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Clinical Characteristics of the Patients with Mycobacterium avium Complex Pulmonary Disease (Mycobacterium avium complex 폐질환 환자의 임상적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.33-44
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    • 2003
  • Background : Mycobacterium avium complex(MAC) is the most common respiratory pathogen in nontuberculous mycobacterial pulmonary disease. This study described the clinical characteristics of the patients with pulmonary disease caused by MAC. Materials and Methods : The clinical characteristics of 24 patients with pulmonary disease caused by the MAC, who fulfilled the 1997 American Thoracic Society diagnostic criteria for nontuberculous mycobacterial pulmonary disease, were retrospectively analyzed. Results : Fourteen patients(58%) were male and the median age at diagnosis was 61 years(range 46-75). Of the 24 patients, 16(67%) had a M. intracellulare infection, 7(29%) had a M. avium infection and one patient was not identified. Coughing (92%) and sputum (88%) were most frequently observed symptoms. The sputum smear for acid-fast bacilli was positive in 17(71%) patients. Fourteen(58%) patients had the upper lobe cavitary form and 10(42%) patients had the nodular bronchiectatic form. In a comparison between the patients with the upper lobe cavitary form and those with the nodular bronchiectatic form, significant differences were found according to sex(male 86% vs. 20%, p=0.003), smoking history(79% vs. 10%, p=0.008), the presence of an underlying disease(64% vs. 20%, p=0.036), the pulmonary function(% forced vital capacity, median 71% vs. 88%, p=0.022; % forced expiratory volume in one second, median 69% vs. 89%, p=0.051) and bilateral disease at chest radiography(29% vs. 90%, p=0.005). The time from the onset of symptoms to diagnosis was longer in those with the nodular bronchiectatic form(median 72 months, range 8-132) than those with the upper lobe cavitary form(median 22 months, range 6-60) Conclusions : MAC pulmonary disease occurs in two distinct populations with two distinct clinical presentations. For a correct diagnosis of MAC pulmonary disease, knowledge of the diverse clinical and radiological findings is essential.

Nutritional Effects of Paper Board Sludge on the Soybean(Glycine max. L.) (대두(大豆)에 대(對)한 제지(製紙) Sludge의 영양학적(營養學的) 연구(昭究))

  • Kim, Moon Kyu;Chang, Ki Woon;Choi, Woo Young;Ham, Suon Kyu;Nam, Yun Kyu;Lee, Chang Jun
    • Korean Journal of Agricultural Science
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    • v.17 no.1
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    • pp.1-8
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    • 1990
  • The paper board sludge(PBS) itself and compost sludge manure(CSM) mixed with sawdust, fowl droppings and urea to the PBS were treated to soybean plants to find the effects of growing characters, yield components, and nutritional compounds in the plant tissues. 1. Percentages of missing plants were 5-9% and 3.6-4.1% in the treatments of PBS and CSM, respectively. After that, the plants were restored to normal conditions. Anyway it is not desirable to use the paper board sludge and immature compost sludge manure in seeding time or to young seedlings. 2. Growth of the plant height was retarded in early growing phase, but it was normal in later stages. And the width and length of the largest leaf, numbers of main stem nodes and pods were not significant among the treatments. 3. The yield intends to increase through the treatments of 1,200, 1,600, and 2,000Kg PBS per 10a. In the CSM treatments with high rate of sawdust, fowl droppings and urea, the numbers of pods and grains were higher than the treatment of high content of PBS. 100-grain and one liter weights were opposite intention. It was suggested that the excess nitrogen amounts from the compost sludge manure than conventional fertilization affected to the yield components. 4. The contents of the main chemical compounds such as N, $P_2O_5$, $K_2O$, Ca, Mg were determined. The concentrations of nitrogen were higher in the treatment of PBS and CSM than none and control. 5. In conclusion, the nutritional effects of PBS were in evidence. To use the sludges, it should be fermented with adequate additives to improve the aeration, C/N ratio, activity of microbial, and other conditions. The sludges could be used to crops as a fertilizers effectively.

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Image Watermarking for Copyright Protection of Images on Shopping Mall (쇼핑몰 이미지 저작권보호를 위한 영상 워터마킹)

  • Bae, Kyoung-Yul
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.147-157
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    • 2013
  • With the advent of the digital environment that can be accessed anytime, anywhere with the introduction of high-speed network, the free distribution and use of digital content were made possible. Ironically this environment is raising a variety of copyright infringement, and product images used in the online shopping mall are pirated frequently. There are many controversial issues whether shopping mall images are creative works or not. According to Supreme Court's decision in 2001, to ad pictures taken with ham products is simply a clone of the appearance of objects to deliver nothing but the decision was not only creative expression. But for the photographer's losses recognized in the advertising photo shoot takes the typical cost was estimated damages. According to Seoul District Court precedents in 2003, if there are the photographer's personality and creativity in the selection of the subject, the composition of the set, the direction and amount of light control, set the angle of the camera, shutter speed, shutter chance, other shooting methods for capturing, developing and printing process, the works should be protected by copyright law by the Court's sentence. In order to receive copyright protection of the shopping mall images by the law, it is simply not to convey the status of the product, the photographer's personality and creativity can be recognized that it requires effort. Accordingly, the cost of making the mall image increases, and the necessity for copyright protection becomes higher. The product images of the online shopping mall have a very unique configuration unlike the general pictures such as portraits and landscape photos and, therefore, the general image watermarking technique can not satisfy the requirements of the image watermarking. Because background of product images commonly used in shopping malls is white or black, or gray scale (gradient) color, it is difficult to utilize the space to embed a watermark and the area is very sensitive even a slight change. In this paper, the characteristics of images used in shopping malls are analyzed and a watermarking technology which is suitable to the shopping mall images is proposed. The proposed image watermarking technology divide a product image into smaller blocks, and the corresponding blocks are transformed by DCT (Discrete Cosine Transform), and then the watermark information was inserted into images using quantization of DCT coefficients. Because uniform treatment of the DCT coefficients for quantization cause visual blocking artifacts, the proposed algorithm used weighted mask which quantizes finely the coefficients located block boundaries and coarsely the coefficients located center area of the block. This mask improves subjective visual quality as well as the objective quality of the images. In addition, in order to improve the safety of the algorithm, the blocks which is embedded the watermark are randomly selected and the turbo code is used to reduce the BER when extracting the watermark. The PSNR(Peak Signal to Noise Ratio) of the shopping mall image watermarked by the proposed algorithm is 40.7~48.5[dB] and BER(Bit Error Rate) after JPEG with QF = 70 is 0. This means the watermarked image is high quality and the algorithm is robust to JPEG compression that is used generally at the online shopping malls. Also, for 40% change in size and 40 degrees of rotation, the BER is 0. In general, the shopping malls are used compressed images with QF which is higher than 90. Because the pirated image is used to replicate from original image, the proposed algorithm can identify the copyright infringement in the most cases. As shown the experimental results, the proposed algorithm is suitable to the shopping mall images with simple background. However, the future study should be carried out to enhance the robustness of the proposed algorithm because the robustness loss is occurred after mask process.

Effect of Sanitation Treatment of Extending Shelf-life on Fresh Poultry Meats (계육(鷄肉)의 유통기간연장(流通期間延長)을 위(爲)한 위생처리방법(衛生處理方法)에 관(關)한 연구(硏究))

  • Cho, M.J.;Jang, P.H.;Park, K.B.;Lee, B.M.
    • Korean Journal of Food Science and Technology
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    • v.14 no.4
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    • pp.291-300
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    • 1982
  • In order to develop effective and simple sanitation method for the extention of shelf-life of fresh poultry meat, the effect of sanitizers, sanitation methods and packaging materials on the extention of shelf-life of poultry meats was observed at the $4^{\circ}C$ and room temp$(10{\sim}20^{\circ}C)$. The results are summarized as follows: 1. The autochonous skin microflora of poultry, before processing, were believed to be removed or killed during the scalding and plucking, and exposed dermal tissue was contaminated by microorganisms from the subsequent stages of processing. 2. In the final stage of poultry processing, total viable counts of microorganisms and coliforms were averaged to $3.5{\times}10^4/cm^2$ and $400/cm^2$, respectively. 3. The refrigerated shelf-life of fresh whole poultry carcasses at $3\;to\;4^{\circ}C$ was extended to 7 to 16 days compared to control with the various treatments of some sanitizers by dipping freshly chilled carcasses for 5 min or spraying 1 liter of sanitizers per carcasses. In the case of storage at $10\;to\;15^{\circ}C$, the shelf-life of poultry carcasses was extended to one to two days by the sanitation treatments compared to control. 4. Spraying sanitation was more effective than dipping sanitation, and 5 minutes dipping and one liter spraying per carcass were enough for effective sanitation of poultry carcasses in most sanitizers. 5. The packaging with an oxygen impermeable polyvinylidene chloride extended the shelf-life to 10 days and 5 days with polyethylene compared to control. When poultry carcasses were sanitized by continuous spraying with one liter of 30 ppm of chlorine and another one liter of 5% of potassium sorbate, packaged with polyvinylidene chlorlde were extended to about 30 days compared to control.

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Usefulness of Troponin-I, Lactate, C-reactive protein as a Prognostic Markers in Critically Ill Non-cardiac Patients (비 순환기계 중환자의 예후 인자로서의 Troponin-I, Lactate, C-reactive protein의 유용성)

  • Cho, Yu Ji;Ham, Hyeon Seok;Kim, Hwi Jong;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.562-569
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    • 2005
  • Background : The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. Methods : From September 2003 to June 2004, 139 patients(Age: $63.3{\pm}14.7$, M:F = 88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health EvaluationII, Simplified Acute Physiologic ScoreII and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. Results : There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day($1.018{\pm}2.58ng/ml$, $98.48{\pm}69.24mg/L$ vs. $4.208{\pm}10.23ng/ml$, $137.69{\pm}70.18mg/L$) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day ($0.99{\pm}2.66ng/ml$, $8.02{\pm}9.54ng/dl$, $96.87{\pm}68.83mg/L$ vs. $3.36{\pm}8.74ng/ml$, $15.42{\pm}20.57ng/dl$, $131.28{\pm}71.23mg/L$) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score($r^2=0.254$, 0.365, p<0.05). Conclusion : Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.

Growth Efficiency, Carcass Quality Characteristics and Profitability of 'High'-Market Weight Pigs ('고체중' 출하돈의 성장효율, 도체 품질 특성 및 수익성)

  • Park, M.J.;Ha, D.M.;Shin, H.W.;Lee, S.H.;Kim, W.K.;Ha, S.H.;Yang, H.S.;Jeong, J.Y.;Joo, S.T.;Lee, C.Y.
    • Journal of Animal Science and Technology
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    • v.49 no.4
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    • pp.459-470
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    • 2007
  • Domestically, finishing pigs are marketed at 110 kg on an average. However, it is thought to be feasible to increase the market weight to 120kg or greater without decreasing the carcass quality, because most domestic pigs for pork production have descended from lean-type lineages. The present study was undertaken to investigate the growth efficiency and profitability of ‘high’-market wt pigs and the physicochemical characteristics and consumers' acceptability of the high-wt carcass. A total of 96 (Yorkshire × Landrace) × Duroc-crossbred gilts and barrows were fed a finisher diet ad laibtum in 16 pens beginning from 90-kg BW, after which the animals were slaughtered at 110kg (control) or ‘high’ market wt (135 and 125kg in gilts & barrows, respectively) and their carcasses were analyzed. Average daily gain and gain:feed did not differ between the two sex or market wt groups, whereas average daily feed intake was greater in the barrow and high market wt groups than in the gilt and 110-kg market wt groups, respectively(P<0.01). Backfat thickness of the high-market wt gilts and barrows corrected for 135 and 125-kg live wt, which were 23.7 and 22.5 mm, respectively, were greater (P<0.01) than their corresponding 110-kg counterparts(19.7 & 21.1 mm). Percentages of the trimmed primal cuts per total trimmed lean (w/w), except for that of loin, differed statistically (P<0.05) between two sex or market wt groups, but their numerical differences were rather small. Crude protein content of the loin was greater in the high vs. 110-kg market group (P<0.01), but crude fat and moisture contents and other physicochemical characteristics including the color of this primal cut were not different between the two sexes or market weights. Aroma, marbling and overall acceptability scores were greater in the high vs. 110-kg market wt group in sensory evaluation for fresh loin (P<0.01); however, overall acceptabilities for cooked loin, belly and ham were not different between the two market wt groups. Marginal profits of the 135- and 125-kg high-market wt gilt and barrow relative to their corresponding 110-kg ones were approximately -35,000 and 3,500 wons per head under the current carcass grading standard and price. However, if it had not been for the upper wt limits for the A- and B-grade carcasses, marginal profits of the high market wt gilt and barrow would have amounted to 22,000 and 11,000 wons per head, respectively. In summary, 120~125-kg market pigs are likely to meet the consumers' preference better than the 110-kg ones and also bring a profit equal to or slightly greater than that of the latter even under the current carcass grading standard. Moreover, if only the upper wt limits of the A- & B-grade carcasses were removed or increased to accommodate the high-wt carcass, the optimum market weights for the gilt and barrow would fall upon their target weights of the present study, i.e. 135 and 125 kg, respectively.

Analysis on Factors Influencing Welfare Spending of Local Authority : Implementing the Detailed Data Extracted from the Social Security Information System (지방자치단체 자체 복지사업 지출 영향요인 분석 : 사회보장정보시스템을 통한 접근)

  • Kim, Kyoung-June;Ham, Young-Jin;Lee, Ki-Dong
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.141-156
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    • 2013
  • Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.

The Melodic Structure of the Bulmosan Youngsanjae, Ongho-ge (불모산 영산재 범패 옹호게의 선율구조)

  • Choi, Heon
    • (The) Research of the performance art and culture
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    • no.34
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    • pp.383-421
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    • 2017
  • Because the Jitsori and the Hotsori of the Beompae(the Korean Budhhist chant) has no meter and no Jangdan(a Rhythmic cycle of the Korean Music), so it is hard to analyze the melody of the Beompae. Also the melody of the Beompae is different from that of the other Korean traditional music, so studying of the Beompae has been out of the limelight of many scholars, studying the Korean music. But the melody of Beompae had been handed down for thousands of years in Korea, it and other Korean trditional music, had exchanged the impacts each other for a longtime. So I thinks that the Korean Beomapae have shared the similarity of the musical features with the other Korean traditional music. Because the Beompae of the Bulmosan Yeongsanjae on the Geongsangnamdo province has also no meters and no Jangdan, it is difficult to understand, too. But because the Onghoge of Bulmosan Yeongsanjae have a well-regulated melodic structure in comparison with the Beompae of the Seoul province, so called Geongjae Beompae, it seem to be easy to analyze its melody. So I will analyze the melody of Bulmosan Yeongsanjae Onghoge. This analyze should be contribute to investigate the rule of the melodic progress method on the convoluted Beompae melody. Onghoge has been sung on the procedure for Siryeon, Samsiniun(Goebuliun), Jojeonjeoman, Sinjungjakbeop. And the monk for the ritual has sung the chant first to purify the ritual place and to protect the soul. They has called the song, Onghoge a Jitsori at the Bulmosan Yeongsanjae preservation society of the Gyeongnam province. Commonly, there were Jitsori and Hotsori in the Beompae melody, and the melody of Jitsori is longer than that of the Hotsori. So, the melody of Onghoge is lengthened. In other word, the melody of the Onghoge show the lengthened and curved melodic feture of the Beompae very well. Hahn Manyeong, who had studied on the Beompae, Budhhist chant, said that the Hotsori has five letters in a phrase, and there were 4 phrases in a song. And he had insisted that the form of the song, Hotsori, is ABAB. I analyze the melody of the Onghoge by the Hahn's method. I will extract the Wonjeom(a primary tone of a skeletal melodic structure) from the melody of Onghoge, and in the progress of the Wonjeom of Onghoge melodies, I will arrange the repeat of the Wonjeom melody. It is a structural melody of Onghoge. The first phrase of Bulmosan Yeongsanjae Onghoge, 'Pal bu geum gang ho do ryang(八部金剛護道場)' have 4 structural melodies, the second phrase 'Gong sin sog bu bo cheon wang(空神速赴報天王)', the third phrase 'Sam gye je cheon ham le jip(三界諸天咸來集)', the firth phrase 'Yeo geum bul chal bo jeong sang(如今佛刹補禎祥)' have 2 structural melodies each. The structural melodies of Onghoge are 10 in total. And the structural melody of the Onghoge is formed the shape of 'Mi - La - do - La - Mi'. All of the Onghoge melodies is repeated 10 times by the melodic shape. The form of the Onghoge is not ABAB by Hahn, but is 10 times repeat of the shape.

Christian Educational Proposals for Revitalizing Research on North Korea's 'education' (북한 '교육' 연구 활성화를 위한 기독교교육적 제언)

  • Ham, Seung su
    • Journal of Christian Education in Korea
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    • v.71
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    • pp.305-340
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    • 2022
  • This study was started to suggest the direction of Christian educational development to revitalize North Korea's 'education' research. Since the two Koreas have experienced heterogeneity in almost all elements of society, such as politics, economy, society, culture, and education, during the period of division in 1977, true unification depends on laying the foundation for social integration that can overcome the sense of heterogeneity between the two Koreas. This is why North Korea's "education" research is needed. Education is the foundation for transferring culture and history, and for bringing about the survival, transformation, and community of society and since it is the mission of Korean churches and Christian educators to establish the direction of North Korean "education" research, North Korean "education" research is very important. Despite this importance, 'North Korean research' in the field of Christian education has not been properly conducted. Research on the "Christian Unification Education Program" that can be used in churches is actively taking place, but research on the macro level of presenting post-unification education blueprints is rare. This study was started to suggest the direction of Christian educational development to revitalize North Korea's 'education' research. For the study, the characteristics of 'North Korea Research' were analyzed according to generational classification. As a result of the study, recent research on North Korea has been expanding in research topics and methodologies, and recent studies have been differentiated into microscopic studies that deviate from existing research trends at a macro level and view North Korea's daily life. The characteristics of 'North Korean education research' are summarized by period. The research on North Korean education, which began in earnest in the 1970s, was divided into the period of start(70s), transition(80s), leap(90s), expansion(2000s), and development(2010s~). and research characteristics for each period were analyzed. Through this, early North Korean education research was also conducted in the policy aspect of the country, and the characteristics of political and social studies were strong, but recent studies have confirmed that the subjects and contents are diversifying. Based on these studies, the pending issues and issues of North Korean education research in the field of Christian education were analyzed. The study of North Korea in the field of Christian education, which began in the 1980s, has been conducted in the engineering aspect of 'development of unification education programs for churches'. However, studies on Christian unification education and North Korean education itself, which can be used in public education sites including Christian schools, have yet to be sufficient. Nevertheless, the diversification of research in the field of Christian education can be evaluated as a positive change. Based on these studies, it was proposed to establish a de-ideological research foundation, secure primary research data(Raw Data), activate research topics and research methodologies, and strengthen research capabilities in the direction of development to revitalize North Korean research in the field of Christian education. I hope this study will trigger various follow-up studies and help Korean churches that must achieve unification.

A Comparison of Tiotropium 18㎍, Once Daily and Ipratropium 40㎍, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 Tiotropium 1일 1회, 1회 18㎍ 요법과 Ipratropium 1일 4회, 1회 40㎍ 요법의 치료효과 및 안전성 비교)

  • Kim, Seung Joon;Kim, Myung Sook;Lee, Sang Haak;Kim, Young Kyoon;Moon, Hwa Sik;Park, Sung Hak;Lee, Sang Yeub;In, Kwang Ho;Lee, Chang Youl;Kim, Young Sam;Kim, Hyung Jung;Ahn, Chul Min;Kim, Sung Kyu;Kim, Kyung Rok;Cha, Seung Ick;Jung, Tae Hoon;Kim, Mi Ok;Park, Sung Soo;Choi, Cheon Woong;Yoo, Jee Hong;Kang, Hong Mo;Koh, Won Jung;Ham, Hyoung Suk;Kang, Eun Hae;Kwon, O Jung;Lee, Yang Deok;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun;Shin, Won Hyuk;Kwon, Sung Yeon;Kim, Woo Jin;Yoo, Chul Gyu;Kim, Young Whan;Shim, Young Soo;Han, Sung Koo;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Mi Hye;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Choi, Byoung Whui;Oh, Yeon Mok;Lim, Chae Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Jung, Sung Soo;Kim, Ju Ock;Ko, Young Chun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.498-506
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    • 2005
  • Background : This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules ($18{\mu}g$ once daily) with a ipratropium metered dose inhaler (2 puffs of $20{\mu}g$ q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). Method : After the initial screening assessment and a two-week run-in period, patients received either tiotropium $18{\mu}g$ once daily or ipratropium $40{\mu}g$ four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second ($FEV_1$) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. Result : In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted $FEV_1$ of 42 (12)% were analyzed. The trough $FEV_1$ response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. Conclusion : This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.