• Korean Journal of Radiology
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• 제23권5호
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• pp.555-565
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• 2022

Objective: To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). Materials and Methods: This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18-87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. Results: Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0-24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1-3 months. Conclusion: US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.

• Journal of Photoscience
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• 제5권1호
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• pp.33-37
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• 1998

One macroscopic effect in the free-running Er:YAG laser is an accumulation of microscopic effects. Understanding of the exogenous water induced mechanical effect on the dental hard tissue by the Qswitched Er:YAG laser has an important impact on the further understanding of the free-running Er:YAG laser ablation on the dental hard tissue. The Q-switched Er:YAG laser (1-$\mu$s-long pulse width) was used in the recoil pressure measurement with an aid of water-jet system and a pressure transducer. The amplitude of the recoil pressure depends on the tooth surface conditions (dry and wet) and the volume of the water upon it. Wet surfaces yielded higher recoil pressure than that of dry, surface, and as the volume of the exogenous water drop increased, the amplitude of the recoil pressure increased also.

• Journal of Magnetics
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• 제4권2호
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• pp.39-45
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• 1999

Sandwich structures of$ Nd_2Fe_{14}B/Fe/Nd_2Fe_{14}B $magnetic films have been grown by a KrF excimer laser (λ=248 nm) ablation technique. Magnetic properties were characterized by varying the thickness of hard ($Nd_2Fe_{14}B$) and soft (Fe) magnetic films and the volume fraction as well. In the (x)nm[NdFeB]/(y)nm[Fe]/(x)nm[NdFeB]/(100) Si structure the thickness (x) was varied from 3.6 to 54 nm, and (y) from 15 to 112 nm. At (y) = 15~20 nm where the volume fraction of Fe corresponded to 61~75%, the sandwich structure exhibited an enhanced Mr/Ms and iHc as well from the result of the exchange coupling between the magnetic layers. Experimentally calculated exchange constant$ (A_s) of A_s = 2.5{\times}10^{-10} J/m$ was estimated using the intrinsic coercivity (iHc) of 1.2 kOe at 5 K for the sandwich magnetic trilayers.

• Korean Journal of Radiology
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• 제24권9호
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• pp.903-911
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• 2023

Objective: Regrowth after radiofrequency ablation (RFA) of symptomatic large thyroid nodules, initially treated as benign, sometimes turns out to be malignancies. This study aimed to assess the ultrasound (US) characteristics of thyroid nodules initially treated as benign with RFA and later diagnosed as cancers, predictive factors for cancers masquerading as benign, and methods to avoid RFA in these cancers. Materials and Methods: We reviewed the medical records of 134 consecutive patients with 148 nodules who underwent RFA between February 2008 and November 2016 for the debulking of symptomatic thyroid nodules diagnosed as benign using US-guided biopsy. We investigated the pre-RFA characteristics of the thyroid nodules, changes at follow-up after RFA, and the final surgical pathology. Results: Nodule regrowth after RFA was observed in 36 (24.3%) of the 148 benign nodules. Twenty-two of the 36 nodules were surgically removed, and malignancies were confirmed in seven (19.4% of 36). Of the 22 nodules removed surgically, pre-RFA median volume (range) was significantly larger for malignant nodules than for benign nodules: 22.4 (13.9-84.5) vs. 13.4 (7.3-16.8) mL (P = 0.04). There was no significant difference in the regrowth interval between benign and malignant nodules (P = 0.49). The median volume reduction rate (range) at 12 months was significantly lower for malignant nodules than for benign nodules (51.4% [0-57.8] vs. 83.8% [47.9-89.6]) (P = 0.01). The pre-RFA benignity of all seven malignant nodules was confirmed using two US-guided fine-needle aspirations (FNAs), except for one nodule, which was confirmed using US-guided core-needle biopsy (CNB). Regrown malignant nodules were diagnosed as suspicious follicular neoplasms by CNB. Histological examination of the malignant nodules revealed follicular thyroid carcinomas, except for one follicular variant, a papillary thyroid carcinoma. Conclusion: Symptomatic large benign thyroid nodules showing regrowth or suboptimal reduction after RFA may have malignant potential. The confirmation of these nodules is better with CNB than with FNA.

• 한국분말재료학회지
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• 제15권1호
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• pp.46-52
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• 2008

The restrictor, which is a fluid channel from a reservoir to a chamber inside a thermal micro actuator, has been fabricated using ArF and KrF excimer lasers, Diode-Pumped Solid State Lasers (DPSSL) and femtosecond lasers for a feasibility study. A numerical model of fluid dynamics for the actuator chamber and restrictor is presented. The model includes bubble formation and growth, droplet ejection through nozzle, and dynamics of fluid refill through the restrictor from a reservoir. Since an optimized and well-fabricated restrictor is important for a high frequency actuator, some special beam delivery setups and post processing techniques have been researched and developed. The effects of variations of the restrictor length, diameter, and tapered shapes are simulated and the results are analyzed to determine the optimal design. The numerical results of droplet velocity and volume are compared with the experimental results of a cylindrical-shaped actuator. It is found that the micro actuators having tapered restrictors show better high frequency characteristics than those having a cylindrical shape without any notable decrease of droplet volume. The laser-fabricated restrictors demonstrate initial feasibility for the laser direct ablation technique although more development is required.

• Advances in biomechanics and applications
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• 제1권1호
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• pp.23-40
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• 2014

This paper examines the blood chamber of a left ventricular assist device (LVAD) under static loading conditions and standard operating temperatures. The LVAD's walls are made of a temperature-sensitive polymer (ChronoFlex C 55D) and are covered with a titanium nitride (TiN) nano-coating (deposited by laser ablation) to improve their haemocompatibility. A loss of cohesion may be observed near the coating-substrate boundary. Therefore, a micro-scale stress-strain analysis of the multilayered blood chamber was conducted with FE (finite element) code. The multi-scale model included a macro-model of the LVAD's blood chamber and a micro-model of the TiN coating. The theories of non-linear elasticity and elasto-plasticity were applied. The formulated problems were solved with a finite element method. The micro-scale problem was solved for a representative volume element (RVE). This micro-model accounted for the residual stress, a material model of the TiN coating, the stress results under loading pressures, the thickness of the TiN coating and the wave parameters of the TiN surface. The numerical results (displacements and strains) were experimentally validated using digital image correlation (DIC) during static blood pressure deformations. The maximum strain and stress were determined at static pressure steps in a macro-scale FE simulation. The strain and stress were also computed at the same loading conditions in a micro-scale FE simulation.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.712-722
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• 2019

Objective : Although magnetic resonance guided focused ultrasound (MRgFUS) has been used as minimally invasive and effective neurosurgical treatment, it exhibits some limitations, mainly related to acoustic properties of the skull barrier. This study was undertaken to identify skull characteristics that contribute to optimal ultrasonic energy transmission for MRgFUS procedures. Methods : For ex vivo skull experiments, various acoustic fields were measured under different conditions, using five non-embalmed cadaver skulls. For clinical skull analyses, brain computed tomography data of 46 patients who underwent MRgFUS ablations (18 unilateral thalamotomy, nine unilateral pallidotomy, and 19 bilateral capsulotomy) were retrospectively reviewed. Patients' skull factors and sonication parameters were comparatively analyzed with respect to the cadaveric skulls. Results : Skull experiments identified three important factors related skull penetration of ultrasound, including skull density ratio (SDR), skull volume, and incidence angle of the acoustic rays against the skull surface. In clinical results, SDR and skull volume correlated with maximal temperature (Tmax) and energy requirement to achieve Tmax (p<0.05). In addition, considering the incidence angle determined by brain target location, less energy was required to reach Tmax in the central, rather than lateral targets particularly when compared between thalamotomy and capsulotomy (p<0.05). Conclusion : This study reconfirmed previously identified skull factors, including SDR and skull volume, for successful MRgFUS; it identified an additional factor, incidence angle of acoustic rays against the skull surface. To guarantee successful transcranial MRgFUS treatment without suffering these various skull issues, further technical improvements are required.

• The Korean Journal of Physiology
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• 제18권2호
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• pp.117-124
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• 1984

It has been recently reported that cingulate cortex mar facilitate gastric acid secretion, but its facilitatory mechanism on the gastric acid secretion is still unclear. This study was undertaken to investigate the facilitatory mechanism of the cingulate cortex upon gastric acid secretion in rats. Twenty·three male albino rats were divided into the cingulate(N= 13) and the operated control(N= 10) groups. The cingulate group in which cingulate cortex was removed by suction through a slit-shaped opening on each side of, and parallel to, the sagittal suture. In the operated control group, the surgical procedure was ended with the skull opening and the incision of dura mater. The gastric juice was collected via a chronic gastric cannula after 24 hours of fast, with water ad libitum. The juice was collected continuously for 6 hours, starting 3 hours prior to the injection of gastric secretagogue, pentagastrin$(12\;{\mu}g/kg)$ or histamine dihydrochloride $(320\;{\mu}g/kg)$. Three one·hour samples were obtained before ana after the administration of each secretagogue. The two agents were injected separately and subcutaneously at intervals of 1 week, the blood samples were drawn from the abdominal aorta for the radioimmunoassay of postprandial plasma gastrin concentration in response to the forced feeding of 10% cod liver oil. 1) After pentagastrin administration, the volume of gastric juice tended to decrease, but its acidity tended to increase in the cingulate group compared with those of the operated control group. However, there was no any difference in the acid output between the two groups. 2) Histamine-stimulated acid output and volume of the gastric juice of the cingulate group decreased significantly compared with those of the operated control group, while there was not significantly different in the acidity between the two groups. 3) Before pentagastrin or histamine administration, any change was not observed in the gastric acid secretion following the cingulate cortical ablation. 4) Postprandial plasma gastrin concentration in response to the forced feeding of 10% cod liver oil was insignificantly lower in the cingulate group than in the operated control group. It is inferred from the above results that the cingulate cortex exerts a facilitatory influence upon the histamine-stimulated gastric acid secretion in rats, and its influence may not be mediated by the stimulation of gastrin secretion.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.8-13
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• 2011

Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.