Therapeutic effects of radio frequency ablation in lung tumor treatment

Radiofrequencyablation(RFA)isarecentlyde-velopedsystemthatprovidesanewapproachforthetreatmentofpatientswithunresectablemalignanttu-mor.Aninsulatedneedleelectrodethatcontains10fineneedleswithinentersthetumortissueunderCTguidanceandthe10fineneedlesstretchasanumbrel-lacoveringanareaapproximately3.5cmindiameter,beforearadiofrequencygeneratortransmitshigh-en-ergyradiofrequencypulsesthroughthewiretothefineneedles.Theenergyreleasedattheneedlepointcantriggerionicagitationandfrictionalheattopro-ducea…     

CT引导经皮肺穿刺锚状电极高温射频消融治疗肺部肿瘤105例

目的 观察ＣＴ引导经皮肺穿刺高温射频消融治疗１０５例肺部恶性肿瘤的近期效果。方法 ＣＴ引导经皮肺穿刺,可扩展锚状电极配合ＲＦ－２０００仪高温射频消融治疗原发性肺癌８１例,肺部转移瘤２４例,共计２４２个肿瘤,每个肿瘤治疗３～８次,持续时间３～３３７ｍｉｎ。结果 完全缓解（ＣＲ）率１１．１％,部分缓解（ＰＲ）率７１．１％,轻微疗效（ＭＲ）率１３．２％,无改变（ＮＣ）率４．５％,其中ＣＲ＋ＰＲ率为８２．     

Hard tissue laser ablation mechanisms

The aim of this work is the experimental and theoretical investigation of the influence of variable laser parameters (wavelength, fluence, pulse repetition rate) and of the optical and thermophysical properties of bone tissue (absorption coefficient, tissue inhomogeneity) as well as of the sample thickness on ablation thresholds and ablation rate. Ablation and perforation experiments were conducted using a semiconductively pre-ionized transverse excitation atmospheric pressure (TEA) carbon dioxide (CO₂) laser (10.6m and a sliding discharge TEA [hydrogen fluoride (HF)] laser (2.9m). The experimental data are discussed with respect to the following ablation mechanisms: thermal melting and vaporization process, pressure oscillation of gases released by the thermal decomposition of collagen and/or apatite, stresses due to the expansion of superheated water.     

Radiofrequency ablation in children

Radiofrequency (RF) catheter ablation has ushered in a new era in the management of patients with symptomatic tachyarrhythmias. By providing the ability to cure the underlying arrhythmic substrate, RF catheter ablation obviates the need for life-long antiarrhythmic drugs. In the reported series, the success has been high and the complications have been infrequent and relatively minor. Not unexpectedly, RF catheter ablation has become the treatment of choice for patients with symptomatic paroxysmal tachyarrhythmias. The role of radiofrequency catheter ablation in infants and small children remains controversial, and awaits a larger experience and longer follow-up data.     

螺旋CT导航多弹头射频消融肝癌的临床应用

目的 探讨并总结螺旋CT导航经皮肝穿刺多弹头射频消融肝癌的特点、安全性及临床近期疗效。方法 对20例肝细胞肝癌及多发肝转移瘤共32个瘤灶在螺旋CT导航下,配合自制穿刺定位定角器,进行了多弹头射频治疗,共消融49个靶位,通过对治疗前后及随访3-8个月的螺旋CT检查的比较及AFP、自觉症状等的改变进行对比观察。结果 20例患者,49个靶位,一次性穿刺及消融操作技术成功率达100％,复查螺旋CT检查:术毕时20例(100％)瘤灶密度减低,其中15例(占75％)病灶内见散在气化影;术后2个月时,20例中的16例(占80％)瘤灶体积缩小10％-20％,增强扫描动脉期瘤灶不强化。另3例瘤灶体积缩小不明显,但动脉期不强化;1例瘤灶略显增大,系邻近门静脉一侧,消融不彻底,病灶呈偏向门静脉一侧生长,动脉期轻度强化;术后6个月时,20例中的8例(占40％)瘤灶体积缩小达20％-30％,动脉期不强化。1例于治疗术后6.5个月死于肝、脑、肺多发转多。术后1个月复查血AFP,20例中13例(占65％)下降,下降值40-210μg/ml,平均下降135.6μg/ml,其中有2例降至正常范围。治疗后2个月内所有患者自觉症状均明显改善。无手术死亡,术中及术后不良反应轻微,无重要并发症发生。结论经皮多弹头射频消融术,是一种安全、可靠、微创的局部疗法,具有较高的临床应用价值。采?     

Histological findings after angioplasty using conventional balloon, radiofrequency thermal balloon, and stent for experimental aortic coarctation

Abstract Background : Use of balloon angioplasty or stent implantation has been reported to be effective in relieving coarctation of the aorta. However, restenosis frequently occurs after balloon angioplasty for native aortic coarctation in small infants, and sometimes develops after stent implantation because of vessel growth. The causes of restenosis remain uncertain. The purpose of this study was to assess the histologic differences in vascular responses to angioplasty using conventional balloon, radiofrequency thermal balloon (RFTB), or stent for experimental aortic coarctation. Methods : The authors surgically created an aortic coarctation model using 14 puppies. Angioplasty using conventional balloon, RFTB, or stent was performed 1 month after the initial operation. At the acute or chronic phase after angioplasty, the animals were killed and histologic studies were performed. Results : More vascular injuries were noted in the specimens from animals undergoing conventional angioplasty than in those with RFTB or stent. However, neointimal hyperplasia was seen more often after RFTB or stent because of the proliferation of smooth muscle cells from the tunica media, caused by secretion of growth factors. Apoptosis reached a peak 1?2 weeks after angioplasty, regardless of the type of intervention. Conclusions : The authors conclude that angioplasty with RFTB or stent can provide relatively small injuries in the vessel wall for aortic coarctation, but care must be taken to prevent restenosis caused by intimal hyperplasia, because neointima hyperplasia is more frequent after RFTB or stent.     

16层螺旋CT在心房颤动射频消融术前的应用测量

目的研究心房颤动导管射频消融肺静脉电隔离术前左心房、肺静脉和食管16层螺旋CT成像技术及临床意义。资料与方法40例心房颤动患者在术前1-3天行多层螺旋CT（MSCT）检查,采用容积再现（VR）、多平面重组（MPR）及最大密度投影（MIP）等方法重组并测量各肺静脉口直径、左心房至肺静脉第一分支的距离、食管与左心房后壁接触的范围、食管壁厚度、左心房后壁厚度以及左心房与食管间的脂肪垫厚度。结果共显示肺静脉165支,右上肺静脉口前后径和上下径分别为（16.3±3.1）mm和（19.0±2.6）mm;右下肺静脉分别为（16.4±3.6）mm和（18.0±3.5）mm;左上肺静脉分别为（14.4±3.0）mm和（18.4±3.6）mm;左下肺静脉分别为（12.6±2.8）mm和（17.0±2.8）mm。食管与左心房后壁接触的平均长度为（56±12）mm,在双上、下肺静脉水平与左心房后壁接触的食管平均宽度分别为（10±5）mm和（14±5）mm。60%的食管位于左心房后壁中线偏左,大致与左上、下肺静脉口平行;40%的食管沿左上肺静脉向右下肺静脉斜行走行。左心房后壁和食管前壁的平均厚度分别为（2.2±0.8）mm和（3.5±1.6）mm。95%的左心房与食管间可见脂肪垫,其平均厚度为（0.8±0.2）mm。结论应用MSCT造影增强扫描可清楚显示各肺静脉口直径、分支特征、走行以及有无发育畸形,同时还能评价食管与左心房的关系,为心房颤动导管射频消融术的顺利实施提供重要解剖依据。     

持续性心房颤动导管消融前后血浆脑钠肽水平的变化

目的 观察持续性心房颤动(简称房颤)导管消融前后血浆脑钠肽(BNP)水平的变化.方法 测定68例持续性房颤且无器质性心脏病患者导管消融术前及术后90 d的血浆BNP水平.结果 在导管消融后大于3个月的随访中,12例(18%)患者复发心房扑动或房颤.导管消融后3个月血浆BNP水平由术前(80±17)ng/L降为(27±9)ng/L,与术前比较差异有统计学意义(P＜0.01).12例复发房性心律失常患者中,术后血浆BNP为(44±8)ng/L,而维持窦性心律者术后血浆BNP为(25±8)ng/L,两者差异有统计学意义(P＜0.01).结论 持续性房颤导管消融后BNP水平下降,且术后维持窦性心律组BNP水平明显低于复发房性心律失常组.     

A technique for periorbital syringomas: intralesional radiofrequency ablation

AIM: To evaluate the efficacy of intralesional radiofrequency ablation in the treatment of periorbital syringomas. METHODS: We tried the intralesional radiofrequency ablation for 64 patients with periorbital syringomas from 2007 to 2011. The operation was performed under 2.5 loupe magnifications. The handpiece was assembled with a needle electrode and connected to the radiofrequency ablation apparatus. The electrode was then inserted into the target lesions in dermis and delivering injury to the base of these tumors. Results were assessed clinically by comparing pre- and post-treatment photographs and patient satisfaction rates. RESULTS: Clinical improvement increased with each subsequent treatment session. The percent of patients whose clinic improvement grade were≥3 after each session was respectively 71.9%(Session1), 83.3%(Session2), and 100%(Session3). The statistical results indicated the concordance of the clinical assessment and the satisfaction level of patients (kappa=0.78 of the session1; kappa=0.82 of the session2). The majority of patients had good or excellent cosmetic results. Postoperatively, there were no permanent side effects or recurrences. CONCLUSION: As a new technique of minimally invasion, the intralesional radiofrequency ablation was found to be an effective, inexpensive, highly precise and safe way of treating periorbital syringomas.