• Title/Summary/Keyword: Ablation treatment

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Current Research Status of Irreversible Electroporation for Hollow Viscus Organ of Gastrointestinal Tract (위장관 비가역적 전기천공법의 연구 현황)

  • Keum, Bora;Choi, Hyuk Soon;Jeon, Han Jo
    • Journal of Digestive Cancer Research
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    • v.8 no.1
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    • pp.61-64
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    • 2020
  • Ablative therapy has drawn attention for cancer treatment as minimally invasive therapy. Recently, irreversible electroporation which has a different concept from the existing ablation method has emerged. Although gastrointestinal tract cancer is commonly managed by ablation such as liver, pancreas cancer, hollow viscus cancer is extremely challenging for applying ablative therapy because of its high perforation risk. Therefore, several studies about hollow viscus irreversible electroporation will be introduced in this review regarding its pre-clinical relevance.

A New Treatment for Severe Incurved Toenail (2 Cases Report) (중증 내향성 족지 발톱의 새로운 치료 (2예 보고))

  • Kim, J-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.100-105
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    • 2008
  • Partial toenail ablation on both sides of the great toenail, unfolding the severely curved toenail, and application of a simple device for maintaining the unfolded state of the incurved toenail is described to treat severely incurved toenails (pincer nails). This technique alleviated symptoms and improved the shape of severely curved toenails of the greater toe.

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Surface Modification Studies by Atomic Force Microscopy for Ar-Plasma Treated Polyethylene

  • Seo, Eun-Deock
    • Macromolecular Research
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    • v.10 no.5
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    • pp.291-295
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    • 2002
  • Atomic force microscopy(AFM) was used to study the polyethylene(PE) surfaces grafted and immobilized with acrylic acid by Ar plasma treatment. The topographical images and parameters including RMS roughness and Rp-v value provided an appropriate means to characterize the surfaces. The plasma grafting and immobilization method were a useful tool for the preparation of surfaces with carboxyl group. However, the plasma immobilization method turned out to have a limitation to use as a means of preparation of PE surface with specific functionalities, due to ablation effect during the Ar plasma treatment process.

A Study For Optimizing Input Waveforms In Radiofrequency Liver Tumor Ablation Using Finite Element Analysis (유한 요소 해석을 이용한 고주파 간 종양 절제술의 입력 파형 최적화를 위한 연구)

  • Lim, Do-Hyung;NamGung, Bum-Seok;Lee, Tae-Woo;Choi, Jin-Seung;Tack, Gye-Rae;Kim, Han-Sung
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.235-243
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    • 2007
  • Hepatocellular carcinoma is significant worldwide public health problem with an estimated annually mortality of 1,000,000 people. Radiofrequency (RF) ablation is an interventional technique that in recent years has come to be used for treatment of the hepatocellualr carcinoma, by destructing tumor tissues in high temperatures. Numerous studies have been attempted to prove excellence of RF ablation and to improve its efficiency by various methods. However, the attempts are sometimes paradox to advantages of a minimum invasive characteristic and an operative simplicity in RF ablation. The aim of the current study is, therefore, to suggest an improved RF ablation technique by identifying an optimum RF pattern, which is one of important factors capable of controlling the extent of high temperature region in lossless of the advantages of RF ablation. Three-dimensional finite element (FE) model was developed and validated comparing with the results reported by literature. Four representative Rf patterns (sine, square, exponential, and simulated RF waves), which were corresponding to currents fed during simulated RF ablation, were investigated. Following parameters for each RF pattern were analyzed to identify which is the most optimum in eliminating effectively tumor tissues. 1) maximum temperature, 2) a degree of alteration of maximum temperature in a constant time range (30-40 second), 3) a domain of temperature over $47^{\circ}C$ isothermal temperature (IT), and 4) a domain inducing over 63% cell damage. Here, heat transfer characteristics within the tissues were determined by Bioheat Governing Equation. Developed FE model showed 90-95% accuracy approximately in prediction of maximum temperature and domain of interests achieved during RF ablation. Maximum temperatures for sine, square, exponential, and simulated RF waves were $69.0^{\circ}C,\;66.9^{\circ}C,\;65.4^{\circ}C,\;and\;51.8^{\circ}C$, respectively. While the maximum temperatures were decreased in the constant time range, average time intervals for sine, square, exponential, and simulated RE waves were $0.49{\pm}0.14,\;1.00{\pm}0.00,\;1.65{\pm}0.02,\;and\;1.66{\pm}0.02$ seconds, respectively. Average magnitudes of the decreased maximum temperatures in the time range were $0.45{\pm}0.15^{\circ}C$ for sine wave, $1.93{\pm}0.02^{\circ}C$ for square wave, $2.94{\pm}0.05^{\circ}C$ for exponential wave, and $1.53{\pm}0.06^{\circ}C$ for simulated RF wave. Volumes of temperature domain over $47^{\circ}C$ IT for sine, square, exponential, and simulated RF waves were 1480mm3, 1440mm3, 1380mm3, and 395mm3, respectively. Volumes inducing over 63% cell damage for sine, square, exponential, and simulated RF waves were 114mm3, 62mm3, 17mm3, and 0mm3, respectively. These results support that applying sine wave during RF ablation may be generally the most optimum in destructing effectively tumor tissues, compared with other RF patterns.

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

  • Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.447-457
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    • 2022
  • Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

Radiofrequency Ablation of Hepatocellular Carcinoma (≤ 5 cm) with Saline-Perfused Electrodes: Factors Affecting Local Tumor Progression (5 cm 이하의 간암에서 식염수 주입방식 전극을 이용한 고주파 소작술: 국소 재발에 영향을 미치는 인자)

  • Dong Ho Kim;Dong Jin Chung;Se Hyun Cho;Joon-Yeol Han
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.620-631
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    • 2020
  • Purpose We aimed to assess local tumor progression (LTP) rate and associated prognostic factors in 92 patients who underwent radiofrequency ablation (RFA) using saline-perfused electrodes to treat hepatocellular carcinoma (HCC) (≤ 5 cm). Materials and Methods Total 92 patients with 148 HCCs were treated with RFA using saline-perfused electrodes, from 2009 to 2015. We retrospectively evaluated technical success, technique efficacy, and LTP rates. Potential prognostic factors for LTP were perivascular tumor, subphrenic tumor, artificial ascites, tumor size (≥ 2 cm), and previous treatment of transarterial chemoembolization. Analysis was performed by lesion, rather than by person. Results During follow-up period from 1 to 97.4 months, total cumulative LTP rates were 7.9%, 11.4%, and 14.6% at 1, 3, and 5 years, respectively. These values were significantly higher in the perivascular (35.1%; p = 0.009) and subphrenic group (38.9%; p = 0.002) at 5-year. We did not observe any significant difference in LTP according to other prognostic factors (p > 0.05). Conclusion RFA with saline-perfused electrode is a safe and effective treatment modality for HCC (≤ 5 cm), with lower LTP rates. Nevertheless, perivascular and subphrenic HCCs demonstrated higher LTP rate than other sites. It is imperative to note that perivascular and subphrenic location of HCC are associated with a high risk of local recurrence, despite the use of saline-perfused electrodes.

Twelve-Month Volume Reduction Ratio Predicts Regrowth and Time to Regrowth in Thyroid Nodules Submitted to Laser Ablation: A 5-Year Follow-Up Retrospective Study

  • Roberto Negro;Gabriele Greco;Maurilio Deandrea;Matteo Rucco;Pierpaolo Trimboli
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.764-772
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    • 2020
  • Objective: Laser ablation is a therapeutic modality used to reduce the volume of large benign thyroid nodules. Unsatisfactory reduction and regrowth are observed in some treated nodules. The aim of the study was to evaluate the long-term outcomes of laser treatment for solid nodules during a 5-year follow-up period, the regrowth rate, and the predictive risk factors of nodule regrowth. Materials and Methods: We retrospectively evaluated patients with benign, solid, cold thyroid nodules who underwent laser ablation and were followed-up for 5 years. According to the selection criteria, 104 patients were included (median baseline nodule volume, 12.5 mL [25.0-75.0%, 8-18 mL]; median energy delivered, 481.5 J/mL [25.0-75.0%, 370-620 J/mL]). Nodule volume, thyroid function test results, and ultrasound were evaluated at baseline and then annually after the procedure. Results: Of 104 patients, 31 patients (29.8%) had a 12-month volume reduction ratio (VRR) < 50.0% and 39 (37.5%) experienced nodule regrowth. Of these 39 patients, 17 (43.6%) underwent surgery and 14 (35.9%) underwent a second laser treatment. The rate of nodule regrowth was inversely related to the 12-month VRR, i.e., the lower the 12-month VRR, the higher the risk of regrowth (p < 0.001). The mean time for nodule regrowth was 33.5 ± 16.6 months. The 12-month VRR was directly related to time to regrowth, i.e., the lower the 12-month VRR, the shorter the time to regrowth (p < 0.001; R2 = 0.3516). Non-spongiform composition increased the risk of regrowth with an odds ratio of 4.3 (95% confidence interval [CI] 1.8-10.2; p < 0.001); 12-month VRR < 50.0% increased the risk of regrowth with an odds ratio of 11.7 (95% CI 4.2-32.2; p < 0.001). Conclusion: The VRR of thyroid nodules subjected to similar amounts of laser energy varies widely and depends on the nodule composition; non-spongiform nodules are reduced to a lesser extent and regrow more frequently than spongiform nodules. A 12-month VRR < 50.0% is a predictive risk factor for regrowth and correlates with the time to regrowth.

Effect of Ar- Plasma Treatment on Mechanical Properties of Acrylic Fiber (아크릴섬유의 기계적 물성에 대한 알곤플라즈마 처리의 영향)

  • Seo Eon Deock
    • Textile Coloration and Finishing
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    • v.16 no.6
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    • pp.30-34
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    • 2004
  • Polyacrylontrile fiber was modified with argon low temperature plasma by RF glow discharge at 240 mTorr, 40 W to investigate the surface morphological changes and mechanical characteristics such as elongation, tenacity, and modulus. Analysis of the SEM images revealed that the plasma treatment resulted in significant ablation on the surfaces rendering a severe crack formation. The morphological changes were evident with short treatment time of argon plasma although longer treatment time damaged the surface more severely. The mechanical characteristics such as tenacity and elongation were deteriorated due to the plasma treatment. The tenacity of the fiber treated with argon-plasma for 5 min showed a decreased value up to 21.9 % when compared to the untreated fiber. While the corresponding initial modulus(0 - 1 %) increased markedly up to 44.3 %.

Treatment of Atrial Fibrillation with Microwave (Microwave를 이용한 심방세동의 치료)

  • 조광현;최강주;강도균;전희재;윤영철;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.329-334
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    • 2003
  • Backgound: Cryoablation and radiofrequency ablation have been used to treat the atrial fibrillation. Some reports insisted that the microwave ablation Is a better method for a deep and extensive lesion. Material and Method: From December 2001 to July 2002, we peformed 8 microwave ablations in patients who needed mitral valve surgery (7 MVR, 1 MVR+AVR). There were 3 men and 5 women, and their mean age was 43.4$\pm$8.3 years and mean follow up period was 5.6$\pm$2.4 months respectively. The microwave was applied on endocardium or epicardium by Lynx (Afx, inc.) using a power of 45 watts for 25 seconds. We studied the left atrial dimension, the left atrial function and the sinus conversion with echocardiography and electro-cardiography at three times; 1) before the operation, 2) immediately after the operation, and 3) 6 months after the operation. Result: There was no complication and no mortality. The mean aortic clamping time was 104.6$\pm$25.0 minutes, and the mean total bypass time was 130.5$\pm$28.7 minutes. The rate of sinus conversion was 75%, A wave across the mitral valve was a mean of 77.0$\pm$24.8 cm/sec, and the AVE was a mean of 0.46$\pm$0.17 at 5.6 months postoperatively Conclusion: There was no difference in the early result of microwave ablation compared to other methods. The microwave ablation was an acceptable method due to its convenient application especially in beating heart.

Pulsed Radiofrequency Ablation Under Ultrasound Guidance for Huge Neuroma

  • Kim, Young Ki;Jung, Il;Lee, Chang Hee;Kim, Se Hun;Kim, Jin Sun;Yoo, Byoung Woo
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.290-293
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    • 2014
  • Amputation neuroma can cause very serious, intractable pain. Many treatment modalities are suggested for painful neuroma. Pharmacologic treatment shows a limited effect on eliminating the pain, and surgical treatment has a high recurrence rate. We applied pulsed radiofrequency treatment at the neuroma stalk under ultrasonography guidance. The long-term outcome was very successful, prompting us to report this case.