• Title/Summary/Keyword: Mean Flow Rate

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Development of KD- Propeller Series using a New Blade Section (새로운 날개단면을 이용한 KD-프로펠러 씨리즈 개발)

  • J.T. Lee;M.C. Kim;J.W. Ahn;H.C. Kim
    • Journal of the Society of Naval Architects of Korea
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    • v.28 no.2
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    • pp.52-68
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    • 1991
  • A new propeller series is developed using the newly developed blade section(KH18 section) which behaves better cavitation characteristics and higher lift-drag ratio at wide range of angle-of-attack. The pitch and camber distributions are disigned in order to have the same radial and chordwise loading distribution with the selected circumferentially averaged wake input. Since the geometries of the series propeller, such as chord length, thickness, skew and rate distribations, are selected by regression of the recent full scale propeller geometric data, the performance prediction of a propeller at preliminary design stage can be mure realistic. Number of blades of the series propellers is 4 and the expanded blade area ratios are 0.3, 0.45, 0.6 and 0.75. Mean pitch ratios are selected as 0.5, 0.65, 0.8, 0.75 and 1.1 for each expanded area ratio. The new propeller series is composed of 20 propellers and is named as KD(KRISO-DAEWOO) propeller series. Propeller open water tests are performed at the experimental towing tank, and the cavitation observation tests and fluctuating pressure measurements are carried out at the cavitation tunnel of KRISO. $B_{P}-\delta$ curves, which can be used to select the optimum propeller diameter at the preliminary design stage, are derived from a regression analysis of the propeller often water test results. The KD-cavitation chart is derived from the cavitation observation test results by choosing the local maximum lift coefficient and the local cavitation number as parameters. The caviy extent of a propeller can be predicted more accurately by using the KD-cavitation chart at a preliminary design stage, since it is derived from the results of the cavitation observation tests in the selected ship's wake, whereas the existing cavitation charts, such as the Burrill's cavitation chart, are derived from the test results in uniform flow.

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Bronchial Responsiveness in Patients with Mitral Valvular Heart Disease (승모판 심장질환 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ho-Cheol;Kim, Min-Gu;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.752-759
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    • 1995
  • Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.

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Change of Pulmonary Artery Hemodynamics and Pulmonary Vascular Resistance in Experimental Pulmonary Embolism (실험적 급성 폐색전증에서 폐동맥혈역학 및 폐혈관저항의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho;Kim, Cheol-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.913-922
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    • 1995
  • Background: When we define the pressure of pulmonary vasculature in which a recruitment of blood flow occurs as $P_I$ and the proportion of change in pulmonary artery to that in cardiac output as IR and then we compare PI and IR with pulmonary vascular resistance, we would find some problems in pulmonary vascular resistance. In other words, it is the theory that, IR should be increased mainly in pulmonary embolism in which decreases the cross sectional area of pulmonary vasculature. But there are many contradictory reports resulted from various researches and the fact is known widely that any difference exists between PVR and PI, IR. For this reason, the purpose of this study is to observe how PI and IR change at the time of the outbreak and during treatment of the pulmonary embolism, and to find out the meaning of these new indicators and the difference from the pulmonary vascular resistance used generally when we subdivide the pulmonary vascular resistance into PI and IR. Method: After making AV fistula in experimental dog, we controlled cardiac output at the intervals of 15 minute in case of three kinds(all AV fistula are obstructed, only one of fistula is open and all of fistula is open), and after evoking massive pulmonary embolism with radioactive autologous blood clots, we measured the mean pulmonary artery pressure, and calculated PI and IR. We observed the pattern of change in PI and IR, without giving the control group any specific treatment and with injecting intravenously rtPA in the Group 1 and Group 2 at the dose of 1mg per kg, for 15 minutes fot the former and 3 hours for the latter. Result: 1) Pulmonary vascular resistance showed a change similar to that of pulmonary artery pressure and in all three group, PVR increased significantly, but group 1 and group 2 showed tendency that PVR keeps on decreasing after treatment, and the rate of decrease in group 1 is more rapid than group 2 significantly. 2) Both intersection(PI) and degree(IR) are proved statistically significant, in view of the straight line relationship between cardiac output and pulmonary artery pressure, calculated by minimal regression method. 3) PI changed similarly to pulmonary vascular resistance, while in the IR which is theoretically more similar to PVR, there was no significant difference or change after rtPA infusion. Conclusion: In the pulmonary embolism, Both change in IR which means real resistance of pulmonary vasculature and PI which was developed due to secondary vasoconstriction by pulmonary embolism are reflected same time.

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Influences of Histamine on Permeability across Blood-brain Barrier (혈액-뇌장벽 투과성에 대한 히스타민의 영향)

  • Kim, Kee-Jin;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.2 no.2
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    • pp.33-43
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    • 1968
  • Histamine, 0.5 mg as histamine base in 4 ml of normal saline solution, was injected into rabbits anesthetized with nembutal and the mean blood pressure was kept in the range of $52{\sim}80\;mmHg$ for over one hour by supplemental additions. Following the injection of the test substances, 300 mg of urea and 200 mg of antipyrine intravenously, serial blood samples were obtained from the femoral artery and the internal jugular vein at $0.5{\sim}3$ minutes interval. The decreasing patterns in the concentrations of arterial and venous blood plasma samples were compared with each other. The ratio of the concentration of brain tissue to that of the final arterial plasma was also studied. By these measures the degrees of penetration of the test substances in the brain in the control and in the histamine treated rabbits were observed. The concentrations of antipyrine and urea in the arterial blood plasma were decreasing exponentially with respect to the time elapsed. The venous concentrations were anticipated to increase initially and to cross the arterial concentration curve in the point of equlibrium between the plasma and the tissue. On the contrary to the expectation venous concentration also revealed the decreasing tendency similar to that of arterial plasma. The similarity between these two curves, arterial and venous, would be atributable to the fact that the cerebral blood flow rate was large enough and the rising phase in the venous concentration curve was instantly over before serial blood samples were taken. Inspite of some similarity in the decreasing tedency in both concentration curves there were appreciable discrepancies between the arterial and venous plasma which would reflect the situation far from the equlibria among several compartments in the brain. Changes in plasma potassium levels caused by the injection of histamine or bleeding were observed, too. Using 8 rabbits as the control and 12 rabbits for the histamine treated group following results were obtained: 1. Both of the concentration curves, arterial and venous, declined rapidly at_first and slowly later on and approached same equilibrium concentration with the passage of time after a single injection. The time at which attained the same concentration was $2.0{\pm}0.54\;min.$ in the control and $4.3{\pm}1.92\;min.$ in the histamine treated group with respect to antipyrine. On the other hand in the case of urea they were $2.4{\pm}0.59\;min.$ in the control and $4.4{\pm}1.31\;min.$ in the histamine group, respectively. In the histamine treated group enlarged spaces for distribution of test substances were postulated. 2. The concentration of antipyrine in the brain tissue water revealed no significant differences between the control and experimental groups, showing $212{\pm}40.2\;mg/l$ in the control and $206{\pm}64.1\;mg/l$ in the histamine treated group. On the other hand urea revealed higher value in the histamine treated group than in the control, showing an enhanced penetration of urea into the tissue after injection of histamine. Urea concentration in the brain water was $32.3{\pm}3.36\;mg%$ in the control and $39.2{\pm}4.25\;mg%$ in the histamine treated group. 3. The distribution ratio of antipyrine in the brain tissue was very close to unity in the histamine treated animals as well as in the control. 4. The average of the distribution ratio of urea in the control animals was 0.77 and it showed the presence of blood-brain barrier with regard to urea. However in the histamine treated animals the distribution ratios climbed up to 0.86 and they were closer to unity than in the control animals. Out of 12 cases 5 were greater than 0.9 and 8 exceeded 0.85. It appeared that histamine enhanced the penetration of urea through the barrier. 5. Histamine injection and or hemorrhage caused an elevation of the concentration of potassium in plasma. In the event that histamine and hemorrhage were applied together the elevation of potassium exceed the elevation seen at the histamine alone. There was no evidence that the leakage of potassium from the brain tissue was dominant in comparison with the general leakage from the whole body.

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Development and Application of the High Speed Weigh-in-motion for Overweight Enforcement (고속축하중측정시스템 개발과 과적단속시스템 적용방안 연구)

  • Kwon, Soon-Min;Suh, Young-Chan
    • International Journal of Highway Engineering
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    • v.11 no.4
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    • pp.69-78
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    • 2009
  • Korea has achieved significant economic growth with building the Gyeongbu Expressway. As the number of new road construction projects has decreased, it becomes more important to maintain optimal status of the current road networks. One of the best ways to accomplish it is weight enforcement as active control measure of traffic load. This study is to develop High-speed Weigh-in-motion System in order to enhance efficiency of weight enforcement, and to analyze patterns of overloaded trucks on highways through the system. Furthermore, it is to review possibilities of developing overweight control system with application of the HS-WIM system. The HS-WIM system developed by this study consists of two sets of an axle load sensor, a loop sensor and a wandering sensor on each lane. A wandering sensor detects whether a travelling vehicle is off the lane or not with the function of checking the location of tire imprint. The sensor of the WIM system has better function of classifying types of vehicles than other existing systems by detecting wheel distance and tire type such as single or dual tire. As a result, its measurement errors regarding 12 types of vehicle classification are very low, which is an advantage of the sensor. The verification tests of the system under all conditions showed that the mean measurement errors of axle weight and gross axle weight were within 15 percent and 7 percent respectively. According to the WIM rate standard of the COST-323, the WIM system of this study is ranked at B(10). It means the system is appropriate for the purpose of design, maintenance and valuation of road infrastructure. The WIM system in testing a 5-axle cargo truck, the most frequently overloaded vehicle among 12 types of vehicles, is ranked at A(5) which means the system is available to control overloaded vehicles. In this case, the measurement errors of axle load and gross axle load were within 8 percent and 5 percent respectively. Weight analysis of all types of vehicles on highways showed that the most frequently overloaded vehicles were type 5, 6, 7 and 12 among 12 vehicle types. As a result, it is necessary to use more effective overweight enforcement system for vehicles which are seriously overloaded due to their lift axles. Traffic volume data depending upon vehicle types is basic information for road design and construction, maintenance, analysis of traffic flow, road policies as well as research.

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Particulate Matter and CO2 Improvement Effects by Vegetation-based Bio-filters and the Indoor Comfort Index Analysis (식생기반 바이오필터의 미세먼지, 이산화탄소 개선효과와 실내쾌적지수 분석)

  • Kim, Tae-Han;Choi, Boo-Hun;Choi, Na-Hyun;Jang, Eun-Suk
    • Korean Journal of Environmental Agriculture
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    • v.37 no.4
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    • pp.268-276
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    • 2018
  • BACKGROUND: In the month of January 2018, fine dust alerts and warnings were issued 36 times for $PM_{10}$ and 81 times for PM2.5. Air quality is becoming a serious issue nation-wide. Although interest in air-purifying plants is growing due to the controversy over the risk of chemical substances of regular air-purifying solutions, industrial spread of the plants has been limited due to their efficiency in air-conditioning perspective. METHODS AND RESULTS: This study aims to propose a vegetation-based bio-filter system that can assure total indoor air volume for the efficient application of air-purifying plants. In order to evaluate the quantitative performance of the system, time-series analysis was conducted on air-conditioning performance, indoor air quality, and comfort index improvement effects in a lecture room-style laboratory with 16 persons present in the room. The system provided 4.24 ACH ventilation rate and reduced indoor temperature by $1.6^{\circ}C$ and black bulb temperature by $1.0^{\circ}C$. Relative humidity increased by 24.4% and deteriorated comfort index. However, this seemed to be offset by turbulent flow created from the operation of air blowers. While $PM_{10}$ was reduced by 39.5% to $22.11{\mu}g/m^3$, $CO_2$ increased up to 1,329ppm. It is interpreted that released $CO_2$ could not be processed because light compensation point was not reached. As for the indoor comfort index, PMV was reduced by 83.6 % and PPD was reduced by 47.0% on average, indicating that indoor space in a comfort range could be created by operating vegetation-based bio-filters. CONCLUSION: The study confirmed that the vegetation-based bio-filter system is effective in lowering indoor temperature and $PM_{10}$ and has positive effects on creating comfortable indoor space in terms of PMV and PPD.

Spatiotemporal and Longitudinal Variability of Hydro-meteorology, Basic Water Quality and Dominant Algal Assemblages in the Eight Weir Pools of Regulated River(Nakdong) (낙동강 8개 보에서 기상수문·기초수질 및 우점조류의 시공간 종적 변동성)

  • Shin, Jae-Ki;Park, Yongeun
    • Korean Journal of Ecology and Environment
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    • v.51 no.4
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    • pp.268-286
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    • 2018
  • The eutrophication and algal blooms by harmful cyanobacteria (CyanoHAs) and freshwater redtide (FRT) that severely experiencing in typical regulated weir system of the Nakdong River are one of the most rapidly expanding water quality problems in Korea and worldwide. To compare with the factors of rainfall, hydrology, and dominant algae, this study explored spatiotemporal variability of the major water environmental factors by weekly intervals in eight weir pools of the Nakdong River from January 2013 to July 2017. There was a distinct difference in rainfall distribution between upstream and downstream regions. Outflow discharge using small-scale hydropower generation, overflow and fish-ways accounted for 37.4%, 60.1% and 2.5%, respectively. Excluding the flood season, the outflow was mainly due to the hydropower release through year-round. These have been associated with the drawdown of water level, water exchange rate, and the significant impact on change of dominant algae. The mean concentration (maximum value) of chlorophyll-a was $17.6mg\;m^{-3}$ ($98.2mg\;m^{-3}$) in the SAJ~GAJ and $29.6mg\;m^{-3}$ ($193.6mg\;m^{-3}$) in the DAS~HAA weir pools reaches, respectively. It has increased significantly in the downstream part where the influence of treated wastewater effluents (TWEs) is high. Indeed, very high values (>50 or $>100mg\;m^{-3}$) of chlorophyll-a concentration were observed at low flow rates and water levels. Algal assemblages that caused the blooms of CyanoHAs and FRT were the cyanobacteria Microcystis and the diatom Stephanodiscus populations, respectively. In conclusion, appropriate hydrological management practices in terms of each weir pool may need to be developed.

Effect of xylazine hydrochloride on histamine release (Xylazine이 histamine 유리에 미치는 영향)

  • 김영환;박준형
    • Korean Journal of Veterinary Service
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    • v.25 no.1
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    • pp.53-73
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    • 2002
  • It has been reported that degranulation of mast cells in rats, rabbits and dog was observed after dosing xylazine hydrochloride(Xh) which has been widely used as sedative, analgesic and muscular relaxant. Therefore, this experiment was conducted to examine the relations between Xh and histamine release and to identify the action of ${\alpha}$-adrenoceptors which exists on the suface of mast cells. 1. The content of histamine within serum was measured with HPLC by performing the O-phthalaldehyde(OPA) fluorescent derivation. The pretreatment method had a little modification from the conventional method. The pretreament was carried out in the following method. 0.2$m\ell$ of serum and 1$m\ell$ of butanol were added to mixed together and then the liquid was centrifugally separated at 4$^{\circ}C$ and 2,000 rpm for 3 minutes. 0.4$m\ell$ of 0.1N HCl and 1.6$m\ell$ of heptane were added to 0.8$m\ell$ of supernatant taken from the liquid, and they were mixed together. This mixture was also centrifugally separated at 4$^{\circ}C$ and 2,000 rpm for 5 minutes. The supernatant was thrown away and the OPA fluorescent derivation was carried out with 0.2$m\ell$ of the lower liquid then, 5 minutes after mixing 400${\mu}\ell$ of 0.1N HCl, 120${\mu}\ell$ of 1N NaOH and 40${\mu}\ell$ of 0.1% OPA in the 0.2$m\ell$ of the lower liquid,120${\mu}\ell$ of 3.57N H$_3$PO$_4$ was added to the mixed liquid, and the liquid, was mixed again and syringe-filtered. Then, the measurement was done with HPLC in the 30 : 70(ν/ν) ratio of 0.004M KH$_2$PO$_4$: CH$_3$CN, flow rate of 1.0$m\ell$/min., and a wavelength of λex= 350nm and λem=444nm at the column temperature of 27$^{\circ}C$, using the fluorescence detector. 2. The content of histamine in each laboratory animal appeared to be higher in such an order as rabbit, rat, guinea pig, dog, Korean indigenous goat, swine, Korean indigenous cattle, Holstein, and mouse, of which the individual mean values${\pm}$standard deviation were 2.0668 ${\pm}$ 0.6049. 0.4999 ${\pm}$ 0.2278, 0.4241 ${\pm}$ 0.1974, 0.1054 ${\pm}$ 0.0556, 0.1028 ${\pm}$ 0.0276, 0.0972 ${\pm}$ 0.0513, 0.0872 ${\pm}$ 0.0373, 0.0717 ${\pm}$ 0.0379, and 0.0706 ${\pm}$ 0.0366, respectively. 3. The content of histamine was measured at the moments of 15-, 30-, 60-, 120-minutes after inoamuscular injection of 20mg/100kg Xh into two to 4 years old Holstein weighing 600∼700kg. The result showed that there was a significant increase at the times of 30- and 90-minutes after injection(p<0.05). 4. Intramuscular injection of 3mg/10kg Xh was given to crossbred pug dogs weighing 2.5∼4.3kg. The content of histamine was measured at the times of 30-, 60-, 90- and 120-minutes after injection. The result revealed that there was a significant increase at the times of 60-and 90-minutes after injection(p<0.05). 5. Intramuscular injection of 10mg/$m\ell$∼25mg/$m\ell$ Xh in concentration of 0.1$m\ell$ was applied to Korean indigenous goat over 5 months old. Then, the content of histamine was measured at the times of 15-, 30-, 60- and 90-minutes after injection. A significant increase was shown at the times of 30- and 60-minutes after injection(p<0.05). 6. The content of histamine was measured at the moments of 30- and 60-minutes after intramuscular injection of 0.1-0.2$m\ell$ Xh (20mg/$m\ell$) into male rabbits weighting 2.5-4kg. A significant increase was found at the moment of 60 minutes after injection(p<0.001). 7. After administering Xh to the mast cell taken from the abdominal cavity of mouse, the content of histamine was measured. The result showed that the higher the concentration, the more significantly the content of histamine was increased(p<0.05). 8. Compound 48/80 was administered in concentration of 5$\mu\textrm{g}$/$m\ell$ and 10$\mu\textrm{g}$/$m\ell$ to the mast cell picked from the abdominal cavity of mouse. The result showed that there was a significant increase in the content of histamine in case of the concentration of 10$\mu\textrm{g}$/$m\ell$(p<0.05). It was found to be about 10,000 to 500,000 times stronger than the Xh. 9. After premedication of 1mg/kg of yohimbine hydrochloride as ${\alpha}$$_2$-adrenergic antagonist to rabbits, the Xh was administered to them. The result was that the value of histamine within serum was decreased significantly(p<0.001). 10. After premeditation of 1mg/kg of prazosin hydrochloride as ${\alpha}$$_1$-adrenergic antagonist to rabbits, the Xh was administered to them. It was found that the value of histamine within serum was decreased significantly(p<0.005). 11, Prazosin hydrochloride and yohimbine hydrochloride as ${\alpha}$$_1$-adrenergic antagonist, respectively, and ${\alpha}$$_2$-adrenergic antagonist were administerd. In this case, the value of histamine within serum was decreased significantly(p<0.0001). As the results, when the Xh is administered to various kinds of animals, the amount of histamine release within serum is increased. In view of the results so far achieved, it is concluded that Xh acted on both a$_1$-adrenoreceptor and ${\alpha}$$_2$-adrenoreceptor induces the degranulation of mast cell.

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.