• Title/Summary/Keyword: Outcome assessment

Search Result 868, Processing Time 0.03 seconds

Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
    • /
    • v.29 no.5
    • /
    • pp.465-473
    • /
    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

Counter-Piracy Cooperation to Strengthen New Southern Policy's "Peace": An Analysis of ROK and ASEAN's Counter-Piracy Practices (신남방정책의 "평화"를 강화하기 위한 해적행위 대응 협력: 한국과 아세안의 해적행위 대응 관행 분석)

  • Boo, Yerin;Kim, Sujin;Yeo, Mathew Jie Sheng
    • Maritime Security
    • /
    • v.3 no.1
    • /
    • pp.141-185
    • /
    • 2021
  • The growing U.S.-China rivalry has placed the countries of Southeast Asia in exceedingly precarious positions. The Republic of Korea (ROK) likewise has been tasked with the challenge of "navigating the waters" between deepening geopolitical divides. It is in this context that the "New Southern Policy" (hereafter NSP) has become a key word in Korea's foreign policy circles. Through NSP, ROK aims to diversify its economic and security interests by strengthening ties with its southern partners, focusing on three key areas (termed as the "3 Ps"): People, Prosperity, and Peace. At the same time, the NSP seeks cooperation with other key diplomatic agendas such as the U.S.'s "Free and Open Indo-Pacific," rendering it crucial for the overall stability of the region. Considering such strategic significance, deeper analysis of the policy is more timely than ever. A brief assessment of the policy's outcome so far, however, reveals that relatively, the "Peace" pillar has been insufficient in achieving satisfactory outcomes. Here, this paper asks the question of: 1) How can the "Peace" pillar of South Korea's New Southern Policy be strengthened? Based on an analysis on the causes of the "Peace" pillar's weakness, this paper identifies counter-piracy cooperation as a solution. This paper then proceeds to answer the next question of: 2) How can ROK and ASEAN cooperate on counter-piracy, and how can these efforts be integrated into ROK's NSP? To answer the above question, this paper conducts in-depth case studies on ASEAN's and ROK's approaches to counter-piracy and identifies specific mechanisms of cooperation. In Chapter I, the paper begins with an overview of the NSP's strategic significance and an evaluation of its "Peace" pillar. Chapter II conducts a literature review on the causes of, and prescriptions for, the weakness of the "Peace" pillar. The paper then justifies why counter-piracy may be a solution. Chapter III examines ASEAN's and ROK's approaches to counter-piracy. By analyzing the general framework and each region's cases, the paper displays the strengths and weaknesses of each region's piracy responses. Based on this analysis, Chapter IV suggests ways to incorporate counter-piracy cooperation into the "Peace" pillar of the NSP. This research bears significance in that it identifies a specific area of cooperation (counter-piracy) to strengthen the "Peace" pillar of ROK's NSP. Such identification is based on a comprehensive study into the two parties' past and current experience in counter-piracy, making it contextual in nature. Furthermore, the study suggests practical mechanisms of cooperation, and considers ways of incorporation into the existing framework of NSP. This approach differs from existing literature that failed to generate case-specific, policy-oriented solutions. The COVID-19 pandemic has exacerbated piracy issues and deepened geopolitical divides. Turbulent seas such as these call for careful navigation. When it comes to promoting "peace," the key lies in combating the pirates that sail those very waters.

  • PDF

Factors influencing health and quality of life among allergy and asthma patients: With specific focus on self-efficacy, social support and health management (건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로)

  • Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
    • /
    • v.11 no.2
    • /
    • pp.143-181
    • /
    • 2005
  • This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.

A Study on Perceived Quality affecting the Service Personal Value in the On-off line Channel - Focusing on the moderate effect of the need for cognition - (온.오프라인 채널에서 지각된 품질이 서비스의 개인가치에 미치는 영향에 관한 연구 -인지욕구의 조정효과를 중심으로-)

  • Sung, Hyung-Suk
    • Journal of Distribution Research
    • /
    • v.15 no.3
    • /
    • pp.111-137
    • /
    • 2010
  • The basic purpose of this study is to investigate perceived quality and service personal value affecting the result of long-term relationship between service buyers and suppliers. This research presented a constructive model(perceived quality affecting the service personal value and the moderate effect of NFC) in the on off line and then propose the research model base on prior researches and studies about relationships among components of service. Data were gathered from respondents who visit at the education service market. For this study, Data were analyzed by AMOS 7.0. We integrate the literature on services marketing with researches on personal values and perceived quality. The SERPVAL scale presented here allows for the creation of a common ground for assessing service personal values, giving a clear understanding of the key value dimensions behind service choice and usage. It will lead to a focus of future research in services marketing, extending knowledge in the field and stimulating further empirical research on service personal values. At the managerial level, as a tool the SERPVAL scale should allow practitioners to evaluate and improve the value of a service, and consequently, to define strategies and actions to address services for customers based on their fundamental personal values. Through qualitative and empirical research, we find that the service quality construct conforms to the structure of a second-order factor model that ties service quality perceptions to distinct and actionable dimensions: outcome, interaction, and environmental quality. In turn, each has two subdimensions that define the basis of service quality perceptions. The authors further suggest that for each of these subdimensions to contribute to improved service quality perceptions, the quality received by consumers must be perceived to be reliable, responsive, and empathetic. Although the service personal value may be found in researches that explore individual values and their consequences for consumer behavior, there is no established operationalization of a SERPVAL scale. The inexistence of an established scale, duly adapted in order to understand and analyze personal values behind services usage, exposes the need of a measurement scale with such a purpose. This need has to be rooted, however, in a conceptualization of the construct being scaled. Service personal values can be defined as a customer's overall assessment of the use of a service based on the perception of what is achieved in terms of his own personal values. As consumer behaviors serve to show an individual's values, the use of a service can also be a way to fulfill and demonstrate consumers'personal values. In this sense, a service can provide more to the customer than its concrete and abstract attributes at both the attribute and the quality levels, and more than its functional consequences at the value level. Both values and services literatures agree, that personal value is the highest-level concept, followed by instrumental values, attitudes and finally by product attributes. Purchasing behaviors are agreed to be the end result of these concepts' interaction, with personal values taking a major role in the final decision process. From both consumers' and practitioners' perspectives, values are extremely relevant, as they are desirable goals that serve as guiding principles in people's lives. While building on previous research, we propose to assess service personal values through three broad groups of individual dimensions; at the self-oriented level, we use (1) service value to peaceful life (SVPL) and, at the social-oriented level, we use (2) service value to social recognition (SVSR), and (3) service value to social integration (SVSI). Service value to peaceful life is our first dimension. This dimension emerged as a combination of values coming from the RVS scale, a scale built specifically to assess general individual values. If a service promotes a pleasurable life, brings or improves tranquility, safety and harmony, then its user recognizes the value of this service. Generally, this service can improve the user's pleasure of life, since it protects or defends the consumer from threats to life or pressures on it. While building upon both the LOV scale, a scale built specifically to assess consumer values, and the RVS scale for individual values, we develop the other two dimensions: SVSR and SVSI. The roles of social recognition and social integration to improve service personal value have been seriously neglected. Social recognition derives its outcome utility from its predictive utility. When applying this underlying belief to our second dimension, SVSR, we assume that people use a service while taking into consideration the content of what is delivered. Individuals consider whether the service aids in gaining respect from others, social recognition and status, as well as whether it allows achieving a more fulfilled and stimulating life, which might then be revealed to others. People also tend to engage in behavior that receives social recognition and to avoid behavior that leads to social disapproval, and this contributes to an individual's social integration. This leads us to the third dimension, SVSI, which is based on the fact that if the consumer perceives that a service strengthens friendships, provides the possibility of becoming more integrated in the group, or promotes better relationships at the social, professional or family levels, then the service will contribute to social integration, and naturally the individual will recognize personal value in the service. Most of the research in business values deals with individual values. However, to our knowledge, no study has dealt with assessing overall personal values as well as their dimensions in a service context. Our final results show that the scales adapted from the Schwartz list were excluded. A possible explanation is that although Schwartz builds on Rokeach work in order to explore individual values, its dimensions might be especially focused on analyzing societal values. As we are looking for individual dimensions, this might explain why the values inspired by the Schwartz list were excluded from the model. The hierarchical structure of the final scale presented in this paper also presents theoretical implications. Although we cannot claim to definitively capture the dimensions of service personal values, we believe that we come close to capturing these overall evaluations because the second-order factor extracts the underlying commonality among dimensions. In addition to obtaining respondents' evaluations of the dimensions, the second-order factor model captures the common variance among these dimensions, reflecting the respondents' overall assessment of service personal values. Towards this fact, we expect that the service personal values conceptualization and measurement scale presented here contributes to both business values literature and the service marketing field, allowing for the delineation of strategies for adding value to services. This new scale also presents managerial implications. The SERPVAL dimensions give some guidance on how to better pursue a highly service-oriented business strategy. Indeed, the SERPVAL scale can be used for benchmarking purposes, as this scale can be used to identify whether or not a firms' marketing strategies are consistent with consumers' expectations. Managerial assessment of the personal values of a service might be extremely important because it allows managers to better understand what customers want or value. Thus, this scale allows us to identify what services are really valuable to the final consumer; providing knowledge for making choices regarding which services to include. Traditional approaches have focused their attention on service attributes (as quality) and service consequences(as service value), but personal values may be an important set of variables to be considered in understanding what attracts consumers to a certain service. By using the SERPVAL scale to assess the personal values associated with a services usage, managers may better understand the reasons behind services' usage, so that they may handle them more efficiently. While testing nomological validity, our empirical findings demonstrate that the three SERPVAL dimensions are positively and significantly associated with satisfaction. Additionally, while service value to social integration is related only with loyalty, service value to peaceful life is associated with both loyalty and repurchase intent. It is also interesting and surprising that service value to social recognition appears not to be significantly linked with loyalty and repurchase intent. A possible explanation is that no mobile service provider has yet emerged in the market as a luxury provider. All of the Portuguese providers are still trying to capture market share by means of low-end pricing. This research has implications for consumers as well. As more companies seek to build relationships with their customers, consumers are easily able to examine whether these relationships provide real value or not to their own lives. The selection of a strategy for a particular service depends on its customers' personal values. Being highly customer-oriented means having a strong commitment to customers, trying to create customer value and understanding customer needs. Enhancing service distinctiveness in order to provide a peaceful life, increase social recognition and gain a better social integration are all possible strategies that companies may pursue, but the one to pursue depends on the outstanding personal values held by the service customers. Data were gathered from 284 respondents in the korean discount store and online shopping mall market. This research proposed 3 hypotheses on 6 latent variables and tested through structural equation modeling. 6 alternative measurements were compared through statistical significance test of the 6 paths of research model and the overall fitting level of structural equation model. and the result was successful. and Perceived quality more positively influences service personal value when NFC is high than when no NFC is low in the off-line market. The results of the study indicate that service quality is properly modeled as an antecedent of service personal value. We consider the research and managerial implications of the study and its limitations. In sum, by knowing the dimensions a consumer takes into account when choosing a service, a better understanding of purchasing behaviors may be realized, guiding managers toward customers expectations. By defining strategies and actions that address potential problems with the service personal values, managers might ultimately influence their firm's performance. we expect to contribute to both business values and service marketing literatures through the development of the service personal value. At a time when marketing researchers are challenged to provide research with practical implications, it is also believed that this framework may be used by managers to pursue service-oriented business strategies while taking into consideration what customers value.

  • PDF

Current Status of Children Born from Renal Transplanted Mother (신이식을 받은 산모로부터 출생한 소아의 성장상태)

  • Ki Mina;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Moon Jang Il;Kim Soon Il;Kim Yu Seun;Park Kiil;Park Young Won
    • Childhood Kidney Diseases
    • /
    • v.4 no.1
    • /
    • pp.77-83
    • /
    • 2000
  • Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

  • PDF

A Study of Reliability and Validity on the Korean Version of Social Adaptation Self Rating Scale(SASS) (한국어판 사회적응자기평가척도(SASS)의 신뢰도 및 타당도 연구)

  • Kim, Hyeong-Seob;Kim, Yong-Ku;Yoon, Choong-Han;Jeong, Han-Yong;Cheong, Young-Ki
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.8 no.2
    • /
    • pp.212-227
    • /
    • 2000
  • This study was designed to testify the reliability and validation on the Korean version of the Social Adaptation Self-rating Scale(SASS) which was developed from Bose et al. for the evaluation of social motivation and behavior of depressed patients in 1997. Interests for the social world, those of social functioning, of patients were involved in the addition of new measure of disturbance. And those were distinct from abnormalities of thought, mood and symptoms of patients with major depression. As the previous reports there were several evidences that treatments may be less likely to be effective if the system they act on is dysfunctional. Thus, a better social situation favoured better outcome. As a matter of fact, however, those reports were developed in the course of the evaluation of interpersonal therapy(IPT) and cognitive therapy. Accordingly the conversed question -whether pharmacological therapy with antidepressants can impact on social functioning in addition to addressing the core features of illness- has been addressed. To date, anyhow, it is accepted that enhancement of social functioning may be a therapeutic principle in its own right and illness rarely divorced from social context. In terms of those concepts the introduction of an assessment of social functioning into pharmacotherapeutic studies of depression has been welcomed and might be a potent instrument for evaluating the relative pharmacoeconomic benefits of different treatments. Despite of many scales which were applied for the evaluation of symptoms in the patients with depression, however, the scale for the evaluation of social functiong has not been introduced in Korea yet. Thus, this study was designed to introduce the concepts of social functioning in the patients with depression and to testify the reliability and validation on Korean version of SASS. This Korean version of SASS was submitted to a reliability and validation procedure based on the data from healthy general population survey in 291 individuals and 40 patients with major depression. Cronbach a was 0.790 in total subjects group and the correlation of test-retest was statistically significant(y=0.653, p<0.0l). Thus, the Korean version of SASS might be shown to be valid and reliable. The results of multivariate analyses allowed the identification of 3 principle factors(factor 1 = intersts in social activities, factor 2 = active interpersonal relationship, factor 3 = selfesteem) in normal group, however, it could be counted as only one factor in the depression group because nearly total items of SASS were involved in factor 1. In the view of these results, the Korean version of SASS may be useful additional tool for the evaluation of social functioning in depression.

  • PDF

The Effect of Corporate SNS Marketing on User Behavior: Focusing on Facebook Fan Page Analytics (기업의 SNS 마케팅 활동이 이용자 행동에 미치는 영향: 페이스북 팬페이지 애널리틱스를 중심으로)

  • Jeon, Hyeong-Jun;Seo, Bong-Goon;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
    • /
    • v.26 no.1
    • /
    • pp.75-95
    • /
    • 2020
  • With the growth of social networks, various forms of SNS have emerged. Based on various motivations for use such as interactivity, information exchange, and entertainment, SNS users are also on the fast-growing trend. Facebook is the main SNS channel, and companies have started using Facebook pages as a public relations channel. To this end, in the early stages of operation, companies began to secure a number of fans, and as a result, the number of corporate Facebook fans has recently increased to as many as millions. from a corporate perspective, Facebook is attracting attention because it makes it easier for you to meet the customers you want. Facebook provides an efficient advertising platform based on the numerous data it has. Advertising targeting can be conducted using their demographic characteristics, behavior, or contact information. It is optimized for advertisements that can expose information to a desired target, so that results can be obtained more effectively. it rethink and communicate corporate brand image to customers through contents. The study was conducted through Facebook advertising data, and could be of great help to business people working in the online advertising industry. For this reason, the independent variables used in the research were selected based on the characteristics of the content that the actual business is concerned with. Recently, the company's Facebook page operation goal is to go beyond securing the number of fan pages, branding to promote its brand, and further aiming to communicate with major customers. the main figures for this assessment are Facebook's 'OK', 'Attachment', 'Share', and 'Number of Click' which are the dependent variables of this study. in order to measure the outcome of the target, the consumer's response is set as a key measurable key performance indicator (KPI), and a strategy is set and executed to achieve this. Here, KPI uses Facebook's ad numbers 'reach', 'exposure', 'like', 'share', 'comment', 'clicks', and 'CPC' depending on the situation. in order to achieve the corresponding figures, the consideration of content production must be prior, and in this study, the independent variables were organized by dividing into three considerations for content production into three. The effects of content material, content structure, and message styles on Facebook's user behavior were analyzed using regression analysis. Content materials are related to the content's difficulty, company relevance, and daily involvement. According to existing research, it was very important how the content would attract users' interest. Content could be divided into informative content and interesting content. Informational content is content related to the brand, and information exchange with users is important. Interesting content is defined as posts that are not related to brands related to interesting movies or anecdotes. Based on this, this study started with the assumption that the difficulty, company relevance, and daily involvement have an effect on the dependent variable. In addition, previous studies have found that content types affect Facebook user activity. I think it depends on the combination of photos and text used in the content. Based on this study, the actual photos were used and the hashtag and independent variables were also examined. Finally, we focused on the advertising message. In the previous studies, the effect of advertising messages on users was different depending on whether they were narrative or non-narrative, and furthermore, the influence on message intimacy was different. In this study, we conducted research on the behavior that Facebook users' behavior would be different depending on the language and formality. For dependent variables, 'OK' and 'Full Click Count' are set by every user's action on the content. In this study, we defined each independent variable in the existing study literature and analyzed the effect on the dependent variable, and found that 'good' factors such as 'self association', 'actual use', and 'hidden' are important. Could. Material difficulties', 'actual participation' and 'large scale * difficulties'. In addition, variables such as 'Self Connect', 'Actual Engagement' and 'Sexual Sexual Attention' have been shown to have a significant impact on 'Full Click'. It is expected that through research results, it is possible to contribute to the operation and production strategy of company Facebook operators and content creators by presenting a content strategy optimized for the purpose of the content. In this study, we defined each independent variable in the existing research literature and analyzed its effect on the dependent variable, and we could see that factors on 'good' were significant such as 'self-association', 'reality use', 'concernal material difficulty', 'real-life involvement' and 'massive*difficulty'. In addition, variables such as 'self-connection', 'real-life involvement' and 'formative*attention' were shown to have significant effects for 'full-click'. Through the research results, it is expected that by presenting an optimized content strategy for content purposes, it can contribute to the operation and production strategy of corporate Facebook operators and content producers.

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
    • /
    • v.58 no.5
    • /
    • pp.498-506
    • /
    • 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.