• Korean Journal of Radiology
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• 제22권10호
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• pp.1730-1741
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• 2021

Objective: Although thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), comparison of treatment outcomes between thermal ablation and surgery has not yet been systematically evaluated. This study aimed to compare the efficacy and safety of thermal ablation and surgery for the treatment of low-risk PTMCs. Materials and Methods: Ovid-MEDLINE and EMBASE databases were searched for studies reporting comparisons of treatment results between thermal ablation and surgery for patients with low-risk PTMC published up to April 6, 2020. The analysis evaluated the efficacy (local tumor recurrence, occurrence of new tumor, metastasis, and rescue surgery) and safety (complication rate) of thermal ablation and surgery. Results: This systematic review included four studies with a total of 339 PTMCs in 339 patients who underwent thermal ablation and 320 PTMCs in 314 patients who underwent surgery. There was no local tumor recurrence or distant metastasis in either group. There was no significant difference in the pooled proportion of lymph node metastasis (2.6% with thermal ablation vs. 3.3% with surgery, p = 0.65), occurrence of new tumors (1.4% with thermal ablation vs. 1.3% with surgery, p = 0.85), or rescue surgery (2.6% with thermal ablation vs. 1.6% with surgery, p = 0.62). However, the pooled complication rate was significantly higher in the surgery group than in the ablation group (3.3% with thermal ablation vs. 7.8% with surgery, p = 0.03). Conclusion: Both thermal ablation and surgery are effective and safe options for the management of low-risk PTMCs, with thermal ablation achieving a lower complication rate. Therefore, thermal ablation may be considered as an alternative treatment option for low-risk PTMC in patients who refuse surgery and active surveillance or are ineligible for surgery.

• Journal of the Korean Physical Society
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• 제73권11호
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• pp.1619-1624
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• 2018

Laser ablation may provide a minimally invasive palliative treatment for pancreatic cancer. The aim of the current study was to assess the feasibility of a 532-nm laser equipped with a cylindrical light diffuser for the treatment of pancreatic cancer. Monolayers of BxPC-3 human pancreatic cancer cell were exposed to 532 nm laser light. Power levels of 5 - 7 W were used to uniformly target the entire cell colonies for 60 and 120 seconds. The cells were incubated for 24 hours after treatment and viabilities were determined by using a MTT assay. Laser ablation was performed by using the cylindrical light diffuser on six pancreatic tumor tissues obtained from pancreatic cancer xenograft mouse models, which were exposed to the 532 nm light at 5W or 7W for 10 to 30 seconds. In the in vitro study, the survival rates of the pancreatic cancer cells were reduced by 6.6% to 98.9% after the treatment, and the survival rates were reduced by increasing laser power and/or irradiation time. In the pancreatic tumor tissues, a homogenous circular ablation zone was observed in all tumors and the ablation distance induced by the laser irradiation showed to be constant from the diffuser to all directions (standard deviation, 0.3 - 1.3 mm). Ablation distance and area increased with increasing laser power and/or irradiation time. The 532 nm laser effectively killed pancreatic cancer cells, and the cylindrical light diffuser was found to be suitable for laser ablation as it provided uniform ablation in pancreatic cancer.

• Journal of the Optical Society of Korea
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• 제13권3호
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• pp.321-329
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• 2009

Following their applications in cardiology, ophthalmology and dentistry among others, the advent of lasers in dermatology and urology had become the success story of the past decade. Laser-assisted treatments in dermatology and urology are mainly based on the laser-induced tissue injury/coagulation and/or ablation, depending upon the desirable clinical endpoint. In this review, we discussed the underlying mechanisms of the laser induced tissue ablation. In any medical laser application, the controlled thermal injury and coagulation, and the extent of ablation, if required, are critical. The laser thermal mechanism of injury is intricately related to the selective absorption of light and its exposure duration, similarly to the laser induced ablation. The laser ablation mechanisms were categorized into four different categories (the photo-thermally induced ablation, the photo-mechanically induced ablation, the plasma induced ablation and the photoablation) and their fundamentals are herein described. The brief history of laser treatment modality in dermatology and urology are summarized.

• Clinical Endoscopy
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• 제55권3호
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• pp.347-354
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• 2022

Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply, but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

• 한국레이저가공학회지
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• 제6권3호
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• pp.37-45
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• 2003

Pulsed laser ablation is important in a variety of engineering applications involving precise removal of materials in laser micromachining and laser treatment of bio-materials. Particularly, detailed numerical simulation of complex laser ablation phenomena in air, taking the interaction between ablation plume and air into account, is required for many practical applications. In this paper, high-power pulsed laser ablation under atmospheric pressure is studied with emphasis on the vaporization model, especially recondensation ratio over the Knudsen layer. Furthermore, parametric studies are carried out to analyze the effect of laser fluence and background pressure on surface ablation and the dynamics of ablation plume. In the numerical calculation, the temperature, pressure, density, and vaporization flux on a solid substrate are obtained by a heat-transfer computation code based on the enthalpy method. The plume dynamics is calculated considering the effect of mass diffusion into the ambient air and plasma shielding. To verify the computation results, experiments for measuring the propagation of a laser induced shock wave are conducted as well.

• International Journal of Arrhythmia
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• 제19권3호
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• pp.285-339
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• 2018

Catheter ablation of atrial fibrillation (AF) is one of the most complex interventional electrophysiological procedures. The success of AF ablation is based in large part on freedom from AF recurrence based on electrocardiography (ECG) monitoring. Arrhythmia monitoring can be performed with the use of noncontinuous or continuous ECG monitoring tools. AF ablation is an invasive procedure that entails risks, most of which are present during the acute procedural period. However, complications can also occur in the weeks or months following ablation. Recognizing common symptoms after AF ablation and distinguishing those that require urgent evaluation and referral to an electrophysiologist is an important part of follow-up after AF ablation. This section reviews the complications associated with catheter ablation procedures performed to treat AF. The types and incidence of complications are presented, their mechanisms are explored, and the optimal approach to prevention and treatment is discussed. Finally, surgical and hybrid AF ablation technology and the indications for concomitant open or closed surgical ablation of AF, stand-alone and hybrid surgical ablation of AF are covered in this section.

• Journal of Chest Surgery
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• 제29권12호
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• pp.1373-1376
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• 1996

1993년 10월부터 1996년 2월까지 9명의 Wolfr-Parkinson-White증후군을 가진 환자에서 우회로의 외과적 절제술을 시행하였다. 수술적응례를 살펴보면 도자절제술이 실패한 경우가 6례, 우회로가 2개 있었던 경우와 도자절제술중 도자 말단부위가 부러졌던 경우가 1례씩 있었으며, 나머지 1례는 승모판막재치환술이 필요했던 경우이다. 수술사망은 없었으며 술후합병증은심낭삼출액과 창상감염이 각각 1례씩 있었다. 모든 환자에서 술후 심전도검사 및 전기생리검사를 통해 우회로가 완전 절제되었슴을 확인할 수 있었으며 추적 관찰기간중 인맥을 보인 환자는 없었다. 이상의 결과로 Wolfr-Parkinson-White증후군에서 우회로의 외과적 절제는 도자절제술이 실패한 경우, 우회로가 여러개 있는 경우, 그리고 동반된 심질환의 교정을 요하는 경우로 국한되며 수술적응례에서 외과적 절제술은 비교적 안전하고 효과적인 치료방법으로 사료된다.

• Korean Journal of Radiology
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• 제20권5호
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• pp.695-708
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• 2019

Atrial fibrillation (AF) is the most common arrhythmia associated with the risk of morbidity and mortality in clinical patients. AF is considered as an arrhythmia type that develops and progresses through close connection with cardiac structural arrhythmogenic substrates. Since the introduction of catheter ablation-mediated electrical isolation of arrhythmogenic substrates, cardiac imaging indicates improved treatment outcome and prognosis with appropriate candidate selection, ablation catheter guidance, and post-ablation follow-up. Currently, cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) imaging are essential in the case management of AF at both pre-and post-procedural stages of catheter ablation. In this review, we discuss the roles and technical considerations of CCT and CMR imaging in the management of patients with AF undergoing catheter ablation.

• 대한방사선협회지
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• 제28권1호
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• pp.145-152
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• 2002

Purpose : Radiofrequency(RF) ablation has known effective treatment in patient with hepatocellular carcinoma(HCC) or hepatic metastases tumor(HMT). The purpose of this study was to evaluate the usefulness of performed patient liver RF ablation guide by CT

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6443-6447
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• 2014

Background: To determine the predictive value of the baseline stimulated thyroglobulin (STg) level for ablation outcome in patients undergoing adjuvant remnant radioiodine ablation (RRA) for differentiated thyroid carcinoma (DTC). Materials and Methods: This retrospective study accrued 64 patients (23 male and 41 female; mean age of $40{\pm}14$ years) who had total thyroidectomy followed by RRA for DTC from January 2012 till April 2014. Patients with positive anti-Tg antibodies and distant metastasis on post-ablative whole body iodine scans (TWBIS) were excluded. Baseline STg was used to predict successful ablation (follow-up STg <2 ng/ml, negative diagnostic WBIS and negative ultrasound neck) at 7-12 months follow-up. Results: Overall, successful ablation was noted in 37 (58%) patients while ablation failed in 27 (42%). Using the ROC curve, a cut-off level of baseline STg level of ${\leq}14.5ng/ml$ was found to be most sensitive and specific for predicting successful ablation. Successful ablation was thus noted in 25/28 (89%) of patients with baseline STg ${\leq}14.5ng/ml$ and 12/36 (33%) patients with baseline STg >14.5 ng/ml ((p value <0.05). Age >40 years, female gender, PTS >2 cm, papillary histopathology, positive cervical nodes and positive TWBIS were significant predictors of ablation failure. Conclusions: We conclude that in patients with total thyroidectomy followed by I-131 ablation for DTC, the baseline STg level is a good predictor of successful ablation based on a stringent triple negative criteria (i.e. follow-up STg < 2 ng/ml, a negative DWBIS and a negative US neck).