Ultrasound-Guided Percutaneous Radiofrequency Ablation of Liver Tumors: How We Do It Safely and Completely

Ultrasound-guided percutaneous radiofrequency (RF) ablation has become one of the most promising local cancer therapies for both resectable and nonresectable hepatic tumors. Although RF ablation is a safe and effective technique for the treatment of liver tumors, the outcome of treatment can be closely related to the location and shape of the tumors. There may be difficulties with RF ablation of tumors that are adjacent to large vessels or extrahepatic heat-vulnerable organs and tumors in the caudate lobe, possibly resulting in major complications or treatment failure. Thus, a number of strategies have been developed to overcome these challenges, which include artificial ascites, needle track ablation, fusion imaging guidance, parallel targeting, bypass targeting, etc. Operators need to use the right strategy in the right situation to avoid the possibility of complications and incomplete thermal tissue destruction; with the right strategy, RF ablation can be performed successfully, even for hepatic tumors in high-risk locations. This article offers technical strategies that can be used to effectively perform RF ablation as well as to minimize possible complications related to the procedure with representative cases and schematic illustrations.

Epidemiologic Study on Clinical Features of Patient with Pressure Ulcer - A Prospective Study

OBJECTIVE: To investigate the characteristics, predictors, and consequences of pressure ulcers and to provide prospective epidemiologic data. METHOD: The prospective data of 100 patients with pressure ulcers were collected who were admitted to the department of rehabilitation medicine of 4 hospitals from 2002 June to 2003 September. We have collected the informations on clinical features of pressure ulcer prospectively. RESULTS: Quadriplegia/Tetraplegia was the most commonly involved type of injury, followed by hemiplegia, paraplegia. Most patients developed pressure ulcer before they were transferred to the rehabilitation unit. The average Braden scale scores was 13.06+/-3.46 and were 16 point or below in 80% of patients, and this point was considered as the cut-off score of the patients with high risk. Sacrum was the most common site of the ulcers and most ulcers were 2nd and 3rd stage. The ulcers were treated with conservative (82%) or surgical management (18%). The more severe and larger ulcers required the surgical management. CONCLUSION: The results of this prospective study on clinical features would be helpful for the understandings, prevention and management of pressure ulcers.

The Effect of Unilateral and Bilateral Superior Rectus Recession for Dissociated Vertical Deviation(DVD)

Dissociated vertical deviation(DVD)is a kind of vertical strabismus of an upward drift of a nonfixating eye, and requires operation when it is cosmetically unacceptable. The authors compared the results of unilateral superior rectus recession with those of bilateral recession in the treatment of DVD, and analyzed the effects and complications of the superior rectus recession. The charts of 58 patients(94 eyes)who underwent superior rectus recession for DVD were retrospectively reviewed, and minimum follow-up was 6 months after operation. In 22 patients, the recession was performed unilaterally, and in 36 patients bilaterally. Satisfactory alignment under 9 PD was obtained in 77.3%of the unilateral cases and 77.8%of the bilateral cases. DVDs developed in unoperated eye in 9 unilateral cases. Graduated superior rectus recession was a quite predictable and effective procedure in the treatment of DVD. In unilateral surgery, it is important to keep in mind that the unmasking of DVD in the fellow eye can occur, but unilateral surgery may be indicated if only when the obvious deviation is diagnosed preoperatively in one eye.

The Surgical Efficacy of External Dacryocystorrhinostomy

PURPOSE: To evaluate the success rate of conventional skin dacryocystorhinostomy(DCR), the success rate and postoperative complications were evaluated after the follow-up period of 6~72 months(average 16.7 months), and compared with those of our previous reports on endonasal DCR, at postoperative 6 months(PO6M) and 12 months(PO12M). METHODS: skin DCR was performed in 76 patients, 89 eyes between July 1993 and June 2000 at the Department of Ophthalmology, Yeungnam University College of Medicine. RESULTS: Primary success rate of skin DCR was 93.3%, and the final success rate after revision of mucosal ostium revealed 96.6%. Postoperative complications included 7 cases of silicone tube protrusion and 4 cases of mucosal ostium obstruction. CONCLUSIONS: Primary success rate of skin DCR was 93.3%, and those of endonasal DCR were 92.3%(PO6M) and 89.8%(PO12M). The final success rate of skin DCR was 96.6%, and those of endonasal DCR were 98.4%(PO6M) and 99.2%(PO12M).