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[Is a presymptomatic malignant hyperthermia in-vitro diagnosis with 4-chloro-3-ethyl phenol possible? A study using porcine skeletal preparations].

Abstract

OBJECTIVE

The diagnosis of malignant hyperthermia is currently performed with the in-vitro contracture test (IVCT) with halothane and caffeine. This test has a sensitivity of 99.0 % but only a specificity of 93.6 %. A cumulative IVCT with 4-chloro-3-ethyl-phenole (CEP) has recently been shown to differentiate between MH susceptible (MHS) and MH normal (MHN) swine. The pur-pose of this study was to investigate the ability of bolus CEP-applications to distinguish between porcine MHS- and MHN-muscle specimens using the IVCT.

METHODS

After approval by the local animal care committee 8 MHS- and 8 MHN-swine were anaesthetized and muscle biopsies taken. For IVCT, muscle specimens were exposed to bolus administration of CEP in concentrations of 75 resp. 100 micro mol l (-1). Predefined parameters were: (1) onset time of the contracture development, (2) time to the achievement of the 2, 5 and 10 mN contracture level and (3) maximum contracture level. Data are expressed as medians and ranges.

RESULTS

After 75 micro mol l (-1) CEP administration all MHS-muscles showed contractures after 0.5 min (0.2 min/0.9 min). The 2 mN contracture level was reached by all MHS-, the 5 mN level by four MHS- and the 10 mN level by one MHS-specimen. The maximum contracture was 5.3 mN (2.4 mN/12.9 mN). The onset time after 100 micro mol l (-1) CEP was registered as 0.3 min (0.1 min/0.7 min) in the MHS-preparations. Again, the 2 mN level was achieved by all MHS-specimens, the 5 mN level by 5 and the 10 mN level by one MHS-bundle. The maximum contracture was measured as 5.9 mN (2.8 mN/13.9 mN). In 7 MHN-specimens no contracture development was measured. After 75 micro mol l (-1) CEP one MHN-muscle showed a maximum contracture of 1.0 mN, after 100 micro mol l (-1) CEP one MHN-bundle demonstrated a maximum contracture of 1.1 mN. Hence, a significant difference between MHS and MHN without overlap was revealed with both CEP-concentrations in the onset time of contracture, in the 2 mN contracture level and the maximum contracture.

CONCLUSION

Since a clear differentiation between MHS and MHN porcine specimens was achieved after bolus application of 75 and 100 micro mol l (-1) CEP, MH-diagnosis might be possible with a CEP-IVCT. It seems worthwhile to examine this hypothesis in men.

Authors+Show Affiliations

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf. gerbershagen@uke.uni-hamburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

14767797

Citation

Gerbershagen, M U., et al. "[Is a Presymptomatic Malignant Hyperthermia In-vitro Diagnosis With 4-chloro-3-ethyl Phenol Possible? a Study Using Porcine Skeletal Preparations]." Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, vol. 39, no. 2, 2004, pp. 81-6.
Gerbershagen MU, Wappler F, Fiege M, et al. [Is a presymptomatic malignant hyperthermia in-vitro diagnosis with 4-chloro-3-ethyl phenol possible? A study using porcine skeletal preparations]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2004;39(2):81-6.
Gerbershagen, M. U., Wappler, F., Fiege, M., Weisshorn, R., Kolodzie, K., & Schulte am Esch, J. (2004). [Is a presymptomatic malignant hyperthermia in-vitro diagnosis with 4-chloro-3-ethyl phenol possible? A study using porcine skeletal preparations]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 39(2), 81-6.
Gerbershagen MU, et al. [Is a Presymptomatic Malignant Hyperthermia In-vitro Diagnosis With 4-chloro-3-ethyl Phenol Possible? a Study Using Porcine Skeletal Preparations]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2004;39(2):81-6. PubMed PMID: 14767797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Is a presymptomatic malignant hyperthermia in-vitro diagnosis with 4-chloro-3-ethyl phenol possible? A study using porcine skeletal preparations]. AU - Gerbershagen,M U, AU - Wappler,F, AU - Fiege,M, AU - Weisshorn,R, AU - Kolodzie,K, AU - Schulte am Esch,J, PY - 2004/2/10/pubmed PY - 2004/4/7/medline PY - 2004/2/10/entrez SP - 81 EP - 6 JF - Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS JO - Anasthesiol Intensivmed Notfallmed Schmerzther VL - 39 IS - 2 N2 - OBJECTIVE: The diagnosis of malignant hyperthermia is currently performed with the in-vitro contracture test (IVCT) with halothane and caffeine. This test has a sensitivity of 99.0 % but only a specificity of 93.6 %. A cumulative IVCT with 4-chloro-3-ethyl-phenole (CEP) has recently been shown to differentiate between MH susceptible (MHS) and MH normal (MHN) swine. The pur-pose of this study was to investigate the ability of bolus CEP-applications to distinguish between porcine MHS- and MHN-muscle specimens using the IVCT. METHODS: After approval by the local animal care committee 8 MHS- and 8 MHN-swine were anaesthetized and muscle biopsies taken. For IVCT, muscle specimens were exposed to bolus administration of CEP in concentrations of 75 resp. 100 micro mol l (-1). Predefined parameters were: (1) onset time of the contracture development, (2) time to the achievement of the 2, 5 and 10 mN contracture level and (3) maximum contracture level. Data are expressed as medians and ranges. RESULTS: After 75 micro mol l (-1) CEP administration all MHS-muscles showed contractures after 0.5 min (0.2 min/0.9 min). The 2 mN contracture level was reached by all MHS-, the 5 mN level by four MHS- and the 10 mN level by one MHS-specimen. The maximum contracture was 5.3 mN (2.4 mN/12.9 mN). The onset time after 100 micro mol l (-1) CEP was registered as 0.3 min (0.1 min/0.7 min) in the MHS-preparations. Again, the 2 mN level was achieved by all MHS-specimens, the 5 mN level by 5 and the 10 mN level by one MHS-bundle. The maximum contracture was measured as 5.9 mN (2.8 mN/13.9 mN). In 7 MHN-specimens no contracture development was measured. After 75 micro mol l (-1) CEP one MHN-muscle showed a maximum contracture of 1.0 mN, after 100 micro mol l (-1) CEP one MHN-bundle demonstrated a maximum contracture of 1.1 mN. Hence, a significant difference between MHS and MHN without overlap was revealed with both CEP-concentrations in the onset time of contracture, in the 2 mN contracture level and the maximum contracture. CONCLUSION: Since a clear differentiation between MHS and MHN porcine specimens was achieved after bolus application of 75 and 100 micro mol l (-1) CEP, MH-diagnosis might be possible with a CEP-IVCT. It seems worthwhile to examine this hypothesis in men. SN - 0939-2661 UR - https://www.unboundmedicine.com/medline/citation/14767797/[Is_a_presymptomatic_malignant_hyperthermia_in_vitro_diagnosis_with_4_chloro_3_ethyl_phenol_possible_A_study_using_porcine_skeletal_preparations]_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2004-817676 DB - PRIME DP - Unbound Medicine ER -