CT Findings in People Who Were Environmentally Exposed to Asbestos in Korea

Asbestos related pleuropulmonary disease has been emerging health problem for recent years. It can cause variable clinical symptoms and radiological abnormalities. However, there has been no report for their characteristics in subjects who were environmentally exposed to asbestos. We reviewed the CT images of 35 people who were environmentally exposed to asbestos in Chungnam province, Korea. The study result showed high incidence of pleural plaque and pulmonary fibrosis on chest CT (94% and 77%, respectively). The common CT findings of lung parenchymal lesions were as follows: centrilobular opacities (94%), subpleural dot-like or branching opacities (80%), interlobular septal thickening (57%), intralobular interstitial thickening (46%), parenchymal bands (43%) and subpleural curvilinear line (29%). There were no significant differences in the prevalence of pulmonary fibrosis and pleural plaques according to sex, age and duration of exposure. In conclusion, pleural plaque and pulmonary fibrosis are common asbestos-related CT finding in the exposed people. Asbestos related lung parenchymal CT findings in the participants with environmental exposure show similar to those observed in the occupational exposure.     

胸膜斑阳性接尘工人血清效应蛋白的研究

目的 监测胸膜斑阳性接尘工人血清效应蛋白质,探讨胸膜斑发病机制及其与石棉肺的关系.方法 将研究对象分为胸膜斑组、阴性对照组和正常对照组.各组人群静脉血应用双向电泳和质谱进行分离和鉴定,以灰度值差异1.5倍为基准获得差异表达蛋白质.结果 胸膜斑组与阴性对照组和正常对照组比较,差异点分别有34和16个;阴性对照组与正常对照组比较,差异点有32个.效应蛋白质如补体因子、α1-抗胰蛋白酶等参与机体免疫、抗肿瘤等过程.部分效应蛋白质与石棉肺血清效应蛋白一致.结论 长期接触石棉导致血清中某些蛋白质表达量改变,进而影响其生物学功能.胸膜斑和石棉肺有相同的靶效应蛋白,提示胸膜斑工人更易患石棉肺.     

Immunogenetic factors as determinants of asbestosis

To evaluate the possible role of immunogenetic factors as predisposing determinants of the development of asbestosis in exposed workers, we obtained 53 phenotypes of the human leucocyte antigen (HLA)-A, B, C, and DR antigens in 72 long-term workers of the mines and mills of Quebec and in a reference population of 150 residents. Among the asbestos workers, 32 did not have any abnormality and 40 had asbestosis. The 2 groups did not differ in term of age, exposure, or cigarette smoking habits. In agreement with previous reports, we found no significant change in frequency of the HLA-A, B, or C phenotypes. Furthermore, we did not find any significant change in the frequency of 10 phenotypes of the HLA-DR loci. We conclude that immunogenetic factors are not major predisposing determinants of asbestosis.     

256例高千伏胸片石棉肺不规则小阴影X线表现分析

目的探讨石棉肺不规则小阴影X线表现。方法通过对256例石棉肺高千伏X线胸片出现影像进行整理分析,备期石棉肺X线小阴影形态,以S影最多见,占本组44．13％,总体密集度Ⅰ期患者绝大多数为1级,占85．16％,病变分布范围Ⅰ期石棉肺病变超过两个肺区占63．28％,胸膜斑出现率占38．67％,“蓬发心”出现3例,各工种发病情况与工龄成正比,与工种有绝对关系即决定于作业场所粉尘浓度、劳动条件及个人防护情况,本组病例中所提到3个多发病工种与上述3个因素有关。结果石棉肺主要X线表现为不规则小阴影,胸膜斑。结论X线表现能准确地反映石棉肺的发展进程,变化规律及分期,胸膜斑在石棉肺诊断中的价值。结合临床和实验室检杏对其诊断有一定帮助。     

Overview of Asbestos Issues in Korea

Asbestos is a carcinogen that causes diseases such as mesothelioma and lung cancer in humans. There was a sharp increase in the use of asbestos in Korea in the 1970s as Korea''s economy developed rapidly, and asbestos was only recently banned from use. Despite the ban of its use, previously applied asbestos still causes many problems. A series of asbestos-related events that recently occurred in Korea have caused the general public to become concerned about asbestos. Therefore, it is necessary to take proper action to deal with asbestos-related events, such as mass outbreaks of mesothelioma among residents who lived near asbestos textile factories or asbestos mines. Although there have been no rapid increases in asbestos-related illnesses in Korea to date, such illnesses are expected to increase greatly due to the amount of asbestos used and long latency period. Decreasing the asbestos exposure level to levels as low as possible is the most important step in preventing asbestos-related illnesses in the next few decades. However, there is a lack of specialized facilities for the analysis of asbestos and experts to diagnose and treat asbestos-related illnesses in Korea; therefore, national-level concern and support are required.     

纤维水镁石与经铝剂处理的温石棉对巨噬细胞毒性比较

应用体外试验，比较了水镁石与经氯化铝处理后的两种温石棉（新康温石棉和四川温石棉）对豚鼠肺泡巨噬细胞的毒性作用。结果显示，经氯化铝处理后的温石棉所引起巨噬细胞产生的Ｏ２＾－、细胞膜脂流动性增加及细胞钾外漏等毒性指标变化，明显低于相同剂量的水镁石组（Ｐ〈０．０５或Ｐ〈０．０１）；引起肺泡巨噬细胞释放乳酸脱氢酶、酸性磷酸酶及致细胞死亡率等指标变化与水镁石组相近似。表明氯化铝拮抗温石棉的致病生物学活性有实     

不同工种石棉肺患者CT肺功能成像指标的差异性研究

目的 采用多层螺旋CT肺功能成像技术评价不同工种石棉肺患者的肺功能指标改变及特点.方法 将30例石棉肺患者按工种分为压型组、梳纺组和原棉组,每组10例.分别于受试者深吸气末和深呼气末屏气行全肺扫描,测定肺容积指标(最大吸气与呼气末肺容积、肺容积差、肺容积比)、平均肺密度指标(吸气与呼气末平均肺密度、肺密度差、肺密度比)和小气道指标(吸气与呼气末壁厚直径比率、吸气末支气管壁面积百分比).结果 压型组、梳纺组和原棉组在性别、年龄、接触史、分期(Ⅰ期)方面差异均无统计学意义(均P＞0.05).肺容积、平均肺密度和小气道指标中,3组间呼气末平均肺密度、呼气末左肺平均肺密度、呼气末右肺平均肺密度、呼气末与吸气末平均肺密度比、吸气末壁厚直径比率、吸气末支气管壁面积百分比和呼气末壁厚直径比率差异均具有统计学意义(均P＜0.05);进一步两两比较发现,梳纺组的上述指标分别与原棉组和压型组比较,差异亦均具有统计学意义(均P＜0.05),而原棉组和压型组间差异均无统计学意义(均P＞0.05);3组间其余指标差异均无统计学意义(均P＞0.05).结论 与压型组和原棉组比较,梳纺组石棉肺患者的肺气肿及小气道壁和肺泡隔纤维性增厚更为明显,应加强对这部分人的保护.     

CT肺功能指标判断评价石棉肺患者呼吸功能的研究

目的 采用多层螺旋CT肺功能成像技术评价石棉肺患者的呼吸功能障碍程度和肺功能指标的改变及特点.方法 61例石棉肺患者与30名健康者根据用力肺活量和第1秒用力肺活量分为肺呼吸功能正常组、轻度损伤组、中重度损伤组.对每个受检者分别在深吸气末和深呼气末屏住气行全肺扫描,对肺容积、肺密度、小气道指标进行测定.结果 肺呼吸功能正常组、轻度损伤组、中重度损伤组的各项肺容积指标(吸气与呼气末肺容积、容积差、容积比)差异具有统计学意义(均P＜0.05);各项平均肺密度指标(吸气与呼气末平均肺密度、肺密度差、肺密度比)差异具有统计学意义(均P＜0.05);各项小气道指标(吸气与呼气末壁厚直径比率、支气管壁面积率)差异具有统计学意义(均P＜0.05).结论 CT肺功能成像技术可以用来评价石棉肺患者的呼吸功能障碍程度.随着石棉肺患者肺呼吸功能障碍的发展,其肺总量降低,双肺的残气量逐渐增多,肺气肿逐渐加重,小气道壁和肺泡隔纤维性肥厚逐渐增厚.     

Review of lung function data in 195 patients with asbestosis of the lung

Summary One hundred ninety-five patients with asbestosis of the lung of all grades were examined and measurements of VC, FRC, C stat., C spez., R tot. pO₂a at rest and under work load were taken. With the intention of looking for functional differences between persons with pleural thickenings or calcifications only and those with real fibrosis of the lung as well as mixed cases, we formed 4 groups of patients according to the radiographic appearances. We could prove that the compliance was not affected in cases of pleural asbestosis but severely changed by fibrosis alone. Only the VC was statistically different to normal values even in cases grouped as pleural disease according to the radiograph. Further examinations were made with respect to the place of work. The first impressions of a long-term study are added.