Classification of broncholiths and clinical outcomes.

BACKGROUND AND OBJECTIVE: We evaluated effective treatments of broncholithiasis based on its radiographical and bronchoscopic features. METHODS: This retrospective study conducted at Samsung Medical Center, Korea enrolled patients who were suspected of having broncholithiasis based on chest computed tomography (CT). The broncholiths were classified as intraluminal, mixed (both intraluminal and extraluminal) and extraluminal based on chest CT and bronchoscopic findings. RESULTS: The study enrolled 46 patients between 1995 and 2009. Symptoms included cough (n = 21, 45.7%), hemoptysis (n = 19, 41.3%) and purulent sputum (n = 11, 23.9%). Cough was more common in intraluminal boncholiths than in other type of broncholiths (P = 0.03). Based on chest CT, there were 15 (32.6%) intraluminal, 15 (32.6%) mixed and 16 (34.8%) extraluminal broncholiths. All 15 intraluminal broncholiths were removed completely via flexible (n = 2) or rigid (n = 13) bronchoscopy. For the 15 mixed broncholiths, seven (46.7%) bronchoscopic interventions were performed, but complete removal of the broncholiths was not accomplished. Six (40%) mixed and four (25%) extraluminal broncholiths were treated by surgical resection for symptom control. None of the patients who underwent surgical resection suffered morbidity or postoperative mortality. CONCLUSIONS: The treatment of broncholithiasis should be based on chest CT and bronchoscopic findings. Intraluminal broncholiths can be removed via bronchoscopy, while surgery should be considered for symptomatic mixed or extraluminal broncholiths.

The validity and reliability of the motor point detection system: a preliminary investigation of motor points of the triceps surae muscles.

OBJECTIVE: To investigate the validity and reliability of the motor point detection system in cadavers and healthy young adults. DESIGN: Correlation statistics. SETTING: University research laboratory. PARTICIPANTS: Sixty-two lower limbs of 31 healthy young adults (mean age, 22.3+/-1.8) and 10 size-matched lower limbs from cadavers were used. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The validity of the motor point detection system's motor point measure was determined by comparing the motor point locations of the lower-leg muscles obtained from the motor point detection system with the established anatomic motor point locations from our previous cadaveric dissection study. The anatomic motor points were determined by tracing the terminal motor nerve branches on soleus, medial, and lateral gastrocnemius muscles through the dissection of adult cadavers. The test-retest reliability was determined by repeatedly measuring the locations of motor points in healthy young adults on 2 separate occasions, approximately 24 hours apart. The intraclass correlation coefficient (ICC) was computed to determine correlation, and an independent t test was used to determine the difference between the demographic and clinical variables at the significance level (P<.05). RESULTS: Correlation analysis revealed relatively high validity between the motor point detection system and cadaver-dissected motor point location measurements (ICC(2,1)=.71-.92, P<.05). The test-retest reliability showed excellent correlation between the repeated measures (range, ICC(1,2)=.90-.95 at P<.05). CONCLUSIONS: Our results showed that the motor point detection system was accurate and consistent in the measurement of motor point locations of the lower-leg muscles. This system can be considered as an alternative device to localize motor points in clinical settings. Our motor point detection system warrants further investigation in pathologic population.

Elemental or contextual? It depends: individual difference in the hippocampal dependence of associative learning for a simple sensory stimulus.

Learning theories categorize learning systems into elemental and contextual systems, the former being processed by non-hippocampal regions and the latter being processed in the hippocampus. A set of complex stimuli such as a visual background is often considered a contextual stimulus and simple sensory stimuli such as pure tone and light are considered elemental stimuli. However, this elemental-contextual categorization scheme has only been tested in limited behavioral paradigms and it is largely unknown whether it can be generalized across different learning situations. By requiring rats to respond differently to a common object in association with various types of sensory cues including contextual and elemental stimuli, we tested whether different types of elemental and contextual sensory stimuli depended on the hippocampus to different degrees. In most rats, a surrounding visual background and a tactile stimulus served as contextual (hippocampal dependent) and elemental (non-hippocampal dependent) stimuli, respectively. However, simple tone and light stimuli frequently used as elemental cues in traditional experiments required the hippocampus to varying degrees among rats. Specifically, one group of rats showed a normal contextual bias when both contextual and elemental cues were present. These rats effectively switched to using elemental cues when the hippocampus was inactivated. The other group showed a strong contextual bias (and hippocampal dependence) because these rats were not able to use elemental cues when the hippocampus was unavailable. It is possible that the latter group of rats might have interpreted the elemental cues (light and tone) as background stimuli and depended more on the hippocampus in associating the cues with choice responses. Although exact mechanisms underlying these individual variances are unclear, our findings recommend a caution for adopting a simple sensory stimulus as a non-hippocampal sensory cue only based on the literature.

Temporal and spatial distributions of aerial contaminants in an enclosed pig building in winter.

Optimal management of indoor air quality in an enclosed swine house, especially in winter, is indispensable for preventing the transmission of infectious respiratory disease to workers and animals. Studies are needed to elucidate the correlation of aerial contaminants and climate factors. It was observed that indoor air contamination in an enclosed pig building was the highest at 2:00--5:00 PM, followed by 8:00--11:00 PM and 8:00--11:00 AM. It was assumed that this was attributed to the increase of swine activities in the afternoon. In general, the concentration of total dust and total airborne bacteria in an enclosed pig building was found to have a significant correlation with temperature and relative humidity (P<0.05). There were significant correlations between total dust and total airborne bacteria, between total dust and ammonia, and between total dust and odor at the 95% confidence level. In conclusion, temperature and total dust concentration correlated significantly with all parameters except hydrogen sulfide (H(2)S). This could have been due to the drying of swine feces due to the increase in interior temperature and the resuspension of feed deposited on the floor of the pig building by the swines' activity, resulting in a high generation of dust that adsorbed and carried the airborne bacteria and odorous compounds in the enclosed pig building. It was proved that an adsorptive capacity of dust for ammonia was higher than for hydrogen sulfide.