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""This book opens with a comprehensive overview of the scientific basis of lung function in health and disease. It then provides detailed coverage of the broad array of diseases and disorders affecting the respiratory system, including obstructive and restrictive diseases, pulmonary vascular disorders, sleep-disordered breathing, lung neoplasms, respiratory infections, and respiratory failure, among others.""

"Tujuan. Banyak pabrik di Indonesia yang mempunyai pajanan silika tinggi seperti pabrik keramik dan pabrik semen, namun belum ada penelitian mengenai penyakit gangguan restriktif pada pekerja akibat pajanan silika. Tujuan penelitian ini adalah mengetahui prevalensi penyakit gangguan paru restriktif pada pekerja laki laki.Metode. Desain penelitian ini adalah cross sectional ,data diambil dari data sekunder bagian batching plant, furnace, cutting line, dan administrasi yang dilakukan pemeriksaan tahun 2003.. Hasil. Dari 449 data, didapatkan prevalensi gangguan pare restriktif pada pekerja PT. X tahun 2003 adalah 48,8%. Hubungan antara gangguan paru restriktif dengan pajanan silika bermakna (p= 0,024). Masa kerja Para pekerja sebagian besar adalah kurang dan 10 tahun (90,6%). Tidak ada hubungan bermakna antara gangguan paru restriktif dengan penggunaan APD, pajanan organofosfat dan merokok.Kesimpulan. Prevalensi gangguan paru restriktif akibat pajanan debu silika terbukti pada pekerja PT. X. sebesar 48,8% pada tahun 2003.

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Prevalence Restrictive Lung Disorders Manufacturing Man Workers in PT. X at Cikarang.Objective of study. Many factories in Indonesia have a high exposure of silica such as cement and ceramic factories, which could cause restrictive pulmonary disease. Until now, no evidence has proved that the restrictive pulmonary disease raised among many workers, was caused by exposure of silica. Objective of study is to find out the prevalence of the restrictive pulmonary disease for man's worker, focusing on the exposure of silica.

Method. The design of this study is cross sectional. Subject of the study was secondary data chosen from the employees. The subject were selected from the hatching plant department, the furnace department, the cutting line and the administrative department, which was the high exposure environment and mild exposure. The employees was examined in 2003.

Result. Of total 449 data, the prevalence of restrictive pulmonary disease is 48.8%. Most of the employees have the duration of work less than 10 years. Correlation between restrictive pulmonary disease and silica exposure was significant (p = 0,024). Correlation between restrictive pulmonary disease and other related factors such as: use of personal protective equipment, organophosphate exposure, and smoking is also not significant.

Conclusion. Prevalence of the restrictive pulmonary disease 48.8% in PT.X. on 2003."

"Ruang Lingkup dan Cara Penelitian: Dalam proses produksinya suatu pabrik semen telah menyebabkan pencemaran limbah debu di lingkungan kerjanya. Hal ini menunjukkan bahwa disamping manfaatnya dalam pembangunan, proses produksi semen juga dapat mengganggu kesehatan paru tenaga kerja. Berhubung masih terdapat kontroversi mengenai jenis kelainan paru yang disebabkan debu semen, maka dilakukan penelitian di pabrik semen. Tujuan penelitian adalah untuk memperoleh data mengenai prevalensi penyakit dan gangguan faal paru di kalangan tenaga kerja Plan III/IV pabrik semen dan kadar debu rata-rata dimana tenaga kerja- terpapar, serta melihat hubungan antara kadar debu dan lama paparan dengan prevalensi tersebut. Secara deskriptif menggunakan disain 'cross sectional' telah diperiksa sejumlah 176 tenaga kerja laki-laki berumur 18-55 tahun dan telah bekerja selama 2 tahun. Pemeriksaan dilakukan dengan menggunakan kuesioner, pemeriksaan fisik, faal paru dan foto toraks. Pengukuran kadar debu dilakukan dengan teknik 'low volume dust sampler' sedangkan untuk silika bebas dengan mikroskop polarisasi.Hasil dan Kesimpulan: Kadar silika bebas di beberapa tempat menunjukkan kadar >1% dan kadar debu di beberapa tempat melebihi NAB. Prevalensi penyakit yang ditemukan rendah sekali, yaitu silikosis 1,13%, tersangka silikosis 1,7%, asma 0,6%, TB 3,4%, sedangkan bronkitis dan emfisema tidak ditemukan. Gangguan faal restriktif ditemukan sebesar 19,9% dan gangguan obstruktif 2,3%. Tidak ditemukan hubungan antara besar risiko dengan gangguan faal paru dan prevalensi penyakit. Demikian pula tidak ditemukan hubungan antara gangguan faal paru dengan kelainan radiologis, umur dan kebiasaan memakai pelindung. Terdapat hubungan antara kebiasaan merokok dan gangguan faal paru; gangguan restriktif lebih banyak ditemukan pada bukan perokok (p <0,05).

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Pulmonary Diseases And Lung Function Abnormalities Among Workers At A Cement FactoryScope and Method of Study: The main hazard during cement processing is dust. This indicates that besides its benefit on our National Development, the cement industry may have some drawbacks on our workers' health. A cement factory was surveyed, since there are still different opinions on the pulmonary effects of cement dust until now. The aim of this study is to measure the level of dust exposure and the silica content at Plant II1/IV of the factory, to study the prevalence of pulmonary diseases and lung function abnormalities of cement workers at Plant III/IV and to observe if there is any relationship between both studies. In this cross-sectional study, 176 cement workers of Plant II1/IV aged between 18 to 55 years were surveyed. A questionnaire, physical examination, chest roentgenogram and Spiro gram were obtained on each person. Dust concentrations were measured with a low volume dust sampler and free silica was measured with a polarizing microscope.Findings and Conclusions: At some workplaces the dust and silica concentrations were above the threshold limit value. The overall prevalence rate of silicosis was 1.13%, suspect silicosis 1.7%, tuberculosis 3.4% and asthma 0.6%, while no signs of bronchitis and emphysema were noted. The vital capacity in 19.9% workers and the FEV1 in 2.3% workers was reduced. No relationship was noted between dust exposure, pulmonary diseases and lung function abnormalities. Neither was there any relationship noted between lung functions abnormalities, smoking habits, roentgen graphic changes, age and the usage of respiratory protective. A significant relationship was noted between smoking habits and lung function abnormalities; restrictive impairments were most pronounced in nonsmokers (p C 0.05)."

"Data pola bakteri yang diisolasi dari sputum penderita penyakit paru obstruktif kronik (PPOK) eksaserbasi akut di Indonesia yang sangat terbatas, menunjukkan terdapat kecenderungan pola bakteri di Indonesia berbeda dengan yang dilaporkan banyak negara lain. Di kebanyakan negara lain Haemophilus injluenzae dan Moraxella catarrhalis merupakan bakteri terbanyak pertama dan kedua yang diisolasi dari sputum penderita PPOK eksaserbasi, sedangkan di Indonesia kekerapan isolasi kedua bakteri tersebut sangat rendah. H influenzae bersifat fastidious dan M catarrhalis sering terabaikan peranannya sebagai patogen. Ditambah lagi sebagian laboratorium di Indonesia belum dapat mengisolasi kedua bakteri ini. Oleh karena itu diperlukan metode deteksi yang lebih efektif untuk kedua bakteri ini. Pada penelitian ini dikembangkan metode PCR multipleks untuk H injluenzae dan M catarrhalis, serta aplikasinya pada sputum penderita PPOK eksaserbasi akut PCR multipleks ini dapat digunakan untuk mendeteksi H injluenzae dan M catarrhalis dalam sputum masing-masingnya sampai 1,5 x 1ifcFU/ml atau 30 CFU/ reaksi PCR pada uji simulasi. Pemeriksaan PCR multipleks pada 30 sampel sputum penderita PPOK eksaserbasi akut memberikan hasil pita yang sesuai untuk H injluenzae sebanyak 60% dan untuk M catarrhalis 46,7%. Sedangkan dari biakan sputum hanya didapatkan satu sampel positif H injluenzae dan tidak ada sampel yang positif untuk M catarrhalis. Dengan jumlah sampel yang terbatas tersebut pemeriksaan PCR multipleks ini memiliki nilai sensitivitas 100%, spesifisitas 41,38%, nilai prediksi positif 5,56% dan nilai prediksi negatif 100% untuk H injluenzae. Nilai spesifisitas dan nilai prediksi negatif untuk M catarrhalis adalah 53,33% dan 100% .. Perlu dilakukan penelitian lanjutan dengan jumlah sampel yang lebih besar dan perlu dilakukan peningkatan· sensitivitas metode kultur untuk H injluenzae dan M catarrhalis.

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Limited database of bacterial pattern recorded in acute exacerbation of chronic obstructive pulmonary diseases (COPD) in Indonesia showed that the trend of bacterial pattern that was isolated from the patients with acute exacerbations of COPD is different from that which was reported in many other countries. In many other countries, Haemophilus inj1uenzae and Moraxella catarrhalis are the first and second most common bacteria that were isolated from the sputum of patients with acute exacerbations of COPD while in Indonesia the frequency of isolation of both bacteria is very low. H inj1uenzae is a fastidious bacteria while M catarrhalis' role as pathogen was frequently ignored. Moreover, many laboratories in Indonesia have no capabilities in the isolation of both bacteria. Thus, more effective detection methods are needed. This study is aimed at developing a multiplex PCR assay for H inj/uenzae and M catarrhalis, as well as the method's application on the sputum of patients with acute exacerbations of COPD. The multiplex PCR can be applied for the detection of both H influenzae and M catarrhalis in sputum up to 1.5 x 102 CFU/ml or 30 CFU per PCR reaction in simulation test. The multiplex PCR analysis on 30 sputum samples of patients with acute exacerbations of COPD yielded band that 60% match that of H inj1uenzae and 46.7% that of M catarrhalis. However, analysis of the sputum culture only produced one positive sample for H inj1uenzae and no positive samples for M catarrhalis. With such limited samples, multiplex PCR assay has 100% sensitivity, 41.38% specificity, 5.56% positive predictive value, and 100% negative predictive value for H inj/uenzae. The aassay has 53.33% specificity and 100% negative predictive value for M catarrhalis. Further study with bigger sample size should be carried out as well as the improvement in the sensitivity of the culture method for H inj1uenzae and M catarrhalis."