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Kathrin Scherer Wolfgang Studer Verena Figueiredo Andreas J Bircher 《Annals of allergy, asthma & immunology》2006,96(3):497-500
BACKGROUND: Blue dyes used for lymphatic mapping in sentinel lymph node biopsy cause intraoperative anaphylactic reactions in up to 2.7% of patients. With increasing implementation of this technique, the incidence of anaphylaxis to these dyes can be expected to increase. In the literature, the chemically often unrelated and inconsistently designated dyes have been confused, adding to other inconsistencies in the nomenclature. OBJECTIVE: To demonstrate the nomenclature, chemical and physiologic differences, and allergenicity of the various blue dyes used in a medical context. METHODS: We describe a patient with an intraoperative grade IV anaphylactic reaction to isosulfan blue. Immediate-type hypersensitivity was proved by positive skin test reactions and CD63 expression to isosulfan blue and cross-reactivity to patent blue V. RESULTS: A review of the literature clarified the exact nomenclature of the blue dyes and the possible pitfalls of confusing nomenclature in the context of structurally closely related dyes with different allergenic properties. For the detection of type I hypersensitivity, intracutaneous tests are valuable tools. An IgE-mediated mechanism has been shown recently. In most cases, sensitization exists without known previous exposure in a medical context. This may be due to the widespread use of such dyes in objects of everyday life. Preoperative antiallergic medication use does not prevent anaphylactic reactions but apparently reduces their severity. CONCLUSION: For better comparison and precision, the Chemical Abstracts Service number of the respective dye should always be given. 相似文献
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Antibodies reacting with the tumor cell line RC-Pa were measured by a quantitative avidin-biotin complex method. Sera of renal cell carcinoma patients, patients with other types of cancer and healthy donors were analyzed. Of 71 sera from renal cell carcinoma patients 67 (94 per cent) were classified as showing renal cell carcinoma, while 32 of 36 sera (89 per cent) from healthy subjects were classified as showing no renal cell carcinoma. Four of 21 serum specimens (19 per cent) from individuals with other than renal cancer were misclassified. Furthermore, sera from renal carcinoma patients immunized with a mixture of autologous tumor cells and Corynebacterium parvum showed a marked increase in reactivity compared to those from patients receiving progesterone. The results indicate that this assay might become useful to detect or monitor renal cell carcinoma. 相似文献
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Kinnison ML; Perler BA; Kaufman SL; Mitchell SE; Kadir S; Williams GM; White RI Jr 《Radiology》1986,160(3):727-730
In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications. 相似文献
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435 isolated coronary artery procedures have been performed between January and December 1989 at the HerzZentrum Hirslanden. In 93% of the cases, one or two internal mammary arteries (IMA) and in 7%, saphenous vein grafts only were used as a bypass conduit. In 12 patients, the right gastroepiploic artery (RGE) was used as a free (3) or pedicled (9) graft to the posterior surface of the heart. This group of 12 patients was analyzed in a retrospective study. Postoperative complications in this group included one myocardial infarction and reexploration for intraabdominal bleeding in the same patient. All patients were discharged from hospital after an average of 9.7 days. After a mean follow-up time of 5 months, all patients are in NYHA-functional class I without antiischemic drugs. Postoperative angiography in 7 patients (mean postoperative interval 4 months) showed all 13 IMA-grafts and 5 RGE-grafts patent, 1 RGE-conduit is occluded, 1 RGE-graft could not been assessed for technical reasons. The RGE is an viable additional arterial bypass conduit and an alternative to other grafts. Indications for use of the RGE are lack of sufficient other conduits, calcified ascending aorta, coronary reoperation after vein graft failure and probably young patients with severe hyperlipidemia. 相似文献