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BACKGROUND: There are a few studies about paradoxical bronchodilator response (BDR), which means a decrease in forced expiratory volume in 1 second (FEV(1)) or forced vital capacity (FVC) after short-acting bronchodilator administration in patients with chronic obstructive pulmonary disease (COPD). We evaluated the effect of paradoxical BDR on the clinical outcomes of COPD patients in South Korea. METHODS: We analyzed the KOrea COpd Subgroup Study team (KOCOSS) cohort data in South Korea between January 2012 and December 2017. BDR was defined as at least a 12% and 200-mL reduction in FEV(1) or FVC after bronchodilator administration. RESULTS: A total of 1,991 patients were included in this study. A paradoxical BDR was noted in 57 (2.9%) patients and was independently associated with worse dyspnea and poor quality of life. High C-reactive protein (CRP) levels were associated with a paradoxical BDR (OR, 1.05; 95% CI, 1.01–1.09; P=0.003). However, paradoxical BDR was not associated with severe acute exacerbations. Pre-bronchodilator FEV(1) (L) showed a higher area under the curve (AUC) for predicting severe acute exacerbations than the post-bronchodilator FEV(1) (L) in the paradoxical BDR group (0.788 vs. 0.752). CONCLUSION: A paradoxical reduction of FEV(1) or FVC after bronchodilator administration may be associated with chronic inflammation in the airway and independently associated with worse respiratory symptoms and poor quality of life.

Air embolism is a rare, fatal complication of computed tomography (CT)‐guided transthoracic needle biopsy (TTNB) of the lung. Here, we report a patient who developed an air embolism after CT‐guided TTNB, which led to ST‐elevation myocardial infarction and acute cerebral ischemia. The patient recovered completely without critical sequelae and was diagnosed with adenocarcinoma harboring activating epidermal growth factor receptor (EGFR) mutation. The patient responded to subsequent treatment with gefitinib. Key points Signficant findings of the study Air embolism is a rare, fatal complication of CT‐guided transthoracic lung biopsy. Only a few cases have been previously reported where myocardial and cerebral infarction occurred after TTNB, demonstrated not only on CT scan, but also electrocardiogram and electroencephalogram. What this study adds Detection of driver gene mutation is crucial for planning lung cancer treatment. Despite the need for tissue biopsy, air embolism propagation to vital organs could result in severe end‐organ damage and multidisciplinary approaches are needed to improve initial outcomes., Systemic air embolism developed after CT‐guided TTNB, leading to ST‐elevation, myocardial infarction and acute ischemic stroke. The patient recovered completely without sequelae and was diagnosed with adenocarcinoma harboring activating EGFR mutation. Treatment with gefitinib showed a response.

Background The fractional exhaled nitric oxide (FENO) test is useful in asthma patients. However, a few studies on its usefulness in chronic obstructive pulmonary disease (COPD) patients have been reported. We analyzed the FENO level distribution and clinical characteristics according to the FENO level in COPD patients. Methods From December 2014 to June 2019, COPD patients who underwent pulmonary function and FENO tests at Chonnam National University Hospital were retrospectively evaluated for FENO, comorbidities, asthma history, blood eosinophil, and pulmonary function test. The high FENO group was defined as those with FENO level>25 parts per billion (ppb). Results A total of 849 COPD patients (mean age, 70.3±9.4 years) were included. The mean forced expiratory volume at 1 second was 66.5±21.7% and the mean FENO level was 24.3±20.5 ppb. Patients with FENO ≤25 ppb were 572 (67.4%) and those with FENO >25 ppb were 277 (32.6%). Blood eosinophil percentage was significantly higher (4.2±4.8 vs. 2.7±2.5, p3% (46.9% vs. 34.8%, p=0.001) and asthma history (25.6% vs. 8.6%, p3%, and positive bronchodilator response (BDR) were independent risk factors for the high FENO level (adjusted odds ratio [aOR], 3.85; p

Background The concurrence of sarcoidosis and primary lung cancer is very rare. We report a very rare case with a delayed diagnosis of primary lung cancer due to its misdiagnosis as worsening of pulmonary sarcoidosis. Case presentation A 68-year-old man presented to the outpatient department for evaluation of a mass in the right hilar area with lymphadenopathies in subcarinal and both interlobar areas on chest computed tomography (CT). Sufficient core samples were obtained from subcarinal and bilateral interlobar lymph nodes using endobronchial ultrasonography (EBUS) guided transbronchial needle aspiration (TBNA). EBUS could not reach the right hilar lymph node due to its high angle. The pathologic findings were consistent with sarcoidosis. After 5 months, chest CT revealed aggravation of the right upper paratracheal lymphadenopathy. Assuming worsening of sarcoidosis, he was prescribed an oral corticosteroid for 5 months. However, follow-up chest CT showed a newly developed right lower paratracheal lymphadenopathy and worsening right hilar lymphadenopathy. Bronchoscopy and EBUS were performed once again. Transbronchial lung biopsy from the right upper lobe and EBUS-TBNA from the right lower paratracheal lymph node revealed adenocarcinoma from the lung. Conclusions Although coexistence of sarcoidosis and lung cancer is very rare, the clinician should consider the possibility of accompanying lung cancer in sarcoidosis patients who are not responding to initial corticosteroid therapy.

BackgroundDendritic cells (DCs) are specialized antigen-presenting cells known to bridge innate and adaptive immune reactions. However, the relationship between circulating DCs and Orientia tsutsugamushi infection is unclear. Therefore, this study aimed to examine the level and function of plasmacytoid DCs (pDCs) and conventional DCs (cDCs), two subsets of circulating DCs, in scrub typhus patients.MethodsThe study included 35 scrub typhus patients and 35 healthy controls (HCs). pDC and cDC levels, CD86 and CD274 expression, and cytokine levels were measured using flow cytometry.ResultsCirculating pDC and cDC levels were found to be significantly reduced in scrub typhus patients, which were correlated with disease severity. The patients displayed increased percentages of CD86+ pDCs, CD274+ pDCs, and CD274+ cDCs in the peripheral blood. The alterations in the levels and surface phenotypes of pDCs and cDCs were recovered in the remission state. In addition, the production of interferon (IFN)-α and tumor necrosis factor (TNF)-α by circulating pDCs, and interleukin (IL)-12 and TNF-α by circulating cDCs was reduced in scrub typhus patients. Interestingly, our in vitro experiments showed that the percentages of CD86+ pDCs, CD274+ pDCs, and CD274+ cDCs were increased in cultures treated with cytokines including IFN-γ, IL-12, and TNF-α.ConclusionsThis study demonstrates that circulating pDCs and cDCs are numerically deficient and functionally impaired in scrub typhus patients. In addition, alterations in the expression levels of surface phenotypes of pDCs and cDCs could be affected by pro-inflammatory cytokines.

Purpose Fluorescence in situ hybridization (FISH) using tumor tissue is the gold standard for detection of anaplastic lymphoma kinase (ALK) rearrangement in non-small cell lung cancer (NSCLC). However, this method often is not repeatable due to difficulties in the acquisition of tumor tissues. Blood-based liquid biopsy using reverse transcription polymerase chain reaction (RT-PCR) is expected to be useful to overcome this limitation. Here, we investigated the feasibility of liquid biopsy using plasma and platelets for detection of ALK rearrangement and prediction of ALK inhibitor treatment outcomes. Methods ALK-FISH assays were performed in 1128 tumor specimens of NSCLC between January 2015 and June 2018. We retrospectively analyzed formalin-fixed paraffin-embedded (FFPE) tissues from previously confirmed FISH-positive (n = 199) and -negative (n = 920) cases. We recruited patients who had available tissue specimens and agreed to venous sampling. RNA was extracted from FFPE blocks, plasma, and platelets. Fusion RNA of echinoderm microtubule-associated protein-like 4 (EML4)-ALK was detected by quantitative PCR. Results Thirty-three FISH-positive and 28 FISH-negative patients were enrolled. In validation, data compared with FISH, RT-PCR using FFPE tissues showed 54.5% sensitivity, 78.6% specificity, and 75.5% accuracy. Liquid biopsy had higher sensitivity (78.8%), specificity (89.3%) and accuracy (83.6%). Higher positivity for liquid biopsy was shown in subgroups with delayed (≥ 6 months from diagnosis) blood sampling (plasma, 85.7%; platelets, 87.0%). In 26 patients treated with crizotinib, the platelet-positive subgroup showed longer median duration of treatment (7.2 versus 1.5 months), longer median progression-free survival (5.7 months versus 1.7 months), a higher overall response rate (70.6% versus 11.1%), and a higher disease control rate (88.2% versus 44.4%) than the platelet-negative subgroup. Conclusion Liquid biopsy could have applications in the diagnosis of ALK-positive NSCLC, even when using RT-PCR, and platelets can be useful for predicting treatment outcomes of ALK inhibitors.

Background/aims Peripheral eosinophilia during tuberculosis (TB) treatment is common, but has not been fully evaluated. The aim of this study was to determine the prevalence and clinical significance of peripheral blood eosinophilia in patients undergoing anti-TB treatment. Methods We retrospectively reviewed the clinical and laboratory data of patients who received anti-TB treatment and had peripheral blood eosinophilia (> 5% of the total white blood cell count) at the Chonnam National University Hospital between January 2010 and December 2014. Results Of all 2,234 patients with TB who received anti-TB treatment, 397 (17.8%) had peripheral blood eosinophilia. Of the 397 with eosinophilia, we reviewed the data of 262 (66%), and cutaneous adverse drug reactions (CADRs) were observed in 161 (61.5%). Of the 161 with CADRs, itching (47.2%) and skin rash (47.8%) were common. Older age, abnormal liver function, and higher peak blood eosinophil percentage were associated with CADRs in multivariate analysis. There was a significant relationship between increased peak eosinophil counts and the degree of severity of CADRs. Conclusion Peripheral blood eosinophilia is a relatively common occurrence during anti-TB treatment. Peripheral blood eosinophil counts were higher according to the degree of severity of CADRs.

Objective Pneumocystis jirovecii pneumonia (PCP) is a fatal respiratory infection, mostly associated with immunocompromised conditions. Several reports have described PCP development in patients who were not immunocompromised, but the clinical course and prognosis of PCP are not well understood. We compared the clinical characteristics and prognoses between patients with and without immunocompromised conditions who developed PCP. Methods We retrospectively analyzed patients who had been treated for PCP from three hospitals. We defined immunocompromised (IC) status as following: human immunodeficiency virus (HIV) infection; hematological malignancy; solid organ tumor under chemotherapy; rheumatic disease; medication with immunosuppressive agents. Patients without immunocompromised status were defined as being non-immunocompromised (non-IC). Results The IC and non-IC groups comprised 173 and 14 patients. The median ages were 62.0 and 74.0 years in the IC and the non-IC group, respectively. The median interval between admission and anti-PCP treatment was significantly longer for patients in the non-IC group than that for patients in the IC group (7 vs. 2 days). The in-hospital mortality rates were significantly higher for patients in the non-IC group than that for patients in the IC group (71.4% vs. 43.9%; P = 0.047). A longer interval between admission and anti-PCP therapy was associated with increased 90-day mortality rate in patients with PCP (hazard ratio, 1.082; 95% confidence interval, 1.015–1.153; P = 0.016). Conclusions Patients with PCP with no predisposing illnesses were older and had higher mortality rates than IC patients with PCP. Delayed anti-PCP treatment was associated with increased 90-day mortality.

BACKGROUND In cases of EGFR-tyrosine kinase inhibitor (TKI) failure, re-biopsy may be useful to understand resistance mechanisms and guide further treatment decisions. However, performing re-biopsy is challenging because of several hurdles. We assessed the feasibility of re-biopsy in advanced non-small cell lung cancer (NSCLC) patients in real-world clinical practice. METHODS We retrospectively reviewed the clinical and pathologic data of advanced NSCLC patients who experienced disease progression after previous treatment with EGFR-TKIs at a single tertiary hospital in Korea between January 2014 and December 2016. Re-biopsy specimens included small biopsy, surgical tissue, or liquid-based cytology. EGFR mutation was tested using peptide nucleic acid-mediated clamping PCR. RESULTS Of the 230 NSCLC patients that experienced progression after EGFR-TKI therapy, 105 (45.7%) underwent re-biopsy. Re-biopsy was successfully performed in 94 (89.5%) patients, and 11 patients were diagnosed with no malignancy. The complication rate was 8.6%, including seven cases of pneumothorax. EGFR mutation testing was performed on 75 patients using re-biopsy specimens. Of the 57 patients who had sensitizing mutations at diagnosis, T790M mutations were found in 19 (33.3%), while 38 (66.7%) had no T790M mutation. Multivariate analysis showed that the re-biopsy group was younger (P = 0.002) and exhibited a previous response to EGFR-TKIs (P

Rationale: Current guidelines for advanced non-small cell lung cancer (NSCLC) recommend the use of targeted agents for specific driver genes after confirming genetic alterations. Although epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement are usually mutually exclusive, EGFR and ALK co-alterations have been reported increasingly in cases of NSCLC. However, the optimal treatment for these cases has not been established. Patient concerns: This case series describes three patients diagnosed with advanced non-squamous NSCLC who harbored EGFR and ALK co-alterations. The complaints for each case are as follows: 57-year-old woman with coughing and dyspnea in case 1, 32-year-old man with diplopia in case 2 and 77-year-old woman with chest discomfort in case 3. Diagnoses: Three never-smokers were diagnosed pathologically with stage IV adenocarcinoma of the lung. Subsequent molecular studies revealed the EGFR L858R mutation gene and ALK rearrangement, which were proven by real-time polymerase chain reaction and fluorescence in situ hybridization, respectively. Interventions: All 3 patients received first-line therapy with EGFR-tyrosine kinase inhibitors (TKIs). Cases 1 and 2 were treated with ALK-TKIs as second-line therapy and received additional EGFR-TKIs as third- and fourth-line regimens. Outcomes: The patients achieved partial responses to EGFR-TKIs according to radiologic findings. However, second-line ALK-TKI therapy was ineffective in cases 1 and 2. Lessons: Cases of NSCLC with concomitant EGFR mutation and ALK rearrangement are rare, and the selection of an optimal targeted therapy is challenging. Here, EGFR-TKI appeared to yield better outcomes than ALK-TKI in patients with NSCLC who harbored EGFR/ALK co-alterations.

Objective This study aimed to evaluate hypersensitivity reactions to anti-tuberculosis (TB) drugs. Methods We retrospectively compared the clinical manifestations and treatment outcomes of single and multiple drug hypersensitivity reactions (DHRs). Results Twenty-eight patients were diagnosed with anti-TB DHRs using oral drug provocation tests. Of these 28 patients, 17 patients (60.7%) had DHRs to a single drug and 11 (39.3%) had multiple DHRs. The median age of patients was 57.5 years (interquartile range [IQR], 39.2–73.2). Of the total patients, 18 patients (64.3%) were men. The median number of anti-TB drugs causing multiple DHRs was 2.0 (IQR 2.0–3.0). Rifampin was the most common drug that caused DHRs in both the single and multiple DHR groups (n = 8 [47.1%] and n = 9 [52.9%], respectively). The treatment success rate was lower in the multiple DHR group than in the single DHR group; however, the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543). Conclusions Multiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug. The treatment outcomes appeared to be poorer in patients with multiple DHRs than in those with single DHRs.

Rational Hemocoagulase, a hemostatic, is used in patients with trauma, gastrointestinal bleeding, or pulmonary hemorrhage or those undergoing surgery. However, paradoxical bleeding after hemocoagulase administration is not considered a clinically significant adverse effect. Here, we report a case of paradoxical pulmonary hemorrhage associated with hypofibrinogenemia after administration of the hemocoagulase batroxobin in a patient with hemoptysis. Patient concerns An 86-year-old woman complained of hemoptysis during hospitalization with organophosphate poisoning. Hemocoagulase was administered to manage bleeding; however, bleeding signs, such as hemoptysis, massive epistaxis, and ecchymosis, recurred. Diagnoses The patient was diagnosed with acquired hypofibrinogenemia on the basis of the reduced plasma fibrinogen level after hemocoagulase administration and lack of other causes of bleeding. Intervention Hemocoagulase administration was discontinued, and fibrinogen-containing plasma products were administered. Outcomes The plasma fibrinogen level normalized and bleeding signs did not recur. Lessons It is necessary to measure plasma fibrinogen levels regularly in patients undergoing hemocoagulase administration and discontinue its administration when acquired hypofibrinogenemia is detected.

We analyze the performance of IEEE 802.15.4 MAC with superframe structure including the inactive period where each device is in non-saturated conditions. The superframe structure with a inactive period has the following two primary characterizations: (i) deferment of packet transmission until the following active period due to insufficient backoff slots for completing the packet transmission, (ii) high competition in the head part of the active period due to packets which were deferred from the previous active period and were arrived during the previous inactive period. These characterizations complicate the construction of a mathematical model of MAC with the superframe structure including a inactive period. In this paper, we construct a discrete time Markov chain (DTMC) model which takes into account these characterizations. By analyzing the DTMC, we obtain the main performance measures such as throughput, packet delay distribution, packet loss probability and energy consumptions of devices and the PAN coordinator. We demonstrate high accuracy of the proposed model by comparing the numerical results with simulation results. Finally, we optimize the lengths of the beacon interval and the active period to maximize the battery life of devices while satisfying quality-of-service (QoS) constraints on packet delay and packet loss probability.

Nowadays, a number of sensors which are placed in industrial complex are monitoring areas involving chemical leak and other faults. However, even in the presence of the sensors, chemical leaks, sometimes involving huge amount of chemicals, continuously led to big losses in the industrial complex. In most industries, sensor installation has been performed using past experience or using senor manufacturers` guideline; which leads to poor performance of the installed sensor grid. Therefore, we investigate an optimal placement methodology of point sensors for rapid detention and response when chemical leaks happen. This research suggests a generalized formulation suitable for the optimized decision making of minimizing number of sensors to be placed and increasing the fraction of covered scenarios under assumption of negligible effect of other structures. The proposed method has been verified for suitable performance for simple leak scenario simulations, by achieving the safety objectives and guaranteeing safe process operations.

Pulmonary sclerosing pneumocytoma (PSP) is a rare benign neoplasm that predominantly affects middle‐aged Asian women. PSP is often asymptomatic and demonstrates a solitary pulmonary nodule on radiologic examination. We report a case of PSP initially misdiagnosed as lung cancer because of strong 18F‐fluorodeoxyglucose (FDG) uptake revealed by 18F‐FDG positron emission tomography‐computed tomography scan. After surgery, pathology revealed that the tumor cells were immunopositive for epithelial membrane antigen and thyroid transcription factor‐1. The patient has been followed up without complication or recurrence.

Rationale Influenza is an infection caused by the influenza virus, and its symptoms are mostly mild and self-limiting. However, influenza can cause severe or fatal complications in high-risk patients. Although tracheobronchitis is one of the common complications of influenza, necrotizing tracheobronchitis is very rare. Herein, we describe a case of necrotizing tracheobronchitis causing airway obstruction complicated by pandemic 2009 H1N1 influenza. Patient concerns A 60-year-old man presented with fever and dyspnea. On arrival at the emergency room (ER), the patient received oxygen 4 L/minute via a nasal prolong owing to mild hypoxemia. And invasive mechanical ventilation was needed 5 hours after arrival at the ER due to progressive hypoxemia. Diagnoses Fiberoptic bronchoscopy was performed owing to bloody secretion in the endotracheal tube and revealed diffuse tracheobronchitis with necrotic and hemorrhagic materials obstructing the trachea and bronchus. The pandemic 2009 H1N1 influenza virus was detected from the bronchial washing sample; no other microorganism was detected. Intervention He received peramivir plus oseltamivir and broad-spectrum antibiotics. Outcomes The bloody secretion continued. He developed cardiac arrest due to airway obstruction on the 6th day of admission. After cardiac arrest, his condition progressed to multi-organ failure, and the patient died on the 10th day of admission. Lessons We suggest that necrotizing tracheobronchitis be considered in patients with influenza who present with unexplained hypoxemia.

Looking at the large and small fire, explosion, or release accidents that occurred recently, we can see that the accident of subcontractor workers has been increased in the contractor workplace while a harmful or dangerous maintenance works. In this study, the actual status of subcontractor's safety management was examined by using the questionnaire to the contractor who submitted the process safety report. In order to improve the safety management of subcontractors, the responsibility and rational role-sharing between the contractors and subcontractors were reviewed. Also, Providing safety and health information and worker protection measures during maintenance were investigated. The results of this study can be used to help strengthen and improvement safety management of the subcontractor at the time of a hazardous or dangerous works. In addition, it will be utilized to reduce industrial accidents and to build mutual cooperation relationship between contractor and subcontractor.

We investigate optimal call admission control (CAC) policy for multicast streaming services (MSS) in 3rd generation (3G) and beyond wireless mobile networks. Several MSS sessions are supported simultaneously in a bandwidth-limited network. Active sessions are those that are currently serving some users, and inactive sessions are those that are currently not serving any users. An admission decision in MSS is required only when an inactive session is requested, unlike in unicasting. For this reason, if a user request for an inactive MSS session arrives, we should make an admission decision in anticipation of ( i ) the possible reward earned based on users served during a session active time generated by accepting it, and ( ii ) the influence of the session active time upon the future status of network bandwidth and admission decisions. Our objective is to determine when to admit or block a user asking an inactive MSS session to achieve the optimality in rewards. We formulate this problem as a semi-Markov decision process (SMDP), and a value iteration algorithm is used to obtain an optimal stationary deterministic policy. We also derive the user blocking probability of the optimal policy by analyzing an embedded Markov chain induced by it.

Carbon dioxide was designated as one of greenhouse gases that cause global warming. Among various ways to solve the emission issue, the 3rd-generation biomass (algae) production is considered as a viable method to reduce in the atmosphere. In this research, we propose a design of an innovative sustainable production system by utilizing the 3rd generation biomass in the environment of floating production storage and offloading (FPSO). Existing biomass production systems depend on the solar energy and they cannot continue producing biomass at night. Electricity produced from offshore wind farms also need an efficient way to store the energy through energy storage system (ESS) or deliver it real-time through power grid, both requiring heavy investment of capital. Thus, we design an offshore grid structure harnessing LED lights to supply the necessary light energy, by using the electricity produced from the wind farm, resulting in the maximized production of biomass and efficient use of wind farm energy. The final design integrates the biomass production system enhanced by LED lights with a wind power generation. The suggested NLP model for the optimal design, implemented in GAMS, would be useful for designing improved offshore biomass production systems combined with the wind farm.

A suitable monitoring method is necessary for successful policy implementation and its evalua-tion, required for effective prevention of abnormal fire occurrences. To do this, there were studies for applying control charts of quality management to fire occurrence monitoring. As a result, it was proved that more fire occurs in winter and its trend moves yearly-basis with some patterns. Although it has trend, if we apply the same criteria for each time, inefficient overreacting fire prevention policy will be accomplished in winter, and deficient policy will be accomplished in summer. Thus, applying different control limits adaptively for each time would enable better forecasting and monitoring of fire occurrences. In this study, we treat fire occurrences as time series model and propose a method for configuring its coefficients with ARIMA model. Based on this, we expect to carry out advanced analysis of fire occurrences and reasonable implementation of prevention activities. Key words : fire occurrence pattern, time series, ARIMA model, autocorrelationKIGAS Vol. 19, No. 2, pp 20~28, 2015 http://dx.doi.org/10.7842/kigas. 2015.19.2.20(Journal of the Korean Institute of Gas)

Human epidermal growth factor receptor 2 (HER2) mutation in non-small cell lung cancer (NSCLC) is an oncogenic driver that possibly becomes a druggable target to HER2-targeted therapy. The benefit of HER2-targeted therapy is much less defined especially in eastern populations. We provide evidence of clinical benefit of afatinib in a 50-year-old Asian woman with HER2-mutant NSCLC who previously failed cytotoxic chemotherapy and gefitinib treatment. Next-generation sequencing of the tumor tissue revealed a HER2 exon 20 mutation (c.2437A>G), which has never been reported. The patient was treated with afatinib for more than four months. She showed rapid radiologic response within a month, and maintained stable state until the last dose of afatinib., Graphical Abstract

Background: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). Methods: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014. Patients who underwent surgery or experienced trauma were excluded from this study. Results: Among the 127 patients requiring PMV, 41 (32.3%) were successfully weaned from MV. The median age of the weaning failure group was higher than that of the weaning success group (74.0 vs . 70.0 years; P=0.003). The proportion of male patients was 58.5% in the weaning success group and 72.1% in the weaning failure group, respectively. The most common reasons for ICU admission were respiratory causes (66.1%) followed by cardiovascular causes (16.5%) in both groups. ICU mortality and in-hospital mortality rates were 55.1% and 55.9%, respectively. In the multivariate analysis, respiratory causes of ICU admission [odds ratio (OR), 3.98; 95% confidence interval (CI), 1.29–12.30; P=0.016] and a high sequential organ failure assessment (SOFA) score on day 21 of MV (OR, 1.47; 95% CI, 1.17–1.85; P=0.001) were significantly associated with weaning failure in patients requiring PMV. The area under the receiver operating characteristic (ROC) curve of the SOFA score on day 21 of MV for predicting weaning failure was 0.77 (95% CI, 0.67–0.87; P=0.000). Conclusions: Respiratory causes of ICU admission and a high SOFA score on day 21 of MV could be predictive of weaning failure in patients requiring PMV.

Chlorine-containing bleach can cause acute respiratory distress syndrome (ARDS) and chemical burns. However, simultaneous occurrence of the two conditions caused by this agent is very rare. We describe the case of a 74-year-old female who presented with shortness of breath and hemoptysis following accidental exposure to chlorine-containing bleach. She had second- to third-degree chemical burns on both buttocks and thighs, and received mechanical ventilation because of the development of ARDS. Mechanical ventilation was discontinued on day 6 of hospitalization because of the rapid improvement of hypoxemia, and the patient was transferred to another hospital for further management of the chemical burns on day 18.

In this study, we suggest a system to build the monitoring model for compressed natural gas (CNG) stations, operated in only non-stationary mod es, and perform the real-time mon-itoring and the abnormality diagnosis using principal component analysis (PCA) that is suitable for processing large amounts of multi-dimensional data among mu ltivariate statistical analysis methods. We build the model by the calculation of the new characteristic variables, called as the major components, finding the factors representing the trend of process operation, or a combina-tion of variables among 7 pressure sensor data and 5 temperature sensor data collected from a CNG station at every second. The real-time monitoring is performed reflecting the data of process operation measured in real-time against the built model. As a r esult of conducting the test of mon-itoring in order to improve the accuracy of the system and verification, all data in the normal operation were distinguished as normal. The cause of abnormality could be refined, when abnor-mality was detected successfully, by tracking the variables out of the score plot.Key words : fault detection, monitoring, diagnosis, principal component analysis (PCA), CNG station

In this work, a ring-rolling process to formulate ring-shaped components for a wind turbine is designed by means of a simulation and in an experimental approach. The target of the ring-rolling design is a yaw ring with an outer diameter of approximately 3,130 mm. The ring-rolling design includes the design of the geometry and the optimization of the process variables. A calculation method was used for the geometry design, in this case for the initial billet and the pre-form (or blank) sizes, and for the final rolled ring shape. Also, a deformation map-based approach was utilized to determine the initial ring-rolling temperature and feed rate of the mandrel. A three-dimensional finite element method was used to predict the formation of rolling defects and the deformed shape in the ring-rolled components. The design criteria are to achieve uniform distributions of the strains and temperatures as well as defect-free ring-shaped components. Finally, an optimum process design to obtain a sound large-scale yaw ring without defects is proposed. It is validated by comparisons between the experimental data and the FE analysis results.

This study aims to suggest risk management plan including safety measures through hazard iden-tification followed by consequence analysis in petrochemical plants. Consequence analysis was performed through practical release scenario by using PHAST RISK(ver. 6.7) software in the propylene recovery proc-ess(PRP). As results, consequences by fire or explosion accidents in the depropanizer zone, deethanizer zone and heat pump zone were relatively larger than other else zones among six process zones in the PRP. In the case of jet fire, it is recommendable not to install residence building within 200 m of the process zone. Additionally, process zones having large inventory or high pressure must be prevented from accidents and required to estab-lish quick response against accidents. Key words : consequence analysis, fire, explosion, propylene recovery process, PHAST RISK 1) I. 서 론 에너지 산업의 급속한 발전에 따라 석유화학공장은 시설이 복잡하고, 다양화되고 있으며, 특히 다양한 종류의 유해물질을 대량으로 취급하고 있다 . 또한 † Corresponding author:kimto@mju.ac.kr Copyright ⓒ 2014 by The Korean Institute of Gas

The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.

Background: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD- 1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. Methods: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. Results: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ≥1% and ≥50%, respectively. The patients were significantly older in TPS ≥1% group than in TPS

BACKGROUND: The radiologic change by tuberculosis can be associated with airflow obstruction. However, the association between airflow obstruction and abnormalities on chest X-ray (CXR) other than tuberculosis (nontuberculous lesion) is not well known. We evaluated the association between airflow limitation and nontuberculous lesion. METHOD: The data of the 4th & 5th Korea National Health and Nutrition Examination Survey; a cross-sectional survey in the general population of Korea was analyzed. CXR findings were categorized into 3 groups; normal, tuberculosis (active, suspicious, inactive tuberculosis), and nontuberculous lesion (pneumonia, emphysema, pulmonary nodule, and others). We compared the prevalence of airflow obstruction according to the presence of the radiologic change. Airflow obstruction was defined as FEV 1 /FVC RESULTS: 11,969 subjects (age ≥ 40 years) who took the spirometry and simple chest radiography were included. A total of 1,746 (14.6%) subjects showed airflow obstruction. A total of 911 (7.6%) and 537 (4.5%) subjects showed radiologic change by tuberculosis and nontuberculous lesion, respectively. Among them, 40.2% for tuberculosis lesion (n= 366/911) and 32.6% for nontuberculous lesion (n= 175/537) had airflow obstruction. For the subjects with normal chest X-ray, the prevalence of airflow obstruction was only 11.5% (n= 1205/10521). The adjusted odds ratio for airflow obstruction according to the radiologic changes, tuberculosis and nontuberculous lesion, was 3.295 (95% CI: 2.78-3.905) and 2.338 (95% CI: 1.884-2.902), respectively. CONCLUSION: The abnormal X-ray change by nontuberculous lesion as well as tuberculosis lesion was associated with airflow limitation.

Background Since the introduction of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.

Background: The rate of hospitalization due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is increasing. Few studies have examined the clinical, laboratory and treatment differences between patients in general wards and those who need transfer to an intensive care unit (ICU). Methods: We retrospectively reviewed clinical, laboratory, and treatment characteristics of 374 patients who were initially admitted to the general ward at Chonnam National University Hospital in South Korea due to AECOPD (pneumonic, 194; non-pneumonic, 180) between January 2008 and March 2015. Of these patients, 325 were managed at the medical ward during their hospitalization period (ward group), and 49 required ICU transfer (ICU group). We compared the clinical, laboratory, and treatment characteristics associated with ICU transfer between patients with AECOPD with and without pneumonia. Results: Male patients were 86.5% in the ward group and 79.6% in the ICU group. High glucose levels [median 154.5 mg/dL, interquartile range (IQR) 126.8–218.3 in ICU group vs. median 133.0, IQR 109.8–160.3 in ward group], high pneumonia severity index scores (median 100.5, IQR 85.5–118.5 vs. median 86.0, IQR 75.0–103.5), low albumin levels (median 2.9 g/dL, IQR 2.6–3.6 vs . median 3.4, IQR 3.0–3.7), and anemia (73.3% vs . 43.3%) independently increased the risk of ICU transfer in the pneumonic AECOPD group. High PaCO 2 levels (median 53.1 mmHg in ICU group, IQR 38.5–84.6 vs . median 39.7, IQR 34.2–48.6 in ward group) independently increased the risk of ICU transfer in the non-pneumonic AECOPD group. Treatment with systemic corticosteroids (≥30 mg of daily prednisolone) during hospitalization in the medical ward independently reduced the risk of ICU transfer in both groups. Conclusions: The characteristics associated with ICU transfer differed between the pneumonic and non-pneumonic AECOPD groups, and systemic corticosteroids use was associated with lower rate of ICU transfer in both groups.

Background Epidermal growth factor receptor (EGFR) gene mutation is a reliable predictive factor for response to EGFR-tyrosine kinase inhibitors (TKIs). The quantified EGFR value may also predict response and survival within an EGFR mutated group. Methods We conducted a retrospective study of 836 lung cancer patients. The patient sample was divided into two groups based on the mean delta cycle threshold (∆Ct) value. EGFR mutation tests using peptide nucleic acid (PNA)-mediated clamping polymerase chain reaction (PCR) were performed. The efficiency of PCR clamping was determined by measuring the Ct value and EGFR quantification was determined by the corrected ∆Ct value. Results EGFR mutation positivity was 30.1% and there were 235 single activating mutations. In this mutation group, the higher corrected ∆Ct value (≥ mean value) group showed better objective response (70.9% vs. 54.9%, P = 0.022) and clinical benefit rates (86.4% vs. 68.3%, P = 0.003) than the lower group. In addition, corrected ∆Ct values were significantly and inversely correlated with disease response (r = −0.184, P = 0.017). In multivariate analysis, both female gender (P = 0.014) and higher corrected ΔCt value (P = 0.012) were independent predictive factors for better clinical benefit rate. The higher corrected ΔCt value group had a tendency for longer progression-free survival than the lower group (P = 0.050). Conclusion The corrected ∆Ct value, which refers to EGFR quantification by PNA-mediated PCR clamping, can predict better clinical response to EGFR-TKI therapy. However, further study is warranted to determine its value as a biomarker to reflect survival.

The presence of human norovirus in the aquatic environment can cause outbreaks related to recreational activities and the consumption of norovirus-contaminated clams. In this study, we investigated the prevalence of norovirus genogroups I (GI) and II (GII) in the coastal aquatic environment in South Korea (March 2014 to February 2015). A total of 504 water samples were collected periodically from four coastal areas (total sites = 63), of which 44 sites were in estuaries (clam fisheries) and 19 were in inflow streams. RT-PCR analysis targeting ORF2 region C revealed that 20.6% of the water samples were contaminated by GI (13.3%) or GII (16.6%). The prevalence of human norovirus was higher in winter/spring than in summer/fall, and higher in inflow streams (50.0%) than in estuaries (7.9%). A total of 229 human norovirus sequences were identified from the water samples, and phylogenetic analysis showed that the sequences clustered into eight GI genotypes (GI. 1, 2, 3, 4, 5, 6, 7, and 9) and nine GII genotypes (GII. 2, 3, 4, 5, 6, 11, 13, 17, and 21). This study highlighted three issues: 1) a strong correlation between norovirus contamination via inflow streams and coastal areas used in clam fisheries; 2) increased prevalence of certain non-GII. 4 genotypes, exceeding that of the GII. 4 pandemic variants; 3) seasonal shifts in the dominant genotypes of both GI and GII.

Fire detection system is used for detection and alarm-generation of danger in case of fire. Most fire detection systems being used these days often malfunction from false positive and false neg-ative errors. To improve detection reliability, an integrated fire detection algorithm using multi-senor information of heat, smoke and carbon monoxide detectors is suggested, then built and tested using the LabVIEW environment. Simulated using sensor measurement data offered by National Institute of Standards and Technology (NIST), possibility of reducing false positive and false negative errors is verified.Key words : fire detection, LabVIEW, test bed, multi-sensor information, false positive error, false negative error 1) I. 서 론 최근 백화점, 대형 지하상가, 공공건물 등은 건축비용 상의 문제로 점차 고층화와 고밀도화가 되고 있으며, 이로 인해 재해가 발생할 경우에는 큰 피해를 초래하게 된다. 2011년도 국내 화재현황을 살펴보면, Fig. 1과 같이 부주의로 인한 화재가 16015건(36.5%)으로 가장 많고, 다음으로 전기적 요인으로 인한 화재가 10793 † Corresponding author:dongil@mju.ac.kr Copyright ⓒ 2012 by The Korean Institute of Gas

Systematic safety research by Korea Government has been made to enhance the safety of CNG (compressed natural gas) vehicles since the burst of compressed cylinder of an urban bus in August 9, 2010. This article summarizes some major activities to ensure the safety of CNG vehicles, which covers review of regulation, safety management system including standard of inspection and certification, and training program of inspectors and car mechanics. Specifically, the followings were reviewed; type of CNG cylinder, location of CNG cylinder, material and type of fuel line and vent line, modification of pipeline connection, installation of gas detector, installation of emergency shutdown valve, installation of protecting cover for cylinder, obligations for CNG vehicle filling station. improving periodical inspection, routine test on gas vehicles, training program for engaged in gas vehicles, and designation of safety manager for CNG bus company. This paper suggests how to improve safety of CNG vehicles as a result of review of above mentioned check items.Key words : CNG vehicles, safety improvement, regulation, safety management

In this paper, an analytical model of a cantilever beam having a midpoint load is considered for structural optimization and design. This involves creation of the geometry through a parametric study of all design variables. For this purpose, the optimization of the cantilever beam was elaborated in order to find the optimum geometry which minimizes its volume eventually for minimum weight by FEM (finite element method) analysis. Such geometry can be obtained by different combinations of width and height, so that the beam may have the same cross-sectional area, yet different dynamic behavior. So for optimum safe design, besides minimum volume it should have minimum vibration as well. In order to predict vibration, different dynamic analyses were performed simultaneously to identify the resonant frequencies and mode shapes belonging to the lowest three modes of vibration. Next, by introducing damping effects, the tip displacement and bending stress at the fixed end was evaluated under dynamic loads of varying frequency. Investigation of the results clearly shows that only structural analysis is not enough to predict the optimum values of dimension for safe design it must be aided by dynamic analysis as well.

Risk-based inspection (RBI) is a inspection technique suggesting inspection plan, such as inspection interval and inspection method, of the pressurized facilities based on its risk in the petrochemical, refinery and gas industries. Therefore, we can intensively and cost-effectively maintain, repair and manage the high-risk facilities through RBI technology. This paper reviews RBI technology, such as principle and implemental procedure of RBI, management of risks and facilities and return of investment through RBI, RBI technology at present and its application in domestic industries. In addition, some improvement directions of RBI are also proposed.

As a way to propose a method for the establishment of practical damage-minimizing plan for chemical plants, the release scenario was established by using API-581 BRD and the effect zone was estimated by the KS-RBI program supporting the quantitative cause analysis. And the risk assessment was performed. As a result, we found that to minimize the damage of a chemical plant, it is effective to use four release hole diameters (small, medium, large and rupture) and release time estimated according to the classes of detection and isolation systems. In addition, it can be safely said that through appling the damage areas considering weighted average by failure frequency and worst-case simultaneously, industrial sites can come up with the effective emergency response plan. Key words : damage-minimizing plan, effect zone, risk assessment, API-581, KS-RBI program, emergency response plan † Ⅰ. 서 론 화학공업은 고도의 기술집약적인 장치산업으로, 생산기술의 발전과 더불어 시설이 대규모화, 고속 † 주저자:kimto@mju.ac.kr화, 그리고 복잡화되고 있을 뿐만 아니라 유해․위험성이 큰 화학물질의 취급량이 증가되고 있다[1,2]. 따라서 최근에는 설비의 자동화, 안전설계, 안전설비 설치, 비상조치계획 수립 등을 통하여 사고위험을 최소화 하려는 노력이 꾸준히 진행되고 있다. 그러나 설비의 노후화, 조작자 실수, 기계적인 고장 등으로 인하여 화재 , 폭발독성물질의 누출 등과 같은 KIGAS Vol. 15, No. 2, April, 2011(Journal of the Korean Institute of Gas)

The interest about new and renewable energy is increasing to reduce the burden of problems by depletion of fossil fuels and air pollutions. For example, LNG/CNG and LPG are expected to be replaced, especially in transportation use, by HCNG mixture and DME-LPG mixture, respectively. Because these new energies are still flammable gases, it is not inherently safe from the explosion. In this research, the quantitative risk analysis for using alternative mixtures in existing recharging facilities has been studied by using three types of explosion models (TNT equivalency model, PHAST and CFD-based FLACS) to manage the risk effectively. The differences of results by models were compared against, and the practical ways of when and how to use these models were suggested. It was also predicted that conventional gas filling stations would be converted as new energy stations without additional explosion risk.

Background: Epidermal growth factor receptor (EGFR) mutations are well known predictive marker of targeted therapy. We compared the sensitivity of EGFR mutation detection techniques between matched achival lung cancer tissue and peripheral blood sample. Methods: We collected the paired samples from plasma and paraffin-embedded tumor tissue obtained before EGFR-tyrosine kinase inhibitor (EGFR-TKI). DNA extraction was performed using the QIAamp MinElute virus spin kit and EGFR mutation analysis was done by two detection methods. The current standard test is the PNAClampTM (Clamp) which is the PNA-based PCR clamping that selectively amplifies only the mutated target DNA sequence. The new technique is the PANAMutyperTM EGFR test (Mutyper), which use PNA clamping-assisted fluorescence melting curve analysis. Results: A total of 295 (188 male and 107 female) patients were analyzed in this study. The histologic types were composed of 258 adenocarcinoma, 22 squamous cell carcinoma and 15 others. Most were clinical stage IV (137, 46.4%) and the EGFR mutation rate of tissue sample by standard Clamp test was 25.7%. Plasma sensitivity was significantly higher in Mutyper than Clamp (71.2% vs. 30.0%, p Conclusions: Mutyper was useful liquid biopsy technique with better sensitivity than standard Clamp test. Citation Format: In-Jae Oh, Hyeong-Won Seo, Hyun-Ju Cho, Ha-Young Park, Bo-Gun Kho, Jin-Sun Chang, Tae-Ok Kim, Hong-Jun Shin, Cheol Kyu Park, Jung-Hwan Lim, Yong-Soo Kwon, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yoo-Duk Choi. Detection of epidermal growth factor receptor mutations from circulating tumor DNA versus archival tissue of lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5589.

Relatively little is known about the efficacy and safety of the programmatic use of bedaquiline and delamanid in multidrug-resistant tuberculosis (MDR-TB) treatment.This study evaluated 61 patients with MDR-TB treated with bedaquiline (n=39), delamanid (n=11) or both, either sequentially (n=10) or in coadministration (n=1), for >1 month, combined with a World Health Organization-recommended regimen.Of these, 49 (80.3%) were male and 12 (19.7%) were female. The median (interquartile range (IQR)) age was 53 (38.5–61.0) years. 42 (68.9%) patients had fluoroquinolone-resistant MDR-TB and 16 (26.2%) had extensively drug-resistant TB. The median (IQR) duration of treatment with bedaquiline and/or delamanid was 168 (166.5–196.5) days, with 33 (54.1%) receiving linezolid for a median (IQR) of 673 (171–736) days. Of the 55 patients with positive sputum cultures at the start of bedaquiline and/or delamanid treatment, 39 (70.9%) achieved sputum culture conversion within a median of 119 days. Treatment was halted in four patients (6.6%) because of prolonged Fridericia's corrected QT interval.Bedaquiline and delamanid were effective and safe for treating MDR-TB, with initial evidence of sequential administration of these two drugs as a viable treatment strategy for patients when an adequate treatment regimen cannot be constructed.

In this paper a new modeling method for an eddy current sensor is presented using geometric and electromagnetic data of a sensor and a measuring target It can predict not only sensor output but also medium behavior related to sensor output The geometric data of a sensor coil and the eddy current generated on a measuring target are simplified to an array of circular loops. And to perform computations of the network circuit between sensor coil loops and eddy current loops using the geometric and electromagnetic data in order to consider all possible interactions, the equivalent network circuit of eddy current sensor’s behavior has been drawn. Because the sensor’s initial value, medium behavior, and final value can be shown quantitatively by the proposed modeling method as the geometric and electromagnetic data varies, it can precisely predict the sensor output depending on the measuring goal and application field. Thus the model can be utilized to improve accuracy, eliminate the need for calibration before use, and produce the best design for any given purpose.

Background The sensitivity of interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection could be affected by conditions of immune dysregulation. For this reason, diabetes mellitus (DM) may increase the frequency of indeterminate results of IGRAs. However, there have been inconsistent reports of role of DM on indeterminate IGRA results. Methods We retrospectively reviewed all patients who underwent QuantiFERON-TB Gold In-Tube testing (QFT-GIT) at Chonnam National University Hospital. We collected the clinical and laboratory data of these patients. Results Of all 3,391 subjects, 1,265 (37.3%) had a positive QFT-GIT result, 266 (7.8%) had an indeterminate result, and 1,860 (54.9%) had a negative result. The mean age was 54.8 ± 18.1 years and 55.0% of the patients were male. There were 512 (15.1%) patients with DM. Multivariable analysis revealed that systemic corticosteroid use, tuberculosis, lymphocytopenia, low serum albumin, and high serum C-reactive protein (CRP) levels were significantly associated with indeterminate QFT-GIT results. However, DM was not associated with indeterminate QFT-GIT results (adjusted odds ratio, 0.98; 95% confidence interval, 0.69-1.41; P = 0.939). After propensity score matching, DM was not associated with indeterminate results of QFT-GIT. Conclusion In this large cohort study, DM does not affect the incidence of indeterminate results of QFT-GIT.

We provide a simple mathematical model of IEEE 802.15.4 unslotted CSMA/CA by busy cycle of M/G/l queueing system to obtain several performance measures. Our performance measures can be used for determining the optimal number of devices while supporting the required QoS constraints on the average packet delay and the packet loss probability, and also for calculating battery lifetime.

Process fault monitoring, detection and diagnosis, and fire detection and isolation technologies have many common characteristics between them, and the amount of technological overlapping is being increased. This paper compares and discusses our works in the areas of conventional abnormal situation management (ASM) as well as fire alarm generation management, as a try to show how the ASM technologies would contribute in developing next-generation fire detection and management technologies and improve the safety of process plants and the public. And the lessons from the fire detection research that could be applied for better monitoring, detection and diagnosis of processes are also discussed.