• Title/Summary/Keyword: 고주파열치료

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Endoscopic Therapy for Pancreatic Benign Neoplasms (췌장 양성 종양의 내시경적 치료)

  • Hwang, Jun Seong;Ko, Sung Woo
    • Journal of Digestive Cancer Research
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    • v.9 no.1
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    • pp.25-32
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    • 2021
  • Since Endoscopic ultrasound (EUS) was introduced in the 1980s, EUS has evolved from a diagnostic tool to a therapeutic modality for patients with pancreatic neoplasms. Traditionally, treatment policy of pancreatic benign neoplasms (PBN) has been a dichotomous approach to observation or surgery. However, EUS guided treatment provides an alternative option with minimally invasiveness for patients with PBN. This review aimed to provide the role of EUS guided treatment for PBN.

The study of thermal change by chemoport in radiofrequency hyperthermia (고주파 온열치료시 케모포트의 열적 변화 연구)

  • Lee, seung hoon;Lee, sun young;Gim, yang soo;Kwak, Keun tak;Yang, myung sik;Cha, seok yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.97-106
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    • 2015
  • Purpose : This study evaluate the thermal changes caused by use of the chemoport for drug administration and blood sampling during radiofrequency hyperthermia. Materials and Methods : 20cm size of the electrode radio frequency hyperthermia (EHY-2000, Oncotherm KFT, Hungary) was used. The materials of the chemoport in our hospital from currently being used therapy are plastics, metal-containing epoxy and titanium that were made of the diameter 20 cm, height 20 cm insertion of the self-made cylindrical Agar phantom to measure the temperature. Thermoscope(TM-100, Oncotherm Kft, Hungary) and Sim4Life (Ver2.0, Zurich, Switzerland) was compared to the actual measured temperature. Each of the electrode measurement position is the central axis and the central axis side 1.5 cm, 0 cm(surface), 0.5 cm, 1.8 cm, 2.8 cm in depth was respectively measured. The measured temperature is $24.5{\sim}25.5^{\circ}C$, humidity is 30% ~ 32%. In five-minute intervals to measure the output power of 100W, 60 min. Results : In the electrode central axis 2.8 cm depth, the maximum temperature of the case with the unused of the chemoport, plastic, epoxy and titanium were respectively $39.51^{\circ}C$, $39.11^{\circ}C$, $38.81^{\circ}C$, $40.64^{\circ}C$, simulated experimental data were $42.20^{\circ}C$, $41.50^{\circ}C$, $40.70^{\circ}C$, $42.50^{\circ}C$. And in the central axis electrode side 1.5 cm depth 2.8 cm, mesured data were $39.37^{\circ}C$, $39.32^{\circ}C$, $39.20^{\circ}C$, $39.46^{\circ}C$, the simulated experimental data were $42.00^{\circ}C$, $41.80^{\circ}C$, $41.20^{\circ}C$, $42.30^{\circ}C$. Conclusion : The thermal variations were caused by radiofrequency electromagnetic field surrounding the chemoport showed lower than in the case of unused in non-conductive plastic material and epoxy material, the titanum chemoport that made of conductor materials showed a slight differences. This is due to the metal contents in the chemoport and the geometry of the chemoport. And because it uses a low radio frequency bandwidth of the used equipment. That is, although use of the chemoport in this study do not significantly affect the surrounding tissue. That is, because the thermal change is insignificant, it is suggested that the hazard of the chemoport used in this study doesn't need to be considered.

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Radiofrequency Thermocoagulation for Recurred Trigeminal Neuralgia -A case report- (고주파 열응고술을 이용한 재발한 삼차 신경통의 치료 경험 -증례 보고-)

  • Lim, Kyung-Joon;Lee, Jae-Chul;Kim, Seung-Soo
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.261-265
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    • 2001
  • Radiofrequency thermocoagulation of the gasserian ganglion is a safe procedure that can be controlled well and provides satisfactory pain relief from trigeminal neuralgia with low risk. Here the authors report a case of radiofrequency thermocoagulation performed on a recurred trigeminal neuralgia patient, with particular attention to the V3 area. The patient was treated with microvascular decompression 7 years previous, which lead to untolerable side effects from carbamazepine medication. Following the paresthesia and masseter muscle contracture test at 50 Hz-0.06 volt and 2 Hz-0.5 volt respectively, RF lesionings were performed for 60 sec at $60^{\circ}C$ and 70 sec at $70^{\circ}C$. One week after the procedure, the pain was reduced with a mild hypoesthesia in the V2 area. After 6 months, the pain recurred. Therefore, we performed the same procedure again. After 8-months of follow-up, there has been no pain or complications.

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Percutaneous Radiofrequency Thermocoagulation of the Stellate Ganglion in the Treatment of Cervical and Upper Extremity Pain -A case report- (경부 및 상지의 통증치료를 위한 성상신경절의 경피적 고주파 열응고술 -증례 보고-)

  • Kim, Ji-Young;Kim, Ki-Yeob
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.239-244
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    • 2001
  • Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

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The Effectiveness of Ultrasound-Guided Thoracic Paravertebral Block for Percutaneous Radiofrequency Ablation of Hepatic Tumors: A Pilot Study (간종양의 경피적 고주파 열치료에서 초음파 유도하 흉부 방척추블록의 효용성: 예비 연구)

  • Kim, Hyungtae;Kim, Youngjun;Kim, Beum Jin;Shin, Sung In;Yim, So Mang;Lee, Ju-Hyung
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.323-331
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.

Clinical Practice Guidelines for Hepatocellular Carcinoma: Current and Future Perspectives (간암 진료가이드라인의 현재와 전망)

  • Bo Hyun Kim;Joong-Won Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.21-28
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    • 2016
  • Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

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음향공에 의한 LOX-RP1 고주파 음향-연소안정화에 관한 연구

  • 이길용;윤웅섭;조용호
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2000.04a
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    • pp.5-5
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    • 2000
  • 액체 추진 로켓 엔진의 고주파 연소 불안정 관련 이론은 대체로 연소기 내부의 음향 공명 모드와 분무 연소 과정의 상호 작용을 구동 메커니즘으로 전제하며 Rayleigh Criterion의 재해석에 기초하여 불안정성 평가를 위한 매개변수를 도입하고 연소 불안정성을 예측한다. 여기에는 음향장 분석 이론, 음향 불안정 이론, 연소응답 및 기화반응 이론 등이 포함된다. 본 연구에서는 LOX/RPl 추진제 조합의 액체 추진 로켓 엔진 연소기를 대상으로 다차원 순수 음향장 해석과 연소-음향장 분석을 통해 대상 엔진의 고주파 연소 불안정 특성을 예측하였다. 수동 제어 기기인 음향공 설치에 따른 연소기의 음향장 및 연소-음향장의 특성 변화를 고찰하고 위 결과를 종합하여 음향공의 연소 불안정 억제 성능 및 대상 엔진의 연소 불안정성을 평가하였다. 연소기 형상 및 음향공 설치에 따른 다차원 순수 음향장 해석은 상용코드인 ANSYS를 사용하여 수행하였다. 내부 유체는 압축성, 비점성 유체로 유체의 평균 유동은 무시하며 위치에 관계없이 균일한 물성치를 부여하였다. 정상상태 연소과정을 가정하고 평형 화학을 이용한 분석 결과로부터 연소 기체의 관련 물성치를 결정하였다. 연소기 길이 방향, 반경 방향, 원주 방향 격자점들의 음향 특성을 주파수 영역에 대해 해석하고 3차원 음향 모드 형상을 토대로 음향장을 분석하였다. 연소-음향장 해석은 음향 불안정 이론 중 n- $\tau$ 2 매개변수 기법을 사용하였다. 연료 액적의 분무 연소 과정을 1차원적으로 가정하고 정상상태의 평형 화학 계산 결과를 이용하여 엔진의 연소면을 1차원적으로 설정하였다. 상류 연소응답과 중립 안정 곡선을 토대로 대상 엔진의 연소 불안정 특성을 분석하였다.구 분석 결과 기술적 문제점으로는 배기 가스온도가 낮은데 따른 출구 부분의 Bearing, Sealing이 문제가 될 수 있다고 판단되며 배기 가스 자체에 대기 공기중에 함유되어 있던 습기가 얼어붙는(Icing화) 문제가 발생하기 때문에 배기가스의 Icing을 방지하기 위하여 압축기 끝단에서 공기를 추출하여 배기부분에 송출할 필요성이 있는 것으로 판단되었다. 출구가스의 기체 유동속도가 매우 빠르므로 (100-l10m.sec) 이를 완화하기 위한 디퓨저의 설계가 요구된다고 판단된다. 또 연소기 후방에 물을 주입하는 경우 열교환기 및 기타 부분품에 발생할 수 있는 부식 및 열교환 효율 저하도 간과할 수 없는 문제로 파악되었다. 이러한 기술적 문제가 적절히 해결되는 경우 비활성 가스 제너레이터는 민수용으로는 대형 빌딩, 산림, 유조선 등의 화재에 매우 적절히 사용되어 질 수 있을 뿐 아니라 군사적으로도 군사작전 중 및 공군 기지의 화재 그리고 지하벙커에 설치되어 있는 고급 첨단 군사 장비 등의 화재 뿐 아니라 대간첩작전 등에 효과적으로 활용될 수 있을 것으로 판단된다.가 작으며, 본 연소관에 충전된 RDX/AP계 추진제의 경우 추진제의 습기투과에 의한 추진제 물성 변화는 미미한 것으로 나타났다.의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다..7%), 혈액투석, 식도부분절제술 및 위루술·위회장문합술을 시행한 경우가 각 1례(2.9%)씩이었다. 13) 심각한 합병증은 9례(26.5%)에서 보였는데 그중 식도협착증이 6례(17.6%), 급성신부전증 1례(2.9%), 종격동기흉과 폐염이 병발한 경우와 폐염이 각 1례(2.9%)였다. 14)

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Effects of Regional Hyperthermia with Moderate Temperature on Cancer Treatment (국부 중등도 온열요법의 암치료 효과)

  • Kang, Chi-Dug;Kim, Sun-Hee
    • Journal of Life Science
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    • v.26 no.9
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    • pp.1088-1096
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    • 2016
  • Despite that moderate hyperthermia can exert various antitumor activities such as direct cytotoxic effects on tumor cells, effects on tumor vasculatures and immunological effects, hyperthermia has been usually combined with radiotherapy or chemotherapy due to its limited efficacy in cancer treatment, showing some positive clinical benefits with generally well-tolerated side effects. Since heat shock responses itself can interfere with the anti-tumor effects of hyperthermia, not all of these studies might have demonstrated positive clinical outcomes in cancer patients. Therefore, the negative anti-tumor effect of hyperthermia should be reduced to enhance the effectiveness of hyperthermia. Although the responses to heat stress of tumor tissues containing vessels, immune cells, connective tissues as well as cancer cells, are very complicated, it is needed to study in the near future if some clinically available drugs, which can modulate heat stress responses, can improve the efficacy of hyperthermia in patients with cancer. In this review, the effect of clinical hyperthermia centered on non-invasive external hyperthermia using radiofrequency at moderate temperature will be discussed, since it is the state-of-the-art technology in the current clinical practice of hyperthermia, and a moderate operational temperature is used to increase the therapeutic effectiveness of conventional therapy without additional toxicity to normal tissues.

A Case of Metastatic Ampulla of Vater Cancer Treated with Chemotherapy Followed by Pylorus Preserving Pancreaticoduodenectomy (항암화학요법과 수술을 통해 완전 관해를 획득한 진행성 십이지장 유두암 증례)

  • Hae Ryong Yun;Moon Jae Chung;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.75-77
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    • 2014
  • Ampulla of Vater (AOV) cancer is rare malignant tumor which arises within the vicinity of the AOV. Metastatic AOV adenocarcinoma has poor prognosis, with an overall survival rate at 2 years ranging from 5 to 10%. The Surveillance, Epidemiology and End Results Program of the National Cancer Institute indicated that lymph node metastasis was present in as many as half of patients which were associated with poor prognosis and liver was the second most common site of distant metastasis in AOV cancer. In this case report, we describe a case of complete resolution of AOV cancer, which was already spread to retroperitoneal lymph node and liver. The patient underwent gemcitabine plus cisplatin chemotherapy for palliative aim. After 12 month of chemotherapy, image study showed partial remission, so intraoperative radiofrequency ablation therapy and pylorus preserving pancreaticoduodenectomy was done. AOV cancer was completely resected and the patient was followed up without recurrence for 7 months.

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A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation (간암환자에서 고주파 열치료 후 발생한 기관지담관루 1예)

  • Lee, Ji-Hyun;Kim, Min-Su;Lee, Jae-Gon;Kim, Dae-Sik;Yang, Hae-Jin;Cho, Dae-Hyeon;Kang, Kyung-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.228-231
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    • 2012
  • Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.