• 제목/요약/키워드: Ablation Rate

검색결과 180건 처리시간 0.029초

2018 심방세동 카테터 절제술 대한민국 진료지침: PART I

  • 박형섭;정동섭;유희태;박희남;심재민;김주연;김준;이정명;김기훈;노승영;조영진;김영훈;윤남식
    • International Journal of Arrhythmia
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    • 제19권3호
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    • pp.186-234
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    • 2018
  • Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience

  • Jiao, De-Chao;Han, Xin-Wei;Wu, Gang;Ren, Jian-Zhuang
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7897-7903
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    • 2015
  • Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellent-poor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans. Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was $24.24{\pm}6.53min$, resulting in a mean effective exposure dose of $15.4{\pm}5.1mSv$. The mean puncture performance level rated for CACT guided RFA procedure was $4.87{\pm}0.35$. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications. Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.

압력과 산화몰분율이 그라이트 목삽입재의 삭마율에 미치는 영향 (The Effect of Pressure and Oxidation Mole Fraction on Ablation Rate of Graphite for Nozzle Throat Insert)

  • 함희철;강윤구
    • 한국추진공학회지
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    • 제18권1호
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    • pp.8-15
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    • 2014
  • 고체 로켓 추진기관의 노즐목 삽입재에 적용하는 그라파이트의 삭마율 특성을 분석하였다. 지상연소시험은 3종류의 일반적인 노즐형태를 갖는 추진기관을 사용하여 수행하였다. 즉, De-Laval 형태, 토출관 형태, 내삽 형태이다. 13종류의 서로 다른 형상의 추진기관에 다양한 추진제를 적용하였고, 노즐목 위치에 그라파이트를 적용하여 총 37회의 연소시험을 수행하였다. 분석결과 그라파이트의 삭마율은 연소실 평균압력이 상승함에 따라, 산화몰분율이 증가함에 따라 증가함을 알 수 있다.

외부의 물과 Er:YAG Laser의 작용에 의한 Dental Hard Tissue에서의 열과 역학적 효과: Free-running 방식 (Exogenous-Water-Induced Thermal and Mechanical Effects on Dental Hard Tissue by the Er:YAG Laser: Free-running Mode)

  • 권용훈
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.380-384
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    • 1997
  • This study was performed to understand the exogenous-water-drop induced thermomechanical effect on the tooth in the free-running Er:YAG laser mode for the proper use of water as a laser energy absorber and coolant in dentistry. The ree-running Er:YAG laser was used in the dental hard tissue ablation study. A Microjet system was employed to dispense precise water drops. Ablation rate, recoil momentum, and temperature rise in the pulp cavity were measured with and without an exogenous water drop on the tooth surface. Exogenous water enhanced ablation rate in the thick tooth in which the ablation rate on the dry surface does not increase linearly but shows plateau. Optimal exogenous water volume was shifted from 2 nl to 4 nl as the laser energy was increased from 48 mJ to 145 mJ. The magnitude of the recoil momentum was increased as the volume of exogenous water increased. The results of this study suggest that we must pay attention to the recoil momentum or recoil pressure study or the optimal and safe usage of water in the dental treatment because these mechanical effects depend on the volume of exogenous water on the tooth surface.

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로켓노즐내부의 공기 열역학적 삭마특성에 관한 연구 (A Study of Aero-thermodynamic Ablation Characteristics for Rocket Nozzle)

  • 서정일;정재헌;김영인;김정훈;송동주;배철호
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 춘계학술대회논문집E
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    • pp.282-287
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    • 2001
  • The CSCM Upwind method and Material Transport Analysis (MTA) have been used to predict the thermal response and ablation rate for non-charring material to be used as thermal protection material (TPM) in KSR-III test rocket nozzle. The thermal boundary conditions such as cold wall heat-transfer rate and recovery enthalpy for MTA code are obtained from the upwind Navier-Stokes solution procedure. The heat transfer rate and temperature variations at rocket nozzle wall were studied with shape change of the nozzle surface as time goes by. The surface recession was severely occurred at nozzle throat and this affected nozzle performance such as thrust coefficient substantially.

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술후 방사성 요오드 사멸요법을 받은 갑상선암 환자들의 재발 관련인자에 관한 연구 (The Study on Recurrence-Related Factors of the Thyroid Cancer Patients Received Postoperative Radioactive Iodine Ablation Therapy)

  • 고양석;윤정한;제갈영종
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.173-178
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    • 2002
  • Background and Objective: Factors that are associated with the recurrence after radioactive iodine ablation therapy have not been identified yet. The aim of this study is to elucidate the factors that are related to the recurrence after thyroid surgery of the thyroid papillary cancer followed by radioactive iodine ablation therapy. Patients and Methods: Fifty four cases who had underwent thyroid cancer surgery and postoperative radioactive iodine ablation therapy were included in this study. Mean followup duration was 7 years. There were 41 women and 13 men. Data analysis was done retrospectively with medical record review. Chi-square test and Fisher's exact test was used for the statistical analysis. Results: Age over 40, capsular invasion, and loca invasion were the factors that were associated with the high rate of recurrence. But sex, size of the tumor, multiplicity and extent of the surgery were not related to the recurrence. Conclusion: Without the curative resection of the tumor, radioactive iodine ablation therapy cannot lower the recurrence rate. So aggressive resection of the thyroid papillary cancer is important.The more data accumulated and the longer the followup, the easier we can reveal the recurrence-related factors of postoperative radioactive ablation therapy.

The Effect of using Gamma Titanium RF Electrodes on the Ablation Volume during the Radiofrequency Ablation Process

  • Mohammed S. Ahmed;Mohamed Tarek El-Wakad;Mohammed A. Hassan
    • International Journal of Computer Science & Network Security
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    • 제23권2호
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    • pp.183-192
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    • 2023
  • Radiofrequency ablation (RFA) is an alternative treatment for liver cancer to the surgical intervention preferred by surgeons. However, the main challenge remains the use of RF for the ablation of large tumours (i.e., tumours with a diameter of >3 cm). For large tumours, RFA takes a large duration in the ablation process compared with surgery, which increases patient pain. Therefore, RFA for large tumours is not preferred by surgeons. The currently materials used in RF electrodes, such as the nickeltitanium alloy (nitinol), are characterized by low thermal and electrical conductivities. On the other hand, the use of materials that have high thermal and electrical conductivities, such as titanium aluminide alloy (gamma titanium), produces more thermal energy for tumours. In this paper, we developed a cool-tip RF electrode model that uses nickel-titanium alloy and replaced it with titanium aluminide alloy by using the finite element model (FEM). The aim of this paper is to study the effect of the thermal and electrical conductivities of gamma titanium on the ablation volume. Results showed that the proposed design of the electrode increased the ablation rate by 1 cm3 /minute and 6.3 cm3/10 minutes, with a decrease in the required time ablation. Finally, the proposed model reduces the ablation time and damages healthy tissue while increasing the ablation volume from 22.5% cm3 to 62.5% cm3 in ten minutes compared to recent studies.

Pearls and Pitfalls of Pulsed Field Ablation

  • Stefan Hartl;Nico Reinsch;Anna Futing;Kars Neven
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.273-293
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    • 2023
  • Pulsed field ablation (PFA) was recently rediscovered as an emerging treatment modality for the ablation of cardiac arrhythmias. Ultra-short high voltage pulses are leading to irreversible electroporation of cardiac cells subsequently resulting in cell death. Current literature of PFA for pulmonary vein isolation (PVI) consistently reported excellent acute and long-term efficacy along with a very low adverse event rate. The undeniable benefit of the novel ablation technique is that cardiac cells are more susceptible to electrical fields whereas surrounding structures such as the pulmonary veins, the phrenic nerve or the esophagus are not, or if at all, minimally affected, which results in a favorable safety profile that is expected to be superior to the current standard of care without compromising efficacy. Nevertheless, the exact mechanisms of electroporation are not yet entirely understood on a cellular basis and pulsed electrical field protocols of different manufactures are not comparable among one another and require their own validation for each indication. Importantly, randomized controlled trials and comparative data to current standard of care modalities, such as radiofrequency- or cryoballoon ablation, are still missing. This review focuses on the "pearls" and "pitfalls" of PFA, a technology that has the potential to become the future leading energy source for PVI and beyond.

Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

  • Kim, Kang Min;Chung, Suryeun;Kim, Sang Yoon;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • 제51권4호
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    • pp.266-272
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    • 2018
  • Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups. Results: At 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063-6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B ($53.1%{\pm}11.5%$ vs. $59.1%{\pm}6.3%$, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was $80.1%{\pm}3.6%$ in group A and $92.1%{\pm}2.9%$ in group B (p=0.400). The 5-year MACCE-free survival rate was $70.3%{\pm}4.0%$ in group A and $70.9%{\pm}5.6%$ in group B (p=0.818). Conclusion: Cryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

가시광선과 근적외선 파장을 이용한 조직 제거 연구 (Comparative Tissue Ablation Study between 532 and 980 nm)

  • 강현욱;오정환
    • 한국광학회지
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    • 제23권3호
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    • pp.108-112
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    • 2012
  • 본 논문에서는 전립선 비대증 환자 치료 시 조직 제거에 사용되는 두 파장들을 비교 연구하였다. 가시광선 영역인 532 nm는 혈액 속의 헤모글로빈에 의한 흡수율이 높은 반면, 근적외선 영역인 980 nm는 물에 의한 빛의 흡수율이 높다. 동물의 간 조직을 각각의 레이저를 이용하여 40 W 출력에서 제거하였으며, 조직 제거율을 제거 횟수, 제거 부피, 열손상 정도를 통해 검사하였다. 532 nm의 경우 높은 레이저 흡수율로 인해 조직 제거율이 980 nm 보다 4배까지 증가하였으며, 열손상은 상대적으로 약 30%까지 낮게 나타났다. 파장에 관계없이 제거 횟수가 높을수록 단위 횟수당 제거율이 낮아졌으며, 이는 레이저 빛이 거리에 따라 발산함과 동시에 제거된 조직의 입자들이 먼지 방해 현상을 일으킴으로써 효율의 저하를 일으켰음을 짐작할 수 있었다. 보다 효율적인 열적 제한 상태와 높은 흡수율로 인해 가시광선 영역의 532 nm가 근적외선 980 nm 보다 전립선 치료에 있어서 더욱 효율적인 파장임을 알 수 있었으며, 이러한 발견을 전임상 및 임상을 통해 확인할 계획이다.