• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1115-1118
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• 2016

Background: There is controversy about ablation efficacy of low or high doses of radioiodine-131 (RAI) in patients with differentiated thyroid cancers (DTC). The purpose of this prospective study was to determine efficacy of 30 mCi and 100 mCi of RAI to achieve successful ablation in patients with low to intermediate risk DTC. Materials and Methods: This prospective cross sectional study was conducted from April 2013 to November 2015. Inclusion criteria were patients of either gender, 18 years or older, having low to intermediate risk papillary and follicular thyroid cancers with T1-3, N0/N1/Nx but no evidence of distant metastasis. Thirty-nine patients were administered 30 mCi of RAI while 61 patients were given 100 mCi. Informed consent was acquired from all patients and counseling was done by nuclear physicians regarding benefits and possible side effects of RAI. After an average of 6 months (range 6-16 months; 2-3 weeks after thyroxin withdrawal), these patients were followed up for stimulated TSH, thyroglobulin (sTg) and thyroglobulin antibodies, ultrasound neck (U/S) and a diagnostic whole body iodine scan (WBIS) for ablation outcome. Successful ablation was concluded with stimulated Tg< 2ng/ml with negative antibodies, negative U/S and a negative diagnostic WBIS (triple negative criteria). ROC curve analysis was used to find diagnostic strength of baseline sTg to predict successful ablation. Results: Successful ablation based upon triple negative criteria was 56% in the low dose and 57% in the high dose group (non-significant difference). Based on a single criterion (follow-up sTg<2 ng/ml), values were 82% and 77% (again non-significant). The ROC curve revealed that a baseline sTg level ${\leq}7.4ng/ml$ had the highest diagnostic strength to predict successful ablation in all patients. Conclusions: We conclude that 30 mCi of RAI has similar ablation success to 100 mCi dose in patients with low to intermediate risk DTC. A baseline $sTg{\leq}7.4ng/ml$ is a strong predictor of successful ablation in all patients. Low dose RAI is safer, more cost effective and more convenient for patients and healthcare providers.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 1995년도 추계학술대회 논문집
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• pp.75-78
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• 1995

This paper presents the feasibility of laser ablation process in 3-D micro machining of MEMS (micro Electro Mechanical System)parts. The micro machining characteristics of polymer(Energy fluence, pulse repetition rate, number of pulse, ablation rate)are investigated and 3-D micro machined samples are demonstrated.

• 대한방사선협회지
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• 제30권1호
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• pp.58-62
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• 2004

The purpose of this study was to determine the factors influencing on the size of Radiofrequency ablation using an internally cooled needle electrodes in cattle liver. Ablation procedures involved the use of cool-tip RF system generator and internally coo

• 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

• 한국방사선학회논문지
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• 제16권4호
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• pp.427-434
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• 2022

심방세동 치료는 3D장비를 이용한 고주파 절제술과 냉각 풍선을 이용한 냉각 풍선 절제술이 있다. 두 시술 모두 혈관 조영 장비를 이용해 심장의 구조를 파악한 뒤 진입하는 공통점이 있다. 따라서 시술 시간에 따른 피폭의 영향이 환자와 시술자 모두 위협이 될 수 있다는 단점이 존재하므로 본 연구를 통해 총 절제술 시간과 방사선 피폭 영향 등의 연관성을 확인하고자 한다. 2019년 03월부터 2022년 07월까지 관상 동맥 조영술과 부정맥 시술을 동시에 시행한 41명 환자의 후행적 데이터를 이용하였다. 총 절제술 시간에 대한 범위는 절제술 시작 시점부터 종료 시점까지의 기록된 데이터를 대상으로 하였다. 3D 고주파 절제술 종료 시점은 4곳의 폐정맥에 대해 절제술 시행을 완료한 시점으로 하였고 냉각 풍선 절제술의 경우 전기적 절연에 성공한 데이터를 대상으로 하였다. 총 절제술에 걸린 시간을 분석한 결과 냉각 풍선 절제술에 걸린 시간이 1037.29±103.66 s로 3D를 이용한 고주파 절제술 3485.9±405.71 s 보다 2448.61 s 더 빠른 시술 시간을 보였고 통계적으로 유의했다. (p<0.05) 총 투시 조영 시간을 분석한 결과 3D를 이용한 고주파 절제술 피폭 시간이 2573.75±239.08 s로 냉각 풍선 절제술 피폭 시간 4290.9±420.42 s 보다 1717.15 s만큼 덜 노출됐으며 통계적으로 유의했다. 총면적 선량의 경우 3D 고주파 절제술이 59.04±13.1 uGy/m²로 냉각 풍선 절제술 980.6±658.07 uGy/m²보다 921.56 uGy/m²만큼 저 선량을 나타냈으며 통계적으로 유의했다. 냉각 풍선 절제술의 절연 시간이 3D 고주파 절제술보다 짧은 것으로 보아 환자의 상태가 좋지 않아 빠른 시술이 필요한 경우 냉각 풍선 절제술을 이용하는 방법이 효과적일 것으로 판단된다. 그러나 심방세동이 오래된 환자일 경우 심장의 구조적 변화가 발생할 확률이 높으므로 조작이 어려운 냉각 풍선 절제술 보다 3D 고주파 절제술을 이용해 치료하는 방법이 좋을 것으로 사료된다.

• Journal of Chest Surgery
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• 제53권5호
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• pp.270-276
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• 2020

Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

• Composites Research
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• 제33권4호
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• pp.205-212
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• 2020

본 연구에서는 기상화학반응공정을 이용하여 실리콘카바이드가 코팅된 2종형상의 탄소/탄소복합재 위에 진공플라즈마용사를이용하여 하프늄카바이드를 코팅하였다. 코팅 전/후 시편을 5.06 MW/㎡의 열유속에서 120초 동안 산화 및 삭마 실험을 진행하였다. 시험 전/후의 질량 변화량을 통해 질량삭마율을 계산하였고 캘리퍼스와 고속카메라를 이용하여 길이변화를 측정하여 길이삭마량을 계산하였다. 시편 단면의 FE-SEM 및 EDS 분석을 통해 산화 및 삭마거동을 관찰하였다. 플라즈마 풍동 시험결과 코팅된 시편이 무게감소 및 길이변화가 적어 내산화 및 내삭마성이 높은 것으로 판단되었다. 그러나 동일조건에서 시험한 반구형과 원통형의 산화 및 삭마정도는 상이하였고 원통형에서 더 높은 내산화 및 내삭마성을 가지는 것으로 평가되었다.

• 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 Chest Surgery
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• 제46권6호
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• pp.461-463
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• 2013

We report the case of a 72-year-old female with persistent atrial fibrillation who underwent a totally thoracoscopic ablation. A successful normal sinus conversion was achieved.