• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.381-387
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• 2005

Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.230-237
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• 1982

Malignant hyperthermia has been reported by many authors since Denborough [1960] first described concerning anesthetic death in a family. Malignant hyperthermia is characterized by a hypermetabolic state [tachycardia, tachypnea, hypercarbia, hypoxia, cyanosis, hypotension, high fever and muscle rigidity] and is related to a hereditary defect of skeletal muscle. In susceptible individuals, it is triggered by potent inhalational anesthetics, depolarizing muscle relaxant [Succinylcholine], amide type local anesthetics [prototype lidocaine] and occasionally by stress due to emotional and environmental factors. Unrecognized and untreated malignant hyperthermia is associated with a very high mortality rate. Recently authors have experienced malignant hyperthermia in 5 year old male child who was diagnosed to have patent ductus arteriosus and interatrial septal defect associated with congenital physical deformities such as short stature, hypotrophic muscles and genu valgus deformity of lower extremity, indirect inguinal hernia and Ramphant caries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.109-114
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• 1997

Malignant hyperthermia is a hypermetabolic, fatal syndrome triggered by anesthetic drugs that occurs frequently in genetically susceptible persons. It is characterized by tachycardia, rapidly increasing temperature, skeletal muscle rigidity, respiratory and metabolic acidosis, cyanosis etc. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. Thus, the accurate prediction of preanesthetic susceptibility and early diagnosis of malignant hyperthermia is necessary to appropriate treatment. Dantrolene sodium has been shown to be effective in the prevention and treatment of malignant hyperthermia. We experienced a case of malignant hyperthermia, which is presented of a 32-year-old healthy male patient in whom a orthognatic surgery was performed under $O_2-N_2O$-enfl-rane anesthesia with induction by pentobarbital and succinylcholine. We discuss this case with reviewing the history, incidence, etiology, pathophysiology, clinical signs & biochemical changes, prevention & treatment.

• Korean Journal of Head & Neck Oncology
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• v.6 no.1
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• pp.40-45
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• 1990

Thirty five lesions of 35 patients with locally advanced malignant tumors of head and neck were received thermoradiotherapy with ultrasound and/or 915 MHz microwave. Most of all patients were failed with previous conventional therapeutic trial. Hyperthermia had been done immediately after radiotherapy, twice a week, $43^{\circ}C$ for one hour and radiotherapy had been done 5 fractions per week with a fraction size of 2 Gy up to total 30 to 60 Gy. Conclusions are as follows; 1) Total response rate (CR+PR) of thermoradiotherapy with microwave and ultrasound was 80%. 2) Tumor depth, minimum temperature of tumor center, number of heat fraction and irradiation dose were statistically significant factors affecting response. 3) Hyperthermia with microwave and ultrasound can be used efficiently to control locally advanced malignant tumors in head and neck whether previously received near tolerance dose of radiotherapy or not.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.75-80
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• 1988

Twenty seven lesions of 25 patients with locally advanced malignant tumors were treated with combined hyperthermia introduced by microwave and ultrasound and radiotherapy. Most of all patients were failed with previous conventional therapeutic trial. Hyperthermia had been done immediately after radiotherapy, twice a week, $43^{\circ}C$ for one hour and radiotherapy had been done 5 fractions per week with fraction size of 2Gy upto 30 to 60Gy. Conclusions are as follows. 1. Total response rate (PR+PR) to thermoradiotherapy with microwave and ultrasound was $81\%$. 2. Tumor depth, minimum temperature of tumor center, number of heat fraction and radiation dose were statistically significant factors affecting response. 3. Hyperthermia with microwave and ultrasound can be used efficiently to control locally advanced malignant disease whether previously received near tolerance dose of radiotherapy or not.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.229-233
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• 2003

Mortality and morbidity of malignant hyperthermia has decreased markedly by the avoidance of succinylcholine, and the earlier detection and introduction of dantrolene. We report a fourteen-year-old boy who developed malignant hyperthermia during general anesthesia. He showed the earlier clinical signs, such as elevation of end-tidal $CO_2$, tachycardia, and hypertension. After prompt administration of dantrolene, operation was continued with profopol and midazolam. Rhabdomyolysis and myoglobinuria followed, and were managed by hydration and alkalinization of urine. Azotemia did not occur, and he was discharged without any sequelae on the $10^{th}$ postoperative day.

• Journal of Biomedical Engineering Research
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• v.8 no.1
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• pp.63-68
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• 1987

The biological effects for the use of hypertherinla to treat malignant tumors has been well studied and encouraging clinical results have been reported. However, the engineering and technical aspects of hyperthermia for the deepseated tumors has not been satisfactory. We have developed the FF capacitive hyperthermia device(GHT RF8)by cooporation with Yonsei Cancer Center and Green Cross Medical Equipment Corporation. It was composed with 8.10 MHz RF generator, capacitive electrode, matching system, cooling system, temperature measuring thermocouples and control PC computer. We have measured the temperature and thermal distribution in agar phantom, animals and human tumors.

• The Journal of Korean Medicine
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• v.25 no.3
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• pp.203-211
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• 2004

Objectives : We report an unusual case of a 57-year old woman with spasticity following fever of unknown origin (the origin of her fever was not certain by western medical diagnosis). Malignant hyperthemia with spasticity couldn't be cured by general western medical therapy, and furthermore the function of liver and renal system was worsened as a consequence of drugs. Methods : We diagnosed the watery state of the patient as seupon (습온) with gyeonggwol (경궐) through pattern identification (변증) of symptoms and signs. Results : This patient who had spasticity with malignant hyperthermia was treated by optical management of herb medicine and acupuncture, and should need long-term observation. Conclusions : We want to show that trial by febrile diseases can solve fever and spasticity.

• Proceedings of the KIEE Conference
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• 1987.07b
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• pp.1309-1312
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• 1987

Hyperthermia for the treatment of cancer has been introduced for a long time and the biological effect for the use of hyperthermia to malignant tumors has been well established and encouraging clinical results has been observed. Unfortunately, the engineering or technical aspects of hyperthermia for the deep seated tumors has not been satisfactory. We have researched and developed the radiofrequency capacitive hyperthermia system (GHT- RF8). It was composed with 8-9 MHZ RF generator, capacitive electrode, matching system, cooling system, temperature measuring system and control computer. The thermal profile was investigated in agar phantom, animals and in human tumors, which was heated with capacitive RF device.

• Animal cells and systems
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• v.1 no.1
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• pp.77-80
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• 1997

DOantrolene is a primary specific therapeutic drug for prevention and treatment of malignant hyperthermia symptoms. The mechanisms underlying the therapeutic effects of the drug are not well understood. The present study aimed at the characterization of the effects of azumolene, a water soluble dantrolene analogue, on ryanodine binding to sarcoplasmic reticulum (SR) from normal and malign::lnt hyperthermia susceptible (MHS) swine muscles. Characteristics of $[^3H]ryanodine$ binding were clearly different between the two types of SR. Kinetic analysis of eH]ryanodine binding to SR in the presence of $2{\mu}M$ $Ca^{2+}$ showed that association constant $(K_{ryanodine}_7$ is significantly higher in MHS than normal muscle SR $(2.83 vs. 1.32{\times}10^7 M^{-1}$, whereas the maximal ryanodine binding capacity $(B_{max})$ is similar between the two types of SR. Addition of azumolene $(e.g. 400{\mu}M)$ did not significantly alter both $K_{ryanodine}$ and $B_{max}$ of $[^3H]$ryanodine binding in both types of SR, indicating that the azumolene effect was not on the ryanodine binding sites. Addition of caffeine activated $[^3H]$ ryanodine binding in both types of SR, and caffeine sensitivity was significantly higher in MHS muscle SR than normal muscle SR $(K_{caffeine}:3.24 vs. 0.82 {\times} 10^2 M^{-l}). Addition of azumolene $(e.g.400{\mu}M)$ decreased Kcaffeine without significant change in $B_{max}$ in both types of SR suggesting that azumolene competes with caffeine binding site(s). These results suggest that malignant hyperthermia symptoms are caused at least in part by greater sensitivity of the MHS muscle SR to the $Ca^{2+}$ release drug(s), and that azumolene can reverse the symptoms by reducing the drug affinity to $Ca^{2+}$ release channels.