Publications by authors named "Shahab Rafieian"

6 Publications

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Development of a new method for isolation of urban air particulates deposited in the human lung tissue.

Chemosphere 2021 Apr 27;280:130585. Epub 2021 Apr 27.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Particulate matters (PMs) are important pollutants in urban air pollution because of their variable composition. The pulmonary clearance of PMs is critical to prevent long-term immunological responses. This study established a new method for the isolation of probably deposited urban air particulates from the human lung tissue, to investigate the features of uncleared particulates. The lung samples were acellularized with SDS solution of various concentrations ranging from 1 to 10%to lyse cells and release the PMs. In addition, the extracellular matrix (ECM) that remained was digested by proteinase K enzyme. The results of this study demonstrated that an SDS solution of 4% is the optimum concentration for the isolation of settled PMs from the lung tissue. Moreover, the used enzymatic method could separate settled PMs from the lung ECM appropriately. The results exhibited that epithelial cells form 46% of the samples' weight on average, whereas just 20% of isolated PMs were found in this part of the tissue. Both groups of separated PMs tend to agglomerate, but it is significantly higher in cellular isolated PMs. The particles separated from ECM have an agglomeration tendency, which is observable only by FE-SEM imaging. Moreover, we found a major part of urban air PMs deposited in ECM. The established method in this study can be used in future investigations to isolate other types of PMs settled in the lung, such as occupationally inhaled carbonaceous particulates.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130585DOI Listing
April 2021

Particulates induced lung inflammation and its consequences in the development of restrictive and obstructive lung diseases: a systematic review.

Environ Sci Pollut Res Int 2021 May 29;28(20):25035-25050. Epub 2021 Mar 29.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Particulate matters (PMs) are significant components of air pollution in the urban environment. PMs with aerodynamic diameter less than 2.5 μm (PM) can penetrate to the alveolar area and introduce numerous compounds to the pneumocystis that can initiate inflammatory response. There are several questions about this exposure as follows: does PM-induced inflammation lead to a specific disease? If yes, what is the form of the progressed disease? This systematic review was designed and conducted to respond to these questions. Four databases, including Web of Science, Scopus, PubMed, and Embase, were reviewed systematically to find the related articles. According to the included articles, the only available data on the inflammatory effects of PM comes from either in vitro or animal studies. Both types of studies have shown that the induced inflammation is type I and includes secretion of proinflammatory cytokines. The exposure duration of longer than 28 weeks was not observed in any of the reviewed studies. However, as there is not a specific antigenic component in the urban particulate matters and based on the available evidence, the antigen-presenting is not a common process in the inflammatory responses to PM. Therefore, neither signaling to repair cells such as fibroblasts nor over-secretion of extracellular matrix (ECM) proteins can occur following PM-induced inflammation. These pieces of evidence weaken the probability of the development of fibrotic diseases. On the other hand, permanent inflammation induces the destruction of ECM and alveolar walls by over-secretion of protease enzymes and therefore results in progressive obstructive effects.
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http://dx.doi.org/10.1007/s11356-021-13559-5DOI Listing
May 2021

Successful tracheal necrosis management using a pedicle pectoralis flap: A case report.

Turk Gogus Kalp Damar Cerrahisi Derg 2020 Jul 28;28(3):547-551. Epub 2020 Jul 28.

Department of Thoracic Surgery, Tehran University of Medical Science, Tehran, Iran.

Thyroidectomy is considered an overall low-risk procedure. However, severe life-threatening complications, including tracheal necrosis may occur postoperatively. A 45-year-old male patient was referred to our clinic for papillary thyroid carcinoma surgery. The patient had mediastinitis signs and symptoms seven days after total thyroidectomy. Subsequent imaging demonstrated air leak and with mediastinitis as the primary diagnosis, and the patient underwent reoperation. During the operation, four necrotic tracheal rings were found to be the source of air leak. Due to tissue inflammation and infection, neither primary repair with tracheal resection and anastomosis, nor strap muscle plugging procedure were feasible. Therefore, a pedicle flap derived from the right pectoralis major muscle was transferred to the necrotic trachea. The patient"s clinical condition improved after the operation and subsequent bronchoscopies confirmed healing of trachea. During six-month follow-up, no complications were observed. In conclusion, the technique discussed in the current report shows promising outcomes for reconstructing large tracheal defects in inflammatory conditions where primary repair techniques are not suitable.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2020.18144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493617PMC
July 2020

Tracheopleural fistula after thoracoscopic esophagectomy: novel therapeutic approach with pericardial and intercostal muscle flaps.

J Surg Case Rep 2018 Oct 16;2018(10):rjy277. Epub 2018 Oct 16.

Department of Respiratory Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Tracheal rupture following thoracoscopic esophagectomy is a dangerous event requiring primary repair with flap reinforcement. If the injury is not diagnosed during the surgery, morbidity and mortality increase significantly. Meanwhile, primary repair in such cases is not feasible due to the inflammation and difficulty in approximating the defect. Here, we report a case of tracheal injury during thoracoscopic esophagectomy with primary repair failure. We successfully repaired the injury by covering the defect first by a pericardial flap, then reinforcing it with an intercostal muscle flap. To our knowledge, there are few reports of such novel surgical techniques.
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http://dx.doi.org/10.1093/jscr/rjy277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189376PMC
October 2018

First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review.

Iran J Med Sci 2018 Sep;43(5):554-559

General Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran Iran.

Pectus excavatum is the most common congenital deformity of the chest wall. The most frequently used techniques include Ravitch (costochondral resection) and Nuss (minimally invasive pectus repair of pectus excavatum [MIRPE]). The Nuss technique includes using temporary metallic bars without costochondral resection to correct the chest wall deformity. Modified MIRPE can be learned easily and performed safely with few complications. There are no reports of successful MIRPE in Iran, although the Ravitch technique is well known. In the present study, we report the first Iranian experience with the modified Nuss procedure in 5 patients with pectus excavatum (age range=13-48 y). All the patients suffered from low self-esteem, and one of them complained of low exercise capacity and occasional chest pain. With single-lung ventilation and sternal elevation, an introducer was entered into the right thoracic cavity and retrosternal tunneling was performed under thoracoscopic vision. The introducer was passed to the left thoracic cavity and exited on the left thoracic wall. A titanium plate bar was implanted and fixed with stabilizers. There were no cases of mortality, and all the patients were discharged in good conditions within 2 weeks. Postoperative complications consisted of 1 case of pneumothorax and 2 cases of fixed bar protrusion. The present case series indicated that a skilled thoracoscopic surgeon is able to do the Nuss procedure in Iranian patients with symmetrical pectus excavatum with few complications. However, mixed or redo cases require more expertise.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123557PMC
September 2018

Percutaneous Transhepatic N-Butyl Cyanoacrylate Injection Therapy of an Isolated Bile Duct Associated with a Bronchobiliary Fistula.

J Vasc Interv Radiol 2016 Jun 3;27(6):930-2. Epub 2016 Jun 3.

General Surgery, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1016/j.jvir.2016.02.024DOI Listing
June 2016