BACKGROUND: Present limitations to monopolar RF include the small lesion size, difficulties in targeting, and questions about the reliability.In contrast with monopolar RF, bipolar RF create larger, more predictable, and more extensive ablative lesion. This study documents the optimal spacing of two needles, temperature, and time required to produce bipolar RF lesions. METHODS: Two 20-gauge 5 mm active tip needles and 10 mm active tip needles were secured in a parallel position 6, 8, and 10 mm apart and submerged in egg white that would allow visualization of the size and shape of the lesion.RF lesions were produced at 70, 80, and 90degrees C.At each temperature, photographs were taken at 30, 60, 90, and 120 seconds. RESULTS: When the 5 mm active tips with 6 mm distance were above 60 s and with 8, 10 mm distance above 120 s, continuous strip lesions were produced.10 mm active tips with 120 s were produced too.The others had discrete unipolar lesions around each cannula.The lesion size increased with a higher temperature and time.But time was the more important factor in determining lesion size. CONCLUSIONS: A continuous strip lesion was produced even though the electrode spaced 10 mm apart.And spacing the electrode 6 mm apart with 5 mm active tip and 8 mm apart with 10 mm active tip at 90degrees C for 90 s maximize the surface area of the lesions.
Egg White ; Electrocoagulation ; Electrodes ; Needles

BACKGROUND: The aim of this study was to document the optimal spacing of two cannulae to form continuous strip lesions and maximal surface area by using water-cooled bipolar radiofrequency technology. METHODS: Two water-cooled needle probes (15 cm length, 18-gauge probe with 6 mm electrode tip) were placed in a parallel position 10, 20, 24, 26, and 28 mm apart and submerged in egg white. Temperatures of the probes were raised from 35degrees C to 90degrees C and the progress of lesion formation was photographed every 1 minute with the increase of the tip temperature. Approximately 30 photographs were taken. The resultant surface areas of the lesions were measured with the digital image program. RESULTS: Continuous strip lesions were formed when the cannulae were spaced 24 mm or less apart; monopolar lesions around each cannula resulted if they were spaced more than 26 mm apart. Maximal surface areas through the formation of continuous strip lesion were 221 mm2, 375 mm2, and 476 mm2 in 10, 20, and 24 mm, respectively. Summations of maximal surface area of each monopolar lesions were 394 mm2 and 103 mm2 in 26 and 28 mm, respectively. CONCLUSIONS: Water-cooled bipolar Radiofrequency technology creates continuous "strip" lesions proportional in size to the distance between the probes till the distance between cannulae is 24 mm or less. Spacing the cannulae 24 mm apart and treating about 80degrees C for 24 minutes maximizes the surface area of the lesion.
Catheters ; Egg White ; Electrodes ; Needles ; Ovum

BACKGROUND: Understanding the electrophysiology of radiofrequency (RF) lesions and determining the size and shape of RF lesions is important for reducing side effects when applied to patients in a clinical setting. We compared the shape and size of RF thermocoagulation produced by straight and curved 20-gauge electrodes and considered its application in clinical settings. METHODS: The white from a fresh hen's egg was warmed to 37oC and placed in a rectangular glass container. Straight and curved 20-gauge electrodes were immersed. The transparency of the egg white and the glass container made it possible to photograph the changes in size of the RF lesions over time. We applied thermocoagulation for 60 seconds at 70, 80, and 90oC. Photographs were taken at 60 seconds. We measured the maximal size of the lesions. A two-way statistical analysis of variance was performed. RESULTS: The thermocoagulations were started at the junction of the insulated and uninsulated portion of the electrode and did not extended beyond the tip. The thermocoagulation size was 4.2 +/- 0.8 at 70oC, 6.1 +/- 2.9 at 80oC and 6.1 +/- 1.9 at 90oC using the 20-gauge, 10 mm active tip, straight electrode and 4.5 +/- 1.1 at 70oC, 7.2 +/- 1.9 at 80oC and 7.9 +/- 2.7 at 90oC using the 20-gauge, 10 mm active tip, curved electrode. There was no observable difference in the size of the lesions produced by the straight and curved electrodes. CONCLUSIONS: We found that temperature was the more important factor in determining lesion size. When the temperature setting is the same, lesions produced by straight and curved electrode of the same gauge are also same size. Therefore the choice of straight or curved electrode should be made to optimize ease of handling and ensure proper location of the electrode tip.
Egg White ; Electrocoagulation ; Electrodes* ; Electrophysiology ; Glass ; Humans ; Ovum

PURPOSE: Egg (egg white) allergies are among the most common food allergies in infants and young children. Serum egg white-specific IgE (sIgE) levels have been shown to be correlated with clinical symptoms, and the predictive decision point of sIgE levels has been proposed and used widely in the clinical setting. However, some patients whose sIgE levels to egg white are higher than the predictive decision point value show no clinical symptoms, and vice versa. This study was conducted to evaluate the clinical usefulness of sIgE antibodies to egg white and its components in the diagnosis of egg allergies. METHODS: Forty-one patients younger than 2 years of age with no experience of egg intake due to concerns regarding allergies or a non-specific clinical response to eggs were enrolled. Total IgE levels and the levels of IgE antibodies specific for egg white and its components (ovomucoid, ovalbumin, and conalbumin) were measured by ImmunoCAP testing. The clinical response of the subjects was confirmed by an open oral food challenge (OFC). RESULTS: Fifteen (71.4%) out of 21 patients in the egg white-sIgE > or =2 kU/L group showed a positive response, while 10 (50.0%) out of 20 patients in the egg white-sIgE <2 kU/L group showed a negative response to the OFC. There were no statistically significant differences in the levels of sIgE antibodies against egg white and its components between the positive and negative open OFC groups. In addition, there were no statistically significant differences in the levels of sIgE antibodies against egg white and its components based on an intra-group analysis. CONCLUSIONS: Our results show that the sensitivity and specificity of the predictive decision point values for egg white-sIgE antibodies by ImmunoCAP were relatively low in Korean children. In addition, no egg white component predicted the clinical reactivity of the subjects. We suggest that the predictive decision point value for a positive egg oral challenge test by ImmunoCAP should be re-evaluated. Moreover, we suggest that careful personal history recording and challenge tests are necessary for the correct diagnosis of an egg allergy.
Antibodies ; Child ; Egg Hypersensitivity ; Egg Proteins ; Egg White ; Eggs ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Ovalbumin ; Ovum

Hen's egg is the most common allergen in IgE-mediated food allergy among children in Japan. Although the majority of patients with egg allergy can eat heated egg yolk safely because of its low allergenicity, severely allergic patients show an immediate-type reaction to heated egg yolk. We hypothesized that patients with hyperresponsiveness to boiled egg yolk may have difficulty in acquiring tolerance to egg. The purpose of this study was to examine the prognosis of patients with hyperresponsiveness to boiled egg yolk. Data from 121 patients with egg allergy who underwent oral food challenge (OFC) with boiled egg yolk between January 2012 and December 2013 were analyzed retrospectively. The proportion of patients who could consume heated whole egg 3 years after OFC was 15.4% in the OFC-positive group and 75.8% in the OFC-negative group. Hyperresponsiveness to boiled egg yolk in early life might lead to prolonged egg allergy in children. This finding might aid in the selection of an appropriate population requiring practical immunotherapy.
Child ; Egg Hypersensitivity ; Egg White ; Egg Yolk ; Food Hypersensitivity ; Hot Temperature ; Humans ; Immunotherapy ; Japan ; Ovum ; Pediatrics ; Prognosis ; Retrospective Studies

PURPOSE: Reliable predictors of tolerance to cooked egg in an egg allergic population are not established. We investigated the usefulness of the skin prick test to cooked egg in children with egg allergy. METHODS: We studied 36 children with egg allergy. Skin prick tests (SPTs) for the uncooked or cooked form of egg white and egg yolk, whole egg, ovomucoid (OVM), and ovalbumin (OVA) were performed at diagnosis. The reagents of cooked egg for SPT were prepared by baking for 25 minutes in 200 degree oven. We also examined specific IgE levels to whole egg, egg white, egg yolk, OVM, and OVA. RESULTS: Patients with history of allergic reaction to extensively heated egg showed significantly increased wheal size for cooked egg white (median [interquartile range]), 10.5 [7.0-14.6] vs. 4.2 [0.0-5.6], P<0.001) and OVM (9.6 [7.3-13.8] vs. 5.6 [0.0-7.8], P=0.001) than those without the history. The strongest positive correlation was found between wheal size for cooked egg white and OVM (r=0.788, P<0.001). SPT wheal size for cooked egg white were positively correlated with serum OVM-specific IgE levels (r=0.691, P<0.001). Cutoff value was 7.0 mm in SPT wheal size for cooked egg white, the sensitivity was 73.1% and specificity was 99.0%. SPT for cooked egg white showed significantly higher area under curve than serum egg white specific IgE. CONCLUSION: Our results suggest that SPT to cooked egg white may be useful predictor of allergic reaction to cooked egg. Further investigations will be needed.
Area Under Curve ; Child* ; Diagnosis ; Egg Hypersensitivity* ; Egg Proteins ; Egg White ; Egg Yolk ; Hot Temperature ; Humans ; Hypersensitivity ; Immunoglobulin E ; Indicators and Reagents ; Ovalbumin ; Ovomucin ; Ovum* ; Skin Tests ; Skin*

Hemo-Q (R) and Albumax (R) solution are widely used antianemics. Hemo-Q (R) contains cow's milk protein (casein) and Albumax (R) contains egg white protein (ovalbumin). Cow's milk protein and egg protein can cause common allergic diseases in infants and young children. We reported two cases of young children with milk and egg allergy who presented skin symptoms after ingestion or cutaneous contact with Hemo-Q (R) or Albumax (R) solution. When Hemo-Q (R) or Albumax (R) solution was taken or rubbed on, erythematous papules and wheals were developed in 10-20 minutes, but other antianemics which don't contain milk or egg protein contents didn't show skin manifestations.
Caseins ; Child ; Eating ; Egg Hypersensitivity ; Egg White* ; Food Hypersensitivity ; Humans ; Infant ; Milk Proteins* ; Milk* ; Ovalbumin ; Ovum* ; Skin ; Skin Manifestations ; Urticaria*

PURPOSE: The present study was performed to determine the factor, either duration or the temperature of heat treatment, exerting maximal and significant influence on the composition and allergenicity of egg white (EW) proteins. METHODS: Raw EW and 4 kinds of heated EW (fried EW, boiled EW for 10 minutes, boiled EW for 30 minutes, and baked EW for 20 minutes at 170degrees C) were prepared, and subsequently protein extraction was carried out. The proteins were separated by SDS-PAGE, and then immunoglobulin E (IgE) immunoblots were performed with the sera of 7 egg-allergic patients. Furthermore, the antigenic activities of ovalbumin (OVA), ovomucoid (OM), and ovotransferrin (OT) in different EW samples were measured by inhibition enzyme-linked Immuno-sorbent assay (ELISA). RESULTS: In SDS-PAGE analysis, the intensity of the protein band at 45 kD (corresponding to OVA) decreased significantly in boiled EW (30 minutes) and baked EW, but no change was observed in the case of boiled EW for 10 minutes. In IgE immunoblots, the IgE response to 34-50 kD (OM and OVA) in boiled EW for 30 minutes decreased significantly, when compared with raw EW and other heated EWs. In inhibition ELISA, a significant decrease in the OVA antigenic activity was observed in boiled EW for 30 minutes amongst other heated EW samples. However, OM antigenic activity in all kinds of heated EW including boiled EW for 30 minutes did not reduce after heat treatment. The OT antigenic activity nearly disappeared in heated EWs except in the case of boiled EW for 10 minutes. CONCLUSIONS: Amongst 4 kinds of heated EWs, the boiled EW for 30 minutes showed the most significant changes both in composition and reduction in allergenicity. Our results revealed that the duration of heat treatment had more influence on the composition and allergenicity of EW proteins than the temperature.
Conalbumin ; Egg Hypersensitivity ; Egg Proteins ; Egg White ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Hot Temperature ; Humans ; Immunoglobulin E ; Immunoglobulins ; Ovalbumin ; Ovomucin ; Ovum ; Proteins

BACKGROUND: The serum levels of serum total IgE, peripheral eosinophils and eosinophil cationic protein (ECP) are known to be elevated in patients with atopic dermatitis. However, the relationship between these laboratory findings and the clinical severity of atolpic dermatitis is controversial. OBJECTIVE: The purpose of this study was to evaluate serum total IgE, peripheral eosinophil counts, ECP as severity indices or disease markers of atopic dermatitis in Korea. METHODS: One hundred and thirty patients were evaluated for the symptoms and signs of atopic dermatitis, and classified into a mild, moderate or severe group according to the clinical severity. We measured for total serum IgE, peripheral eosinophil counts, ECP and assessed allergen-specific IgE using multiple allergosorbent test-chemiluminescent assay (MAST-CLA) and CAP-fluoroenzyme immunoassay (CAP-FEIA). RESULTS: Serum total IgE and peripheral eosinophil counts of patients with atopic dermatitis showed a statistically significant correlation with the clinical severity (p<0.05). Patients from the severe atopic dermatitis group revealed significantly higher ECP level than those in the mild or moderate group (p<0.05). The most common inhalant allergen was D. farinae, followed by D. pteronyssinus, housedust, and the most common food allergen was wheat, followed by soyabean and egg white. CONCLUSION: Total serum IgE, peripheral eosinophils and eosinophil cationic protein (ECP) were good indices reflecting the severity of atopic dermatitis.
Dermatitis ; Dermatitis, Atopic* ; Dust ; Egg White ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoassay ; Immunoglobulin E ; Korea ; Triticum

BACKGROUND: The MAST CLA test is known to have almost the same sensitivity and specificity as the skin prick test for diagnosing allergic diseases. We report the types of allergens causing allergic diseases in Korean pediatric patients and re-evaluate the positive cut-off level used in Korea. METHODS: The MAST CLA tests were done on patients, ages less than 14-years, who visited the allergy clinic in the pediatric department from May 1999 to September 2000. We separated the patients into 2 age groups, one group of less than 3 years and dependent on milk feeding and another group of older than 3 years. RESULTS: Among 599 patients, 353 patients were male, 246 patients were female. 261 patients had at least one positive allergen-specific IgE antibody in the allergy disease group. The overall positive rate was 63.0% and 61.3% in the male and female groups, respectively among the allergy diseases group. The order of allergic origin frequencies was; milk, egg whites, D. farinae, D. pteronyssinus, and house dust. But patients who were less than 3 years of age and dependent on milk feeding, the order of allergen frequencies changed to milk, egg whites, and soybeans. By changing the positive cut-off from class 2 to class 1, the positive rates for allergen-specific IgE increased from 34.4% to 62.3%. Class 1 positive results showed good clinical correlations. CONCLUSIONS: Allergen origins for patients under 3 years of age and those of older groups were different. By changing the positive cut-off from class 2 to class 1, the detection rate for allergens increased which also showed good clinical correlation with symptoms. Allergen origin should be defined by the MAST CLA test for prompt therapy.
Allergens ; Dust ; Egg White ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Male ; Milk ; Sensitivity and Specificity ; Skin ; Soybeans