• Title/Summary/Keyword: 의료 장비

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Research on Surface Contamination Analysis of Radiology Examination Equipment in Medical Institutions (의료기관 내 영상의학 검사 장비의 표면 오염도 분석 연구)

  • Shin-Woo Lee;Da-eun Kim;Chae-won Mun;Gap-Jung Kim;Sang-Ha Kim;Hye-mi Park;Se-Jong Yoo
    • Journal of the Korean Society of Radiology
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    • v.18 no.2
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    • pp.171-177
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    • 2024
  • In this study, two general X-ray device, CT, and MRI inspection devices were selected from general hospitals in the Daejeon area and an experiment was conducted to predict the level of infection by measuring the surface contamination of the inspection devices at different times and to use it as basic data for infection prevention. As a result, the surface contamination level by time zone for general X-ray devices and MRI examination devices was in the order of 13H > 8H > 16H, and for CT examination devices, it was 13H > 16H > 8H, which appeared to be influenced by the number of tests. In addition, the surface contamination results for each part of the test device showed that the highest ATP contamination value was found on the stand bucky handle for the general X-ray device, the headrest for the CT examination device, and the operation switch for the MRI examination device, which was closely related to the number of contacts. As a result of comparing before and after disinfection, all devices showed a significant decrease after disinfection. Based on the results of the experiment, it is believed that it can be used as basic data to identify the level of contamination in radiology laboratories and prevent infectious diseases.

Current Status of Respiratory Care in Korean Intensive Care Units (국내 중환자실내 호흡치료의 현황)

  • Park, So-Yeon;Kim, Tae-Hyung;Kim, Eun-Kyung;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.343-352
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    • 2000
  • Backgrounds : Respiratory care for patients in intensive care units (ICUs) has been performed mainly by nurses in Korea. However, the current status of respiratory care in the Korea ICUs is not well known. Respiratory care and the methods of delivery in ICUs were surveyed. Method : A confidential questionnaire was distributed to the head nurses working the ICUs at 117 hospitals in Korea. One hundred hospitals returned the questionnaires, for a response rate of 85%. The hospitals were divided into three groups : Main university hospitals (MUH), university associated hospitals (UAH), and general hospitals (GH) Result : Eighteen units of 66 units in MUH and 35 units of 58 units in GH were organized as a general ICUs. The percentage of ICUs with full-time doctors was 47.1%. The nurses usually delivered respiratory care spending from 1 to 4 h during their 8 h of working time. Although the respondents felt that respiratory care should be delivered by trained respiratory therapists, these therapists were not found at the hospitals. Most of the units performed percussion, tracheal suctioning, and positional changes. However, vibration and IPPB were less frequently performed in GH. Among oxygen supply apparatus, venturi mask and T-piece were not frequently used in GH. GH applied a noninvasive ventilator mode less frequently than MUH and UAH. The percentage of Swan-Ganz catheter monitoring was only 21.4% in GH. Conclusion : Respiratory care for patients in the Korean ICUs was provided by nurses on the whole. In addition, there were many differences in the level of respiratory care according to the type of hospital. To overcome the current problems revealed, an effective in-hospital training program for the development of full-time respiratory care therapists should be established urgently in Korea.

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Negligence theory of Aviation accident with reference to the japanese aviation accident precedent (항공 사고에서의 과실 이론 - 일본 항공 사고 판례를 중심으로 -)

  • Hwang, Ho-Won;Ham, Se-Hun
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.115-136
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    • 2008
  • The development of the aviation technology is beyond the people's imagination. For example, with some exaggeration, If the autopilot engage upon take off, You will realize that you are on the centerline of the foggy JFK runway 13R after 15 hours with only once or twice of intervention. But the more aviation technology develops, the more responsible the pilot will be who has the final authority of the aviation safety. In the JAL 706 accident caused by unidentified reason, the pilot increased pitch abruptly and overrode the control from the autopilot. The result of this process made the death of a flight attendant and some injuries of a few passengers. The district court found the pilot not guilty at the first trial on the ground that the control override was not connected to the possibility of foresight and avoidance of the human death. The pilot was proved to be innocent through the analysis of the DFDR and ADAS that the override did not precede the unidentified pitch up motion. The judicial precedent related to aviation accidents in Korea requires pilots' absolute and extended care compared to the ordinarily prudent or reasonably careful behaviors in the vehicle and medical accidents. Although there is some controversy about the standard care, the care required in the actual operation of high tech aircraft by a pilot should include objective and standard care and be judged by analysis of the scientific data. Although the pilot maintained the unusual hi speed that doesn't have safety margin and descended under turbulence in case of the JAL 706 accident, the court negatived its relation to the cause of pitch up. Also, the override of the control after initial pitch up might have caused the possibility of the death and injury, but the court denied it. Because of this complex cause of the aviation accidents, it is important for a court to figure out the core reason of the event and casual relationship with the pilot Now, It is required that the judgement of negligence in the aviation accidents should include an objective care with scientific data from simulated circumstances(or a simulator) as the Japanese court not from the theory of vehicle's negligence.

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A Study on the Tendency of Dose value According to Dose calibrator Measurement Depth and Volume (Dose calibrator 측정 깊이와 용량의 변화에 따른 선량 값의 성향에 대한 고찰)

  • Kim, Jin Gu;Ham, Jun Cheol;Oh, Shin Hyun;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.20-26
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    • 2020
  • Purpose It is intended to figure out the errors derived from changes in depth and volume when measuring the Standard source and 99mTc-pertechnetate by using a Dose calibrator. Then recommend appropriate measurement depth and volume. Materials and Methods As a Dose calibrator, CRC-15βeta and CRC-15R (Capintec, New Jersey, USA) was used, and the measurement sources were 57Co, 133Ba, 137Cs and 99mTc-pertechnetate was also adopted due to its high frequency of use. The Standard source was respectively measured the changes according to its depth without changing the volume, in a range of 0 cm to 15 cm from the bottom of the ion chamber. 99mTc-pertechnetate was measured at each depth by changing the volume with 0.1 mL, 0.3 mL, 0.5 mL, 0.7 mL and 0.9 mL Respectively. And the depth range was from 0 cm to 15 cm at the bottom of the ion chamber. Results In the case of Standard source 57Co, 133Ba, 137Cs and 99mTc-pertechnetate, there were significant differences according to the measurement depth(p<0.05). 99mTc-pertechnetate has a negative correlation coefficient according to the depth, and the error of the measured value was negligible at a depth from 0 cm to 7 cm at 0.3 mL and 0.5 mL, and the range of error increased as the volume increased. Conclusion In clinical practice, it is sometimes installed differently than the Standard depth recommended by the equipment company. If it's measured at the recommended depth and volume, it could be thought that unnecessary exposure of the operator and the patient will be reduced, and more accurate radiation exams will be possible in quantitative analysis.

Evaluation of Image Quality for 2D TSE(RT) and 3D GRASE in MRCP Study: Fast MRCP Method (췌담관자기공명영상에서 2D TSE(RT)와 3D GRASE(BH) 기법에 대한 영상의 질 평가 : Fast MRCP 기법)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.983-989
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    • 2021
  • In this study, we intend to evaluate image quality and provide to clinical basic data by applying to 2D TSE (RT) and 3D GRASE (BH) techniques using Fast MRCP testing methods for application to patients in poor patient condition. Data were analyzed for 30 patients (15 males, 15 females, and 64±4.26 average age) who underwent MRCP tests. The equipment used was Ingenia CX 3.0 T equipment and Ds anterior coil was used for data acquisition. SNR and CNR of each image were measured through quantitative analysis, and the quality of the image was evaluated by dividing it into 5 grades for qualitative evaluation. The image evaluation was performed on the paired t-test and the Wilcoxon test, and when the p value was 0.05 or less, it was considered to be significant. As a result of quantitative analysis of SNR and CNR, 3D GRASE (BH) was measured high when comparing the two techniques, 2D TSE (RT) MRCP and 3D GRASE (BH) (p<0.05). The qualitative analysis result is a sharpness of the bile duct: 3D GRASE(BH): 4.12±0.03, Overall image quality: 3D GRASE(BH): 4.21±0.91 was high (p=0.001). The motion artifact of the bile duct showed no significant difference with two techniques(2D TSE(RT): 4.41±0.04, 3D GRASE(BH): 4.53±0.14(p=0.067). However, the background suppression obtained significant results with 2D TSE(RT) of 4.14±0.55(p=0.001). In conclusion, as a result of using the Fast MRCP testing method, MRCP images obtained by 3D GRASE (BH) had an advantage over MRCP images using 2D TSE (RT). However, there will be useful results of 2D TSE(RT) MRCP technique in patients who have difficulty holding their breath.

Image Evaluation for Optimization of Radiological Protection in CBCT during Image-Guided Radiation Therapy (영상유도 방사선 치료 시 CBCT에서 방사선 방호최적화를 위한 영상평가)

  • Min-Ho Choi;Kyung-Wan Kim;Dong-Yeon Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.305-314
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    • 2023
  • With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.

Relation between Ablation Execution Time and Radiation Exposure Effect in the Treatment of Atrial-fibrillation using Cryo-balloon and 3D Radio-frequency Ablation (냉각 풍선 절제술과 3D 고주파 절제술을 이용한 심방세동 치료 시 절제술 시행 시간과 방사선 피폭 영향과의 연관성)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.427-434
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    • 2022
  • Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m2, which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m2 by 921.56 uGy/m2, which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.

The Comparative Analysis of Exposure Conditions between F/S and C/R System for an Ideal Image in Simple Abdomen (복부 단순촬영의 이상적 영상구현을 위한 F. S system과 C.R system의 촬영조건 비교분석)

  • Son, Sang-Hyuk;Song, Young-Geun;Kim, Je-Bong
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.37-43
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    • 2007
  • 1. Purpose : This study is to present effective exposure conditions to acquire the best image of simple abdomen in Film Screen (F.S) system and Computed Radiography (C.R) system. 2. Method : In the F.S system, while an exposure condition was fixed as 70kVp, images of a patients simple abdomen were taken under the different mAs exposure conditions. Among these images, the best one was chosen by radiologists and radiological technologists. In the C.R system, the best image of the same patient was acquired with the same method from the F.S system. Both characteristic curves from F.S system and C.R system were analyzed. 3. Results : In the F.S system, the best exposure condition of simple abdomen was 70kVp and 20mAs. In the CR system, with the fixed condition at 70kVp, the image densities of human organs, such as liver, kidney, spleen, psoas muscle, lumbar spine body and iliac crest, were almost same despite different environments (3.2mAs, 8mAs, 12mAs, 16mAs and 20mAs). However, when the exposure conditions were over or under (below) 12mAs, the images between the abdominal wall and the directly exposed part became blurred because the gap of density was decreased. In the C.R system, while the volume of mAs was decreased, an artifact of quantum mottle was increased. 4. Conclusion : This study shows that the exposure condition in the C.R system can be reduced 40% than in the F.S system. This paper concluded that when the exposure conditions are set in CR environment, after the analysis of equipment character, such as image processing system(EDR : Exposure Data Recognition processing), PACS and so on, the high quality of image with maximum information can be acquired with a minimum exposure dose.

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Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island (울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태)

  • Kim, Tae-Hun;Lim, Hyun-Sul;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.115-123
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    • 2002
  • Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

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A Comparative Study on Image Quality of Breast Image Tests using ACR Phantom (ACR 팬텀을 이용한 시스템별 유방검사 영상의 비교 연구)

  • Hong, Dong-Hee;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.241-247
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    • 2006
  • Recently, interests and utilization on Computed Radiography(CR) and Digital Radiography(DR) tends to increase owing to an introduction of Picture Archiving and Communication System(PACS) and an accuracy control of special medical equipment for a breast imaging examination. This study was intended to compare and analyze a detector's imaging quality by each system to be used for the breast imaging examination by using ACR Phantom used at the accuracy control. As an evaluation method, a significance and reliability of image's value using the ACR Phantom was analyzed by using SPSS program. The results are followed. 1. For the fiber, there was 3.9 score in Screen-Film, 4.2 score in CR($50{\mu}m$), 3.2 score in CR($100{\mu}m$), and 4.2 score in DR. There was the high score in the order of CR($50{\mu}m$), DR, Screen-Film, and CR($100{\mu}m$)(P<0.05). 2. For the calcification, there was 2.7 score in Screen-Film, 2.5 score in CR($50{\mu}m$), 2.0 score in CR($100{\mu}m$), and 2.9 score in DR. There was the high score in the order of DR, Screen-Film, CR($50{\mu}m$), and CR($100{\mu}m$).(0.025(P<0.05). 3. For Mass, there was 3.8 score in Screen-Film, 3.8 score in CR($50{\mu}m$), 3.6 score in CR($100{\mu}m$), and 4.5 score in DR. There was the high score in the order of DR, CR($50{\mu}m$), Screen-Film, and CR($100{\mu}m$) (P<0.1). 4. As the total score, there was 10.4 score in Screen-Film, 10.6 score in CR($50{\mu}m$), 8.7 score in CR($100{\mu}m$), and 11.3 score in DR. There was the high score in the order of DR, $CR(50{\mu}m$), Screen-Film, and $CR(100{\mu}m$). As shown in the above results, it can be known that DR and Screen-Film System has higher image quality than CR. But, DR has unstability caused by element, and Screen-Film has the low image quality caused by artifact as disadvantages. When Dual-Side CR($50{\mu}m$) was used among CR systems which had the problem of low image quality, it was indicated that there was no difference with Screen-Film System. Because the radiation imaging examination tends to become digitalized, each system for the breast imaging examination will need to be developed and supplemented.

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