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Kenji Yoshimura, Ryoji Maekura, Toru Hiraga, Seigo Kitada, Keisuke Miki, Mari Miki, Yoshitaka TateishiDepartment of Respiratory Medicine, Toneyama National Hospital, Osaka, JapanBackground: Tiotropium partially relieves exertional dyspnea and reduces the risk of congestive heart failure in chronic obstructive pulmonary disease (COPD) patients. However, its effect on the sympathetic activation response to exercise is unknown.Aims: This study aimed to determine whether tiotropium use results in a sustained reduction in sympathetic activation during exercise.Methods: We conducted a 12-week, open-label (treatments: tiotropium 18 µg or oxitropium 0.2 mg × 3 mg), crossover study in 17 COPD patients. Treatment order was randomized across subjects. The subjects underwent a pulmonary function test and two modes of cardiopulmonary exercise (constant work rate and incremental exercise) testing using a cycle ergometer, with measurement of arterial catecholamines after each treatment period.Results: Forced expiratory volume in 1 second and forced vital capacity were significantly larger in the tiotropium treatment group. In constant exercise testing, exercise endurance time was longer, with improvement in dyspnea during exercise and reduction in dynamic hyperinflation in the tiotropium treatment group. Similarly, in incremental exercise testing, exercise time, carbon dioxide production, and minute ventilation at peak exercise were significantly higher in the tiotropium treatment group. Plasma norepinephrine concentrations and dyspnea intensity were also lower during submaximal isotime exercise and throughout the incremental workload exercise in the tiotropium treatment group.Conclusion: Tiotropium suppressed the increase of sympathetic activation during exercise at the end of the 6-week treatment, as compared with the effect of oxipropium. This effect might be attributed to improvement in lung function and exercise capacity and reduction in exertional dyspnea, which were associated with decreases in respiratory frequency and heart rate and reduced progression of arterial acidosis.Keywords: chronic obstructive pulmonary disease (COPD), anticholinergics, exercise testing, sympathetic activation

Nuclear emulsion plates for studying elementary particle physics as well as cosmic ray physics are very powerful tracking tools with sub-micron spatial resolutions of charged particle trajectories. Even if gamma rays have to be detected, electron-positron pair tracks can provide precise information to reconstruct their direction and energy with high accuracy. Recent developments of emulsion analysis technology can digitally handle almost all tracks recorded in emulsion plates by using the Hyper Track Selector of the OPERA group at NAGOYA University. On the other hand, the potential of time resolutions have been equipped by emulsion multilayer shifter technology in the GRAINE (Gamma Ray Astro-Imager with Nuclear Emulsion) experiments, the aims of which are to detect cosmic gamma rays such as the Vela pulsar stellar object by precise emulsion tracking analysis and to study cosmic ray particle interactions and chemical compositions. In this paper, we focus on the subject of cosmic ray nuclei detection in the GRAINE balloon flight experiments launched at Alice Springs, Australia in May 2015.

Nuclear emulsion plates for studying elementary particle physics as well as cosmic ray physics are very powerful tracking tools with sub-micron spatial resolutions of charged particle trajectories. Even if gamma rays have to be detected, electron-positron pair tracks can provide precise information to reconstruct their direction and energy with high accuracy. Recent developments of emulsion analysis technology can digitally handle almost all tracks recorded in emulsion plates by using the Hyper Track Selector of the OPERA group at NAGOYA University. On the other hand, the potential of time resolutions have been equipped by emulsion multilayer shifter technology in the GRAINE (Gamma Ray Astro-Imager with Nuclear Emulsion) experiments, the aims of which are to detect cosmic gamma rays such as the Vela pulsar stellar object by precise emulsion tracking analysis and to study cosmic ray particle interactions and chemical compositions. In this paper, we focus on the subject of cosmic ray nuclei detection in the GRAINE balloon flight experiments launched at Alice Springs, Australia in May 2015.