We examined Ca"-induced Ca2+ release mechanism in skinned fibers of biopsied muscles from 84 patients of whom the majority were suspected of malignant hyperthermia, the others being normal control (n=5). Rates of Ca" release were measured at 0, 0.3, 1.0, 3.0 and 10 ,uM Ca2+. Cluster analyses based on the Ca2+ release rates objectively classified the patients into three groups: unaccelerated (n=6l, group 1), moderately accelerated (n=19, group 2), and highly accelerated (n=4, group 3). Almost all the patients with conspicuous fever (240.0°C and/or 205°C rise/ 15 min) during anesthesia belonged to group 2 or 3. The normal controls were all in group 1. Among the clinical signs, acidosis and fever correlated with the Ca" release rates, while little correlation was found between postoperative high creatine kinase value and the Ca" release rates. These results suggest that the abnormality in the Ca"-
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