRS.

CONCLUSION

The diagnostic accuracy of 4D-MRA at 3.0 T seems high, but there is still the possibility of further improving the spatiotemporal resolution of this technique.

Carotid baroreceptor reaction after stenting in 2 locations of carotid bulb lesions of different embryologic origin

BACKGROUND AND PURPOSE

The carotid bulb is innervated by the sinus nerve of Hering, a branch of the glossopharyngeal nerve, derived from the third pharyngeal arch. The aim of this study was to determine the frequency, predictors, and outcome of the carotid BR after carotid stent placement according to the location of the plaque lesion.

MATERIALS AND METHODS

Atherosclerotic carotid plaques of apical versus body lesions were prospectively analyzed in 95 consecutive patients who underwent carotid stent placement. Patients with hypertension after stent placement were excluded, and transient (<3 hours) and prolonged (3-24 hours) BR, together with AEs such as strokes and death, were assessed in the 2 lesion locations (apical versus body). Other factors known to affect the carotid baroreceptor were also investigated, and the results were analyzed by χ(2) or Mann-Whitney U tests.

RESULTS

Transient BR occurred in 30% of apical lesions in contrast to 70% of body lesions (P = .001). Transient BR showed a significant relationship to lesion location (P = .001), occurring most frequently in body lesions, and to the distance of maximum stenosis from the ICA ostium (P = .001). Hyperperfusion and AE rates (P = .076) in 1 month occurred more frequently in apical lesions.

CONCLUSIONS

The frequency of transient BR after carotid stent placement was lower in the apical region of the carotid bulb. Different cardiovascular disturbances after carotid stent placement can be attributed to anatomically different areas of the carotid bulb.

MR diagnosis of facial neuritis: diagnostic performance of contrast-enhanced 3D-FLAIR technique compared with contrast-enhanced 3D-T1-fast-field echo with fat suppression

BACKGROUND AND PURPOSE

Current MRI with the CE T1-weighted sequence plays a limited role in the evaluation of facial neuritis due to prominent normal facial nerve enhancement. Our purpose was to retrospectively investigate the usefulness of the CE 3D-FLAIR sequence compared with the CE 3D-T1-FFE sequence in facial neuritis patients.

MATERIALS AND METHODS

We assessed 36 consecutive patients who underwent temporal bone MR imaging at 3T for idiopathic facial palsy. Two readers independently reviewed CE 3D-T1-FFE and CE 3D-FLAIR images to determine the degree of enhancement in each of 5 segments of the facial nerve. We compared AUCs using the Z-test, compared diagnostic performance of 2 MR techniques with the McNemar test, and evaluated interobserver agreement. The Pearson χ(2) test was used for each segment of the facial nerve.

RESULTS

The AUC of CE 3D-FLAIR (reader 1, 0.754; reader 2, 0.746) was greater than that of CE 3D-T1-FFE (reader 1, 0.624; reader 2, 0.640; P < .001). The diagnostic sensitivities, specificities, and accuracies were 97.2%, 86.1%, and 91.7%, respectively, for CE 3D-FLAIR, and 100%, 56.9%, and 78.5%, respectively, for CE 3D-T1-FFE. The specificity and accuracy of CE 3D-FLAIR were greater than those of CE 3D-T1-FFE (specificity, P = .029; accuracy, P = .008). The interobserver agreements for CE 3D-FLAIR (κ-value, 0.831) and CE 3D-T1-FFE (κ-value, 0.694) were excellent. Enhancement of the canalicular and anterior genu segments on CE 3D-FLAIR were significantly correlated with the occurrence of facial neuritis (P < .001 for canalicular; P = .032 and 0.020 for anterior genu by reader 1 and reader 2, respectively).

CONCLUSIONS

CE 3D-FLAIR can improve the specificity and overall accuracy of MR imaging in patients with idiopathic facial palsy.

Recent developments of optically stimulated luminescence materials and techniques for radiation dosimetry and clinical applications

During the last 10 years, optically stimulated luminescence (OSL) has emerged as a formidable competitor not only to thermoluminescence dosimetry (TLD) but also to several other dosimetry systems. Though a large number of materials have been synthesized and studied for OSL, Al₂O₃:C continues to dominate the dosimetric applications. Re-investigations of OSL in BeOindicate that this material might provide an alternative to Al₂O₃:C. Study of OSL of electronic components of mobile phones and ID cards appears to have opened up a feasibility of dosimetry and dose reconstruction using the electronic components of gadgets of everyday use in the events of unforeseen situations of radiological accidents, including the event of a dirty bomb by terrorist groups. Among the newly reported materials, a very recent development of NaMgF₃:Eu²⁺ appears fascinating because of its high OSL sensitivity and tolerable tissue equivalence. In clinical dosimetry, an OSL as a passive dosimeter could do all that TLD can do, much faster with a better or at least the same efficiency; and in addition, it provides a possibility of repeated readout unlike TLD, in which all the dose information is lost in a single readout. Of late, OSL has also emerged as a practical real-time dosimeter for in vivo measurements in radiation therapy (for both external beams and brachytherapy) and in various diagnostic radiological examinations including mammography and CT dosimetry. For in vivo measurements, a probe of Al₂O₃:C of size of a fraction of a millimeter provides the information on both the dose rate and the total dose from the readout of radioluminescence and OSL signals respectively, from the same probe. The availability of OSL dosimeters in various sizes and shapes and their performance characteristics as compared to established dosimeters such as plastic scintillation dosimeters, diode detectors, MOSFET detectors, radiochromic films, etc., shows that OSL may soon become the first choice for point dose measurements in clinical applications. A brief review of the recent developments is presented.

Outcomes after endovascular treatment of symptomatic patients with Takayasu's arteritis

We report our experience with endovascular treatment of supra-aortic arteries and follow-up results in patients with Takayasu's arteritis (TA) presenting with neurological symptoms. Of the 20 patients with TA who underwent cerebral angiography for neurological manifestations between May 2002 and May 2009, 12 (11 females, one male; mean age, 39 years; range 31-56 years) underwent endovascular treatment and evaluated outcome for 21 lesions, including nine common carotid arteries, four vertebral arteries, four subclavian arteries, two internal carotid arteries, and one brachiocephalic artery. Eight patients underwent multiple endovascular procedures for different lesions in single or multiple stages. Mean angiographic and clinical follow-up durations were 34 months (range, 11-79 months) and 39 months (range 11-91 months), respectively. Technical success was achieved for 20 procedures in 11 patients. One procedure failed, with 50% residual stenosis after stenting due to dense calcification of vessel walls. There were no procedure-related complications. Restenosis occurred at two lesions in two patients were treated by re-stenting. Asymptomatic occlusion occurred at two lesions in one patient. Ten patients remained in 0-1 on the modified Rankin scale (mRs) during mean 39 months. One patient, however, had a score of 3 on mRs due to a traumatic contusion during follow-up. One patient died from cardiac failure 36 months after successful angioplasty.Our data suggest that endovascular treatment of symptomatic supra-aortic lesions of TA is effective and durable in selected patients with neurologic symptoms.

Presentation and minimally invasive treatment of a type IV giant paraesophageal hernia

Paraesophageal hernias (PEHs) result from a defect of the diaphragmatic hiatus with a gradual enlargement of the hiatal opening, allowing abdominal contents to shift into the mediastinum. PEHs are often confused with sliding hiatal hernias; however, it is paramount that physicians understand the subtle presentation differences in the types of diaphragmatic incompetence, as treatment may vary greatly. The type IV giant PEH is a dangerous variant that, once recognized, usually requires surgical intervention. In recent years, the laparoscopic approach has been associated with decreases in morbidity, hospital stay, and time off work, as well as increased quality of life. This case involves the proper workup and minimally invasive treatment of a 56-year-old black female who presented with a symptomatic giant PEH with colon, stomach, and duodenum displacement into the chest.

Quantitative PCR analysis of fungal DNA in Swedish day care centers and comparison with building characteristics and allergen levels

Abstract Sweden has had allergen-avoidance day care centers (AADCs) since 1979. The aim of this study was to measure fungal DNA by quantitative polymerase chain reaction (qPCR), a new method, in AADCs and ordinary day care centers (ODCs) and examine associations between allergen levels and building characteristics. Dust samples were collected by swabbing doorframes, vacuum-cleaning, and using Petri dishes. In total, 11 AADCs and 11 ODCs were studied (70 rooms). Total fungal DNA, measured by qPCR in the swab dust, was detected in 89%, Aspergillus or Penicillium (Asp/Pen) DNA in 34%, and Stachybotrys chartarum DNA in 6% of the rooms. Total fungal DNA was significantly higher in rooms with linoleum floor (P = 0.02), textile carpets (P = 0.03), reported dampness/molds (P = 0.02) and reported odor (P < 0.001) in the buildings, and significantly lower in wooden facade buildings (P = 0.003). Reported odor was related to the amount of sieved fine dust, reported dampness/molds and type of building construction. Total fungal DNA was related to cat, dog, horse and total allergen levels (P = 0.003) in the day care centers. In conclusion, total fungal DNA is related to reported dampness/molds, reported odor, and type of wall construction. The association between fungal and allergen contamination indicated a general 'hygiene factor' related to biological contaminants. Practical Implications The associations between fungal DNA, reported dampness/molds, and odor support the view that buildings with odor problems should be investigated for possible hidden fungal growth. There is a need to measure fungal biomass in different types of building constructions by monitoring fungal DNA. Analysis of fungal DNA with quantitative PCR can be a fast and practical way to study indoor fungal contamination. Swabbing dust from the doorframe of the main entrance to the room can be a convenient method of sampling dust for fungal DNA analysis. The high prevalence of reported dampness/molds and the common occurrence of fungal DNA indicate the need to improve the indoor environment of Swedish day care centers.

Development and validation of reverberation-chamber type whole-body exposure system for mobile-phone frequency

We developed whole-body exposure systems for in-vivo study at cellular (848.5 MHz) and Personal Communication System (PCS, 1,762.5 MHz) frequency, utilizing reverberation chamber. The field uniformities in the test area of the designed chambers were verified by simulation and measurement. In the whole-body exposure environment, Specific Absorption Rate (SAR) distributions inside of mice were calculated using Finite Difference Time Domain (FDTD) simulation. Key results are presented in this article.

Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools--associations with asthma and respiratory symptoms in pupils

We investigated asthma and atopy in relation to microbial and plasticizer exposure. Pupils in eight primary schools in Uppsala (Sweden) answered a questionnaire, 1014 (68%) participated. Totally, 7.7% reported doctor-diagnosed asthma, 5.9% current asthma, and 12.2% allergy to pollen/pets. Wheeze was reported by 7.8%, 4.5% reported daytime breathlessness, and 2.0% nocturnal breathlessness. Measurements were performed in 23 classrooms (May-June), 74% had <1000 ppm CO(2) indoors. None had visible mold growth or dampness. Mean total microbial volatile organic compound (MVOC) concentration was 423 ng/m(3) indoors and 123 ng/m(3) outdoors. Indoor concentration of TMPD-MIB (2,2,4-trimethyl-1,3-pentanediol monoisobutyrate, Texanol) and TMPD-DIB (2,2,4-trimethyl-1,3-pentanediol diisobutyrate, TXIB), two common plasticizers, were 0.89 and 1.64 microg/m(3), respectively. MVOC and plasticizer concentration were correlated (r = 0.5; P < 0.01). Mold concentration was 360 cfu/m(3) indoors and 980 cfu/m(3) outdoors. At higher indoor concentrations of total MVOC, nocturnal breathlessness (P < 0.01) and doctor-diagnosed asthma (P < 0.05) were more common. Moreover, there were positive associations between nocturnal breathlessness and 3-methylfuran (P < 0.01), 3-methyl-1-butanol (P < 0.05), dimethyldisulfide (P < 0.01), 2-heptanone (P < 0.01), 1-octen-3-ol (P < 0.05), 3-octanone (P < 0.05), TMPD-MIB (P < 0.05), and TMPD-DIB (P < 0.01). TMPD-DIB was positively associated with wheeze (P < 0.05), daytime breathlessness (P < 0.05), doctor-diagnosed asthma (P < 0.05), and current asthma (P < 0.05). In conclusion, exposure to MVOC and plasticizers at school may be a risk factor for asthmatic symptoms in children.

PRACTICAL IMPLICATIONS

Despite generally good ventilation and lack of visible signs of mold growth, we found an association between respiratory symptoms and indoor MVOC concentration. In addition, we found associations between asthmatic symptoms and two common plasticizers. The highest levels of MVOC, TMPD-MIB, and TMPD-DIB were found in two new buildings, suggesting that material emissions should be better controlled. As MVOC and plasticizers concentrations were positively correlated, while indoor viable molds and bacteria were negatively correlated, it is unclear if indoor MVOC is an indicator of microbial exposure. Further studies focusing on health effects of chemical emissions from indoor plastic materials, including PVC-floor coatings, are needed.

Respiratory symptoms, asthma and allergen levels in schools--comparison between Korea and Sweden

We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0-21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5-6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO(2) levels were high in most Korean schools (range 907-4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue.

PRACTICAL IMPLICATIONS

This study showed that furry pet allergen contamination was common in both Korean and Swedish schools. In addition, house dust-mite (Der f 1) allergen contamination was common in Korean schools, probably because of transport of allergen from other environments. Transfer should therefore be minimized. Korean schools had high CO(2) levels and the concept of mechanical ventilation should be introduced. Measurement of airborne allergen levels is quite new and seems to be a more convenient and correct way to monitor allergen exposure in classrooms.

Development of LiF:Mg,Cu,Si TL material (new KLT-300) with a low-residual signal and high-thermal stability

LiF-based thermoluminescence (TL) materials have been widely used for radiation dosimetry due to their attractive features. LiF:Mg,Cu,P is one of the most sensitive tissue-equivalent TL materials, approximately 40 times more sensitive than LiF:Mg,Ti (TLD-100), but it has two main drawbacks: a thermal loss of the TL sensitivity when annealed at temperatures>240 degrees C, and a relatively high-residual signal. Recently, LiF:Mg,Cu,Na,Si TL material was developed to overcome these drawbacks at the Korea Atomic Energy Research Institute, but it provided only marginal improvements in reducing the residual signal. The newly developed LiF:Mg,Cu,Si TL material has a significantly lower residual signal and a better stability to thermal treatments. In this article, the preparation method and some dosimetric properties (sensitivity and residual signal) of the new LiF:Mg,Cu,Si TL material are presented. At the end of the preparation procedures, a dual-step annealing method is introduced and this has proved as a very efficient method to reduce the high-temperature peak and is the cause of residual signal. Therefore, the high-temperature peak in the glow curve was significantly reduced. The sensitivity is approximately 20 times higher than that of TLD-100 and the residual signal was estimated to be approximately 0.04%.

Determination of the neutron fluence spectra in the neutron therapy room of KIRAMS

High energy proton induced neutron fluence spectra were determined at the Korea Institute of Radiological and Medical Sciences (KIRAMS) using an extended Bonner Sphere (BS) set from the Korea Atomic Energy Research Institute (KAERI) in a series of measurements to quantify the neutron field. At the facility of the MC50 cyclotron of KIRAMS, two Be targets of different thicknesses, 1.0 and 10.5 mm, were bombarded by 35 and 45-MeV protons to produce six kinds of neutron fields, which were classified according to the measurement position and the use or no use of a beam collimator such as the gantry of the neutron therapy unit. In order to obtain a priori information to unfold the measured BS data the MCNPX code was used to calculate the neutron spectrum, and the influence of the surrounding materials for cooling the target assembly were also reviewed through this calculation. Some dosimetric quantities were determined by using the spectra determined in this measurement. Dose equivalent rates of these neutron fields ranged from 0.21 to 5.66 mSv h(-1)nA(-1) and the neutron yields for a thick Be target were 3.05 and 4.77% in the case of using a 35 and a 45-MeV proton, respectively.

Correlation of gastroesophageal reflux disease symptoms characteristics with long-segment Barrett's esophagus

Thus far, there has been a paucity of studies that have assessed the value of the different gastroesophageal reflux disease (GERD) symptom characteristics in identifying patients with long-segment Barrett's esophagus versus those with short-segment Barrett's esophagus. To determine if any of the symptom characteristics of GERD correlates with long-segment Barrett's esophagus versus short-segment Barrett's esophagus. Patients seen in our Barrett's clinic were prospectively approached and recruited into the study. All patients underwent an endoscopy, validated GERD symptoms questionnaire and a personal interview. Of the 88 Barrett's esophagus patients enrolled into the study, 47 had short-segment Barrett's esophagus and 41 long-segment Barrett's esophagus. Patients with short-segment Barrett's esophagus reported significantly more daily heartburn symptoms (84.1%) than patients with long-segment Barrett's esophagus (63.2%, P = 0.02). There was a significant difference in reports of severe to very severe dysphagia in patients with long-segment Barrett's esophagus versus those with short-segment Barrett's esophagus (76.9%vs. 38.1%, P = 0.02). Longer duration in years of chest pain was the only symptom characteristic of gastroesophageal reflux disease associated with longer lengths of Barrett's mucosa. Reports of severe or very severe dysphagia were more common in long-segment Barrett's esophagus patients. Only longer duration of chest pain was correlated with longer lengths of Barrett's esophagus.

Microencapsulated Cells Genetically Modified to Overexpress Human Transforming Growth Factor-β1: Viability and Functionality in Allogeneic and Xenogeneic Implant Models

This study explores the suitability of using encapsulated genetically modified fibroblasts for orthopedic tissue engineering by examining cell survival and persistence of human transforming growth factor-beta (hTGF-beta) overexpression in xenogeneic and allogeneic implant models. Human wild-type fibroblasts, modified to produce a latent form of hTGF-beta, and murine mutant-type fibroblasts, engineered to release a constitutively active form of hTGF-beta, were encapsulated separately in Ca2+ -alginate microcapsules. Following a percentage viability assessment by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) test, microcapsules were implanted into either the subcutaneous or intraperitoneal cavities of mice. Explanted encapsulated cells were characterized for percentage viability and subjected to a release study and a viability test 1 week and 3 weeks following implantation, a time frame consistent with the requirement for orthopedic tissue engineering application of this growth factor. On average, percentage viabilities of encapsulated cells were 64%at implantation, 52% at explantation, and 56%after 1 week following either 1- or 3-week explantation. hTGF-beta release declined following in vivo implantation, more so for xenogeneic than allogeneic models, but remained in the clinically attractive range of 2 to 30 ng/(10(6) implanted cells 24 h). This technical platform for hTGF-beta is very encouraging for cartilage regeneration using orthopedic tissue engineering, and further evaluation is warranted.

Energy responses of the LiF series TL pellets to high-energy photons in the energy range from 1.25 to 21 MV

The energy responses for the KLT-300(LiF:Mg,Cu,Na,Si, Korea), GR-200(LiF:Mg,Cu,P, China) and MCP-N(LiF:Mg,Cu,P, Poland) thermoluminescence(TL) pellets were studied for a photon radiation with energies from 1.25 MeV(60Co) to 21 MV (Microtron) to verify the usefulness of the calibration for the radiotherapy beams. The International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) have performed thermoluminescence dosimetry (TLD) audits to verify the calibration of the beams by TL powder, but TL pellets were used in this study because the element correction factor (ECF), defined as the factor to correct the variations that all TL dosemeters cannot be manufactured to have exactly the same TL efficiency, for each TL pellet could be accurately derived and be handled conveniently when compared with the powder. Also several works for the energy response of the TLDs were done for the low-energy photon beams up to 60Co, but they will be extended in this experiment to the high photon energies (up to 20 MV), which are widely used in the therapy level of a radiation. The PTW 30006 ionisation chamber was calibrated by the Korea primary standards to establish the air-kerma rates and the TL pellets were irradiated in a specially designed waterproof pellet holder in a water phantom (30 x 30 x 30 cm3) just like the IAEA postal audits programme. This result was compared with that of another type of phantom [10 (W) x 10 (L) x 10 (H) cm3 PMMA Perspex phantom for the 60Co and 6 MV photon, and 10 x 10 x 20 (H) cm3 for the 10 and 21 MV photon] for its convenient use and easy handling and installation in a hospital. The results show that the differences of the responses for the water phantom and PMMA Perspex phantom were negligible, which is contrary to the general conception that a big difference would be expected. For an application of these results to verify the therapy beams, an appropriate energy correction factor should be applied to the energies and phantom types in use.

Monte Carlo simulation of the photon beam characteristics from medical linear accelerators

The MCNPX code has been employed on a personal computer to calculate the dosimetric characteristics of the photon beams from the 6 MV Siemens MX2 and the 10 MV Varian Clinac 2100C linear accelerators. A model of the treatment head includes the major geometric structure within the beam path. The model was used to calculate the energy spectra of the photon beam, percentage depth dose and the dose profiles. The accuracy of the calculated results is examined by comparing them with the measured dose distributions for the two machines. The computed and measured depth dose curves agree to within 2% for all the depths beyond the build-up region for both treatment machines. The calculations agree to within 2% of the measured profiles within the 100-50% dose level. It has been found that the MCNPX code is an effective tool for simulating the clinical photon beam.

On the relationship between dose-, energy- and LET-response of thermoluminescent detectors

Measurements of the response of thermoluminescent (TL) detectors after gamma ray doses high enough to observe signal saturation provide input to microdosimetric models which relate this gamma-ray response with the energy response after low doses of photons (gamma rays and low-energy X rays) and after high-LET irradiation. To measure their gamma ray response up to saturation, LiF:Mg,Ti (MTS-7 and MTT), LiF:Mg,Cu,P (MCP-7), CaSO4:Dy (KCD) and Al2O3:C detectors were irradiated with 60Co gamma rays over the range 1-5000 Gy. The X-ray photon energy response and TL efficiency (relative to gamma rays) after doses of beta rays and alpha particles, were also measured, for CaSO4:Dy and for Al2O3:C. Microdosimetric and track structure modelling was then applied to the experimental data. In a manner similar to LiF:Mg,Cu,P, the experimentally observed under response of alpha-Al2O3:C to X rays <100 keV, compared with cross-section calculations, is explained as a microdosimetric effect caused by the saturation of response of this detector without prior supralinearity (saturation of traps along the tracks). The enhanced X-ray photon energy response of CaSO4:Dy is related to the supralinearity observed in this material after high gamma ray doses, similarly to that in LiF:Mg,Ti. The discussed model approaches support the general rule relating dose-, energy- and ionisation density-responses in TL detectors: if their gamma ray response is sublinear prior to saturation, the measured photon energy response is lower, and if it is supralinear, it may be higher than that expected from the calculation of the interaction cross sections alone. Since similar rules have been found to apply to other solid-state detector systems, microdosimetry may offer a valuable contribution to solid-state dosimetry even prior to mechanistic explanations of physical phenomena in different TL detectors.

Thermoluminescence emission spectra for the LiF:Mg,Cu,Na,Si thermoluminescent materials with various concentrations of the dopants (3-D measurement)

The thermoluminescence (TL) emission spectra from LiF TL materials, called KLT-300 (LiF:Mg,Cu,Na,Si) with various dopant concentrations are measured and analysed. These KLT-300 materials were developed by the Korea Atomic Energy Research Institute (KAERI) to achieve an enhancement of the thermal stability in TL readings. Six types of samples are prepared with different dopant concentrations in the following ranges; Mg (0-0.20 mol%), Cu (0-0.05 mol%), Na and Si (0-0.9 mol%). The spectra measurements are carried out for the six types of samples using a TL emission spectra measurement device. The spectra measurement device consists of a monochromator, photomultiplier tube and temperature control unit to thermally stimulate the samples. The measured data shows the light emission during heating of the sample as a function of temperature and wavelength (three-dimensional TL spectra). The spectra were analysed using a method of deconvolution based on gaussian curve. The wavelength of a main peak of the emission spectra changes depending on the existence of the Cu dopant, while intensity of the spectra rapidly changes with the Cu dopant concentrations. The 385 nm emission is mainly observed in all the spectra from the samples with the Cu dopant, but in those from the samples without the Cu dopant a very weak 401 nm emission is mainly observed. However, any change in the wavelength at a main peak of the TL emission spectra from the sample materials with Na and Si dopants is not observed but that in the intensity at a peak of the spectra is observed.

Species status and phylogeography of two closely related Coptolabrus species (Coleoptera: Carabidae) in South Korea inferred from mitochondrial and nuclear gene sequences

We investigated the species status and intraspecific phylogeography in South Korea of two ground beetle species, Coptolabrus jankowskii and Coptolabrus smaragdinus (Coleoptera: Carabidae), using statistical parsimony networks and nested clade analyses based on sequences from the mitochondrial cytochrome oxidase subunit I (COI) and nuclear phosphoenolpyruvate carboxykinase (PepCK) and wingless (Wg) genes. Although traditional parsimony tree construction generally failed to resolve interspecific relationships and construct biologically meaningful genealogies, analysis using statistical parsimony networks yielded statistically significant inter- and intraspecific genealogical structures. We found that although these two species represent a notable case of trans-species polymorphisms in both mitochondrial and nuclear gene sequences, their status as separate species was evidenced by the nonrandom association between species and nested clades at various nesting levels. The exceptional occurrence of shared identical or very similar COI sequences was considered to be the result of introgressive hybridization. In addition, range expansion and fragmentation events across the Korean Peninsula and adjacent islands were inferred from nested clade phylogeographical analyses. The COI gene revealed the geographical divergence of major eastern and western clades and historical biogeographical events within each major clade, whereas the nuclear PepCK gene, which did not reveal corresponding east-west clades, indicated past fragmentation and range expansion across wide areas that may have been the result of older biogeographical events. Thus, phylogeographical inferences drawn from analyses of mitochondrial and nuclear genes can reveal different and potentially complementary information about phylogeographical processes.

In vitro Characterization of TGF-??1 Release from Genetically Modified Fibroblasts in Ca2+-Alginate Microcapsules

This study was undertaken to develop an in situ source of transforming growth factor-beta1 (TGF-beta1), one of several molecules potentially useful for a tissue-engineered bioartificial cartilage. Primary human fibroblasts and murine NIH 3T3 cells were genetically modified via viral transfection to express human TGF-beta1. Two viral constructs were used, one expressing a gene encoding for the latent and the other for the constitutively active form of the growth factor. Unmodified cells served as controls. Four genetically modified cohorts and two controls were separately encapsulated in a 1.8% alginate solution using a vibrating nozzle and 0.15M calcium chloride crosslinking bath. Diameter of the spherical capsules was 410 +/- 87 microm. In vitro release rate measured over 168 hours varied with cell types and ranged from 2-17 pg/(milligram of capsules x 24 h) or 2-17 ng/(10(6) cells x 24 h). None of the formulations exhibited a large initial bolus release. Even when serum-supplemented medium was not replenished, cell viabilities remained over 55% after 1 week for all cell types. Microencapsulated genetically modified cells were capable of a constitutive synthesis and delivery of biologically significant quantity of TGF-beta1 for at least 168 hours and thus are of potential utility for artificial cartilage and other orthopedic tissue engineering applications.

Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment

The aim was to study asthma and allergy in relation to diet and the school environment. Pupils (5-14 years) in eight schools received a questionnaire, 1014 participated (68%). Settled dust was collected on ALK-filters and analyzed for allergens from cat (Fel d 1), dog (Can f 1), horse (Equ cx), house dust mites (Der p 1, Der f 1), and cockroach (Bla g 1) by ELISA. In total, 6.8% reported cat allergy, 4.8% dog allergy, 7.7% doctor's diagnosed asthma and 5.9% current asthma, and 7.8% reported wheeze. Current asthma was less common among those consuming more fresh milk (P < 0.05) and fish (P < 0.01). Poly-unsaturated fatty acids was associated with more wheeze (P < 0.05), olive oil was associated with less doctors' diagnosed asthma (P < 0.05). Totally, 74% of the classrooms had mean CO(2) <1000 ppm. The median concentration per gram dust was 860 ng/g Fel d 1, 750 ng/g Can f 1 and 954 U/g Equ cx. Horse allergen was associated with more wheeze (P < 0.05), daytime breathlessness (P < 0.05), current asthma (P < 0.05) and atopic sensitization (P < 0.05). Dog allergen was associated with wheeze (P < 0.05) and daytime breathlessness (P < 0.05). The associations between allergens and respiratory symptoms were more pronounced among those consuming margarine, not consuming butter, and with a low intake of milk. In conclusion, cat, dog and horse allergens in schools could be a risk factor for asthma and atopic sensitization, and dietary factors may interact with the allergen exposure.

PRACTICAL IMPLICATIONS

Previous school studies performed by us in mid-Sweden, showed that most classrooms did not fulfill the ventilation standards. In this study, most of the classrooms fulfilled the ventilation standard, but despite that had widespread allergen contamination. Most previous studies have focused on cat allergen, but our study has shown that also dog and horse allergens can be risk factors for asthma and allergy in schools. As allergens are transported from other environments, mainly the home environment, the main prevention should be to minimize transfer of allergens. This could be achieved by reducing contacts with furry pets and horses, or using different clothes at home and at school (e.g. school uniforms). Increased cleaning in the schools may reduce allergen levels, but the efficiency of this measure must be evaluated in further intervention studies. Finally, our study supports the view that dietary habits among pupils should not be neglected and interaction between dietary factors and indoor allergen exposure needs to be further investigated.

Dosimetric properties of the newly developed KLT-300 (LiF:Mg,Cu,Na,Si) TL detector

The dosimetric properties of the newly developed KLT-300 (KAERI LiF:Mg,Cu,Na,Si TL detector) in KAERI (Korea Atomic Energy Research Institute) were investigated. The sensitivity of the TL detector was about 30 times higher than that of the TLD-100 by light integration. In the study of the dose linearity of the detector, the dose response was very linear up to 10 Gy and a sublinear response was observed at higher doses. The energy response of the detector was studied for photon energies from 20 to 662 keV. The results show that a maximum response of 1.004 at 53 keV and a minimum response of 0.825 at 20 keV were observed. The reproducibility study for the TL detector was also carried out. The coefficients of variation for each detector separately did not exceed 0.016, and for all the 10 detectors collectively it was 0.0054. IEC Standard requires that the coefficient of variation shall not exceed 0.075. So, the reproducibility of this new TL detector sufficiently satisfied the IEC requirements. A detection threshold of the detector was investigated and found to be 70 nGy by Harshaw 4500 TLD Reader.

On the roles of the dopants in LiF: Mg,Cu,Na,Si thermoluminescent material

In this paper, some results of the study on the roles of the dopants in the LiF:Mg,Cu,Na,Si thermoluminescent (TL) material that was developed at the Korea Atomic Energy Research Institute for radiation protection are presented. Although there have been many studies to investigate the roles of the dopants in LiF:Mg,Cu,P TL material in the TL process, there are some discrepancies in the understanding of the roles of Cu and P between various researchers. In case of LiF:Mg,Cu,Na,Si TL material, there are a few studies on the roles of the dopants. Three kinds of samples in each of which one dopant is excluded, and the optimised sample, were prepared for this study. The measurements and analysis of the three-dimensional TL spectra, based on the temperature, wavelength and intensity, and the glow curves for those samples are used in this study. The results show that Mg plays a role in the trapping of the charge carriers and Cu plays a role in the luminescence recombination process; however, the effect of Na and Si on the glow curve structure and the TL emission spectra is much less than that of Mg and Cu. It is considered that Na and Si each plays a role in the improvement of the luminescence efficiency.

A computer program for the deconvolution of thermoluminescence glow curves

A quick and efficient computer program was developed in order to resolve the peaks from the thermoluminescence (TL) glow curve. The program was designed to be easily used on any MS Windows-based computer with a graphical user interface. In this program, a new method based on the general one-trap TL equation was adopted to analyse the TL glow curve with the traditional first-order, second-order and general-order kinetics model. The method described here, general approximation, generates TL glow peaks and interpolates the relevant TL parameters from the glow data. The program was tested with simulated and experimental TL glow data and the results were found to be adequate and reliable.

Developments in the synthesis of LiF:Mg,Cu,Na,Si TL material

A procedure for synthesis of the highly sensitive pellet-type LiF:Mg,Cu,Na,Si thermoluminescent (TL) detector has been newly developed. It was found that the optimum concentrations of dopants for a pellet-type LiF:Mg,Cu,Na,Si TL detector were found to be Mg: 0.2 mol %, Cu: 0.05 mol %, Na: 0.9 mol%, and Si: 0.9 mol%. The TL sensitivity of this new detector was about 30 times higher than that of the TLD-100 by light integration measurements. Reusability study of the detector was carried out for 10 cycles. The results show that the coefficients of variation for each detector separately did not exceed 0.016, and that for all 10 detectors collectively was 0.0054.

Recovery, growth, and development of Acanthoparyphium tyosenense (Digenea: Echinostomatidae) in experimental chicks

Chicks were experimentally infected with Acanthoparyphium tyosenense (Digenea: Echinostomatidae) metacercariae per os, and the growth and development of worms in this host were observed from days I to 38 postinfection (PI). The worms grew rapidly and matured sexually in the small intestine (chiefly in the jejunum) of chicks by day 5 PI. and survived at least up to day 38 Pi, although worm recovery decreased after day 5 PI. Both parenchymal and reproductive organs increased greatly in size from day 2 to day 10 PI and then continued to increase gradually in size up to day 38 PI. The number of uterine eggs reached a peak on days 10 and 15 PI and then decreased gradually. The results suggest that chicks are a fairly suitable definitive host for experimental infection with A. tyosenense.

Emission of a hot electron jet from intense femtosecond-laser-cluster interactions

A directional hot electron jet with energy higher than 100 keV was generated along the laser propagation direction from Ar clusters irradiated with a laser pulse of duration 28 fs and intensity 1 x 10(17) W/cm(2). The hot electron jet was detected only with linearly polarized laser pulses, not with circularly polarized pulses. Channel betatron resonance is believed to be the main accelerating mechanism for this directional hot electron jet.

Microdosimetric interpretation of the photon energy response of LiF:Mg,Ti detectors

Photon energy response of MTS-N (LiF:Mg,Ti) detectors (TLD Poland) and of MTS-N detectors sensitised with 200 Gy of 60Co gamma rays, followed by UV irradiation (sMTS-N), has been determined using X rays with narrow energy spectra, in the energy range from 20 to 300 keV. The over-response of LiF:Mg,Ti detectors for X rays (relative TL efficiency eta = 1.1) can be explained as an ionisation density effect. Low energy X rays produce short electron tracks, which locally deposit a high radiation dose and, consequently, lead to an enhanced (supralinear) response. This over-response has not been observed in sensitised MTS-N where supralinearity in the response after gamma ray doses above 1 Gy is not seen. Using the dose-response curves measured for MTS-N detectors after 137Cs gamma ray irradiation and local doses calculated using Monte Carlo generated electron tracks, it was possible to predict the relative TL effectiveness for different X ray energies. The calculation procedure can be applied to predict the photon energy response of LiF:Mg,Ti detectors in an arbitrary photon field.

Thermoluminescence characteristics of teflon embedded CaSO4:Dy TLD

The Korea Atomic Energy Research Institute (KAERI) is manufacturing CaSO4:Dy Teflon TL pellets which have more sensitivity and stability than commercial TLD. A method is presented of preparing the CaSO4:Dy phosphor-embedded Teflon powder, which is then compressed to a thin pellet form used as the TLD element. Investigations are made to determine optimum preparation conditions and dosimetric characteristics of the CaSO4:Dy Teflon pellet such as the sensitivity, energy response, dose response, fading, re-usability, and lowest level of detection. The results show that the sensitivity of the CaSO4:Dy pellet is 2 times higher than that of the commercial Teledyne CaSO4:Dy pellet. A dose-response was observed to be linear in the range from 10(-5) to 10 Gy. The relative energy response in the low energy region was 9.6 (normalised to the 137Cs gamma source), and the fading rate was about 10% for five months. The re-usability was estimated to be more than 60 cycles, and the low level of detection dose was 22 microGy. From the results, the CaSO4:Dy pellet developed in KAERI can be successfully used in personal dosemeters through appropriate filter design for compensating the energy response.

Thermoluminescence properties of LiF:Mg,Cu,Na,Si pellets in radiation dosimetry

Sintered LiF:Mg,Cu,Na,Si thermoluminescence (TL) pellets have been developed for application in radiation dosimetry. LiF:M,Cu,Na,Si TL pellets were made from TL powders using a sintering process, that is, pressing and heat treatment. These pellets have a diameter of 4.5 mm, and a thickness of 0.8 mm are blue in colour and have a mass of 28 mg each. After 400 pellets had been produced they were irradiated with 137Cs gamma radiation and samples having a sensitivity within a +/-5% standard deviation were selected for experimental use. In the present study, the physical and dosimetric properties of LiF:Mg,Cu,Na,Si TL pellets were investigated for their emission spectrum, dose response, energy response and fading characteristics. Photon irradiation for the experiments was carried out using X ray beams and a 137Cs gamma source at the Korea Atomic Energy Research Institute (KAERI). The average energies and the dose were in the range of 20-662 keV and 10(-6) - 10(2) Gy respectively. The glow curves were measured with a manual type thermoluminescence dosimetry reader (system 310, Teledyne) at a constant nitrogen flux and a linear heating rate. For a constant heating rate of 5 degrees C.s(-1). the main dosimetric peak of the glow curve appeared at 234 degrees C, its activation energy was 2.34 eV and the frequency factor was 1.00 x 10(23). The TL emission spectrum appeared at the blue region centred at 410 nm. A linearity of photon dose response was maintained up to 100 Gy. The photon energy responses relative to the 137Cs response were within +/-20% in the overall photon energy region. No fading of the TL sensitivity of the pellets stored at room temperature was found over the course of a year. Therefore LiF:Mg,Cu,Na,Si TL pellets can be used for personal dosimetry, but more research is needed to improve the characteristics for repeated use.

Comparison of TLD algorithms for monochromatic fluorescent radiation and continuous spectrum X rays

A personal dosimetry system is required to measure the personal dose equivalent accurately in a wide range of radiation fields. However, the dose evaluation algorithm at the Korea Atomic Energy Research Institute (KAERI) has been developed with the spectral X ray fields described in the American National Standards Institute (ANSI) Standard N13.11 and the actual fields to be monitored may be significantly different from these. To evaluate the dose more accurately when workers are exposed to non-ANSI N13.11 radiation fields, a dose evaluation algorithm using monochromatic radiation (monochromatic algorithm) was developed using the experimental data of the energy responses of CaSO4:Dy thermoluminescent materials irradiated by monochromatic fluorescent X ray fields recently established at KAERI; this was compared with another algorithm developed on the basis of the ANSI N13.11 continuous spectrum X ray fields (spectrum algorithm). The paper concludes with discussions about some results of the algorithm test, including mixed field irradiation and angular response, conducted in an International Atomic Energy Authority/Regional Cooperation of Asia (IAEA/RCA) intercomparison study.

Analysis of the glow curves obtained from LiF:Mg,Cu,Na,Si TL material using the general order kinetics model

Three-dimensional thermoluminescence (TL) spectra based on temperature, wavelength and intensity for newly developed LiF:Mg,Cu,Na,Si TL material at the Korea Atomic Energy Research Institute (KAERI) were measured and analysed. The glow curves were obtained by integration of luminescence intensity over all wavelengths at each temperature, and various trapping parameters related to the traps were determined by analysing these curves. A computerised glow curve deconvolution (CGCD) method which was based on the general order kinetics (GOK) model was used for the glow curve analysis. The glow curves of LiF:Mg,Cu,Na,Si TL material were deconvoluted to six isolated glow curves which have peak temperatures at 333, 374, 426, 466, 483 and 516 K. The main glow peak of peak temperature at 466 K had activation energy of 2.06 eV and a kinetic order of 1.05. This TL material was also found to have three recombination centres, 1.80 eV, 2.88 eV and 3.27 eV by analysis of the TL spectra.

5-HT2A receptor gene promoter polymorphism -1438A/G and bipolar disorder

Genetic factors, such as the genes involved in the serotonin pathway, probably play an important role in the pathogenesis of bipolar disorder, and serotonin type 2A (5-HT2A) receptor gene promoter polymorphism -1438A/G has been reported. This study investigated the association between -1438A/G polymorphism of 5-HT2A receptor gene promoter and bipolar disorder in a Korean population. Using the polymerase chain reaction, -1438A/G polymorphism typed in 142 patients with bipolar disorder and in 148 normal control subjects. Differences in genotype distributions and allele frequencies of -1438A/G between patients with bipolar disorder and normal control subjects were tested for significance using the chi-squared test. There were significant differences in genotype distributions [chi2 = 9.697, degrees of freedom (df) = 2, P = 0.008] and allele frequencies (chi2 = 7.284, df = 1, P = 0.007) of -1438A/G between patients with bipolar disorder and normal control subjects. Although further studies are necessary, these results in a Korean population suggest that -1438A/G polymorphism of 5-HT2A receptor gene promoter may be causally related to the development of bipolar disorder.

A nationwide survey of the prevalence of human Gymnophalloides seoi infection on western and southern coastal islands in the Republic of Korea

A nationwide survey was performed to know the distribution and prevalence of human Gymnophalloides seoi infection on western and southern coastal islands in the Republic of Korea. A total of 4,178 fecal specimens were collected from residents on 45 (24 western and 21 southern) islands, and examined by Kato-Katz and formalin-ether sedimentation techniques. Eggs of G. seoi were detected from 160 (3.8%) people living on 22 (13 western and 9 southern) islands. The prevalence varied by the location of islands; higher on western islands than on southern islands. The highest prevalence was found on Amtaedo (25.3%), followed by Cheungdo (25.0%), and Anchwado (20.9%) (Shinan-gun). A little lower prevalence was observed on Munyodo (13.3%), Shinshido (12.9%), and Sonyudo (10.3%) (Kunsan-shi). Of the remaining islands, the regions showing the prevalence greater than 5% included Kohado, Dallido (Mokpo-shi), Pyeongildo, Kogumdo (Wando-gun), and Keogumdo (Kohung-gun). A strong age predilection was noted (p < 0.05); 95% of the infected people were over 40 years old. Females showed a little higher prevalence than males. The results indicate that human G. seoi infection is more widely distributed than previously considered. Nine of 11 islands (excluding the 2 known areas Munyodo and Sunyudo) that showed greater prevalence than 5% are regarded as new endemic foci of G. seoi.

High endemicity of Metagonimus yokogawai infection among residents of Samchok-shi, Kangwon-do

A small-scale epidemiological survey was undertaken during 1997-1998 on the residents along the Osib-chon (Stream), Samchok-shi (City), Kangwon-do (Province), to evaluate the status of Metagonimus yokogawai infection. A total of 165 fecal samples was collected and examined by cellophane thick smear and formalin-ether sedimentation techniques. The egg positive rate of M. yokogawai was 29.7%, showing a remarkable difference between males (46.6%) and females (16.3%). To obtain the adult flukes of M. yokogawai, 11 egg positive persons were treated with praziquantel and purged with magnesium sulfate. A total of 242,119 adult flukes (average 22,010 per person, 367-119,650 in range) was collected from diarrheic stools, all of which were identified as M. yokogawai. The results show that M. yokogawai is still highly endemic in this area.

Structure and Function of Hepatitis C Virus NS3 Helicase

Hepatitis C Virus helicase activity has been mapped to the COOH-terminal 450 residues of the NS3 protein. Due to its complexity and presumed essentiality for viral replication, the helicase is an attractive target for drug discovery. The elucidation of the atomic structure of the HCV NS3 helicase in complex with oligonucleotide and with ADP has helped clarify our understanding of potential sites for inhibitor binding. Molecular details of the mechanism of this enzyme, and in particular, a better understanding of the mechanism by which ATP hydrolysis is coupled to unwinding of double-stranded substrate may facilitate more efficient structure-based drug design.

TATA element recognition by the TATA box-binding protein has been conserved throughout evolution

Cocrystal structures of wild-type TATA box-binding protein (TBP) recognizing 10 naturally occurring TATA elements have been determined at 2.3-1.8 A resolution, and compared with our 1.9 A resolution structure of TBP bound to the Adenovirus major late promoter (AdMLP) TATA box (5'-TATAAAAG-3'). Minor-groove recognition by the saddle-shaped protein induces the same conformational change in each of these oligonucleotides, despite variations in promoter sequence that reduce the efficiency of transcription initiation. Three molecular mechanisms explain assembly of diverse TBP-TATA element complexes. (1) T --> A and A --> T transversions leave the minor-groove face unchanged, permitting formation of TBP-DNA complexes on many A/T-rich core promoter sequences. (2) Cavities in the interface between TBP and the minor-groove face of the AdMLP TATA box accommodate the exocyclic NH(2) groups of G in a TACA box and in a TATAAG box. (3) Formation of a C:G Hoogsteen basepair in a TATAAAC box eliminates steric clashes that would be produced by the Watson-Crick base pair. We conclude that the structure of the TBP-TATA box complex found at the heart of the polymerase II (pol II) transcription machinery has remained constant over the course of evolution, despite variations in TBP and its DNA targets.

New hydrolysis method for extremely small amount of lipids and capillary gas chromatographic analysis as n(O)-tert.-butyldimethylsilyl fatty acid derivatives compared with methyl ester derivatives

The organic basic solution, 1 M tetramethylammonium hydroxide (TMAH) in methanol, was employed for the hydrolysis of extremely small amounts of lipids compared to the classical inorganic basic solution, 1 M KOH in ethanol. The hydrolysed fatty acids were derivatized as N(O)-tert.-butyldimethylsilyl (tBDMSi) esters with N-methyl-N-(tert.-butyldimethylsilyl) trifluoroacetamide (MTBSTFA) and compared with the classical derivatives, the methyl esters, made by the BF3-methanol method. Recoveries of fatty acids determined on the standard fatty acids and soybean oil hydrolysed with TMAH were high: about 1.1-2.1- and 2.0-5.4-times, respectively, in all fatty acids compared with the hydrolysis by KOH regardless of derivatization method. The relative standard deviations (RSDs) on the recoveries of standard fatty acids were less than 5% when hydrolysed with TMAH, regardless of derivatives, but when hydrolysed with KOH, RSDs were more than 5% for most fatty acids, especially for long-chain fatty acids. The RSDs on the recoveries of fatty acids on the soybean oil were also very high in the KOH hydrolysis. Fatty acid compositions of soybean oil were similar in the main fatty acids regardless of hydrolysis methods, but showed slightly different values, depending on the methods of derivatization. RSDs were also very high in the KOH hydrolysis. In view of these results, precision of analysis by KOH hydrolysis was very poor, so we could not rely on the data. On the other hand, the reliability of data by TMAH hydrolysis method was very high, so it is a useful new hydrolysis method for extremely small amounts of lipid samples. Both derivatives of 35 standard fatty acids were successfully separated on a HP-1 nonpolar capillary column. tBDMSi derivatives were completely resolved in 70 min by 295 degrees C. In the methyl ester derivatives it took about 80 min to get satisfying resolution, but these derivatives were completely resolved by 250 degrees C. The sensitivity of tBDMSi derivatives was about 1.5-6.3-times higher than that with methyl ester derivatives. The stability of tBDMSi derivatives was constant for about 144 h except arachidic, docosahexanoic, behenic and heneicosanoic acids, which were stable for only 86 h.

Structure-based mutagenesis study of hepatitis C virus NS3 helicase

The NS3 protein of hepatitis C virus (HCV) is a bifunctional protein containing a serine protease in the N-terminal one-third, which is stimulated upon binding of the NS4A cofactor, and an RNA helicase in the C-terminal two-thirds. In this study, a C-terminal hexahistidine-tagged helicase domain of the HCV NS3 protein was expressed in Escherichia coli and purified to homogeneity by conventional chromatography. The purified HCV helicase domain has a basal ATPase activity, a polynucleotide-stimulated ATPase activity, and a nucleic acid unwinding activity and binds efficiently to single-stranded polynucleotide. Detailed characterization of the purified HCV helicase domain with regard to all four activities is presented. Recently, we published an X-ray crystallographic structure of a binary complex of the HCV helicase with a (dU)(8) oligonucleotide, in which several conserved residues of the HCV helicase were shown to be involved in interactions between the HCV helicase and oligonucleotide. Here, site-directed mutagenesis was used to elucidate the roles of these residues in helicase function. Four individual mutations, Thr to Ala at position 269, Thr to Ala at position 411, Trp to Leu at position 501, and Trp to Ala at position 501, produced a severe reduction of RNA binding and completely abolished unwinding activity and stimulation of ATPase activity by poly(U), although the basal ATPase activity (activity in the absence of polynucleotide) of these mutants remained intact. Alanine substitution at Ser-231 or Ser-370 resulted in enzymes that were indistinguishable from wild-type HCV helicase with regard to all four activities. A mutant bearing Phe at Trp-501 showed wild-type levels of basal ATPase, unwinding activity, and single-stranded RNA binding activity. Interestingly, ATPase activity of this mutant became less responsive to stimulation by poly(U) but not to stimulation by other polynucleotides, such as poly(C). Given the conservation of some of these residues in other DNA and RNA helicases, their role in the mechanism of unwinding of double-stranded nucleic acid is discussed.