• 제목/요약/키워드: Coal workers' Pneumoconiosis

검색결과 36건 처리시간 0.024초

진폐증 환자에서의 혈청학적 표지자의 변화 (The Changes of Serologic Markers in Pneumoconiosis of Coal Workers)

  • 유광하;윤호상;이상엽;진춘조;안철민;김형중
    • Tuberculosis and Respiratory Diseases
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    • 제50권5호
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    • pp.615-623
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    • 2001
  • Background : Pneumoconiosis is a parenchymal lung disease that results from the accumulation of coal dust in the lungs and the consequent tissue reaction. To evaluate the role of various personal factors in pneumoconiosis and the significance of some serologic markers for assessing the disease activity related to pneumoconiosis, the Rheumatoid Factor(RF), ${\alpha}_1$-AT, C-Reactive Protein(CRP), ceruloplasmin and fibrinogen levels were measured. Method : All the patients were males, 45-76 years old, and the mean duration of coal dust exposure was 23.2 years. 51 patients were classified as having Simple Pneumoconiosis (SP), 59 had Progressive Massive Fibrosis (PMF). Fifty eight men with ages ranging from 26-70 years were used as normal controls. The serum RF and CRP were titrated using an Autochemistry analyzer (HITACHI 7150 : Japan) and the ${\alpha}_1$-AT and ceruloplasmin levels were measured using a Nephelometer (Behring Nephelometer : Germany) and the fibrinogen levels were estimated by using an Autoanalyzer for hematologic coagulation. Result : There was a higher RF level in the SP, and PMF groups than in the control groups but there was no statistical difference. The CRP, ${\alpha}_1$-AT, and ceruloplasmin levels were also higher in the SP, and PMF groups. However, the fibrinogen concentration was within the normal ranges in both the SP and PMF groups. Conclusion : The CWP (Ed note : Define CWP) patients had significantly higher CRP, ${\alpha}_1$-AT, and ceruloplasmin levels compared to the control group. It is believed that these serologic changes could be used as a marker of the disease activity.

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Serum Levels of Interleukin-8 and Tumor Necrosis Factor-alpha in Coal Workers' Pneumoconiosis: One-year Follow-up Study

  • Lee, Jong-Seong;Shin, Jae-Hoon;Lee, Joung-Oh;Lee, Kyung-Myung;Kim, Ji-Hong;Choi, Byung-Soon
    • Safety and Health at Work
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    • 제1권1호
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    • pp.69-79
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    • 2010
  • Objectives: Various cytokines induced by inhalation of coal dust may mediate inflammation and lead to tissue damage or fibrosis, such as coal workers' pneumoconiosis (CWP). Methods: To investigate the relevance of serum cytokines in CWP, the levels of serum interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-${\alpha}$) as CWP biomarkers in 110 retired coal miners (22 controls and 88 CWP subjects) were related to cross sectional findings and 1-year progressive changes of the pneumoconiosis. Progressive changes of CWP were evaluated by paired comparison of chest radiographs. Analysis by a receiver operating characteristic curve assessed the biomarker potential of each cytokine. Results: The mean serum IL-8 level was significantly higher in CWP compared to controls and IL-8 levels correlated with the degree of CWP. The median serum TNF-${\alpha}$ level was significantly higher in subjects with progressive CWP compared to subjects without CWP progression. The area under the ROC curve for IL-8 (0.70) and TNF-${\alpha}$ (0.72) for CWP identification and progression, respectively, indicated the biomarker potential of the two cytokines. Serum cutoff values of IL-8 and TNF-${\alpha}$ were 11.63 pg/mL(sensitivity, 69%; specificity, 64%) and 4.52 pg/mL (sensitivity, 67%; specificity, 79%), respectively. Conclusion: The results suggest that high levels of serum IL-8 are associated with the presence of CWP and those of serum TNF-${\alpha}$ are associated with the progression of CWP.

진폐증의 조기진단에 관한 연구 (A Study on the Early Diagnosis of Pneumoconiosis)

  • 임영;윤임중
    • Journal of Preventive Medicine and Public Health
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    • 제23권3호
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    • pp.262-273
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    • 1990
  • In order to assess the method which is more sensitive one to detect the early change of lung tissue by the inhaled dust, we have performed the various medical examinations such as chest radiography, pulmonary function test, high resolution chest CT, brnchoalveolar lavage and lung biopsy used bronchoscope and ultrathin bronchoscopy examination to 48 persons. The control group were 8 persons who did not exposed to dust, 40 cases of the experimental group have professionally exposed to the mineral dust. The results were as follows 1. The total number of cells in bronchoalveolar lavage was significantly increased in all of the pneumoconiosis group classified by chest and high resolution chest CT. 2. The composition rate of macrophage to the total number of cells in bronchoalveolar lavage fluid was significantly decreased in all of the pneumoconiosis group compared with the control group. 3. The composition rate of neutophils and lymphocytes to the total number of cells in bronchoalveolar lavage fluid was significantly increased in all of the pneumoconiosis group compared with the control group. 4. The forced expiratory volume in one second ($FEV_{1-0}$), maximal mid-expiratory flow (MMF), and maximal voluntary ventilation (MVV) were significantly increased only in the group of the progressed pneumoconiosis relatively. 5. We observed submucosal edema, anthracotic pigmentation and granuloma formation in transbronchial lung biopsy of the suspected pneumoconiosis (category 0/1) case which is thought to the early change of coal workers' pneumoconiosis.

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요양 중인 탄광부 진폐증자의 생존율 연구 - 요양 입원시 특성을 중심으로 - (Survival Rate of Hospitalized Coal Workers' Pneumoconiosis Patients: According to Characteristics at the Time of Hospitalization)

  • 이경용;정호근
    • Journal of Preventive Medicine and Public Health
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    • 제22권1호
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    • pp.81-89
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    • 1989
  • The authors investigated mortality rate of hospitalized CWP(coal workers' pneumoconiosis) patients. Date, which was composed of age, date of hospitalization, date of death, and radiological findings(profusion of small opacity, type of large opacity, tuberculosis, emphysema, pneumothorax, and cardiac abnormality), was gathered from medical charts and chest x-ray films at the time of hospitalization of CWP patients. Among 738 CWP patients, that were entered survey differently and have followed different period, 160 CWP patients were died during different observational period. Mean value of observational period was 203 weeks, and mean age at hospitalization was 51 years. Because of short observational period, mean survival time could not found. There was statistically significant difference of mortality rate between group of small opacity and that of large opacity. In group of small opacity 5 year survival rate was 0.80 and in group of large opacity that was 0.73. And 80 percentile survival time was 57 months in group of small opacity and that was 40 months in group of large opacity.

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탄광부 진폐증자의 폐조직내 금속농도 (Metal Concentrations in Lungs of Coal Workers' Pneumoconiosis Patients)

  • 최호춘;정호근;김해정;전향숙;이관형
    • 한국산업보건학회지
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    • 제1권1호
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    • pp.89-99
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    • 1991
  • The metal concentrations in lungs from 12 coal workers' pneumoconiosis(CWP) patients and 6 controls, who were not exposed occupationally to coal mine dust and metals during their life time, were analyzed by atomic absorption spectrophotometry. 1. Copper, lead, nickel, magnesium, manganese, zinc and iron concentrations in lungs of CWP patients were $1.10{\pm}0.088$, $1.12{\pm}0.068$, $0.22{\pm}0.020$, $113.7{\pm}1.31$, $0.19{\pm}0.012$, $10.2{\pm}1.54$, $426.7{\pm}2.63{\mu}g/g$ wet weight. 2. Copper, lead, nickel, magnesium, manganese, zinc and iron concentrations in lungs of controls were $1.10{\pm}0.013$, $0.85{\pm}0.007$, $0.10{\pm}0.008$, $87.6{\pm}1.29$, $0.18{\pm}0.005$, $10.6{\pm}1.44$, $164.9{\pm}3.29{\mu}g/g$ wet weight. 3. The ratios of concentrations for copper, lead, nickel, magnesium, manganese, zinc, and iron in lungs for CWP patients and controls were 1 : 1, 1.32 : 1, 2.20 : 1, 1.30 : 1, 1.06 : 1, 0.92 : 1, 2.58 : 1, respectively. There were significant differences in concentrations of lead, nickel, magnesium, iron by group(p<0.05). 4. There was no significant difference in metal concentrations of right upper lobe, right lower lobe, left upper lobe and left lower lobe for both CWP patients and controls (p>0.05, p>0.05). 5. In CWP patients lead was well correlated with nickel showing a rank correlation coefficient of 0.533, and zinc was correlated with copper showing a rank correlation coefficient of 0.476. 6. The concentrations of copper, nickel, maganese, and zinc in Korean CWP patients were lower than those in foreign CWP patients.

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진폐증환자에서의 임파구 분획 및 싸이토카인의 역할 (The Role of Lymphocyte Compartment and Cytokine in Coal Workers Pneumoconiosis)

  • 이정연;유광하;안해련;김성렬;이해운;안철민;김형중
    • Tuberculosis and Respiratory Diseases
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    • 제52권3호
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    • pp.241-250
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    • 2002
  • 연구배경 : 진폐증은 주로 분진흡입에 의해 폐실질에 섬유화를 일으키는 질환으로 만성염증에 의해 폐포내에 대식세포를 축적시키는 특정이 있으며, 크게 단순진폐증(SP)과 진행성 종괴성 폐섬유증(PMF)으로 구분된다. 본 연구의 목적은 진폐증 환자에서 질환의 심한 정도를 ILO 분류에 따라 SP, PMF로 구분한 후, 감염이나 기타 기저질환이 없는 상태에서 혈중 임파구 분획 및 싸이토카인의 농도를 비교한 것이다. 방 법 : 태백 중앙 병원과 영동 병원의 진폐증 환자 중 정밀 검사를 시행하기 위해 병원을 방문한 단순진폐증 환자와 입원 중이거나 정밀검사를 시행한 진행성 종괴성 폐섬유증 환자, 대조군을 대상으로 하였고, 대조군(C;10), 단순진폐증 (S;19), 진행성 종괴성 폐섬유증 (P;30명)에서 혈중 임파구 분획을, C(10), S(14), P(14명)에서 싸이토카인 (IFN-${\gamma}$, TNF-${\alpha}$, IL-6, IL-4))의 농도를 비교하고, 특히 흡연력이나 연령, 폐기능에 의해 변할 수 있는 싸이토카인의 변화를 동시에 고려하여 진폐증의 심한 정도와의 연관성을 관찰하였다. 결 과 : C, S, P 3 군간의 B-임파구, T, $T_H$, Ts, 및 NK-세포를 측정하였을 때 대조군과 단순진폐증환자 사이에서 T, $T_H$는 통계학적으로 의미있게 증가하였으며(P<.01) $T_H$는 두 군간에 의미있게 감소하였으나(P<.01), S, P 두 군 사이에는 특별한 변화가 없었다. 세 군 사이의 싸이토카인 분비 양상은 통계학적인 의의를 발견할 수 없었다. 결 론 : 혈청 임파구 분획은 C군과 비교하여 S군에서 T, $T_H$는 통계학적으로 의미 있게 증가하였으며 Ts는 감소하는 경향을 나타내어 진폐증의 진행 초기에 이들이 연관성이 있다고 추측되어진다.

진폐증 환자에서의 혈청 면역 글로불린의 변화 (Serum Immunoglobulin levels in Coal Worker's Pneumoconiosis Patients)

  • 유광하;안철민;김형중;김영호;이용규;김성규;이원영
    • Tuberculosis and Respiratory Diseases
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    • 제46권2호
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    • pp.165-174
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    • 1999
  • 연구배경: CWP은 주로 석탄 분진을 흡입함으로써 발생하는 폐 실질의 병변으로 단순 흉부 방사선 소견상 폐 결절의 기준을 1cm로 하여 SP과 PMF으로 구분한다. PMF의 경우 환기 능력의 장애가 심하고 조기사망율이 증가하고 있으나 모든 광부에서 PMF이 발생하는 것은 아니여서 이러한 CWP의 발생에 관여하는 요인을 찾기 위한 많은 연구가 있어왔다. 본 연구의 주목적은 진폐증 환자에서 질환의 심한 정도를 ILO 분류에 따라 SP, PMF으로 구분한 후 감염이나 기타 기저 질환이 없는 상태에서의 혈중 면역 글로블린 농도를 흡연력과 연령에 의한 면역 글로불린의 변화를 고려한 후 진폐증의 심한 정도와 혈청면역 글로불린 농도와의 연관성을 관찰하기 위하여 시행하였다. 방 법: 태백 중앙 병원과 영동 병원의 진폐증 환자중 정밀 검사를 시행하기 위해 병원을 내원한 SP 환자 51명과 입원중이거나 정밀검사를 시행한 PMF 환자 59명을 대상으로 하였고 대조군은 진폐증 환자와 나이, 성별 및 흡연 병력이 적합하면서 진폐에 노출된 병력이 전혀 없는 주변 아파트 경비원과 병원내 지원자 58명을 대상으로 하였다. 면역 글로불린의 검사(IgA, IgG, IgM)는 독일 Behring사에서 제조한 각 각의 Kit를 사용하여 Nephelometer 분석기(Behring Nephelometer : Germany)를 사용하여 측정하여 대조군 57명, SP 51명, PMF 49명의 면역 글로불린을 측정하였다. 결 과: 본 연구에서 대조군의 나이에 따른 혈청 면역 글로불린의 변화는 나이가 증가 할수록 IgG는 의의 있게 증가 하였고 흡연력에 의한 면역 글로불린의 차이는 없었다. 대조군, SP, PMF사이의 혈중 면역 글로불린의 농도간에는 차이가 없었으나 흡연력과 나이의 영향을 고려한 다중회귀 분석에서 IgG의 농도는 대조군과 비교하여 SP 환자군에서 통계학적으로 의미 있게 감소하였고 PMF환자군에서는 감소하는 경향이 있었다. 폐기능 검사의 중증도와 면역 글로불린 농도사이에는 관련이 없었다. 결 론: 흡연력과 연령을 고려한 상태에서 진폐증 환자의 혈청 면역 글로불린의 농도는 대조군과 비교하여 SP 환자군에서 IgG의 농도가 감소하였으며 PMF 환자군에서도 감소하는 경향을 나타내어 진폐증과 IgG사이에 연관성이 있다고 생각되며 폐기능 검사의 중증도와 면역 글로불린과는 관련이 없다고 생각된다. 향후에 CWP의 발생 및 진행 기전을 이해하기 위해서 많은 수의 진폐증 환자를 대상으로 하는 전향적 연구와 함께 염증세포 및 싸이토카인의 역할에 대한 연구가 필요할 것으로 생각된다.

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호흡기내과의사를 위한 직업성 폐질환 리뷰 (Clinical Year-in-Review of Occupational Lung Disease)

  • 리원연
    • Tuberculosis and Respiratory Diseases
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    • 제71권5호
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    • pp.317-321
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    • 2011
  • Occupational lung disease (OLD) is a group of lung diseases caused and/or aggravated by organic and inorganic inhaled dust, fumes, and mist. OLD can develop under various occupational situations. Therefore, occupational history should be considered when evaluating respiratory symptoms. Once OLD is developed, it may not be treated and may even progress after exposure to the causative agents has stopped. The best ways to treat OLD are prevention and early detection by controlling the working environment and conducting regular surveillance of workers. Common OLDs in Korea are coal worker's pneumoconiosis, asbestos-related diseases, and occupational asthma. Recent aspects of these common OLDs in Korea will be described based on recently published studies.

석탄광부 진폐증 환자에서 PDGF-BB, IGF-1의 의의 (Clinical Significance of Serum PDGF-BB and IGF-1 in Coal Workers' Pneumoconiosis)

  • 신표진;용석중;신계철;리원연;김신태;차봉석;전근재
    • Tuberculosis and Respiratory Diseases
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    • 제52권4호
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    • pp.338-345
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    • 2002
  • 연구배경: 본 연구는 진폐증의 폐섬유화에 관여하는 사이토카인 중 PDGF-BB와 IGF-1의 혈청내 농도를 측정 비교함으로서 폐섬유화 관정에서의 역할을 간접적으로 확인하고 진폐증 진단의 생화학적 지표자로서 의미가 있는지 알아보고자, 충주의료원과 연세대학교 원주의과대학 원주기독병원에 내원한 환자를 대상으로 정상대조군과 단순형 석탄광부 진폐증군, 복잡형 석탄광부 진폐증군으로 나누어 혈청내 PDGF-BB와 IGF-1 농도를 측정하여 다음과 같은 결과를 얻었다. 방 법: 직업력과 방사선학적 소견으로 석탄광부 진폐증으로 진단된 환자중 단순형 석탄광부 진폐증 13예와 복잡형 석탄광부 진폐증 17예, 정상 대조군 10명을 대상으로 하였다. Human PDGF-BB immunoassay kit (R&D system, Minneapolis, MN)와 Human IGF-1 immunoassay kit (R&D system, Minneapolis, MN)를 이용하여 각 대상의 혈청내 PDGF-BB와 IGF-1의 농도를 측정하였다. 결 과: 1. 복잡형 석탄광부 진폐증군에서의 혈청 PDGF-BB 농도($10083.76{\pm}5639.07pg/mL$)가 정상 대조군 ($3726.17{\pm}1292.20pg/mL$)이나 단순형 석탄광부 진폐증($8493.88{\pm}5848.51pg/mL$)에 비해 통계학적으로 유의하게 높았다(P<0.05). 2. 정상대조군 ($413.40{\pm}61.94ng/mL$)과 단순형 석탄광부 진폐증($366.77{\pm}183.67ng/mL$), 복잡성 석탄광부 진폐증($403.40{\pm}115.39ng/mL$)의 혈청 IGF-1 농도는 각 군간 통계학적 유의한 차이는 관찰되지 않았다(P>0.05). 3. 작업년수에 따른 혈청 PDGF-BB와 IGF-1의농도는 통계학적으로 유의한 차이가 없었다(P>0.05). 결 론: 이상의 결과를 종합하여 보면 석탄광부 진폐증군에서 혈청내 PDGF-BB 농도의 증가는 폐섬유화 진행을 나타내는 생화학적 지표로서의 의미를 갖는 것으로 생각된다.