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단순진폐증에 대한 흉부 고해상 전산화 단층촬영의 진단적 의의
김경아,김지홍,장황신,안형숙,임영,윤임중,Kim, Kyoung-Ah,Kim, Hi-Hong,Chang, Hwang-Sin,Ahn, Hyeong-Sook,Lim, Young,Yun, Im-Goung 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.3
Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending eve, two o, more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiogrphy in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in $FEV_1,\;FEV_1/FVC$, PEFR, $FEF_{25},\;FEF_{50},\;and\;FEF_{75}$ and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.
유리규산과 청석면에 의한 실험 진폐증에서의 아포프토시스
안형숙,윤임중 가톨릭대학산업의학센타 산업의학연구소 1996 韓國의 産業醫學 Vol.35 No.3
The deposition of silica and crocidolite in the pulmonary system results in a fibrotic reaction. Using intratacheal instilled exposures,we have attempted to assess the infiuence on the pulmonary fibrosis ad apoptosis due to silica and crocidolite. To accomplish this,we investigated the changes of the cellularities in bronchoalveolar lavage fiuid(BALF),tissue pathology and apoptosis assays of tissue specimens in the experimental silicosis and asbestosis according to time sequence. 30 Sprague Dawley rats weighing 250-300g were divided into 3 groups:saline group received only intratracheal instillation of 0.5ml saline,while silica group was instilled 40mg silica with 0.5ml saline, and crocidolite group was instilled 2mg crocidolite with 0.5ml saline intratracheally at once. These rats were sacrificed at the 4th and the 8th week after intratracheal instilation. We observed the total cell count and differential count using hemocytometer in BALF and cell viability was determined using trypan blue exclusion. Pulmonary tissue sections were stained by H-E method for pathological change and by In situ cell death detection kit for apoptosis assays. The results were as follows: 1. The total cell count and the percentages of neutrophils and lymphocytes in bronchoalveolar lavage fluid were significantly increased in silica and crocidolite group at the 4th week after intratracheal instillation,compared with the control group.These changes persisted to the 8th week and were markedly apparent in silica group. 2. Silica instilled lungs showed remarkable developments of BALT(bronchus associated lymphoid tissue),granulomas and fibrotic changes of alveolar walls at the 4th week. These changes further progressed at the 8th week. In the crocidolite group,the fibrotic changes were rare and diffuse alveolitis findings were more common at the same time sequence. 3. The silica group showed strong positive reaction for the apoptic reaction in the 4th and 8th week while crocidolite group has only the week reaction. These results suggest that the neutrophils and the lymphocytes have also participated in the pulmonary fibrosis resulting from silica and crocidolite even though alveolar macrophage has a major role. Moreover apoptosis followed by pulmonary fibrosis also has a major role in the pathogensis of experimental pneumoconiosis.