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OPERATION MANUAL

FOR
MOBILE C-ARM X-RAY SYSTEM

KMC-650
No.00000525-00

KMC-650
(Fluoroscopic X-Ray System) 1023
Doc.No. 00000525-00

Operator’s Manual

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CONTENTS

1. Quality Warranty P.4


2. Symbol Explanations P.6
3. Introduction P.7
4. Basic Application P.8
5. Composition P.9
6. Marking plate P.10
7. Safety Precautions P.14
8. Specifications P.16
9. Electrical Safety P.21
10. Environmental Condition for manipulation P.24
11. Getting start and initial state P.25

12. C-ARM operation method P.26


(1) C-ARM position control P.26
(2) C-Arm movement method P.29
• Steering control and fixing P.30

11. Control of the X-RAY P.31


(1) Operation panel control P.31
1) OP – PICTURE P.31
2) OP –BASIC CONTROL P.32
3) OP – MENU EXPLAIN P.33
4) KEY EXPLAIN P.36
5) MODE FUNCTION P.40
6) ALRAM DISPLAY P.44

12. MAINTENANCE PROCEDURE P.46

13. Appendix P.48


(1) ERROR MESSAGE P.48
(2) SCATTER RADIATION FROM KMC -650 C-ARM P.49
(3) TECHNICAL CHART P.52

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1. Quality Warranty
 Scope & Duration of Warranty

Every products manufactured by GEMSS Medical Systems CO., LTD. are warranted to be free from defects for a

period of one year after purchase date. If during the warranty period the product you purchased is found to be

defective, it will be repaired free of charge.

In the case of one of the following, however, a certain amount of service fees will be charged.

• Defect or damage found after the warranty period.

• Defect or damage in appearance which is not related to main function of the system.

• Damage caused by a natural disaster; such as fire, earthquake, or lightning strikes.

• Damage resulting from either improper movement or inattention to the precautions.

• Damage resulting from repair or modification by someone other than GEMSS or the authenticated by GEMSS.

• Damage caused by a natural disaster; such as fire, earthquake, or lightning strikes.

• Incidental or indirect loss caused during system manipulation.

Any or all defect or damages in appearance, which do not affect the main functions of the

product are not covered by this free of charge warranty.

 Prerequisites for Repair Request

- When a defect is found, stop the using immediately. It is strongly recommended to refer to related material on

the User Manual.

- Before a service request, must power off the entire system and check the model number, serial number, and the

purchase date. Then contact an authorized service office

 Any product with a defect in appearance only shall not be returned to nor replaced by GEMSS.

 GEMSS shall not be liable any incidental or consequential damages arising out of or relating to the use of the

product

 GEMSS shall not be liable for any damages or losses occurring after the warranty period

 This Quality Warranty prevails over the detailed Warranty for fitness or all other warranties in relation to the product

GEMSS MEDICAL SYSTEMS CO., LTD..

2nd Floor ,29, Dunchon-daero 541(obaeksasibil) beon-gil,


Jungwon-gu, Seongnam-si, Gyeonggi-do, Korea

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WARNING

X-RAY EQUIPMENT IS DANGEROUS TO BOTH PATIENT AND OPERATOR


UNLESS MEASURES OF PROTECTION ARE STRICTLY OBSERVED

Though this equipment is built to the highest standards of electrical and mechanical safety, the
useful X-Ray beam becomes a source of danger in the hands of the unauthorized or unqualified
operator. Excessive exposure to x-radiation causes damage to human tissue.

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2. Symbol Explanations

No Symbol Explanations

1
~ AC voltage

2 DC voltage

3 O/I POWER switch ON/OFF

4 Ground mark

5 Warning mark

6 Type B mark

7 High voltage mark

8 Head caution mark

9 Foot caution mark

10 Hand caution mark

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3. Introduction

The KMC-650 is a great solution to produce radiological images of patient during medical
operations. This inverter control X-ray unit visualizes the anatomical structure on screen, which is
obtained by X-ray fluoroscopy and the image intensifier. This system can be applied in emergency
room, operation room, cast room or etc. of hospital.
The KMC-650 has following features

(1) The high voltage generation circuit uses the method of inverter with a high power of 3.0kW,
to ensure that stable X-Ray with small amount of ripples are obtained.

(2) The X-Ray tube system uses the X-Ray tube with fixing anode and minute focus, thus
enabling to obtain high-quality images necessary for the longtime operation or diagnosis.

(3) Control panel adopting TACT key, segment display for excellent controllability and visibility.

(4) Soft but solid motions of the large size C-Arm, which has a 650mm radius, gives facility to
perform an operation.(Depth:692mm)

(5) For fluoroscopy, the collimator is used to reduce an unnecessary irradiation of X-Ray..

(6) Using the built-in SNAP SHOOT mode, the image quality is improved further and it can built-
in DIS(Digital Interface System) in option.

(7) Thermal sensor prevent the tube from overheating.

KMC-650 should be operated by authorized person under law only, like a doctor or a
radiologist.

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4. Basic Application

This manual is about the KMC-650 surgical mobile system,

which is a C-ARM X-Ray system, including high frequency

inverter, CCD and image-intensifier device controlled by DICOM.

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5. Composition

This product is composed of the X-ray support, the display device, accessories, and
options. Detail information of each component follows below.

(1) X-ray support


 CCD Camera
 IMAGE INTENSIFIER
 COLLIMATOR
 X-ray Tube and X-ray generator
 C-ARM
 C-ARM support
 Control Panel
 X-ray control part
 HAND SWITCH
 FOOT SWITCH

(2) Display image part


 Monitor STAND
 MONITOR
 CABLE

(3) Accessories
 Disinfected covers (Two sets of three kinds of cover, including four of clips)
 Operation Manual

(4) Option
 DIS(Digital subtraction angiography)

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6. Marking Plate
(1) SPECIFICATION/COMPOSITION LABEL
SPECIFICATION LABEL

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(2) WARNING LABEL POSITION

[FIG 1. KMC-650 WARNING LABEL POSITION ]

① HEAD CAUTION LABEL : ☞ The lower part of I.I. cover

② HAND CAUTION LABEL : ☞ Sliding part of the C-arm

③ FOOT CAUTION LABEL : ☞ Near the break part

④ HIGH VOLATAGE CAUTION : ☞ HV Tank inside of C-arm, Entrance


LABEL of HV cable

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(3) EARTH(GROUND) LABEL & POSITION

[FIG 2. KMC-650 EARTH (GROUND) LABEL POSITION]

① EARTH (GROUND) LABEL

: Two sides of each Earth terminal in the C-arm main body

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(4) FUSE WARNING, TUBE FOCAL SPOT LABEL & LABEL POSITION
① FUSE WARNING LABEL :
:Under the fuse board cover
☞ Make sure that read and follow the manual before
using this equipment.

[FIG 3. KMC-650 FUSE WARNING LABEL POSITION]

② TUBE FOCAL SPOT LABEL :


: For more detail information,
TUBE SPECIFICATION DATA
(Doc.no.: )

[FIG 4. KMC-650 TUBE FOCAL SPOT LABEL POSITION]

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7. Safety Precautions
1. Only an experienced expert can operated this product.
2. When install the system, the following must be considered.
(1) Install away from a water.
(2) Install so that the system is not influenced by air pressure, temperature, humidity, ventilation,
sunlight, and the air containing dirt, salinity, sulfur or etc
(3) Consider stability, free of slope, vibration and shock, in placing as well as in moving.
(4) Avoid place where gas is leaking and where chemical storage is nearby.
(5) Carefully follow the power specifications, such as frequency, voltage, current and power.
3. Before using the system, the following must be considered.
(1) Check connector contacts, polarities, dial settings, and measuring devices. Make it sure that
everything behaves precisely.
(2) Make every junction safe and correct.
(3) Aware that using a machine may result in unreliable judgments or give rise to a dangerous
situation.
(4) Carefully checking again what contacts the patient directly.
(5) C-ARM disinfected cover should be disinfected every time before use.

 WARNING !
In the operation, disinfected covers of C-ARM, Tube and I.I. must be disinfected to prevent the
patient’s infection

4. When a running machine, the following must be considered.


(1) Do not exceed the standard of exposure time and quantity. Maximum exposure time is 5min,
If exceed a time, this structure automatically stopped the irradiation. When need irradiation
again, please refer Limit Reset Switch.
(2) Carefully check the status of the system and the patient.
(3) If found any abnormal situation, either to the system or to the patient, make sure of patient
protection, stop the machine and perform appropriate procedure.
(4) Do not let patient touch the unit unnecessarily.

WARNING !
Do not let the operator, doctor or nurse but patients touch the system and the patients at the same
time! It might be occurred the patient leakage current.

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WARNING
In the normal fluoroscopy mode, it is desirable that shooting X-ray for 5minutes continuously, and
5minutes break, and then 5minutes shooting, and 5minutes break again. In the radiography mode,
it is desirable that shooting X-ray 1 time, and 40seconds break, and then shooting 1 time, and
40seconds break again. In the boost mode, you don’t have to push the foot switch over 3seconds
per 1 shooting, because the X-ray exposes just for 3seconds per 1time shooting in the boost
mode. As above, it is desirable that shooting X-ray for 3seconds per 1time, and then 30seconds
break, and then 3seconds shooting, and then 30seconds break again in the boost mode.

WARNING
If the tube is overheated, thermal sensor attached to the exterior of it warns the system and ‘Tube
Limit’ sign will be displayed on the TFT screen. Then the machine can work again by the time the
tube gets cooled.

WARNING
The significant zone of occupancy has a floor area not less than 60x60cm, and a height of not less
than 200cm
5. After operation, the following must be considered.
(1) Restore switches and dials to initial states and power off.
(2) When disconnecting the power cord, be sure to hold its plug and pull it out gently.
(3) When keep the machine, the following must be considered.
1) Keep away from a water.
2) keep so that the system is not influenced by air pressure, temperature, humidity, ventilation,
sunlight, and the air containing dirt, salinity, sulfur or etc.
3) Consider stability, free of slope, vibration and shock, in placing as well as in moving.
4) Avoid place where gas is leaking and where chemical storage is nearby
5) Put together accessories, cord and connecter etc after cleaning.
6) Machine must be clean for next operation.

6. If the system breaks down, leave a suitable mark on it and let the expert fix the unit.

7. Never disassemble or tamper the machine for the individual purpose.

8. Maintenance
(1) Follow the maintenance procedure in the chapter 12.
(2) When the machine is not be used, check that the system works correctly and safely before.

9. If the tube is overheated, thermal sensor attached to the exterior of it warns the system and
‘E16’ sign will be displayed on the screen. Then the machine can work again by the time the tube
gets cooled.

10. etc
Please try to follow operation on this manual.
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8. Specifications

1) System power requirement


(1) Line voltage ~220-230 V 50/60Hz : for UL
(2) Line phase Single
(3) Input power 3.0KVA @~220V : for UL

2) Rating
(1) Macro focus rating
 Tube Voltage 40 ~ 100 KV
 Tube Current range 8 mA Snap shot Mode
20 mA Boost Mode
 mAs range 8 ∼100mAs 14step
mAs step
8.0 10.0 12.0 15.0 20.0 25.0 30.0 40.0
50.0 60.0 70.0 80.0 90.0 100

(2) Micro focus rating


 Tube Voltage 40∼110 KV
 Maximum Tube Current 4 mA
 Tube Current range 0.5 ~4mA(Normal Mode)

3) X-Ray High-voltage device


(1) High-voltage generate circuit High frequency INVERTER type
(2) High-voltage RIPPLE less 1 KV
(3) Tube voltage peak time less 5ms (to 75% of the peak value)
(4) convert frequency 40KHz

4) X-ray control
(1) Type MICRO PROCESSOR controlled digital interface
(2) Fluoroscope Mode MANUAL mode
ABC(Automatic Brightness control) mode
(3) Radiography Mode MANUAL MODE

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5) X-Ray tube
(1) T Y P E Fixing anode X-ray tube
(2) TUBE NAME TOSHIBA DF-151SBR
(3) Focus 0.5mm / 1.5mm
(4) Anode Capacity 50 KHU
(5) Maximum tube voltage 110 KV
(6) TARGET angle 16°
(7) Unique filter 0.8 mm Beryllium
(8) Cooling type OIL COOLING
(9) FILAMENT volatage Fluoroscopy(Small) – 4V ~ 6V
Radiography(Large) – 4V ~ 12V
(10) Operation voltage 40 ~ 110KV
(11) Operation current Fluoroscopy(Small) – 0.5 ~ 4mA
Fluoroscopy(Large) – 8mA, 20mA
Radiography(Large) – 20mA

6) IMAGE INTENSIFIER( EN60601-1:1993, EN60601-1-2:, IEC1262-1 to 7 : 1994 )


9” I.I
(1) MAKER THALES(TOSHIBA)
(2) Input window size(6") 215/160/120mm
(3) Output window size(6") 20mm
(4) Resolution 48, 56, 64lp/cm
(5) Contrast 23:1, 25:1, 30:1

7) XTV Monitor and Camera(9” in a basic)


(1) LCD 19" (MM-190)
(2) TYPE B/W Active matrix TFT
(3) Contrast Ratio 900 : 1
(4) Brightness 1,000 cd/㎡ (Center 1-Point, type)
(5) Resolution 1280 x 1024 (60Hz)
(6) Response Time Sampling rate: 2,500 sample/sec
(7) Pixel Pitch 0.294(H)mm x 0.294(V)mm
(8) Viewable Angle(CR>10) R/L/U/D 85/85/85/85 (Min)
(9) Sensor Format 1/2 Inch CCD-Camera
(10) Number of Picture Elements 1024 (H) x 1024 (V)
(11) Converting system progressive scan with micro lenses

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8) Radiography support
(1) C-ARM movement
C-ARM Inner circle space 797mm
C-ARM depth 692mm
C-ARM Orbital movement 135°
Horizontal movement 200mm
Vertical movement 450mm
PANNING ± 12.5°
Width 800mm
(2) C-ARM rotation
rotation range right 180°, left 180°
Locking Manual

(3) SID 1000mm Fluoro


970mm RAD
☞ The size of X-Ray field does not differ from markings by more than 2% from the FOCAL SPOT

(4) Beam Limiting Device (COLLIMATOR)


(1) Manufacturer GEMSS MEDICAL SYSTEMS
(2) Model KMC-650CM
(3) Electric energy input 24VDC
(4) Operating type REMOTE MOTOR DRIVE
(5) Structure Lead Shutters
(6) Speed
Rotation 360°/ Maximum less than 18 sec
Open-Close Maximum less than 10 sec
Iris 2 sec
(7) Serial No.

9) Accessories
(1) Disinfected covers two sets of three kinds of cover (Four of clips)

10) Option
(1) DSA Digital subtraction angiography

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11) Dimension( 9” in a basic)


(1) Height 1745mm (2) Width 797mm
(3) Length 1843mm (4) Weight 280Kg

C-arm Unit

[FIG 5. KMC-650 Dimension]


Standard Monitor Cart

[FIG 6. KMC-650 Standard Monitor Cart]

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Movement

Horizontal Movement 200mm Vertical Movement 500mm

Orbital Rotation 135° (90°/45°) C-arc Rotation 360°

Planning Motion ±12.5°


[FIG7. KMC-650 Movement Range]

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9. Electric Safety

1) Before running the system, the following must be considered.

(1) Check a suitable voltage and capacity between PSU(Power Supply Unit) and Systems

(2) Check correctly connected all connecting terminal(voltage-line, optional device etc)

(3) Check the system correctly earthed (If not correctly earthed, a noise may be occurred)

WARNING
To reduce noise during examination, do not place the system near a voltage generator, broadcast
lines nor any other X-ray devices. And use exclusive power and be sure to earth the system.
Noise can make screen distorted and interfere with getting an uniform screen.

2) System power classifications


The KMC-650 can be used in ~220-230V mode. The methods of electric wiring of the main
transformer are as pictures below;

[ FIG 8. KMC-650 ELECTRIC WIRING OF TRANSFORMER :~220-230V]

WARNING
The KMC-650 can be used in ~220-230V mode. If you want to change the input voltage mode, it
should be handled by expert of this system. You should call GEMSS R&D center before changing
the input voltage.

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3) Fuse board LAYOUT & CLASSIFICATIONS.

F5 F4 F3 F2 F1

[FIG 9. KMC-650 Fuse board layout]

(1). Fuse board

CONNECTOR NO. SPEC. COMMENT REMARK

Fuse # 1 CN 4 ( F5 ) NOT USED

Fuse # 2 CN 5 ( F4 ) 3.15A/250V PSU BOARD POWER

Fuse # 3 CN 6 ( F3 ) 6.3 A/250V ELEVATOR

Fuse # 4 CN 7 ( F2 ) 6.3 A/250V TIMER RELAY POWER

Fuse # 5 CN 8 NOT USED

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(2). HFG GENATOR DC POWER BOARD(PWR BOARD & DRIVER BOARD)

CONNECTOR NO. SPEC. COMMENT REMARK


CONTROL BOARD
Fuse # 1 F1 2A/250V
POWER
Fuse # 2 F2 30 A/250V High Voltage Power

(3). SMPS(Power supply board)

CONNECTOR NO. SPEC. COMMENT REMARK

PSU BOARD
Fuse # 1 FUSE 1 3.15 A/250V
MAIN POWER

WARNING
- When you change fuse
1. You should check the rating, power, part no., and marking according with the
manual.
2. It should be performed by an expert or an engineer who is well trained.

The class and type of protection against electric shock


 ClassⅠ: This is the equipment in which protection against electric shock does not rely on
BASIC insulation only, but which includes an additional safety precaution in that means
are provided for the connection of the equipment to the protective earth conductor in the
fixed wiring of the insulation in such a way that accessible metal parts cannot become live
in the event of a failure of the basic insulation
 Type B : This is the equipment providing a particular degree of protection against electric
shock, particularly regarding:
- Allowance leakage current
- Reliability of the protective earth connection

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10. Environmental Condition for operation

♦ Do not install and operate the machine at any of the places described below.
 Highly humidified or dusty place
 Places exposed by direct sunlight
 Places with poor ventilation
 Places with high salinity, leaking gas, or chemical material

♦The machine should be within the following temperature and humidity. Also, strong vibration
would be harmful to the system

 Range of the temperature and humidity : 5 ~ 40°C, 5 ~ 90%RH


 Range of the temperature and humidity for operating 10~°C, 30~85 % RH
 Range of the temperature and humidity for recommend : 17 ~ 23°C, 40 ~ 60%RH
 Extended Storage and Transportation > 2 days: 5 ~ 40°C, 5 ~ 90%RH
 Short-term Storage and Transportation < 2 days: 0 ~ 45°C, 5 ~ 90%RH

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11. Getting start and initial state


♦ Booting the system
Turn off the power switch and insert the power plug into an outlet. Turn the power switch on,
and check the messages on the SEGMENT. (If occurs an error, refer to 13.(1))

MONITOR PLUG POWER S/W

HAND S/W PLUG FOOT S/W PLUG

[FIG 10. Power Plug and Power Switch]

♦ Initial status
When powered on, the startup screen (FIG 11.) is displayed on the SEGMENT. (During about
10sec and not allowed input with key)
After10sec, Initial display will be changed like as Fig 11. And displayed normal fluoro
offset condition “60KV, 1.0mA”

[Fig 11. Initial state & Initial mode state]

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12. C-ARM operation method


(1) C-ARM position control
♦ Left-right rotation of the C-ARM
The C-ARM can rotate 180 degrees to left and right, as shown in Fig 12.

[Fig 12. The left-right rotation of the C-ARM]

♦ Locking of the left-right rotation of the C-ARM


During left-right rotation, set the rotation lever to ‘free’ position. After adjusting you
can lock the C-Arm position by setting the lever to ‘lock’ position as shown in Fig 13.

[Fig 13. The locking lever of the left-right rotation of the C-ARM]

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♦Orbital rotation of the C-ARM


The C-Arm can rotate 135(-45˚,+90˚)degrees in orbital direction, as shown in
Fig 14.

[Fig14. Orbital rotation of the C-ARM]

♦ Locking of the orbital rotation of the C-ARM


During orbital rotation, set the orbital rotation lever to ‘free’ position. After adjusting you
can lock the C-Arm position by setting the lever to ‘lock’ position as shown in Fig 15.

[Fig 15. Lock lever of the orbital rotation of the C-ARM]

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♦ Horizontal movement of the C-ARM


The C-Arm can move horizontally by 200mm, as shown in Fig 16.

[Fig 16. Horizontal movement of the C-ARM]

♦ Locking of the horizontal movement of the C-ARM


During horizontal movement, set the horizontal movement lever to ‘free’ position.
After adjusting you can lock the C-Arm position by setting the lever to ‘lock’
position as shown in Fig 17.

[Fig 17. Locking lever of the horizontal movement of the C-ARM]

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(2) C-ARM Movement method

(a) Locking brake b) Steering handle

[Fig 18. Movement of the C-ARM]

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♦ Steering movement
To move the whole C-Arm, push the front-side of the break pedal to release the
steering handle and the break. Hold the handle of the main unit, and move it. Use the
steering handle to change the direction

♦ Fixing
Fix the unit in a new location by pushing the back-side of the brake pedal.

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11. Control of the X-RAY

(1) Operation panel control


1) OP - PICTURE

[Fig 19. OP control panel]

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2) OP – BASIC CONTROL

1. FLUORO S/W

2. EMERGENCY S/W

3. OP – PANNEL

[Fig 20. OP PANNEL DRAWING]

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3) OP- MENU EXPLAIN

1. INTRODUCE NAME OF DISPLAY AND KEY

INDEX EXPLAIN SYSMBOL REFER

A C-ARM Up-Down Key

Collimator forward-backward
B
direction Open-Close

C Collimator rotation Key

D Collimator IRIS Open-Close

E LASER ON OFF Key (OPTION)

F Horizontal image flip Key

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G Vertical image flip Key

H Clockwise Image Rotation KEY

Counterclockwise Image Rotation


I
KEY

J ABS KEY

K KVP DISPLAY

L mA(mAs) DISPLAY

M MEMORY DISPLAY

N X-RAY TIME DISPLAY

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O INCREASE AND DECREASE KEY

P STORE KEY

Q ZOOM key & Zoom display

Radiography key
R
READY & X-RAY ON Key
ALRAM DISPLAY

MODE SELECT KEY

Fluoroscopy Switch
U
(instead of the Foot Switch)

V Emergency Switch

[TABLE 1. OP control menu outline]

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4). KEY EXPLAIN

A. C-ARM Vertical Up-Down Key


KMC-650 has two C-Arm Up-Down keys in both side of the OP panel for the user
convenience.

C-ARM Up
While pressed, C-ARM goes upward direction.
Automatically stopped a maximum height 1370mm ± 15mm
position

C-ARM Down
While pressed, C-ARM goes downward direction.
Automatically stopped a minimum height 920mm± 15mm position

B - D. Collimator Control Key


Open and close the collimator and rotated.

X-axis collimator close


Decrease the width of the range of the X-Ray

X-axis collimator open


Increase the width of the range of the X-Ray

IRIS collimator close


Decrease the length of the range of the X-Ray

IRIS collimator open


Increase the length of the range of the X-Ray

CW collimator rotation
Rotate the range of the X-Ray to clockwise direction.

CCW collimator rotation


Rotate the range of the X-Ray to counterclockwise direction.

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E. LASER Key

LASER On Key
Be capable of adjusting the operating position easily, with a high-
brightness laser beam.

F - I. Image flip and rotation Key

Horizontal image flip Key


This key flips the fluoroscope image on the monitor horizontally..

Vertical image flip Key


This key flips the fluoroscope image on the monitor vertically.

Clockwise Image Rotation Key


This key rotates the fluoroscope image on the monitor clockwise.

Counterclockwise Image Rotation Key


This key rotates the fluoroscope image on the monitor
counterclockwise.

J-N ABS AND DISPLAY

ABS KEY
Activates ABS(Automatic Brightness System)
function

Kvp display and key


Kvp display and increse or decrease enable key

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mA (mAs)display and key


mA (fluoro) or mAs(radio) display and increse or
decrease enable key.

Memory display and select key


Image read or write to Memory and than display in
monitor and Memory select key.
If user want save image. Press “STORE”key

X-RAY time display


We are the device to mark an investigation hour.
We express by the minute and mark whole investigation
time to be inspected to whole because we block the power
supply.
We mark also a consecutive radiography air time when we
are the radiography mode.

O – T. STORE and Additional key

Memory key
The key to store the image to 16 if we push
STORE key at the seeing Monitor through.

Zoom key
The key to choose the size of image.

Radiography key
This key is same function with Hand s/w.
When pushing ready s/w, system is ready to
exposure state.
And pushing the X-ray s/w enable to exposure.

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U. Fluoro Switch (instead of the Foot Switch)

Fluoro Switch
Start Fluoroscopy. You can use foot switch either. Both keys have
exactly same function.

V. Emergency STOP key

Emergency STOP
If emergency arises on positioning the C-Arm, press the Emergency
switch. Then the movement stops immediately, “Emergency S/W
Pressed” is displayed on the LCD and alarm sounds. To escape the
emergency state, turn the Emergency switch clockwise direction.

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5) MODE FUNCTION

NORMAL FLOURO MODE


Normal fluoro mode select key
When pushing the foot s/w, x-ray emission start
Continuously.
We are used as most general selection mode.

The area:

KVP : 40 – 110 KVP


mA : 0.5 – 4.0 mA

SNAP SHOOT FLOURO MODE


Snap shoot fluoro mode select key.
When pushing the foot s/w, We order the motive at
a camera motive signal and creat the x-ray.
And than We can see superior image, because use
high current(8mA)

The area:

KVP : 40 – 110 KVP


mA : Fixed 8.0mA

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MULTI FLOURO MODE


Multi Fluoro mode select key.
When pushing the foot s/w, We order x-ray
emission interval time and creat the x-ray.
This means that we divide as the turnaround to be
set at the exposure number/1sec .
And than reduce the x-ray quantity of the ccurrence.

The area:

KVP : 40 – 110 KVP


mA : 0.5 – 4.0 mA
Exposure number/1sec :1-5

BOOST MODE
Boost mode select key
When pushing the foot s/w, x-ray emission is
continued 3sec with highest current(20mA).

The area:

KVP : 40 – 100 KVP


mA : Fixed 20 mA
Exposure time: 3sec

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RADIOGRAPHY MODE
Radiography mode select key
The film must prepare the cassette to install.
Should be use hand s/w or ready and x-ray key in
OP- pannel.

The area:

KVP : 40 – 100 KVP


mA : Fixed 20 mA
mAs : 8-100 mAs 14 Step

mAs step
8.0 10.0 12.0 15.0 20.0 25.0 30.0 40.0
50.0 60.0 70.0 80.0 90.0 100

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X-RAY Filed Size of KMC-650

X-ray field size of fluoroscopy mode

X-ray field size of radiography mode

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6) ALRAM DISPLAY

Fluoro mode select display


When select Fluoro mode, light on.

ABS select display


When select ABS mode, light on.

X-RAY emission display


When pushing foot s/w, light on.

Radiography mode select display


When select Radio mode, light on.

Radiography ready state didplay


When pushing hand s/w, light on.

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 WARNING !
Operating the hand switch comprise two procedures. Though you jump to the second
procedure at once, X-Ray emits after two seconds.

 WARNING !
For complete X-Ray emitting, HAND SWITCH BUTTON must pressed until the
end of the X-Ray emitting

 WARNING !
The hand switch is a dead man switch, which means that you should hold to
press the button during the whole X-ray emitting procedure. In any case you release
the button before the emitting is over, the procedure stops, the examination does not
finish. But it can be restarted without any problem.

 WARNING !
In order to protect the tube, the machine should have enough wait time. After each
fluoroscopy, this system has the wait time of 30 seconds

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12. MAINTENANCE PROCEDURE

(1) General caution


It is recommended to follow the maintenance procedure described below, for the reliable
operation. The routine inspection should be committed by a trained expert

(2) MAINTENANCE SCHEDULE

Maintenance/control item Period


RAD mA :
1
1 Should be within accuracy boundary of ±10% (20mA),
Year
with the voltage set by 40 kV and 100 kV.
Fluoro mA :
1
2 Should have accurate 1mA step for 1~4mA, with the
Year
voltage range of 40 ~ 110 kV
RAD mAs :
1
3 Should be within accuracy boundary of ±7%, when the
Year
mAs value is between 0.4mAs and 100 mAs.
RAD KV :
1
4 Should be within accuracy boundary of ±10%, when the
Year
kV value is between 40kV and 110kV.
Fluoro KV:
1
5 Should be within accuracy boundary of ±10%, with the
Year
voltage range of 40 ~ 110 kV
Optical Maintenance :
1
6 When dirt appears on the image, remove dirt on the
Year
camera lens with soft brush or ‘Kodak Lens Cleaner’.

(3) CLEANING
Keep the machine clean when it gets dirt, especially after a surgery.
To clean the main-body, turn off the power and pull the plug out from the outlet.
Scrub surfaces smoothly with soft fabric or gauze.

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Keep the machine clean when it gets dirt, especially after a surgery.

[FIG 21. KMC-650 System power off]


To clean the main-body, turn off the power and pull the plug out from the outlet as
pictures above. Do not allow liquids and water enter inside the unit, to prevent from
short circuits and corrosion of inner parts.

WARNING
Make sure the disconnection from the mains before cleaning the unit !

Clean the painted surfaces using


only a damp cloth and neutral
detergents. Take care to dry the parts
with a dry cloth. Do not use corrosive
solvents(Alcohol, Gasoline)

[FIG 22. Cleaning tool for KMC-650]

Clean the extra covers, carrying handles, foot switch, hand switch, breakers, X-TV
monitors and the accessories using a damp cloth.

Periodically and when necessary decontaminate the op panel, the carrying


handles, the breakers, the surfaces of monitors using a proper decontaminator.

WARNING
Do not keep near the magnetic stuffs and water pails etc! They might bring a serious
harm to the system
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13. Appendix
(1) Error Message
When an error occurs, error message appears on the SEGMENT and indicates what the
problem is.

Emergency Switch Pressed : error code 17

Filament is not on : error code 01

X-ray Tube Overheated : error code 16

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(2) Scatter Radiation from KMC-650 C-Arm


Conditions:
110kVp @ 4mA

The measurement points are 30 cm apart.

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Scatter Radiation Measurements


Technique : Fluoroscopic;110kVp @ 4mA
Point 1 Point 2 Point 3

Point Rate Point Rate Point Rate


L1 91.8 mR/hr L1 83 mR/hr L1 59.2 mR/hr

L2 108 mR/hr L2 96 mR/hr L2 79.1 mR/hr

L3 107.8 mR/hr L3 101.5 mR/hr L3 80.4 mR/hr

L4 135 mR/hr L4 114.5 mR/hr L4 93.4 mR/hr

L5 143 mR/hr L5 123.9 mR/hr L5 107.5 mR/hr

L6 150 mR/hr L6 126.8 mR/hr L6 110.5 mR/hr

L7 144 mR/hr L7 121.9 mR/hr L7 110.6 mR/hr

L8 125 mR/hr L8 109.8 mR/hr L8 100.9 mR/hr

Point 4 Point 5 Point 6

Point Rate Point Rate Point Rate


L1 37.8 mR/hr L1 63.3 mR/hr L1 50.4 mR/hr

L2 77.6 mR/hr L2 69.2 mR/hr L2 57.9 mR/hr

L3 78.4 mR/hr L3 71.2 mR/hr L3 55.4 mR/hr

L4 95.8 mR/hr L4 77.2 mR/hr L4 60.5 mR/hr

L5 102.4 mR/hr L5 83.2 mR/hr L5 67.2 mR/hr

L6 107.5 mR/hr L6 87.6 mR/hr L6 72.6 mR/hr

L7 113.3 mR/hr L7 90.1 mR/hr L7 70.5 mR/hr

L8 94.5 mR/hr L8 85.6 mR/hr L8 71.8 mR/hr

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Point 7 Point 8

Point Rate Point Rate


L1 3.1 mR/hr L1 3.7 mR/hr

L2 4.1 mR/hr L2 4.1 mR/hr

L3 4.6 mR/hr L3 5.4 mR/hr

L4 6.2 mR/hr L4 6.3 mR/hr

L5 13.3 mR/hr L5 10.1 mR/hr

L6 20.5 mR/hr L6 12.1 mR/hr

L7 18.5 mR/hr L7 13.9 mR/hr

L8 18.1 mR/hr L8 13.8 mR/hr

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(3) Technical Chart

KMC-650 Radiography Chart


(Technic Chart for KMC-650)
Part Direction Depth (Cm) Distance Tube MAs Grid
(Cm) voltage
Skull A.P. 18 80 70 25 +
A.P. 20 80 75 25 +
Lat. 15 80 70 20 +
Lat. 17 80 70 25 +
Thoracic spine A.P. 19 80 65 20 +
A.P. 12 80 70 16 +
Lat. 26 80 80 25 +
Lat. 11 80 70 12 +
Lumber spine A.P. 19 80 80 25 +
A.P. 21 80 80 32 +
Lat. 25 80 100 40 +
Lat. 28 80 100 50 +
Pelvis A.P. 19 80 80 25 +
A.P. 21 80 80 32 +
Shoulder joint 9 80 60 8 -
Humerus 6 80 55 6 -
Hand 2 80 45 3 -
Femur 15 80 65 8 -
Knee joint 12 80 65 10 -
Ankle 7 80 65 6 -
Toes 3 80 50 6 -
Bladder 20 80 80 20 +

+ : Include Grid , - : Not include Grid

Manufacturer : GEMSS MEDICAL SYSTEMS CO., LTD.


( 82-31-764-7321~3)
A/S Company :

☞ NOTE !

The statistics and specifications of this unit and manual can be modified with or without
notification for the improvement of performance and safety.

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CXVIEW USER GUIDE

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INDEX

1. INTRODUTION p. 56

2. QUICK START p. 58
A. Composition of a picture p.59
B. Turn on the system p.60
C. Set the study Information p.61
D. Select the operating mode p.64
E. Acquire an image p.64
F. Image Tools p.65
G. DICOM sending p.66
H. Load Previous Images p.66
I. Quit p.68

3. Database p. 69
VIEW p.69
EXAM p.69
CONTINU p.69
NEW p.70
DELETE p.70
EDIT p.70
TRANSFER p.70
EXPORT p.71
SEARCH p.72

4. Viewer p. 74

A. Displaying Images p.74


B. Image management p.75

SAVE
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IMPORT
SENT TO SERVER
DICOM &MACHINE
PACS
SYSTEM
MACHINE
PRINTER
IMAGE CONTROL MENU

5. Trouble Shooting p. 101

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1. Introduction

Thank you for choosing our new CXVIEW system for KMC surgical C-
ARM unit.

CXVIEW supports your surgical C-ARM system with very essential and
useful features for managing the unit and images.

CXVIEW has various image tools. Also with DIS system, volatile images of
surgical C-ARM will turn into very well organized DICOM database. These
features are integrated in a single system, providing full access of useful
functions.

This manual describes every features of CXVIEW system. CXVIEW


system will help you to implement maximum efficiency of managing surgical
images.

CXVIEW system consists of PC system and software, with two connections


with C-ARM unit. One of the connections is RS-232C serial connection, and
the other is the connection of CAMERA LINK cable for image acquisition.

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1. RS-232C COM1
2.RS-232C COM2
3. RS-232C COM3
4. FRM-11
4.1 Camera Link
4.2 Digital I/O

Standard

Surgical C-Arm System

[FIG 1. CXVIEW System]

For proper operation, please consider following descriptions carefully.

• Make sure all the connections are tight and fixed. RS-232C cable should be
plugged in COM1, COM2 port of PC System.
• Try to use isolation adapter for RS-232C connection. This is for the safe
grounding of RS-232C port of PC System.

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2. Quick Start

Turn on the system.



Set the patient and
Study information.
(in CXVIEW)

Select the operating
mode (in KMC unit)

Control C-ARM Unit.
(In KMC unit)

Acquire an image
(In CXVIEW or KMC
unit)

Image Tools
(In CXVIEW)

DICOM Sending
(In CXVIEW)

Managing Database
(In CXVIEW)

Quit

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A. Composition of a Program

View Toolbar View Thumbnail

Display Window

[FIG 2. DB View]

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B. Turn on When power switch is on, both the C-ARM unit and the PC system
begin the booting procedure. When CXVIEW is loaded without problem,
The system. following screen will appear.

[FIG 3. DIS starts]

(KMC – 650 X-ray Statuses)

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C. Set the study In the left monitor, ‘NEW’ window is opened. You can set study
information here.
Information.

[FIG 4. New Exams. Registration Window]

Input the patient Information, “Press new button ( )Button”.


( ) Make sure that you set a (*) mark before start examination.

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If the patient exists in the tree, simply click the ( ).

And then selector ( ) click START EXAM.

[FIG 5. Local Patient View Window]

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If you want to change the other patient or Exam after finishing an
operating, you should finish the DIS program at “Close Study”

( )

 CXVIEW is Support Patient – Study – Image BAR.


 Select Study

VIEW in Patient Study ID, DATE, Modality and Body Part

 Select Image

View in Study ID, DATE and PATH

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D. Select the In KMC-650 unit, select operating mode. You cannot enter each
operating mode in CXVIEW application. CXVIEW shows which mode
operating the system is operating in
mode

[FIG 6 - C-arm NORMAL FLUORO Main]

 Again, before selecting operating mode, set the patient information first.

E. Acquire When the image you want to save appears on Main View window,
click Memory button on ‘Memory’ layer of Control window or press
an image
memory button on the touch screen of C-ARM unit. Then the image is
captured and you can see the image on Display window of the right
monitor.

[FIG 7. C-arm Unit NORMAL FLUORO ]

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F. Image Tools Now we consider the right monitor. In the right monitor, you can see
‘Display Window’, ‘View Thumbnail’, ‘View Thumbnail Toolbar’ and
‘View Toolbar’.

[FIG 9. Thumbnail View]


[FIG 8. Image Tools Toolbar]

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G.DICOM To send an image somewhere in DICOM format, click “Transfer” button.


The host address, port number and AE Title of DICOM server must be
Sending configured in file. Read “chapter 4” for detailed information.


To save images and information in CXVIEW, the system has its own database system so normally you
don’t need to care about a DICOM file.
But sometimes you still need to extract a DICOM file to copy or to backup, etc.

H. Database window to load images of previous examination into Display


Load Previous
window (( ). As described before, select study that
Images
you want to review. The images of that study will be displayed in
thumbnail window.

To view one image, select the image and it will be highlighted with a
green line. Then click View button below the thumbnail window, and it
will be loaded in Display window, of the right monitor. The patient
information is along to the image, and you can check image information
in Display Window (Read chapter 4 to know how to check patient
information in Display Window). To load all images of the Exam, click

View ( ) All button.

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[FIG 10. Work list Windows]

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I. QUIT
First, In the DIS program Exit ( ) click

[FIG 11. – CXVIEW EXIT]

 Please always try to turn off the PC system with Windows™


menu. If you power off without that, the operating system of Microsoft™
may work wrong.

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3. Database
In this chapter, you will learn how to manipulate patient information and
Images. To select a command described below, Click an item on the
Database View (FIG 12)

( ) Click “Work list” Button.

[FIG 12. - Database View Menu]

VIEW
Search the patient and View the Patient Information at the Monitor.

EXAM
Before exists Work list, existing patient Examination.
(Created new Study)

[FIG 13. - EXAM]

CONTINUE
The patient exists in the EXAM tree, to continue a study of the patient.

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[FIG 14. EXAM Menu]

NEW
Add new patient & new Exam. Fill the dialog (FIG. 4) with the patient information and
new patient is created

DELETE
Delete an Exam. You should select a Exam to perform this action. Every images of the Exam will be
deleted too, and never be recovered. Be careful to use this command.

 Delete the each Patient, Exam, and Image

EDIT
Edit patient & Exam information. You should select a study to perform this action. Dialog box shows
up, and edit patient information as you want and confirm.

TRANSFER
Send every image as a DICOM format of selected EXAM to Display Window.

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 < Confirm the run “StoreSCU”>

EXPORT
Export an image as a *.bmp file, *.jpg file, *.dcm file, DICOMDIR. You should select Exam to
perform this action.
And, the selected Exam List will be saved to the CD disk,
Converted to the DICOMDIR automatically

<Save variety format.>

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< Enable Check save CD-ROM. >

SEARCH

Search a patient in the patient tree. You can search a patient with name, or ID string
(Select search option in the dialog)

 Search a term Select the Configuration.

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[FIG 15. Search Menu]

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4. Viewer
In this chapter, you will learn how to view images, use image tools on it and manage
image information. This will cover every features on the right monitor screen.

A. Displaying Images
▌Thumbnail Window and select an image to view
When you acquire images from surgical C-ARM system, the images are displayed in a
row in Thumbnail window. You can scroll images with scroll bar and select an image to
view in Display window.
To load an image in Display Window, double-click on the image you want to see in
Display window.
▌Selected key image view and Delete images in Thumbnail Window
When you click on an image on thumbnail window, the image will be highlighted with
a Yellow line. This Yellow line means that the image is selected in thumbnail window. It
is different from the main image of Display window, which will be described in next
section.

[FIG 16. Selected image of thumbnail window]


Also all image delete, click on delete button below the thumbnail window.
If the image is loaded in Display window, that image will disappear as well. But
if the image has DICOM information, the image of internal DICOM database
will remain undeleted. If you want to delete it from database, delete it from DB
view window. If the image has no DICOM information, this command will
completely delete the image.

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B. Image management

▌Load/Save Option

An image can be saved and loaded in following three formats.


• Internal DICOM Database
• Independent DICOM file
• JPGE file – for image only (cannot save patient information)
• DICOMDIR file
• CD-Burn with Image viewer (DICOMDIR file)

[FIG 17. save Tool View]

Every image with patient information is saved in internal DICOM database.


Also you can browse the images and information in DB view window, and load it
again. And when you want to send DICOM information to other DICOM server,
DIS automatically creates a DICOM file and sends it. So in most cases, you need
not care about DICOM format or JPGE format.

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• Save

( )

- Save an image as a JPGE file.


You should select main image to perform this action.
JPGE files are useful when you should show the image without DICOM viewer
software.

[FIG 18 – Select Format]

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• Import

( )

- Existed Patient in Database DICOM file, load the Display View, Save and Transfer
Server.

Want an Image file


C:\Image\ExamDate\Patient ID\Patient NAME Folder

[FIG 19. Import View Menu]

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• Send to server
- Transfer IMAGE File, DICOM file format to Server.
Select Want Transfer IMAGE in Thumbnail Windows
Click the Mouse Right Button “Send to server”

< Select Send to Server >

< Complete Transfer Marked “S” >

[FIG 20. Database Transfer Menu]

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[FIG 21. Send to Server]

· DICOM Transfer Sewtting & Machine Setting

 Setting the Image to server.

( )

Close Study -> configuration Button Click.

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[FIG 22. Server setting Dialog]

• PACS

Appear setting Dialog, Select the PACS.
Select Server of Change setting and Edit Button
Modify Display Window Text and“OK” then “Select” Button click.

 After setting must be “Select” Button click.

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• SYSTEM

Change IMAGE PATH and Search option and Monitor setting in “System TEP”
Setting Dialog.

[FIG 23. Configuration Menu]

• Machine

Via Change Operator, input the ID and Password enable Machine TAP.

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< Input the Operator and Password. >

< Displayed enable Machine. >

 After Change setting, must be “Save” Button Click.

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• Print

( ) Imager (option)/ ( ) Paper print


- Imager (option) or Paper print

[FIG 24. Film print & paper print preview]


( ) Paper print is appointed as a “basic printer” used in the window.
If there are no printers appointed in the window, no images will be displayed
in the paper print preview. Please register printer at“Windows print setting”.

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 Imager setting ( )
(Option)

Film Print Setting path C:/Cxview/CFG/ FILMPRINT.ini file.


 Below File text

[PRINTING_INFO-1]
AETITLE=PRINTSCP Print Name
HOSTNAME=127.0.0.1 Print IP Address
PORT=104 Print Port
DESC=TEST SERVER
ALIAS=EM
SEND=Y
PRINT_LEVEL=S
PRIORITY=LOW
REG_APP_NAME=SCAN
WAIT_COUNT=1

Change connects information, modify mark the underline.

Display Window click the Film print below the picture.

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[FIG 25. Film print Dialog]

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▌Image Control Menu

[FIG 26. Image Control Tool View]

• Adjust Live Screen

( ) - Adjust (left monitor)


Auto & manual mode.

Recursive Filter
1, 2, 4, 8, 16

[FIG 27. Dialog main Windows Live setting]

- Adjust left manual mode (Uncheck Auto).

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 A dialog (FIG 28) will appear, and you can manually adjust brightness

[FIG 28. Manual IMAGE Setting Dialog]

 Check “LUT” and “SET” Button click.

- Adjust video image Adaptive mode (Check Auto)

A dialog will appear, and you can modify set brightness

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1) Example setting Value.

1. Kvp : 50 Brightness : 50 Contrast : 95


Apply: 50kvp under Brightness: 50 Contrast: 95.
2. Kvp : 60 Brightness : 50 Contrast : 95
Apply: 50kvp ~ 50kvp Brightness: 50 Contrast: 50
3. Kvp : 70 Brightness : 10 Contrast : 67
Apply: 70kvp ~ 60kvp Brightness: 10 Contrast: 67

2) Auto mode Brightness_ Contrast set


- Kvp value modify

Example) If 43KV under Brightness_ Contrast 0, 0


B/C Modify clicks.

End setting Save B/C click.

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[FIG 29. Dialog Adaptive Image]

- Kvp value add Set B/C click.


Example) 50KVp ~ 60 Kvp  insert 55Kvp
Set B/C click Kvp Value 55 set Brightness_ Contrast set  Ok click.
Finally, save B/C click.

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• Horizontal Flip

( )
- Flip image horizontally.

• Vertical Flip

( )
- Flip image vertically.

• Inverse

( )
- Get a negative image.

• Window Level

( )
-

• Left Rotate

( )

• Right Rotate

( )

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• Gamma

( )
-

• Zoom & Pan

- The functions of ZOOM ( ) and PAN ( ) are applied to each image.


When move the mouse left or right keep clicking the left-sided button, the image would
be magnified or reduced Each Image

• Magnify

( )

“ZOOM” It can be magnified in part, and examined

[FIG 30. Magnify image]

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• Layout

( )
Display Window mode 1X1, 2X2 and etc change button.

[FIG 31. 3X3]

 View IMAGE 1X1 ~ 4X4 Proportion


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- Info

( )

Search DICOM Information.

- Overlay

( )
Image Information The information is displayed at each edge of left corner of
monitor as a form of “OVERLAY”

[FIG 32. Info Message]

• Annotation

- Each Image Angle ( ), Arrow ( ),

Caliper ( ), Annotation ( ) Function.

-93 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

[FIG 33. Adjust Annotation]

 Change View Window disappear Annotation.

 Below Digital “Angio” Function is option

-94 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

• CINE

- Run CINE
CINE-REC

[FIG 34. CINE View Windows]

CINE-REC ON and X-RAY ON  SAVE CINE.

- After save, thumbnail Windows CINE file

-95 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

- Save as CINE ICON, Enable PLAY and STOP.

CINE PLAY STOP

CINE PLAY

Speed Cine

[FIG 35. Digital Angio]

CINE save setting CONFIGURATION


(Maximum 30 fps/ 6sec = 180)

-96 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

[FIG 36. Config]

-97 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

• DSA & Roadmap

[FIG 37. Digital Angio Icon]

[FIG 38. REC & DSA & Roadmap]

-98 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

- DSA

Select DSA Button ( ) and X-RAY on,


After 1sec Display “DSA IMAGE”

[FIG 39. DSA]

-99 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

- Roadmap

“Roadmap” ( ).

Left Monitor Right upside ( )


① First X-RAY on and () Injection Jod.
X-ray off.
② Second X-RAY on live.

[FIG 40. Roadmap Chaser]

-100 - GEMSS MEDICAL SYSTEMS CO., LTD.


No.00000525-00

5. Trouble Shooting
Captured image have interlaced lines on it.
It happens when you capture an image exactly when A/D converter triggers on
NTSC video signal. Please try again to acquire a good image.

I changed Host address setting for DICOM transfer but it still sends images to
old address.
You should reboot the PC after you change DICOM.ini file.

-101 - GEMSS MEDICAL SYSTEMS CO., LTD.

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