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Report on the External Audits Conducted by Korean Society of Medical Physics (한국의학물리학회 선형가속기 외부 품질관리 실시 현황보고)

  • Huh, Hyun Do;Cho, Kwang Hwan;Cho, Sam Ju;Choi, Sang Hyoun;Kim, Dong Wook;Hwang, Ui-Jung;Kim, Ki Hwan;Min, Chul Kee;Choi, Tae Jin;Oh, Young Kee;Lee, Seoung Jun;Park, Dahl;Park, Sung-Kwang;Ji, Young Hoon
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.315-322
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    • 2013
  • The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

Functional MR Imaging Using BOLD Technique in Patients with Brain Tumors (뇌종양 환자에서 BOLD 기법을 이용한 기능적 자기공명영상)

  • Kim Jeong;Yim Nam-Yeol;Shin Sang-Soo;Lim Hyo-Soon;Yoon Woong;Chung Tae-Woong;Jeong Yong-Yeon;Jeong Gwang-Woo;Park Jin-Gyoon;Kang Heoung-Keun;Jung Shin;Kang Sam-Suk;Seo Jeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.124-131
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    • 2003
  • Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

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Effects of GnRH Agonist Used for Ovarian Hyperstimulation in Human IVF-ET on the Apoptosis of Preovulatory Follicular Cells (인간 체외수정 및 배아이식에 있어서 과배란 유도 과정에 사용한 GnRH Agonist가 배란 전 난포내 과립 세포의 세포자연사에 미치는 영향)

  • Yang, Hyun-Won;Kwon, Hyuck-Chan;Hwang, Kyung-Joo;Park, Jong-Min;Oh, Kie-Suk;Yoon, Yong-Dal
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.55-65
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    • 1999
  • There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-eosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged $11.09{\pm}8.75\;and\;10.33{\pm}4.53$ per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental rate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.

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The Effects of Self-Congruity and Functional Congruity on e-WOM: The Moderating Role of Self-Construal in Tourism (중국 관광객의 온라인 구전에 대한 자아일치성과 기능일치성의 효과: 자기해석의 조절효과를 중심으로)

  • Yang, Qin;Lee, Young-Chan
    • The Journal of Information Systems
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    • v.25 no.1
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    • pp.1-23
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    • 2016
  • Purpose Self-congruity deals with the effect of symbolic value-expressive attributes on consumer decision and behavior, which is the theoretical foundation of the "non-utilitarian destination positioning". Functional congruity refers to utilitarian evaluation of a product or service by consumers. In addition, recent years, social network services, especially mobile social network services have created many opportunities for e-WOM communication that enables consumers to share personal consumption related information anywhere at any time. Moreover, self-construal is a hot and popular topic that has been discussed in the field of modem psychology as well as in marketing area. This study aims to examine the moderating effect of self-construal on the relationship between self-congruity, functional congruity and tourists' positive electronic word of mouth (e-WOM). Design/methodology/approach In order to verify the hypotheses, we developed a questionnaire with 32 survey items. We measured all the items on a five-point Likert-type scale. We used Sojump.com to collect questionnaire and gathered 218 responses from whom have visited Korea before. After a pilot test, we analyzed the main survey data by using SPSS 20.0 and AMOS 18.0, and employed structural equation modeling to test the hypotheses. We first estimated the measurement model for its overall fit, reliability and validity through a confirmatory factor analysis and used common method bias test to make sure that whether measures are affected by common-method variance. Then we tested the hypotheses through the structural model and used regression analysis to measure moderating effect of self-construal. Findings The results reveal that the effect of self-congruity on tourists' positive e-WOM is stronger for tourists with an independent self-construal compared with those with interdependent self-construal. Moreover, it shows that the effect of functional congruity on tourists' positive e-WOM becomes salient when tourists' self-construal is primed to be interdependent rather than independent. We expect that the results of this study can provide important implications for academic and practical perspective.

Empirical Study of Key Factors in Satisfaction with Subway Services (지하철 이용만족도 결정요인에 관한 실증적 연구 -서울지역을 중심으로-)

  • Shim, Jong-Seop;Jeon, Ki-Heung
    • Korean Business Review
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    • v.13
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    • pp.49-66
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    • 2000
  • Despite the fact that understanding customers satisfaction with transportation services is a subject of great importance, authors, so far, found no systematic researches referred to that issue. From this point, studying the satisfaction with subways services can be extremely useful. Empirical study of key factors in the satisfaction with subway services is the departure point, which holds as objectives, and we believe, will contribute to overall increasing in the number of subways services used and in the amount of public benefits derived from that usage. In order to achieve these goals: First, several items referred to some key factors in the satisfaction of subway usage were systemized. Second, a research of specific weights attached to those key factors by subway passengers was conducted. Knowledge of the satisfaction variables system can provide deep insights into ones perceptual experience when using a subway. The results were as follows: Various interrelated factors compose a passengers satisfaction with subway services. People do not just use subway passively; a number of key factors, like physical and personal services, exact timing, easiness to access etc. determine the passengers satisfaction with subway. In order to find out specific weights of these key factors multiple regression analysis was employed. Results showed that satisfaction with subway is determined by (in order of importance) easiness to access, quality of physical services, friendliness of working stuff and timing exactness. According to the findings, passengers do not use subway as a simple mean of transportation, rather they perceive it as a complex combination of environmental elements and overall satisfaction depends on these various factors. Therefore, to learn passengers satisfaction with subways services, passengers subway experience must be thoroughly studied and analyzed, and this is where papers value resides.

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A Review of Statistical Methods in the Korean Journal of Orthodontics and the American Journal of Orthodontics and Dentofacial Orthopedics (대한치과교정학회지(KJO)와 미국교정학회지(AJODO)에서 사용된 통계기법의 비교분석 및 고찰(1999-2003))

  • Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.371-379
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    • 2004
  • The purpose of this study was to investigate the changes and types of statistical methods used in the Korean Journal of Orthodontics (KJO) and the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO) from )999 to 2003. The frequency of use, transitions, assumption check of statistical methods and types of advanced statistical methods were examined from each journal. The study consisted of 247 articles published in the KJO and randomly chosen 50 articles per year which were original articles and used statistical methods T-test, analysis of variance(ANOVA), correlation analysis, nonparametric analysis. regression analysis chi-square test. factor analysis, were the order of statistical methods most frequently used in the KJO, while t-test. ANOVA, nonparametric analysis, correlation analysis, regression analysis, chi-square test. factor analysis. were the order of statistical methods used in the AJODO The changes of statistical methods observed in the KJO were not significant $(X^2=17.4\;p=0.5881)$ but the changes observed in the AJODO was seen to be significant $(x^2=42.4,\;p=0.0397)$ Some of the studies examined had overlooked the assumptions of the statistical methods employed. Data investigation such as outlier should be performed before analysis and alternative statistical approaches are applied for a small sample size. Types of advanced statistical methods were factor analysis and discriminant analysis in the KJO and Intention-To-Treat (ITT) analysis in clinical trials through multi-center, survival analysis and Generalized Estimating Equations (GEE) in the AJODO. Appropriate analysis approaches and interpretations should be applied for the correlated and repeated measurements of the orthodontic data set.

SOFT TISSUE PROFILE CHANGE PREDICTION IN MAXILLARY INCISOR RETRACTION BASED ON CEPHALOMETRICS (두부방사선 분석에 의한 상악전치부 후방이동시 연조직 변화 예측에 대한 연구)

  • Choi, Jin-Hee;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.65-78
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    • 1997
  • This study was carried out in order to determine soft tissue response to incisor movement and mandibular repositioning and to determine feasibility of predicting vertical and horizontal changes in soft tissue with hard tissue movement. For this study, cephalometric records of 41 orthodontically treated adult females who had Angle's Class II division 1 malocclusion were selected and stepwise multiple regression analysis was employed. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. Hard tissue measurements that showed significant changes before and after treatment were horizontal and angular changes of maxillary incisor, horizontal,vertical and angular changes of mandibular incisor, overjet, overbite, interincisal angle, mandibular repositioning, A,B, skeletal convexity and soft tissue measurements that showed significant changes were horizontal, thickness and angular changes of upper lip, horizontal and angular changes of lower lip, interlabial angle, nasolabial angle labiomental angle, Sri, Ss, Si and soft tissue convexity(P<0.05). 2. All Soft tissue measurements changed significantly before and after treatment had between one and four hard tissue independent variables at statistically significant level, indicating that all soft tissue changes were direct relationship with hard tissue changes 3. Ova jet, horizontal change of maxillary incisor, horizontal change of maxillary root apex and horizontal change of pogonion entered into prediction equations most frequentely indicating that they were more significant variables in prediction of vertical and horizontal changes in the soft tissue with treatment, but vertical changes of mandibular incisor not entered any prediction equations, indicating that it was not considered a good predictor for soft tissue changes with maxillary incisor retraction. 4. Horizontal and vertical changes in subnasale were found to have most independent variables, significant at the 0.05 level in prediction-equations(${\Delta}$Sn(H):Ur, Is(H), Pg(H), UIA,${\Delta}$Sn(V): Is(H), Pg(H), overjet, A), indicating that subnasale changes are influenced by complex hard tissue interaction. 5. Multiple correlation coefficient($R^2$) of the soft tissue prediction equations ranges from 0.2-0.6.

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Analysis of Factors Associated with Number of Decayed Tooth (우식치아수의 관련요인에 대한 연구)

  • Choi, Jun-Seon;Han, Gyeong-Soon
    • Journal of dental hygiene science
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    • v.6 no.2
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    • pp.55-63
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    • 2006
  • The purpose of this study was to provide the basic data for preventing dental caries, and maintaining and enhancing oral health. The subjects of this study were 138 male and female students who were in the 6th grade of elementary schools in Gimpo city. This study investigated the number of decayed tooth and the factors related to the number of decayed tooth, by using the results of questionnaire and oral health survey over such subjects. So, this study obtained the following conclusions. 1. For the number of decayed tooth, 'nothing(D = 0)' was the highest as 37.7%, and 'from two to three' was 23.9%, 'more than four' was 21%, and 'one' was 17.4% in order. 2. For the frequency of visiting dental clinics within the last one year, 'one to two times' was the highest as 52.2%, and the children who have not visited dental clinics even one time during one year were 23.9%. 3. For average daily tooth brushing frequency, 'two times' was the highest as 71.7%. For the use of oral health devices besides toothbrushes, 'I don't use' was the highest as 54.3%. For the experience of sealant and fluoride application, 'nothing' was the highest as 86.9% and 71.3% respectively. For the recognition on the use of fluoride dentifrice, 'I don't know' was the highest as 66.9%. 4. The socio-demographic factors related to the number of decayed tooth were mother's age, mother's background, mother's employment, and after-school fosterer(p > 0.05). 5. The oral health care factors related to the number of decayed tooth were average daily tooth brushing frequency, the use of oral health devices besides toothbrushes, and the experience of fluoride application.(p > 0.05) 6. The snack intake factors related to the number of decayed tooth were tooth care foods intake frequency and decaying foods intake frequency(p > 0.05). 7. The oral health belief item related to the number of decayed tooth was susceptibility(p > 0.05). 8. According to the results of regression analysis, the less mother was employed, the more the average daily tooth brushing frequency was, the more the tooth care foods intake frequency was, the less the decaying foods intake frequency was, and the higher susceptibility was, the lower the number of decayed tooth. 9. In order to prevent and cure early the dental caries which occur frequently in elementary school students, the establishment of oral health centers within schools should be expanded to promote tooth brushing instruction, fluoride solution rinsing, diet control, periodic oral examination.

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The Effect of K-IFRS Adoption on Goodwill Impariment Timeliness (K-IFRS 도입이 영업권손상차손 인식의 적시성에 미친 영향)

  • Baek, Jeong-Han;Choi, Jong-Seo
    • Management & Information Systems Review
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    • v.35 no.1
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    • pp.51-68
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    • 2016
  • In this paper, we aim to analyze the effect of accounting policy change subsequent to the adoption of K-IFRS in Korea, whereby the firms are required to recognize impairment losses on goodwill on a periodic basis rather than to amortize over a specific period. As a principle-based accounting standard, the K-IFRS expands the scope of fair value measurement with a view to enhance the relevance and timeliness of accounting information. In the same vein, intangibles with indefinite useful life, of which goodwill is an example, are subject to regulatory impairment tests at least once a year. Related literature on the impact of mandatory change in goodwill policy document that impairment recognition is more likely to be practiced opportunistically, mainly because managers have a greater discretion to conduct the tests under K-IFRS. However, existing literature examined the frequency and/or magnitude of the goodwill impairment before versus after the K-IFRS adoption, failing to notice the impairment symptoms at individual firm level. Borrowing the definition of impairment symptoms suggested by Ramanna and Watts(2012), this study performs a series of tests to determine whether the goodwill impairment recognition achieves the goal of communicating timelier information under the K-IFRS regime. Using 947 firm-year observations from domestic companies listed in KRX and KOSDAQ markets from 2008 to 2011, we document overall delays in recognizing impairment losses on goodwill after the adoption of K-IFRS relative to prior period, based on logistic and OLS regression analyses. The results are qualitatively similar in robustness tests, which use alternative proxy for goodwill impairment symptom. Afore-mentioned results indicate that managers are likely to take advantage of the increased discretion to recognize the impairment losses on goodwill rather than to provide timelier information on impairment, inconsistent with the goal of regulatory authority, which is in line with the improvement of timeliness and relevance of accounting information in conjunction with the full implementation of K-IFRS. This study contributes to the extant literature on goodwill impairment from a methodological viewpoint. We believe that the method employed in this paper potentially diminishes the bias inherent in researches relying on ex post impairment recognition, by conducting tests based on ex ante impairment symptoms, which allows direct examination of the timeliness changes between before and after K-IFRS adoption.

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The Effect of the Participative Leadership on Creative Behavior - Focusing on Unidimensional and Multidimensional Mediating Effects of Psychological Empowerment - (참여적 리더십이 창의적 행동에 미치는 영향 - 심리적 임파워먼트의 단일차원과 다차원 매개효과를 중심으로 -)

  • Tak, Je-Woon;Shin, Je-Goo
    • Management & Information Systems Review
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    • v.36 no.5
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    • pp.61-83
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    • 2017
  • The purpose of this study is to investigate the mediating effects of psychological empowerment between participative leadership and creative behavior. Especially, it aims to analyze the unidimension and multidimension of psychological empowerment in an integrated manner, and to suggest effective practice of participative leadership together with theoretical and methodological implications. In this study, the dependent variable was measured separately with time lag as a method to solve the common method bias that can be shown by the self-report type survey method, and positive emotions and negative emotions expressing emotional states in job situations were employed as control variables along with rank. A total of 283 questionnaires were collected from employees who work for companies in various industries with more than 300 domestic employees. SPSS PROCESS macro program('model 4') was used for statistical analysis. Results, First, the full mediation effect of psychological empowerment(unidimension) was confirmed in the relationship between participative leadership and creative behavior. Second, the analysis of the multidimension of psychological empowerment revealed the full mediating effect of meaning, self-determination, and impact, and the mediating effect of competence was not significant. Third, as a result of comparing the mediating effects of unidimension of psychological empowerment and the mediating effects of multidimension, the magnitude of mediating effect of unidimension was found to be much greater than mediating effect of multidimension. And The magnitudes of the three multidimensional mediating effects were similar. This is a case in which the motivational model of participative leadership revealed in the overseas study is proven in the domestic management environment and is significant in that it is the basis of future research. Based on the results of the empirical studies, the implications and limitations of the study and future research directions are presented.