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Biomedical subjects

P Komericki

Publications and source records attributed to P Komericki.

18 recordsLinked to original sources
PubMed2006

Tryptase as severity marker in drug provocation tests.

BACKGROUND: In the absence of objective symptoms, it is difficult to assess an adverse reaction during drug provocation testing. We evaluated the value of serum tryptase levels to distinguish between positive, negative and, even more important, so-called 'hysterical' reactions (conversion symptoms). The latter are occasionally observed in drug provocation tests when the patient experiences ambiguous subjective symptoms. METHODS: In a prospective single-center study, 303 patients underwent 785 drug provocation tests. Blood was taken for tryptase measurement on each test day before and after drug challenge, and the changes in serum tryptase levels in patients with no reactions were compared with those who experienced immediate reactions to a drug. RESULTS: Thirty-four of 785 drug provocations were clinically judged as being positive. Despite objective symptoms, median serum tryptase values in the afternoon were even lower than baseline levels. However, this decrease was not statistically significant. In the 751 patients suffering no objective reactions, the median values of post-testing tryptase values were statistically significantly decreased as compared with pretesting values. CONCLUSIONS: The measurement of serum tryptase levels does not appear to be helpful to differentiate mild allergic or nonallergic reactions from 'hysterical' ones. The milder decrease in the group with objective drug reactions might indicate slight mast cell activation in some patients. More severe clinical drug reactions led to stronger mast cell degranulation. Mild reactions did not increase the tryptase levels consistently.

Acetaminophen↗
PubMed2005

[ABO blood group expression in corneal allograft failures].

BACKGROUND: ABO blood group antigens are only expressed by the epithelial cells of normal human corneas. Since AB0 blood group antigens are also known to be expressed on stromal and endothelial cells of inflamed corneas, this study aimed to investigate the extend of ABO blood group antigen expression in corneal allograft failures. MATERIAL AND METHODS: Twenty-two failed corneal allografts of 22 patients were examined. In 12 cases the patients had clinically proven corneal allograft rejection. In 10 cases there was no evident history of allograft rejection and the diagnosis graft failure due to chronic endothelial cell loss was made. Immunohistochemical staining of paraffin embedded sections was performed with monoclonal mouse antibodies to human blood group antigen A or B using the streptavidin-biotin-peroxidase complex technique. RESULTS: Blood group antigens A or B were expressed by stromal keratocytes in 5 out of 12 and by endothelial cells in 7 out of 12 corneas with clinically proven immunologic graft rejection. Corneal transplants with chronic endothelial cell loss expressed blood group antigens A and/or B on the endothelial cells in three out of ten cases. CONCLUSION: The results of this study show that ABO blood group antigens can be up-regulated in cases of corneal allograft failure, especially in cases of immune mediated graft rejection. This phenomenon might play a role in corneal allograft rejection.

ABO Blood-Group System↗
PubMed2003

[Epidemiologic surveillance of contact allergens. The "monitoring series" of IVDK (Information Network ofDermatologic Clinics for Detection and Scientific Evaluation of Contact Allergy].

The selection of the most important contact allergens is subject to a continuous change. Several factors may influence the sensitization rates and thus the decision, which substances to include in the standard series of the most frequent allergens. The Information Network of Departments of Dermatology adds substances of interest for a certain time period to the standard series in order to evaluate parameters such as sensitization rate, grade of reaction, and clinical relevance of positive reactions. In 6 testing periods starting in 1996, 13 test substances were evaluated. Due to the results, propolis, compositae mix, and bufexamac were included in the standard series in 1999, while lyral was added in 2002. Sorbitansesquioleat, dispers blue mix, and iodopropynyl butylcarbamate are under further discussion. Substances such as glutaraldehyde and p-aminoazobenzole should be tested in certain risk groups only, whereas the steroids budesonide and tixocortol should be tested when clinically suspected.

Allergens↗
PubMed2001

The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.).

Medical remedies of plant origin have gained increasing popularity in recent years. Both anaphylactic and eczematous allergic reactions are on the rise, accordingly. Arnica and marigold, both of the Compositae family, are in widespread use, but only limited data are available on their allergenic potential. We tested 443 consecutive patients, in addition to the European standard and other series, with Compositae mix, sesquiterpene lactone mix, arnica, marigold, and propolis. 5 subjects ( approximately 1.13%) reacted to arnica, 9 ( approximately 2.03%) to marigold. The Compositae mix was positive in 18 cases ( approximately 4.06%). Among them were 3 out of 5 individuals with a sensitization to arnica, and 4 out of 9 who reacted to marigold. Sensitization to arnica and marigold was often accompanied by reactions to nickel, Myroxylon Pereirae resin, fragrance mix, propolis, and colophonium. We conclude that Compositae allergy contributes significantly to the epidemiology of contact dermatitis and that sensitization to arnica and marigold cannot be assessed by testing with the Compositae or sesquiterpene mix alone. As extracts of these plants are frequently used in occupational and cosmetic products, patch testing with additional plant extracts or adjustment of the commercial Compositae mix to regional conditions is recommended.

Adult↗
PubMed2001

Pigmented purpuric contact dermatitis from Disperse Blue 106 and 124 dyes.

The diagnosis of purpura pigmentosa progressiva in a female patient had to be changed to purpuric contact dermatitis after patch testing with textile dyes. A modified patch test performed in the area in which most of her skin lesions were located revealed a petechial reaction to the azo dye Disperse Blue 124/106. For evaluation of purpura pigmentosa progressiva we suggest a patch test with potential allergens, and, especially for textile dyes, a patch test at the lesion site may be helpful.

Allergens↗
PubMed2000

Face dermatitis from contaminants on a mask for anaesthesia.

Allergic and irritant contact reactions to face masks for anaesthesia have rarely been reported. We present a 55-year-old female patient who developed facial allergic contact dermatitis after an operation requiring general anaesthesia. Patch tests showed positive reactions to cocospropylenediamin-guanidinium-diacetate (trivial name Dodigen 3558), a preservative used in disinfectants for medical instruments. It could be proven that residues of the causative allergen in the disinfectant adhered to the mask. This is the first report of a clinically relevant sensitization to this increasingly widely used agent.

Adrenal Cortex Hormones↗
PubMed1997

[The significance of tissue storage time for success after corneal transplantation].

BACKGROUND: HLA-DR antigen plays a key role in transplantation immunology. Organ culture storage leads to loss of HLA-DR-positive corneal Langerhans cells. This study investigates the importance of prolonged storage period for the success rate after penetrating keratoplasty. PATIENTS AND MATERIAL: Eighty-four patients with 99 penetrating corneal transplantations were examined retrospectively. Group 1 represented keratoplasty patients with an average corneal storage period of 1.9 days (+/- 1.4) and in group 2 the patients received tissues stored for 9.8 days (+/- 4.7). RESULTS: The success rate of high-risk patients was 34.4% (+/- 8.7) in group 1 and 69.2% (+/- 12) in group 2 after 18 months (p < 0.01). In non-risk patients we had a success quota of 72.7% (+/- 8.2) in group 1 and 91% (+/- 6.1) in group 2 (p < 0.01). CONCLUSION: We found significantly better results in patients receiving tissues stored for an average time of 9.8 days than in those receiving corneas preserved for 1.9 days. The results are thought to be based on the loss of HLA-DR-positive cells during prolonged organ culture preservation.

Cornea↗
PubMed1997

[Corneal Langerhans cells. Behavior during storage in organ culture].

BACKGROUND: Corneal HLA-DR antigens are going to be lost during organ culture storage. This study investigated if this phenomenon is based on down-regulation of the HLA-DR antigen, or on a loss of the HLA-DR-positive corneal Langerhans cells (LCs). MATERIAL AND METHODS: Corneal LCs were stained in situ by the method of fluorescence-associated immunohistochemistry, and the organ culture mediums underwent flow cytometric analysis for HLA-DR-positive corneal LC at the end of the storage period. RESULTS: All stored corneas were negative for HLA-DR after 14 days and HLA-DR antigens could be detected in culture medium at the end of the storage time. CONCLUSION: Flow cytometry showed that organ culture storage leads to loss of HLA-DR-positive cells and not only to a loss of antigen presentation.

Antigen Presentation↗
PubMed1997

Epidemiological significance of bufexamac as a frequent and relevant contact sensitizer.

Bufexamac-containing ointments and creams are widely used by many patients with eczematous disorders as an alternative to topical corticosteroids. Recent studies provide evidence of a notable prevalence of contact sensitization in patch test populations. The aim of this study was to assess the frequency of use of this topically-applied drug by eczema patients in general, and to evaluate its potential to cause allergic contact reactions. 500 routinely patch tested patients (f:m = 377:123) were tested with bufexamac 5% and Parfenac ointment (the only commercial product available in Austria) in addition to the standard and other series of the German Contact Dermatitis Group. The packaging of the commercial product was shown to the entire study population, to decide whether or not they had ever used this product. In addition, their general practitioner was contacted to verify the anamnestic data. A total of 30 patients agreed that they had definitely used bufexamac, 5 others having probably applied it. The indication for and the duration of treatment were noted. Positive and relevant patch test reactions to bufexamac, as well as the bufexamac-containing ointment, were seen in 20 out of these 35 patients (57%), and sensitization occurred even after short-term application. Our study demonstrates that bufexamac has to be assumed to be a topical drug with a very high sensitization rate in an unselected patch test population (4% of 500 patients), and should therefore be added to the standard series.

Administration, Topical↗
PubMed1997

Olive oil--contact sensitizer or irritant?

Adverse cutaneous reactions to topically applied olive oil are seldom reported, and positive patch tests to it are mostly regarded as allergic. To evaluate such "positive" patch test reactions, 77 female (mean age: 44 years) and 23 male eczema patients (mean age: 46 years) were prospectively patch tested with freshly prepared olive oil. Tests were performed openly (including ROAT) as well as using Al-tests and Finn Chambers on Scanpor. 5 patients (2 male) showed "positive" test reactions (all patients at the Al-test site, 3 at the Finn Chamber site, 1 with ROAT). In only 1 patient could the reaction be classified as probably allergic, in contrast to previous reports. In conclusion, olive oil is very weakly irritant in general, but bears relevant irritant capacity when applied under occlusive conditions. Therefore, olive oil appears to be less than suitable for the topical therapy of patients with venous insufficiency and associated eczema of the lower extremities.

Adult↗
PubMed1995

[Patch testing with the "Austrian standard series"--epidemiologic test values and results].

Patch testing for contact allergies is routinely performed by applying a "standard series" of the most frequently occurring contact allergens. Internationally "established" standard series have to be adapted to country- and population-specific factors (i.e., distribution of gender and age, occupational behavior, environmental factors etc.). In 1992 and 1993 altogether 11,690 patients were patch tested in 14 Austrian test centers with the "Austrian standard patch test series" as recommended by the working group "Contact Allergy" of the Austrian Society of Dermatology. Altogether data on 11,544 patients were complete and are analyzed in this study. 71.5% of the test population were female with an average age of 39 years, whereas the male patients had an average age of 40 years. 38.1% of the patients were younger than 30 years, 47.8% were in the group ranging from 31 to 60 years and 14% of the tested patients were older than 60 years. Cutaneous sensitization was found in 51% of the people tested with the "Austrian standard series". This proportion varied between 40.8 and 61.4% from center to center (with more than 100 tested persons). 15 (60%) of the 25 test substances in 1992 and 17 (68%) in 1993 surpassed the limit of a sensitization frequency of 1%. The "hit list" of substances did not differ qualitatively from those of other international studies, with only one remarkable, well described "Austrian-specific" exception, namely the mercury-containing thiomersal (second place).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Auriculotemporal (Frey) syndrome in late childhood: an unusual variant presenting as gustatory flushing mimicking food allergy.

Auriculotemporal or Frey syndrome is characterized mainly by recurrent episodes of facial gustatory flushing and/or sweating, limited to the cutaneous distribution of the auriculotemporal nerve. Although relatively common in adults following injury to the auriculotemporal nerve or parotid disease, the condition has rarely been reported in children. Moreover, in childhood, auriculotemporal syndrome has been described mainly in infancy and early childhood as a sequel of perinatal birth trauma resulting from assisted forceps delivery. We report a 13-year-old girl with a 2-month history of recurrent, painless, preauricular gustatory flushing without sweating, initially suspected to be a food allergy. Detailed inquiry revealed a history of a bicycle accident with mandibular condyle fracture 7 years prior to the onset of symptoms. Our patient demonstrates an unusual presentation of auriculotemporal syndrome in late childhood as gustatory flushing mimicking food allergy. Awareness of this variant is essential for prompt recognition, thus avoiding unnecessary laboratory tests, especially as this condition usually resolves spontaneously.

Adolescent↗