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The Effect and Safety of Alveolar Recruitment Maneuver using Pressure-Controlled Ventilation in Acute Lung Injury and Acute Respiratory Distress Syndrome (급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성)

  • Chung, Kyung Soo;Park, Byung Hoon;Shin, Sang Yun;Jeon, Han Ho;Park, Seon Cheol;Kang, Shin Myung;Park, Moo Suk;Han, Chang Hoon;Kim, Chong Ju;Lee, Sun Min;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.423-429
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    • 2007
  • Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of $30cmH_2O$ and a PEEP of $20cmH_2O$ in a 2-minute PCV mode. The venous $O_2$ saturation, central venous pressure, blood pressure, pulse rate, $PaO_2/FiO_2$ ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean $PaO_2/FiO_2$ ratio was 130.3 before RM. The $PaO_2/FiO_2$ ratio increased by 45% after alveolar RM. The $PaO_2/FiO_2$ ratio reached a peak 60 minutes after alveolar RM. The Pa$CO_2$ increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.

Effect of Short-term Nutrition Education Camp on Food and Nutrient Intakes of Obese Children (단기간 영양교육 캠프가 비만아동의 식품과 영양소 섭취에 미치는 영향)

  • Shin, Eun-Kyung;Lee, Jin-Hwa;Lee, Yeon-Kyung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.987-999
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    • 2005
  • The purpose of this study was to evaluate the effect of short-term nutrition education camp on food and nutrient intakes of obese children. The subjects of the study were 30 obese children in Gumi city who have obesity index over $130\%$. The food consumption of the subjects was surveyed for three days before the camp, for eleven days during the first camp and for three days after the second camp, by food record method. The mean intakes of energy and carbohydrates in obese children were significantly decreased during and after the nutrition education camp, and that of vitamin C was significantly increased after the camp. The mean daily total food intake of the subjects was gradually decreased from 1646.4g before the camp to 1438.6g during the camp and 1412.66g after the camp. Energy and fat intake ratios from grains and milks were significantly decreased after the camp compared with that before the camp, and the energy intake ratio from grains, milks and eggs was significantly low during the camp. The protein intake ratios from grains, potatoes, vegetables and fishes were significantly increased after the camp. The calcium intake ratios from potatoes and milks were significantly increased during and after the camp, and the ratio from eggs was significantly decreased after the camp. The iron intake ratios from potatoes and fishes were significantly increased during and after the camp, and the ratio from grains was significantly low during the camp. The results of the study demonstrated that the short-term nutrition education program positively affected the overall food consumption and nutrients intakes of obese children.

The Relationship between Trust, Trustworthiness, and Repeat Purchase Intentions: A Multidimensional Approach (신뢰대상의 다차원적 접근법에 의한 신뢰와 재구매 의도와의 관계)

  • Lee, Soo-Hyung;Park, Mi-Ryong
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.1-31
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    • 2008
  • Trust is central to human relationships, at all times and places. The importance of trust is fundamental in all areas of human life, not only in the area of business administration. 2,500 years ago in China, Confucius taught that the foundation of politics was the trust of the people, more important even than military strength or the supply of food. Shakespeare's play, "Much Ado about Nothing' is about trust and deception. These days, trust and transparency in a commercial organization's business culture form the basis of the 'social capital' by which that organization increases its productivity. A successful company raises productivity by the accumulation of social capital, derived from a trust relationship between business partners, and between the company and consumers. Trust is the crucial factor. At the national level, building trust determines a nation's competitiveness. For a company, long term trust relationships with customers are essential for its survival in a business environment of rapid change. Such relationships, based on trust, are important assets to ensure a company's competitive advantage, and need to be organic to that company's business culture. Because of this importance, trust relationships have been studied in diverse areas within business administration, and especially within marketing, where they form the basis of a successful relationship between producer and consumer. However, what has been lacking is a unified definition of trust. Research has been conducted on the basis of various definitions and models. The majority of researchers have not considered the multidimensional character of the concept of trust until now. Approaches based on a one dimensional model have undermined the value of research results. Furthermore, researchers have only considered trust and trustworthiness as a single component. The majority of research has explored the consequences of perceived trust for outcomes such as loyalty or cooperation, but has neglected the effects of trustworthiness upon the mechanisms of consumer trust. This study focuses on the dimension of trust from such a perspective. It seeks to verify the effect of trust on customer intentions by breaking it down into three separate components: 1) the salesperson, 2) the product/service, and 3) the company. The purposes of this paper are as follows: Firstly, we review the multidimensional nature of trust objects: the salesperson, the product/service, and the company. Secondly, we analyze the relationship between multidimensional trust and trustworthiness. Thirdly, we analyze the connection between trust and repeat purchase intentions for the maintenance of long term relationships. For these purposes the author has developed several hypotheses as follows: H1-1: The competence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H1-2: The benevolence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H2-1: The competence of product/service is positively associated with the trust given by the consumer to the product/service. H2-2: The benevolence of product/service is positively associated with the trust given by the consumer to the product/service. H3-1: The reputation of a company is positively associated with the trust given by the consumer to the company. H3-2: The physical environment of a company is positively associated with the trust given by the consumer to the company. H4-1: Trust in a salesperson is positively associated with repeat purchase intentions. H4-2: Trust in a product/service is positively associated with repeat purchase intentions. H4-3: Trust in a company is positively associated with repeat purchase intentions. The data was compiled from 366 questionnaires. 500 questionnaires were collected, but some of the data was considered unsuitable and inappropriate. The subjects of the survey were male and female customers purchasing products at department stores in Seoul, Daegu and Gyeongbuk. It was carried out between Oct. 25 and 29, 2007. The data was analyzed by frequency analysis using SPSS 12.0 and structural equation modeling using LISREL 8.7. The result of the overall model analysis is as follows: Chi-Square=445.497, d.f.=185, p-value=0.0, GFI=.901, RMSEA=.0617, NNFI=.986, NFI=.981, CFI=.989, AGFI=.864, RMR=.0872. The results of the overall model analysis were coherent. It was found that trust is a multi-dimensional construct, that each of the dimensions of trust are meaningful influences on customer's repurchase intention. Trust in a company may be the most relevant, while trust in a product/service and a salesperson may be less relevant to repurchase intentions. The effective factors in determining trust in a salesperson and a company's product/service were found to be competence and benevolence. Factors in determining trust in a company were its reputation and physical environment, and the relationship of each effective trust factor has been verified in this research. As a result, it was found that competence and benevolence have a meaningful influence on trust in a salesperson and in product/service. It was also found that a company's reputation influences the overall trust in the company significantly but a company's physical environment does not have much effect.

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Term Mapping Methodology between Everyday Words and Legal Terms for Law Information Search System (법령정보 검색을 위한 생활용어와 법률용어 간의 대응관계 탐색 방법론)

  • Kim, Ji Hyun;Lee, Jong-Seo;Lee, Myungjin;Kim, Wooju;Hong, June Seok
    • Journal of Intelligence and Information Systems
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    • v.18 no.3
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    • pp.137-152
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    • 2012
  • In the generation of Web 2.0, as many users start to make lots of web contents called user created contents by themselves, the World Wide Web is overflowing by countless information. Therefore, it becomes the key to find out meaningful information among lots of resources. Nowadays, the information retrieval is the most important thing throughout the whole field and several types of search services are developed and widely used in various fields to retrieve information that user really wants. Especially, the legal information search is one of the indispensable services in order to provide people with their convenience through searching the law necessary to their present situation as a channel getting knowledge about it. The Office of Legislation in Korea provides the Korean Law Information portal service to search the law information such as legislation, administrative rule, and judicial precedent from 2009, so people can conveniently find information related to the law. However, this service has limitation because the recent technology for search engine basically returns documents depending on whether the query is included in it or not as a search result. Therefore, it is really difficult to retrieve information related the law for general users who are not familiar with legal terms in the search engine using simple matching of keywords in spite of those kinds of efforts of the Office of Legislation in Korea, because there is a huge divergence between everyday words and legal terms which are especially from Chinese words. Generally, people try to access the law information using everyday words, so they have a difficulty to get the result that they exactly want. In this paper, we propose a term mapping methodology between everyday words and legal terms for general users who don't have sufficient background about legal terms, and we develop a search service that can provide the search results of law information from everyday words. This will be able to search the law information accurately without the knowledge of legal terminology. In other words, our research goal is to make a law information search system that general users are able to retrieval the law information with everyday words. First, this paper takes advantage of tags of internet blogs using the concept for collective intelligence to find out the term mapping relationship between everyday words and legal terms. In order to achieve our goal, we collect tags related to an everyday word from web blog posts. Generally, people add a non-hierarchical keyword or term like a synonym, especially called tag, in order to describe, classify, and manage their posts when they make any post in the internet blog. Second, the collected tags are clustered through the cluster analysis method, K-means. Then, we find a mapping relationship between an everyday word and a legal term using our estimation measure to select the fittest one that can match with an everyday word. Selected legal terms are given the definite relationship, and the relations between everyday words and legal terms are described using SKOS that is an ontology to describe the knowledge related to thesauri, classification schemes, taxonomies, and subject-heading. Thus, based on proposed mapping and searching methodologies, our legal information search system finds out a legal term mapped with user query and retrieves law information using a matched legal term, if users try to retrieve law information using an everyday word. Therefore, from our research, users can get exact results even if they do not have the knowledge related to legal terms. As a result of our research, we expect that general users who don't have professional legal background can conveniently and efficiently retrieve the legal information using everyday words.

An Analysis on the Conditions for Successful Economic Sanctions on North Korea : Focusing on the Maritime Aspects of Economic Sanctions (대북경제제재의 효과성과 미래 발전 방향에 대한 고찰: 해상대북제재를 중심으로)

  • Kim, Sang-Hoon
    • Strategy21
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    • s.46
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    • pp.239-276
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    • 2020
  • The failure of early economic sanctions aimed at hurting the overall economies of targeted states called for a more sophisticated design of economic sanctions. This paved way for the advent of 'smart sanctions,' which target the supporters of the regime instead of the public mass. Despite controversies over the effectiveness of economic sanctions as a coercive tool to change the behavior of a targeted state, the transformation from 'comprehensive sanctions' to 'smart sanctions' is gaining the status of a legitimate method to impose punishment on states that do not conform to international norms, the nonproliferation of weapons of mass destruction in this particular context of the paper. The five permanent members of the United Nations Security Council proved that it can come to an accord on imposing economic sanctions over adopting resolutions on waging military war with targeted states. The North Korean nuclear issue has been the biggest security threat to countries in the region, even for China out of fear that further developments of nuclear weapons in North Korea might lead to a 'domino-effect,' leading to nuclear proliferation in the Northeast Asia region. Economic sanctions had been adopted by the UNSC as early as 2006 after the first North Korean nuclear test and has continually strengthened sanctions measures at each stage of North Korean weapons development. While dubious of the effectiveness of early sanctions on North Korea, recent sanctions that limit North Korea's exports of coal and imports of oil seem to have an impact on the regime, inducing Kim Jong-un to commit to peaceful talks since 2018. The purpose of this paper is to add a variable to the factors determining the success of economic sanctions on North Korea: preventing North Korea's evasion efforts by conducting illegal transshipments at sea. I first analyze the cause of recent success in the economic sanctions that led Kim Jong-un to engage in talks and add the maritime element to the argument. There are three conditions for the success of the sanctions regime, and they are: (1) smart sanctions, targeting commodities and support groups (elites) vital to regime survival., (2) China's faithful participation in the sanctions regime, and finally, (3) preventing North Korea's maritime evasion efforts.

The Effect of Two Terpenoids, Ursolic Acid and Oleanolic Acid on Epidermal Permeability Barrier and Simultaneously on Dermal Functions (우솔릭산과 올레아놀산이 피부장벽과 진피에 미치는 영향에 대한 연구)

  • Suk Won, Lim;Sung Won, Jung;Sung Ku, Ahn;Bora, Kim;In Young, Kim;Hee Chang , Ryoo;Seung Hun, Lee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.263-278
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    • 2004
  • Ursolic acid (UA) and Oleanolic acid (ONA), known as urson, micromerol and malol, are pentacyclic triterpenoid compounds which naturally occur in a large number of vegetarian foods, medicinal herbs, and plants. They may occur in their free acid form or as aglycones for triterpenoid saponins, which are comprised of a triterpenoid aglycone, linked to one or more sugar moieties. Therefore UA and ONA are similar in pharmacological activity. Lately scientific research, which led to the identification of UA and ONA, revealed that several pharmacological effects, such as antitumor, hepato-protective, anti-inflammatory, anticarcinogenic, antimicrobial, and anti-hyperlipidemic could be attributed to UA and ONA. Here, we introduced the effect of UA and ONA on acutely barrier disrupted and normal hairless mouse skin. To evaluate the effects of UA and ONA on epidermal permeability barrier recovery, both flanks of 8-12 week-old hairless mice were topically treated with either 0.01-0.1mg/mL UA or 0.1-1mg/mL ONA after tape stripping, and TEWL (transepidermal water loss) was measured. The recovery rate increased in those UA or ONA treated groups (0.1mg/mL UA and 0.5mg/mL ONA) at 6h more than 20% compared to vehicle treated group (p < 0.05). Here, we introduced the effects of UA and ONA on acute barrier disruption and normal epidermal permeability barrier function. For verifying the effects of UA and ONA on normal epidermal barrier, hydration and TEWL were measured for 1 and 3 weeks after UA and ONA applications (2mg/mL per day). We also investigated the features of epidermis and dermis using electron microscopy (EM) and light microscopy (LM). Both samples increased hydration compared to vehicle group from 1 week without TEWL alteration (p < 0.005). EM examination using RuO4 and OsO4 fixation revealed that secretion and numbers of lamellar bodies and complete formation of lipid bilayers were most prominent (ONA=UA > vehicle). LM finding showed that thickness of stratum corneum (SC) was slightly increased and especially epidermal thickening and flattening was observed (UA > ONA > vehicle). We also observed that UA and ONA stimulate epidermal keratinocyte differentiation via PPAR Protein expression of involucrin, loricrin, and filaggrin increased at least 2 and 3 fold in HaCaT cells treated with either ONA (10${\mu}$M) or UA (10${\mu}$M) for 24 h respectively. This result suggested that the UA and ONA can improve epidermal permeability barrier function and induce the epidermal keratinocyte differentiation via PPAR Using Masson-trichrome and elastic fiber staining, we observed collagen thickening and elastic fiber elongation by UA and ONA treatments. In vitro results of collagen and elastin synthesis and elastase inhibitory activity measurements were also confirmed in vivo findings. These data suggested that the effects of UA and ONA related to not only epidermal permeability barrier functions but also dermal collagen and elastic fiber synthesis. Taken together, UA and ONA can be relevant candidates to improve epidermal and dermal functions and pertinent agents for cosmeseutical applications.

Antibacterial and Antioxidative Activities of Quercus acutissima Carruth Leaf Extracts and Isolation of Active Ingredients (상수리나무 잎 추출물의 항균 및 항산화 활성과 활성 물질 분리)

  • Park, Soo-Nam;Kim, So-I;Ahn, You-Jin;Kim, Eun-Hee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.35 no.2
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    • pp.159-169
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    • 2009
  • In this study, the antibacterial activity, antioxidative effects, inhibitory effects on tyrosinase, inhibitory effects on elastase, and components of Quercus acutissima Carruth leaf extracts were investigated. MIC values of ethyl acetate fraction from Q. acutissima Carruth leaf on P. acnes, S. aureus, P. ovale, and E. coli were 0.13 %, 0.25 %, 0.13 % and 0.25 %, respectively. The results showed that the antibacterial activity of the ethyl acetate fraction was the highest in the S. aureus, P. acnes, and P. ovale. The free radical (1,1-diphenyl-2-picrylhydrazyl, DPPH) scavenging activity ($FSC_{50}$) of extract/fractions of Q. acutissima Carruth. leaf was in the order: 50 % ethanol extract (12.13 ${\mu}g/mL$) < ethyl acetate fraction (7.07 ${\mu}g/mL$) < deglycosylated flavonoid aglycone fraction (6.20 ${\mu}g/mL$). Reactive oxygen species (ROS) scavenging activities ($OSC_{50}$) of some Q. acutissima Carruth leaf extracts on ROS generated in $Fe^{3+}-EDTA/H_2O_2$ system were investigated using the luminol-dependent chemiluminescence assay. The order of ROS scavenging activity was 50 % ethanol extract ($OSC_{50}$, 1.81 ${\mu}g/mL$) < ethyl acetate fraction (1.70 ${\mu}g/mL$) < deglycosylated flavonoid aglycone fraction (0.70 ${\mu}g/mL$). Deglycosylated flavonoid aglycone fraction showed the most prominent scavenging activity. The protective effects of extract/fractions of Q. acutissima Carruth leaf on the rose-bengal sensitized photohemolysis of human erythrocytes were investigated. The Q. acutissima Carruth leaf extracts suppressed photohemolysis in a concentration dependent manner, particularly deglycosylated flavonoid aglycone fraction exhibited the most prominent celluar protective effect (${\tau}50$, 220.00 min at 25 ${\mu}g/mL$). Aglycone fractions obtained from the deglycosylation reaction of ethyl acetate fraction among the Q. acutissima Carruth leaf extracts, showed 3 bands (QA 1, QA2 and QA3) on TLC. TLC chromatogram of ethyl acetate fraction of Q. Carruth. leaf extract revealed 4 bands (QA 1 ${\sim}$ QA 4), Among them, kaempferol (QA 1), quercetin (QA 2), and gallic acid (QA 3) were identified. The inhibitory effect ($IC_{50}$) of aglycone fraction on tyrosinase was 65.7 ${\mu}g/mL$. The inhibitory effect ($IC_{50}$) of aglycone fraction on elastase was 24.50 ${\mu}g/mL$. These results indicate that extract/fractions of Q. acutissima Carruth. can functionized as antioxidants in biological systems, particularly skin exposed to UV radiation by scavenging $^1O_2$ and other ROS, and protect cellular membranes against ROS. Extract/fractions of Q. acutissima Corruth can be applicable to new functional cosmetics for antioxidant, antiaging, antibacterial activity.

Crystal Structures of Dehydrated Partially $Sr^{2+}$-Exchanged Zeolite X, $Sr_{31}K_{30}Si_{100}A1_{92}O_{384}\;and\;Sr_{8.5}TI_{75}Si_{100}AI_{92}O_{384}$ (부분적으로 스트론튬이온으로 교환되고 탈수된, 제올라이트 X의 결정구조)

  • Kim Mi Jung;Kim Yang;Seff Karl
    • Korean Journal of Crystallography
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    • v.8 no.1
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    • pp.6-14
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    • 1997
  • The crystal structures of $Sr_{31}K_{30}-X\;(Sr_{31}K_{30}Si_{100}A1_{92}O_{384};\;a=25.169(5) {\AA}$) and $Sr_{8.5}Tl_{75}-X (Sr_{8.5}Tl_{75}Si_{100}A1_{92}O_{384};\;a=25.041(5) {\AA}$) have been determined by single-crystal X-ray diffraction techniques in the cubic space group $\=F{d3}\;at\;21(1)^{\circ}C$. Each crystal was prepared by ion exchange in a flowing stream of aqueous $Sr(ClO_4)_2\;and\;(K\;or\;T1)NO_3$ whose mole ratio was 1 : 5 for five days. Vacuum dehydration was done at $360^{\circ}C$ for 2d. Their structures were refined to the final error indices $R_1=0.072\;and\;R_w=0.057$ with 293 reflections, and $R_1= 0.058\;and\;R_w=0.044$ with 351 reflections, for which $I>2{\sigma}(I)$, respectively. In dehydrated $Sr_{31}K_{30}-X,\;all\;Sr^{2+}$ ions and $K^+$ ions are located at five different crystallographic sites. Six-teen $Sr^{2+}$ ions per unit cell are at the centers of the double six-rings (site I), filling that position. The remaining 15 $Sr^{2+}$ ions and 17 $K^+$ ions fill site II in the supercage. These $Sr^{2+}$ and $K^+$ ions are recessed ca $0.45{\AA}\;and\;1.06{\AA}$ into the supercage, respectively, from the plane of three oxygens to which each is bound. ($Sr-O=2.45(1){\AA}\;and\;K-O=2.64(1){\AA}$) Eight $K^+$ ons occupy site III'($K-O=3.09(7){\AA}\;and\;3.11(10){\AA}$) and the remaining five $K^+$ ions occupy another site III'($K-O=2.88(7){\AA}\;and\;2.76(7){\AA}$). In $Sr_{8.5}Tl_{75}-X,\;Sr^{2+}\;and\;Tl^+$ ions also occupy five different crystallographic sites. About 8.5 $Sr^{2+}$ ions are at site I. Fifteen $Tl^+$ ions are at site I' in the sodalite cavities on threefold axes opposite double six-rings: each is $1.68{\AA}$ from the plane of its three oxygens ($T1-O=2.70(2){\AA}$). Together these fill the double six-rings. Another 32 $Tl^+$ ions fill site II opposite single six-rings in the supercage, each being $1.48{\AA}$ from the plane of three oxygens ($T1-O=2.70(1){\AA}$). About 18 $Tl^+$ ions occupy site III in the supercage ($T1-O=2.86(2){\AA}$), and the remaining 10 are found at site III' in the supercage ($T1-O=2.96(4){\AA}$).

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Study for Treatment Effects and Prognostic Factors of Bronchial Asthma -Follow Up Over 2 Years- (2년 이상 관찰중인 성안 기관지 천식환자의 치료 효과 및 예후인자에 관한 연구)

  • Choung, Bo-Young;Park, Jung-Won;Kim, Sung-Kyu;Hong, Chein-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.559-573
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    • 1997
  • Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

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Clinical Efficacy of Erdosteine in Patients with Acute or Chronic Bronchitis -A Randomized, Double Blind, Comparative Study vs. Ambroxol- (급.만성 기관지염 환자에서 엘도스$^{(R)}$(Erdosteine)의 임상효과 -염산 암브록솔과의 무작위 이중맹검 비교시험-)

  • Kim, Seok-Chan;Lee, Sang-Hoak;Song, So-Hyang;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1296-1307
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    • 1997
  • Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

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