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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Maligne Hyperthermie ; Halothan ; Koffein ; Serotonin ; in vitro-Kontrakturtest ; Key words Malignant hyperthermia ; Halothane ; Caffeine ; Serotonin ; In vitro contracture test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract In pigs genetically susceptible to malignant hyperthermia (MH), it has been shown that serotonin (5-HT2) receptor agonists can induce MH and “psychotic” behaviour. Both can be prevented by 5-HT2 receptor antagonists. Furthermore, free levels of serotonin in plasma increased concomitantly with clinical and laboratory parameters during halothane-induced MH in pigs. In this study the in vitro-effects of the 5-HT2 receptor agonist1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) were investigated in muscle specimens of MH-susceptible (MHS) and normal (MHN) patients. Methods. Muscle biopsies were obtained from 37 patients aged 5–69 years (23.6±5.3 years) with clinical suspicion for MH. The patients were first classified as MHS, MHN or MHE (MH equivocal) by the in vitro contracture test (IVCT) according to the European MH protocol. After MH classification, surplus muscle specimens were subjected to the DOI study. DOI was added to the organ bath in a concentration of 0.02 mmol/l. The in vitro effects on contracture development and muscle twitch were observed for 120 min. Results. Muscle specimens of all patients developed contractures after administration of DOI. However, DOI produced an earlier development of contracture in MHS (17.0±1.8 min; n=17) than in MHN (64.7±5.9 min; n=15) muscles. In MHS muscles, contractures were more distinct than in MHN muscles; at the end of the experiment, contractures had reached a maximum of 12.5±0.9 mN in MHS and 5.1±0.7 mN in MHN muscles. Muscle twitch following DOI administration was reduced significantly in both MHS and MHN muscles. The results of four MHE muscles were comparable with MHS. Conclusion. The present study supports the assumption that an altered serotonin system might be involved in the development of MH. In further studies it should investigated whether 5-HT2 receptors of skeletal muscles from MHS subjects are disordered in function or structure. 5-HT2 receptor agonists should be considered as MH-triggering agents.
    Notes: Zusammenfassung Im Tierexperiment löste die Applikation von Agonisten für Serotonin 2 -Rezeptoren eine maligne Hyperthermie (MH) aus, Antagonisten konnten hingegen die Entwicklung einer MH beim Schwein verhindern. In einer weiteren Studie wurde ein Anstieg des Serotonins im Plasma während einer Halothan-induzierten MH beim Schwein nachgewiesen. Ziel dieser Untersuchung war die Registrierung der in vitro-Effekte des Serotonin 2 -Rezeptoragonisten 1-(2,5-Dimethoxy-4-Iodophenyl)-2-Aminopropan (DOI) auf menschliche Skelettmuskelpräparate von MH-Anlageträgern (MHS) und Nichtanlageträgern (MHN). Nach Gabe von 0,02 mmol/l DOI entwickelten die Muskelpräparate aller 37 Patienten Kontrakturen. Allerdings begann in der MHS-Gruppe (n= 17) die Kontrakturentwicklung mit 17,0±1,8 min signifikant früher als in der MHN-Gruppe (64,7± 5,9 min; n=15). Die Kontrakturen der MHS-Muskeln waren signifikant stärker als in der Vergleichsgruppe. Am Ende des Beobachtungszeitraums von 120 min wurde ein Kontrakturmaximum von 12,5±0,9 mN bei MHS- und von 5,1±0,7 mN bei MHN-Muskeln registriert, die Muskelkontraktionskraft zeigte sich in beiden Gruppen signifikant reduziert. Die Ergebnisse von vier als MHE klassifizierten Muskeln waren vergleichbar mit denen der MHS-Muskeln. Die vorgelegte Studie unterstützt die Vermutung, daß bei der MH ein verändertes Serotoninsystem ursächlich beteiligt sein könnte. In weiteren Studien sollte untersucht werden, ob Serotonin 2 -Rezeptoren der Skelettmuskulatur von MHS Individuen in ihrer Funktion oder Struktur alteriert sind. Serotonin 2 -Rezeptoragonisten sollten als Triggersubstanzen der MH gelten.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Malignant hyperthermia ; Halothane ; Caffeine ; Diabetes ; Stress ; Cresol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Malignant hyperthermia (MH) in humans is usually triggered by volatile anaesthetics and depolarizing muscle relaxants. However, other factors or drugs (e.g. cresol) are thought to induce MH. We report a case of fulminant MH associated with a ketoacidotic diabetic coma. After therapy for diabetic coma with insulin (containing the preservative cresol) and electrolyte solutions was started, the patient complained of increasing myalgia, developed a high fever and respiratory and metabolic acidosis and lost consciousness. MH was treated immediately with dantrolene; the patient recovered within 14 days. Five months later the patient was diagnosed as MH-susceptible by the in vitro caffeine and halothane contracture test. This case supports the assessment that MH and diabetes are associated diseases and that cresol could possibly trigger MH. Furthermore, therapy with dantrolene has been demonstrated to the beneficial in the treatment of MH associated with diabetic coma.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Key words Malignant hyperthermia ; Halothane ; Caffeine ; Diabetes ; Stress ; Cresol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Malignant hyperthermia (MH) in humans is usually triggered by volatile anaesthetics and depolarizing muscle relaxants. However, other factors or drugs (e.g. cresol) are thought to induce MH. We report a case of fulminant MH associated with a ketoacidotic diabetic coma. After therapy for diabetic coma with insulin (containing the preservative cresol) and electrolyte solutions was started, the patient complained of increasing myalgia, developed a high fever and respiratory and metabolic acidosis and lost consciousness. MH was treated immediately with dantrolene; the patient recovered within 14 days. Five months later the patient was diagnosed as MH-susceptible by the in vitro caffeine and halothane contracture test. This case supports the assessment that MH and diabetes are associated diseases and that cresol could possibly trigger MH. Furthermore, therapy with dantrolene has been demonstrated to be beneficial in the treatment of MH associated with diabetic coma.
    Type of Medium: Electronic Resource
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