The Role of Lymphocyte Compartment and Cytokine in Coal Workers Pneumoconiosis / 결핵

BACKGROUND: Coal-worker's pneumoconiosis(CWP) is characterized by a chronic inflammatory lung reaction associated with macrophage accumulation in the alveolar spaces. CWP is usually divided into two stages : simpl e pneumoconiosis(SP) where there are a limited number of fibrotic lesions remain limited, with radiological opacities smaller than 1cm and progressine massive fibrosis(PMF), which is characterized by the development of a perifocal extensive fibrotix response of the lung and severws alterations in pulmonary function. In this study, the lymphocyte compartment and cytokine were evaluated by measuring the serum levels in the control, SP and PMF groups. METHODS: The coal workers selected for this study were employees(patients?) of the Tae-Baek and Dong-Hae hospital. All were men, 45-76 years old and the mean duration of their exposure to coal dust was 23.2 years in the lymphocyte compartment and 24.3 years in the cytokine checked group. According to the X-ray examination results, the patients were classified into either one of the SP, PMF categories. The normal controls examnied were 26-70 years old men. The serum cytokine levels were estimated by using an end point enzyme immunoassay technique. RESULTS: T lymphocyte, helper and suppressor T cells were highly related to pneumoconiosis in this study. A statistically significant decrease in the number of suppressor T lymphocytes was observed in this simple pneumoconiosis patients and at the same time, there was an increase in the lymphocyte index. However, there was no statistically defference in the serum cytokines levels among the SP, PMF and control groups. CONCLUSION: T lymphocyte, helper T, and suppressor T cells may be highly related to the development of CWP compared to the control group particularly in the early stage of pneumoconiosis. The changes obseved in the immunological system in patients with pneumoconiosis may lie at the bottom of the pathogenesis of fibrosis. Further study is needed to evaluated the lymphocyte compartment as a marker of pneumoconiosis developement in the early stage.

A Case of Lung with Jejunal Metastasis / 결핵

Primary lung cancer can metastasize by a direct local extension, hematogenous dessemination, and lymphatic spread. However, it less commonly metastasizes via a transbronchial invasion. A pproximately half of all patients with lung cancer have metastases at the initial presentation. Autopsy data showed that there are an average of 4.8 metastatic sites. The most common sites for metastases include the lymph nodes, liver, adrenal gland, bone, and brain. However, clinically significant metastases isolated in the small bowel seldom occur. Here we report a case of lung cancer with a small bowel metastasis.

Effects of Carvedilol on Left Ventricular Function in Elderly Patients with Congestive Heart Failure

BACKGROUND AND OBJECTIVES: Neurohormonal compensation plays an important role on the pathophysiologic aspects of congestive heart failure (CHF). There is recent clinical evidence that beta blocker is beneficial in selected patients. However, there is little information regarding the effect of beta blocker on elderly patients. MATERIALS AND METHODS: 26 patients of CHF under stable condition by conventional management were selected and were divided into two age subgroup. Group 1 were more than 65 years (n=12) and group 2 were less than 65 years (n=14). From 12.5 to 25 mg/day of carvedilol was given according to the clinical condition. The left ventricular end diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD), left ventricular volume index (LVVI), ejection fraction (LVEF), E/A ratio and E wave deceleration time (EwDT) of mitral inflow doppler velocity were measured by echocardiographic examination before and 3 months after carvedilol trial. Six-minute walk distance were also measured. RESULTS: Between before and after carvedilol treatment, there were significant decrease of LVVI and sign-ificant increase of EF in group I and group II. The EwDT and 6 minute walk distance of both group were also increased significantly after carvedilol trial. The delta EF of group I is smaller than group II (4.1+/-5.7 vs 9.7+/-10.0, p<0.05). CONCLUSION: When compared to younger patients with CHF, the efficacy of carvedilol on LV function in aged patients was evident. Improved clinical conditions would be expected by using carvedilol in elderly patients with CHF.