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Hemorrhagic Stroke and Blindness after Hyaluronic Acid/Polylactic Acid Filler Injection
Yeo Jun Yoon,Doyeon Kook,Hye Sun Choi,Jiyun Lee,Yo Han Jung 대한신경초음파학회 2023 대한신경초음파학회지 (JNN) Vol.15 No.1
The number of people receiving facial filler injections is increasing as it is relatively safe than the other cosmetic procedures. However, complications of facial filler injection range from mild redness and inflammation to cerebral infarction. We report the case of a patient who was diagnosed with cerebral infarction and intracranial hemorrhage after facial filler injection. A 61-year-old male presented to the emergency department with ocular pain and visual loss in the left eye after filler injection into the glabella. Neurological examination revealed monocular blindness. Initial brain magnetic resonance imaging (MRI) revealed small, acute multifocal infarctions in the left frontal, parietal, and temporal lobes. Follow-up MRI revealed subarachnoid hemorrhages in the left frontal and parietal lobe. Follow-up brain computed tomography showed small intracerebral hemorrhage in the left frontal lobe. Clinicians must be aware that not only cerebral infarction, but intracranial hemorrhage could also be a potential adverse effect of the cosmetic filler injection in the face.
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( Sojung Han ),( Do Young Kim ),( Ho Yeong Lim ),( Jung Hwan Yoon ),( Baek-yeol Ryoo ),( Yujeong Kim ),( Kook-hee Kim ),( Boyeon Kim ),( So Young Yi ),( Dong-sook Kim ),( Doyeon Cho ),( Jina Yu ),( Su 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The purpose of this study was to investigate the characteristics, treatment patterns including subsequent treatment and outcomes of sorafenib of whole HCC patients in South Korea. Methods: This is a retrospective, single-arm, and observational study. Data sources came from the national health insurance data. Included patients were those who had been diagnosed as HCC and received sorafenib between 1 July 2008 and 31 December 2014. A total of 9,923 patients were recruited in this study. Results: The mean age of 9,923 patients were 59 years with male predominance (84.6%). The mean HCC-prevalent duration was 663 days (22.1 months). The most common etiology of HCC was hepatitis B (66%). Before sorafenib treatment, 6,669 (67.2%) patients received other kinds of therapies for HCC including transarterial chemoembolization (TACE), resection and radiation therapy. During sorafenib therapy, 1,565 (15.8%) received combined treatment with other modalities. After sorafenib therapy, 2,591 (26.1%) patients received rescue therapies, of which TACE was the most common modality applied in 1,498 (15.1%) patients. The mean duration of sorafenib administration in all the patients was 105.7 days. In 7,159 (72.2%) patients, the initial and mean sorafenib dose were the same. There were 7,023 (70.8%) patients whose initial sorafenib dose was 600-800mg. The survival was longest in patients with recommended starting dose of 800mg, followed by dose reduction to 400mg (15.0 months). The second longest survival was demonstrated in patients with starting dose of 800mg, followed by dose reduction to 400-600mg (9.6 months). A total of 3,591 patients underwent rescue therapy after sorafenib, and the median OS was 14.5 months which were longer than 4.6 months in 7,332 patients who received supportive care after sorafenib. The most commonly applied treatment after sorafenib was TACE (30.8%). Conclusions: Real-life data show that the efficacy of sorafenib seems to be similar with that in clinical trials. Appropriate subsequent therapy after sorafenib might prolong the patient survival.
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