• Title/Summary/Keyword: High Intensity Focused Ultrasound

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Ultrasonic dissection versus electrocautery for immediate prosthetic breast reconstruction

  • Lee, Dongeun;Jung, Bok Ki;Roh, Tai Suk;Kim, Young Seok
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.20-25
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    • 2020
  • Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

A Non-Invasive Ultrasonic Urinary Bladder Internal Pressure Monitoring Technique: Its Theoretical Foundation and Feasibility Test (비침습적 초음파 방광 내압 측정 기술: 이론적 기초 및 실현 가능성 평가)

  • Choi, Min Joo;Kang, Gwan Suk;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.526-539
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    • 2012
  • A new approach was proposed in this article, named, a non-invasive ultrasonic method to monitor the urinary bladder internal pressure which can resolve the shortcomings of the existing methods. The proposed method makes use of acoustic cavitation. It is based on a physical phenomenon that an extracorporeal high intensity focused ultrasonic pulse generates bubbles inside the urinary bladder and the dynamic properties of the bubbles are related to the urinary bladder internal pressure. The article presents the theoretical foundation for the proposed technique and verifies its feasibility with preliminary experimental data. The suggested ultrasonic urinary bladder internal pressure monitoring method is non-invasive and can be used any time regardless of sex and age, so that it will be of a great benefit to the diagnosis and therapy of urination related diseases.

Clinical Outcome of Treatment for Stage IIA, IIB and III Osteosarcomas (Comparative Studies between Invasive Surgical Treatment and Non-invasive HIFU Technique) (진행된 장관골 골육종의 수술 및 비수술적 강력 집속 초음파 치료의 장기 추적 결과)

  • Wenzhi, Chen;Wei, Wang;Zhibiao, Wang;Hui, Zhu;Kequan, Li;Hao, Piao Xiang;Haibing, Su;Chengbing, Jin;Feng, Wu;Jin, Bai;Rhee, Seung-Koo;Kang, Yong-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Huh, Sung-Woo;Lee, Eun-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.37-46
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    • 2006
  • Purpose: To evaluate the end results between the surgical treatment with neo-adjuvant chemotherapy in Korea and non-invasive high intensity focused ultrasound (HIFU) technique in China for osteogenic sarcomas. Materials and Methods: The surgical treatment with neoadjuvant chemotherapy for total 67 cases (4 IIA, 58 IIB, and 5 III) in Korea since 1993 and the HIFU therapy for total 71 cases (57 II and 14 III) in China since 1997 was performed. In Korea, neo-adjuvant chemotherapy in 66 cases out of total 67 patients, but the adjuvant chemotherapy in only one case was done. On the contrary, in China, full chemotherapy for more than 9 times for 37 patients with stage II out of total 71 cases, but for less than 8 times of partial chemotherapy for 23 patients (stage II) and 14 patients (stage III) was done. The surgical treatment in total 67 Korean patients was done with wide resection and reconstruction for 56 patients, but wide resection without reconstruction for 5 patients and amputation for 6 patients. In china, total 71 patients was treated with average 1.5 times (1~4 times) of HIFU, and if there are some evidences of residual tumor after HIFU with following MRI, the second HIFU therapy was given 2~4 weeks later. After then, the bony defect was in no touch, keep bracing for long time expecting regeneration. All of them were followed for average 46 Mo (12~150 Mo) in Korea, but followed for average 22 Mo (9 years~8 months) in China. Results: The 5 year survival rate (stage II), was average 92.7% (IIA 100%, IIB 85.5%) in Korea series, and average 78.7% (full chemotherapy 91.8%, part chemotherapy 56.6%) in China series. The 3 year survival rate (stage III) was 20% in Korea and 7.1% in China. So, the final overall survival rate was 65.2% in Korea and 51.8% in China. The overall functional outcome score by ISOLS was 24.3 (81%) in Korea and 19.8 (73%) in China. There are 25.4% (17/67 cases) of complications in Korea and 31% (27 complications in 22 patients out of total 71 cases) in China after each treatment. Conclusions: The end results of Korea series which was treated with neoadjuvant chemo- and surgical methods are better than that of non-invasive thermal ablation in china. But we also believe the HIFU, as one of, was also effective to decrease the local recurrence and symptomatic releaf for stage II or even in III of osteogenic sarcomas.

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Cavitation suppression through the modification of spectral characteristics in the field of high intensity focused ultrasound (주파수 특성 변환을 통한 고강도 집속형 초음파 공동 현상의 억제)

  • 최민주
    • Proceedings of the Acoustical Society of Korea Conference
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    • 1998.06c
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    • pp.449-454
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    • 1998
  • 전립선 비대증 및 각종 고형암 조직을 제거하기 위해 이용되는 고강도 집속형 초음파 시스템은 초음파의 조직에 대한 열 효과를 이용한다. 이 경우 수MPa의 고 압력 초음파를 사용하기 때문에 수술시 초음파에 의한 조직내의 공동 현상이 수반되고 이로 인해 초음파의 집속 효과가 감소하게 된다. 본 논문에서는 초음파 공동 현상을 억제하기 위하여 초음파의 주파수 특성을 고려하였다. 초음파의 크기는 일정하게 유지하면서 증가하는 주파수로 변조된 초음파와 비선형 고저파 (nonlinear harmonics) 성분을 포함한 왜곡된 초음파에 대한 기포의 반응을 Gilmore 기포 모델을 이용하여 관찰하였다. 초음파의 주파수 변조는 10 $\mu\textrm{s}$ 동안 초기 주파수 1 MHz부터 시작하여 7 MHz까지 선형적으로 증가하도록 하였다. 파형을 왜곡시키는 고저파 성분의 크기는 주파수에 역 비례 하도록 하였다. 초음파의 기본 주파수는 1 MHz로 하였고, 압력은 0.1 MPa과 1 MPa의 두 경우를 고려하였다. 초기 기포의 반경은 1 $\mu\textrm{m}$으로 하였고, 기포 주위의 유체는 물로 가정하였다. 시뮬레이션 결과로부터, 주파수를 변조시키거나 파형을 왜곡시킨 초음파에 대한 기포의 진동은, 동일한 압력의 정현파에 대한 경우 보다 작은 것으로 나타났다. 주파수 변조된 초음파에 반응한 기포의 진동은 압력이 낮을 때 (0.1 MPa), 변조된 주파수가 기포의 공진 주파수인 3 MHz 부근에서 최대치를 보이다가 이후 급격히 감소하는 경향을 보였다. 반면, 압력이 높아지면 (1 MPa) 기포의 진동은 주파수의 증가와 함께 감소하다가 3 MHz 이상으로 변조 될 경우, 유의한 변화를 보이지 않는 것으로 나타났다. 이 결과는 초음파의 적절한 주파수 성분 조절로 초음파 공동 현상을 일정 수준 억제할 수 있음을 시사한다. 고려가 수반되어야 할 것으로 보인다. 다음 내용을 정리해 보고자 한다.리해 보고자 한다.rc$ 구입할 때 중점적으로 살펴보는 사항은 신선도와 순수재래종 여부, 위생상태였다. 한편 소비자가 언제나 구입할 수 없다는 의견이 85.2%나 되어 원활한 공급과 시장조성이 아직 정착되지 않고 있었다. $\bigcirc$ 현재 유통되고 있는 재래종닭은 소비자 대부분이 잡종으로 인식하고 있었으며, 재래종과 일반육계와의 구별은 깃털색, 피부색, 정강이색등 외관상으로 구별하고 있었다. 체중에 대한 반응은 너무 작다는 의견이었고, 식품으로의 인식도는 비교적 고급식품으로 인식하고 있다. $\bigcirc$ 재래종닭고기의 브랜드화에 대한 견해는 젊고 소득이 높은 계층에서 브랜드화의 필요성을 강조하고 있다. $\bigcirc$ 재래종달걀의 소비형태는 대부분의 소비자가 좋아하였으나 아직 먹어보지 못한 응답자가 많았다. 재래종달걀의 맛에 대해서는 고소하고 독특하여 차별성을 느끼고 있었다. $\bigcirc$ 재래종달걀의 구입장소는 계란판매점(축협.농협), 슈퍼, 백화점, 재래닭 사육 농장등 다양하였으며 포장단위는 10개를 가장 선호하였고, 포장재료는 종이, 플라스틱, 짚의 순으로 좋아하였다. $\bigcirc$ 달걀의 가격은 200원정도를 적정하다고 하였으며, 크기는 (평균 52g)는 가장 적당하다고 인식하고 있으며, 난각색은 대부분의 응답자가 갈색을 선호하였다. $\bigcirc$ 재래종달걀의 구입시 애로사항은 믿을수 없고, 구입장소를 몰라서, 값이 싸다 등이었고, 앞으로 신뢰할 수 있고 위생적인 생산 및 유통체계가 확립될 경우 더 많이 소비하겠다는 의견이었다. $\bigcirc$ 재래닭 판매업소(식당)의 판매형태는 66.7%인 대부분

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Dynamic Contrast-Enhanced MR Imaging in Detecting Local Tumor Progression after HIFU Ablation of Localized Prostate Cancer (국소적 전립선암의 고강도 집속 초음파 치료 후 국소적 암 재발의 발견과 역동적 조영증강 자기공명영상의 역할)

  • Park, Jung Jae;Kim, Chan Kyo;Lee, Hyun Moo;Park, Byung Kwan;Park, Sung Yoon
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.192-199
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    • 2013
  • Purpose : To retrospectively evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging (DCE-MRI) in detecting recurrent prostate cancer after HIFU of clinically localized cancer, as compared with T2-weighted imaging (T2WI). Materials and Methods: Twenty-six patients with increased prostate-specific antigen levels after HIFU were included in this study. All MR examinations were performed using T2WI and DCE-MRI, followed by transrectal ultrasound-guided biopsy. MRI and biopsy results were correlated in six prostate sectors. Residual or recurrent cancer after HIFU was defined as local tumor progression if biopsy results showed any cancer foci. Two independent readers interpreted the MR images. Results: Of 156 prostate sectors, 51 (33%) were positive for cancer in 17 patients. For detecting local tumor progression, the sensitivity of DCE-MRI and T2WI was 80% and 57% for reader 1 (P < 0.001) versus 84% and 61% for reader 2 (P < 0.001), respectively. The specificity and overall accuracy between DCE-MRI and T2WI showed no statistical difference in both readers (P > 0.05). Interobserver agreement of DCE-MRI and T2WI was moderate and fair, respectively. Conclusion: For detecting local tumor progression of prostate cancer after HIFU, DCE-MRI was more sensitive than T2WI, with less interobserver variability.