• Journal of Chest Surgery
• /
• v.45 no.1
• /
• pp.11-18
• /
• 2012

Background: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases. Materials and Methods: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups' baseline characteristics, a propensity score analysis was performed. Results: After adjustment, there were no significant differences in the two groups' baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group ($176.0{\pm}49.5$ minutes) than the sternotomy group ($150.0{\pm}51.9$ minutes). There were no significant differences (p=0.31) in the two groups' rate of reoperation for bleeding (MICS=6 vs. sternotomy=2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were $87.4{\pm}8.1%$ in the MICS group and $89.6{\pm}5.8%$ in the sternotomy group (p=0.92). Freedom from late AF at 2 years was $86.8{\pm}6.2%$ in the MICS group and $85.0{\pm}6.9%$ in the sternotomy group (p=0.86). Conclusion: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.

• Journal of the Korean Magnetics Society
• /
• v.7 no.6
• /
• pp.299-307
• /
• 1997

NdFeB films have been grown onto Si(100) substrate by a KrF pulsed laser ablation of the targets of $Nd_xFe_{90.98-x}B_{9.02}$ (x=17.51~27.51) at the substrate temperature of 620~700 $^{\circ}C$ and the laser beam energy density of 2.75~5.99 J/$\textrm{cm}^2$. The films exhibit no preferred orientation, however, good hard magnetic properties were produced from as-deposited condition : $4{\pi}M_s$=7 kG, $4{\pi}M_r$=4 kG, and $H_c$=300~1000 Oe. The depositon rate was not greatly influenced by changing the substrate temperature, but it increases linearly by increasing the beam energy density. The beam energy density of 3 J/$\textrm{cm}^2$ gave the optimal condition to have the highest $4{\pi}M_r$ and $H_c$ as well. The higher content of Nd induces a higher coercivity and $4{\pi}M_r$ at the same time without prominent change in $4{\pi}M_s$.

• Korean Journal of Radiology
• /
• v.25 no.3
• /
• pp.289-300
• /
• 2024

Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion: US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.

• Proceedings of the Korean Vacuum Society Conference
• /
• 2013.02a
• /
• pp.294-294
• /
• 2013

소수성을 띄는 표면은 자연으로부터 시작된 연구이다. 연잎, 소금쟁이 다리, 매미 날개 등 많은 자연의 표면은 150o보다 높은 접촉각을 지니기 때문에 물에 대한 반발이 심해져 약간의 기울임에도 쉽게 물방울이 굴러 떨어지고 이때 먼지를 제거할 수 있다. 자연현상을 이용해 물질 표면의 소수성 제어에 대한 다양한 연구가 진행 중이다. 친수성과 소수성은 일반적으로 표면에서 물방울의 contact angle 측정으로 확인 할 수 있다. Contact angle이 $90^{\circ}$ 작을 경우 친수성, $90^{\circ}$보다 클 경우 소수성이라고 한다. 이러한 기술을 이용해서 solar cell, 자동차 유리, 건물외벽, 등 다양한 분야에서 사용하고 있으며, 소수성 구조를 만드는 방법으로는 laser ablation, wet etching, 리소그라피 공정이 있는데, laser ablation의 경우 가격이 비싸다는 단점을 가지고 있으며, 반면 가격이 저렴한 wet etching의 경우 제어가 힘들다는 단점을 지니고 있다. 리소그라피 공정은 비싼 비용과 시간을 소비해야 하는 단점을 지니고 있다. 본 연구에서는 이러한 단점들을 개선하기 위해 공정 시간의 감소와, 저 비용으로 제작이 가능한 RIE (Recative Ion Etching)로 피라미드 구조를 만들었다. 형성된 구조물에 투명하고 균일하며, 낮은 계면에너지를 갖고 있는 PDMS (polydimethelsiloxine)로 mold을 수행하였다. RIE를 이용한 표면 구조는 Gas, Flow rate, Pressure, Power, Time 등을 조절하여 단결정 실리콘 기판 위에 피라미드의 크기를 조절하였다. 피라미드의 크기가 커짐에 따라 물과 PDMS가 닿는 면적이 줄어들면서 높은 소수성을 가지게 되는데, 높은 소수성 구조를 가지는 피라미드 형상을 찾기 위한 실험을 진행하였다. RIE 조건은 Flow rate: 30 sccm, Temperature: $10^{\circ}C$ Pressure: 100 mTorr, Power: 200 W, Process Time: 5~50 min으로 조절하며 공정을 수행하였고 RIE공정 후 SAMs (Self-Assembly Monolayers)을 진행하였으며, 마지막으로 PDMS를 이용하여 mold공정을 진행하였다. 그리고 SEM (Scanning Electron Microscope)장비를 이용하여 Etching된 단면을 관찰하였으며, 접촉각을 측정하였다. Process Time을 50 min로 공정하였을 때, 측정된 접촉각은 $134^{\circ}$였다.

• Korean Circulation Journal
• /
• v.53 no.8
• /
• pp.550-562
• /
• 2023

Background and Objectives: To identify the factors associated with adverse outcomes following surgery for functional insufficiency of the mitral valve (MV) or tricuspid valve (TV) associated with atrial fibrillation (AF). Methods: We evaluated 100 patients (age, 66.5±10.0 years; 47 males) who consecutively underwent surgery for functional insufficiency of the MV or TV associated with AF between January 2000 and December 2020 at our center. The primary outcome was a composite endpoint of all-cause death, valve reoperation, congestive heart failure (CHF) requiring rehospitalization, and stroke. Results: During follow-up (532 patients-years [PYs]), adverse events included death in 16 (3.0%/yr), MV reoperation in 1 (0.2%/yr), CHF in 14 (2.6%/yr), and stroke in 5 (0.9%/yr) patients, demonstrating a 5-year rate of freedom from the primary endpoint of 69.5%. The rate of postoperative AF was high even in those who underwent AF ablation (n=92), with cumulative rates of 48.1% at 1 year and 60.2% at 5 years. In multivariable analyses, the primary outcome was significantly associated with age (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.02-1.10; p=0.005), chronic kidney disease (aHR, 7.76; 95% CI, 2.28-26.38; p=0.001), left atrial appendage exclusion (aHR, 0.35; 95% CI, 0.16-1.78; p=0.010), and postoperative AF as a time-varying covariate (aHR, 3.33; 95% CI, 1.50-7.40; p=0.003). Conclusion: Among patients undergoing surgery for functional atrioventricular insufficiency associated with AF, a significant proportion showed recurrence of AF over time after concomitant AF ablation, which was significantly associated with poor clinical outcomes.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.635-641
• /
• 2010

Background: Radiofrequency endovenous ablation of incompetent saphenous vein has gaining popularity over the conventional ligation and stripping as a minimally invasive technique. The latest version of radiofrequency endovenous catheter, $VNUS^{\circledR}Colosure$ fast VNUS medical Technologies, San Jose, CA, adopted a segmental ablation system, instead of continous pullback, is designed to reduce treatment time in comparison with the previous model $VNUS^{\circledR}Colosure$ plus VNUS medical Technologies, San Jose, CA. The purpose of this study is to compare the difference between two endovenous radiofrequency ablation systems in terms of treatment efficacy and complication rates. We analyze the initial efficacy and complication rates of $VNUS^{\circledR}Colosure$ fast with $VNUS^{\circledR}Colosure$ plus. Material and Method: Between June 2006 and August 2009, $VNUS^{\circledR}Colosure$ plus was performed to treat varicose vein on 59 limbs in 41. patients and $VNUS^{\circledR}Colosure$ fast was performed on 76 limbs in 67 patients. We retrospectively compared in both group with sex, mean treatment time, mean treatment diameter, conjugated treatment, and complications after the procedure. Result: All patient were symptomatic and diagnosed as varicose vein and underwent level 2 clinical classification with color duplex scan. The mean treatment time for the great saphenous vein was significantly less with $VNUS^{\circledR}Colosure$ fast ($17.0{\pm}6.5min$) than $VNUS^{\circledR}Colosure$ plus ($62.7{\pm}9.8min$). There was no significant difference in 1 yr closure rate between groups (p=0.32). Minor complications such as skin burn, thrombophlebitis, ecchymosis, hematoma, cellulitis, tenderness, and there were not different between the groups. Conclusion: Both $VNUS^{\circledR}Colosure$ fast and $VNUS^{\circledR}Colosure$ plus are effective methods of endovenous saphenous ablation. $VNUS^{\circledR}Colosure$ fast is superior to the previous model with less treatment time preserving compatible efficacy and complications. The efficacy of $VNUS^{\circledR}Colosure$ fast for long term closure rate remains to be established.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.29.1-29.7
• /
• 2020

Background: Microvascular reconstruction is the treatment of choice after oral cancer ablation surgery. There are few published studies of free flap survival among Korean populations. This study aimed to determine the survival rate after 121 consecutive cases of maxillofacial microvascular reconstruction and to analyze the complications associated with microsurgery. Methods: This study included consecutive patients who underwent microsurgical reconstruction with free flaps, from January 2006 through September 2019, performed by a single surgeon at the oral and maxillofacial surgery department of a tertiary medical center. A total of 121 cases were reviewed retrospectively. The flap survival rate, flap type, radiotherapy history, complications, and treatment results were analyzed. Results: Four different flap types were used for microvascular reconstruction: radial forearm (n = 65), fibula (n = 34), latissimus dorsi (n = 21), and serratus anterior muscle with rib bone free flap (n = 1). Total necrosis of the flap was found in four cases (two latissimus dorsi flaps and two fibular flaps). The free flap survival rate was 97.5%. Nineteen patients received radiotherapy before surgery, and none of them experienced flap failure. The mean operation time was 334 ± 83.1 min, and the mean ischemic time was 48.9 ± 12.7 min. Conclusions: The success rate was reliable and comparable with previous studies. The success rate was not affected by radiation therapy. Free flaps can be safely used even after radiation treatment.

• Proceedings of the KSME Conference
• /
• 2002.08a
• /
• pp.229-232
• /
• 2002

For the purpose of Thermal Protection Material design problem, a numerical analysis of axisymmetric high temperature supersonic impinging jet flows of exhaust gas from combustor on curved surfaces has been accomplished. A modifed CSCM Upwind Navier-Stokes method which is able to cure the carbuncle Phenomena has been developed to study strong shock wave structure and thermodynamic wall properties such as pressure and heat transfer rate on various curved surfaces. The results show that the maximum heat transfer rate which is the most important parameter affecting thermo-chemical surface ablation on the plate did not occur at the center of jet impingement, but rather on a circle slightly away from the center of impingement and the shear stress distribution alone the wall is similar to the wall heat transfer late distribution.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1085-1090
• /
• 2007

Purpose : Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. Methods : We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. Results : Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways ($13.7{\pm}4.6yr$, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract ($12.3{\pm}5.0yr$, 10/11), 13 atrioventricular nodal reentrant tachycardia ($12.6{\pm}4.4yr$, 13/13), 4 atrial flutter ($13.0{\pm}7.4yr$, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. Conclusion : These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.

• Journal of Veterinary Clinics
• /
• v.33 no.4
• /
• pp.234-236
• /
• 2016

A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.