The totally implantable venous port device is used in patients undergoing chemotherapy. The complications associated with this device include venous thrombosis, infection, catheter fracture, extravasation, and intravascular dislodgement. The incidence of port catheter dislodgement is low. The treatment of choice for port dislocation involves immediate retrieval of the distal migrated part, and percutaneous transcatheter retrieval is regarded as the standard method. A 40-year-old female presented with intermittent palpitation. She was referred from the Department of General Surgery after detection of a fractured and dislocated implantable venous port system into the main pulmonary artery. We successfully retrieved the dislocated fractured device using a 5-Fr pigtail catheter and snare catheter. We herein report this case with a literature review.
Cardiac Complexes, Premature ; Catheterization, Central Venous ; Catheters ; Catheters, Indwelling ; Dislocations ; Female ; Humans ; Incidence ; Pulmonary Artery ; SNARE Proteins ; Vascular Access Devices ; Venous Thrombosis

PURPOSE: There is growing evidence that nasal airway remodeling occurs in allergic rhinitis (AR). Although angiogenesis is an important component of airway remodeling in asthma, its involvement in AR has been little studied. Furthermore, information regarding the role of potent angiogenic factors, such as vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF), in the nasal airway remodeling process is limited. This study was conducted to investigate the role of VEGF and PDGF in nasal airway remodeling, and to assess the preventive effects of anti-angiogenic drugs on this process in a murine AR model. METHODS: Mice were systemically sensitized and subjected to inhalation of ovalbumin (OVA) twice a week for 3 months. Control mice were challenged with phosphate buffered saline, while the treatment group received SU1498, a VEGF receptor inhibitor, and/or AG1296, a PDGF receptor inhibitor, via intraperitoneal injection 4 hours prior to each OVA inhalation. Staining using hematoxylin and eosin, Masson's trichrome, and periodic acid-Schiff were separately performed to assess eosinophil infiltration, subepithelial fibrosis, and goblet cell hyperplasia, respectively, in the nasal airway. Immunohistochemical staining for matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) was also conducted. RESULTS: Repetitive intranasal inhalation of OVA resulted in significant increases in eosinophil infiltration, subepithelial fibrosis, goblet cell count, and MMP-9/TIMP-1 expression. Administration of SU1498 or AG1296 prevented these abnormal responses. CONCLUSIONS: The results of this study suggest that a causal relationship may exist between angiogenic factors and nasal airway remodeling in AR. Inhibition of VEGF or PDGF receptors may, in turn, suppress the remodeling process through the regulation of MMP-9/TIMP-1 expression.
Airway Remodeling ; Angiogenesis Inducing Agents ; Angiogenesis Inhibitors ; Animals ; Asthma ; Cinnamates ; Eosine Yellowish-(YS) ; Eosinophils ; Fibrosis ; Goblet Cells ; Hematoxylin ; Hyperplasia ; Inhalation ; Injections, Intraperitoneal ; Matrix Metalloproteinase 9 ; Mice ; Nose ; Ovalbumin ; Ovum ; Platelet-Derived Growth Factor ; Receptors, Platelet-Derived Growth Factor ; Receptors, Vascular Endothelial Growth Factor ; Rhinitis ; Rhinitis, Allergic, Perennial ; Tissue Inhibitor of Metalloproteinase-1 ; Tyrphostins ; Vascular Endothelial Growth Factor A

OBJECTIVES: The internet has become an important source of medical information and a great amount of information related to allergic rhinitis (AR) is available on the internet. However, the quality of this information is still a matter of debate. Therefore, this study was conducted to assess the AR-related information on Korean websites. METHODS: The key word "allergic rhinitis" was entered into 4 popular search engines, and this led to identifying 40 websites. After being categorized according to authorship, the informational value of these websites was evaluated using 4 different assessment tools such as the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire, the Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update and the Health On the Net (HON) code. RESULTS: The 40 websites containing AR-related information were categorized according to their authorship as Western physician: 20, Oriental physician: 14, commercial: 1, and others: 5. The mean citation frequencies of the JAMA benchmarks and the ARIA 2008 Update concepts was 1.23 out of 4 and 4.33 out of 8, respectively, while the mean DISCERN score was 1.92 out of 5. When the websites were evaluated based on the type of authorship, the mean citation frequencies of the ARIA 2008 Update concepts were Western physician: 5.35, Oriental physician: 2.64. Additionally, three websites authored by Western physicians and 13 authored by Oriental physicians contained unreliable information. Among these 16 websites, only 3 websites met the requirements for the HON code "Justification". CONCLUSION: AR-related information available on Korean websites is of variable quality and not all of the information provided is justifiable. Thus, performing surveillance of the medical information on these websites is necessary. Furthermore, common criteria that can be used to evaluate the websites created by both Western and Oriental physicians are also needed.
American Medical Association ; Asthma ; Authorship ; Internet ; Korea ; Rhinitis ; Rhinitis, Allergic, Perennial ; Search Engine ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: The aim of this study is to identify differences in polysomnographic findings according to the upper airway obstruction level in patients with obstructive sleep apnea (OSA). SUBJECTS AND METHOD: Eighty-four patients with OSA were included in this study. Every patient underwent polysomnography (PSG) and upper airway pressure measurement using a four-sensor catheter simultaneously. The catheter was positioned at the posterior nasal cavity, uvula tip, tip of the epiglottis, and mid-esophagus level, which was inserted through the nasal cavity down to the esophagus. The patients were categorized into two groups of single site obstruction and multi-site obstruction. RESULTS: Twenty-one patients showed single site obstruction and sixtythree patients showed multi-site obstruction. Apnea-hypopnea index, apnea index, and minimal oxygen saturation showed statistically significant differences between two groups. There was no difference in bony mass index (BMI). CONCLUSION: Upper airway pressure measurement can be a method to evaluate the upper airway obstruction site. This study shows that OSA patients with multisite obstruction have severer sleep apnea than those with single site obstruction.
Airway Obstruction ; Apnea ; Catheters ; Epiglottis ; Esophagus ; Humans ; Nasal Cavity ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Uvula

BACKGROUND: Osteoprotegerin (OPG) is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF-kappa B ligand (RANKL). OPG has been shown to be an important inhibitor of osteoclastogenesis and arterial calcification in animal models. Recently, OPG has been proposed as a link molecule between osteoporosis and arterial calcification, but the relationship between OPG gene and cardiovascular system in human populations is unclear. Thus, the aim of this study was to investigate the relationship between OPG gene polymorphisms and aortic calcification in healthy Korean women. METHODS: We observed 251 healthy Korean women (mean age, 51.3+/-6.9 yr). We determined cardiovascular risk factors. Thoracic and abdominal aortic calcifications were examined by simple radiological methods. A163G, G209A, T245G, and T950C polymorphisms of OPG gene were analyzed by allelic discrimination using the 5' nuclease polymerase chain reaction assay. RESULTS: The frequency of mutant allele was increased in the aortic calcification (+) group as compared with aortic calcification (-) group (G209A, 28.6% vs. 18.7%, p=0.029; T950C, 75.9% vs. 65.4%, p=0.017). However, no significant relationship was found between OPG gene polymorphisms and serum OPG levels and cardiovascular risk factors. CONCLUSIONS: We observed that the OPG gene polymorphisms were partly associated with aortic calcification in healthy Korean women. Further studies are needed to clarify this relationship.
Alleles ; Cardiovascular System ; Discrimination (Psychology) ; Female ; Humans ; Models, Animal ; Osteoporosis ; Osteoprotegerin* ; Polymerase Chain Reaction ; Receptor Activator of Nuclear Factor-kappa B ; Risk Factors

BACKGROUND: Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF-kappaB ligand(RANKL), and has also been shown to be an important inhibitor of osteoclastogenesis in animal models. However, the relationship between OPG gene polymorphism and female bone stati in human populations is unclear. In this study, the relationship between OPG gene polymorphisms and bone mineral metabolism in healthy Korean women was investigated. METHODS: We observed 251 healthy women(mean age, 51.3+/-6.9 yr). The serum OPG concentrations were determined using ELISA, and the biochemical markers of bone turnover and FSH measured using standard methods. The bone mineral densities at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. The A163G, G209A, T245G and T950C polymorphisms of the OPG gene were analyzed by allelic discrimination using the 5 nuclease polymerase chain reaction assay. RESULTS: The lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group(A163G, 0.98+/-0.14g/cm2[GG+GA] vs. 1.05+/- 0.15g/cm2[AA], P =0.070; T245G, 0.97+/-0.13g/cm2[GG+GT] vs. 1.04+/-0.15g/cm2[TT], P=0.056). In the linkage of polymorphisms A163G and T245G, the lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group([AATT] vs. [AGTG+AGGG+GGTG+GGGG]: 1.04+/-0.15 vs. 0.97+/- 0.13; P=0.072). However, there were no differences in the serum OPG levels and bone turnover markers among the different genotypes. CONCLUSION: The A163G and T245G polymorphisms of the OPG gene were observed to be marginally associated with the lumbar spine BMD in healthy premenopausal Korean women, but further studies will be needed to clarify this relationship
Absorptiometry, Photon ; Alleles ; Biomarkers ; Bone Density ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Humans ; Metabolism* ; Models, Animal ; NF-kappa B ; Osteoprotegerin* ; Perimenopause* ; Polymerase Chain Reaction ; Spine

BACKGROUND: Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF-kappaB ligand(RANKL), and has also been shown to be an important inhibitor of osteoclastogenesis in animal models. However, the relationship between OPG gene polymorphism and female bone stati in human populations is unclear. In this study, the relationship between OPG gene polymorphisms and bone mineral metabolism in healthy Korean women was investigated. METHODS: We observed 251 healthy women(mean age, 51.3+/-6.9 yr). The serum OPG concentrations were determined using ELISA, and the biochemical markers of bone turnover and FSH measured using standard methods. The bone mineral densities at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. The A163G, G209A, T245G and T950C polymorphisms of the OPG gene were analyzed by allelic discrimination using the 5 nuclease polymerase chain reaction assay. RESULTS: The lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group(A163G, 0.98+/-0.14g/cm2[GG+GA] vs. 1.05+/- 0.15g/cm2[AA], P =0.070; T245G, 0.97+/-0.13g/cm2[GG+GT] vs. 1.04+/-0.15g/cm2[TT], P=0.056). In the linkage of polymorphisms A163G and T245G, the lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group([AATT] vs. [AGTG+AGGG+GGTG+GGGG]: 1.04+/-0.15 vs. 0.97+/- 0.13; P=0.072). However, there were no differences in the serum OPG levels and bone turnover markers among the different genotypes. CONCLUSION: The A163G and T245G polymorphisms of the OPG gene were observed to be marginally associated with the lumbar spine BMD in healthy premenopausal Korean women, but further studies will be needed to clarify this relationship
Absorptiometry, Photon ; Alleles ; Biomarkers ; Bone Density ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Humans ; Metabolism* ; Models, Animal ; NF-kappa B ; Osteoprotegerin* ; Perimenopause* ; Polymerase Chain Reaction ; Spine

BACKGROUND: A novel gene, termed klotho, has been identified as a suppressor of several aging phenotypes, a genetic defect in klotho in mice resulted in a syndrome resembling human aging, i.e., arteriosclerosis and osteoporosis, but the relationship between KLOTHO gene with cardiovascular system and bone metabolism in human populations is unclear. Thus, the aim of this study was to investigate the relationship between the KLOTHO polymorphism with cardiovascular risk factors and bone metabolism in Korean women. METHODS: In 243 women(mean age, 51.2+/-6.9 yr), cardiovascular risk factors and bone turnover markers were measured using standard methods. Bone mineral densities(BMD) were measured by dual energy X-ray absorptiometry. The genotyping of the KLOTHO G395A polymorphism were performed by allelic discrimination using a 5' nuclease polymerase chain reaction assay. RESULTS: Allele frequencies were 0.829 for the G allele and 0.171 for the A allele, which was in Hardy-Weinberg equilibrium. Mean systolic blood pressure(BP) was significantly higher in A allele carriers compared with non-carriers. In logistic regression analysis with the cardiovascular risk factors as the independent variable, only systolic BP was identified as a significant variable for A allele carriers. Mean lumbar spine BMD was significantly lower in A allele carriers compared with non-carriers. This difference became marginally significant after adjustment for age and BMI. CONCLUSION: We observed that the KLOTHO G395 polymorphism is related with BP in Korean women. Also, these data suggest that the KLOTHO G395 polymorphism was marginally associated with lumbar spine BMD in Korean women.
Absorptiometry, Photon ; Aging ; Alleles ; Animals ; Arteriosclerosis ; Blood Pressure ; Bone Density ; Cardiovascular System ; Discrimination (Psychology) ; Female ; Gene Frequency ; Humans ; Logistic Models ; Metabolism* ; Mice ; Osteoporosis ; Phenotype ; Polymerase Chain Reaction ; Risk Factors* ; Spine

BACKGROUND: A novel gene, termed klotho, has been identified as a suppressor of several aging phenotypes, a genetic defect in klotho in mice resulted in a syndrome resembling human aging, i.e., arteriosclerosis and osteoporosis, but the relationship between KLOTHO gene with cardiovascular system and bone metabolism in human populations is unclear. Thus, the aim of this study was to investigate the relationship between the KLOTHO polymorphism with cardiovascular risk factors and bone metabolism in Korean women. METHODS: In 243 women(mean age, 51.2+/-6.9 yr), cardiovascular risk factors and bone turnover markers were measured using standard methods. Bone mineral densities(BMD) were measured by dual energy X-ray absorptiometry. The genotyping of the KLOTHO G395A polymorphism were performed by allelic discrimination using a 5' nuclease polymerase chain reaction assay. RESULTS: Allele frequencies were 0.829 for the G allele and 0.171 for the A allele, which was in Hardy-Weinberg equilibrium. Mean systolic blood pressure(BP) was significantly higher in A allele carriers compared with non-carriers. In logistic regression analysis with the cardiovascular risk factors as the independent variable, only systolic BP was identified as a significant variable for A allele carriers. Mean lumbar spine BMD was significantly lower in A allele carriers compared with non-carriers. This difference became marginally significant after adjustment for age and BMI. CONCLUSION: We observed that the KLOTHO G395 polymorphism is related with BP in Korean women. Also, these data suggest that the KLOTHO G395 polymorphism was marginally associated with lumbar spine BMD in Korean women.
Absorptiometry, Photon ; Aging ; Alleles ; Animals ; Arteriosclerosis ; Blood Pressure ; Bone Density ; Cardiovascular System ; Discrimination (Psychology) ; Female ; Gene Frequency ; Humans ; Logistic Models ; Metabolism* ; Mice ; Osteoporosis ; Phenotype ; Polymerase Chain Reaction ; Risk Factors* ; Spine

BACKGROUND AND OBJECTIVES: In 2002, Friedman et al. suggested a clinical staging system of obstructive sleep disorder patients based on palate position, tonsil size, and body mass index. The purpose of this study was to compare the treatment outcomes of uvulopalatopharyngoplasty (UPPP) and coblation assisted uvulopalatopharyngoplasty (CAUP) according to the Friedman staging system. SUBJECTS AND METHOD: Fifty patients with obstructive sleep apnea who underwent UPPP or CAUP were included. Apnea index (AI), Respiratory distress index (RDI), and Body-mass index (BMI) of preoperative polysomnography were measured. The questionnaires about snoring, apnea, and Epworth sleepiness scale (ESS) were taken by the patients and their bed partners before and after operation. All patients were stratified according to the Friedman staging system. RESULTS: Stage II patients were most common (41 cases, 82%). There was no difference in preoperative polysomnography parameters among stages. Preoperative polysomnography was decisive parameters on the determination of operative modality. UPPP was more effective than CAUP for symptom of sleep apnea with high success rate of 92.7%. CONCLUSION: In stage II, the success rates of sleep apnea and snoring were 80.4% and 63.4%. Though UPPP showed better success rate in treating sleep apnea, the success rate of CAUP in treating snoring was comparable to that of UPPP. CAUP is a good alternative to UPPP in treating snoring.
Apnea ; Body Mass Index ; Humans ; Palate ; Palatine Tonsil ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring