Identification of Pulmonary Nodules by Sweeping the Surface of the Lung with an Electrical Bioimpedance Probe: A Feasibility Study

Purpose: Identifying and localizing the invisible and nonpalpable pulmonary nodules are among the main challenges surgeons face during open and thoracoscopic surgeries. This in vitro study explores the feasibility of utilizing a simple and safe electrical bioimpedance probe in locating the pulmonary nodules by sweeping the surface of the lung tissue. Methods: A probe was designed with four spherical electrodes that were used for recording the bioimpedance spectrum of the lung tissue in a frequency range of 50 kHz to 5 MHz. In each of the 10 resected surgical specimens, the bioimpedance of normal lung tissue as well as the tumoral lung tissue were recorded and compared with each other. Results: By drawing the Nyquist curves, it was determined that the amplitude of the electrical impedance measured by moving the probe from the healthy point to the region of the pulmonary nodule decreases and the frequency characteristics of the bioimpedance spectrum increases. Conclusion: This method could be potentially beneficial in the localization of invisible and even nonpalpable in-depth pulmonary nodules in thoracic surgeries

Identifying and Localizing of the In-depth Pulmonary Nodules Using Electrical Bio-Impedance

Intraoperative localization of small and in-depth pulmonary nodules particularly during video-assisted thoracoscopic surgery (VATS), is one of the main challenges for Thoracic surgeons. Failure to determine the location of nodules may lead to a large incision in the normal lung tissue or the conversion of the minimally invasive surgery to an open thoracotomy. The aim of this study is to evaluate the use of electrical bio-impedance measurement to precisely determine the position of in-depth pulmonary nodules and tumors, which are not visible during thoracoscopic surgeries or even are not palpable during open thoracic surgeries. With this regard, a suitable bio-impedance sensor similar to a biopsy forceps has been designed in order to measure the lung tissue bio-impedance. Using the available data on the electrical properties recorded from lung tissue during inhalation and exhalation, combined with the tumor modeling in COMSOL software, the effect of different parameters including the size and depth of tumor and the relative difference of electrical properties between healthy and tumoral tissue has been assessed. Furthermore, the geometric characteristics of the proposed sensor are considered. The results generally verify that larger size of nodules results in an easier distinguishing process. Additionally, it is worthy to note that applying a larger geometrically sensor is essential to detect the small and in-depth nodules

تغییرات بافتی در موارد تنگی ناشی از لوله گذاری طولانی مدت در نای

زمینه و هدف: لوله گذاری داخل نای [1]عملی است کمک تنفسی که در بیماران به کما رفته و یا بیمارانی که به هر دلیل قادر به تنفس خود به خودی نیستند انجام می گیرد. تنگی تراشه[2] یکی از مهمترین عوارض اینتوباسیون است. شناحت کافی از تغییرات پاتولوژیک این عارضه برای بررسی علل احتمالی ضروری است که در این مطالعه به بررسی دقیق تغییرات هیستوپاتولوژیک تراشه در بیماران مبتلا به این عارضه پرداخته شده است. مواد و روش ها: در اين مطالعه مقطعی نمونه‌ی نای در ناحیه ی دچار تنگی با انتخاب 15 بيمار مبتلا به تنگي تراشه از بانک داده های البرز که تمام موارد تنگی نای در آن ثبت می گردد با رنگ آميزي هماتوکسیلین/ائوزین و تری کروم ماسون تحت بررسی قرار گرفت و نتایج بافت شناسی ارایه گردید. یافته‌ها:  رنگ آمیزی هماتوکسیلین / ائوزین نشان داد که تخریب کامل در اپیتلیوم سطحی تراشه صورت گرفته است و این تخریب در بسیاری از بیماران باعث از بین رفتن لایه ساب اپیتلیوم، غدد سروزی و موکوسی نیز می‌گردد که گاهی تا تخریب لایه عمقی غضروف هیالین نیز پیش می رود. رنگ آمیزی تری کروم ماسون نیز تجمع بسیار وسیع و حجیم بافت فیبروز و الیاف کلاژن را نشان داد که همین تجمع باعث تنگ شدن راه هوائی بیمار می‌گردد . نتیجه‌گیری: تخریب بافتی در تنگی تراشه گاها تا عمق لایه غضروفی پیش می رود و برگشت ناپذیر بوده لذا در بسیاری از موارد جراحی رزکسیون آناستوموز تنها راه درمان می‌باشد. روش‌های دیگر درمانی نیز با توجه به نتایج هیستوپاتولوژیک قابل ارزیابی می‌باشند.         [1] Intubation [2] Tracheal Stenosi

Expression of long non-coding RNAs (lncRNAs) has been dysregulated in non-small cell lung cancer tissues

Abstract Background Non-small cell lung cancer (NSCLC) as the most frequent type of lung cancer is associated with extensive mortality. Researchers have studied the suitability of several molecules as biomarkers for early detection of this cancer. Long non-coding RNAs (lncRNAs) as the main regulators of gene expression have also been assessed in this regard. Methods In the present study, we compared expression level of Fas-antisense 1 (FAS-AS1), Growth Arrest Specific 5 (GAS5), PVT1, Nuclear Paraspeckle Assembly Transcript 1 (NEAT1), HOXA transcript antisense RNA myeloid-specific 1 (HOTAIRM1), taurine upregulated gene 1 (TUG1) and TNFα and hnRNPL related immunoregulatory LincRNA (THRIL) in 32 NSCLC samples and their corresponding adjacent non-cancerous tissues (ANCTs). Results NEAT1 has been significantly over-expressed in NSCLC tissues obtained from male subjects compared with the corresponding ANCTs (Relative expression (REx) = 3.022, P = 0.019) but not in female subjects (P = 0.975). FAS-AS1 was significantly down-regulated in NSCLC tissues obtained from both males and females subjects compared with the corresponding ANCTs (REx = − 4.12 and − 3.14, P = 0.015 and 0.033 respectively). TUG1, GAS5, THRIL and HOTAIRM1 were significantly down-regulated in tumoral tissues obtained from male subjects compared with the corresponding ANCTs. Conclusions The observed dysregulation of these lncRNAs in NSCLC tissues compared with the corresponding ANCTs warrants future studies to confirm the results of the current study in larger sample sizes to elaborate their role as cancer biomarkers

A Comparative Study on Tobacco Cessation Methods: A Quantitative Systematic Review

Background: During recent years, there have been many advances in different types of pharmacological and non-pharmacological tobacco control treatments. In this study, we aimed to identify the most effective smoking cessation methods used in quit based upon a review of the literature. Methods: We did a search of PubMed, limited to English publications from 2000 to 2012. Two trained reviewers independently assessed titles, abstracts and full texts of articles after a pilot inter-rater reliability assessment which was conducted by the author (GH). The total number of papers and their conclusions including recommendation of that method (positive) or not supporting (negative) was computed for each method. The number of negative papers was subtracted from the number of positive ones for each method. In cases of inconsistency between the two reviewers, these were adjudicated by author. Results: Of the 932 articles that were critically assessed, 780 studies supported quit smoking methods. In 90 studies, the methods were not supported or rejected and in 62 cases the methods were not supported. Nicotine replacement therapy (NRT), Champix and Zyban with 352, 117 and 71 studies respectively were the most supported methods and e-cigarettes and non-Nicotine medications with one case were the least supported methods. Finally, NRT with 39 and Champix and education with 36 scores were the most supported methods. Conclusions: Results of this review indicate that the scientific papers in the most recent decade recommend the use of NRT and Champix in combination with educational interventions. Additional research is needed to compare qualitative and quantitative studies for smoking cessation

Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience

Introduction: Tracheoesophageal fistula (TEF) is a rare condition, which could be life-threatening if diagnosed late or mismanaged. Post-intubation TEF is the most common form of acquired, non-malignant TEF and is usually associated with tracheal stenosis, which makes the treatment more challenging. Here, we present our experience of managing 21 patients with post-intubation TEF.   Materials & Methods: Twenty one patients including seven women and fourteen men with mean age of 38.05 years, who had post-intubation TEF were managed in our center (Massih Daneshvari Hospital, Tehran, Iran) during 2004-2013. None of the patients were operated before weaning from mechanical ventilation. Single division and closure of the fistula was performed in one patient who did not have accompanying tracheal stenosis. One-stage surgical repair including tracheal resection, anastomosis, primary closure of the esophageal defect, and muscle flap Interposition was the main treatment method in all other cases. Patients were followed up for at least two years. Results: Excellent and good results achieved in 85.7% of our patients. Major complications including permanent vocal cord paralysis and recurrence of tracheal stenosis necessitating T-tube insertion occurred in two patients (9.5%). Severe cachexia and sepsis secondary to sputum retention resulted in one mortality (4.8%). Conclusion: Surgery might provide the best treatment results along with low mortality and morbidity rates in post-intubation TEFs if performed within the proper time