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Myung-hwan Kim - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic ultrasound-guided Radiofrequency ablation for management of benign solid pancreatic tumors.
Endoscopy, 2018Co-Authors: Joon Hyuk Choi, Dong Wan Seo, Hyun Park, Sang Soo Lee, Sung Koo Lee, Tae-jin Song, Myung-hwan KimAbstract:Background Radiofrequency ablation (RFA) has been increasingly employed in experimental and clinical settings for the management of pancreatic lesions. This study aimed to assess the safety and efficacy of endoscopic ultrasound (EUS)-guided RFA for benign solid pancreatic tumors. Methods In a single-center, prospective study, 10 patients with benign solid pancreatic tumors underwent EUS-RFA. After the RFA electrode had been inserted into the pancreatic mass, the Radiofrequency Generator was activated to deliver 50 W of ablation power. Results Among the 10 patients, 16 sessions of EUS-RFA were successfully performed. Diagnoses included nonfunctioning neuroendocrine tumor (n = 7), solid pseudopapillary neoplasm (n = 2), and insulinoma (n = 1); the median largest diameter of the tumors was 20 mm (range 8 – 28 mm). During follow-up (median 13 months), radiologic complete response was achieved in seven patients. Two adverse events (12.4 %; 1 moderate and 1 mild) occurred. Conclusions EUS-RFA may be a safe and potentially effective treatment option in selected patients with benign solid pancreatic tumors. Multiple sessions may be required if there is a remnant tumor, and adverse events must be carefully monitored.
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Initial experience of EUS-guided Radiofrequency ablation of unresectable pancreatic cancer
Gastrointestinal endoscopy, 2015Co-Authors: Tae Jun Song, Dong Wan Seo, Sundeep Lakhtakia, Nageshwar D. Reddy, Hyun Park, Sang Soo Lee, Sung Koo Lee, Myung-hwan KimAbstract:Background and Aims Radiofrequency ablation (RFA) has been used as a valuable treatment modality for various unresectable malignancies. EUS-guided Radiofrequency ablation (EUS-RFA) of the porcine pancreas was reported to be feasible and safe in our previous study, suggesting that EUS-RFA may be applicable as an adjunct and effective alternative treatment method for unresectable pancreatic cancer. This study aimed to assess the technical feasibility and safety of EUS-RFA for unresectable pancreatic cancer. Methods An 18-gauge endoscopic RFA electrode and a Radiofrequency Generator were used for the procedure. The length of the exposed tip of the RFA electrode was 10 mm. After insertion of the RFA electrode into the mass, the Radiofrequency Generator was activated to deliver 20 to 50 W ablation power for 10 seconds. Depending on tumor size, the procedure was repeated to sufficiently cover the tumor. Results EUS-RFA was performed successfully in all 6 patients (median age 62 years, range 43-73 years). Pancreatic cancer was located in the head (n = 4) or body (n = 2) of the pancreas. The median diameter of masses was 3.8 cm (range 3cm-9cm). Four patients had stage 3 disease, and 2 patients had stage 4 disease. After the procedure, 2 patients experienced mild abdominal pain, but there were no other adverse events such as pancreatitis or bleeding. Conclusions EUS-RFA could be a technically feasible and safe option for patients with unresectable pancreatic cancer.
Jeong Hyun Lee - One of the best experts on this subject based on the ideXlab platform.
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Locoregional Control of Metastatic Well-Differentiated Thyroid Cancer by Ultrasound-Guided Radiofrequency Ablation
AJR. American journal of roentgenology, 2011Co-Authors: Jung Hwan Baek, Jin Yong Sung, Yoon Suk Kim, Hoon Choi, Jeong Hyun LeeAbstract:OBJECTIVE. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided Radiofrequency ablation (RFA) in the control of metastatic well-differentiated thyroid carcinoma in patients for whom surgery is not feasible. MATERIALS AND METHODS. Between December 2004 and June 2008, 12 metastatic differentiated thyroid carcinomas (mean diameter, 13.8 mm; range, 4–28 mm) in 10 patients (six women, four men; mean age, 44.8 years) were treated with RFA. The inclusion criteria for RFA were fewer than three metastatic tumors confirmed with ultrasound-guided fine-needle aspiration biopsy, no metastatic tumor beyond the neck at RFA, and infeasibility of surgery. A Radiofrequency Generator and 18-gauge internally cooled electrodes with a 7-cm shaft length and 0.5- and 1-cm active tips were used depending on the size of the targeted tumors. Ten of the 12 metastatic tumors (83%) were treated in a single session of RFA, and the other two required two sessions. The ablation time ranged from 60 to 900...
Heinrich Kreuzer - One of the best experts on this subject based on the ideXlab platform.
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Radiofrequency catheter ablation in recurrent ventricular tachycardia.
European heart journal, 1991Co-Authors: Bernd-dieter Gonska, S. Brune, K P Bethge, Heinrich KreuzerAbstract:Catheter ablation by Radiofrequency energy was carried out in 10 patients with one type of recurrent monomorphic sustained ventricular tachycardia resistant to medical antiarrhythmic management. Electrophysiological studies before ablation included activation and pace-mapping. In all patients, the origin of the tachycardia was localized in the left ventricle: in the septum in six, at the posterolateral wall in three and anterobasal in one. The earliest onset of endocardial activation preceding the QRS complex during ventricular tachycardia ranged between -45 and -90 ms. Transcatheter ablation was performed with a bipolar or quadripolar catheter using a Radiofrequency Generator (HAT 100, Osypka). No complications occurred during the ablation procedure. Thereafter, in all patients, the clinical tachycardia was no longer inducible by programmed stimulation. During a follow-up period of 22 to 32 months including eight patients, the tachycardia recurred in two; one of these patients subsequently died suddenly. A third patient had one episode of a new type of sustained ventricular tachycardia some hours after catheter ablation. In the remaining patients, there was no recurrence of symptomatic tachycardia under maintenance of the antiarrhythmic management which, prior to ablation had been ineffective. Thus, our preliminary results suggest that Radiofrequency catheter ablation might be beneficial for these high risk patients.
Jung Hwan Baek - One of the best experts on this subject based on the ideXlab platform.
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Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology North American Hyperthermia Group, 2016Co-Authors: Ji Hoon Kim, Jung Hwan Baek, Jin Yong Sung, Hye Sook Min, Kyung Won Kim, J. Hun Hah, Joon Park, Kwang Hyun Kim, Bo Youn ChoAbstract:AbstractPurpose: The purpose of this study is to retrospectively evaluate the outcomes of Radiofrequency ablation (RFA) of low-risk small papillary thyroid carcinomas (PTCs) in patients who were ineligible for surgery.Materials and methods: Between 2005 and 2009, six PTCs (mean diameter, 0.92 cm; range, 0.6–1.3 cm) in six patients were treated with RFA by three radiologists in two hospitals. The inclusion criteria for this study were (1) pathologically confirmed PTC without cytological aggressiveness, (2) single PTC without extrathyroidal extension, (3) no metastatic tumours and (4) ineligibility for surgery. RFA was performed using a Radiofrequency Generator and an 18-gauge internally cooled electrode. The medical records were reviewed and analysed, focussing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in tumours on follow-up ultrasonography.Results: Before and after RFA, the results of thyroid function tests were normal in all patients. During 48.5 ± 1...
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Locoregional Control of Metastatic Well-Differentiated Thyroid Cancer by Ultrasound-Guided Radiofrequency Ablation
AJR. American journal of roentgenology, 2011Co-Authors: Jung Hwan Baek, Jin Yong Sung, Yoon Suk Kim, Hoon Choi, Jeong Hyun LeeAbstract:OBJECTIVE. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided Radiofrequency ablation (RFA) in the control of metastatic well-differentiated thyroid carcinoma in patients for whom surgery is not feasible. MATERIALS AND METHODS. Between December 2004 and June 2008, 12 metastatic differentiated thyroid carcinomas (mean diameter, 13.8 mm; range, 4–28 mm) in 10 patients (six women, four men; mean age, 44.8 years) were treated with RFA. The inclusion criteria for RFA were fewer than three metastatic tumors confirmed with ultrasound-guided fine-needle aspiration biopsy, no metastatic tumor beyond the neck at RFA, and infeasibility of surgery. A Radiofrequency Generator and 18-gauge internally cooled electrodes with a 7-cm shaft length and 0.5- and 1-cm active tips were used depending on the size of the targeted tumors. Ten of the 12 metastatic tumors (83%) were treated in a single session of RFA, and the other two required two sessions. The ablation time ranged from 60 to 900...
Pravin J. Gupta - One of the best experts on this subject based on the ideXlab platform.
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Advanced grades of bleeding hemorrhoids in a young boy.
European review for medical and pharmacological sciences, 2007Co-Authors: Pravin J. GuptaAbstract:We report a case of advanced grades of bleeding hemorrhoids in a 10-yrs-old boy, who had a history of bleeding per rectum since he was 5 year of age. The diagnosis was made on anoscopic examination after ruling out other colorectal pathologies by a full-length colonoscopy. There was no evidence of portal hypertension. He was successfully treated with Radiofrequency ablation and plication of hemorrhoids using a Ellman Radiofrequency Generator. Though rare to be found at the age of ten years without any obvious etiology, hemorrhoids should be considered as one of the causes of bleeding per rectum in children.
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Combined Thiersch’s Procedure and Subanodermal Coagulation for Complete Rectal Prolapse in the Elderly
Digestive surgery, 2006Co-Authors: Pravin J. GuptaAbstract:Background: The author describes a modification of Thiersch’s procedure in patients with complete rectal prolapse by inducing fibrosis at the anal verge through circumferential subanodermal coagulation using a Radiofrequency device. Materials and Methods: An Ellman Radiofrequency Generator was used for coagulation. The postoperative events were recorded. The patients were followed over a period of 2 years to assess late outcome. Results: Postoperative complications were observed in 2 patients. One of these developed suppuration in the tract of the encircling wire that needed removal, while the other had a recurrence due to loosening of the wire. At a 2-year follow-up, 3 patients developed recurrence while 1 had a persistent complaint of fecal incontinence. Conclusion: This study shows that a combined procedure of Radiofrequency coagulation followed by Thiersch’s circumanal wiring is quick and easy to perform with no formidable morbidity in elderly patients who are otherwise considered at high risk for definitive surgical procedures.
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Radiofrequency surgery--novel techniques in the treatment of ano-rectal disease.
Acta chirurgica Iugoslavica, 2006Co-Authors: Pravin J. GuptaAbstract:Background: Radiofrequency surgery is a method of utilizing high frequency (3.8 to 4MHz) radio wave energy to incise, excise, or coagulate tissues. Radiofrequency (RF) is a relatively new modality that is being used for ano-rectal surgeries with increasing frequency. As the RF energy is applied, frictional heating of tissues results, with cell death occurring at temperatures between 60 and 1000 C. Objective- This paper discusses author’s clinical experience with Radiofrequency for various ano-rectal pathologies namely hemorrhoids, anal fistula, anal polyps, sinuses and anal papillae. A Ellman dual frequency Radiofrequency Generator was used to carry out the procedures. This study is intended to be somewhat of a "how we do it" manual, explaining the principles of Radiofrequency. Conclusion: Radiofrequency proctological procedures are simple to perform with many advantages over the more traditional techniques. The procedures take less operative time, the postoperative recovery is accelerated and the incidences of complications are negligible.
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Randomized controlled study: Radiofrequency coagulation and plication versus ligation and excision technique for rectal mucosal prolapse
American journal of surgery, 2006Co-Authors: Pravin J. GuptaAbstract:Abstract Background A novel technique of Radiofrequency ablation and plication of the rectal mucosa (RAMP) as a treatment for rectal mucosal prolapse is reported. The results of this technique are compared with the conventional ligature and excision procedure (LEP). Methods Radiofrequency ablation was performed using an Ellman Radiofrequency Generator. Patients with rectal mucosal prolapse were randomized to undergo either LEP or RAMP. The intra- and postoperative outcomes and complications were recorded. Results RAMP on average resulted in reduced operation time, shorter hospitalization, and significantly less postoperative pain. Return to work was earlier and wound healing times were shorter than that of patients in the control group. The complication rates also were significantly shorter (9% in the RAMP group and 29% in the conventional LEP group). Conclusion The procedure of Radiofrequency ablation and plication of rectal mucosa is safe, effective, and swift. It can be proposed as an effective alternative to conventional surgical procedures.
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Radiofrequency ablation and plication--a new technique for prolapsing hemorrhoidal disease.
Current surgery, 2006Co-Authors: Pravin J. Gupta, P. S. Heda, Surekha KalaskarAbstract:Background The author describes a modified procedure of ablation with a Radiofrequency device and plication of the hemorrhoidal mass for prolapsing hemorrhoids. The study is aimed at ascertaining if this procedure provides any advantages over the conventional hemorrhoid surgery. Materials and methods Two different studies are included. The first study describes 600 serial patients with prolapsing hemorrhoids treated with this technique over a period of 18 months. An Ellman Radiofrequency Generator was used for the ablation of the hemorrhoids. The operative technique and postoperative outcome is reported. The second study compares this technique with standard Milligan–Morgan hemorrhoidectomy in a randomized trial of 100 patients. Results With this new procedure, the post-defecation pain and pain at rest were within tolerable limits (pain scores 1 to 4 on visual analog scale). Post-defecation bleeding was present in 60% of the patients. Pruritus and perianal thrombosis were complained by few others. No patient encountered any incontinence, prolapse, or stenosis. The comparative study showed definite advantages of this modified technique over Milligan–Morgan hemorrhoidectomy. Conclusion The procedure of Radiofrequency ablation and plication of hemorrhoids restricts the hospital stay to only a few hours and provides rapid physical recovery. It does seem to be a better alternative to the conventional surgical procedures in terms of postoperative pain, return to work, and complications.