• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.2
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• pp.119-140
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• 2019

Objectives: This study was based on the occurrence of a coffee roasting process-related disorder(bronchiolitis obliterans; published by NIOSH in the US) among workers exposed to chemicals called diacetyl in a coffee processing facility. Flavorings added to coffee contain diacetyl and 2,3-pentanedione, all of which are subject to exposure in a number of food manufacturing processes, including coffee roasting, grinding, and packaging. Therefore, this study aims to review the toxicity to workers related to food processing and food additive manufacturing to prevent occupational diseases. Methods: We surveyed the related literature, domestic and international references, and the status of relevant domestic and foreign professional organizations. The present situation of workers was investigated by reviewing literature on the safety and health of workers in the coffee roasting process using domestic and foreign literature and presentations. Expert advisory opinions were reflected, and experts were consulted by participating in domestic and overseas academic conferences. Results: Most of the fragrance materials for coffee were harmful and hazardous substances according to the GHS classification, and research was carried out through a second external consultation. A literature review on the measurement of air pollutant emissions from coffee roasters and the estimation of air pollutant emissions during coffee roasting examined the characteristics of pollutants emitted during coffee roasting. Conclusions: Two chemicals identified as causing bronchiolitis obliterans in the coffee roasting process are believed to explain why the disease is difficult to treat. This information can be used effectively in the future prevention of this disease. Future studies should clearly identify the potential for toxicity of alpha-diketones and the bases of OELs in relation to the occurrence of obstructive bronchiolitis, including measurement of various organic compounds and alpha-diketones from ground coffee, as well as various coffee grinds and coffee bean varieties. In particular, it is necessary to clarify the current understanding of the dose-response relationship between alpha-diketone and lung disease in workers involved in coffee roasting.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.103-109
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• 1999

Respiratory bronchiolitis-associated interstitial lung disease has been described among current or former smokers and has features consistent with interstitial lung disease. Symptoms include cough, dyspnea on exertion. Lung pathology is characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent air spaces associated with mild thickening of the peribronchiolar interstitium. It must be separated from the other interstitial lung disease because of marked differences in treatment and prognosis. Recently we experienced a case of respiratory bronchiolitis-associated interstitial lung disease in a 48-year-old man. As far as we know, this is the first case in Korea.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.541-545
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• 2005

Respiratory bronchiolitis associated interstitial lung disease is a rare condition among current or ex-smokers, which has features consistent with interstitial lung disease. The presentations are non-specific, but symptoms generally include a cough and dyspnea on exertion, and its pathology is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles and adjacent air spaces, and is associated with mild thickening of the peribronchiolar interstitium. Recently, the case of a 54-year-old woman passive smoker, diagnosed as having respiratory bronchiolitis associated interstitial lung disease, was experienced at our institution.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.204-212
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• 1998

Bronchiolitis obliterans organizing pneumonia(BOOP) is a type of diffuse interstitial lung disease that has emerged in the past decade as an important cause of acute respiratory illness in adult. Clinically, the entity usually starts with a subacute influenza-like illness, followed by cough, progressive dyspnea, and weight loss. Organized inflammatory polypoid materials predominantly affecting distal bronchioles, alveolar ducts, and peribronchial alveolar spaces are a key pathologic findings. BOOP is characterized by a good response to glucocorticoid and an excellent prognosis. However, there is a subset of BOOP who presents with a fulminant course leading to death or chronic severe fibrosis with marked impairment of lung function. Recently, we have experienced a case of rapidly progressive BOOP, diagnosed by open lung biopsy and showed a reluctant response to corticosteroid.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.536-541
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• 1992

Bronchiolitis obliterans organizing pneumonia (BOOP) is a type of diffuse interstitial lung disease that primarily affects the small conducting airways and characterized by the presence of granulation tissue plugs within the lumen of small airways often extending into alveolar ducts. It is associated with a number of different causes, including a variety of infections, fume exposures, drugs, collagen diseases and idiopathic. Recently we have experienced one patient with idiopathic BOOP. The patient was a 58 year old man presented with 2 months' history of dry cough and exertional dyspnea. The phyical examination showed inspiratory crackles at both lower lung field. Chest X-ray showed bilateral multiple patchy alveolar density. Pulmonary function studies showed a moderate degree of restrictive lung disease. Open lung biopsy carried out and revealed findings characteristic of BOOP. There was a dramatic response clinically and radiologically to high dose predinisolone therapy. Chest X-ray and pulmonary function test under-taken one year later showed marked improvement. New lesion on chest PA was developed during the period of tapering of prednisolone dose, but it was soon disappeared after increasing of prednisolone dose. One year later, he is well without steroid therapy.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.382-385
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• 2017

A 47-year-old man with myasthenia gravis (MG) was admitted for a lung transplant. He had bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia. MG developed after stem cell transplantation. Bilateral sequential lung transplantations and a total thymectomy were performed. The patient underwent right diaphragmatic plication simultaneously due to preoperatively diagnosed right diaphragmatic paralysis. A tracheostomy was performed and bilevel positive airway pressure (BiPAP) was applied on postoperative days 8 and 9, respectively. The patient was transferred to the general ward on postoperative day 12, successfully weaned off BiPAP on postoperative day 18, and finally discharged on postoperative day 62.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.518-522
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• 2005

Purpose : To evaluate the effect of inhaled hypertonic saline solution in hospitalized infants with bronchiolitis. Methods : A randomized double blind trial was performed from October 2003 to May 2004. A total of eighty patients <1 year of age with a clinical diagnosis of acute viral bronchiolitis were enrolled and assigned to receive either of the following : inhalation of 2 mL(0.5 mg) fenoterol added to 2 mL of 0.9 percent saline solution(group 1; n=40) or 2 mL(0.5 mg) fenoterol added to 2 mL of 3 percent saline solution(group 2; n=40). This therapy was repeated at six hours interval after admission. They were evaluated daily just before and 20 minutes after nebulization. The outcome measures included changes in clinical severity score(based on respiratory rate, presence of wheezing, retraction, and general condition) after nebulization and duration of hospitalization. Results : In the clinical severity score, a significant improvement was observed during the 72 hours of hospitalization in both groups(P<0.05). The basic clinical severity scores before inhalation were decreased significantly faster in group 2 as compared to group 1 on each day of treatment(P<0.05). The mean duration of hospital stay was significantly reduced in group 2 than group 1($5.9{\pm}1.9days$ versus $7.4{\pm}2.0days$, P<0.05). No adverse effects were associated with inhaled therapy. Conclusion : These results suggest that a nebulized 3 percent saline solution plus 0.5 mg fenoterol may be more effective than a 0.9 percent saline solution plus 0.5 mg fenoterol in accelerating the clinical recovery of infants with viral bronchiolitis.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.215-223
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• 1999

Background: The replacement of the narrowed long-segment trachea with various prosthetic materials or tissue grafts remains a difficult and unsolved surgical problem. Homologous cryopreserved tracheal transplantation has been considered to treat the irreversibly-damaged organs, such as in the lung or heart transplantation and also to overcome the limited supply of donor organs. We examined the morphological changes and the immunosuppressive effects of the cryopreserved trachea after the heterotopic transplantation in the rats. Material and Method: Sixty tracheal segments harvested from 30 donor Wistar rats were heterotopically implanted into the peritoneal cavity of 20 recipient Wistar rats and 40 Sprague Dawley rats. The 60 recipient rats were divided into 6 groups(10 rats/ group). In groups I, II, and III, 30 tracheal segments were implanted immediately after the harvesting and in groups IV, V, and VI, the segments were implanted 28 days after the cryopreservation. Groups I and IV were Wistar syngeneic controls. Groups II and V were Sprague Dawley recipients receiving no immunosuppression and Groups III and VI, were Sprague Dawley recipients receiving immunosuppressive agents. At 28 days all rats were sacrificed and the tracheal segments were evaluated grossly and histologically. Result: Immunosuppression of the tracheal segments had a significant influence on the changes of the tracheal lumen and tracheal epithelial cells, irrespective of the cryopreservation of the trachea(p<0.001). In groups III and VI receiving immunosuppressive agents, the tracheal lumen was patent and the normal epithelial cells were observed, however in the other groups not receiving the immunosuppressive agents, there were almost luminal obliteration by the proliferation of the fibrous tissues and a loss of the epithelial cells, the findings were similar to those in the case of obliterative bronchiolitis after a lung and a heart-lung transplantation. Conclusion: With the appropriate immunosuppressive agents, the lumen and the respiratory epithelium of the transplanted tracheal segment were well preserved, even after the cryopreservation of the tracheal segment, which shows the possibility of the long-term preservation and homologous transplantation of the trachea. But fibroproliferative obliteration of the tracheal lumen and the loss of the normal respiratory epithelial cells, characteristic findings of obliterative bronchiolitis, were observed in the groups without the immunosuppression. This experiment using the rat trachea may be useful in studying the pathogenesis, treatment, and prevention of obliterative bronchiolitis after a lung and a heart-lung transplantation.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.630-636
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• 1996

Bronchiolitis obliterans organizing pneumonia(BOOP) is a pathologic entity characterized by the formation of plugs of fibrous tissue in bronchioles and alveolar ducts. It clad been described in association with several connective tissue diseases, i.e. systemic lupus erythematosus, Behcet's disease, polymyositis-dermatomyositis, polymyalgia rheumatica and Sjogren's syndrome. Recently, there were few additional reports on BOOP, anteceded by rheumatoid arthritis. We clad experienced a case of 60 years old female patient who clad been admitted for acute respiratory difficulty and abnormal chest roentgenographic findings. She was diagnosed as having rhematoid arthritis 20 years ago. On the course of our treatment, she did not respond to antibiotics. Moreover, no microorganism grew in the sputum and blood. Thus, the bronchoscopic biopsy was done. The patient showed a dramatic response to steroid therapy, and the pathologic bindings of the bronchoscopic biopsy confirmed as BOOP. To our knowledge, this is the first reported case of BOOP anteceded by rheumatoid arthritis in Korea.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.495-499
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• 2005

Purpose : Interleukin-4(IL-4) is a critical component of the Th2 cytokine pathway and contributes to severity of respiratory syncytial virus(RSV) bronchiolitis. Previous studies observed an association between severe RSV bronchiolitis in Korean children with a common haplotype of the IL4 promoter. This study was performed to investigate functional differences of the variant IL4 promoter haplotypes. Methods : Genomic DNA was obtained from 20 children from 6 to 48 months of age in the Department of Pediatrics, Seoul National University Bundang Hospital. The IL4 promoter spanning an 1.2 kb region was amplified and haplotype was determined by cloning and the PHASE reconstruction. Transcriptional activity of Jurkat T cells which were transfected with each IL4 haplotype were analyzed by use of luciferase assay. Results : Three haplotypes of the IL4 promoter have been identified with the frequency of GCC(7 percent), TCC(17 percent), and TTT(76 percent). The TTT haplotype demonstrated the highest luciferase values in both unstimulated and PMA-stimulated Jurkat T cells. Increases in transcriptional activity compared to GCC have been shown in TTT(5.3 fold higher) followed by TCC(4.2 fold higher) in unstimulated Jurkat T cells. Conclusion : We provided evidence that increased transcriptional activity of the TTT haplotype of the IL4 promoter, which has previously been over-represented in Korean children with severe RSV bronchiolitis. Therefore, IL-4 could play a potential role in the pathogenesis of RSV infection, possibly via an altered transcriptional activity of the different IL4 haplotypes.