• Title/Summary/Keyword: Assurance

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Using CR System at the Department of Radiation Oncology PACS Evaluation (방사선 종양학과에서 CR System을 이용한 PACS 유용성 평가)

  • Hong, Seung-Il;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.143-149
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    • 2012
  • Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

Simplistic QA for an Enhanced Dynamic Wedge using the Reversed Wedge Pair Method (역방향 조사방식을 통한 동적쐐기의 품질관리)

  • Lee Jeong Woo;Hong Semie;Suh Tae Suk
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.161-166
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    • 2004
  • A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

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Accurate Quality Control Method of Bone Mineral Density Measurement -Focus on Dual Energy X-ray Absorptiometry- (골밀도 측정의 정확한 정도관리방법 -이중 에너지 방사선 흡수법을 중심으로-)

  • Kim, Ho-Sung;Dong, Kyung-Rae;Ryu, Young-Hwan
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.361-370
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    • 2009
  • The image quality management of bone mineral density is the responsibility and duty of radiologists who carry out examinations. However, inaccurate conclusions due to lack of understanding and ignorance regarding the methodology of image quality management can be a fatal error to the patient. Therefore, objective of this paper is to understand proper image quality management and enumerate methods for examiners and patients, thereby ensuring the reliability of bone mineral density exams. The accuracy and precision of bone mineral density measurements must be at the highest level so that actual biological changes can be detected with even slight changes in bone mineral density. Accuracy and precision should be continuously preserved for image quality of machines. Those factors will contribute to ensure the reliability in bone mineral density exams. Proper equipment management or control methods are set with correcting equipment each morning and after image quality management, a phantom, recommended from the manufacturer, is used for ten to twenty-five measurements in search of a mean value with a permissible range of ${\pm}1.5%$ set as standard. There needs to be daily measurement inspections on the phantom or at least inspections three times a week in order to confirm the existence or nonexistence of changes in values in actual bone mineral density. in addition, bone mineral density measurements were evaluated and recorded following the rules of Shewhart control chart. This type of management has to be conducted for the installation and movement of equipment. For the management methods of inspectors, evaluation of the measurement precision was conducted by testing the reproducibility of the exact same figures without any real biological changes occurring during reinspection. Bone mineral density inspection was applied as the measurement method for patients either taking two measurements thirty times or three measurements fifteen times. An important point when taking measurements was after a measurement whether it was the second or third examination, it was required to descend from the table and then reascend. With a 95% confidence level, the precision error produced from the measurement bone mineral figures came to 2.77 times the minimum of the biological bone mineral density change. The value produced can be stated as the least significant change (LSC) and in the case the value is greater, it can be stated as a section of genuine biological change. From the initial inspection to equipment moving and shifter, management must be carried out and continued in order to achieve the effects. The enforcement of proper quality control of radiologists performing bone mineral density inspections which brings about the durability extensions of equipment and accurate results of calculations will help the assurance of reliable inspections.

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The Development of On-Line Statistics Program for Radiation Oncology (방사선종양학과 On-line 통계처리프로그램의 개발)

  • Kim Yoon-Jong;Lee Dong-Hoon;Ji Young-Hoon;Lee Dong-Han;Jo Chul-Ku;Kim Mi-Sook;Ru Sung-Rul;Hong Seung-Hong
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.369-380
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    • 2001
  • Purpose : By developing on-line statistics program to record the information of radiation oncology to share the information with internet. It is possible to supply basic reference data for administrative plans to improve radiation oncology. Materials and methods : The information of radiation oncology statistics had been collected by paper forms about 52 hospitals in the past. Now, we can input the data by internet web browsers. The statistics program used windows NT 4.0 operation system, Internal Information Server 4.0 (IIS4.0) as a web server and the Microsoft Access MDB. We used Structured Query Language (SQL), Visual Basic, VBScript and JAVAScript to display the statistics according to years and hospitals. Results : This program shows present conditions about man power, research, therapy machines, technics, brachytherapy, clinic statistics, radiation safety management, institution, quality assurance and radioisotopes in radiation oncology department. The database consists of 38 inputs and 6 outputs windows. Statistical output windows can be increased continuously according to user's need. Conclusion : We have developed statistics program to process all of the data in department of radiation oncology for reference information. Users easily could input the data by internet web browsers and share the information.

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A Quality Assurance Study for the Application of Cook/Chill System in School Foodservice Operation (II) - Pork Bulgogi (Broiled Sliced Pork with Sauces) - (학교급식에 Cook/Chill System 적용을 위한 품질보증연구(II) - 돼지불고기 -)

  • Kwak, Tong-Kyung;Moon, Hye-Kyung;Park, Hye-Won;Hong, Wan-Soo;Ryu, Kyung;Chang, Hye-Ja;Kim, Sung-Hee;Choi, Eun-Jung
    • Journal of Food Hygiene and Safety
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    • v.13 no.4
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    • pp.319-331
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    • 1998
  • The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.

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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

A Study on Antecedents of Ethical Leadership of Power Retailers, : Focusing on the Relationship between Discount Stores and Their Suppliers (대형 유통업체 윤리적 리더십의 선행변수에 관한 연구 : 할인점과 공급업체 간 관계를 중심으로)

  • Kim, Sang-Deok
    • Journal of Distribution Research
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    • v.17 no.3
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    • pp.59-92
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    • 2012
  • With accumulated research evidence, there is little doubt that leadership behavior is related to a wide variety of positive individual and organizational outcomes. Indeed, leadership behavior has been empirically linked to increased employee satisfaction, organizational commitment, extra effort, turnover intention, organizational citizenship behavior, and overall employee performance. Although leadership behavior has been linked to a number of positive organizational outcomes, research regarding the antecedents of such behavior is limited. Especially there is little research dealing with the antecedents of inter-organizational leadership behavior. This study interests in inter-organizational ethical leadership among marketing channel members. In both the mass media and the academic association, there has been a surge in interest in the ethical and unethical behavior of leaders. Although the corporate scandals in recent years may explain much of the mass media and popular focus, academics' interest has been limited by evidence that ethical leadership behavior is associated with both positive and negative inter-organizational processes and performances. This study tried to contribute to this body of knowledge by examining antecedents of ethical leadership. Ethical leadership is defined "the demonstration of normatively appropriate conduct through personal actions and interpersonal relationships, and the promotion of such conduct to followers through two-way communication, reinforcement, and decision-making." Ethical leaders not only inform individuals of the behefits of ethical behavior and the cost of inappropriate behavior, such leaders also set clear standards and use rewards and fair and balanced punishment to hold followers accountable for their ethical conduct. Despite the assume importance and prominence of ethical leadership among organizations, there are still many questions relating to its antecedents and consequences. One is whether the likelihood of an leading organization being perceived as an ethical leader among other following organizations in marketing channels can be predicted using its characteristics and inter-organizational relationship maintenance skills. Identifying trait and skill antecedents will aid in the development of strategies for selecting and developing ethical leaders and determining the best means to reinforce ethical behaviors. The purpose of this study is to investigate the effects of three categorized variables on ethical leadership of channel leader. To be concrete, this study develops a model of the antecedents of three conceptually distinct forms of channel leader characteristics, such as organizational traits, inter-organizational relationship maintenance strategies, and supplier management strategies, and tests the hypothesized differential effects on ethical leadership of marketing channel leaders. The reason why this study deals with discount store channel is that there is very strong inter-dependence between a discount store and its suppliers. Their strong inter-dependence makes their relationship as the relationship between a leader and suppliers and creates an atmosphere that leadership occur without difficulty. The research model is as follows. For the purpose of empirical testing, 295 respondents of suppliers of discount store channel in Korea were surveyed. The procedures included scale reliability, and discriminant and convergent validity were used to validate measures. Also, the reliability measurements traditionally employed, such as the Cronbach's alpha, were used. All the reliabilities were greater than .70. This study conducted confirmatory factor analyses to assess the validity of our measurements. All items loaded significantly on their respective constructs(with the lowest t-value being 15.2), providing support for convergent validity. We then examined composite reliability and average variance extracted(AVE). The composite reliability of each construct was greater than .70. The AVE of each construct was greater than .50. This study tested research model using Partial Least Square(PLS). The estimation of the structural equation model revealed an acceptable fit of the model to the data($r^2$=.851). Thus, This study concluded that the model fit was considered acceptable. The results of PLS are as follows. The results indicated that conscientiousness, openness, conflict management, social networks, training, fair reward had positive effects on ethical leadership of channel leaders. On the other hand, emotional insecure had negative effect and agreeableness, assurance, and inter-organizational communication had no significant effect on supply chain leadership.

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A Numerical Study on the CO2 Leakage Through the Fault During Offshore Carbon Sequestration (해양지중에 저장된 이산화탄소의 단층을 통한 누출 위험 평가에 관한 수치해석 연구)

  • Kang, Kwangu;Huh, Cheol;Kang, Seong-Gil
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.18 no.2
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    • pp.94-101
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    • 2015
  • To mitigate the greenhouse gas emission, many carbon capture and storage projects are underway all over the world. In Korea, many studies focus on the storage of $CO_2$ in the offshore sediment. Assurance of safety is one of the most important issues in the geological storage of $CO_2$. Especially, the assessment of possibility of leakage and amount of leaked $CO_2$ is very crucial to analyze the safety of marine geological storage of $CO_2$. In this study, the leakage of injected $CO_2$ through fault was numerically studied. TOUGH2-MP ECO2N was used to simulate the subsurface behavior of injected $CO_2$. The storage site was 150 m thick saline aquifer located 825 m under the continental shelf. It was assumed that $CO_2$ leak was happened through the fault located 1,000 m away from the injection well. The injected $CO_2$ could migrate through the aquifer by both pressure difference driven by injection and buoyancy force. The enough pressure differences made it possible the $CO_2$ to migrate to the bottom of the fault. The $CO_2$ could be leaked to seabed through the fault due to the buoyancy force. Prior to leakage of the injected $CO_2$, the formation water leaked to seabed. When $CO_2$ reached the seabed, leakage of formation water stopped but the same amount of sea water starts to flow into the underground as the amount of leaked $CO_2$. To analyze the effect of injection rate on the leakage behavior, the injection rate of $CO_2$ was varied as 0.5, 0.75, and $1MtCO_2/year$. The starting times of leakage at 1, 0.75 and $0.5MtCO_2/year$ injection rates are 11.3, 15.6 and 23.2 years after the injection, respectively. The leakage of $CO_2$ to the seabed continued for a period time after the end of $CO_2$ injection. The ratios of total leaked $CO_2$ to total injected $CO_2$ at 1, 0.75 and $0.5MtCO_2/year$ injection rates are 19.5%, 11.5% and 2.8%, respectively.

Study on the Various Size Dependence of Ionization Chamber in IMRT Measurement to Improve Dose-accuracy (세기조절 방사선치료(IMRT)의 환자 정도관리에서 다양한 이온전리함 볼륨이 정확도에 미치는 영향)

  • Kim, Sun-Young;Lee, Doo-Hyun;Cho, Jung-Keun;Jung, Do-Hyeung;Kim, Ho-Sick;Choi, Gye-Sook
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.1-5
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    • 2006
  • Purpose: IMRT quality assurance(Q.A) is consist of the absolute dosimetry using ionization chamber and relative dosimetry using the film. We have in general used 0.015 cc ionization chamber, because small size and measure the point dose. But this ionization chamber is too small to give an accurate measurement value. In this study, we have examined the degree of calculated to measured dose difference in intensity modulated radiotherapy(IMRT) based on the observed/expected ratio using various kinds of ion chambers, which were used for absolute dosimetry. Materials and Methods: we peformed the 6 cases of IMRT sliding-window method for head and neck cases. Radiation was delivered by using a Clinac 21EX unit(Varian, USA) generating a 6 MV x-ray beam, which is equipped with an integrated multileaf collimator. The dose rate for IMRT treatment is set to 300 MU/min. The ion chamber was located 5cm below the surface of phantom giving 100cm as a source-axis distance(SAD). The various types of ion chambers were used including 0.015cc(pin point type 31014, PTW. Germany), 0.125 cc(micro type 31002, PTW, Germany) and 0.6 cc(famer type 30002, PTW, Germany). The measurement point was carefully chosen to be located at low-gradient area. Results: The experimental results show that the average differences between plan value and measured value are ${\pm}0.91%$ for 0.015 cc pin point chamber, ${\pm}0.52%$ for 0.125 cc micro type chamber and ${\pm}0.76%$ for farmer type 0.6cc chamber. The 0.125 cc micro type chamber is appropriate size for dose measure in IMRT. Conclusion: IMRT Q.A is the important procedure. Based on the various types of ion chamber measurements, we have demonstrated that the dose discrepancy between calculated dose distribution and measured dose distribution for IMRT plans is dependent on the size of ion chambers. The reason is small size ionization chamber have the high signal-to-noise ratio and big size ionization chamber is not located accurate measurement point. Therefore our results suggest the 0.125 cc farmer type chamber is appropriate size for dose measure in IMRT.

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토양 및 지하수 Investigation 과 Remediation에 대한 현장적용

  • Wallner, Heinz
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.44-63
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    • 2000
  • Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

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