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Objective: To identify the risk factors for catheter migration and demonstrate possible mechanisms of this migration., Design: Retrospective study., Setting: Chang Gung Memorial Hospital, a tertiary medical centre in Taiwan., Patients: Patients who underwent implantation of intravenous ports via the superior vena cava (SVC)., Interventions: Procedures involving catheter placement and re-intervention for catheter migration., Main Outcome Measures: The anatomic location of the catheter tip was confirmed by plain chest X-rays (postero-anterior view). From these plain radiographs, the distance (in cm) between the carina and catheter tip and the angle (in degrees) between the locking nut and catheter were measured., Methods: A total of 1542 procedures related to intravenous port implantation were retrospectively reviewed but only procedures involving implantation via the SVC were included in the analysis. The study group was composed of 31 interventions because of catheter migration, while the control group consisted of 1475 implantation and re-intervention procedures except those involving catheter migrations., Results: Shallow catheter-tip location (p < 0.0001) and the presence of lung cancer (p = 0.006) were risk factors for catheter migration., Conclusions: Shallow catheter-tip location and the presence of lung cancer are risk factors for catheter migration. Strategies that ensure low catheter-tip location and avoid increased thoracic pressure may be useful preventive measures., (Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)

The cyclosporine (CsA) blood concentration at 2 hours postdose (C2) has been shown to be better than trough level (C0) to predict acute cellular rejection (ACR) in solid organ transplantations. We tried to assess the superiority of C2 monitoring to C0 in heart transplantation (HTx). Prospective data were collected from the HTx recipients from November 1991 to April 2003. The 100 patients surviving longer than 3 months after HTx, provided 237 sample sets, with ACR graded by endomyocardial biopsy (EMB) and concurrent C0 and C2 levels. ACR was defined as International Society of Heart and Lung Transplantation (ISHLT) grade lb or higher. Nonparametric methods, logistic regression model, and receiver operating characteristic (ROC) analysis were used. There was no significant demographic heterogeneity between ACR and non-ACR groups. C2 was significantly lower in ACR than non-ACR groups (P = .0192) whereas C0 showed no significant difference. In the logistic regression model, C2 was a significant predictor against ACR (P = .026, odds ratio = 0.76 per 100 ng/mL), but C0 was not. ROC analysis showed that C2 of 600 ng/mL might provide the optimal cut-off point, with a sensitivity of 51.23% and a specificity of 71.43%, but C0 did not show this association. In conclusion, C2 monitoring is superior to C0 for predicting ACR in HTx. ACR should be suspected when the C2 value is below 600 ng/mL.

This study identified that the carcinogenesis of hamster buccal pouch (HBP) induced by 7,12-dimethylbenz[a]anthracene (DMBA) was greatly enhanced (18 folds) by a combination treatment with Taiwanese betel quid (BQ) extract. A new cell line, HCDB-1, has been established from induced carcinomas. The cultured monolayer cells were epithelioid in shape with irregular nuclei. They demonstrated abundant cytokeratin and tonofilaments; however, ultrastructural well-organized desmosomes were lacking. The HCDB-1 cell exhibited population doubling in 19 h and was highly tumorigenic in nude mice. A C-->T transition at codon 141 (Ala to Val) of the p53 gene was detected in this cell. This mutation is equivalent to a specific temperature-sensitive mouse p53Ala135Val mutant that causes transformation by shifting to 37.5 degrees C. HCDB-1 is the first cell line established from the HBP model of oral carcinogenesis induced by DMBA/Taiwanese BQ extract. It might be valuable for exploring the molecular pathogenesis of oral cancer.