Acute Renal Failure due to Rhabdomyolysis Following Laparoscopic Cholecystectomy in a Post-Thyroidectomy Patient: A case report / 대한마취과학회지

Anesthesia in post-thyroidectomy patients carries the risk of potential complications such as the depression of myocardial function, decreased spontaneous ventilation, abnormal baroreceptor function, reduced plasma volume, anemia, hypoglycemia, hyponatremia, and impaired hepatic drug metabolism. In addition, these patients may be complicated by pigment induced acute renal failure such as rhabdomyolysis. Rhabdomyolysis is a common syndrome in which injury to skeletal muscle results in the leakage of intracellular contents from myocytes into plasma. Moreover, massive rhabdomyolysis can produce life-threatening disseminated intravascular coagulation, myoglobinuric renal failure, acute cardiomyopathy, and various other complications. We experienced a case of acute renal failure caused by rhabdomyolysis during emergence from anesthesia in a post-thyroidectomy patient.

Inhibitory Effect of Tranilast on the Proliferation of Human Conjunctival Epithelial Cells and Subconjunctival Fibroblasts

PURPOSE: Tanilast has been clinically used for various allergic diseases. Recently, it has also been found to inhibit excessive scarring in wound healing process. The purpose of this study is to investigate the inhibitory effect of Tranilast on the proliferation of human conjunctival epithelial cells and subconjunctival fibroblasts. METHODS: Human conjunctival epithelial cells and subconjunctival fibroblasts were exposed for 24 hours to Tranilast 0.05, 0.2, 0.4, 0.8, and 1.6 mg/ml. MTT based calorimetric assay was performed to assess the metabolic activity and inhibition of cellular proliferation. RESULTS: As the concentration of Tranilast increased, the absorbance of spectrometer decreased. Inhibitory effect of cellular proliferation was stronger in subconjunctival fibroblasts than in conjunctival epithelial cells. The inhibitory effect of celluar proliferation in conjunctival epithelial cells was 75%, 66%, 64%, 59%, and 39% at 0.05, 0.2, 0.4, 0.8, and 1.6 mg/ml, respectively (LD50 was 0.9 mg/ml). In subconjunctival fibroblasts, the inhibitory effect of celluar proliferation was 66%, 62%, 47%, 33%, and 23% at 0.05, 0.2, 0.4, 0.8, and 1.6 mg/ml, respectively (LD50 was 0.3 mg/ml). CONCLUSION: Tranilast may prevent excessive proliferation of both human conjunctival epithelial cells and subconjunctival fibroblasts. This inhibitory effect on cellular proliferation was higher in subconjunctival fibroblasts than in conjunctival epithelial cells, suggesting the possibility of being used after glaucoma filtering surgery or pterygium excision.

Vasovagal Syncope during a Caudal Epidural Block in a Patient with Vertebral Fractures: A case report / 대한마취과학회지

Age-related vertebral fractures occur frequently in the elderly recently. An epidural block has been introduced as an effective management for the treatment of pain with vertebral compression fractures. While an epidural block is considered to be reasonably safe, serious complications may occur even when this invasive procedure is related to pain. Vasovagally mediated episodes of hypotension and bradycardia are thought to be a common cause of recurrent unexplained syncope. Precipitating factors include pain, trauma, fatigue, blood loss, or prolonged motionless standing. We report one case of vasovagal syncope associated with severe bradycardia and hypotension in a 78 year-old male patient with vertebral fractures. Syncopal attacks occurred during a caudal epidural block. The patient was resuscitated successfully and recovered without any adverse effects.