• Title, Summary, Keyword: Ablation

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2018 심방세동 카테터 절제술 대한민국 진료지침: PART III

  • Lee, Jeong-Myeong;Jeong, Dong-Seop;Yu, Hui-Tae;Park, Hyeong-Seop;Sim, Jae-Min;Kim, Ju-Yeon;Kim, Jun;Yun, Nam-Sik;O, Se-Il;No, Seung-Yeong;Jo, Yeong-Jin;Kim, Ki-Hun
    • International Journal of Arrhythmia
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    • v.19 no.3
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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.

The Advent of Laser Therapies in Dermatology and Urology: Underlying Mechanisms, Recent Trends and Future Directions

  • Lee, Ho;Jeong, Yeon-Uk;Chan, Kin F.
    • Journal of the Optical Society of Korea
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    • v.13 no.3
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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.

Enhancement of Pulsed-Laser Ablation by Phase Explosion of Liquid (액체의 상폭발 과정에 의한 펄스 레이저 용발률의 증진)

  • Kim, Dong-Sik;Lee, Ho
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.25 no.11
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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$^2$).

Baseline Stimulated Thyroglobulin Level as a Good Predictor of Successful Ablation after Adjuvant Radioiodine Treatment for Differentiated Thyroid Cancers

  • Fatima, Nosheen;uz Zaman, Maseeh;Ikram, Mubashir;Akhtar, Jaweed;Islam, Najmul;Masood, Qamar;Zaman, Unaiza;Zaman, Areeba
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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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).

2018 심방세동 카테터 절제술 대한민국 진료지침: Part II

  • Yu, Hui-Tae;Jeong, Dong-Seop;Park, Hui-Nam;Park, Hyeong-Seop;Kim, Ju-Yeon;Kim, Jun;Lee, Jeong-Myeong;Kim, Gi-Hun;Yun, Nam-Sik;No, Seung-Yeong;O, Yong-Seok;Jo, Yeong-Jin;Shim, Jaemin
    • International Journal of Arrhythmia
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    • v.19 no.3
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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.

Numerical simlation of nanosecond pulsed laser ablation in air (대기중 나노초 펄스레이저 어블레이션의 수치계산)

  • 오부국;김동식
    • Laser Solutions
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    • v.6 no.3
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    • pp.37-45
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    • 2003
  • Pulsed laser ablation is important in a variety of engineering applications involving precise removal of materials in laser micromachining and laser treatment of bio-materials. Particularly, detailed numerical simulation of complex laser ablation phenomena in air, taking the interaction between ablation plume and air into account, is required for many practical applications. In this paper, high-power pulsed laser ablation under atmospheric pressure is studied with emphasis on the vaporization model, especially recondensation ratio over the Knudsen layer. Furthermore, parametric studies are carried out to analyze the effect of laser fluence and background pressure on surface ablation and the dynamics of ablation plume. In the numerical calculation, the temperature, pressure, density, and vaporization flux on a solid substrate are obtained by a heat-transfer computation code based on the enthalpy method. The plume dynamics is calculated considering the effect of mass diffusion into the ambient air and plasma shielding. To verify the computation results, experiments for measuring the propagation of a laser induced shock wave are conducted as well.

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Nanoparticle Synthesis by Pulsed Laser Ablation of Consolidated Microparticles (압밀 금속 마이크로 입자의 펄스 레이저 ABLATION에 의한 나노입자 합성)

  • 장덕석;오부국;김동식
    • Laser Solutions
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    • v.5 no.2
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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.

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Excimer Laser Micromachining of Polymers Assisted by Liquid (액체 보조 방식의 Excimer 레이저 폴리머 미세가공)

  • Jang, Deok-Suk;Kim, Dong-Sik
    • Laser Solutions
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    • v.10 no.1
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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.

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Comparison study of nanosecond laser induced wet and dry ablation of PMMA (나노초 레이저를 이용한 PMMA의 습식 및 건식어블레이션 비교 연구)

  • lee, Ho
    • Journal of the Korean Society of Industry Convergence
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    • v.22 no.3
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    • pp.243-250
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    • 2019
  • The nanosecond laser assisted ablation have been investigated. The biocompatable polymer PMMA was employed as the target material and the two distinctive surface conditions were test. The first surface condition is a dry surface for which the target surface is exposed to air and the second surface condition is the wet surface for which the target surface is covered with dehydrated water. The ablation volume, the laser induced acoustic wave, the laser induced plasma were investigated for both wet and dry condition. The nanosecond laser pulse ablatied more on the wet surface compared to the dry surface. The enhanced ablation of wet surface is attributed to the confined acoustic wave and the laser-induced plasma in the liquid layer.

Initial Experience with Total Thoracoscopic Ablation

  • Lee, Hee Moon;Chung, Su Ryeun;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.1-5
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    • 2014
  • Background: Recently, a hybrid surgical-electrophysiological (EP) approach for confirming ablation lines in patients with atrial fibrillation (AF) was suggested. The aim of this approach was to overcome the limitations of current surgery- and catheter-based techniques to yield better outcomes. Methods: Ten consecutive patients with AF underwent total thoracoscopic ablation (TTA) following transvenous catheter EP ablation (residual gap and cavotricuspid isthmus [CTI] ablation). Holter monitoring was performed 6 months postoperatively. Results: Ten patients (90% with persistent AF) underwent successful hybrid procedures, and there was no in-hospital mortality. An EP study was performed in 8 patients and showed that successful antral ablation in all pulmonary veins was achieved in 7 of them. The median follow-up duration was 7.63 months (range, 6.7 to 11.6 months). Nine patients underwent Holter monitoring 6 months postoperatively, and the results indicated an underlying sinus rhythm without AF, atrial flutter, or atrial tachycardia lasting more than 30 seconds in all of the patients. There was no recurrence of AF during follow-up. Conclusion: A hybrid approach that consists of TTA followed by transvenous catheter EP ablation (residual gap and CTI ablation) yielded excellent outcomes in our patient population. A hybrid approach should be considered in patients with a high risk of AF recurrence.