• 제목/요약/키워드: 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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폐암으로 오인된 진행성 거대종괴성 섬유화: 두 건의 증례 보고 및 감별에 유용한 컴퓨터단층촬영 소견 (Progressive Massive Fibrosis Mimicking Lung Cancer: Two Case Reports with Potentially Useful CT Features for Differential Diagnosis)

  • 강세리;노지영
    • 대한영상의학회지
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    • 제83권5호
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    • pp.1175-1181
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    • 2022
  • 진행성 거대종괴성 섬유화는 비정형적인 소견을 나타낼 경우 종종 폐암으로 오인된다. 현재까지 비정형적인 소견을 나타내는 진행성 거대종괴성 섬유화에 대해 몇 개의 보고가 있으나 짧은 문헌 고찰과 함께 사례를 소개했을 뿐이었다. 이에 저자들은 컴퓨터단층촬영에서 기저에 단순 진폐증이 없거나, 빠르게 커지는 비정형적 위치의 고립성 종괴로 보여 원발성 폐암으로 오인되었던 진행성 거대종괴성 섬유화 2예를 보고하고 감별에 도움이 되는 컴퓨터단층 촬영 소견을 제시하고자 한다.

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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만성폐쇄성폐질환을 동반한 탄광부진폐증자의 혈청 중 LD 및 CRP 농도 (The Serum Levels of LD and CRP in Patients of Coal Workers' Pneumoconiosis with Chronic Obstructive Pulmonary Disease)

  • 이종성;신재훈;이유림;백진이;최병순
    • 대한임상검사과학회지
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    • 제49권3호
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    • pp.214-219
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    • 2017
  • 탄광부진폐증(CWP)과 만성폐쇄성폐질환(COPD)은 석탄분진에 노출되는 탄광부의 폐에서 나타나는 만성적 폐 염증의 특성을 가진다. 이번 연구의 목적은 대조군 27명, CWP 40명, COPD를 동반한 CWP 30명 등 총97명을 대상으로 염증지표로서 혈청 중의 LD와 CRP 수준을 비교하고자 하였다. 혈청 중의 LD 평균 농도(165.7 vs 184.6 U/L, p=0.016)와 CRP 평균 농도(0.08 vs 0.15 mg/dL, p=0.002)는 CWP군에서 유의하게 높았다. 혈청 중의 CRP 평균 농도(0.10 vs 0.19 mg/dL, p=0.008)는 COPD군에서 높았다. 연령을 통제한 공분산분석에서, 혈청 중 CRP 평균 농도는 대조군, CWP군 및 CWP+COPD군 간에 통계적으로 유의한 차이가 있었으며(0.07 vs 0.13 vs 0.19 mg/dL, p=0.005), CWP+COPD 군의 혈청 CRP 평균 농도가 대조군보다 유의하게 높았다(p=0.001). 이러한 결과는 높은 수준의 혈청 중 CRP는 탄광부 이직근로자에서의 CWP 및 COPD와 관련이 있는 것으로 보인다.

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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탄광부 진폐증 환자에 동반된 기관지 탄분섬유화증의 임상적 의의 (The Clinical Significance of Bronchial Anthracofibrosis Associated with Coal Workers' Pneumoconiosis)

  • 김미혜;이홍열;남기호;임재민;정복현;류대식
    • Tuberculosis and Respiratory Diseases
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    • 제68권2호
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    • pp.67-73
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    • 2010
  • Background: In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers' pneumoconiosis (CWP) is unknown. Methods: Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review. Results: Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF. Conclusion: Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.

용접공진폐증 집단검진을 위한 단순 흉부방사선 촬영과 고해상 흉부전산화 단층촬영의 진단적 의의 (Diagnostic Meaning of High Resolution Computed Tomography Compared with Chest Radiography for Screening of Welder's lung)

  • 강정학;전진호;구혜원;고광수;유병철;손혜숙;이종태;이채언;김건일;최석진
    • Journal of Preventive Medicine and Public Health
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    • 제29권4호
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    • pp.853-861
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    • 1996
  • Pneumoconiosis is one of the major problem in the field of occupational health at Korea. Therefore, the efficient diagnosis of pneumoconiosis is a hot issue on the occupational health program. The author executed this study to estimate the diagnostic value of high resolution computed tomography(HRCT) compared with chest radiography for screening of welder's lung. HRCT was introduced very recently for the diagnosis of pneumoconiosis, however, the diagnostic value for screening of welder's lung - principally nonfibrogenic and reversible - has not been evaluated. The subjects were fifty cases of welder's lung or suspected cases who had been collected between 1989 and 1994 from one shipyard and continuously followed-up on the basis of in-plant periodic health check program. We applied both chest radiography and HRCT on the same subjects from May 1 to 30, 1996. The images were evaluated by two careered radiologists independently. The findings of chest radiography were classified into four category by ILO classification, and the findings of HRCT according to the criteria of Bergin et al. The concordance between two radiologists expressed with Kendall's tau-b was 0.72 by chest radiography and 0.44 by HRCT- that is, interobserver variation of HRCT was bigger than that of chest radiography. The concordance between the two different methods was highly variable as 0.44 by radiologist A and 0.06 by radiologist B - that is, interobserver variation was very big. However, HRCT looked more detectable for the minor parenchymal change. These findings suggested that it is not appropriate to use HRCT routinely for screening of welder's lung due to lack of diagnostic criteria, and feasibility, acceptability and economic aspects. Nevertheless, HRCT might be recommendable in the case of equivocal parenchymal features on the chest radiography, unexplained respiratory symptoms, and/or lung function abnormalities suggestive of interstitial fibrosis.

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