The impact of 4-chloro-m-cresol in heparin formulas on malignant hyperthermia: in vitro and in vivo.

Background: The preservative 4-chloro-m-cresol (4CmC) is a specific activator of sarcoplasmic Ca2- release and induces contractures in skeletal muscles of malignant hyperthermia susceptible (MHS) patients in vitro. Clinical formulas of heparin contain 4CmC. We studied whether (a) these heparin formulas induce contractures in isolated MHS and normal (MHN) human skeletal muscles and whether (b) significant serum levels of 4CmC are reached after heparinization in cardiopulmonary bypass patients.

[Are morphologic changes in skeletal muscles of patients with malignant hyperthermia diagnostically useful?].

Malignant Hyperthermia (MH) represents a functional myopathy triggered by volatile anesthetics and depolarizing muscle relaxants, and leading to metabolic disturbances of intracellular Calcium homeostasis. Central-Core-like-structures (CCLS) were recently described as central defects in enzyme-histochemical stains and well correlated to the autosomal-dominant MH-predisposition. We studied the correlation of a MH-predisposition with specific myopathological signs.

[Stereoroentgenology in endourology].

Three-dimensional stereofluoroscopic pictures of the kidney and renal calyces were first used for percutaneous renal surgery with a laboratory prototype equipment. The grid-controlled X-ray tube provides sequential images, which are separated into pairs by digital image processing and storage and can be seen on a 3-D display unit. This method allows exact and rapid puncture of a suitable calyx for percutaneous nephrolithotomy, shortens the learning process for the endourologist, reduces the radiation exposure, and thus makes the method safer.