Prolonging viability of swine muscle biopsy specimens in malignant hyperthermia testing.

In North America, the caffeine halothane contracture test (CHCT) is the standard test for the diagnosis of malignant hyperthermia (MH). Current CHCT protocol recommends that the test be completed within 5 h of muscle excision. The purpose of this study was to investigate whether the period of skeletal muscle viability could be extended to 24 h. We tested the gracilis muscle from normal (n = 8) and MH-susceptible swine (n = 8). After baseline (1-2 h after excision) CHCT, the remaining muscles were placed into one of the following four treatment groups. In Groups 1 and 2, the muscles remained under tension and were stored in Krebs buffer (pH 7.4) at 23 degrees C-25 degrees C (clamped-warm) and 4 degrees C (clamped-cold), respectively. In Groups 3 and 4, the muscle strips were dissected, and the ends were tied with silk sutures, cut from the clamp, and placed in Krebs buffer at 23 degrees C-25 degrees C (free-warm) and 4 degrees C (free-cold), respectively. The responses of the treatment groups to halothane (3%) and caffeine (0.5-32 mM) were tested 22-26 h after excision. The clamped-warm storage was the only storage method to correctly diagnose MH susceptibility in all muscle strips tested. This finding was also confirmed in muscle stored under clamped-warm conditions and shipped overnight to another testing center for a parallel CHCT.

Intravenous lecithin-coated microcrystals of dantrolene are effective in the treatment of malignant hyperthermia: an investigation in rats, dogs, and swine.

Dantrolene effectively treats malignant hyperthermia (MH) hut the current form, Dantrium, must be dissolved to a 0.33 mg/mL, pH 9.5 solution. This study describes lecithin-coated microcrystal formulations of sodium dantrolene (MC-NaD) and neutral dantrolene (MC-D) which reconstitute to 200 mg/mL within 1 min. In rats, the pharmacokinetics and pharmacodynamics of MC-NaD and Dantrium were similar: half-lives of 3.1 h, volume distributions of 0.54 and 0.59 L/kg, and 95% effective dose (ED95) values for depression of skeletal muscle twitch height (ED95T) of 2.6 +/- 0.7 and 2.8 +/- 0.5 mg/kg. In swine, the ED95T values for MC-NaD and Dantrium were also similar (2.8 +/- 0.4 vs 2.7 +/- 0.6 mg/kg), but MC-D and Dantrium were only similar at doses more than 2.5 mg/kg (ED95T: 3.5 +/- 0.4 vs 2.7 +/- 0.5 mg/kg). In susceptible swine, MC-NaD successfully treated five of six MH episodes and prevented MH in three of four swine. However, MC-NaD caused marked pulmonary hypertension in swine, while MC-D caused only a mild response that was eliminated by filtration. Likewise, MC-D caused no pulmonary response in dogs. These observations suggest that MC-D has potential to improve the treatment of MH.

Ultra-long-duration local anesthesia produced by injection of lecithin-coated tetracaine microcrystals.

This study was designed to determine if microencapsulated tetracaine would provide a longer duration of local anesthesia than nonmicroencapsulated (neat) tetracaine. Local anesthesia was determined by monitoring the response of the rat to tail clamping after the installation of a subcutaneous ring block. Ten percent microencapsulated tetracaine was found to provide local anesthesia of the tail for a 43-hour duration. Ten percent tetracaine solution was toxic. One percent tetracaine solution provided a tail block lasting 8 hours. Lecithin membranes without drug provided no block. This study demonstrates that lecithin-coated tetracaine microcrystals produce a local anesthetic effect that is ultra-long in duration, reversible, and not systemically toxic.

Adriamycin cardiotoxicity and proton nuclear magnetic resonance relaxation properties.

Present noninvasive techniques to detect Adriamycin (doxorubicin) cardiotoxicity rely on assessment of myocardial function rather than direct observation of change in tissue character. Proton nuclear magnetic resonance imaging may provide a unique means of characterizing the myocardium. The relaxation properties T1 and T2 are related to certain biophysical properties of tissue such as water, lipid, and macromolecular content and have considerable impact on the intensity observed in nuclear magnetic resonance images. In a model of chronic Adriamycin cardiotoxicity in rats, T1 values of excised hearts were elevated, relative to control, in rats with histologic evidence of chronic cardiotoxicity (651 msec vs 622 msec, p less than 0.05) and more so in rats with gross evidence of toxicity or heart failure (668 msec, p less than 0.005). No significant change in T2 was observed. This T1 prolongation increases as disease worsens, whereas water concentration did not change significantly. The results suggest that predictable prolongation in T1 occurs in association with cardiotoxicity. In conclusion, proton nuclear magnetic resonance imaging methods could provide a new means for assessing Adriamycin cardiotoxicity.