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Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents (성장기 청소년의 혈압변화와 결정요인)

  • Suh, Il;Nam, Chung-Mo;Jee, Sun-Ha;Kim, Suk-Il;Kim, Young-Ok;Kim, Sung-Soon;Shim, Won-Heum;Kim, Chun-Bae;Lee, Kang-Hee;Ha, Jong-Won;Kang, Hyung-Gon;Oh, Kyung-Won
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.308-326
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    • 1997
  • Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

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Memory Organization for a Fuzzy Controller.

  • Jee, K.D.S.;Poluzzi, R.;Russo, B.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1041-1043
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    • 1993
  • Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)+dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

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A Study of Guidelines for Genetic Counseling in Preimplantation Genetic Diagnosis (PGD) (착상전 유전진단을 위한 유전상담 현황과 지침개발을 위한 기초 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Kang, Inn-Soo;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.125-132
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    • 2010
  • Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

Growth and Survival by the Breeding Method of Early Young Spats of the Hard Clam, Meretrix petechiails (LAMARCK) (말백합, Meretrix petechiails (LAMARCK) 초기치패의 사육방법별 성장 및 생존)

  • Kim, Byeong-Hak;Cho, Kee-Chae;Jee, Young-Ju;Byun, Soon-Gyu;Kim, Min-Chul
    • The Korean Journal of Malacology
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    • v.27 no.2
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    • pp.115-119
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    • 2011
  • To establish technical development for artificial seed production, growth and survival for early young spats of the hard clam, Meretrix petechialis, were investigated by breeding methods. Adult clams were collected at Hasa-ri, Baeksu-eup, Yeonggwang-gun, Jeollanam-do on July 13, 2010, and then transported to the indoor aquarium at the laboratory. Eggs which were taken from mother clams, were inseminated, and after they were fertilized in the aquarium, 60 million bottom-clinging spats ($198{\pm}12{\mu}m$ in shell length) were produced and bred. The breeding experiments were carried out from July 16 to October 4, 2010 for 80 days. The methods of sand box, sand bottom circulation filter, inclosing net, floor were used for the breeding experiments, and the experimental condition of sea water temperature for larvae were at 25, 28, 31, $34^{\circ}C$. Four marine cultured food organisms were used for this study as follows: Isochrysis galbana, Chaetoceros gracilis, Phaeodactylum tricornutum, Tetraselmis tetrathele. According to the experimental conditions, experimental groups of the spats in the early stage were investigated the growth rate and the survival. As the result, the method of the inclosing net section was the fastest (grew up to $2.64{\pm}0.59{\mu}m$ in shell length), followed by sandbox ($2.59{\pm}0.64{\mu}m$, bottom circulating filter ($2.56{\pm}0.52{\mu}m$), and floor ($2.52{\pm}0.56{\mu}m$). The survival was the highest in the experimental condition of sandbox (35.9%), followed by floor (34.6%), bottom circulating filter (29.5%), and inclosing net (9.3%). Eexperimental condition of water temperature of $34^{\circ}C$ showed the fastest growth rate (grew up to $2.70{\pm}0.76{\mu}m$ in shell length), and showed the latest growth rate (grew up to $2.45{\pm}0.41{\mu}m$ in shell length) at $25^{\circ}C$. The survival (%) was the highest under the water temperature conditions at $31^{\circ}C$, and showed the lowest (14.2%) at $34.^{\circ}C$. The growth rate of the experimental group fed the mixture live food was the fastest with shell length $2.52{\pm}0.66{\mu}m$, and that of experimental group fed P. tricornutum showed the latest (grew up to $2.29{\pm}0.43{\mu}m$ in shell length). The survival was the highest (36.9%) under the experiment condition fed mixture live food and experimental group fed T. tetrathele showed the lowest rate (16.2%).

Effects of Soil Organic Matter Contents, Paddy Types and Agricultural Climatic Zone on CH4 Emissions from Rice Paddy Field (벼 논에서 토양 유기물 함량, 논 유형 및 농업기후대가 CH4 배출에 미치는 영향)

  • Ko, Jee-Yeon;Lee, Jae-Saeng;Woo, Koan-Sik;Song, Seok-Bo;Kang, Jong-Rae;Seo, Myung-Chul;Kwak, Do-Yeon;Oh, Byeong-Gun;Nam, Min-Hee
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.5
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    • pp.887-894
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    • 2011
  • To evaluate the effects of abiotic factors of paddy fields on greenhouse gases (GHGs) emissions from rice paddy fields, $CH_4$ emission amounts were investigated from rice paddy fields by different soil organic matter contents, paddy types, and agricultural climatic zone in Yeongnam area during 3 years. $CH_4$ emission amounts according to soil organic matter contents in paddy field were conducted at having different contents of 5 soil organic matters fields (23.6, 28.7, 31.0, 34.5, and $38.0g\;kg^{-1}$), The highest $CH_4$ emission amount was recorded in the highest soil organic matters plot of $38.0g\;kg^{-1}$. High correlation coefficient (r=$0.963^{**}$) was obtained between $CH_4$ emissions from paddy fields and their soil organic matter contents. According to paddy field types, $CH_4$ emission amounts were investigated at 4 different paddy fields as wet paddy, sandy paddy, immature paddy, and mature paddy. The highest $CH_4$ emissions was recorded in wet paddy (100%) and followed as immature paddy 64.0%, mature paddy 46.8%, and sandy paddy 23.8%, respectively. For the effects of temperature on $CH_4$ emissions from paddy fields, 4 agricultural climatic zones were investigated, which were Yeongnam inland zone (YIZ), eastern coast of central zone (ECZ), plain area of Yeongnam inland mountainous zone (PMZ), and mountainous area of Yeongnam inland mountainous zone (MMZ). The order of $CH_4$ emission amounts from paddy fields by agricultural climatic zone were YIZ (100%) > ECZ (94.6%) > PMZ (91.6%) > MMZ (78.9%). The regression equation between $CH_4$ emission amounts from paddy fields and average air temperature of Jul. to Sep. of agricultural climatic zone was y = 389.7x-4,287 (x means average temperature of Jul. to Sep. of agricultural climatic zone, $R^2=0.906^*$)

Energy and nutrition evaluation per single serving package for each type of home meal replacement rice (가정간편식 밥류의 유형별 1회 제공 포장량 당 에너지 및 영양성분 함량 평가)

  • Choi, In-Young;Yeon, Jee-Young;Kim, Mi-Hyun
    • Journal of Nutrition and Health
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    • v.55 no.4
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    • pp.476-491
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    • 2022
  • Purpose: The purpose of this study was to evaluate the energy and nutrient contents of home meal replacement (HMR) rice products per single serving package based on nutrition labels. Methods: The market research was conducted from February to July 2021 on products sold on the internet, at convenience stores, etc. A total of 406 products were investigated. The products were divided into the following 6 classifications: instant rice (n = 45), cup rice (n = 64), frozen rice (n = 188), rice bowls with toppings (n = 32), gimbap (n = 38), and triangular gimbap (n = 39). Results: The mean packaging weight per serving was the highest in the rice bowl with toppings at 297.1 g, followed by cup rice (264.0 g), frozen rice (239.5 g), gimbap (230.2 g), instant rice (193.4 g), and triangular gimbap (121.6 g) (p < 0.001). The energy per serving package for the rice bowl with toppings was significantly the highest at 496.0 kcal (p < 0.001). The sodium content per serving package of gimbap was the highest at 1,021.8 mg and that of the instant rice was lowest at 37.4 mg (p < 0.001). The price per serving package of the rice bowl with toppings at 4,333.8 won was the highest. The contribution to the daily nutritional value per serving package of all types of HMR rice products surveyed showed an average range of 10-25% for energy, 11-22% for carbohydrates, and 2-51% for sodium. Conclusion: These results indicate the energy and nutrient contents of HMR rice products, vary by type. Therefore, consumers should review the nutrition labeling to select an appropriate HMR rice product based on their intended consumption.

The Effects of Entrepreneurship Mentoring on Entrepreneurial Will and Mentoring Satisfaction: Focusing on Opus Entrepreneurship Education (창업 멘토링 기능이 창업의지와 멘토링 만족도에 미치는 영향: 오퍼스 창업교육을 중심으로)

  • Kim, Ki-Hong;Lee, Chang-Young;Joe, Jee-Hyung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.3
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    • pp.211-226
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    • 2023
  • As we transition into the post-COVID era, economic activities that were stagnant are regaining momentum. In particular, there is a growing trend of technology entrepreneurship driven by the opportunities of digital transformation in the Fourth Industrial Revolution. However, entrepreneurship education content is struggling to keep up with the rapid pace of technological change. This study aims to emphasize the importance of entrepreneurship mentoring as a crucial component of entrepreneurship education content that requires adaptation and advancement due to the increasing demand for technology entrepreneurship. This study redefines startup mentoring, which is differentiated from general mentoring, at the present time when the demand for startups, which increases with the declining employment rate, increases, and the development of quality startup education contents and securing professional startup mentors are required. According to the start-up stage, it is divided into preliminary entrepreneurs and early entrepreneurs, and the effect of entrepreneurship knowledge and self-efficacy among start-up mentoring functions on entrepreneurial will and mentoring satisfaction is improved by empirically researching the effects of start-up mentoring functions in the case of initial entrepreneurs as a moderating effect. To confirm the importance of entrepreneurship mentoring effect for. To this end, among the mentoring functions, entrepreneurship knowledge and self-efficacy were set as independent variables, and entrepreneurial will and mentoring satisfaction were set as dependent variables. The research model was designed and hypotheses were established. In addition, empirical analysis was conducted by conducting a questionnaire survey on trainees who received entrepreneurship mentoring education at ICCE Startup School and Opus Startup School. To summarize the results of the empirical analysis, first, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on entrepreneurial will. Second, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on mentoring satisfaction. Third, it was analyzed that entrepreneurship had no significant moderating effect on entrepreneurial knowledge and entrepreneurial will. Fourth, it was analyzed that entrepreneurship had no significant moderating effect on mentoring satisfaction. Fifth, it was found that entrepreneurship had a significant moderating effect between self-efficacy and will to start a business. As a result of the research analysis, the first implication is that the mentoring function in start-up education is analyzed to produce meaningful results for both the initial entrepreneurs and the prospective entrepreneurs in the will to start a business and satisfaction. . Second, it was analyzed that there was no significant relationship between whether a business was started and the mentoring function and effect. However, it was analyzed that the will to start a business through improvement of self-efficacy through mentoring was significantly related to whether or not to start a business. turned out to be helpful. Many start-up education programs currently conducted in Korea educate both early-stage entrepreneurs and prospective entrepreneurs at the same time for reasons such as convenience. However, through the results of this study, even in small-scale entrepreneurship mentoring, it is suggested that customized mentoring through detailed classification such as whether the mentee has started a business can be a method for successful entrepreneurship and high satisfaction of the mentee.

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Four-year change and tracking of serum lipids in Korean adolescents (강화지역 청소년의 4년간 혈청 지질의 변화와 지속성)

  • Lee, Kang-Hee;Suh, Il;Jee, Sun-Ha;Nam, Chung-Mo;Kim, Sung-Soon;Shim, Won-Heum;Ha, Jong-Won;Kim, Suk-Il;Kang, Hyung-Gon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.45-59
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    • 1997
  • It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

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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.