title: Ring fibers visualized by electron microscopy in a Japanese patient with malignant hyperthermia.
abstract: This report describes an episode of malignant hyperthermia (MH) in a 53-year-old Japanese man during general anesthesia that was triggered by isoflurane and succinylcholine. His past history and family history were unremarkable. From our analysis of ten exons, he had no recognizable mutation in the ryanodine receptor gene, but compatible with his MH reaction, he showed positive sensitivity to the Ca-induced Ca-release test. Histochemical and electron microscopic studies of muscle biopsy tissue demonstrated unusual "ring fibers," which have never before been reported to be associated with MH. The presence of ring fibers in this patient might indicate muscle regeneration, suggesting a recovery process from the MH episode.
authors.affiliation: Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan. ykitagaw@den.hokudai.ac.jp.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kitagawa
authors.affiliation: Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Hokkaido University Graduate School of Dental Medicine, North 13, West 7, Kita-ku, Sapporo, 060-8586, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sato
authors.affiliation: Division of Neurology and Gastroenterology, Second Department of Internal Medicine, Fukui University, Matsuoka, Fukui, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kuriyama
authors.affiliation: Division of Dentistry and Oral Surgery, Department of Sensory and Locomotor Medicines, School of Medicine, Fukui University, Matsuoka, Fukui, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sano
authors.affiliation: Department of Dentistry and Oral and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D004252:DNA Mutational Analysis; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology / Q000235:genetics / Q000473:pathology*; D008406:Masseter Muscle / Q000473:pathology* / Q000648:ultrastructure; D008854:Microscopy, Electron; D008875:Middle Aged; D009210:Myofibrils / Q000648:ultrastructure; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects; D012433:Ryanodine; D019837:Ryanodine Receptor Calcium Release Channel / Q000235:genetics; D012519:Sarcoplasmic Reticulum / Q000473:pathology / Q000648:ultrastructure*; D013390:Succinylcholine / Q000009:adverse effects
chemical_list: D018685:Anesthetics, Inhalation; D009467:Neuromuscular Depolarizing Agents; D019837:Ryanodine Receptor Calcium Release Channel; D012433:Ryanodine; D007530:Isoflurane; D013390:Succinylcholine