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Biomedical subjects

R Brehler

Publications and source records attributed to R Brehler.

35 records · Page 2Linked to original sources
PubMed1997

Contact urticaria due to rubber chemicals?

Contact urticaria due to gloves is mostly related to immediate-type allergy to natural rubber latex (NRL), and rarely due to rubber chemicals. We report the results of prick tests with rubber chemicals carried out on 75 latex-allergic patients. Clinically relevant hypersensitivity was not observed in our patient collection. Thus, we conclude that contact urticaria due to rubber chemicals is a very rare finding in latex-allergic patients, but has to be considered in patients with contact urticaria due to synthetic rubber gloves, as well as in patients with contact urticaria due to NRL gloves but no latex allergy. Therefore prick tests with rubber chemicals are unnecessary in the routine diagnostic assessment of latex-allergic patients.

Adolescent↗
PubMed1997

Glove powder--a risk factor for the development of latex allergy?

Studies are described which compare the prevalence of sensitisation against latex proteins in medical personnel in different hospitals. The objective of these studies was to find out whether the use of powdered or unpowdered gloves could be related to the prevalence of latex allergy. Employees of one of the investigated hospitals (Germany) were using only powdered latex gloves, and in the other two hospitals (Great Britain) low protein powder-free latex gloves were used. Methods by which latex allergy can be avoided are suggested.

Allergens↗
PubMed1996

[Ficus benjamina allergy].

We report the case of a 48-year-old patient suffered from asthma and conjunctivitis caused by an immediate type allergy to weeping fig (Ficus benjamina). By RAST inhibition test we could demonstrate that IgE antibodies react with allergens of fig; however our patient tolerated figs in oral provocation test. Sensitization to latex proteins reported to be cross reactive to Ficus species was not found. Ficus benjamina allergens represent relevant indoor allergens. A standardized allergen extract for skin testing is not yet available. Allergen specific IgE is mostly found in patients with strongly positive prick test results using the native sap of the tree. In 12 of 64 latex allergic patients we found simultaneous sensitization to weeping fig, so that cros-sensitization has to been considered in patients with IgE-mediated sensitization to latex.

Asthma↗
PubMed1995

[Allergic and pseudo-allergic reactions in anesthesia. I: Pathogenesis, risk factors, substances].

In this article we present a survey on the pathogenesis of allergic or pseudoallergic reactions in anaesthesia, the risk factors and the responsible substances. The incidence of anaphylactoid reactions is between 1:3500 and 1:20,000 anaesthetic cases. The estimated mortality rate amounts to 3-6%. Neuromuscular blocking drugs account for most of the cases of significant anaphylactoid reactions (59-70%). However, the incidence of latex-related reactions in increasing. Risk factors for anaphylaxis are a history of IgE-mediated drug allergy, repeated anaesthesias, atopy, hyperventilation tetany, and the use of neuromuscular blocking drugs in females. Risk factors for pseudoallergic reactions are emotional stress, atopic predisposition, increased sensitivity for histamin, hyperventilation tetany and female gender.

Analgesics↗
PubMed1995

[Allergic and pseudo-allergic reactions in anesthesia. II: Symptoms, diagnosis, therapy, prevention].

In this article we present the symptomatic features and discuss relevant diagnostic and therapeutic aspects of anaphylactoid reactions. In addition we give practical advice as to how to avoid and manage allergic or pseudoallergic reactions during anaesthesia. Measurements of serum tryptase-levels and of methylhistamine in urine have been introduced in clinical diagnostic routine. Skin tests and determination of specific antibodies are essential to identify responsible substances. Preventive measures like careful premedication, calm atmosphere, slow injection of drugs, the use of diluted solutions, and the use of drugs with a low potential for anaphylactoid reactions are important. Substances like inhalation anaesthetics, propofol, etomidate, ketamine, midazolam, fentanyl, alfentanil and bupivacain without epinephrine should be used.

Anesthesia, General↗
PubMed1994

[Clinically relevant solitary palladium allergy].

A 54-year-old woman patient had symptoms of stomatitis and asthma following the provision of a dental prosthesis in July 1991. We found a positive patch test reaction to palladium only, without any concomitant metallic contact dermatitis; in particular there was no sensitization to nickel. This is a very rare sensitization. After replacement of the dental alloy the clinical symptoms improved.

Dental Prosthesis↗
PubMed1993

[Mercury sensitization in amalgam fillings. Assessment from a dermatologic viewpoint].

Epicutaneous tests were performed on 88 patients (27 men, 61 women; mean age 36.8 [18-68] years) thought to have an allergy against amalgam or mercury. In addition their oral mucosa was assessed clinically. The epicutaneous test was positive for mercury sensitization in seven patients, five of them reporting oral mucosa symptoms. Such symptoms also occurred, although less frequently, in non-sensitized patients (30 of 81). In three sensitized patients there was evidence of perioral dermatitis which in two of them cleared up after removal of the amalgam fillings. Two further patients had no further complaints, such as burning sensation on the oral mucosa, recurrent aphthous ulcers or gingivitis, after removal of amalgam fillings. In one patient each peroral eczema and diarrhoea aggravated after amalgam fillings had been taken out. These observations indicate that responses to mercury allergy are not uniform and show considerable individual variations. There is no reason to advise against or prohibit the use of amalgam fillings. Their substitutions by other materials may well bring about other types of allergy.

Adolescent↗
PubMed1993

[Lymphoplasmocytoid immunocytoma of the skin].

A 68-year-old male patient presented with numerous red-brown papules on the trunk and neck. Cutaneous lymphoplasmocytoid immunocytoma was diagnosed following histological and electron microscopical detection of atypical lymphoid cells in the dermis. Immunohistochemistry revealed a monoclonal proliferation of IgG-kappa-positive B-lymphocytes. There was no extracutaneous manifestation of the lymphoma. Complete remission was affected by total-body irradiation with an electron beam.

Biomarkers, Tumor↗
PubMed1986

[Immunohistochemical studies of the determination of the hormone receptor status of breast cancer].

Immunohistochemical examinations of 89 breast cancer specimens were performed using two different monoclonal antibodies. One marked the nuclear estrogen-receptor (ER) protein (anti-ER, Abbott), whereas the other marked an ER-related cytoplasmic protein (ER-D5 Amersham). Comparison of the results of the biochemical assay with those of the immunohistochemical markers revealed the following correlations: 75% anti ER and 71% ER-D5. Clinical follow-up studies are necessary to specify the relevance of these new immunohistochemical techniques in the anti-hormonal therapeutic management of breast cancer patients.

Antibodies, Monoclonal↗
PubMed1986

[Morphologic criteria in breast-saving surgery].

Efficiency of radiation therapy is dependent on the tumor mass on the one hand and on "radiosensitivity" on the other hand. Thus the locoregional acribic surgery is an urgently required presupposition regarding therapeutic success. In cases of early breast cancer (pT 1 N0 M0) unfavorable prognostic factors may initiate a discussion on adjuvant therapy. From the curative point of view at present breast preserving surgery referring tumors bigger that 2 cm (pT2) should be performed in cases with more advantageous prognostic parameters (low grade malignancy up to grade II a, low degree of tumor cell dissociation, favorable subtype, no relevant lymphangiosis carcinomatosa detectable, etc.). Additional immunohistochemical analysis of the receptor status and the proliferative compartment can be helpful for later therapeutic decisions. The possibility of breast preservation in only palliatively treated cases must be discussed separately.

Breast↗
PubMed1986

Localization of endogenous lectins in normal human breast, benign breast lesions and mammary carcinomas.

Specific antisera against three mammalian beta-galactoside-specific lectins of apparent molecular weights 14.5 kDa, 18 kDa and 29 kDa have been used to localize these lectins in normal breast, and in benign and malignant mammary lesions. In normal breast tissue discrete localization of two lectins (Mrs 14.5 kDa and 18 kDa) was demonstrated in fibroblasts, smooth muscle cells, myoepithelial cells and capillary endothelium. Extracellular localization of one lectin (Mr 14.5 kDa) in collagen was apparent. The third lectin (Mr 29 kDa) labelled preferentially luminal cells and their secretory product. Two benign tumours (an analyzed fibroadenoma and a papilloma) revealed strong staining with two lectins (Mrs 18 kDa and 29 kDa). Of the 24 mammary carcinomas examined, the lectin (Mr 14.5 kDa) was expressed by only occasional tumour cells, the lectin (Mr 18 kDa) occurred in many tumour cells and the lectin (Mr 29 kDa) labelled tumour cells in nearly all cases. The expression of these beta-galactoside-specific endogenous lectins therefore appears to be regulated differently in normal breast compared with mammary tumours.

Breast↗
PubMed1980

[The structure of the t. muscularis propria of the human small intestine as base for a biomechanical model for motility (author's transl)].

The structure of the t. muscularis propria of the small intestine was examined in cleared specimen of human cadavers and the scissor like railings arrangement of the muscle-bundles is described. The constant and varying form of the small intestine is directly correlated with the structure of its t. muscularis propria. There exist spheric angles between circular and longitudinal muscle-bundles measuring during dilatation more, during concentration less than 53 degrees. According to this gives a simple biomechanical model for motility an angle of 55 degrees for maximal dilatation.

Biomechanical Phenomena↗