• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.194-199
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• 1996

Laser therapy is becoming an accepted procedure for tissue coagulation and ablation and is especially useful in treating tumors. The laser energy is applied to the tissue of interest through various delivery systems which are introduced percutaneously, via blood vessels, through body openings, or during surgical exposure of the tissue. One of the major obstacles to effective application of lasers has been the lack of reliable method to determine the extent of tissue involvement in real time. Several methods have been proposed for monitoring the tissue response and controlling the laser in real time during laser therapy. Among them, magnetic resonance imaging(MRI) has been introduced to monitor laser-tissue interactions because laser irradiation induces changes not only in the thermal motions of the hydrogen protons within the tissue but also in the distribution and mobility of water and lipids. The buttocks of New Zealand rabbits were treated by KTP and $CO_2$laser(power : 10 watts, exposure time:10 seconds). m images were taken at immediately after lasering, 1 week later, 2 weeks later, and at the same time, tissues were harvested for histopathologic study. We analyzed MR images and histopathologic findigs of laser-treated tissues. The MR images taken immediately after laser treatment showed 3 layer pattern and which was correlated with histopathologic changes. We suggest MRI may become a useful monitoring tools for laser-tissue interaction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.134-137
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• 2017

Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous $H_2$ blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.

• The Journal of the Acoustical Society of Korea
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• v.29 no.2E
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• pp.55-63
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• 2010

High Intensity Focused Ultrasound (HIFU) is a noninvasive surgical method mainly targeting deeply located cancer tissue. Ultrasound is generated from an extemally located transducer and the beam is focused at the target volume, so that selective damage can be achieved without harm to overlying or surrounding tissues. The mechanism for cell killing can be combination of thermal and cavitational damage. Although cavitation can be an effective means of tissue destruction, the possibility of massive hemorrhage and the unpredictable nature of cavitational events prevent clinical application of cavitation. Hence, thermal damage has been a main focus related to HIFU research. 2D phased array transducer systems allow electronic scanning of focus, multi-foci, and anti-focus with multi-foci, so that HIFU becomes more applicable in clinical use. Currently, lack of noninvasive monitoring means of HIFU is the main factor to limit clinical applications, but development in MRI and Ultrasound Imaging techniques may be able to provide solutions to overcome this problem. With the development of advanced focusing algorithm and monitoring means, complete noninvasive surgery is expected to be implemented in the near future.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.457-460
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• 2007

Primary hyperparathyroidism (PHP) is rare in dogs. Mainly functional solitary parathyroid adenoma causes hypercalcemia due to excessive autonomous secretion of parathyroid hormone (PTH). PHP can be diagnosed based on serum calcium phosphorus, ionized calcium and PTH, and cervical ultrasound provides important information about the number size and location of parathyroidal lesion. Ultrasound guided intralesional ethanol injection has been used as an alternative to surgical treatment of PHP. In this case, PHP was diagnosed in 12 year-old Pug with clinicopathologic examination and cervical ultrasound, and the parathyroidal mass was ablated successfully through ultrasound guided ethanol injection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.388-393
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• 2021

At present, in Korea, due to developments in medicine and technology and an increasing mean lifespan, the expected lifetime for elderly people is increasing (at 70 years, the expected additional lifespan is 14.8 years for males and 18.3 years for females). However, among all causes of death, malignant neoplasm is ranked first for all ages. Further, the incidence rate of oral cancer tends to increase with age. Thus, oral and maxillofacial surgeons have increased opportunity to experience the 'oldest old' patients with oral cancer. Elderly patients commonly have several comorbidities, poor general condition, limited socioeconomic support, fear of various postoperative complications, and perception of short for the rest of their life. In this situation, the patient, caregiver, and surgeon often choose undergraded treatment rather than standard treatment for oral squamous cell carcinoma owing to patient age. In elderly patients with oral cancer, ablation of tumor or reconstructive surgery is challenging for surgeons. Oral and maxillofacial surgeons must evaluate carefully the patient's medical condition and make a decision regarding treatment plans after sufficient discussion with patient and caregivers. We review the literature to consider the factors involved for deciding on a treatment plan regarding surgery in elderly patients with oral cancer.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.1-24
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• 2024

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3595-3604
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• 2015

Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.60-64
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• 2002

Objectives: Three classic treatment modalities have been used to treat Graves' disease: antithyroid medication, radioiodine ablation, and subtotal thyroidectomy. Postoperative thyroid functions were studied in patients with Graves' disease treated by subtotal thyroidectomy to evaluate the superiority of surgical treatment. Materials and Methods: One hundred fourty patients of Graves' disease were analysed retrospectively in follow-up for more than three years following subtotal thyroidectomy. Postoperative serum levels of $T_3,\;T_4, TSH, TSH-R Ab, free $T_4$, were evaluated to watch hypo- or hyperthyroidsm. Results: In the evaluation of preop- and postoperative thyroid function after three years of subtotal thyroidectomy, $T_3$ was changed from $464.10{\pm}196.16ng/dl$ to $140.41{\pm}76.56ng/dl$ in mean value, $T_4$ was changed from $20.76{\pm}7.98{\mu}g/dl$ to $9.54{\pm}4.02{\mu}g/dl$, $TSHT_3$ was changed from $0.55{\pm}4.42{\mu}u/ml$ to $4.96{\pm}7.20{\mu}u/ml$, TSH-R Ab was changed from $41.6{\pm}28.27%$ to $28.7{\pm}28.79%$ and free $T_4$ was changed from $4.45{\pm}2.33ng/dl$ to $1.44{\pm}0.69ng/dl$ in mean value. Euthyroidism was noted in 118 patients(84.3%), overt hyperthyroidism in 6 patiens(4.3%), latent hyperthyroidism in 8 patients(5.7%), overt hypothyroidism in 2 patint(1.4%), and latent hypothyroidism in 6 patients(4.3%). Of surgical complications, permanant hypoparathyroidism was found in one patient, recurrent laryngeal nerve injury in two patients, postoprative bleeding with reoperation in two patients, and death in one patient. Conclusion: The thyroid function after subtotal thyroidectomy in diffuse toxic goiter is normal level (euthyroidism) in 84.3% and low recurrence rate of hyperthyroidism is showed with rare surgical complication. Therefore, subtotal thyroidectomy in diffuse toxic goiter is more effective and safe than RI or longterm ATD treatment, if the operation is performed by skillful surgeon.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.12
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• pp.1301-1307
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• 2011

Electrosurgical knee wand (EKW) is a high-frequency thermocautery instrument and is often used for coagulation, ablation, excision, and extirpation of knee ligaments and tissues. In order to maximize the success rate, ease, and safety of knee surgery using EKW and radiofrequency ablation, it is necessary to ensure that the EKW selectively approaches the lesion with utmost accuracy and safety. The key feature of this instrument is its excellent maneuverability. Hence, the authors constructed a tensile spring model based on a shape memory alloy (SMA), which exhibits the shape memory effect. This model can be used in knee surgery as it is considered the most biocompatible femorotibial surgical actuator. The changes in external temperature with current and the thermoelectric characteristics of the SMA were investigated. The relationship between the restoring force and the typical stroke (TS) in response to the conditions in the SMA tensile spring design were evaluated. In conclusion, as the diameter of the SMA tensile spring decreased, the maximum temperature increased. The strain in the actuator caused a stable and proportional increase in the force and induced current for up to 15s, but this increase became very unstable after 30s. Moreover, the relationship between the current and the TS was more stable than that between the current and the restoring force.