• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권4호
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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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• 제15권2호
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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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• 제19권1호
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• pp.109-114
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• 1997

악성고열증은 마취중 혹은 마취 후에 나타나는 마취 합병증으로 발병률은 매우 희귀하나 높은 치사율 때문에 일단 발현하면 치명적인 결과를 초래하므로 예방 및 조기 발견에 의한 조기 치료가 매우 중요하다. 예방을 위해서는 보유자의 감별이 무엇보다 중요하고 이를 위해서는 철저한 개인력 및 가족력 조사와 술전 감수성 검사가 이루어져야 한다. 의심이 되는 환자는 마취 전후에 dantrolene sodium을 투여하여야 하고 마취시 유발 마취제 및 유발 인자를 피하며 emotional stress를 피하기 위해 충분한 sedation이 요구된다. 그러나 우리 나라에는 특수 치료제인 dantrolene sodium의 확보가 어려워 조기 발견을 하고도 효과적인 치료를 하지 못하는 경우가 흔히 있으므로 dantrolene sodium을 상비약으로 비치하는 것이 좋을 것으로 사료된다. 저자들은 32세의 건강한 젊은 남자 환자가 악성형수술도중 갑작스런 체온 상승과 빈맥근강직등이 발현하여 술 후 5일만에 급성 신부전증 및 파종성혈액내응고병증(DIC)으로 사망한 악성고열증 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한두경부종양학회지
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• 제6권1호
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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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• 제6권1호
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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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• 제7권2호
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• pp.229-233
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• 2003

악성 고열증은 succinylcholene과 같은 유발약제의 사용을 피하고, 조기 진단과 dantrolene의 조기 투여에 의해 사망률과 이환률이 현저히 감소하게 되었다. 본 증례는 전신 마취 후 호기말 이산화탄소 분압 증가, 빈맥, 고혈압 등의 조기 징후로 악성 고열증이 발견된 14세 남자 환아에 대한 보고이다. Dantrolene의 조기 투여 후 profopol과 midazolam으로 수숱을 지속할 수 있었다. 횡문근 융해증이 발생하였으나 수액 투여와 요의 알칼리화를 유도하여 신부전이 발생하지 않았다. 환아는 수술 10일 후에 합병증 없이 퇴원하였다.

• 대한의용생체공학회:의공학회지
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• 제8권1호
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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.

• 대한한의학회지
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• 제25권3호
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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.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1987년도 전기.전자공학 학술대회 논문집(II)
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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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• 제1권1호
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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.