Evidence for oxidised low density lipoprotein in synovial fluid from rheumatoid arthritis patients

The oxidative modification of human LDL has been implicated in atherosclerosis, but the mechanisms by which such modification occurs in vivo are not fully understood. In the present study, we have isolated LDL from knee-joint synovial fluid of patients with rheumatoid arthritis. We demonstrate that such LDL is oxidatively modified as evidenced by an increased negative charge, distorted particulate nature and more rapid degradation by cultured macrophages. These results indicate that formation of oxidised LDL is associated with the local inflammatory response. Because the cellular interactions in rheumatoid arthritis have analogies with those in atherogenesis, we suggest that the rheumatoid joint is a useful model of atherosclerosis in which the in vivo process of LDL oxidation may be readily studied.

The gene cloning and sequencing of Bm-12, a chlorotoxin-like peptide from the scorpion Buthus martensi Karsch

According to the known amino acid sequence of Bm-12, a short chain insect neurotoxin from the venom of the scorpion Buthus martensi Karsch (BmK) with considerable primary sequence homology to chlorotoxin, the gene specific primers were designed and synthesized for 3' and 5'RACE (Rapid Amplification of cDNA Ends). The two partial cDNA fragments obtained by 3' and 5'RACE were cloned and sequenced, and the full length cDNA sequence of Bm-12 was then completed by overlapping these two partial cDNA sequences. The predicted amino acid sequence consists of 59 amino acid residues including a putative signal peptide of 24 residues and a mature toxin of 35 residues. The predicted amino acid sequence of Bm-12 was almost consistent with the determined, different only in one residue at position 27, Lys was replaced by Gly. Based on the determined cDNA sequence, and using the total DNA isolated from the scorpion venom glands as a template, the genomic DNA of Bm-12 was also amplified by PCR and sequenced. The genomic DNA sequence revealed an intron of 93 bp present within the signal peptide region.

Genomic organization of three novel toxins from the scorpion Buthus martensi Karsch that are active on potassium channels

The cDNA and genomic DNA of three novel toxins from the scorpion Buthus martensi Karsch that are active on K(+) channels, designated BmKTX (where KTX is kaliotoxin), BmTX1 and BmTX2, were cloned and sequenced. On the basis of their known amino acid sequences, gene-specific primers for 3' and 5' rapid amplification of cDNA ends (RACE) were designed and synthesized. By overlapping the two partial cDNA sequences obtained by 3' and 5' RACE, their full-length cDNA sequences were completed. BmKTX encodes a signal peptide of 22 amino acid residues and a mature toxin of 38 residues, whereas BmTX1 and BmTX2 encode signal peptides of 20 and 21 residues respectively and a mature toxin of 38 residues for each. Their cDNA-deduced amino acid sequences were totally consistent with those determined except that the C-terminus of BmKTX had an additional Gly residue, which was removed during post-translational processing and was indispensable for the amidation of its C-terminal Lys residue. In addition, the first deduced amino acid for both BmTX1 and BmTX2 is Gln instead of pyro-Glu in the reported toxins, which obviously also undergoes post-translational processing. The genomic DNA species of these three toxins were also amplified by PCR, then cloned and sequenced. They all consisted of two exons disrupted by a small single intron. All of these introns were inserted within the signal peptides at position -6 for BmKTX and at position -5 for both BmTX1 and BmTX2 upstream of the mature toxins, and consisted of 87, 87 and 80 bp respectively.

Lumbosacral transitional vertebrae and low back pain

The correlation between lumbosacral transitional vertebrae and low back pain was analyzed in a study of plain radiographs from normal subjects and patients with chronic low back pain. Of 184 normal subjects, only 29 (15.8%) had transitional vertebrae, while 97 (35.1%) of 276 patients were noted to have transitional vertebrae. The difference was highly significant (p < 0.01). The incidence of Castellvi type II transitional vertebrae was significantly higher in patients with low back pain than in controls (p < 0.01). This study indicates the etiologic significance of lumbosacral transitional vertebra in low back pain.

Sacral fractures

OBJECTIVE

To delineate the clinical spectrum and treatment choice of sacral fractures.

METHODS

In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis' classification. There were 21 Zone I fractures, 6 Zone II fractures and 12 Zone III fractures. Neurological deficits were present in seven patients. Thirty seven patients were treated conservatively and two underwent surgical management.

RESULTS

Thirty eight patients were followed up for three months to 19 years. Thirty three have recovered, four improved, and one remained disabled.

CONCLUSION

The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually permits satisfactory results.

[A descriptive epidemiological investigation of anophthalmos and microphthalmos in China during 1988 - 1992]

OBJECTIVE

To investigate the descriptive epidemiological characteristics of cases with anophthalmos and microphthalmos in China.

METHOD

According to the hospital-bases monitoring method, the birth defects monitoring program was undertaken in 443 - 588 hospitals from 30 provinces, cities and autonomous regions in China. Data of the new born babies including intra-uterine death and stillbirth from 28 weeks of gestation to a period of 7 days after birth were collected between 1988 and 1992.

RESULTS

There were 3,246,408 babies monitored, among which 382 cases of anophthalmos and microphthalmos were found. The average prevalence rate was 1.18/10,000 in China. The decreasing tendency of prevalence rate was shown during the period (chi(2) = 7.381, P < 0.01). The average prevalence rate in the rural area was significantly higher than that in the urban area, and the female cases were higher than that of male cases. The prevalence rates among various regions varied from 0.21 to 2.29/10,000 with the highest in Gansu province and lowest in Tianjin city. 87.7% of the cases with anophthalmos and microphthalmos were associated with other congenital malformations (multiple malformations). The associated malformations were mostly facial (including ear, neck, etc.) followed by skeletomuscular system and central nervous system. 8.1% of cases were diagnosed as syndromes, among which trisomy 21 was the most common condition.

CONCLUSIONS

There were large variations in the prevalence rates of anophthalmos and microphthalmos in different parts in China. Careful analysis, particularly the chromosome analysis, should be performed to correctly diagnose the cases, especially for those with multiple malformations.

Os odontoideum: etiology, diagnosis, and management

BACKGROUND

There have been few reports of os odontoideum since the initial description.

METHODS

Forty-four patients with os odontoideum treated during the period 1980 through 1996 were reviewed. There were 33 males and 11 females. Their ages ranged from 7 to 56 years, with an average of 24.6 years. Five patients with no symptoms were treated conservatively. Thirty-nine patients underwent operative treatment including nine posterior atlantoaxial fusions and 33 occipitocervical fusions.

RESULTS

The patients were followed up for one to 16 years, with an average of 6.5 years. Five patients treated conservatively have remained stable. All 39 treated patients achieved solid arthrodesis. The results were satisfactory.

CONCLUSIONS

We conclude that fusion is indicated if atlantoaxial instability or clinical symptoms are significant, and that occipitocervical fusion should be considered in the operative management of os odontoideum if atlantoaxial arthrodesis is impossible.

Central cord injury complicating acute cervical disc herniation in trauma

STUDY DESIGN

A retrospective study on 24 patients with acute central cervical cord injury caused by traumatic disc herniation.

OBJECTIVES

To determine the correlation of disc herniation with central cord injury and to evaluate the role of anterior cervical decompression and interbody fusion in management of this injury.

SUMMARY OF BACKGROUND DATA

Acute cervical disc herniation has been documented as a causative factor in spinal cord injury but has been infrequently reported with central cord syndrome.

METHODS

Between 1989 and 1994, 24 patients with acute cervical disc herniation and central cord syndrome were studied. These patients underwent anterior decompression and fusion, and were followed for 2 to 7 years, with an average follow-up period of 3 years and 8 months. The degree of disc herniation and neurologic scores were rated.

RESULTS

During follow-up period, the American Spinal Injury Association motor score in 24 patients was increased to 86.46 +/- 10.22 from 47.79 +/- 19.66. The age of the patients was very negatively correlated with recovery rate (P < 0.01), but no correlation was observed between severity of cord compression and neurologic scores (P > 0.05). Postoperative neurologic improvement in patients with fracture or dislocation was very significantly slower (P < 0.01) than in those without these injuries.

CONCLUSIONS

Far more common than previously expected, acute disc herniation in cervical spine injury is the one of principal cause for central cord syndrome. Magnetic resonance imaging assessment and surgical intervention are required.

[The significance of endometrial biopsy during luteal median phase in diagnosis of luteal function]

OBJECTIVE

To investigate the significance of progesterone profile and endometrial biopsy during luteal median phase in diagnosis of luteal function.

METHODS

The progesterone profile during median luteal phase and endometrial histology during median and late luteal phase of 53 infertile women with infertile and recurrent abortion for unknown reasons were studied.

RESULTS

Retarded endometrial development occurred in the median luteal phase in 24 of the 53 cases, 9 of which lasted into the late phase. The average progesterone profile of these patients was markedly lower compared with the control group (P < 0.05). However, the average progesterone profile remained normal in the other 13 cases, in whom, RED got normalized in the late luteal phase. Endometrial biopsies taken during the median and late luteal phase from the rest of 29 cases were normal.

CONCLUSIONS

In patients with retarded endometrial development during the full luteal phase, luteal function was decreased, but in patients with retarded endometrial development only during the median luteal phase, luteal function appeared to be normal.

[Radiculopathy after cervical laminectomy]

OBJECTIVE

To investigate radiculopathy after multilevel laminectomy in patients with cervical compression myelopathy and underlying mechanism.

METHODS

We retrospectively reviewed 287 consecutive patients with cervical compression myelopathy treated by multilevel cervical laminectomy and identified 37 patients (12.9%) with postoperative radiculopathy. There were 27 men and 10 women, with an average age of 56 years at time of surgery. The diagnosis was either cervical spondylosis (25 patients) or ossification of the posterior longitudinal ligament (12 patients).

RESULTS

Radiculopathy was observed from 4 hours to 6 days after surgery. The most frequent patterns of paralysis were C(5) and C(6) root involvements of the motor-dominant type. All patients showed complete recovery in 2 weeks to 3 years (average, 5.4 months). Follow up results showed that the recovery rate was negatively related to the duration of complete recovery of postoperative radiculopathy (r = -0.832, P < 0.01) and the patients with spondylotic myelopathy had a significantly better clinical recovery rate than those with ossification of the posterior longitudinal ligament (t = 2.960, P < 0.01).

CONCLUSIONS

Postoperative radiculopathy is complicated with posterior cervical decompression and associated with tethering effect upon the nerve root. More logical procedures for prevention of postoperative radiculopathy are decompression through an anterior decompressive procedure in conjunction with a spinal fusion, which may achieve stabilization and directly remove all of the anterior spinal cord compression at multiple levels.

Striking activation of oxidative enzymes suspended in nonaqueous media

The catalytic activity of four lyophilized oxidative enzymes-horseradish peroxidase, soybean peroxidase, Caldariomyces fumago chloroperoxidase, and mushroom polyphenol oxidase-is much lower when directly suspended in organic solvents containing little water than when they are introduced into the same largely nonaqueous media by first dissolving them in water and then diluting with anhydrous solvents. The lower the water content of the medium, the greater this discrepancy becomes. The mechanism of this phenomenon was found to arise from reversible denaturation of the oxidases on lyophilization: because of its conformational rigidity, the denatured enzyme exhibits very limited activity when directly suspended in largely nonaqueous media but renatures and thus yields much higher activity if first redissolved in water. Two independent means were discovered for dramatically minimizing the lyophilization-induced inactivation, both involving the addition of certain types of excipients to the aqueous enzyme solution before lyophilization. The first group of excipients consists of phenolic and aniline substrates as well as other hydrophobic compounds; these presumably bind to the hydrophobic pocket of the enzyme active site, thereby preventing its collapse during dehydration. The second group consists of general lyoprotectants such as polyols and polyethylen glycol that apparently preserve the overall enzyme structure during dehydration. The activation effects of such excipients can reach into the tens and hundreds of fold. Moreover, the activations afforded by the two excipient groups are additive, resulting in up to a complete protection against lyophilization-induced inactivation when representatives of the two are present together.

[Time effect of restraint stress-induced suppression of lymphocyte transformation]

In the present study, restraint, which caused no direct tissue damage, was selected as a method of stress to investigate time effect of stress-induced suppression of lymphocyte transformation in rats. The lymph node and spleen extract or the serum from rats restrained for 3, 6, 12, 18 h or 12, 24, 48, 72, 96 h after restraint, with concanavalin A (Con A), was added to the lymphocyte suspension of rat mesenteric lymph node and was incubated for 72 h. The optical density (OD) value indicating the level of lymphocyte transformation was determined by colorimetric assay of methylthiazol tetrazolium bromide (MTT). The results are as follows. (1) The lymph node and spleen extract or the serum from the rats restrained for 3 or 6 h did not markedly affect the lymphocyte transformation. (2) The lymph node and spleen extract or the serum from the rats restrained for 12 h or 18 h significantly inhibited the lymphocyte transformation and stronger inhibition occurred at 18 h. (3) Up to 96 h after restraint, the suppressive effect of the lymph node or spleen extract on the lymphocyte transformation still existed, but the suppression of the serum on the lymphocyte transformation almost disappeared. These results suggest that the restraint of rats may cause lymphoid tissues to produce some immune suppressive protein of stress, which is released into blood leading to a generalized suppression of cellular immunity.

Radiographic evaluation of Baumann angle in Chinese children and its clinical relevance

Normal Baumann angles in 98 children aged 2 to 13 years and abnormal Baumann angles in 71 children with supracondylar humeral fractures were evaluated. In healthy children, Baumann angles ranged from 64 degrees to 80 degrees (72.4 degrees +/- 4.6 degrees) in boys and from 65 degrees to 81 degrees (72.9 degrees +/- 5.9 degrees) in girls. A significant negative relation (P < 0.01) between Baumann angle and carrying angle was noted, but there were no significant differences in Baumann angles between boys and girls (P > 0.05) and no significant correlation of Baumann angle with increasing age (P > 0.05). In patients with fractures, the Baumann angle measured after immediate reduction correlated well with the carrying angle measured after union or at final follow-up (P < 0.01). This angle measured after reduction may be used to predict the final carrying angle so that cubitus varus deformity can be effectively prevented.

Genomic organization of three neurotoxins active on small conductance Ca2+-activated potassium channels from the scorpion Buthus martensi Karsch

According to the known primary sequences of three neurotoxins active on small conductance Ca2+-activated potassium channels from the scorpion Buthus martensi Karsch, their corresponding cDNAs were cloned and sequenced using 3'- and 5'-RACE. All of them encoded a signal peptide composed of 28 residues and a mature toxin of 29, 28 and 33 residues, respectively. Their cDNA deduced sequences were totally consistent with those determined, and the C-terminal amidation of one neurotoxin was confirmed. The genomic DNAs of these three toxins were also amplified by PCR, cloned and sequenced. They all consisted of two exons disrupted by a small single intron. All of these introns were inserted within the signal peptide at the same -10 position upstream from the mature toxin, consisting of 94, 78 and 87 bp, respectively.

Gene cloning and sequencing of BmK AS and BmK AS-1, two novel neurotoxins from the scorpion Buthus martensi Karsch

Based on the known amino acid sequences of BmK AS and BmK AS-1, the gene specific primers were designed and synthesized for 3' and 5' RACE (Rapid Amplification of cDNA Ends). Their partial cDNA fragments obtained by 3' and 5' RACE were cloned and sequenced, and the full length cDNA sequences of BmK AS and BmK AS-1 were then completed by overlapping their two partial cDNA sequences, respectively. The predicted amino acid sequences both consist of 85 amino acid residues including a putative signal peptide of 19 residues and a mature toxin of 66 residues. They are different in 17 amino acid residues, among them 11 residues in the mature toxin. The predicted amino acid sequences of BmK AS and BmK AS-1 were almost consistent with those determined and revised (personal communication), only different in one and two residues at their COO-terminal parts, respectively. Based on the determined cDNA sequences, and using the total DNAs isolated from the scorpion venom glands as a template, the genomic DNAs of BmK AS and BmK AS-1 were also amplified by PCR and sequenced. It showed that no intron was inserted in their open reading frames, while in the exon of signal peptide sequences of other Na+, K+ and Cl- channel toxins from the same scorpion, an intron is usually found. However, the Northern blot hybridization results indicated that the sizes of their mRNA should be around 800 bp. Their extra sequences around 400 bp which might function as an intron should be located at their 5' untranslated regions.

Near-field mapping of the emission distribution in semiconductor microdiscs

We have used a scanning near-field optical microscope to study the fluorescent light distribution in the near- and far-fields with two types of microdiscs, InGaP and GaN, fabricated in our laboratory. The InGaP microdisc has a radius of 2.5-5.0 microm, a thickness of 0.15-0.2 microm and a circular shape and the GaN disc has a radius of 5-8 microm with a thickness of 0.5-2 microm. Spontaneous emission enhancement in these microdiscs has been observed with emitting wavelengths of 650 and 550 nm respectively In both types of microdisc, the whispering-gallery mode (WCM) has been observed on the top surface using near-field optical and far-field microscopic methods. However, due to the different disc structures and optical confinements, the light distributions of the type types of disc are quite different. In the case of the InGaP disc, WGM is the dominant mode with a mixture of other modes. Interference-like ring intensities have been observed both inside the disc surface and outside, with a period ratio of 1:2. In addition, the propagating waves emitted from the side of the disc have been collected for the first time by using near-field optical microscopy. A theoretical calculation based on the theory of optical modes in microdisc lasers confirmed this observation. It also predicted the behaviour of the electric field distribution (transverse electric) inside and outside the disc, as well as the period of the wave propagation. In contrast, the near-field mapping of the GaN fluorescence showed not only a ring-like emission intensity along the circumference of the disc, an indication of WGM, but also an even intensity distribution inside the disc. This can be explained as the combination of the WGM with the Fabry-Perot mode of multi-reflection between the GaN layer and the substrate. The results also demonstrate the potential application of near-field optics to explore the light emission mode of a microdisc on a nanometre scale.

[Disc degeneration and cervical instability]

OBJECTIVE

To evaluate disc degeneration and segmental instability in the cervical spine by comparing the magnetic resonance imaging assessment of disc degeneration with conventional plain radiographic evaluation with cervical segmental instability.

METHODS

Two hundred sixty consecutive patients with suspected cervical spine disorders were analyzed for horizontal and angular displacements on lateral flexion and extension radiographs and disc degeneration on T(2)-weighted magnetic resonance images of the cervical vertebrae.

RESULTS

In all intervertebral levels, the grade of disc degeneration increased significantly (P < 0.01) with age. Cervical instability was identified in 151 segments (14.5%) and correlated with Grade 1 and Grade 2 degeneration in the intervertebral discs (P < 0.01).

CONCLUSIONS

Cervical segmental instability may indicate early degeneration of intervertebral disc in the cervical vertebrae.

[Helicobacter pylori and congestive gastropathy]

OBJECTIVE

This study evaluates the prevalence and significance of Helicobacter pylori(H. pylori) infection in patients with portal hypertension.

METHODS

177 patients were selected. Among whom, 135 patients with portal hypertension and 42 noncirrhotic patients with nonulcerative dyspepsia as a control group. In all patients diagnostic upper endoscopy was performed and gastric biopsies were taken for histological examination and diagnosis of H. pylori infection.

RESULTS

Of the portal hypertensive patients, 63 patients had congestive gastropathy, 17(27%) of whom were positive for H. pylori infection and 72 patients did not have gastropathy, 18(25%) of whom were positive for H. pylori infection. In the control group 23 of 42(55%) were positive for H. pylori infection. H. pylori was found less frequently in congestive gastropathy patients than in the control group. We also found that the presence and severity of congestive gastropathy is independent of the H. pylori status.

CONCLUSION

The role of H. pylori infection in the pathogenesis of congestive gastropathy seems to be unlikely and we suggest that there is no need for its routine eradication in cirrhotic patients.

[The therapeutic effect of ligustrazin and salvia miltiorrhiza on the gene expression of alpha1 (I) and alpha1 (III) procollagen in rat pulmonary fibrosis]

OBJECTIVE

To evaluate the effect of ligustrazin and salvia miltiorrhiza on collagen gene expression in rat pulmonary fibrosis (PF).

METHODS

The tested animals were divided into 7 groups: normal control, untreated animal groups (day 7, 14 and 29), Ligustrazin, Salvia Miltiorrhiza and hydrocortisone groups. Treatment was started from day 15 to day 28. HE stain and in situ hybridization with alpha(1) (I) and alpha(1) (III) procollagen (PC) cDNA probes were applied to rat lungs on day 29. The results were quantified by a feature analysor.

RESULTS

All the three drugs were effective, ligustrazin the best (P < 0.01), salvia miltiorrhiza the second (P < 0.01). In untreated groups both alpha(1) (I) and alpha(1) (III) PC mRNA reached the maximum on day 7. Alpha(1) (I) PC mRNA still kept high on day 29 while alpha(1) (III) PC mRNA had decreased to normal. In ligustrazin group alpha(1) (I) PC mRNA decreased to normal (P > 0.05) but in salvia miltiorrhiza and hydrocortisone groups it was still above normal level (P < 0.01). In all groups alpha(1) (III) PC mRNA had decreased to normal on day 29.

CONCLUSIONS

Inhibitive effect of ligustrazin on alpha(1) (I) PC mRNA may play an important role in treating PF. The effect of salvia miltiorrhiza is less than ligustrazin.

Heterotopic ossification of the hip after spinal cord injury

OBJECTIVE

To analyse the risk factors of heterotopic ossification after spinal cord injury.

METHODS

Of 104 patients with spinal cord injury, 47 (45.2%) were complicated by heterotopic ossification of the hip. These patients with heterotopic ossification were compared with 57 patients without heterotopic ossification.

RESULTS

Statistical analysis showed that complete paraplegia, spasticity and pressure sore were significantly (P < 0.05) or highly significantly (P < 0.01) related to heterotopic ossification formation. The coexistence of two or three of these factors in the paraplegic patients was found to significantly (P < 0.01) enhance the risk of heterotopic ossification formation.

CONCLUSION

When the spinal cord injured patients have single or multiple risk factors, they should be predicted for susceptibility of heterotopic ossification.

[Gene expression of messenger RNA coding for procollagen and tumour necrosis factor-alpha in lungs undergoing bleomycin-induced pulmonary fibrosis]

OBJECTIVE

mRNA for tumour necrosis factor-alpha(TNF-alpha) and procollagen I [pro alpha 1(I)] and III (pro alpha 1(III) was measured in bleomycin treated mice to evaluate their roles in pulmonary fibrosis.

METHOD

30 male Wistar rats were divided into normal control group and groups treated by bleomycin on days 3, 7, 14, 21, 30. Each group included 5 rats, and the rats were treated by single intratracheal instillation with sterile saline solution or with 5 mg/kg body weight of bleomycin. The rats were sacrificed at different days, and total RNA from the lungs of bleomycin or saline solution instilled rats was extracted. Expression of TNF-alpha, pro alpha 1 (I) and pro alpha 1 (III) mRNA was measured by dot blot and Northern blot hybridization.

RESULT

The levels of TNF-alpha mRNA in lungs of bleomycin groups on days 3,7 were significantly higher than those of control group (t = 10.33 and 12.54 respectively; P < 0.01). The levels of pro alpha 1 (I) and pro alpha 1(III) mRNA in lungs of bleomycin group on day 7 were higher than those of control group(t = 10.56 and 24.23 respectively; P < 0.01), After reaching the peak levels in two weeks, the levels of pro alpha 1(III) mRNA in lungs of bleomycin group on day 30 declined slowly to approximately the values of normal control group (t = 1.95; P > 0.05); but the levels of pro alpha 1(I) mRAN on day 30 after bleomycin administration were higher than those of control group (t = 16.67; P < 0.01). The mRNA coding pro alpha 1(I) and pro alpha 1(III) in lungs of rats had two mRNA species.

CONCLUSION

The results suggested that the metabolism of mRNAs for pro alpha 1 (I) and pro alpha 1 (III) may be preferentially perturbed, and that increase of collagen gene expression in the transcriptional level might be involved in the mechanism of collagen accumulation. The increased expression of TNF-alpha gene may play an important role in the early events of bleomycin-induced pulmonary fibrosis.

[Comparing the bronchodilating effects of ipratropium bromide and theophylline]

OBJECTIVE

To compare the bronchodilating effects of ipratropium bromide and theophylline in chronic obstructive pulmonary disease(COPD).

METHOD

In 26 patients, mean peak forced expiratory volume in 1 second(FEV1) were measured at the time before and 30 minute, 1, 2, 3, 4, 5, 6 hours after the drugs were administered in a double-blind, placebo-controlled crossover method.

RESULT

The mean peak of FEV1, increased over baseline were 34% and 19% respectively, for ipratropium bromide and theophylline (P < 0.01), and the reaching duration were 1-2 hours and 2-3 hours, the proportion of patients attaining at least a 15% (P < 0.01) increase in the FEV1, responders were 19% and 50% (P < 0.01) respectively, for ipratropium bromide and theophylline. The average FEV1, increased during the 6-hours observation period were 18% for ipratropium bromide and 8% for theophylline (P < 0.01). The mean duration of FEV1 > 15% was 3.6 and 1.6 hours respectively.

CONCLUSION

Ipratropium bromide nebulized is a more potent bronchodilator than the oral theophylline in patients with chronic airflow obstruction.