• 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 Yeungnam Medical Science
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• 제41권4호
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• pp.279-287
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• 2024

Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing health-care burden. A recent landmark randomized trial, the EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), highlighted the importance of early rhythm control in AF, which was previously underemphasized. Rhythm control therapy includes antiarrhythmic drugs, direct-current cardioversion, and catheter ablation. Currently, catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized according to the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). Catheter ablation techniques can also be divided into the point-by-point ablation method, which ablates the pulmonary vein (PV) antrum one point at a time, and the single-shot technique, which uses a spherical catheter to ablate the PV antrum in a single application. PFA is known to be applicable to both point-by-point and single-shot techniques and is expected to be promising owing to its tissue specificity, resulting in less collateral damage than catheter ablation involving thermal energy, such as RFA and cryoablation. In this review, we aimed to outline catheter ablation for rhythm control in AF by reviewing previous studies.

• 대한기계학회논문집B
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• 제25권11호
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• pp.1483-1491
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• 2001

Enhancement of pulsed-laser ablation by an artificially deposited liquid film is presented. Measurements of ablation rate, ablation threshold, and surface topography arc performed. Correlation between material ablation and photoacoustic effect is examined by the optical beam deflection method. The dependence of ablation rate on liquid-film thickness and chemical composition is also examined. The results indicate that photomechanical effect in the phase explosion of liquid is responsible for the enhanced ablation. The low critical temperature of liquid induces explosive vaporization with localized photoacoustic excitation in the superheat limit and increases the ablation efficiency. Experiments were carried out utilizing a Q-swiched Nd:YAG laser at near-threshold laser fluences with negligible plasma effect (up to ∼100 MW/cm$^2$).

• 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.

• 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.

• Korean Journal of Radiology
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• 제22권9호
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• pp.1490-1496
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• 2021

• 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).

• International Journal of Arrhythmia
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• 제19권3호
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• pp.235-284
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• 2018

In this part the writing group will cover strategies, techniques, and endpoints of atrial fibrillation (AF) ablation. Prior to all, electrical isolation of the pulmonary veins is recommended during all AF ablation procedures. In addition, techniques to be used for ablation of persistent and long-standing persistent AF, adjunctive ablation strategies, nonablative strategies to improve outcomes of AF ablation, and endpoints for ablation of paroxysmal, persistent, and long-standing persistent AF will be reviewed. Currently many technologies and tools are employed for AF ablation procedures. Radiofrequency energy, cryoablation, and other energy sources and tools are in various stages of development and/or clinical investigation. Finally, anticoagulation strategies pre-, during, and postcatheter ablation of AF and technical aspects of ablation to maximize safety are discussed in this section.

• 한국레이저가공학회지
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• 제10권1호
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• pp.19-27
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• 2007

Previous studies demonstrated that laser ablation under transparent liquid can result in ablation enhancement and particle removal from the surface. Although the ablation enhancement by liquid is already known for semiconductor and metal, the phenomena of polymer ablation have not been studied. In this work, tile liquid-assisted excimer laser ablation process is examined for polymer materials, such as polyethylene terephthalate (PET), polymethyl methacrylate (PMMA) with emphasis on ablation enhancement and surface topography. In the case of PET and PMMA, the effect of liquid is analyzed both for thin water film and bulk water. The results show that application of liquid increases the ablation rate of PMMA while that of PET remains unchanged even in the liquid-assisted process. However, the surface roughness is generally deteriorated in the liquid-assisted process. The surface topography is found to be strongly dependent on the method of liquid application, i.e., thin film or bulk liquid.

• 한국레이저가공학회지
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• 제5권2호
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• pp.31-38
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• 2002

This paper describes the process of nanoparticle synthesis by laser ablation of consolidated microparticles. We have generated nanoparticles by high-power pulsed laser ablation of Al, Cu and Ag microparticles using a Q-switched Nd:YAG laser (wavelength 355 nm, FWHM 5 ㎱, fluence 0.8∼2.0 J/㎠). Microparticles of mean diameter 18∼80 ㎛ are ablated in the ambient air The generated nanoparticles are collected on a glass substrate and the size distribution and morphology are examined using a scanning electron microscope and a transmission electron microscope. The effect of laser fluence and collector position on the distribution of particle size is investigated. The dynamics of ablation plume and shock wave is analyzed by monitoring the photoacoustic probe-beam deflection signal. Nanosecond time-resolved images of the ablation process are also obtained by laser flash shadowgraphy. Based on the experimental results, discussions are made on the dynamics of ablation plume.