• The Journal of Korean Society for Radiation Therapy
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• v.12 no.1
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• pp.144-146
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• 2000

삼차원 입체조형치료는 정상조직의 장해를 최소화하고 종양부위에 집중적으로 조사할 수 있는 장점을 가지고 있어 임상 적용범위가 넓어지고 있다. 일반적으로 정상조직의 장해를 줄이기 위해 다양한 방사선 조사방향이 사용되며 특히 비 동일면상에서의 조사가 많이 이루어진다. 따라서 couch 회전이 동반되며 couch는 선형가속기의 다른 기계적 오차보다 많은 오차를 유발할 수 있는 잠재적인 위험을 안고 있다. 저자는 이러한 오차의 정도를 파악하고 이를 개선할 수 있는 방법에 대해 알아보고자 했다. couch 회전에 따른 Isocenter의 변화를 평가하기 위해 3대(Primus, Simens, USA/CL600c & 2100c, Varian, USA)의 선형가속기를 이용하였으며 이중 1대의 장비에는 couch 회전시 오차를 줄이기 위해 고안된 couch 고정장치를 장착하였다. 환자가 테이블에 부하를 주지 않은 상태에서 회전을 실시하여 Isocenter의 변화를 측정하고 환자가 테이블에 누워있는 상황을 재현하기 위해 human phantom을 위치시킨 후 동일한 회전검사를 실시하여 각각의 오차를 비교 분석하였다. 각 실험은 10회씩 반복 측정하여 평균치를 얻었으며 오차의 분석은 AAPM 권고안인 오차중심의 반경으로 표현했다. 3대의 선형가속기를 이용하여 얻은 결과 테이블에 부하를 주지 않은 상태의 회전오차는 평균 2mm, 3.2mm, 2mm로 측정되었으며 휴먼 phantom을 올려놓고 부하를 준 상태에서의 오차는 평균 2.1mm, 4mm, 2.1 mm이였다. 또한 고정장치를 이용한 상태에서의 평균오차는 1.9mm로 나타났다. 삼차원 입체조형치료 시 couch 회전에 따른 Isocenter 오차는 장비의 종류 및 작업자의 사용방법에 따라 다르게 나타났으며 테이블의 부하가 클수록 많은 오차를 보였다. 또한 couch 고정장치를 부착한 장비에서의 결과치 만이 AAPM에서 권고하는 오차의 한계에(${\le}2mm$) 들어감을 알 수 있었다. 따라서 정기적인 QA가 필수적이며 Couch Locking System과 같이 오차를 줄일 수 있는 보조장치의 부착이 많은 도움을 줄 것으로 생각된다. 아울러 이러한 오차를 보정할 수 있는 방법이 강구되어야 할 것으로 사료된다.

• Journal of Korean Academy of Nursing
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• v.41 no.4
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• pp.568-579
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• 2011

Purpose: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. Methods: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. Conclusion: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.

• Progress in Medical Physics
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• v.15 no.2
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• pp.59-62
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• 2004

We developed very small parallel plate radiation detector by using our existing experience of mating radiation dosimeter and capability of analyzing characteristics of dosimeter. The radiation detector was consisted of microfilm and carbon electrode. The detector was parallel plate type of all-filled ionization chamber. The ionization chamber had been fabricated using an acrylic plate for the air cavity and carbon coated microfilm for electrical configuration. The alr gap between two electrodes was 0.48 mm. The diameters of collect electrode and guard electrode were 3.3 mm, 5 mm respectively. The diameter of high voltage electrode was 5 mm. Nominal sensitive volume of the chamber was 0.016 ㎤. The major parameters of the chamber characteristics such as leakage current, reproducibility, dose rate effect, and polarity effect were measured. The experimental results were as followings. Leakage current was 0.1 pA. Standard deviation of reproducibility was less than 0.1%. Dose rate effect was less than 1.5%. Polarity effect was less than 2.4%. These data were comparable to those of commercially available dosimetric system for QA-purpose. As the result, we found that the radiation detector consisting of the ionization chamber, microfilm and carbon electrode, was satisfactory for the purpose of the small field dosimetry in size and characteristics. In the future, We will try to refine the dosimeter for use in very small volume.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.72-111
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• 1996

Background: Group occupational health program by non-for-profit agency, started five years ago, for management of health problems in small and medium sized industries, is one of the measures to cope with limited human and financial resources in occupational health. The program has been rapidly expanding to include 54 participating institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. Objectives : The aim of this study are to develop and apply criteria to assess quality of newly developed Korean group occupational health program. Methods : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, we included followings as core elements of sound occupational health program; accessibility, continuity, intersectoral collaboration, comprehensiveness, community participation, technical quality, adequacy, focus on preventive services, acceptability, and workers' satisfaction. Again we divided each elements into five major components of national health system infrastructures developed by World Health Organization; development of health resources organized arrangement or resources, delivery of health care, economic support, and management. In turn, we categorized each component into input, process and outcome aspects. After discussions in expert panel, several criteria were selected for evaluation of program. The criteria were modified according to each group of interviewees. Results: We developed five sets of questionnaire that evaluate the quality of 'Group occupational health program'. Conclusion : The refining of the measurement tool and the continuing evaluation process for the 'Group occupational health institute' should be done further.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.74-89
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• 2002

Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extubation in ICUs for providing baseline data in developing prevention strategies and administrative standards. the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, ${\chi}^2$- test, t-test, Fisher's exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirtyfour( 72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patient status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more applied physical restraints(P=.000) than planned extubation group. 5) As for the intubation related variables, unplanned extubation group revealed more intubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio=13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.

• International Journal of Highway Engineering
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• v.17 no.6
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• pp.1-9
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• 2015

PURPOSES : The objective of this study is to propose a quality control and quality assurance method for use during asphalt pavement construction using non-destructive methods, such as ground penetrating radar (GPR) and an infrared (IR) camera. METHODS : A 1.0 GHz air-coupled GPR system was used to measure the thickness and in situ density of asphalt concrete overlay during the placement and compaction of the asphalt layer in two test construction sections. The in situ density of the asphalt layer was estimated based on the dielectric constant of the asphalt concrete, which was measured as the ratio of the amplitude of the surface reflection of the asphalt mat to that of a metal plate. In addition, an IR camera was used to monitor the surface temperature of the asphalt mat to ensure its uniformity, for both conventional asphalt concrete and fiber-reinforced asphalt (FRA) concrete. RESULTS : From the GPR test, the measured in situ air void of the asphalt concrete overlay gradually decreased from 12.6% at placement to 8.1% after five roller passes for conventional asphalt concrete, and from 10.7% to 5.9% for the FRA concrete. The thickness of the asphalt concrete overlay was reduced from 7.0 cm to 6.0 cm for the conventional material, and from 9.2 cm to 6.4 cm for the FRA concrete. From the IR camera measurements, the temperature differences in the asphalt mat ranged from $10^{\circ}C$ to $30^{\circ}C$ in the two test sections. CONCLUSIONS : During asphalt concrete construction, GPR and IR tests can be applicable for monitoring the changes in in situ density, thickness, and temperature differences of the overlay, which are the most important factors for quality control. For easier and more reliable quality control of asphalt overlay construction, it is better to use the thickness measurement from the GPR.

• Hwankyungkyoyuk
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• v.10 no.2
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• pp.311-324
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• 1997

General citizens can be a valuable resource for various types of environmental monitoring when they are well-trained and managed. Successful use of volunteer monitors depends on understanding that citizens are partners sharing expanded roles as the guardians of their local environment. Citizen volunteer monitoring programs are developed for three reasons: 1) to supplement environmental data collected by professional staffs in governmental agencies and scientific institutions; 2) to educate the public about local environmental problems; 3) to build a constituency of citizen to practice sound environmental management at a local level and build public support for environmental protection. All three goals can be achieved with a well-organized program which provides useful and credible data. Initial step in planning a successful volunteer monitoring project is to clearly identify the use to be made of the data. Technical advice from the identified potential user groups should be convened early in the planning stage to refine the program objectives and determine if volunteers can provide the level of expertise required. Data users must have confidence in the representativeness, consistency, and accuracy of data collected by volunteers. Effective quality assurance and quality control(QA/QC) procedures are essential to ensure the utility of environmental monitoring data. Volunteers must be trained in advance to carry out specific environmental monitoring tasks. Another components of successful volunteer monitoring programs is to give the volunteers praise and feedback as well as to encourage experienced volunteers to impose increased responsibilities. The increase of volunteer monitoring programs in Korea will play a major role in developing a participatory system in which the people are "empowered" to make decisions and make a difference.

• Progress in Medical Physics
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• v.28 no.2
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• pp.54-60
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• 2017

This study was designed to measure transit dose with an electronic portal imaging device (EPID) in eight patients treated with intensity modulated radiotherapy (IMRT), and to verify the accuracy of dose delivery to patients. The calculated dose map of the treatment planning system (TPS) was compared with the EPID based dose measured on the same plane with a gamma index method. The plan for each patient was verified prior to treatment with a diode array (MapCHECK) and portal dose image prediction (PDIP). To simulate possible patient positioning errors during treatment, outcomes were evaluated after an anthropomorphic phantom was displaced 5 and 10 mm in various directions. Based on 3%/3 mm criteria, the $mean{\pm}SD$ passing rates of MapCHECK, PDIP (pre-treatment QA) for 47 IMRT were $99.8{\pm}0.1%$, $99.0{\pm}0.7%$, and, respectively. Besides, passing rates using transit dosimetry was $90.0{\pm}1.5%$ for the same condition. Setup errors of 5 and 10 mm reduced the mean passing rates by 1.3% and 3.0% (inferior to superior), 2.2% and 4.3% (superior to inferior), 5.9% and 10.9% (left to right), and 8.9% and 16.3% (right to left), respectively. These findings suggest that the transit dose-based IMRT verification method using EPID, in which the transit dose from patients is compared with the dose map calculated from the TPS, may be useful in verifying various errors including setup and/or patient positioning error, inhomogeneity and target motions.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.68-73
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• 2002

In standard teletherapy, a treatment plan is generated with the aid of a treatment planning system, but it is common to perform an independent monitor unit verification calculation (MUVC). In exact analogy, we propose and demonstrate that a simple and accurate MUVC in Intensity Modulated Radiotherapy (IMRT) is possible. We introduce a concept of Modified Clarkson Integration (MCI). In MCI, we exploit the rotational symmetry of scattering to simplify the dose calculation. For dose calculation along a central axis (CAX), we first replace the incident IMRT fluence by an azimuthally averaged fluence. Second, the Clarkson Integration is carried over annular sectors instead of over pie sectors. We wrote a computer code, implementing the MCI technique, in order to perform a MUVC for IMRT purposes. We applied the code to IMRT plans generated by CORVUS. The input to the code consists of CORVUS plan data (e.g., DMLC files, jaw settings, MU for each IMRT field, depth to isocenter for each IMRT field), and the output is dose contribution by individual IMRT field to the isocenter. The code uses measured beam data for Sc, Sp, TPR, (D/Mu)$\_$ref/ and includes effects from MLC transmission, and radiation field offset. On a 266 MHZ desktop computer, the code takes less than 15 sec to calculate a dose. The doses calculated with MCI algorithm agreed within +/- 3% with the doses calculated by CORVUS, which uses a 1cm x 1cm pencil beam in dose calculation. In the present version of MCI, skin contour variations and inhomogeneities were neglected.

• Smart Structures and Systems
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• v.22 no.2
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• pp.185-192
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• 2018

Participants in the Asia Pacific Conference of the Prognostics and Health Management Society 2017 (PHMAP 2017) Data Challenge were given measured vibration signals from motor-driven gearboxes used in pulverizers. Using this information, participants were requested to predict failure dates and the faulty components. The measured signals were affected by significant noise and disturbance, as the pulverizers in the provided data worked under actual operating conditions. This paper thus presents a fault prediction method for a motor-driven gearbox in a pulverizer system that can perform under external noise and disturbance conditions. First, two fault features, an RMS value in the higher frequency zones (HRMS) and an amplitude of a period for high-speed shaft in the quefrency domain ($QA_{HSS}$), were extracted based on frequency analysis using the higher and lower sampling rate data. The two features were then applied to each pulverizer based on results of frequency responses to impact loadings. Then, a regression analysis was used to predict the failure date using the two extracted features. A weighted regression analysis was used to compensate for the imbalance of the features in the given period. In addition, the faulty components in the motor-driven gearboxes were predicted based on the modulated frequency components. The score predicted by the proposed approach was ranked first in the PHMAP 2017 Data Challenge.