RESUMEN
We report a case of intraoperative fentanyl anaphylactic reaction. The patient was a previously healthy 12-year-old boy with severe head injury by a traffic accident. We experienced a rapid hemodynamic change after fentanyl injection and that occurred again after another fentanyl injection. In the second hemodynamic change, red wheals appeared on the skin. We clinically diagnosed this as fentanyl anaphylactic reaction. Six weeks later we performed prick test and intradermal test, but the patient had negative results for fentanyl in both tests. Although it is rare that opioids cause anaphylactic reaction, we must differentiate them when we search causative agents. Even if skin tests are negative, there is a possibility of false negative reactions. Therefore it is safe to regard suspicious agents as causative agents in cases where the agents are clinically suspected.
Asunto(s)
Analgésicos Opioides/efectos adversos , Anafilaxia/inducido químicamente , Fentanilo/efectos adversos , Complicaciones Intraoperatorias/inducido químicamente , Accidentes de Tránsito , Anafilaxia/diagnóstico , Niño , Traumatismos Craneocerebrales/cirugía , Humanos , Masculino , Pruebas CutáneasRESUMEN
We have developed a microfabricated fluorescence-activated cell sorter system using a thermoreversible gelation polymer (TGP) as a switching valve. The glass sorter chip has Y-shaped microchannels with one inlet and two outlets. A biological specimen containing fluorescently labeled cells is mixed with a solution containing a thermoreversible sol-gel polymer. The mixed solution is then introduced into the sorter chip through the inlet. The sol-gel transformation was locally induced by site-directed infrared laser irradiation to plug one of the outlets. The fluorescently labeled target cells were detected with sensitive fluorescence microscopy. In the absence of a fluorescence signal, the collection channel is plugged through laser irradiation of the TGP and the specimens are directed to the waste channel. Upon detection of a fluorescence signal from the target cells, the laser beam is then used to plug the waste channel, allowing the fluorescent cells to be channeled into the collection reservoir. The response time of the sol-gel transformation was 3 ms, and a flow switching time of 120 ms was achieved. Using this system, we have demonstrated the sorting of fluorescent microspheres and Escherichia coli cells expressing fluorescent proteins. These cells were found to be viable after extraction from the sorting system, indicating no damage to the cells.