• Title/Summary/Keyword: cryoprobe

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Design of the miniature Joule-Thomson refrigerator as a cryoprobe (저온 수술 프로브용 소형 Joule-Thomson 냉동기의 설계)

  • Hwang, Gyu-Wan;Jeong, Sang-Kwon;In, Se-Hwan
    • Progress in Superconductivity and Cryogenics
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    • v.9 no.1
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    • pp.86-90
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    • 2007
  • The cryoprobe used in cryosurgery should be fabricated in milimeter-order size for its practical usage. In general a miniature J-T(Joule-Thomson) refrigerator is applied to a cryoprobe. In case of the miniature J-T refrigerator, the mass flow rate of working fluid is small due to considerable friction in a minute flow path. For that reason, the miniature J-T refrigerator has a limited cooling power. To obtain the large cooling power from the J-T refrigerator, the refrigerator should have large mass flow rate and effective J-T temperature drop. These quantities are closely related to the geometry of the heat exchanger and the expansion nozzle in a cryoprobe, and are contradictory. The large mass flow rate leads to the small J-T temperature drop and vice versa in the miniature J-T refrigerator. Therefore, the optimal design of a cryoprobe to achieve maximum cooling power at fixed tube size and fixed operating temperature is required. This paper presents the design procedure of such case.

Miniature J-T Refrigerator Using Triplet Heat Exchanger (Triplet 열교환기를 사용하는 소형 J-T 냉동기)

  • Hwang, G.;Jeong, S.
    • Progress in Superconductivity and Cryogenics
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    • v.11 no.1
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    • pp.60-63
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    • 2009
  • Most J-T (Joule-Thomson) refrigerators use a Giaque-Hampson type heat exchanger due to its excellent thermal performance and compactness. The cryoprobe (cryosurgical probe) treating prostate cancer usually has a dimension of 17 gauge (1.6 mm diameter), so it does not have enough space to bear a Giaque-Hampson type heat exchanger. In this paper, the triplet heat exchanger is adopted as the heat exchanger of cryoprobe, and the performance is investigated with an experimental test. The result shows that the triplet heat exchanger can be substituted for Giaque-Hampson type heat exchanger in the application of cryosurgery.

Efficacy of Cox Maze IV Procedure Using Argon-Based Cryoablation: A Comparative Study with $N_2O$-Based Cryoablation

  • Lee, Kyung-Hak;Min, Jooncheol;Kim, Kyung-Hwan;Hwang, Ho Young;Kim, Jun Sung
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.367-372
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    • 2014
  • Background: We compared the mid-term results of the Cox maze IV procedure using argon-based cryoablation with a procedure using $N_2O$-based cryoablation. Methods: From May 2006 to June 2012, 138 patients (mean age, $58.2{\pm}11.0$ years) underwent the Cox maze IV procedure. Eighty-five patients underwent the maze procedure using an $N_2O$-based cryoprobe (group N), and 53 patients underwent the maze procedure using an argon-based cryoprobe (group A). Bipolar radiofrequency ablation was concomitantly used in 131 patients. The presence of atrial fibrillation immediately, 6 months, 1 year, and 2 years after surgery was compared. Results: Early mortality occurred in 6 patients (4.3%). There were no differences in early mortality or postoperative complications between the two groups. Nineteen of 115 patients (16.5%) remained in atrial fibrillation at postoperative 12 months (14 of 80 patients (17.5%) in group N and 5 of 35 patients (14.3%) in group A, p=0.669). There were no differences in the number of patients who remained in atrial fibrillation at any of the time periods except in the immediate postoperative period. A multivariable analysis revealed that the energy source of cryoablation was not associated with the presence of atrial fibrillation at 1 year (p=0.862) and that a fine F wave (<0.1 mV) was the only risk factor predicting the presence of atrial fibrillation at 1 year (p<0.001, odds ratio=20.287). Conclusion: The Cox maze IV procedure using an argon-based cryoprobe was safe and effective compared with the maze procedure using an $N_2O$-based cryoprobe in terms of operative outcomes and the restoration of sinus rhythm for up to 2 years after surgery.

Cryosurgery for Malignant Endobronchial Tumor (악성 기관-기관지 종양에 대한 냉동 수술법)

  • Cho, Jong Ho;Kim, Kwang Taik;Lee, Sung Ho
    • Korean Journal of Bronchoesophagology
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    • v.18 no.1
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    • pp.5-8
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    • 2012
  • Cryosurgery is a safe method for palliation of endobronchial malignancies causing airway obstruction. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryosurgery is considered to be a good method that is clinically applicable to a malignant endobronchial tumor. In cases with stenosis caused by an endoluminal tumor, cryo-recanalization with a cryoprobe was immediately effective in most of the patients. A novel technique described by Hetzel in 2004 to achieve rapid recanalization of central airway obstruction with endobronchial cryoprobe. Cryorecanalization technique is feasible and offers many advantages in the interventional therapy of malignant intraluminal tumors of the respiratory tract.

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Clinical Benefits and Complications of Cryotherapy in Advanced Lung Cancer with Central Airway Obstruction (중심성 기도 폐쇄를 동반한 폐암에서 냉동치료의 임상적 유용성 및 부작용)

  • Jung, Jin Yong;Lee, Sung Yong;Kim, Dae Hyun;Lee, Kyung Joo;Lee, Eun Joo;Kang, Eun Hae;Jung, Ki Hwan;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.272-277
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    • 2008
  • Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately $-89^{\circ}C$, and the icing time was 5~20 seconds. Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications- one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.

Familial Surpravalvular Aorctic Stenosis in Two Silings (남매에서 발생한 가족성 판상부 대동맥협착증)

  • 강재걸
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1145-1151
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    • 1988
  • Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60` for 90 seconds. The accessory pathway was successfully ablated without specific problems.

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NMR Study of larger proteins using isotope labeling

  • Park, Sung Jean
    • Journal of the Korean Magnetic Resonance Society
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    • v.18 no.2
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    • pp.47-51
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    • 2014
  • Larger proteins (above molecular weight 50 kDa) usually show slow motional tumbling in solution, which facilitates the decay of NMR signal, resulting in poor signal-to-noise. In the past twenty years, researchers have tried to overcome this problem with higher molecular weight by improvement of hardware (higher magnetic field and cryoprobe), optimization of pulse sequences for lager molecules, and development of isotope-labeling techniques. Actually, GroEL/ES complex (${\approx}$ 900 kDa) was successfully studied using combination of above techniques. Among the techniques used in large molecular studies, the impact of isotope-labeling for large molecules study is summarized and discussed here.

A Numerical Study on the Phase-change Heat transfer problem in Cryosurgery (냉동수술시 수반되는 상변화 열전달 문제에 대한 수치해석적 연구)

  • 김동혁
    • Journal of Advanced Marine Engineering and Technology
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    • v.20 no.3
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    • pp.162-170
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    • 1996
  • A numerical study on the Stefan problem occurred in cryosurgery is performed. Crank-Nicholson type finite difference algorithm based on the enthaly method is adapted to solve the phase change problem in this study. As it is a moving boundary problem, special emphasis is put on the estimation of the freezing front location. Two cases selected here are freezings of human tissue by disk type cryoprobe and by hemispherical one. In both cases, the heat flows are considered to be one dimensional. The calculated results using enthalpy method are compared with those using the program TRUMP and with Neumann's solution. These results agree guite well with each other. While it is pretty difficult to get accurate freezing front location by TRUMP due to the so- called "phase change knee" occured during the phase change, the algorithm based on the enthalpy method is proved to be very powerful to cope with this kind of problem.f problem.

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Percutaneous Cryoablation of Multiple Pulmonary Endometriosis

  • Kim, Chong Hoon;Lee, Doo Yun;Moon, Duk Hwan;Lee, Sungsoo
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.75-78
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    • 2021
  • Minimally invasive cryoablation is often considered for lung tumor patients with high surgical risk or inoperable metastatic lung tumors. Cryoablation is a type of thermal percutaneous ablation in which argon and helium gases are delivered via a cryoprobe to induce tissue freezing and necrosis. We report the case of a 23-year-old woman who had suffered from multiple pulmonary endometriosis with frequent intermittent hemoptysis during menstruation for 6 years prior to her visit. She was treated with cryoablation at our hospital, and since her treatment, she has been doing well with no hemoptysis for at least 6 months. Although endometriosis is a benign lung disease, cryoablation is an ideal and effective treatment option for patients with multiple endometriosis.

Cryosurgery of Lung with 2.4 mm Cryoprobe: An Experimental in vivo Study of the Cryosurgery in Canine Model (냉동침을 이용한 폐 냉동수술의 동물실험: 냉동수술 방법의 비교 실험)

  • Kim Kwang-Taik;Chung Bong-Kyu;Lee Sung-Ho;Cho Jong-Ho;Son Ho-Sung;Fang Young-Ho;Sun Kyung;Park Sung-Min
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.520-526
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    • 2006
  • Background: The clinical application of cryosurgery the management of lung cancer is limited because the response of lung at low temperature is not well understood. The purpose of this study is to investigate the response of the pulmonary tissue at extreme low temperature. Material and Method: After general anesthesia the lungs of twelve Mongrel dogs were exposed through the fifth intercostal space. Cryosurgical probe (Galil Medical, Israel) with diameter 2.4 mm were placed into the lung 20 mm deep and four thermosensors (T1-4) were inserted at 5 mm intervals from the cryoprobe. The animals were divided into group A (n=8) and group B (n=4). In group A the temperature of the cryoprobe was decreased to $-120^{\circ}C$ and maintained for 20 minutes. After 5 minutes of thawing this freezing cycle was repeated. In group B same freezing temperature was maintained for 40 minutes continuously without thawing. The lungs were removed for microscopic examination on f day after the cryosurgery. In four dogs of the group A the lung was removed 7 days after the cryosurgery to examine the delayed changes of the cryoinjured tissue, Result: In group A the temperatures of T1 and T2 were decreased to the $4.1{\pm}11^{\circ}C\;and\;31{\pm}5^{\circ}C$ respectively in first freezing cycle. During the second freezing period the temperatures of the thermosensors were decreased lower than the temperature during the first freezing time: $T1\;-56.4{\pm}9.7^{\circ}C,\;T2\;-18.4{\pm}14.2^{\circ}C,\;T3\;18.5{\pm}9.4^{\circ}C\;and\;T4\;35.9{\pm}2.9^{\circ}C$. Comparing the temperature-distance graph of the first cycle to that of the second cycle revealed the changes of temperature-distance relationship from curve to linear. In group B the temperatures of thermosensors were decreased and maintained throughout the 40 minutes of freezing. On light microscopy, hemorrhagic infarctions of diameter $18.6{\pm}6.4mm$ were found in group A. The infarction size was $14{\pm}3mm$ in group B. No viable cell was found within the infarction area. Conclusion: The conductivity of the lung is changed during the thawing period resulting further decrease in temperature of the lung tissue during the second freezing cycle and expanding the area of cell destruction.