Diagnostic features of atherosclerosis development in miners having anthracosilicosis.

To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group. markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.

Rapid Growth of Lung Nodules due to Combined Pulmonary Vasculitis, Silicoanthracosis, and Chondrocalcinosis.

Background. Silicoanthracosis is a pneumoconiosis due to occupational inhalation of silica and carbon dusts. Clinically, it can be associated with vasculitis or rheumatoid arthritis. In association with these diseases, silicoanthracosis can present within the lung with multiple pulmonary nodules which, as a differential diagnosis, can mimic metastatic disease or multiple abscesses. Case Presentation. We present the case of a 62-year old former pit worker with pulmonary nodules, chondrocalcinosis due to calcium pyrophosphate deposition (CPPD), and a history of renal cancer. Within a short period of time, pulmonary nodules grew rapidly. Thoracoscopically, the resected lung specimen revealed silicoanthracosis associated with small-to-medium-size vasculitis in the presence of antineutrophil cytoplasmatic autoantibodies (c-ANCA). Conclusion. Pulmonary silicoanthracotic lesions on the base of ANCA-associated vasculitis and CPPD arthritis can rapidly grow. A mutual correlation between silicoanthracosis, ANCA-associated vasculitis, and CPPD seems possible. Apart from this, consideration of metastatic disease should be obligatory in patients with a history of cancer at the same time being immunosuppressed.

[A clinicopathological study of 16 autopsy cases of anthracosilicosis with lung cancer].

OBJECTIVE: To investigate the clinicopathological characteristics of anthracosilicosis complicated with lung cancer. METHODS: Tissue specimens from 16 autopsy cases of 0(+) anthracosilicosis complicated with lung cancer were retrospectively studied by hematoxylin-eosin, histochemical, and immunohistochemical staining. RESULTS: All of 16 patients were male. The patient's age ranged from 46 to 57 years (average: 52.8 years). The dust-exposure time were over 25 years. The pneumoconiosis and dust fibrosis of different degrees in the lung were found. The positive detected rate of coal silicotic nodules was 93.75% (15/16). Among 16 cases of lung cancer, there were 5 cases of squamous cell carcinoma, and 5 cases of small cell undifferentiated carcinoma, 3 cases of bronchioloalveolar carcinoma, 2 cases of adenocarcinoma and 1 case of adenosquamous carcinoma. The typical pathological changes of anthracosilicosis complicated with lung cancer were: the cancer tissue was located at the side of coal dust fibrous focus and fibrosis lesion, or mixte with silicotic lesion. CK, EMA and CEA were positively expressed in most of the tumor cells, while vimentin was positive in the fibrocyte of dust fibrosis. CONCLUSIONS: The occurrence of some lung cancer may be related with fibrosis. The dust-exposed workers can suffer from lung cancer which is histologically identical to the general lung tumor. PCNA and Ki67 may be a prognostic index for anthracosilicosis with lung cancer, while vimentin may be a marker for the examination of dust fibrosis in anthracosilicosis.

Debilitating lung disease among surface coal miners with no underground mining tenure.

OBJECTIVE: To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis survey. METHODS: Job history, tenure, and radiograph interpretations were verified. Previous radiographs were reviewed when available. Telephone follow-up sought additional work and medical history information. RESULTS: Among eight miners who worked as drill operators or blasters for most of their tenure (median, 35.5 years), two reported poor dust control practices, working in visible dust clouds as recently as 2012. Chest radiographs progressed to progressive massive fibrosis in as few as 11 years. One miner's lung biopsy demonstrated fibrosis and interstitial accumulation of macrophages containing abundant silica, aluminum silicate, and titanium dust particles. CONCLUSIONS: Overexposure to respirable silica resulted in progressive massive fibrosis among current surface coal miners with no underground mining tenure. Inadequate dust control during drilling/blasting is likely an important etiologic factor.

[Silicosis and primary Gougerot-Sjögren syndrome]. / Silicose et syndrome de Gougerot-Sjögren primitif.

We report three cases of primary Sjögren's syndrome in silicotic coal miners. All patients fulfilled the diagnostic criteria for Sjögren's syndrome recently established by the European Community study group. One patient had cryoglobulinemia and polynevritis. Another had Raynaud's phenomenon, arthralgia, purpura and polynevritis. Capillary microscopy was normal in all the three patients. Antinuclear antibodies were detected only in one patient, who had also anti-SSa and anti-SSb antibodies. The prevalence of systemic sclerosis, rheumatoid arthritis and probably systemic lupus erythematosus is significantly higher after longstanding occupational exposure to silica. On the contrary, any case of Sjögren's syndrome was till now described in the course of pulmonary silicosis. The physiopathological mechanisms of these associations are misunderstood.

[Bronchial cancer in anthracosilicosis and silicosis. Study of workers in coal fields in Wallonia]. / Le cancer bronchique chez les anthracosilicotiques et silicotiques. Etude chez les travailleurs des bassins houillers wallons.

This study was carried out between 1973 and 1982 on the proportional mortality by lung cancer of a group of workers living either in Brussells or in Wallonia and receiving compensation for silicosis or anthrasilicosis. The majority of patients suffered from anthrasilicosis (more than 96%) and had been exposed to the risk of pneumoconiosis in one of the four coal fields in Wallonia. If, in 13,822 deaths studied the proportional mortality from lung cancer had grown by 0.56% per year reaching 3.7% in 1973 and 9.3% in 1982, it remained below that for a similar Belgian population matched for age and sex. No correlation could be found between the occurrence of this tumour and one or other radiological category as defined by the international classification of pneumoconiosis in 1980. In addition the severity of pneumoconiosis, either from a radiological or functional view, hardly had any influence on the genesis of lung cancer. Finally, the localisation of the tumour and the different histological types do not differ from that reported in the literature among the general population. On the other hand a significant rise in proportional mortality from lung cancer between 1973 and 1982 (p less than 0.001) seemed to be related to two factors, smoking habitis (89.1% of subjects dying from lung cancer were smokers at the moment of death against 68.5% of smokers among other causes of death), and above all the progressive aging of the population of pneumoconioties receiving compensation, the cross section 50-69 rose from 53.17% in 1973 to 73.8% in 1982.

[Pathological observations on massive fibrosis of coal-mine pneumoconiosis].

Morphological studies on massive pulmonary fibrosis due to pneumoconiosis in 42 cases were performed. The cases were divided into two types: the coalescence of fibrotic nodules type and the progressive massive fibrosis type. The former includes fusion of simple silica or coal-silica nodules and coalescence of mainly coal-silico-tubercle nodules. When pneumoconiosis is complicated by tuberculosis, the coal-silico-tubercle is the pathological change caused by the combination of dust and inflammation. The resulting conglomerate mass can be classified as progressive massive fibrosis. A comparison of micro-element content between non-massive fibrosis and massive fibrosis was made, and only the silicon content showed a significant difference (P < 0.05). The morphology, pathogenesis and formation of progressive massive fibrosis are discussed.

[Pathological study of 16 cases of lung cancer with long-term exposure to dusts in coal mine].

16 cases of lung cancer with long-term exposed to dusts in coal mine were studied by autopsies. This group of lung cancer's pathologic characteristics were: The mean of the age of death of the patients were 51.3 yrs, 10 years younger than that of the general population. In addition to the main tumor, multiple origin of bronchial mucosa with epithelial hyperplasia, metaplasia, and carcinoma in situ were seen. Dusts smear were seen under polar-microscope and identification by EDAX in H-800 electronic microscope. According to EDAX analysis, on the surface of some particles, Co, Cr, ions were detected.

[New morphological aspects of pathogenesis of pneumofibrosis in anthracosis]. / Novye morfologicheskie aspekty patogeneza pnevmofibroza pri antrakoze.

The death of the alveolar macrophage stimulating the activation of fibroblast in pneumoconiosis is not a single trigger mechanism of pneumofibrosis in anthracosis. Alteration of the microcirculatory bed and lung aerohematic barrier plays an essential pathogenetic role in coal pneumoconiosis. Polycarbonic acids which are formed in the organism from coal as a result of its oxidative-hydrolytic degradation are the cause of the damage and loss of the structural components of the aerohematic barrier.

[Role of pneumotachography in the diagnosis and assessment of treatment effectiveness in bronchial dystonia in respiratory tract diseases of dust etiology]. / Rol' pnevmotakhografii v diagnostike i otsenke éffektivnosti lecheniia distonii bronkhov pri zabolevaniiakh organov dykhaniia pylevoi étiologii.

Flow-volume values and their changes in response to salbutamol and methacin inhalations were studied with the help of a pneumotachograph in 69 patients with anthracosilicosis stage I, and in 70 patients with chronic dust bronchitis stages I and II. Pneumotachography was shown to extend diagnostic potentialities in the detection of ventilation insufficiency in patients with dust pulmonary pathology, making it possible to determine not only a degree but also a site of obstructive disorders. Disorders of the sympathetic and parasympathetic bronchial innervation and associated biochemical mechanisms were important in the mechanism of bronchospasm development. Pneumotachography was recommended in combination with bronchospasmolytic drugs of sympathomimetic and cholinolytic action for elucidation of the mechanism of disorders of the bronchial tone, a choice of adequate therapy and assessment of its efficacy.

[The role of pulmonary surfactant in the atherogenesis process in patients with dust-induced respiratory organ diseases]. / Rol' surfaktanta legkikh v protsesse aterogeneza u bol'nykh pylevymi zabolevaniiami organov dykhaniia.

There have been established opposite reactions in the cardiovascular system during formation of dust-induced pathology of lungs: a common finding in patients with pneumoconiosis is alterations in the left heart, while in chronic dust bronchitis the same is true of the right heart. In the authors' opinion, different states of pulmonary surfactant in the above conditions account for this observation. Inhibition of synthesis of the pulmonary surfactant associated with the development of the blood and tissue phospholipid deficiency makes for the evolution of atherosclerosis in patients with pneumoconiosis while enhancement of the phospholipid production by the lungs accompanied by elevation of their blood content is an important factor inhibiting the processes of atherogenesis in patients with dust bronchitis.