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1.  Bronchial stump closure with amniotic membrane in animal model 
Background:
Coverage of the bronchial stumps (BSs) with adjacent tissues can improve healing and reduce bronchial complications in complex thoracic surgery. There is no evidence for the application of human amnion allograft for prevention of air leak from the BS. The comparison of the amniotic membrane (AM) and pleural patch for BS healing after lobectomy in dogs was our aim in this study.
Materials and Methods:
A total of eight males and females 12-24-month-old dogs between 17 and 22 kg body-weight were used in this study in 2010, Isfahan University of Medical Sciences. Animals were separated into two groups: group A (n = 4; amniotic membrane) and group P (n = 4; pleural patch) according to the BS closure technique performed. After lobectomy of the right middle lobe, the BS was closed, while a small bronchopleural fistula (BPF) was created by inserting a catheter via edges of closed stump. Then, it was covered with a piece of AM3 × 3 cm in group A and with a pedicle graft of pleura in group P. Rethoracotomy was performed after 15 days of observation, and the BS was removed for histological examination. Histological healing was classified as complete or incomplete healing. Neoangiogenesis was measured by Von Willebrand expression using immunohistochemistry (IHC). Data were analyzed by SPSS version 15 using Fisher's exact test, Mann-Whitney test, and T tests.
Results:
BPF complications were not seen during observation period. There was no significant difference in histological healing between two groups. Similarly, no significant difference was observed between the groups in terms of neoangiogenesis based on IHC examination (P value = 0.69).
Conclusion:
Human amnion allograft could be as effective as pleural patch for BS wrapping following pulmonary resections.
PMCID: PMC4061641  PMID: 24949027
Amniotic membrane; bronchial stump; bronchopleural fistula; pneumonectomy
2.  Azygos Vein Aneurysm as a Posterior Mediastinal Mass Discovered After Minor Chest Trauma 
Iranian Journal of Radiology  2014;11(1):e7467.
Azygos vein aneurysm is a rare cause of a posterior or paratracheal mediastinal mass. Trauma or conditions causing elevated flow or pressure in the azygos system, such as cardiac failure or cirrhosis of the liver are secondary causes of aneurysm of the azygos vein. We report a case of asymptomatic saccular aneurysm of the azygos vein in a 45-year-old man with blunt minor chest trauma. The azygos vein aneurysm was managed by conservative treatment.
doi:10.5812/iranjradiol.7467
PMCID: PMC3955859  PMID: 24693303
Azygos Vein; Aneurysm; Mediastinum; Tomography, X-Ray Computed; Magnetic Resonance Angiography
3.  Successful auto-implantation of hepatic cells in lung tissue: An animal study 
Background:
This study was proposed to evaluate a new method for autograft transplantation of liver tissue fragments (LTF) in the lung parenchyma and bronchus of dogs and to compare the results to find out if they are suitable sites for hepatocyte implantation or not.
Materials and Methods:
The dogs were randomly assigned into two categories: LTF auto-transplantation to the lung parenchyma and into the bronchus. The suspensions of normal saline and LTF were injected and implanted into the lung parenchyma and the main bronchus of the right accessory lobe in first and second groups, respectively. Two weeks later the right accessory lobe was removed and sent for a histopathological study. All samples were checked under a light microscope with regard to the presence of hepatocytes, with both the Hematoxylin and Eosin (H and E) preparation and immunohistochemistry (IHC) method, using a CK-18 marker. All results were double-checked with a polymerase chain reaction (PCR).
Results:
The mean weight of all the dogs was 19.87 ± 0.93 kg and mean age was 3.58 ± 0.31 years. After 15 days, the H and E, IHC, and PCR studies revealed that in the first group, all the dogs (n = 4) had living liver tissue, which survived in the lung parenchyma successfully. In contrast, none of the dogs (n = 0) in the second group showed surviving hepatocytes in the bronchus (P < 0.001).
Conclusion:
Implantation of the LTFs into the lung parenchyma could be a source of hepatic cell production.
PMCID: PMC3872589  PMID: 24381624
Auto-transplantation; IHC; PCR
4.  A rare case of laryngotracheal chondrosarcoma in a patient with past history of radioiodine therapy for thyroid cancer 
Tracheal chondrosarcoma is a rare malignant mesenchymal tumor and there are less than 15 reports in the literature. We report a rare case of laryngotracheal chondrosarcoma in a 74-year-old man. He gave a history of radioiodine therapy for thyroid papillary carcinoma about 24 years ago. Diagnostic steps, histological presentation, and therapy are described in detail.
doi:10.4103/2277-9175.115802
PMCID: PMC3814568  PMID: 24223389
Radioiodine therapy; thyroid cancer; tracheal chondrosarcoma
5.  Micrometastasis in non–small-cell lung cancer: Detection and staging 
Annals of Thoracic Medicine  2012;7(3):149-152.
BACKGROUND:
The clinical relevance of bone marrow micrometastasis (BMM) in non–small-cell lung cancer is undetermined, and the value of such analyses in advanced stage patients has not been clearly assessed previously. This study was conducted to estimate the accuracy of both polymerase chain reaction (PCR) and immunohistochemistry (IHC) in micrometastases detection and determine the best site for bone marrow biopsy in order to find micrometastasis.
METHODS:
This prospective cross-sectional study was performed in the Department of Thoracic Surgery, Alzahra University Hospital from September 2008 to June 2009. To evaluate the bone marrow, a 3-cm rib segment and an aspirated specimen from the iliac bone prior to tumor resection were taken. PCR and IHC were performed for each specimen to find micrometastasis.
RESULTS:
Of 41 patients, 14 (34%) were positive for BMM by PCR compared with two positive IHC (4.8%). All BMMs were diagnosed in rib segments, and iliac specimens were all free from metastatic lesion. Our data showed no significant association between variables such as age, sex, histology, tumor location, side of tumor, involved lobe, smoking, or weight loss and presence of BMM.
CONCLUSION:
PCR could use as a promising method for BMM detection. BMM in a sanctuary site (rib) is not associated with advanced stages of lung cancer. In addition, when predictor variables such as age, sex, histology, tumor location, smoking, or weight loss are analyzed, no correlation can be found between micrometastasis prevalence and any of those variables.
doi:10.4103/1817-1737.98848
PMCID: PMC3425047  PMID: 22924073
IHC; lung cancer; micrometastasis; PCR
6.  Incidence and risk factors predisposing anastomotic leak after transhiatal esophagectomy 
Annals of Thoracic Medicine  2009;4(4):197-200.
OBJECTIVE:
The objective of our study was to identify the incidence and risk factors of anastomotic leaks following transhiatal esophagectomy (THE).
MATERIALS AND METHODS:
A prospective study was conducted on 61 patients treated for carcinoma of the esophagus between 2006 and 2007. We examined the following variables: age, gender, preoperative cardiovascular function, intraoperative complications such as hypotension, arrhythmia, mediastinal manipulation period, blood loss volume, blood transfusion, duration of surgery, postoperative complications such as anastomotic leak, anastomotic stricture, requiring reoperation, respiratory complications, and total morbidity and mortality. Variables were compared between the patients with and without anastomotic leak. T-test for quantitative variables and Chi-square test for qualitative variables were used to find out any relationship. P value less than 0.05 was considered significant.
RESULTS:
Out of 61 patients, anastomotic leaks occurred in 13 (21.3%). Weight loss, forced expiratory volume (FEV1) <2 lit, preoperative albumin, intaoperative blood loss volume, and respiratory complication were associated with the anastomotic leak in patients undergoing THE. Anastomotic leaks were the leading cause of postoperative morbidity, anastomotic stricture, and reoperation.
CONCLUSION:
Anastomotic leakage is a life-threatening postoperative complication. Careful attention to the factors contributing to the development of a leak can reduce the incidence of anastomotic complications postoperatively.
doi:10.4103/1817-1737.56012
PMCID: PMC2801044  PMID: 19881165
Anastomotic leak; risk factor; transhiatal esophagectomy

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