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- 저자 : ( Joao Gomes Pereira ) (검색결과 2 건)
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( Joao Gomes Pereira ),( Joana Cochicho ),( Rui Baptista ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Levosimendan is a calcium sensitiser, acting by increasing the sensitivity of the heart cells to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect by binding to cardiac troponin C in a calcium-dependent manner. It also has a vasodilatory effect, by opening adenosine triphosphate (ATP)-sensitive potassium channels in vascular smooth muscle to cause smooth muscle relaxation. The combined inotropic and vasodilatory actions result in an increased force of contraction, decreased preload and decreased afterload. Moreover, by opening also the mitochondrial (ATP)-sensitive potassium channels in cardiomyocytes, the drug exerts a cardioprotective effect. Levosimendan is indicated for inotropic support in acutely-decompensated severe congestive heart failure. Having in mind the crescent use of this drug in patients with severe heart failure admitted to the ICU, it is important to assess the security and the different outcomes and cross-reference this information with the various comorbidities found in each patient. Therefore, it is possible to identify in which patients the use of levosimendam is preferred over the other various positive inotropic drugs available in the ICU, in order to establish a valuable treatment guideline.
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( Conceicao Quadrado ),( Jose Braz Nogueira ),( Joao Gomes Pereira ),( Rita Azenha Cardoso ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: To present a case of anterior abdominal wall mass in a young adult male with histopathologic diagnosis of carcinosarcoma. Design: Case Report Setting: Tertiary Hospital in Davao City, Philippines This is a case of a 22-year-old male who presented with progressive knee pain and an incidental fi nding of anterior abdominal wall mass with spinal cord compression symptoms. He underwent posterior decompression and screw fi xation of vertebra, and excision of anterior abdominal wall mass. Microscopic fi ndings of tissue specimens revealed malignant small round cell tumor. Immunohistochemical stain done on abdominal wall mass was strongly positive for cytokeratin and vimentin, negative for leukocyte common antigen (LCA), non-specifi c esterase (NSE), desmin, and chromogranin A. The stained cells were distinctive and separated but admixed which was more compatible with carcinosarcoma. The patient however succumbed to sepsis prior to further management. This paper serves to report a highly aggressive tumor in a previously- well young man whose histopathologic diagnosis with basic microscopy yielded diverse differentials. Further workup with immunohistochemistry came up with a fi nal diagnosis of carcinosarcoma in the anterior abdominal wall metastatic to bone, spine, and soft tissue in the head.
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