Anaphylactic Reaction Rates to Blue Dyes Used for Sentinel Lymph Node Mapping

Perenyei, Miklos; Barber, Zoe; Gibson, John; Hemington-Gorse, Sarah; Dobbs, Thomas D.

doi:10.1097/sla.0000000000004061

Cited by 31 publications

(13 citation statements)

References 41 publications

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“…[35][36][37][38] Although suitable for vascular and lymphatic studies, methylene blue, India ink and even submicron fluorescent dyes are unable to enter many of the CSF pathways in nerves and brain. 39 In addition, large molecules fail to identify cell-to-cell transport of CSF and solutes (eg, glucose and monocarboxylates) that may occur through gap junctions known to exist between adjacent Schwann and other glial cells. When these size constraints are followed, CSF flow in neural sheaths and meninges may be studied using a variety of nanoprobes, including fluorescent, metallic, and functionalized-energy transport molecules (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…A variety of peripheral neuropathies are related to sheath and Schwann cell dysfunction. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Traumatic nerve stretch injuries are associated with disruption of the myelin sheath. 14,15 Demyelinating diseases such as multiple sclerosis affect cranial nerves (eg, optic, trigeminal), which are easily studied using these techniques.…”

Section: Discussionmentioning

confidence: 99%

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Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves

Pessa

2022

Plastic and Reconstructive Surgery - Global Open

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Background: Growing evidence suggests that cerebrospinal fluid circulates in human nerves. Several conditions encountered by the plastic surgeon may be related to dysregulation of this system, including nerve transection, stretch injuries, and peripheral neuropathy. The purpose of this study was to show how ventricular infusion and nanoprobes identify CSF and glymphatic circulation in neural sheaths of human nerves. Methods:The technique of ventricular infusion using buffered saline was developed in 2017. The technique was used in a series of eight fresh cadavers before dissection of the median nerve, and combined with fluorescent imaging and nanoprobe injections in selected specimens. Results: Eight cadaver specimens underwent ventricular infusion. There were six female and two male specimens, ages 46-97 (mean 76.6). Ventricular cannulation was performed successfully using coordinates 2 cm anterior to coronal suture and 2.5 cm lateral to sagittal suture. Depth of cannulation ranged from 44 to 56 mm (mean 49.7). Ventricular saline infusion complemented by nanoprobe injection suggests CSF flows in neural sheaths, including pia meninges, epineurial channels, perineurium, and myelin sheaths (neurolemma). Conclusions: Ventricular infusion and nanoprobes identify CSF flow in neural sheaths of human nerves. CSF flow in nerves is an open circulatory system that occurs via channels, intracellular flow, and cell-to-cell transport associated with glial cells. Neural sheaths, including neurolemma, may participate in glucose and solute transport to axons. These techniques may be used in anatomic dissection and live animal models, and have been extended to the central nervous system to identify direct ventricle-to-pia meninges CSF pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves

Pessa

2022

Plastic and Reconstructive Surgery - Global Open

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“…Whereas, radioactive colloid exhibits certain disadvantages, such as the need for specialized nuclear doctors, high costs, and the lack of visual information. In addition, the blue dye staining can only determine lymph vessels and SLNs after incising the skin during operation [43], and cannot provide information to doctors before operation. In our study, ICG-NIR-II imaging could provide real-time visualization of lymphatic drainage and necessary information for preoperative surgical planning without radiation, especially for the precise choice of surgical incision.…”

Section: Discussionmentioning

confidence: 99%

Dynamically monitoring lymphatic and vascular systems in physiological and pathological conditions of a swine model via a portable NIR-II imaging system with ICG

Wang¹,

Yu²,

Wu³

et al. 2022

Int. J. Med. Sci.

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Objective: NIR-II imaging with indocyanine green (ICG) has been clinically used in liver tumor resection. However, few data are available concerning the application of ICG-NIR-II in lymphatic and vascular systems in clinic. To expand the application and promote the clinical translation of this approach, we aimed to investigate the feasibility of ICG-NIR-II imaging for monitoring both lymphatic and vascular systems in physiological and pathological conditions using a swine model and compared it to ICG-NIR-I imaging. Methods: we constructed a portable NIR-II imaging system suitable for large animals. Different simulated clinical scenarios in lymphatic and vascular systems of pigs, including lymphatic drainage, lymphorrhea, lymphatic obstruction, lymphatic reconstruction in flaps, venous thrombus formation and vascular anastomosis were modeled to evaluate the reliability of our NIR-II imaging system and the imaging quality of ICG in the NIR-I/II window. Results: Under different simulated clinical scenarios, our portable NIR-II imaging system showed good reliability for pigs. With the help of the portable imaging system, dynamical visualization of lymph vessels, lymph nodes and blood vessels of pigs in different clinical scenarios could be achieved in NIR-II imaging by using the tail fluorescence of ICG. Moreover, ICG-NIR-II imaging has lower background fluorescence and higher resolution than ICG-NIR-I imaging. Conclusions: We demonstrated the first application of a portable NIR-II imaging system for dynamically monitoring both lymphatic and vascular systems in physiological and pathological conditions using a swine model. Our study indicates that ICG-NIR-II imaging be a promising approach for the diagnosis of malfunctions in lymphatic and vascular systems and the surgical navigation of microsurgery and reconstructive surgery.

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“…Due to the many possibilities of sensitization, anaphylaxis can also occur for the first time, for example, in the case of deliberate first contact in the context of the use of patent blue in a sentinel lymph node operation. A skin prick test may be positive; a CAST is commercially available [12][13][14][15][16].…”

Section: Anaphylaxis To Dyesmentioning

confidence: 99%

Anaphylaxis to food additives

Treudler¹,

Simon²

2022

Allergo J Int

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A variety of additives found in foodstuffs have been associated with triggering of a number of clinical pictures. Hypersensitivity reactions of allergic and non-allergic etiology have been widely described, but are reported to be rare overall. This review presents a selection of food additives for which anaphylactic reactions have been described. These include colorants (e.g., tartrazine, carmine, patent blue), preservatives (e.g., sulfites, sodium benzoate), and thickeners/gelling agents (e.g., carboxymethylcellulose, guar, gum arabic). Possible diagnostic procedures (skin test, specific IgE, cellular antigen stimulation test, oral provocation) are presented. For those affected, avoidance of consumption is facilitated by the mandatory declaration (class name, E‑number/designation) required in the European Union. Only sulfur dioxide and sulfites have to be highlighted as food allergens, depending on the concentration. Due to the limited diagnostic procedures available, it cannot be excluded that the frequency of hypersensitivity to food additives is underestimated.

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Anaphylactic Reaction Rates to Blue Dyes Used for Sentinel Lymph Node Mapping

Abstract: Supplemental Digital Content is available in the text

Cited by 31 publications

References 41 publications

Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves

Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves

Dynamically monitoring lymphatic and vascular systems in physiological and pathological conditions of a swine model via a portable NIR-II imaging system with ICG

Anaphylaxis to food additives

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