• Title/Summary/Keyword: Ablation Rate

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Clinical Experience of $VNUS^{(R)}Closure$ fast in Treatment of Varicose Vein: Comparison with Traditional Radiofrequency Ablation (하지정맥류 치료를 위한 2세대 고주파 열폐쇄술($VNUS^{(R)}Colosure$ fast)과 기존의 고주파 열폐쇄술($VNUS^{(R)}Closure$ plus)의 임상치험 비교 분석)

  • Kim, Woo-Shik;Lee, Jeong-Sang;Jeong, Seong-Cheol;Shin, Vong-Chul
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.635-641
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    • 2010
  • Background: Radiofrequency endovenous ablation of incompetent saphenous vein has gaining popularity over the conventional ligation and stripping as a minimally invasive technique. The latest version of radiofrequency endovenous catheter, $VNUS^{\circledR}Colosure$ fast VNUS medical Technologies, San Jose, CA, adopted a segmental ablation system, instead of continous pullback, is designed to reduce treatment time in comparison with the previous model $VNUS^{\circledR}Colosure$ plus VNUS medical Technologies, San Jose, CA. The purpose of this study is to compare the difference between two endovenous radiofrequency ablation systems in terms of treatment efficacy and complication rates. We analyze the initial efficacy and complication rates of $VNUS^{\circledR}Colosure$ fast with $VNUS^{\circledR}Colosure$ plus. Material and Method: Between June 2006 and August 2009, $VNUS^{\circledR}Colosure$ plus was performed to treat varicose vein on 59 limbs in 41. patients and $VNUS^{\circledR}Colosure$ fast was performed on 76 limbs in 67 patients. We retrospectively compared in both group with sex, mean treatment time, mean treatment diameter, conjugated treatment, and complications after the procedure. Result: All patient were symptomatic and diagnosed as varicose vein and underwent level 2 clinical classification with color duplex scan. The mean treatment time for the great saphenous vein was significantly less with $VNUS^{\circledR}Colosure$ fast ($17.0{\pm}6.5min$) than $VNUS^{\circledR}Colosure$ plus ($62.7{\pm}9.8min$). There was no significant difference in 1 yr closure rate between groups (p=0.32). Minor complications such as skin burn, thrombophlebitis, ecchymosis, hematoma, cellulitis, tenderness, and there were not different between the groups. Conclusion: Both $VNUS^{\circledR}Colosure$ fast and $VNUS^{\circledR}Colosure$ plus are effective methods of endovenous saphenous ablation. $VNUS^{\circledR}Colosure$ fast is superior to the previous model with less treatment time preserving compatible efficacy and complications. The efficacy of $VNUS^{\circledR}Colosure$ fast for long term closure rate remains to be established.

Microvascular reconstruction for maxillofacial defects: a retrospective analysis of outcomes and complications in 121 consecutive cases

  • Kim, SeongRyoung;Lee, Dong-Hun;Ahn, Kang-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.29.1-29.7
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    • 2020
  • Background: Microvascular reconstruction is the treatment of choice after oral cancer ablation surgery. There are few published studies of free flap survival among Korean populations. This study aimed to determine the survival rate after 121 consecutive cases of maxillofacial microvascular reconstruction and to analyze the complications associated with microsurgery. Methods: This study included consecutive patients who underwent microsurgical reconstruction with free flaps, from January 2006 through September 2019, performed by a single surgeon at the oral and maxillofacial surgery department of a tertiary medical center. A total of 121 cases were reviewed retrospectively. The flap survival rate, flap type, radiotherapy history, complications, and treatment results were analyzed. Results: Four different flap types were used for microvascular reconstruction: radial forearm (n = 65), fibula (n = 34), latissimus dorsi (n = 21), and serratus anterior muscle with rib bone free flap (n = 1). Total necrosis of the flap was found in four cases (two latissimus dorsi flaps and two fibular flaps). The free flap survival rate was 97.5%. Nineteen patients received radiotherapy before surgery, and none of them experienced flap failure. The mean operation time was 334 ± 83.1 min, and the mean ischemic time was 48.9 ± 12.7 min. Conclusions: The success rate was reliable and comparable with previous studies. The success rate was not affected by radiation therapy. Free flaps can be safely used even after radiation treatment.

A Numerical Analysis of Supersonic Impinging Jet Flows on Curved Surfaces using Upwind Wavier-Stokes Method (Upwind Navier-Stokes 방법을 이용한 굴곡면에 충돌하는 초음속 제트유동의 수치 해석적 연구)

  • Seo Jeong Il;Song Dong Joo
    • Proceedings of the KSME Conference
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    • 2002.08a
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    • pp.229-232
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    • 2002
  • For the purpose of Thermal Protection Material design problem, a numerical analysis of axisymmetric high temperature supersonic impinging jet flows of exhaust gas from combustor on curved surfaces has been accomplished. A modifed CSCM Upwind Navier-Stokes method which is able to cure the carbuncle Phenomena has been developed to study strong shock wave structure and thermodynamic wall properties such as pressure and heat transfer rate on various curved surfaces. The results show that the maximum heat transfer rate which is the most important parameter affecting thermo-chemical surface ablation on the plate did not occur at the center of jet impingement, but rather on a circle slightly away from the center of impingement and the shear stress distribution alone the wall is similar to the wall heat transfer late distribution.

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Results of radiofrequency catheter ablation in children and adolescent with tachyarrhythmia (소아 청소년 부정맥 환자에서 고주파 전극도자 절제술의 이용 성적)

  • Chang, Young Beom;Lee, Seung Hyun;Kang, Eun Young;Rhee, Kyoung-Suk;Joo, Chan Uhng
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1085-1090
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    • 2007
  • Purpose : Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. Methods : We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. Results : Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways ($13.7{\pm}4.6yr$, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract ($12.3{\pm}5.0yr$, 10/11), 13 atrioventricular nodal reentrant tachycardia ($12.6{\pm}4.4yr$, 13/13), 4 atrial flutter ($13.0{\pm}7.4yr$, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. Conclusion : These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.

Trigeminocardiac Reflex Induced by Electrohemostasis during Total Ear Canal Ablation in a Dog (개의 전이도적출술 중 전기지혈에 의해 발생한 삼차신경심장반사 1례)

  • Jo, Sang-min;Son, Won-gyun;Jang, Min;Kim, Wan Hee;Lee, Byung-Cheon;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.33 no.4
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    • pp.234-236
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    • 2016
  • A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.

Clinical Manifestations of Papillary Thyroid Carcinoma Recurred as Distant Metastases (원격 전이로 재발한 갑상선 유두암에 대한 임상적 고찰)

  • Kim, Nam Young;Kim, Kyoung Hun;Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung-Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.11-15
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    • 2015
  • Background and Objectives: This study aimed to analyze the features of patients with papillary thyroid carcinoma (PTC) recurred as distant metastases (DM). Materials and Method: We retrospectively reviewed and analyzed clinical records of 63 patients who were treated for PTC recurred as DM between 2000 and 2006. Univariate and multivariate analyses of various clinical factors were performed. Results: Male patients were 12, and female patients were 51. The 5- and 10-year survival rates for PTC recurred as DM were 85% and 73%, respectively. Size of tumor, multiplicity of tumor, lateral neck node metastasis, and RAI ablation therapy with other treatments such as surgery were associated with survival rate (p < 0.005) in univariate analysis. The lateral neck node metastasis[p =0.039, hazard ratio=2.2(95% CI. 1.18~3.24)] and multiple organ DM[p =0.041, hazard ratio=2.18(95% CI. 1.03~2.89)] were related to the survival in multivariate analysis. Conclusion: PTC recurred as DM is uncommon (2.2%). The size of tumor, the multiplicity of tumor, lateral neck node metastasis and RAI ablation therapy with other treatments for DM were revealed as associated factors for the survival. Evaluation of DM should be considered in patients with PTC during long-term follow-up.

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Selective Removal of Thin Film on Glass Using Femtosecond Laser (펨토초 레이저 응용 선택적 어블레이션 연구)

  • Yu, J.Y.;Cho, S.H.;Park, J.K.;Yoon, J.W.;Whang, K.R.;Sugioka, K.;Hong, J.W.;Heo, W.R.;Boehme, D.;Park, J.H.;Zander, S.
    • Laser Solutions
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    • v.14 no.2
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    • pp.17-23
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    • 2011
  • Active thin films are ubiquitous in the manufacture of all forms of flat panel display (FPD). One of the most widely employed thin films is indium tin oxide (ITO) and metal films used electrically conductive materials in display industries. ITO is widely used for fabrication of LCD, OLED device, and many kinds of optical applications because of transparency in visible range and its high conductivity and metal films are also widely employed as electrodes in various electric and display industries. It is important that removing specific area of layer, such as ITO or metal film on substrate, to fabricate and repair electrode in display industries. In this work, we demonstrate efficient selective ablation process to ITO and aluminum film on glass using a femtosecond laser (${\lambda}p=1025nm$) respectively. The femtosecond laser with wavelength of 1025nm, pulse duration of 400fs, and the repetition rate of 100kHz was used for selectively removing ITO and Al on glass in the air. We can successfully remove the ITO and Al films with various pulse energies using a femtosecond laser.

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Conjugate Simulation of Heat Transfer and Ablation in a Small Rocket Nozzle (소형 시험모터의 노즐 열전달 및 삭마 통합해석)

  • Bae, Ji-Yeul;Kim, Taehwan;Kim, Ji Hyuk;Ham, Heecheol;Cho, Hyung Hee
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.30 no.2
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    • pp.119-125
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    • 2017
  • Ablative material in a rocket nozzle is exposed to high temperature combustion gas, thus undergoes complicated thermal/chemical change in terms of chemical destruction of surface and thermal decomposition of inner material. Therefore, method for conjugate analysis of thermal response inside carbon/phenolic material including rocket nozzle flow, surface chemical reaction and thermal decomposition is developed in this research. CFD is used to simulate flow field inside nozzle and conduction in the ablative material. A change in material density and a heat absorption caused by the thermal decomposition is considered in solid energy equation. And algebraic equation under boundary layer assumption is used to deduce reaction rate on the surface and resulting destruction of the surface. In order to test the developed method, small rocket nozzle is solved numerically. Although the ablation of nozzle throat is deduced to be higher than the experiment, shape change and temperature distribution inside material is well predicted. Error in temperature with experimental results in rapid heating region is found to be within 100 K.

No-Touch vs. Conventional Radiofrequency Ablation Using Twin Internally Cooled Wet Electrodes for Small Hepatocellular Carcinomas: A Randomized Prospective Comparative Study

  • Yun Seok Suh;Jae Won Choi;Jeong Hee Yoon;Dong Ho Lee;Yoon Jun Kim;Jeong Hoon Lee;Su Jong Yu;Eun Ju Cho;Jung Hwan Yoon;Jeong Min Lee
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.1974-1984
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    • 2021
  • Objective: This study aimed to compare the efficacy between no-touch (NT) radiofrequency ablation (RFA) and conventional RFA using twin internally cooled wet (TICW) electrodes in the bipolar mode for the treatment of small hepatocellular carcinomas (HCC). Materials and Methods: In this single-center, two-arm, parallel-group, prospective randomized controlled study, we performed a 1:1 random allocation of eligible patients with HCCs to receive NT-RFA or conventional RFA between October 2016 and September 2018. The primary endpoint was the cumulative local tumor progression (LTP) rate after RFA. Secondary endpoints included technical conversion rates of NT-RFA, intrahepatic distance recurrence, extrahepatic metastasis, technical parameters, technical efficacy, and rates of complications. Cumulative LTP rates were analyzed using Kaplan-Meier analysis and the Cox proportional hazard regression model. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat and as-treated analyses were performed. Results: Enrolled patients were randomly assigned to the NT-RFA group (37 patients with 38 HCCs) or the conventional RFA group (36 patients with 38 HCCs). Among the NT-RFA group patients, conversion to conventional RFA occurred in four patients (10.8%, 4/37). According to intention-to-treat analysis, both 1- and 3-year cumulative LTP rates were 5.6%, in the NT-RFA group, and they were 11.8% and 21.3%, respectively, in the conventional RFA group (p = 0.073, log-rank). In the as-treated analysis, LTP rates at 1 year and 3 years were 0% and 0%, respectively, in the NT-RFA group sand 15.6% and 24.5%, respectively, in the conventional RFA group (p = 0.004, log-rank). In as-treated analysis using multivariable Cox regression analysis, RFA type was the only significant predictive factor for LTP (hazard ratio = 0.061 with conventional RFA as the reference, 95% confidence interval = 0.000-0.497; p = 0.004). There were no significant differences in the procedure characteristics between the two groups. No procedure-related deaths or major complications were observed. Conclusion: NT-RFA using TICW electrodes in bipolar mode demonstrated significantly lower cumulative LTP rates than conventional RFA for small HCCs, which warrants a larger study for further confirmation.

Laparoscopic Hepatic Resection Versus Laparoscopic Radiofrequency Ablation for Subcapsular Hepatocellular Carcinomas Smaller Than 3 cm: Analysis of Treatment Outcomes Using Propensity Score Matching

  • Seong Eun Ko;Min Woo Lee;Soohyun Ahn;Hyunchul Rhim;Tae Wook Kang;Kyoung Doo Song;Jong Man Kim;Gyu-Seong Choi;Dong Ik Cha;Ji Hye Min;Dong Hyun Sinn;Moon Seok Choi;Hyo Keun Lim
    • Korean Journal of Radiology
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    • v.23 no.6
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    • pp.615-624
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    • 2022
  • Objective: To compare the therapeutic outcomes of laparoscopic hepatic resection (LHR) and laparoscopic radiofrequency ablation (LRFA) for single subcapsular hepatocellular carcinoma (HCC). Materials and Methods: We screened 244 consecutive patients who had received either LHR or LRFA between January 2014 and December 2016. The feasibility of LRFA in patients who underwent LHR was retrospectively assessed by two interventional radiologists. Finally, 60 LRFA-feasible patients who had received LHR and 29 patients who had received LRFA as the first treatment for a solitary subcapsular HCC between 1 cm and 3 cm were finally included. We compared the therapeutic outcomes, including local tumor progression (LTP), recurrence-free survival (RFS), and overall survival (OS) between the two groups before and after propensity score (PS) matching. Multivariable Cox proportional hazard regression was also used to evaluate the difference in OS and RFS between the two groups for all 89 patients. Results: PS matching yielded 23 patients in each group. The cumulative LTP and OS rates were not significantly different between the LHR and LRFA groups after PS matching (p = 0.900 and 0.003, respectively). The 5-year LTP rates were 4.6% and 4.4%, respectively, and OS rates were 100% and 90.7%, respectively. The RFS rate was higher in LHR group without statistical significance (p = 0.070), with 5-year rates of 78.3% and 45.3%, respectively. OS was not significantly different between the LHR (reference) and LRFA groups in multivariable analyses, with a hazard ratio (HR) of 1.33 (95% confidence interval, 0.12-1.54) (p = 0.818). RFS was higher in LHR (reference) than in LRFA without statistical significance in multivariable analysis, with an HR of 2.01 (0.87-4.66) (p = 0.102). Conclusion: There was no significant difference in therapeutic outcomes between LHR and LRFA for single subcapsular HCCs measuring 1-3 cm. The difference in RFS should be further evaluated in a larger study.