Diagnosis and Treatment Evaluation of 48 Cases of Broncholithiasis.

Background Broncholithiasis is a rare disease with various clinical classifications. The aim of this study was to evaluate the imaging diagnosis and surgical treatment of broncholithiasis. Methods and Materials Forty-eight patients with broncholithiasis were enrolled in this retrospective study between January 1985 and December 2009. Patients were classified into intraluminal, transluminal, and extraluminal broncholith according to the anatomy between the calculus and the bronchial lumen confirmed by chest computed tomography (CT), bronchoscopy, and pathology after operation. Result Forty-eight patients were enrolled, with 33 males and 15 females. The sex ratio (male:female) was 2.2:1, and average age was 54.3 ± 13.6 years. There were 8, 19, and 21 patients in intraluminal, transluminal, and extraluminal broncholith group, respectively. Cough, hemoptysis, and chest pain were the most common symptoms. Four patients with intraluminal broncholith and two with transluminal broncholith underwent broncholith removal via bronchoscopy, and the other 42 patients underwent thoracotomy. Conclusion Bronchoscopy combined with CT examination is helpful in diagnosing and typing broncholithiasis. An optimal treatment method, either bronchoscopic removal of broncholithiasis or thoracotomy, according to the clinical typing and indications, is the key to improve the treatment effect.

Common genetic variants on 3q28 contribute to non-small cell lung cancer susceptibility: evidence from 10 case-control studies.

The association between common variations (rs10937405, rs4488809) on 3q28 and lung cancer has been widely evaluated in various ethnic groups, since it was first identified through genome-wide association approach. However, the results have been inconclusive. To derive a more precise estimation of the relationship and the effect of factors that might modify the risk, we performed this meta-analysis. The random-effects model was applied, addressing heterogeneity and publication bias. A total of 10 articles involving 36,221 cases and 58,108 controls were included. Overall, the summary per-allele OR of 1.19 (95 % CI 1.14-1.25, P < 10(-5)) and 1.17 (95 % CI 1.10-1.23, P < 10(-5)) was found for the rs10937405 and rs4488809 polymorphisms, respectively. Significant results were also observed in heterozygous and homozygous when compared with wild genotype for these polymorphisms. Significant results were found in East Asians when stratified by ethnicity, whereas no significant associations were found among Caucasians. After stratifying by sample size, study design, control source and sex, significant associations were also obtained. In addition, our data indicate that these polymorphisms are involved in lung cancer susceptibility and confer its effect primarily in lung adenocarcinoma when stratified by histological subtype. Furthermore, significant associations were also detected both never-smokers and smokers for these polymorphisms. In conclusion, this meta-analysis demonstrated that rs10937405 and rs4488809 are a risk factor associated with increased non-small cell lung cancer susceptibility, particularly for East Asian populations.

Surgical treatment of bronchiectasis: a retrospective observational study of 260 patients.

OBJECTIVE: This study aims to demonstrate our surgical experience for bronchiectasis and analyze the risk factors related with the surgery outcome. METHODS: We retrospectively reviewed medical records of 260 consecutive patients who underwent surgery for bronchiectasis between January 2000 and December 2010. The factors related with the outcome were analyzed and the candidate factors were screened by χ(2) test and t test. Furthermore, logistic regression analysis was used for multiple factor analysis to obtain the independent factors that affected the surgical outcome. RESULTS: Complications occurred in 30 (11.5%) patients during perioperative period. The univariate analysis showed that significant differences can be observed in age (P = 0.000), sputum volume (P = 0.000), smoking history (P = 0.033), pulmonary function (P = 0.003), Gram-negative bacillus infection (P = 0.000), bronchial stump coverage (P = 0.016) using intercostals muscles or pedicle pleura embedding and surgical approach (P = 0.003) between the patients with excellent and poor outcome. The multivariable analyses showed that sputum volume (P = 0.000), Gram-negative bacillus infection (P = 0.000) and bronchial stump coverage (P = 0.000) were the three independent factors related with surgical outcome. CONCLUSION: Surgery is an effective treatment option for bronchiectasis. Sputum volumes lower than 30 mL, negative proof of Gram-negative bacteria and bronchial stump coverage using intercostals muscles or pedicle pleura embedding are the key factors for successful treatment. Special attention has to be given to any complications in elderly patients.