[Anesthetic Management for a Patient with Fibromyalgia].

A 22-year-old female with fibromyalgia (FM) was scheduled for tonsillectomy under general anesthesia. Her medication included pregabalin 300 mg x day(-1) and dantrolene 50 mg x day(-1). Anesthesia was maintained with sevoflurane-remifentanil-fentanyl. Intravenous injection of fentanyl 20 µg x hr(-1) and droperidol 100 µg x hr(-1) was continued for 24 hours. On the first postoperative day, she reported that she had slept well and had no pain. There are some perioperative problems in a patient with FM. Therefore, anesthetic managements for a patient with FM is worth reporting.

[Perioperative management and postoperative complication rates of patients on dual antiplatelet therapies after coronary drug eluting stent implantation].

BACKGROUND: Few studies have examined the perioperative status of dual antiplatelet therapy and postoperative thrombotic or bleeding complication rates of patients undergoing non-cardiac surgery with recent history of coronary stent implantation. METHODS: Eight patients underwent surgery with antiplatelet therapy discontinued on both pre- and post-operative period (pre/postop group); 7 patients with only post-operative discontinuation (postop group); and 2 patients with therapy maintained (maintained group). All patients had history of coronary drug eluting stent implantation within 12 months of surgery. RESULTS: Antiplatelets were discontinued 7 days before surgery and restarted on postoperative day 7 for the pre/postop group, and on postoperative day 5 for postop group. Re-exploration due to bleeding complication was required in 1 patient in the postop group. Two or more units of red cell concentrate transfusion were required in 2 pre/postop, 3 postop, and 1 maintained group patients intraoperatively. No cardiac thrombotic complications including in-hospital stent thrombosis were observed, in line with previous reports of low stent thrombosis rates in Asian patients. CONCLUSIONS: In the present study, bleeding complications requiring transfusion were frequently observed in patients with dual antiplatelet therapy undergoing non-cardiac surgery, whereas perioperative therapy discontinuation did not trigger thrombotic complications including stent thrombosis.

Analysis of estrogen-like compounds in the environment by high performance liquid chromatography bioassay.

To identify chemicals with endocrine-disrupting activity easily, we developed a new bioassay system, consisting of bioassay using genetically modified yeast expressing human estrogen receptor and high performance liquid chromatography (HPLC), in which advantages of instrumental analysis and bioassay are combined. The peaks in the mixture of these estrogen-like compounds analyzed using an HPLC bioassay were similar to those obtained by analysis using an HPLC-UV detector. Underground water and sea sediment were analyzed by an HPLC bioassay, and detected a few estrogen-like compounds, respectively. Estrogen-like compounds and yeast-growth inhibitors can be separated by HPLC-bioassay.